High HIV incidence in men who have sex with men following an early syphilis diagnosis: is there room for pre-exposure prophylaxis as a prevention strategy?

Girometti, Nicolò; Gutierrez, Angela; Nwokolo, Nneka; McOwan, Alan; Whitlock, Gary

doi:10.1136/sextrans-2016-052865

Cited by 18 publications

(15 citation statements)

References 12 publications

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“…A classificação clínica mais frequente foi a terciária. Pesquisa realizada em Nova Iorque com registros de Vigilância dos agravos em estudo constatou que somente 14% dos homens eram portadores de sífilis em sua fase terciária (12), o que corrobora com os achados da investigação desenvolvida em Londres, com homens diagnosticados com sífilis em suas fases iniciais (primária e secundária) (19) .…”

Section: Discussionunclassified

Notificação Da Sífilis Adquirida Em Uma Superintendência Regional De Saúde Do Sul De Minas Gerais

et al. 2019

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Objetivo: avaliar as notificações dos casos de sífilis adquirida em uma Superintendência Regionalde Saúde do Sul de Minas Gerais.Método: estudo transversal-descritivo-analítico dos 294 casos de sífilis notificados entre janeiro de2010 e junho de 2017. Na coleta utilizou-se um instrumento elaborado pelos pesquisadores e osdados foram analisados com os testes Qui-quadrado de Pearson e Exato de Fisher. Estimou-se oodds ratio das variáveis, com o intervalo de confiança de 95%.Resultados: observou-se maior frequência de pessoas com faixa etária de 20 a 35 anos, 162(55,1%); sexo masculino, 203 (69%); escolaridade de ensino médio completo, 58 (19,7%); resultadodo teste não-treponêmico reagente, 256 (87,1%), 156 (53,1%); classificação clínica em fase terciária,89 (30,3%). A variável sexo apresentou associação significativa com o comportamento sexual(p<0,001).Conclusão: a avaliação das notificações foi alcançada, o que pode favorecer a detecção precoce, odiagnóstico apropriado e o tratamento imediato à pessoa.

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Section: Discussionunclassified

Notificação Da Sífilis Adquirida Em Uma Superintendência Regional De Saúde Do Sul De Minas Gerais

et al. 2019

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“…Even with undetectable viral loads, BMSMW and their partners are still susceptible to other STIs (Fleming & Wasserheit, 1999; Kidd, Stenger, Kirkcaldy, Llata, & Weinstock, 2015; Solomon et al, 2014; Wasserheit, 1992), and the profiles within latent classes 1 and 2 (Seropositive Serosorters and Seronegative/unknown Serosorters) demonstrate high potential for STI acquisition and transmission. Future studies should explore the relationship between condomless sexual positioning practices and STI prevalence, which can increase HIV risk and transmission (Craib et al, 1995; Girometti, Gutierrez, Nwokolo, McOwan, & Whitlock, 2016; Solomon et al, 2014). …”

Section: Discussionmentioning

confidence: 99%

Latent Classes of Sexual Risk Among Black Men Who Have Sex with Men and Women

et al. 2018

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Black men who have sex with men and women (BMSMW) are at high risk for HIV and other sexually transmitted infections (STIs). Despite knowing that HIV/STI risk varies by sexual positioning practices, limited data have characterized the risk profiles of BMSMW. This study utilized latent class analysis (LCA) to explore BMSMW’s sexual risk profiles regarding condomless sexual positioning practices. Participants were BMSMW who participated in intervention studies in Los Angeles, Chicago, and Philadelphia. LCA was used to characterize sexual risk profiles. Age, study location, HIV status, social support, and internalized homophobia were used as covariates in a multinomial regression model predicting the likelihood of latent class membership. Among the 546 participants, three latent classes of risk were identified: Seropositive Serosorters, Seronegative/unknown Serosorters, and Main Partners Only. All groups had the greatest probabilities of condomless sex with main partners. Seropositive Serosorters had the highest probabilities of condomless sex with HIV-positive partners. Seronegative/unknown Serosorters had highest probabilities of condomless sex with HIV-negative or unknown status partners. HIV-positive BMSMW had 87% lower odds of being classified as Seronegative/unknown Serosorters than Seropositive Serosorters than HIV-negative/unknown status BMSMW (AOR=0.13, 95% CI=0.06, 0.28). HIV-positive BMSMW had 71% lower odds of being classified as Main Partners only than Seropositive Serosorters than HIV-negative/unknown status BMSMW (AOR=0.29, 95% CI=0.16, 0.51). Findings highlight opportunities for clinicians to promote condom use and risk reduction among BMSMW with differing sexual risk profiles. Increased understanding of sexual positioning practices among BMSMW might help address HIV/STIs among this group.

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“…Syphilis can be diagnosed by darkfieldmicroscopy, PCR, or direct immunofluorescence [29]. Girometti et al [30] showed the importance of the diagnosis of early syphilis as it entails a high HIV seroconversion rate and its detection should be prioritised before PrEP is prescribed.…”

Section: Resultsmentioning

confidence: 99%

Sexually Transmitted Infections in the PReP Era. Are Family Doctors Ready to Give Advice?

Cerdeira¹,

E²,

B³

et al. 2017

TODJ

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Background:Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) as a method of HIV prevention is not without controversy, and there has been concern that it may lead its users to think that they no longer need other preventive measures such as condoms. Thus, healthcare providers are convinced that PrEP decreases condom use and increases sexually transmitted infections (STIs). This treatment has been studied in men who have sex with men, men and women in heterosexual HIV-discordant couples, and heterosexual men and women. Objective:The objective of this study was to review the current state of evidence on the association of PrEP with condom use, the incidence of STIs, and the change in sexual behaviours in populations with risky practices. Materials and Methods:PubMed (National Center for Biotechnology Information, Bethesda, MD, USA), Science Direct (Elsevier Ltd., Oxford, UK), and Google Scholar (Google Inc., Mountain View, CA, USA) search engines were used during the study. We used the terms HIV, PrEP, sexually transmitted infections (STIs), MSM, condom, heterosexual men / women to search the databases. Results:Here, we present evidence that daily oral treatment is safe and effective in these populations studied, especially when medication adherence is high. STI testing should include extra-genital testing regardless of PrEP use to prevent health deficits and onward transmission. Conclusion:Despite this safety and efficacy, we strongly advise that patients continue to use condoms as a prophylactic measure against other sexually transmitted diseases. This update addresses the benefits and precautions that must be taken when establishing PrEP treatment, focusing mainly on family doctorswho are best positioned to provide follow-up and advice to patients and their relatives.

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High HIV incidence in men who have sex with men following an early syphilis diagnosis: is there room for pre-exposure prophylaxis as a prevention strategy?

Cited by 18 publications

References 12 publications

Notificação Da Sífilis Adquirida Em Uma Superintendência Regional De Saúde Do Sul De Minas Gerais

Notificação Da Sífilis Adquirida Em Uma Superintendência Regional De Saúde Do Sul De Minas Gerais

Latent Classes of Sexual Risk Among Black Men Who Have Sex with Men and Women

Sexually Transmitted Infections in the PReP Era. Are Family Doctors Ready to Give Advice?

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