“The condom broke and I’m tired of worrying about HIV”

HIV ◽  
2020 ◽  
pp. 1-8
Author(s):  
Sybil Hosek ◽  
Raphael J. Landovitz
Keyword(s):  
At Risk ◽  
Hiv Infection ◽  
Sexually Transmitted Infections ◽  
Hiv Transmission ◽  
Drug Regimen ◽  
Transmission Risk ◽  
Sexually Transmitted ◽  
Preexposure Prophylaxis ◽  
Seamless Transition ◽  
Hiv Transmission Risk

Potential nonoccupational exposures to HIV should be considered as emergencies and access to postexposure prophylaxis (PEP) is urgently required. There is no need to wait for initial HIV testing results before dispensing PEP because a 3-drug regimen is being used. For patients who remain at risk of HIV infection during or after the course of PEP, a seamless transition from PEP to preexposure prophylaxis (PrEP) is ideal along with appropriate testing for HIV and other sexually transmitted infections. There also is no need to have a “break” between PEP and PrEP, particularly if HIV transmission risk is ongoing. Interval testing before again prescribing medications is needed.

Superimposing incident sexually transmitted infections on HIV phylogram to investigate possible misclassification of men who have sex with men as heterosexuals in a cohort in Antwerp, Belgium

2019 ◽  
Vol 30 (5) ◽  
pp. 486-495
Author(s):  
Kara K Osbak ◽  
Conor J Meehan ◽  
Sergio G Ribas ◽  
Leo Heyndrickx ◽  
Kevin K Ariën ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexual Behaviour ◽  
Hiv Transmission ◽  
Phylogenetic Analyses ◽  
Laboratory Data ◽  
Risk Groups ◽  
Transmission Risk ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Hiv Transmission Risk

In this study, we assessed if the superimposition of incident sexually transmitted infections (STIs) on HIV phylogenetic analyses could reveal possible sexual behaviour misclassifications in our HIV-infected population. HIV-1 sequences collected between 1997 and 2014 from 1169 individuals attending a HIV clinic in Antwerp, Belgium were analysed to infer a partial HIV transmission network. Individual demographic, clinical and laboratory data collected during routine HIV follow-up were used to compare clustered and non-clustered individuals using logistic regression analyses. In total, 438 (37.5%) individuals were identified in 136 clusters, including 76 transmission pairs and 60 clusters consisting of three or more individuals. Individuals in a cluster were more likely to have a history of syphilis, Chlamydia and/or gonorrhoea (P < 0.05); however, when analyses were stratified by HIV transmission risk groups (heterosexual and men who have sex with men [MSM]), this association only remained significant for heterosexuals with syphilis (P = 0.001). Under closer scrutiny, this association was driven by six heterosexual men who were located in six almost exclusively MSM clusters. A parsimonious conclusion is that these six individuals were potentially misclassified as heterosexual. Improving the accuracy of sexual behaviour reporting could improve care.

scholarly journals Sexually Transmitted Infections Among HIV-Infected Individuals in the District of Columbia and Estimated HIV Transmission Risk: Data From the DC Cohort

2018 ◽  
Vol 5 (2) ◽  
Author(s):  
Jose Lucar ◽  
Rachel Hart ◽  
Nabil Rayeed ◽  
Arpi Terzian ◽  
Amy Weintrob ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Poisson Regression ◽  
Hiv Transmission ◽  
The United States ◽  
Transmission Risk ◽  
Virologic Suppression ◽  
Sexually Transmitted ◽  
Sex With Men ◽  
Hiv Transmission Risk ◽  
Hiv Acquisition

Abstract Background Washington, DC, has one of the highest rates of HIV infection in the United States. Sexual intercourse is the leading mode of HIV transmission, and sexually transmitted infections (STIs) are a risk factor for HIV acquisition and transmission. Methods We evaluated the incidence and demographic factors associated with chlamydia, gonorrhea, and syphilis among HIV-infected persons enrolled at 13 DC Cohort sites from 2011 to 2015. Using Poisson regression, we assessed covariates of risk for incident STIs. We also examined HIV viral loads (VLs) at the time of STI diagnosis as a proxy for HIV transmission risk. Results Six point seven percent (451/6672) developed an incident STI during a median follow-up of 32.5 months (4% chlamydia, 3% gonorrhea, 2% syphilis); 30% of participants had 2 or more STI episodes. The incidence rate of any STIs was 3.8 cases per 100 person-years (95% confidence interval [CI], 3.5–4.1); age 18–34 years, 10.8 (95% CI, 9.7–12.0); transgender women, 9.9 (95% CI, 6.9–14.0); Hispanics, 9.2 (95% CI, 7.2–11.8); and men who have sex with men (MSM), 7.7 (95% CI, 7.1–8.4). Multivariate Poisson regression showed younger age, Hispanic ethnicity, MSM risk, and higher nadir CD4 counts to be strongly associated with STIs. Among those with an STI, 41.8% had a detectable VL within 1 month of STI diagnosis, and 14.6% had a VL ≥1500 copies/mL. Conclusions STIs are highly prevalent among HIV-infected persons receiving care in DC. HIV transmission risk is considerable at the time of STI diagnosis. Interventions toward risk reduction, antiretroviral therapy adherence, and HIV virologic suppression are critical at the time of STI evaluation.

Sexually Transmitted Infections and HIV Transmission: What Do We Know?

2021 ◽  
Vol 3 (1) ◽  
pp. 8-13
Author(s):  
Mpundu Makasa ◽  
◽  
Charles Michelo ◽  
Keyword(s):  
Public Health ◽  
At Risk ◽  
Hiv Infection ◽  
Sexually Transmitted Infections ◽  
Health Problem ◽  
Hiv Transmission ◽  
Public Health Problem ◽  
Mixed Infections ◽  
Infection Transmission ◽  
Sexually Transmitted

Sexually transmitted infections have remained a public health problem mainly in the developing world, where the burden of HIV is also high. Effects of sexually transmitted infections can be devastating and have also been shown to enhance transmission of HIV. The risk of transmission depends on the type of infection, whether it presents with an ulcer or it is it is only inflammatory. Mixed infections further increase the probability of HIV transmission, making the overall risk even higher. Understanding the dynamics of transmission is important. It is also essential to know which groupsof people are more at risk as this is fundamental in designing appropriate control interventions. This article gives an overview of sexually transmitted infections, and gives insight on their association with HIV infection, transmission risks and some control based interventions. In addition we also aimed to increase the understanding of where preventive and management gaps may still exist and in what contexts

scholarly journals Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection

JAMA ◽  
2019 ◽  
Vol 321 (14) ◽  
pp. 1380 ◽  
Author(s):  
Michael W. Traeger ◽  
Vincent J. Cornelisse ◽  
Jason Asselin ◽  
Brian Price ◽  
Norman J. Roth ◽  
...  
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Sexually Transmitted Infections ◽  
Sexually Transmitted ◽  
Preexposure Prophylaxis

scholarly journals Association between Knowledge of Sexually Transmitted Infections and Sources of the Previous Point of Care among Nigerians: Findings from Three National HIV and AIDS Reproductive Health Surveys

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Imran O. Morhason-Bello ◽  
Adeniyi F. Fagbamigbe
Keyword(s):  
Reproductive Health ◽  
Hiv Infection ◽  
Sexually Transmitted Infections ◽  
Hiv Transmission ◽  
Point Of Care ◽  
Health Facilities ◽  
Hiv And Aids ◽  
Good Knowledge ◽  
Effective Control ◽  
Sexually Transmitted

Background. Adequate knowledge of sexually transmitted infections (STIs) is critical for effective control of disease. Health education/counselling at the point of care provides ample opportunities to improve knowledge of patient seeking treatment. There is no study from Nigeria that investigates association between sources of previous point of care of STI and quality of knowledge of people on STI. We hypothesised that previous treatment of STI will be associated with better knowledge of STI and HIV infection. Methods. Three consecutives nationally representative cross-sectional surveys on HIV and AIDS Reproductive Health in Nigeria, conducted in 2005, 2007, and 2012 were analysed. Outcome measures were knowledge of STI only, and a combined knowledge of STI and HIV transmission and prevention. We designed a knowledge scale of 14-item questions for STI and 41-item questions for STI and HIV. Logistic regression was used to identify risk factors at 5% significance level. Results. Knowledge of STI increased from 13.4% in 2005 to 15.0% in 2007 to 26.5% in 2012. Respondents that received treatment from pharmacy and patient medicine vendors had higher odds of good knowledge of STI than those who did not receive any treatment (aOR = 2.55) in 2005. In 2012, respondents treated at health facilities were over two times likely to have good knowledge of STI and HIV transmission and prevention (aOR = 2.35). STI positive individuals in the highest economic class were two times likely to have good knowledge of STI and HIV transmission and prevention than those in the lowest class. Conclusion. Participants that previously sought care from health facilities, pharmacy, and patient medicine vendors had better knowledge of STIs and HIV infection prevention and transmission than those who sought care from unorthodox sources. We recommend a national awareness creation on STI prevention including provision of information on safe point of care for STIs in Nigeria.

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