Preventing human immunodeficiency virus (HIV) and other sexually transmitted infections and reducing HIV-stigmatizing attitudes in high-risk youth: Evaluation of a comprehensive community-based and peer-facilitated curriculum

Abstract Background Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) decreases HIV transmission. Some studies have raised concerns about a potential association between the implementation of HIV PrEP and the growing incidence rates of sexually transmitted infections (STIs) in the United States. Methods We conducted a quasi-experimental (interrupted time series) analysis of STI (syphilis, gonorrhea, and chlamydia) rates before (2000–2012) and after (2013–2017) the implementation of HIV PrEP. We also performed correlations between HIV PrEP utilization and STI cases at the national (2012–2017) and state (2017) levels. We defined HIV PrEP utilization as the number of people taking tenofovir disoproxil fumarate/emtricitabine for HIV prevention. Results HIV PrEP implementation was associated with 25% (relative risk [RR] 1.254, 95% confidence interval [CI] 1.245–1.263; P < .001) and 26% (RR 1.260, 95% CI 1.257–1.264; P < .001) increases in syphilis and gonorrhea rates, respectively, and a 12% reduction in chlamydia rates (RR: 0.884, 95% CI 0.883–0.885; P < .001). HIV PrEP utilization was correlated with the numbers of syphilis, gonorrhea, and chlamydia cases (spearman coefficients 1.00, 0.94, and 0.94, respectively; P < .001, P < .01, and P < .01, respectively). At the state level, HIV PrEP was also correlated with the number of cases of syphilis, gonorrhea, and chlamydia (spearman coefficients 0.85, 0.81, and 0.85, respectively; Ps < .001 for all correlations). Conclusions The implementation and utilization of HIV PrEP in the United States were associated with increased rates of STIs. Further studies to confirm these associations and to elucidate potential causes are needed.

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Research Priorities for Human Immunodeficiency Virus and Sexually Transmitted Infections Surveillance, Screening, and Intervention in Emergency Departments: Consensus-based Recommendations

Academic Emergency Medicine ◽

10.1111/j.1553-2712.2009.00546.x ◽

2009 ◽

Vol 16 (11) ◽

pp. 1096-1102 ◽

Cited By ~ 14

Author(s):

Jason S. Haukoos ◽

Supriya D. Mehta ◽

Leah Harvey ◽

Yvette Calderon ◽

Richard E. Rothman

Keyword(s):

Human Immunodeficiency Virus ◽

Sexually Transmitted Infections ◽

Emergency Departments ◽

Research Priorities ◽

Sexually Transmitted ◽

Immunodeficiency Virus

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Development of vaccines against the sexually transmitted infections gonorrhoea, syphilis, Chlamydia, herpes simplex virus, human immunodeficiency virus and Zika virus

Therapeutic Advances in Vaccines and Immunotherapy ◽

10.1177/2515135520923887 ◽

2020 ◽

Vol 8 ◽

pp. 251513552092388

Author(s):

Edwin David G. McIntosh

Keyword(s):

Human Immunodeficiency Virus ◽

Herpes Simplex Virus ◽

Herpes Simplex ◽

Sexually Transmitted Infections ◽

Zika Virus ◽

Vaccine Development ◽

Current Status ◽

Sexually Transmitted ◽

Immunodeficiency Virus ◽

Simplex Virus

The success in preventing hepatitis B virus and human papillomavirus infections by means of vaccination paves the way for the development of other vaccines to prevent sexually transmitted infections (STIs) such as gonorrhoea, syphilis, chlamydia, herpes simplex virus, human immunodeficiency virus and Zika virus. The current status of vaccine development for these infections will be explored in this review. The general principles for success include the need for prevention of latency, persistence and repeat infections. A reduction in transmission of STIs would reduce the global burden of disease. Therapeutic activity of vaccines against STIs would be advantageous over preventative activity alone, and prevention of congenital and neonatal infections would be an added benefit. There would be an added value in the prevention of long-term consequences of STIs. It may be possible to re-purpose ‘old’ vaccines for new indications. One of the major challenges is the determination of the target populations for STI vaccination.

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