Impact of recurrent sexually transmitted infections on HIV seroconversion: Results from multi-state frailty models

2021 ◽  
pp. 095646242110365
Author(s):  
Handan Wand ◽  
Jayajothi Moodley ◽  
Tarylee Reddy ◽  
Sarita Naidoo
Keyword(s):  
Sexually Transmitted Infections ◽  
Critical Role ◽  
Population Level ◽  
Frailty Models ◽  
African Women ◽  
Cumulative Impact ◽  
Sexually Transmitted ◽  
Hiv Seroconversion ◽  
The Impact

After several decades of research, South Africa is still considered to be the epicentre of HIV epidemic. The country also has the highest burden of sexually transmitted infections (STIs) which have been frequently linked to increasing rates of HIV transmission due to biological and behavioural associations between these two pathogeneses. We investigated the cumulative impact of recurrent STIs on subsequent HIV seroconversion among a cohort of South African women. We used the ‘ frailty’ models which can account for the heterogeneity due to the recurrent STIs in a longitudinal setting. The lowest HIV incidence rate was 5.0/100 person-year among women who had no baseline STI and remained negative during the follow-up. This estimate was three times higher among those who had recurrent STIs in the follow-up period regardless of their STI status at baseline (15.8 and 14.0/100 person-year for women with and without STI diagnosis at baseline, respectively). Besides younger age and certain partnership characteristics, our data provided compelling evidence for the impact of recurrent STI. diagnoses on increasing rates of HIV. At the population-level, 65% of HIV infections collectively associated with recurrent STIs. These results have significant clinical and epidemiological implications and may play critical role in the trajectory of the infections in the region.

scholarly journals Cohort profile: l’Actuel Pre-Exposure Prophylaxis (PrEP) Cohort study in Montreal, Canada

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e028768 ◽  
Author(s):  
Zoë R Greenwald ◽  
Mathieu Maheu-Giroux ◽  
Jason Szabo ◽  
Judith Alexia B Robin ◽  
Michel Boissonnault ◽  
...  
Keyword(s):  
Population Level ◽  
Hiv Infections ◽  
Health Clinic ◽  
Moderate Increase ◽  
Hiv Incidence ◽  
Sexually Transmitted ◽  
Before And After ◽  
Exposure Prophylaxis ◽  
The Impact

PurposeThel’Actuel PrEP Cohortwas established to monitor the uptake, effectiveness, safety and changes in sexual risk behaviours among individuals receiving pre-exposure prophylaxis (PrEP) for the prevention of HIV. This prospective dynamic cohort is based at Clinique médicale l’Actuel, a large sexual health clinic located in Montreal, Canada.ParticipantsSince the cohort inception in January of 2013 through June 2018, 2156 individuals consulted for PrEP as participants in the l’Actuel PrEP Cohort. Median age was 35 years (IQR: 29–44 years) and the majority (96%) were men who have sex with men. Among 1551 individuals who initiated PrEP care, the median duration of follow-up was 9.2 months (IQR: 3.7–19.6), with substantial variation based on year of cohort entry. Thel’Actuel PrEP Cohortcontains both daily and intermittent ‘on-demand’ PrEP users and has the largest reported population of intermittent PrEP users (n=406) in North America.Findings to dateNo incident HIV infections have occurred among individuals using PrEP over 1637 person-years of follow-up. However, retention in PrEP care is essential as three individuals who discontinued PrEP subsequently acquired HIV, translating to an HIV incidence of 3.9 cases per 100 person-years (95% CI: 1.3 to 12.1). Among a sample of participants with 1 year of follow-up before and after PrEP initiation (n=109), a moderate increase in sexually transmitted infections was observed following PrEP start.Future plansThel’Actuel PrEP Cohortcontinues to grow with new participants starting PrEP monthly and extended follow-up for existing users. The cohort data will be used for ongoing monitoring of PrEP and for population-level modelling of the impact of PrEP on HIV incidence in Montreal.

scholarly journals COVID-19 impact on testing, diagnosis and care of people with sexually transmitted infections in a low human development region, Minas Gerais, Brazil

2021 ◽  
Vol 10 (16) ◽  
pp. e525101623897
Author(s):  
Pollyanna Roberta Campelo Gorgens ◽  
Danilo Bretas de Oliveira
Keyword(s):  
Sexually Transmitted Infections ◽  
Human Development ◽  
Minas Gerais ◽  
Sexually Transmitted ◽  
Viral Loads ◽  
Rapid Tests ◽  
Load Tests ◽  
Recent Diagnosis ◽  
The Impact

This study aimed to analyze the impact of the COVID-19 pandemic on the care of people with Sexually Transmitted Infections (STIs) in a region of low human development, located in Minas Gerais, Brazil. Methods: The number of monthly procedures during pandemic period, January to December 2020, and comparison period, January to December 2019, in a SUS regional clinic, a reference for STIs, were analyzed. Visits were categorized into follow-up appointments, rapid tests, viral loads and first appointment due a recent diagnosis. Comparison between both periods was performed by frequency analysis, difference in the mean monthly attendances (DM) and  prevalence ratios (PR), considering ratio between the proportion of attendances in the pandemic period/proportion of attendances in the comparative period. During the pandemic period, the average number of monthly consultations reduced for all consultations (DM = -105.25) and categories. Proportion of consultations reduced for rapid tests (PR = 0.46; 95% CI = 0.41-0.52) and first consultation due  recent diagnosis (PR = 0.90; 95% CI = 0.65-1, 25), procedures that are usually scheduled by the user. There was an increase in the proportion of follow-up visits (PR = 1.18; 95% CI = 1.09-1.27) and viral load tests (PR = 1.41; 95% CI = 1.32-1, 88), monitoring procedures usually scheduled by the clinic. There was a trend to maintain risk exposure for STIs. Conclusion: These findings may guide better strategies to care for individuals with STIs.

scholarly journals Understanding and responding to COVID-19 in Wales: protocol for a privacy-protecting data platform for enhanced epidemiology and evaluation of interventions

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e043010
Author(s):  
Jane Lyons ◽  
Ashley Akbari ◽  
Fatemeh Torabi ◽  
Gareth I Davies ◽  
Laura North ◽  
...  
Keyword(s):  
Policy Development ◽  
Healthcare Utilisation ◽  
Population Data ◽  
Population Level ◽  
Risk Groups ◽  
Service Utilisation ◽  
Natural Experiments ◽  
Spread Of Infection ◽  
The Impact

IntroductionThe emergence of the novel respiratory SARS-CoV-2 and subsequent COVID-19 pandemic have required rapid assimilation of population-level data to understand and control the spread of infection in the general and vulnerable populations. Rapid analyses are needed to inform policy development and target interventions to at-risk groups to prevent serious health outcomes. We aim to provide an accessible research platform to determine demographic, socioeconomic and clinical risk factors for infection, morbidity and mortality of COVID-19, to measure the impact of COVID-19 on healthcare utilisation and long-term health, and to enable the evaluation of natural experiments of policy interventions.Methods and analysisTwo privacy-protecting population-level cohorts have been created and derived from multisourced demographic and healthcare data. The C20 cohort consists of 3.2 million people in Wales on the 1 January 2020 with follow-up until 31 May 2020. The complete cohort dataset will be updated monthly with some individual datasets available daily. The C16 cohort consists of 3 million people in Wales on the 1 January 2016 with follow-up to 31 December 2019. C16 is designed as a counterfactual cohort to provide contextual comparative population data on disease, health service utilisation and mortality. Study outcomes will: (a) characterise the epidemiology of COVID-19, (b) assess socioeconomic and demographic influences on infection and outcomes, (c) measure the impact of COVID-19 on short -term and longer-term population outcomes and (d) undertake studies on the transmission and spatial spread of infection.Ethics and disseminationThe Secure Anonymised Information Linkage-independent Information Governance Review Panel has approved this study. The study findings will be presented to policy groups, public meetings, national and international conferences, and published in peer-reviewed journals.

scholarly journals A risk-based model for predicting the impact of using condoms on the spread of sexually transmitted infections

2017 ◽  
Vol 2 (1) ◽  
pp. 100-112 ◽  
Author(s):  
Asma Azizi ◽  
Karen Ríos-Soto ◽  
Anuj Mubayi ◽  
James M. Hyman
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexually Transmitted ◽  
The Impact

scholarly journals Methodology of Natsal-COVID Wave 1: a large, quasi-representative survey with qualitative follow-up measuring the impact of COVID-19 on sexual and reproductive health in Britain

2021 ◽  
Vol 6 ◽  
pp. 209
Author(s):  
Emily Dema ◽  
Andrew J Copas ◽  
Soazig Clifton ◽  
Anne Conolly ◽  
Margaret Blake ◽  
...  
Keyword(s):  
General Population ◽  
Reproductive Health ◽  
Sexual Behaviour ◽  
Sexual And Reproductive Health ◽  
Service Use ◽  
Population Data ◽  
Population Level ◽  
Level Data ◽  
The Impact

Background: Britain’s National Surveys of Sexual Attitudes and Lifestyles (Natsal) have been undertaken decennially since 1990 and provide a key data source underpinning sexual and reproductive health (SRH) policy. The COVID-19 pandemic disrupted many aspects of sexual lifestyles, triggering an urgent need for population-level data on sexual behaviour, relationships, and service use at a time when gold-standard in-person, household-based surveys with probability sampling were not feasible. We designed the Natsal-COVID study to understand the impact of COVID-19 on the nation’s SRH and assessed the sample representativeness. Methods: Natsal-COVID Wave 1 data collection was conducted four months (29/7-10/8/2020) after the announcement of Britain’s first national lockdown (23/03/2020). This was an online web-panel survey administered by survey research company, Ipsos MORI. Eligible participants were resident in Britain, aged 18-59 years, and the sample included a boost of those aged 18-29. Questions covered participants’ sexual behaviour, relationships, and SRH service use. Quotas and weighting were used to achieve a quasi-representative sample of the British general population. Participants meeting criteria of interest and agreeing to recontact were selected for qualitative follow-up interviews. Comparisons were made with contemporaneous national probability surveys and Natsal-3 (2010-12) to understand bias. Results: 6,654 participants completed the survey and 45 completed follow-up interviews. The weighted Natsal-COVID sample was similar to the general population in terms of gender, age, ethnicity, rurality, and, among sexually-active participants, numbers of sexual partners in the past year. However, the sample was more educated, contained more sexually-inexperienced people, and included more people in poorer health. Conclusions: Natsal-COVID Wave 1 rapidly collected quasi-representative population data to enable evaluation of the early population-level impact of COVID-19 and lockdown measures on SRH in Britain and inform policy. Although sampling was less representative than the decennial Natsals, Natsal-COVID will complement national surveillance data and Natsal-4 (planned for 2022).

scholarly journals Male Urethritis Caused by Trichomonas vaginalis

2021 ◽  
Vol 79 (1) ◽  
pp. 71-73
Author(s):  
Ângela Roda ◽  
João Borges-Costa
Keyword(s):  
Sexually Transmitted Infections ◽  
Sexually Transmitted Diseases ◽  
Trichomonas Vaginalis ◽  
Unusual Case ◽  
Parasitic Infection ◽  
Men And Women ◽  
Sexually Transmitted ◽  
Molecular Assays ◽  
The Past ◽  
The Impact

Trichomoniasis is one of the most common sexually transmitted infections worldwide. In women, Trichomonas vaginalis infection may present with vaginitis, cervicitis, or pelvic inflammatory disease, while in men it is mainly asymptomatic or causes mild and transient symptoms of urethritis, epididymitis, or prostatitis. In the past, little importance had been given to the impact of T. vaginalis infection on men’s health, since it was believed to be a self-limited condition without sequelae. However, there is growing evidence it is associated with more serious disorders in both men and women and efforts to diagnose and treat this parasitic infection have increased. Recent advances in testing for sexually transmitted diseases using multiplex molecular assays have increased diagnostic opportunities for T. vaginalis infection, especially in men, as detection of the parasite by traditional methods is much more challenging. We describe an unusual case of male urethritis caused by T. vaginalis observed in our consultation of Sexually Transmitted Infections.

scholarly journals Impact of chemokine C–C ligand 27, foreskin anatomy and sexually transmitted infections on HIV-1 target cell availability in adolescent South African males

2019 ◽  
Vol 13 (1) ◽  
pp. 118-127
Author(s):  
Clive M. Gray ◽  
Kyle L. O’Hagan ◽  
Ramon Lorenzo-Redondo ◽  
Abraham J. Olivier ◽  
Sylvie Amu ◽  
...  
Keyword(s):  
Gene Expression ◽  
Sexually Transmitted Infections ◽  
Target Cell ◽  
Langerhans Cells ◽  
Medical Male Circumcision ◽  
Sexually Transmitted ◽  
T Cell Migration ◽  
Cell Changes ◽  
The Impact ◽  
Hiv 1

Abstract We compared outer and inner foreskin tissue from adolescent males undergoing medical male circumcision to better understand signals that increase HIV target cell availability in the foreskin. We measured chemokine gene expression and the impact of sexually transmitted infections (STIs) on the density and location of T and Langerhans cells. Chemokine C–C ligand 27 (CCL27) was expressed 6.94-fold higher in the inner foreskin when compared with the outer foreskin. We show that the density of CD4+CCR5+ cells/mm2 was higher in the epithelium of the inner foreskin, regardless of STI status, in parallel with higher CCL27 gene expression. In the presence of STIs, there were higher numbers of CD4+CCR5+ cells/mm2 cells in the sub-stratum of the outer and inner foreskin with concurrently higher number of CD207+ Langerhans cells (LC) in both tissues, with the latter cells being closer to the keratin surface of the outer FS in the presence of an STI. When we tested the ability of exogenous CCL27 to induce T-cell migration in foreskin tissue, CD4 + T cells were able to relocate to the inner foreskin epithelium in response. We provide novel insight into the impact CCL27 and STIs on immune and HIV-1 target cell changes in the foreskin.

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