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.

“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.

scholarly journals HIV prevention strategies and risk of infection: a model-based analysis

2018 ◽  
Vol 146 (8) ◽  
pp. 1015-1025 ◽  
Author(s):  
A. Hahn ◽  
R. Hinz ◽  
T. Meyer ◽  
U. Loderstädt ◽  
O. Herchenröder ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Condom Use ◽  
Hiv Transmission ◽  
Hiv Infections ◽  
Risk Groups ◽  
Unprotected Sex ◽  
Transmission Risk ◽  
Prevention Strategies ◽  
Hiv Prevention Strategies ◽  
Hiv Transmission Risk

AbstractRisk populations for HIV infections tend to neglect condom use, making alternative preventive approaches necessary. Accordingly, we modelled the risk of sexual HIV transmission for condom usevs.use of rapid diagnostic test (RDT) systems with subsequent exclusion of potential sexual partners with a correctly or falsely positive test from unprotected sex with and without the use of HIV pre-exposure prophylaxis (PrEP) in a bio-statistical approach. We combined a previously described model of transmission risk for HIV-exposed individuals with a newly suggested model of risk of HIV exposure for sexually active HIV-negative individuals. The model was adapted for several stages of infection and different strategies of HIV infection prevention.HIV prevention with RDTs can reduce the transmission risk by up to 97% compared with having sex without any prevention and up to 80% compared with condom use. Nevertheless, RDT-based prevention strategies demonstrate a lack of protection in several stages of infection; in particular, RNA-based RDT systems may fail under treatment. RDT-based pre-screening of potential sex partners prior to unprotected sexual contacts substantially reduces HIV transmission risk. Combination of different prevention strategies is advisable for high-risk groups.

Risky sexual behavior and sexually transmitted infections among men who have sex with men and purchase sex attending an Israeli sexually transmitted infection clinic

2019 ◽  
Vol 31 (3) ◽  
pp. 236-243 ◽  
Author(s):  
Rivka S Rich ◽  
Alex Leventhal ◽  
Rivka Sheffer ◽  
Zohar Mor
Keyword(s):  
High Risk ◽  
Sexually Transmitted Infections ◽  
Sexual Behaviors ◽  
Risky Sexual Behavior ◽  
Laboratory Data ◽  
Cross Sectional Study ◽  
Transmitted Infection ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Sex With Men

Men who have sex with men (MSM) and purchase sex (MPS) are a sub-group potentially at high risk for acquiring and transmitting sexually transmitted infections (STIs). This is a hard-to-reach population resulting in a scarcity of studies covering the issue. This cross-sectional study aimed to assess the association between purchasing sex and high-risk behaviors related to HIV/STI transmission and appraise the STI prevalence among MSM. All MSM who attended the STI clinic in Tel Aviv between 2003 and 2010 were included. Demographics, behavioral, clinical, and laboratory data were compared between MPS and non-MPS to identify high-risk sexual behaviors and STI prevalence associated with purchasing sex. Of the first visits of 2694 MSM who attended the STI clinic during the study period, 151 (5.6%) paid for sex. MPS were more commonly older and married than non-MPS. MPS were more likely to engage in behaviors associated with high risk for HIV/STI transmission, including infrequent condom use during anal sex, substance use during sex, and selling sex themselves. MPS had a higher STI prevalence than non-MPS, although this was not statistically significant ( p = 0.05). These findings highlight the need to establish culturally tailored interventions for MPS addressing the potential risks associated with purchasing sex.

scholarly journals Potential HIV transmission risk among spouses: marriage intention and expected extramarital male-to-male sex among single men who have sex with men in Hunan, China

2019 ◽  
Vol 96 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Weizi Wu ◽  
Xiaochen Yan ◽  
Xiaoxia Zhang ◽  
Lloyd Goldsamt ◽  
Yuanyuan Chi ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
Multivariate Logistic Regression Analysis ◽  
Transmission Risk ◽  
Cross Sectional Survey ◽  
Sexual Behaviours ◽  
Route Of Transmission ◽  
Related Stigma ◽  
Male Sex ◽  
Sex With Men ◽  
Hiv Transmission Risk

ObjectiveThe HIV epidemic in China is shifting from the high-risk groups of men who have sex with men (MSM), injection drug users and sex workers to the general population, and sexual contact among spouses is assumed to be one route of transmission. Our objective was to determine the intention to marry and the expected extramarital male-to-male sex among single Chinese MSM, in order to estimate the potential HIV transmission risk among MSM living with HIV and their female spouses.MethodsWe conducted a web-based, cross-sectional survey between May 2016 and May 2017. A questionnaire covering sociodemographic characteristics, sexual behaviours, HIV-related and homosexuality-related stigma, marriage intention, and expected extramarital sexual behaviours was completed by 556 single MSM in Hunan, China. Descriptive statistics, χ2 test, two-sample t-test and multivariate logistic regression analysis were performed.ResultsCurrently 48.9% of the participants intended to marry a woman in their lifetime, and 91% of them reported that they would continue to have sex with men after getting married. Those who were living with parents (OR=2.26), self-identified as bisexual (OR=2.57), had at least one heterosexual partner in the previous 6 months (OR=0.33) and perceived a higher level of self-homosexual stigma (OR=1.78) had greater intention to marry a woman.ConclusionNearly half of Chinese MSM intend to marry women, which has significantly dropped from the estimated percentage more than 10 years ago for Chinese MSM. However, the expectation of extramarital homosexual behaviours was common in these men. Sexual and gender minority stresses especially from family members, homosexual identity assertiveness and related stigma were the main factors for marriage intention, which should be addressed in future studies and practices.

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