Female Genital Schistosomiasis as a Risk-Factor for the Transmission of HIV

1994 ◽  
Vol 5 (5) ◽  
pp. 368-372 ◽  
Author(s):  
H Feldmeier ◽  
I Krantz ◽  
G Poggensee
Keyword(s):  
Risk Factor ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Risk Groups ◽  
Point Of View ◽  
Genital Ulcer ◽  
Published Data ◽  
Ulcer Disease ◽  
Sexually Transmitted ◽  
Female Genital

Sexually transmitted diseases increase the probability for HIV transmission, presumably through lesions in the genital mucosa. Female genital schistosomiasis, a special form of urinary schistosomiasis due to infection with Schistosoma haematobium, may be another risk-factor for transmission of HIV. From published data there seem to be pathophysiological, immunological and epidemiological evidence for an association between genital ulcer disease due to S. haematobium and HIV-infection in women. Female genital schistosomiasis could be seen as an example of how an interaction between a parasitic disease and HIV facilitates the propagation of the latter. As long as the prevalence of HIV is low in the general population, interventions targeted to high risk groups will significantly delay, or even prevent, widespread dissemination of the HIV infection in the rest of the population. If female genital schistosomiasis is a risk factor for the spread of HIV like other genital ulcer diseases, there should be interesting ways to intervene from the public health point of view.

Haemophilus Ducreyi

1993 ◽  
Vol 4 (6) ◽  
pp. 317-321 ◽  
Author(s):  
J A Jonasson
Keyword(s):  
Developing Countries ◽  
Risk Factor ◽  
Hiv Transmission ◽  
Haemophilus Ducreyi ◽  
Genital Ulcer ◽  
Industrialized Countries ◽  
Ulcer Disease ◽  
Genital Ulcer Disease ◽  
Fastidious Bacterium ◽  
Hygienic Conditions

Genital ulcer disease as a risk factor for HIV transmission has become apparent in the fight against AIDS. In poor communities in developing countries with people living under low hygienic conditions chancroid is often reported to be the most common form of genital ulcer. It is caused by Haemophilus ducreyi; a fastidious bacterium, notoriously difficult to grow in the laboratory. Apart from a few small micro-epidemics from time to time the disease, which has interesting immunological aspects, is now rare and almost forgotten in most industrialized countries. This may be part of the reason why there is no simple and inexpensive diagnostic test available yet that would be useful in the low-resource settings where chancroid is prevalent. The present review focuses on the diagnosis and pathogenesis of chancroid.

THE ETIOLOGY OF GENITAL ULCER DISEASE AND ITS RELATIONSHIP TO HIV INFECTION IN INDIAN SEXUALLY TRANSMITTED DISEASE CLINICS

1995 ◽  
Vol 88 ◽  
pp. S55
Author(s):  
Arun Risbud ◽  
Kirk Chan-Tack ◽  
Robert Bollinger ◽  
Sanjay Mehendale ◽  
Deepak Gadkari ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Sexually Transmitted Disease ◽  
Transmitted Disease ◽  
Genital Ulcer ◽  
Ulcer Disease ◽  
Sexually Transmitted ◽  
Genital Ulcer Disease

Genital ulcer disease among STD clinic attenders in Nairobi: association with HIV-1 and circumcision status

1996 ◽  
Vol 7 (6) ◽  
pp. 410-414 ◽  
Author(s):  
James M Nasio ◽  
Nico J D Nagelkerke ◽  
Anthony Mwatha ◽  
Stephen Moses ◽  
Jackoniah O Ndinya-Achola ◽  
...  
Keyword(s):  
Risk Factor ◽  
Transmitted Disease ◽  
Genital Ulcer ◽  
Ulcer Disease ◽  
Sexually Transmitted ◽  
Unknown Risk ◽  
Increased Risk ◽  
Male Patients ◽  
Genital Ulcers ◽  
Hiv 1

In previous studies, genital ulcers in men have been found to be associated with increased risk of HIV-1 seroconversion. To further explore this association male patients attending a sexually transmitted disease STD clinic in Nairobi for either urethritis controls, n 276 or a genital ulcer cases, n 607 were compared with respect to sexual behaviour, presence of HIV-1 antibody and circumcision status. Patients were followed to study risk factors for incident genital ulcers and HIV-1 seroconversion. At entry, being married was associated with higher prevalence of HIV-1 OR 1.76 and genital ulcers OR 1.42 . Lack of circumcision was associated with both HIV-1 infection OR 4.67 and the presence of a genital ulcer OR 2.23 . Genital ulcers were also associated with HIV-1 infection OR 1.87 independent of circumcision status. On follow-up, HIV-1 seropositivity was associated with incident genital ulcers. It is argued that the association between genital ulcers and HIV-1 infection may be more complex than ulcers simply being a risk factor for HIV-1 infection, and that HIV-1 infection may either increase the risk of acquiring a genital ulcer, or HIV-1 infection and genital ulcers may have some unknown risk factor in common.

scholarly journals Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Wei Ang ◽  
Carmen Low ◽  
Chen Seong Wong ◽  
Irving Charles Boudville ◽  
Matthias Paul Han Sim Toh ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Risk Groups ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Voluntary Testing ◽  
Recent Hiv Infection

AbstractBackgroundEarly diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore.MethodsAs part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses.ResultsA total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81).ConclusionAlthough there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups.

Confound it: latent lessons from the Mwanza trial of STD treatment to reduce HIV transmission

2003 ◽  
Vol 14 (3) ◽  
pp. 179-184 ◽  
Author(s):  
David Gisselquist ◽  
John J Potterat
Keyword(s):  
Sexually Transmitted Disease ◽  
Hiv Transmission ◽  
Additional Data ◽  
Transmitted Disease ◽  
Published Data ◽  
Hiv Incidence ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Safe Injection ◽  
Injection Safety

In 1995, an international team reported that improved syndromic management of sexually transmitted disease (STD) in Mwanza, Tanzania, had reduced HIV incidence by 38% in intervention compared to control communities. However, the team has not addressed confound: project interventions might have reduced HIV transmission during health care through provision of syringes and benzathine (replacing short acting) penicillin and through interactions with a coeval safe injection initiative. Mwanza's success in lowering HIV incidence is a puzzle, since it was achieved with only minor reductions in observed STD prevalence. Despite incomplete analyses, reports from Mwanza have encouraged expansion of STD treatment. However, should success be attributed to injection safety rather than to decreased STD prevalence — an hypothesis that fits published data — expanded STD treatment without attention to injection safety could, ironically, increase rather than decrease HIV incidence. To control for confound, additional data and analyses from the Mwanza study are warranted.

The Causal Role for Genital Ulcer Disease as a Risk Factor for Transmission of Human Immunodeficiency Virus

1996 ◽  
Vol 23 (5) ◽  
pp. 429-440 ◽  
Author(s):  
MARY C. DICKERSON ◽  
JEFF JOHNSTON ◽  
THOMAS E. DELEA ◽  
ALICE WHITE ◽  
ELIZABETH ANDREWS
Keyword(s):  
Human Immunodeficiency Virus ◽  
Risk Factor ◽  
Causal Role ◽  
Genital Ulcer ◽  
Ulcer Disease ◽  
Genital Ulcer Disease ◽  
Immunodeficiency Virus

Etiology of Genital Ulcer Disease in Dakar, Senegal, and Comparison of PCR and Serologic Assays for Detection of Haemophilus ducreyi

2000 ◽  
Vol 38 (1) ◽  
pp. 268-273
Author(s):  
Patricia A. Totten ◽  
Jane M. Kuypers ◽  
Cheng-Yen Chen ◽  
Michelle J. Alfa ◽  
Linda M. Parsons ◽  
...  
Keyword(s):  
Transmitted Disease ◽  
Haemophilus Ducreyi ◽  
Genital Ulcer ◽  
Serological Tests ◽  
Past Infection ◽  
Ulcer Disease ◽  
Sexually Transmitted ◽  
Genital Ulcer Disease ◽  
Pcr Assays ◽  
Simplex Virus

ABSTRACT We used PCR assays to determine the etiology of genital ulcers in patients presenting to a sexually transmitted disease clinic in Dakar, Senegal, and evaluated the ability of two PCR tests ( groEL and recD ) and two serological tests (adsorption enzyme immunoassay [EIA] and lipooligosaccharide [LOS] EIA) to detect current Haemophilus ducreyi infection. We found that in this population, H. ducreyi , T. pallidum , and herpes simplex virus HSV DNA were detected in 56, 15, and 13% of 39 genital ulcer specimens, respectively, and H. ducreyi DNA was detected in 60% (3 of 5) of samples from ulcerated bubos. Among 40 consecutive patients with genital ulcer disease and with sufficient sample for both PCR assays, the recD and groEL H. ducreyi PCR assays were 83% concordant, with the recD PCR assay detecting six (15%) additional positive specimens and the groEL assay detecting one (3%) additional positive specimen. Compared to PCR, the adsorption EIA and LOS EIA tests had sensitivities of 71 and 59% and specificities of 57 and 90%, respectively, for the diagnosis of current H. ducreyi infection. While these differences in specificity could be due either to previous infection with H. ducreyi or to the detection of cross-reacting antibodies, only 6% of patients from a nearby family planning clinic gave a positive reaction in both the adsorption EIA and LOS EIA assays, indicating that cross-reacting antibodies are not prevalent among clinic attendees in this city. Our studies indicate that the adsorption EIA detects both current and past infection, while the LOS EIA assay is more specific for current infection with H. ducreyi in this population.

Commentary on the Possibility That Viagra May Contribute to Transmission of HIV and other Sexual Diseases among Older Adults

1999 ◽  
Vol 85 (3) ◽  
pp. 942-944 ◽  
Author(s):  
Freddy A. Paniagua
Keyword(s):  
Older Adults ◽  
Hiv Infection ◽  
Sexually Transmitted Diseases ◽  
Hiv Transmission ◽  
Aids Prevention ◽  
Sexual Relationships ◽  
Factual Knowledge ◽  
Sexually Transmitted ◽  
Sexual Activities ◽  
Media Reports

Many older male adults experiencing impotence are being treated with Viagra. Scientific and media reports indicate that this medication is effective in re-establishing sexual relationships among these men. Despite the benefits that Viagra may have in the treatment of impotence among older adults, increased sexual activities could also facilitate the spread of HIV infection and other sexually transmitted diseases. This holds for older adults who may lack factual knowledge of HIV transmission and perceive themselves as nonsusceptible to this disease. Prescription of Viagra in combination with HIV/AIDS prevention programs may be helpful.

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.

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