scholarly journals Investigating the decline in Lymphogranuloma venereum diagnoses in men who have sex with men in the United Kingdom since 2016: an analysis of surveillance data

Sexual Health ◽  
2020 ◽  
Vol 17 (4) ◽  
pp. 344
Author(s):  
Hester Allen ◽  
Rachel Pitt ◽  
Megan Bardsley ◽  
Christa Smolarchuk ◽  
Ann Sullivan ◽  
...  
Keyword(s):  
Laboratory Data ◽  
Lymphogranuloma Venereum ◽  
Surveillance Data ◽  
Multiple Sources ◽  
Policy And Practice ◽  
Management Guidelines ◽  
Asymptomatic Patients ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
The Uk

Abstract Background Following an upward trajectory in Lymphogranuloma venereum (LGV) diagnoses in the UK from 2004 to 2016, with annual diagnoses increasing from 28 to 904, diagnoses fell to 641 in 2017; this was inconsistent with the upward trend in other bacterial sexually transmissible infections (STIs) between 2016 and 2017. An analysis of surveillance data from multiple sources to investigate the possible factors contributing to this decline in LGV was performed. Methods: LGV tests and diagnoses in the UK from 2004 to 2018 were captured through laboratory data from the LGV Reference Laboratories and laboratories conducting in-house LGV testing. These data and clinical diagnoses data from England were analysed alongside the national management guidelines issued over the course of the epidemic. Results: LGV diagnoses increased between 2004 and 2015 and then decreased between 2016 and 2018. LGV testing increased from 2010 to 2018 (2690–10850). Test positivity halved between 2015 (14.8%, 929–6272) and 2018 (7.3%, 791–10850). Peaks in LGV testing and diagnoses appeared to coincide with the publication of national LGV management guidelines and changes to clinical practice. The proportion of LGV diagnoses among HIV-positive men who have sex with men (MSM) fell between 2013 and 2018 (74–48%). Conclusions: The fall in diagnoses and positivity were likely due to increasing earlier clinical diagnosis and treatment. Changes to the national management guidelines, the clinical policy and practice of some larger clinics and potentially changes to the guidelines for the treatment of chlamydia broadened the scope of testing and increased testing in asymptomatic patients which, in combination, likely had a positive effect on the control of LGV infection.

Could sexually transmissible infections be contributing to the increase in HIV infections among men who have sex with men in Australia?

Sexual Health ◽  
2008 ◽  
Vol 5 (2) ◽  
pp. 131 ◽  
Author(s):  
Melanie G. Middleton ◽  
Andrew E. Grulich ◽  
Ann M. McDonald ◽  
Basil Donovan ◽  
Jane S. Hocking ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Hiv Infections ◽  
Surveillance Data ◽  
Multiple Sources ◽  
The Past ◽  
Sti Testing ◽  
Urban Men ◽  
Sexually Transmissible Infections ◽  
Laboratory Surveillance ◽  
Sex With Men

Background: To review existing data on sexually transmissible infections (STI) in men who have sex with men in Australia in order to determine the possible contribution of STI to diverging trends in HIV notifications in different states. Methods: We reviewed data from multiple sources, including routine national surveillance data, laboratory surveillance data, self-reported information on STI testing in men who have sex with men and ad hoc reports of STI prevalence. Results: We found increasing rates of gonorrhoea and infectious syphilis notifications in urban men in Australia between 1997 and 2006, and increasing rates of chlamydia notifications in men aged 30–49 years. There was little difference in these trends by state. Differences in the population groups sampled meant we were unable to gain further information on trends in men who have sex with men from these studies. Data on STI testing showed an increase in anal STI testing between 2003 and 2006, which may have increased the number of diagnoses of chlamydia and gonorrhoea for men who have sex with men during this period. Conclusions: Over the past 10 years, there has been a substantial increase in diagnoses of gonorrhoea and infectious syphilis, and probably chlamydia, in men who have sex with men in Australia. However, it is unlikely that changes in the pattern of STI transmission are responsible for the recent divergence in HIV rates between Australian states because there is little evidence that trends in STI also differ by state.

Computer-assisted survey of attitudes to HIV and sexually transmissible infection partner notification in HIV-positive men who have sex with men

Sexual Health ◽  
2010 ◽  
Vol 7 (4) ◽  
pp. 460 ◽  
Author(s):  
Clare L. N. Woodward ◽  
Sherie Roedling ◽  
Simon G. Edwards ◽  
Alice Armstrong ◽  
John Richens
Keyword(s):  
Hiv Transmission ◽  
Partner Notification ◽  
Hiv Positive ◽  
Computer Assisted ◽  
Hiv Status ◽  
Targeted Interventions ◽  
Sexually Transmissible Infections ◽  
Sex With Men ◽  
The Uk ◽  
Median Rating

Background: HIV infection continues to rise in men who have sex with men (MSM) in the UK. Of concern are the high rates of sexually transmissible infections (STI) among HIV-positive MSM, as this is associated with onward HIV transmission. Conventional partner notification (PN) may be limited in this group by the presence of multiple non-contactable partners and the fear of breach of HIV status. Methods: We explored attitudes to PN in HIV-positive MSM having an STI screen using a computer-assisted self interview. Results and Conclusion: Our study shows HIV+ MSM, rate conventional methods of PN highly (median rating 8/10) but are also supportive of new approaches to PN particularly anonymous email when linked to website information. They would also be open to targeted interventions such as peer recruitment.

scholarly journals Population-based methods for estimating the number of men who have sex with men: a systematic review

Sexual Health ◽  
2019 ◽  
Vol 16 (6) ◽  
pp. 527
Author(s):  
Daniel E. Mauck ◽  
Merhawi T. Gebrezgi ◽  
Diana M. Sheehan ◽  
Kristopher P. Fennie ◽  
Gladys E. Ibañez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Population Size ◽  
Survey Data ◽  
Census Data ◽  
Population Based ◽  
Surveillance Data ◽  
European Countries ◽  
Sexually Transmissible Infections ◽  
The Us ◽  
Sex With Men

The objective of this systematic review was to summarise population-based methods (i.e. methods that used representative data from populations) for estimating the population size of men who have sex with men (MSM), a high-risk group for HIV and other sexually transmissible infections (STIs). Studies using population-based methods to estimate the number or percentage of MSM or gay men were included. Twenty-eight studies met the inclusion criteria. Seven studies used surveillance data, 18 studies used survey data, and six studies used census data. Sixteen studies were conducted in the US, five were conducted in European countries, two were conducted in Canada, three were conducted in Australia, one was conducted in Israel, and one was conducted in Kenya. MSM accounted for 0.03–6.5% of men among all studies, and ranged from 3.8% to 6.4% in the US, from 7000 to 39100 in Canada, from 0.03% to 6.5% in European countries, and from 127947 to 182624 in Australia. Studies using surveillance data obtained the highest estimates of the MSM population size, whereas those using survey data obtained the lowest estimates. Studies also estimated the MSM population size by dimensions of sexual orientation. In studies examining these dimensions, fewer people identified as MSM than reported experience with or attraction to other men. Selection bias, differences in recall periods and sampling, or stigma could affect the estimate. It is important to have an estimate of the number of MSM to calculate disease rates, plan HIV and STI prevention efforts, and to allocate resources for this group.

scholarly journals Routine surveillance data on AIDS and HIV infections in the UK: a description of the data available and their use for short-term planning

1988 ◽  
Vol 100 (1) ◽  
pp. 157-169 ◽  
Author(s):  
Hilary E. Tillett ◽  
N. S. Galbraith ◽  
S. Elizabeth Overton ◽  
Kholoud Porter
Keyword(s):  
Risk Group ◽  
Laboratory Data ◽  
Finite Size ◽  
Hiv Infections ◽  
Surveillance Data ◽  
Drug Abusers ◽  
Short Term ◽  
Routine Surveillance ◽  
Reporting Systems ◽  
The Uk

SUMMARYIn the UK surveillance of AIDS and HIV infection is based on routine reporting systems. Whilst attempts are made to ensure that AIDS data are as complete as possible, numbers of reports fluctuate from month to month for reasons which are described. In 1986 there was an increase in death certificates naming AIDS as a cause of death in patients who were not identifiable in the surveillance data. More active surveillance is now undertaken in order to minimize this and other possible discrepancies.It is probable that most cases of AIDS are reported and therefore these data can be used to describe trends in the epidemic by ‘risk group’. Laboratory reports of HIV antibody-positive tests could give an earlier indication of trends because of the long incubation period of AIDS. But these laboratory data are difficult to interpret because they represent an incomplete and biased sample of all positive persons.AIDS cases are still being reported at a rate which is increasing approximately exponentially. Short-term predictions are presented showing a growth in the epidemic which is consistent with previously published predictions. Most cases are in the homosexual risk group. New asymptomatic homosexual patients with HIV antibody are still being identified.The epidemic of AIDS in haemophilia patients should be of finite size although new cases of AIDS are likely to continue to be diagnosed for several years. AIDS due to blood transfusion given in the UK before donor screening appears to be a much smaller epidemic. The epidemic in drug abusers is increasing. Heterosexually acquired AIDS and HIV infections are being reported in small but increasing numbers.

scholarly journals High-resolution genotyping of Lymphogranuloma Venereum (LGV) strains of Chlamydia trachomatis in London using multi-locus VNTR analysis-ompA genotyping (MLVA-ompA)

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254233
Author(s):  
Chloe Manning ◽  
Colette O’Neill ◽  
Ian N. Clarke ◽  
Monica Rebec ◽  
Penelope R. Cliff ◽  
...  
Keyword(s):  
High Resolution ◽  
Chlamydia Trachomatis ◽  
Protein A ◽  
Lymphogranuloma Venereum ◽  
Nucleic Acid Amplification ◽  
Study Population ◽  
Monitoring And Surveillance ◽  
Sex With Men ◽  
The Uk ◽  
Vntr Analysis

Background Lymphogranuloma venereum (LGV) is caused by Chlamydia trachomatis strains with ompA genotypes L1 to L3. An LGV epidemic associated with the L2b genotype has emerged in the past few decades amongst men who have sex with men (MSM). C. trachomatis genotypes can be discriminated by outer membrane protein A gene (ompA) sequencing, however this method has limited resolution. This study employed a high-resolution genotyping method, namely, multi-locus tandem repeat (VNTR) analysis with ompA sequencing (MLVA-ompA), to assess the distribution of LGV MLVA-ompA genotypes amongst individuals attending genitourinary medicine (GUM) clinics in London. Methods Clinical specimens were collected from individuals attending eight London-based GUM clinics. Specimens that tested positive for C. trachomatis by commercial nucleic acid amplification test (NAAT) were confirmed as LGV by pmpH real-time PCR. LGV-positive DNA extracts were subsequently genotyped using MLVA-ompA. Results Two hundred and thirty DNA extracts were confirmed as LGV, and 162 (70%) yielded complete MLVA-ompA genotypes. Six LGV MLVA-ompA genotypes were identified: 1.9.2b-L2, 1.9.3b-L2b, 1.9.2b-L2b, 1.9.2b-L2b/D, 1.4a.2b-L2b, and 5.9.2b-L1. The following LGV ompA genotypes were identified (in descending order of abundance): L2, L2b, L2b/D, and L1. Eight ompA sequences with the hybrid L2b/D profile were detected. The hybrid sequence was identical to the ompA of a recombinant L2b/D strain detected in Portugal in 2017. Conclusions The L2 ompA genotype was found to predominate in the London study population. The study detected an unusual hybrid L2b/D ompA profile that was previously reported in Portugal. We recommend further monitoring and surveillance of LGV strains within the UK population.

Some Useful Sources

2010 ◽  
Vol 9 (4) ◽  
pp. 591-597 ◽  
Author(s):  
Lucy Loveless ◽  
Kate Hickling
Keyword(s):  
Social Exclusion ◽  
Task Force ◽  
Multiple Sources ◽  
Policy And Practice ◽  
Policy Documents ◽  
Complex Needs ◽  
Family Approach ◽  
The Uk ◽  
Recent Government

As this themed section has illustrated, understanding and supporting families with multiple and complex needs is an area of policy and practice that is gaining importance and emphasis in the UK. This growth in interest is reflected in the developing field of family focused policy and practice work. In this article, we review a range of recent government-led initiatives and interventions developed principally through the Cabinet Office's Social Exclusion Task Force Think Family initiative. Whilst we recognise that there are a number of related policy documents and initiatives (many of which are discussed by Murray and Barnes in this edition), we choose to focus on Think Family due to its emphasis on a ‘whole family’ approach for families facing multiple sources of disadvantage.

scholarly journals Lymphogranuloma venereum is on the rise in Belgium among HIV negative men who have sex with men: surveillance data from 2011 until the end of June 2017

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Irith De Baetselier ◽  
Achilleas Tsoumanis ◽  
Ruth Verbrugge ◽  
Bénédicte De Deken ◽  
Hilde Smet ◽  
...  
Keyword(s):  
Lymphogranuloma Venereum ◽  
Surveillance Data ◽  
Sex With Men ◽  
Hiv Negative

The clinical manifestations of anorectal infection with lymphogranuloma venereum (LGV) versus non-LGV strains of Chlamydia trachomatis: a case–control study in homosexual men

2007 ◽  
Vol 18 (7) ◽  
pp. 472-475 ◽  
Author(s):  
M Hamill ◽  
P Benn ◽  
C Carder ◽  
A Copas ◽  
H Ward ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Case Control Study ◽  
Clinical Manifestations ◽  
Case Control ◽  
Sexual Contact ◽  
Lymphogranuloma Venereum ◽  
Homosexual Men ◽  
Sex With Men ◽  
The Uk ◽  
Control Study

Lymphogranuloma venereum (LGV) has recently been reported in men who have sex with men. In a case–control study we compared behavioural and clinical features of 32 men with LGV (cases) and 31 men with non-LGV chlamydial proctitis (controls). LGV was associated with rectal discharge (odds ratio [OR] 4.15, 95% confidence interval [CI] 1.42, 12.2), and there was a tendency to association with HIV infection (OR 3.60, CI 0.67–19.4), sexual contact in the UK (OR 3.03, CI 1.02–9.01) and fisting (OR 5.04, CI 0.98–26.1). LGV should be considered a possible diagnosis in men with rectal discharge.

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