scholarly journals Influence of sexual risk behaviour and STI co-infection dynamics on the evolution of HIV set point viral load in MSM

2019 ◽  
Author(s):  
Diana M Hendrickx ◽  
Wim Delva ◽  
Niel Hens

AbstractHIV set-point viral load (SPVL) is an important predictor of HIV progression and transmission. Although it has been reported that anti-retroviral therapy (ART) reduces viral load (VL), increased SPVL levels have been observed in MSM in the decade following the introduction of ART in the Netherlands. Several studies have been devoted to explain these counter-intuitive trends in SPVL. However, to our knowledge, none of these studies has investigated an explanation in which it arises as the result of a sexually transmitted infection (STI) co-factor in detail.In this study, we adapted an event-based, individual-based model to investigate how STI co-infection and sexual risk behaviour affect the evolution of HIV SPVL in MSM before and after the introduction of ART.The results suggest that both STI co-factors and sexual risk behaviour have an effect on SPVL. However, the observed trends in SPVL cannot be explained by sexual risk behaviour and STI co-factors only.We recommend to develop mathematical models including also factors related to viral evolution as reported earlier in the literature. However, this requires more complex models, and the collection of more data for parameter estimation than what is currently available.

Author(s):  
Murugan Swamiappan ◽  
Manjula Jagannathan ◽  
Aysha Abdulla

<p class="abstract"><strong>Background:</strong> In India the estimated men who have sex with men (MSM) population is around 352, 000, among that 4.3% are living with HIV. The incidence of sexually transmitted infections (STIs) in MSM is greater than that reported in women and men who have sex with women only. The aim of the study is to determine the trends of sexual behaviour and the pattern of sexually transmitted infections in men who have sex with men.</p><p class="abstract"><strong>Methods:</strong> A retrospective study of the data collected from the clinical records of all MSM, who had attended the STI clinic of Kilpauk Medical College, Chennai, Tamil Nadu, during the three-year study period, from July 2016 to June 2019. Demographic data, sexual risk behaviour, condom usage and STIs, among the MSM, were computed and analyzed.<strong></strong></p><p class="abstract"><strong>Results:</strong> During the study period 489 MSM attended the STI clinic, 51.9% were bisexual and 48.1 % were homosexual. Among them, exclusive penetrative sex in 50.7%, exclusive receptive sex in 15.7% and both in 33.6% were reported. Condom usage was consistent in 18.8%, inconsistent in 28.8% and 52.9% never used condom. Unprotected sex is more common in oral sex than with anal sex. STIs were seen in 20.9% and HIV in 1.4% of MSM. Syphilis was the most common STI seen.</p><p class="abstract"><strong>Conclusions:</strong> Our study elucidated the high prevalence of STIs among MSM and increasing trends of sexual risk behaviour. Health service providers must take necessary steps to improve the provision of biological and medical measures to screen, treat and prevent infections.</p><p class="abstract"> </p>


AIDS ◽  
2004 ◽  
Vol 18 (14) ◽  
pp. 1943-1949 ◽  
Author(s):  
Ineke G Stolte ◽  
John BF de Wit ◽  
Arne van Eeden ◽  
Roel A Coutinho ◽  
Nicole HTM Dukers

2017 ◽  
Vol 94 (3) ◽  
pp. 206-211 ◽  
Author(s):  
Michael J Stirratt ◽  
Gary Marks ◽  
Christine O’Daniels ◽  
Edward R Cachay ◽  
Meg Sullivan ◽  
...  

ObjectivesViral load and sexual risk behaviour contribute to HIV transmission risk. High HIV viral loads present greater transmission risk than transient viral ‘blips’ above an undetectable level. This paper therefore characterises sexual risk behaviour among patients with HIV in care with viral loads>1500 copies/mL and associated demographic characteristics.MethodsThis cross-sectional study was conducted at six HIV outpatient clinics in USA. The study sample comprises 1315 patients with HIV with a recent viral load >1500 copies/mL. This study sample was drawn from a larger sample of individuals with a recent viral load >1000 copies/mL who completed a computer-assisted self-interview (CASI) regarding sexual risk practices in the last 2 months. The study sample was 32% heterosexual men, 38% men who have sex with men (MSM) and 30% women.ResultsNinety per cent of the sample had their viral load assay within 60 days of the CASI. Thirty-seven per cent reported being sexually active (vaginal or anal intercourse) in the last 2 months. Most of the sexually active participants reported always using condoms (56.9%) or limiting condomless sex to seroconcordant partners (serosorting; 29.2% overall and 42.9% among MSM). Among sexually active participants who reported condomless anal or vaginal sex with an at-risk partner (14%), most had viral loads>10 000 copies/mL (62%).ConclusionsA relatively small number of patients with HIV in care with viral loads above 1500 copies/mL reported concurrent sexual transmission risk behaviours. Most of the individuals in this small group had markedly elevated viral loads, increasing the probability of transmission. Directing interventions to patients in care with high viral loads and concurrent risk behaviour could strengthen HIV prevention and reduce HIV infections.Trial registration numberNCT02044484, completed.


2019 ◽  
Vol 4 (2) ◽  
pp. e001349 ◽  
Author(s):  
Yasmin Ogale ◽  
Ping Teresa Yeh ◽  
Caitlin E Kennedy ◽  
Igor Toskin ◽  
Manjulaa Narasimhan

BackgroundSelf-collection of samples for diagnostic testing offers the advantages of patient autonomy, confidentiality and convenience. Despite data showing their feasibility and accuracy, there is a need to better understand how to implement such interventions for sexually transmitted infections (STIs). To support WHO guidelines on self-care interventions, we conducted a systematic review to investigate whether self-collection of samples should be made available as an additional approach to deliver STI testing services.MethodsPeer-reviewed studies were included if they compared individuals who self-collected samples for chlamydia, gonorrhoea, syphilis and/or trichomonas testing to individuals who had samples collected by clinicians on the following outcomes: uptake/frequency of STI testing, social harms/adverse events, positive yield (case finding), linkage to clinical assessment/treatment and reported sexual risk behaviour. We searched PubMed, CINAHL, LILACS and EMBASE for articles published through July 2018. Risk of bias was assessed using the Cochrane tool for randomised controlled trials (RCTs) and the Evidence Project tool for non-RCTs. Meta-analysis was conducted using random effects models to generate pooled estimates of relative risk (RR).ResultsEleven studies, including five RCTs and six observational studies with a total of 202 745 participants, met inclusion criteria. Studies were conducted in Australia, Denmark and the USA. Meta-analysis found that programmes offering self-collection of samples increased overall uptake of STI testing services (RR: 2.941, 95% CI 1.188 to 7.281) and case finding (RR: 2.166, 95% CI 1.043 to 4.498). No studies reported measuring STI testing frequency, social harms/adverse events, linkage to care or sexual risk behaviour.DiscussionWhile greater diversity in study designs, outcomes and settings would strengthen the evidence base, findings from this review suggest that self-collection of STI samples could be an effective additional strategy to increase STI testing uptake.Prospero registration numberPROSPERO CRD42018114866.


2019 ◽  
Vol 17 (1) ◽  
pp. 24-33
Author(s):  
Lekey Khandu ◽  
P. Zwanikken ◽  
S. Wangdi

Introduction: The rapid socio-economic development in Bhutan has brought changes in individual lifestyles resulting in increased risk behavior of the urban population, particularly the Drayang girls. This study investigated the underlying factors influencing the sexual risk behaviour of Drayang girls and their vulnerability to HIV and Sexually Transmitted Infection (STI). The Drayangs are dance bars in Bhutan where the women perform Bhutanese songs/dances on the stage to entertain the bar patrons and making them pay for their performance. Methods: This is a cross-sectional descriptive study conducted from May-July 2015 in three urban districts (Thimphu, Paro, and Phuentsholing) of Bhutan. The convenient non-random sampling method was used to recruit the respondents. We have collected the data using structured questionnaires including the taking of blood samples for HIV, Hepatitis B, and Syphilis testing. Results: Of the 245 Drayang girls recruited for this study, 28.2% have engaged in transactional sex and 71.8% in non-transactional sex within last month. Condom use during transactional sex was 36.2% and non-transactional sex was 21.6%. The prevalence of HIV was 0.82%, hepatitis B 6.9%, and syphilis 2.8%. The factors such as marital status (divorced and unmarried), living arrangements, current living cities, and alcohol consumption were significantly (p<0.05) associated with transactional sex among Drayang girls. Conclusion: Although the prevalence of HIV and STIs is low among the Drayang girls, the presence of high riskbehavior with low condom use still makes them vulnerable to HIV and STIs. The study recommends putting more effort in prevention of HIV and STI by increasing awareness of HIV and STI, targeted interventions like Behaviour Change Communications (BCC), condom promotion, condom negotiation skills and access for testing and treatment of HIV and STI.


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