Strongyloides stercoralis infection in HIV-positive men who have sex with men

2020 ◽  
Vol 31 (5) ◽  
pp. 398-401
Author(s):  
Sophie A Ross ◽  
Hannah Pintilie ◽  
James Hatcher ◽  
Olamide Dosekun ◽  
Graham S Cooke ◽  
...  
Keyword(s):  
Sexual Transmission ◽  
Parasitic Infection ◽  
Case Series ◽  
Strongyloides Stercoralis ◽  
Hiv Positive ◽  
Gastrointestinal Infections ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Immunosuppressed Patients ◽  
Sex With Men

Strongyloides stercoralis is a common parasitic infection in tropical and subtropical areas which may result in fatal hyperinfection syndrome in immunosuppressed patients. Infection occurs through skin or mucous membrane contact with material contaminated with infected human faeces. Sexual transmission of other gastrointestinal infections has been observed in men who have sex with men (MSM), with human immunodeficiency virus (HIV) a known risk factor. We present a case series of strongyloidiasis in seven HIV-positive MSM living in a non-endemic area. We found high rates of concomitant sexually transmitted infection and chemsex drug use, suggesting high-risk sexual behaviour.

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.

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.

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.

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.

Rates of sexual history taking and screening in HIV-positive men who have sex with men

2016 ◽  
Vol 28 (3) ◽  
pp. 294-296 ◽  
Author(s):  
Alasdair MacRae ◽  
Emily Lord ◽  
Annabel Forsythe ◽  
Jackie Sherrard
Keyword(s):  
Drug Use ◽  
Sexual History ◽  
Hiv Positive ◽  
Recreational Drug ◽  
Sexually Active ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Recreational Drug Use ◽  
Sex With Men ◽  
Hiv Positive Men

A case note audit was undertaken of HIV-positive men who have sex with men (MSM) to ascertain whether national guidelines for taking sexual histories, including recreational drug use and sexually transmitted infection (STI) screening were being met. The notes of 142 HIV-positive men seen in 2015 were available, of whom 85 were MSM. Information was collected regarding sexual history, recreational drug use documentation, sexually transmitted infection screen offer and test results. Seventy-seven (91%) of the MSM had a sexual history documented, of whom 60 (78%) were sexually active. STI screens were offered to 58/60 (97%) of those who were sexually active and accepted by 53 (91%). Twelve (23%) of these had an STI. A recreational drug history was taken in 63 (74%) with 17 (27%) reporting use and 3 (5%) chemsex. The high rate of STIs highlights that regular screening in this group is essential. Additionally, the fact that over a quarter reported recreational drug use and given the increasing concern around chemsex, questions about this should be incorporated into the sexual history proforma.

scholarly journals Syphilis reinfections pose problems for syphilis diagnosis in Antwerp, Belgium – 1992 to 2012

2014 ◽  
Vol 19 (45) ◽  
Author(s):  
C Kenyon ◽  
L Lynen ◽  
E Florence ◽  
S Caluwaerts ◽  
M Vandenbruaene ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Sexually Transmitted Infection ◽  
Tropical Medicine ◽  
Hiv Positive ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Strong Case ◽  
Sex With Men

Persons with multiple syphilis reinfections may play an important role in syphilis transmission. We analysed all syphilis tests carried out for people attending the HIV/sexually transmitted infection (STI) clinic at the Institute of Tropical Medicine, Antwerp, Belgium, from 1992 to 2012 to evaluate the extent to which syphilis reinfections were contributing to the syphilis epidemic in Antwerp. We then characterised the features of the syphilis infections in individuals with five or more episodes of syphilis. A total of 729 syphilis episodes were diagnosed in 454 persons. The majority of syphilis episodes occurred in people who had more than one episode of syphilis (445/729; 61%). A total of 10 individuals had five or more episodes of syphilis diagnosed over this period. All were men who have sex with men, HIV positive and on antiretroviral therapy. They had a total of 52 episodes of syphilis diagnosed and treated. In 38/42 of the episodes of repeat syphilis in these 10 individuals, they presented without any signs or symptoms of syphilis. Given that the majority of cases of incident syphilis in our clinic were persons with reinfections and that they frequently presented without signs of symptoms of syphilis, there is a strong case for frequent and repeated screening in all persons with a diagnosis of syphilis.

scholarly journals Steady increase of lymphogranuloma venereum cases, Czech Republic, 2010 to 2015

2016 ◽  
Vol 21 (11) ◽  
Author(s):  
Filip Rob ◽  
Kateřina Jůzlová ◽  
Helena Krutáková ◽  
Hana Zákoucká ◽  
Daniela Vaňousová ◽  
...  
Keyword(s):  
Czech Republic ◽  
Western Europe ◽  
Lymphogranuloma Venereum ◽  
Hiv Positive ◽  
Steady Increase ◽  
Transmitted Infection ◽  
The Czech Republic ◽  
Sexually Transmitted ◽  
First Case ◽  
Sex With Men

Since the notification of the first case of lymphogranuloma venereum (LGV) in the Czech Republic in 2010, the numbers of LGV cases have steadily increased in the country. In 2015, 40 LGV cases were diagnosed, bringing the total for 2010–2015, to 88 cases. The profile of the most affected group, HIV-positive men who have sex with men with a previous sexually transmitted infection, matches that of those described in LGV outbreaks in western Europe.

Regular STI testing amongst men who have sex with men and use social media is suboptimal – a cross-sectional study

2016 ◽  
Vol 28 (6) ◽  
pp. 573-583 ◽  
Author(s):  
Jamie Frankis ◽  
Lisa Goodall ◽  
Dan Clutterbuck ◽  
Abdul-Razak Abubakari ◽  
Paul Flowers
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Anal Intercourse ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Male Sex ◽  
Sex With Men

Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more ‘out’ (adjusted odds ratio = 1.79; confidence interval = 1.20–2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03–28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47–3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27–83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00–0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19–0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men’s STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

Triple site sexually transmitted infection testing as a crucial component of surveillance for men who have sex with men: A prospective cohort study

2021 ◽  
pp. 095646242110474
Author(s):  
Roy Zucker ◽  
Michael Gaisa ◽  
Keith Sigel ◽  
Ilan Singer ◽  
Amos Adler ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Study Groups ◽  
Sexual Risk Taking ◽  
Syphilis Infection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Crucial Component ◽  
Sex With Men

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are common among men who have sex with men (MSM). Many oropharyngeal and anorectal infections remain asymptomatic. We aimed to evaluate triple-site screening following PrEP introduction. We enrolled a prospective cohort study including 210 asymptomatic MSM during 2019–2020, analyzed by groups: HIV positive (HIV+), HIV−uninfected using PrEP (HIV−/PrEP+), or HIV-uninfected not using PrEP (HIV−/PrEP−). A self-administered questionnaire captured demographic information and sexual risk-taking behaviors. CT/NG testing results were compared between study groups and predictors of infection were evaluated. We included 59 HIV+, 70 HIV−/PrEP+, and 81 HIV−/PrEP− subjects. 30% ( n = 62) of participants tested positive for CT/NG. HIV−/PrEP+ group had highest proportion of infections ( n = 33, 47%) followed by HIV−/PrEP− ( n = 16, 22%) and HIV+ ( n=13, 20%; p < .001). Importantly, 98% (80/82) of pharyngeal/anorectal CT/NG infections were missed in genitourinary tract screening alone. PrEP use and previous syphilis infection were the strongest risk factor for CT/NG. Extra-genital asymptomatic CT/NG infections were prevalent among MSM. These data highlight the importance of routine extra-genital CT/NG testing in asymptomatic sexually active MSM. The study describes the consequences for three-site testing lack of implementation in the PrEP era.

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