High subsequent and recurrent sexually transmitted infection prevalence among newly diagnosed HIV-positive Thai men who have sex with men and transgender women in the Test and Treat cohort

2018 ◽  
Vol 30 (2) ◽  
pp. 140-146 ◽  
Author(s):  
Akarin Hiransuthikul ◽  
Supanit Pattanachaiwit ◽  
Nipat Teeratakulpisarn ◽  
Parinya Chamnan ◽  
Panita Pathipvanich ◽  
...  
Keyword(s):  
Transgender Women ◽  
Hiv Positive ◽  
Infection Prevalence ◽  
Anatomical Site ◽  
Newly Diagnosed ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Test And Treat ◽  
Increased Risk ◽  
Sex With Men

We determined subsequent and recurrent sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender women (TGW) in the Test and Treat cohort. Thai MSM and TGW adults with previously unknown HIV status were enrolled and tested for HIV. Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and syphilis were tested at baseline, month 12, and month 24 to identify subsequent STIs (any STIs diagnosed after baseline) and recurrent STIs (any subsequent STIs diagnosed among those with positive baseline STIs). Among 448 participants, 17.8% were HIV-positive, the prevalence of subsequent STIs and recurrent STIs was 42% (HIV-positive versus HIV-negative: 66.3% versus 36.7%, p < 0.001) and 62.3% (81% versus 52.5%, p < 0.001), respectively. Common subsequent STIs by anatomical site were rectal CT infection (21.7%), rectal NG infection (13.8%), pharyngeal NG infection (13.1%), and syphilis (11.9%). HIV-positive status was associated with both subsequent STIs (adjusted hazard ratio [aHR] 2.38; 95%CI 1.64–3.45, p < 0.001) and recurrent STIs (aHR 1.83; 95%CI 1.16–2.87, p = 0.01). The results show that newly diagnosed HIV-positive MSM and TGW were at increased risk of STIs despite being in the healthcare system. STI educational counseling is necessary to improve STI outcomes among MSM and TGW in both HIV prevention and treatment programs.

Prevalence of bacterial sexually transmitted infections and coinfection with HIV among men who have sex with men and transgender women in Tijuana, Mexico

2021 ◽  
pp. 095646242098775
Author(s):  
Claire C Bristow ◽  
Cristina Espinosa da Silva ◽  
Alicia H Vera ◽  
Jesus E Gonzalez-Fagoaga ◽  
Gudelia Rangel ◽  
...  
Keyword(s):  
Sexually Transmitted Infection ◽  
Transgender Women ◽  
Nucleic Acid Amplification ◽  
Hiv Positive ◽  
P Value ◽  
Infection Prevalence ◽  
Newly Diagnosed ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Hiv Negative

We estimated the prevalence of syphilis and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections, as well as human immunodeficiency virus (HIV) coinfection among cisgender men who have sex with cisgender men (MSM) and transgender women (TW) in Tijuana, Mexico. MSM and TW ( N = 212) recruited via respondent-driven and venue-based sampling for HIV testing underwent sexually transmitted infection (STI) testing and completed interviewer-administered surveys in this study (2017–2018). Treponemal rapid tests were used at the point-of-care with positives undergoing confirmatory testing following the reverse syphilis-testing algorithm. Nucleic acid amplification testing of urine and swabs (rectal and pharyngeal) was used to detect CT/NG at three anatomic sites. Chi-squared tests were used to compare STI prevalence by HIV status. Sexually transmitted infection prevalence was 39.6% overall but higher for newly diagnosed HIV-positive (55.7%; N = 88) than HIV-negative (28.2%; N = 124) participants ( p-value < 0.0001). Among newly diagnosed HIV-positive participants, the prevalence of syphilis was 35.2% (31/88), CT infection was 27.3% (24/88; nine urethral; 16 rectal; four pharyngeal), and NG infection was 26.1% (23/88; six urethral; 19 rectal; nine pharyngeal). Among HIV-negative participants, the prevalence of syphilis was 12.1% (15/124), CT infection was 13.7% (17/124; seven urethral; nine rectal; two pharyngeal), and NG infection was 9.7% (12/124; three urethral; seven rectal; seven pharyngeal). Over 60% of all CT (25/41) and NG (26/35) infections in the full sample occurred extragenitally in the absence of urethral infections, and over 80% of rectal (30/37) and pharyngeal (16/18) infections were asymptomatic. The high prevalence of syphilis, CT, and NG infections among MSM and TW in Tijuana suggests STI screening that includes extragenital tests, particularly at HIV diagnosis, may help curb HIV/STI transmission.

scholarly journals Similar Sexually Transmitted Infections Prevalence Despite Lower HIV Prevalence Among Transgender Women Compared with Men Who Have Sex With Men in Thai Community-Based Test and Treat Cohort

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S106-S106 ◽  
Author(s):  
Akarin Hiransuthikul ◽  
Nanthika Prawepray ◽  
Supab Pengpum ◽  
Ratchadej Reankhomfu ◽  
Phubet Panpet ◽  
...  
Keyword(s):  
Sexually Transmitted Infections ◽  
Transgender Women ◽  
Sexual Partners ◽  
Hiv Prevalence ◽  
Hiv Positive ◽  
Community Based ◽  
Sexually Transmitted ◽  
Test And Treat ◽  
Sex With Men ◽  
Gender Specific

Abstract Background Men who have sex with men (MSM) and transgender women (TG) are at increased risk for sexually transmitted infections (STIs). To understand potential different characteristics, we assessed gender-specific, demographic data, behavioral risks and prevalence of STIs. Methods Thai MSM and TG aged ≥18 years from six community-based organizations in Thailand were enrolled into the Test and Treat cohort during 2015–2016. Baseline demographic and behavior risk assessment and HIV/STIs testing were done. Blood for syphilis serology and pharyngeal and anal swab, and urine for gonorrhea and chlamydia nucleic acid amplification testing were collected. Logistic regression was used to determine factors associated with gender-specific STIs prevalence. Results From 1862 MSM and 787 TG enrolled, 874 (33%) had STI and 402 (15.2%) were HIV-positive. Compared with MSM, more TG were single (79.7% vs. 71.6%), had lower education (23.6% vs. 40% with diploma or higher), had lower income (35.7% vs. 42.6% gained &gt;288 USD/month), had first sex at young age (20.1% vs. 12.8% at &lt;15 years old), and reported &gt;3 sexual partners in the past 6 months (32.9% vs. 24.6%) (all P &lt; 0.001). The overall STIs prevalence was similar between both genders (31.5% vs. 33.6%, P = 0.29), but TG had lower HIV prevalence (8.9% vs. 17.8%, P &lt; 0.001). TG had higher prevalence of pharyngeal and anal chlamydia (5.5% vs. 2.9%, P = 0.001 and 19.5% vs. 15.1%, P = 0.007, respectively), while syphilis prevalence was higher in MSM (9.9% vs. 3.6%, P &lt; 0.001). Among HIV-positive participants, MSM had higher prevalence of HIV and syphilis coinfection (26.2% vs. 8.6%, P = 0.001). STIs prevalence among TG was associated with HIV-positive status (adjusted odd ratio [aOR] 2.74; 95% CI 1.52–4.95, P = 0.001), having multiple sexual partners or refused to answer (aOR 2.36; 95% CI 1.31–4.24, P = 0.004 and 2.33; 95% CI 1.24–4.37, P = 0.009, respectively) and unprotected sexual intercourse (aOR 1.66; 95% CI 1.02–2.69, P = 0.041). Conclusion Almost one-third of TG enrolled into the Test and Treat cohort had STI. TG had lower HIV prevalence but similar STIs prevalence compared with MSM, despite practicing riskier sexual behaviors. Our findings signified the importance of studying TG sexual networks in Thailand to better strategize sexual health programs. Disclosures All authors: No reported disclosures.

scholarly journals Hepatitis C virus infection in HIV-infected men who have sex with men: sustained rising incidence in Antwerp, Belgium, 2001–2009

2010 ◽  
Vol 15 (39) ◽  
Author(s):  
E Bottieau ◽  
L Apers ◽  
M Van Esbroeck ◽  
M Vandenbruaene ◽  
E Florence
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Hiv Positive ◽  
Acute Hepatitis C ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Awareness Campaigns ◽  
Rising Incidence ◽  
Sex With Men

During the last decade, outbreaks of acute hepatitis C virus (HCV) infection have been reported among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) in several European countries. To study this emerging infection in MSM in Antwerp, Belgium, we reviewed all cases of newly acquired HCV infection in HIV-positive MSM followed from 2001 to 2009 at the HIV/sexually transmitted infection (STI) reference clinic of the Institute of Tropical Medicine in Antwerp. Newly acquired HCV infection was considered as certain or probable according to local definitions. During the study period, 69 episodes of newly acquired HCV infection (40 certain and 29 probable) were diagnosed in 67 HIV-infected MSM. In only 10 episodes (14%) were the patients symptomatic. The annual incidence of HCV infection in our population of HIV-infected MSM rose steadily from 0.2% in 2001 to 1.51% in 2008, and then peaked to 2.9% in 2009. For 60 episodes (87%), another STI (mainly syphilis and lymphogranuloma venereum) had been diagnosed within the six months before the diagnosis of HCV infection. All but one patient with available genotyping (n=54) were found to be infected with the difficult-to-treat HCV genotypes 1 or 4. Our results therefore demonstrate the rising incidence of HCV infection in HIV-positive MSM in Antwerp, since 2001, which reached an alarming level in 2009. Targeted awareness campaigns and routine screening are urgently needed to limit further HCV spread and its expected long-term consequences.

scholarly journals Sexual behaviours and sexually transmitted infection outcomes in a cohort of HIV-negative men who have sex with men attending sexual health clinics in England

2018 ◽  
Vol 29 (14) ◽  
pp. 1407-1416 ◽  
Author(s):  
S Desai ◽  
F Burns ◽  
G Schembri ◽  
D Williams ◽  
A Sullivan ◽  
...  
Keyword(s):  
High Risk ◽  
Sexual Health ◽  
Receptive Anal Intercourse ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual Behaviours ◽  
Increased Risk ◽  
Sex With Men ◽  
Clinical Records ◽  
Hiv Negative

Men who have sex with men (MSM) attending sexual health (SH) clinics are at high risk for HIV acquisition and are disproportionately affected by sexually transmitted infections (STIs). We collected standardised behavioural data from MSM attending clinics to characterise sexual behaviours and identify predictors for HIV and STIs. In 2012–2013, HIV-negative MSM attending five SH clinics in England reported sexual behaviours in the previous three months via a self-administered questionnaire. Behaviours were linked to the individual’s clinical records using national surveillance. The prevalence and incidence of bacterial STIs (gonorrhoea, Chlamydia, lymphogranuloma venereum and syphilis) and incidence of HIV were calculated. Adjusted odds ratios and hazard ratios with 95% confidence interval (CI) were reported for significant predictors. Of 1278 HIV-negative MSM, 54% were of white ethnicity and UK-born and 43% were 25–34 years old. Almost all men reported at least one partner in the last three months. Half reported condomless anal sex and 36% condomless receptive anal intercourse (CRAI). Incidence of bacterial STIs was 46/100 (95%CI 39–54) person years (py) and of HIV was 3.1/100 (95%CI 1.7–5.6) py. A STI at baseline and CRAI with increasing numbers of partners were associated with both incident infections. In this cohort of MSM high-risk behaviours and STIs were prevalent. Engagement in CRAI increased the likelihood of subsequent infection, while men diagnosed with a bacterial STI were at increased risk of a future STI. Clinical and behavioural risk assessments to determine an individual’s risk of infection could allow a more nuanced prevention approach that has greater success in reducing transmission.

scholarly journals Perinatal Outcomes in HIV Positive Pregnant Women with Concomitant Sexually Transmitted Infections

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Erin Burnett ◽  
Tammy L. Loucks ◽  
Michael Lindsay
Keyword(s):  
Preterm Birth ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Neonatal Outcomes ◽  
Hiv Positive ◽  
City Hospital ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Increased Risk

Objective. To evaluate whether HIV infected pregnant women with concomitant sexually transmitted infection (STIs) are at increased risk of adverse perinatal and neonatal outcomes.Methods. We conducted a cohort study of HIV positive women who delivered at an inner-city hospital in Atlanta, Georgia, from 2003 to 2013. Demographics, presence of concomitant STIs, prenatal care information, and maternal and neonatal outcomes were collected. The outcomes examined were the association of the presence of concomitant STIs on the risk of preterm birth (PTB), postpartum hemorrhage, chorioamnionitis, preeclampsia, intrauterine growth restriction, small for gestational age, low Apgar scores, and neonatal intensive care admission. Multiple logistic regression was performed to adjust for potential confounders.Results. HIV positive pregnant women with concomitant STIs had an increased risk of spontaneous PTB (odds ratio (OR) 2.11, 95% confidence interval [CI] 1.12–3.97). After adjusting for a history of preterm birth, maternal age, and low CD4+ count at prenatal care entry the association between concomitant STIs and spontaneous PTB persisted (adjusted OR 1.96, 95% CI 1.01–3.78).Conclusions. HIV infected pregnant women with concomitant STIs relative to HIV positive pregnant women without a concomitant STI are at increased risk of spontaneous PTB.

Tackling STI epidemics through the HIV clinic: is sex high enough on the agenda?

2008 ◽  
Vol 19 (10) ◽  
pp. 711-712 ◽  
Author(s):  
R A Ferrand ◽  
S De Silva ◽  
J D Cartledge
Keyword(s):  
Significant Proportion ◽  
Sexual History ◽  
High Rate ◽  
Hiv Positive ◽  
Medical Problems ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sexual History Taking ◽  
Sex With Men ◽  
A Prospective Study

Sexually transmitted infection (STI) rates among men having sex with men continue to increase. HIV services may operate independently to genitourinary medicine clinics and the sexual health of HIV-positive patients may be of low priority in the context of medical problems related to HIV. A prospective study of HIV-positive gay men was conducted in a London outpatient clinic over a three-month period. Data were available for 90 men. Forty-five percent had STI screens in the preceding six months. These revealed a high rate of infections; 26 infections diagnosed in 14 men in the study period. Fifty-seven percent of the 90 men in the study had more than one partner in the past three months and approximately one-third had unprotected sexual activity. A significant proportion of men were unaware of recent outbreaks of hepatitis C and lymphogranuloma venereum and of HIV postexposure prophylaxis. We therefore recommend that sexual history-taking, STI screens and health promotion should become a routine feature of HIV outpatient consultations in this group.

Anatomical site distribution and genotypes of Chlamydia trachomatis infecting asymptomatic men who have sex with men in northeast Thailand

2018 ◽  
Vol 29 (9) ◽  
pp. 842-850 ◽  
Author(s):  
Saowarop Hinkan ◽  
Jureeporn Chuerduangphui ◽  
Tipaya Ekalaksananan ◽  
Jiratha Budkaew ◽  
Kanisara Proyrungroj ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Anatomical Site ◽  
Northeast Thailand ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Site Distribution ◽  
Treatment And Prevention ◽  
Concurrent Infections ◽  
Polymerase Chain ◽  
Sex With Men

Chlamydia trachomatis is a common agent of sexually transmitted infection, especially in asymptomatic extra-genital sites among men who have sex with men (MSM). This study aims to investigate anatomical site distribution and genotypes of C. trachomatis from asymptomatic MSM in northeast Thailand. Specimens were collected using swabs from anorectal, oropharyngeal, and urethral sites in 346 asymptomatic MSM. C. trachomatis infection was determined by real-time polymerase chain reaction and genotyping was based on sequences of the ompA gene. The results showed that infection by C. trachomatis was most common at the urethral site (29.1%, 101/346) followed by oropharyngeal (17.6%, 61/346) and anorectal site (17.0%, 59/346). In addition, C. trachomatis infection was significantly associated with absence of condom use (odds ratio = 1.909, 95%CI = 1.054–3.457, P = 0.033) at the urethral site. Overall 49.4% (171/346) of individuals were infected in at least one site. Infection at only the anorectum, oropharynx, or urethra was seen in 9.0, 9.3, and 18.5% of participants, respectively. Concurrent infections at anorectum/oropharynx, anorectum/urethra, oropharynx/urethra, and all three sites were 2.0, 4.3, 4.6, and 1.7%, respectively. Genotype D predominated at the anorectal and urethral sites among asymptomatic MSM in northeast Thailand. Concurrent infection in two or three anatomical sites occurred. C. trachomatis screening at all three sites in asymptomatic MSM is important and should be considered for proper treatment and prevention of transmission.

scholarly journals Syphilis surveillance and trends of the syphilis epidemic in Germany since the mid-90s

2004 ◽  
Vol 9 (12) ◽  
pp. 9-10 ◽  
Author(s):  
U Marcus ◽  
V Bremer ◽  
O Hamouda
Keyword(s):  
Reporting System ◽  
The United States ◽  
Population Movement ◽  
Hiv Positive ◽  
Transmitted Infection ◽  
Notification System ◽  
Sexually Transmitted ◽  
High Incidence ◽  
Sex With Men ◽  
Epidemiological Information

Recent surveillance reports from Europe and the United States show an increase in syphilis cases. Accurate epidemiological information about the distribution of syphilis is important for targeting screening and intervention programmes. The German syphilis notification system changed in 2001 from physician to laboratory-based reporting, which is complemented by a newly introduced sexually transmitted infection (STI) sentinel system. After reaching an all time low during the 1990s, syphilis notifications have increased significantly since 2001, coinciding with the introduction of the new reporting system. However, the increased reported incidence is reflecting a true rise in the number of cases and is not predominantly determined by more underreporting through the previous reporting system. The increase reflects syphilis outbreaks among men who have sex with men (MSM). The first of these outbreaks was observed in Hamburg in 1997. In 2003, incidence in men was ten times higher than in women. An estimated 75% of syphilis cases are currently diagnosed among MSM. A high proportion (according to sentinel data, up to 50%) of MSM diagnosed with syphilis are HIV positive. The continuously high number of syphilis cases diagnosed among heterosexuals in Germany in recent years compared with other western European countries may reflect the higher population movement between Germany and syphilis high incidence regions in south-east and eastern Europe.

Sexually transmitted infection screening and diagnosis among adolescent men who have sex with men, three US cities, 2015

2019 ◽  
Vol 31 (1) ◽  
pp. 53-61
Author(s):  
Qian An ◽  
Kyle T Bernstein ◽  
Alexandra B Balaji ◽  
Cyprian Wejnert ◽  
Keyword(s):  
Transmitted Infection ◽  
Sexually Transmitted ◽  
National Hiv Behavioral Surveillance ◽  
Increased Risk ◽  
Characteristics Analysis ◽  
Young Msm ◽  
Sex With Men ◽  
Stis And Hiv ◽  
Associated Risk Factors ◽  
Screening And Diagnosis

Adolescent men who have sex with men (MSM) are at increased risk for sexually transmitted infections (STIs) and HIV; however, data documenting STI screening, STI burden, and associated risk factors for STIs are extremely limited. Using 2015 data from the National HIV Behavioral Surveillance among Young MSM, we examined self-reported STI screening and STI diagnosis of chlamydia, gonorrhea, or syphilis among sexually active adolescent MSM by selected characteristics. Analysis of STI diagnosis was limited to participants who reported an STI screening. Differences in STI screening and STI diagnosis and factors associated with screening and diagnosis were examined using bivariate and multivariable binomial regression models. Less than half of adolescent MSM reported having ever been screened for an STI. Among these, more than a quarter reported having ever been diagnosed with chlamydia, gonorrhea, or syphilis. STI screening was associated with visiting a healthcare provider in the past 12 months and having ever been tested for HIV. Having ever had an STI diagnosis was associated with the participant age of 18 years and having sex before 13 years old. Among adolescent MSM, STI screening was suboptimal and STI burden was significant. STI intervention and prevention programs are urgently needed to promote STI awareness, timely screening, and early diagnosis to interrupt transmission among this vulnerable population.

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