Global travel and HIV/STI epidemics among MSM: what does the future hold?

Abstract

Abstract. Infectious disease epidemics occur within dynamic systems and environments that shape risk and, ultimately, the spread of infectious diseases. Gay men and other men who have sex with men (MSM) are disproportionately impacted by HIV everywhere in the world. Several emerging trends present risks for sustained or increased HIV acquisition and transmission, and the growth of global travel in the context of emerging online platforms for social/sexual networking is discussed here. Four factors associated with travel that could potentiate HIV transmission are highlighted: different patterns of sexual risk behaviours during travel; the growth of online tools to meet sex partners more efficiently; the global heterogeneity of HIV strains; and the potential for diassortative mixing of men from high-and low-HIV prevalence areas. Prevention tools and services must rise to these challenges, and innovative mobile applications and programs have played, and will continue to play, an important role in supporting MSM at risk for or living with HIV during their periods of travel.

Hepatitis A outbreak among men who have sex with men (MSM) predominantly linked with the EuroPride, the Netherlands, July 2016 to February 2017

“…To better understand transmission chains and the epidemiology of this outbreak, we recently introduced an additional, more detailed questionnaire for hepatitis A-positive MSM to complement routinely collected epidemiological data. Given the high outbreak potential of hepatitis A in the MSM community and the high interconnectedness through global travel of this risk group [18], increasing awareness of hepatitis A among MSM as well as health professionals at sexually transmitted disease clinics and public health services should be emphasised. To increase hepatitis A vaccination uptake, the Regional Public Health Services and ‘STI AIDS the Netherlands’ (centre of expertise for HIV and other sexually transmitted infections) have been engaging in activities to remind professionals and the Dutch MSM community of the availability of hepatitis A vaccination within the hepatitis B vaccination programme.…”

Epidemiology of gonorrhoea: a global perspective

“…[43][44][45] Increasing use of geospatial applications to find sex partners, use of HIV seroadaptive behaviours, the introduction of HIV PrEP and proliferation of circuit parties and group sex events, particularly those involving chemsex, might contribute to changes in behaviour and development of large and dense sexual networks that may facilitate gonorrhoea transmission. [46][47][48][49][50][51][52][53][54][55][56][57] Emerging gonococcal antimicrobial resistanceparticularly resistance to the only remaining currently recommended antimicrobialsamong MSM is of grave concern. While the pattern is not universal, gonococcal isolates from MSM often demonstrate greater prevalence of antimicrobial resistance than isolates from heterosexuals.…”

Place and practice: Sexual risk behaviour while travelling abroad among Swedish men who have sex with men

“…The meanings of international travel vary depending on region, citizenship and practical matters such as transportation availability and visa requirements. Aside from geographical variations in HIV and STI prevalence, availability and cost of testing for HIV/STI as well as routines for STI testing for MSM, treatment for STI, PEP, PrEP and ART differ between and within different countries 125,126 . This contributes to geographical differences in the transmission risk of HIV and STIs.…”

“…This means that the connotations of being risky or at risk change with regard to HIV status 56 . Still, men living with HIV risk being reinfected with drug-resistant HIV virus strains 126 . Further, the risk of STI transmission remains for MSM regardless of HIV status, and the risk of STIs has been shown to be high among sexually adventurous MSM 83 and in networks tied to specific venues among MSM 183 .…”