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Wang S, Chen J, Li Y, Zhang B, Li X, Han Y, Zhang J. Trends in sexually transmitted and blood-borne infections in China from 2005 to 2021: a joinpoint regression model. BMC Infect Dis 2023; 23:741. [PMID: 37904156 PMCID: PMC10614345 DOI: 10.1186/s12879-023-08733-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 10/20/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Sexually transmitted and blood-borne infections (STBBIs) is a major public health concern in China. This study assessed the overall trends in STBBIs to improve the comprehensive understanding of the burden of STBBIs and provide evidence for their prevention and control. METHODS Data for the period from 2005 to 2021 were analyzed across China on infections with hepatitis B or C; syphilis; gonorrhea; and HIV infection. Trends, annual percent change (APC), and average annual percent change (AAPC) in diagnosis rate was analyzed using joinpoint regression models for the five STBBIs together or individually. RESULTS From 2005 to 2021, the overall diagnosis rate of all five STBBIs increased, with an AAPC of 1.3% [95% confidence interval (CI) -0.5% to 3.1%]. Diagnosis rates of HIV, syphilis and hepatitis C increased individually, but it decreased for infections of hepatitis B and gonorrhea. Joinpoint analysis identified four phases in diagnosis rate of hepatitis C; three phases in diagnosis rate of hepatitis B, HIV infection, and syphilis; two in diagnosis rate of gonorrhea infection. CONCLUSION Despite national efforts to prevent and control STBBIs, their overall diagnosis rate has continued to rise in China, and they remain an important public health challenge. Further efforts should be made to educate the general population about STBBIs, particularly HIV. Interventions targeting vulnerable groups should be adopted and their efficacy monitored through regular analysis of trends.
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Affiliation(s)
- Shuyuan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Jialu Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Yuansheng Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Beibei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Xiang Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Ying Han
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China
| | - Junhui Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southwest Medical University, Longmatan District, No.1, Section 1, Xianglin Road, Luzhou, Sichuan, People's Republic of China.
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Wiginton JM, Eaton LA, Kalinowski J, Watson RJ, Kalichman SC. Lifetime prevalence of syphilis infection among predominantly Black sexual and gender minorities living with HIV in Atlanta, Georgia: a cross-sectional analysis. ETHNICITY & HEALTH 2023; 28:159-169. [PMID: 34818951 PMCID: PMC9126996 DOI: 10.1080/13557858.2021.2007225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/11/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Syphilis infection disproportionately impacts Black sexual and gender minorities (SGM) in the United States. The extent of this impact among those living with HIV has been minimally examined. This study sought to examine lifetime syphilis prevalence and associated factors in a community sample of predominantly Black SGM living with HIV in the Southeastern US. DESIGN Participants (N = 174) enrolled in a stigma-mitigation trial for people living with HIV in Atlanta, Georgia, completed a sub-study involving testing for Treponema pallidum antibodies, indicative of lifetime syphilis infection. We performed chi-square and Fisher's exact tests to assess sociodemographic and healthcare differences by presence/absence of lifetime syphilis infection. RESULTS Most participants identified as non-Hispanic Black (n = 142/174; 81.6%) and cisgender male (n = 146/174; 83.9%). More than two thirds (n = 120/174) identified as gay/homosexual. We documented a 55.7% (n = 97/174) lifetime prevalence of syphilis infection and observed differences by sexual identity, with 77.3% (n = 75/97) of those screening positive reporting gay/homosexual identity relative to 58.4% (n = 45/77) of those screening negative (chi-square[1] = 7.8, p < 0.010). CONCLUSION Findings underscore how syphilis prevention efforts have missed the most marginalized, warranting a renewed, comprehensive strategy for improving the sexual health of Black SGM. Embedding targeted, respectful community engagement, expanded testing access, and healthcare provider training into broader sexual health and psychosocial wellness efforts is needed.
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Affiliation(s)
- John Mark Wiginton
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lisa A. Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Jolaade Kalinowski
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Seth C. Kalichman
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Cullinen K, Hill M, Anderson T, Jones V, Nelson J, Halawani M, Zha P. Improving sexually transmitted infection screening, testing, and treatment among people with HIV: A mixed method needs assessment to inform a multi-site, multi-level intervention and evaluation plan. PLoS One 2021; 16:e0261824. [PMID: 34962965 PMCID: PMC8714108 DOI: 10.1371/journal.pone.0261824] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 12/10/2021] [Indexed: 11/19/2022] Open
Abstract
Bacterial sexually transmitted infections (STIs) continue to be a worsening public health concern in the United States (US). Though the national incidence of HIV infection has decreased over recent years, that of chlamydia, gonorrhea, and syphilis have not. Despite national recommendations on prevention, screening, and treatment of these STIs, these practices have not been standardized. Nine Health Resources and Services Administration Ryan White HIV/AIDS Program funded clinics across 3 US jurisdictions (Florida, Louisiana, and Washington, DC), were selected as clinical demonstration sites to be evaluated in this mixed method needs assessment to inform a multi-site, multi-level intervention to evaluate evidence-based interventions to improve STI screening and testing of bacterial STIs among people with or at risk for HIV. These 3 US jurisdictions were selected due to having higher than national average incidence rates of HIV and bacterial STIs. Descriptive statistics and deductive analysis were used to assess quantitative and qualitative needs assessment data. Results indicate the following needs across participating sites: inconsistent and irregular comprehensive sexual behavior history taking within and among sites, limited routine bacterial STI testing (once/year and if symptomatic) not in accordance with CDC recommendations, limited extragenital site gonorrhea/chlamydia testing, limited annual training on STI-related topics including LGBTQ health and adolescent/young adult sexual health, and limited efforts for making high-STI incidence individuals feel welcome in the clinic (primarily LGBTQ individuals and adolescents/young adults). These findings were used to identify interventions to be used to increase routine screenings and testing for bacterial STIs.
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Affiliation(s)
- Kathleen Cullinen
- François-Xavier Bagnoud Center, School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
- * E-mail:
| | - Macsu Hill
- François-Xavier Bagnoud Center, School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
| | - Taylor Anderson
- François-Xavier Bagnoud Center, School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
| | - Veronica Jones
- François-Xavier Bagnoud Center, School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
| | - John Nelson
- François-Xavier Bagnoud Center, School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
| | - Mirna Halawani
- François-Xavier Bagnoud Center, School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
| | - Peijia Zha
- François-Xavier Bagnoud Center, School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, United States of America
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Borena W, Kruis S, Kitchen M, Taylor N, Gisinger M, Oberkofler H, Stoiber H, Zangerle R, von Laer D, Sarcletti M. Anal Ureaplasma spp. positivity among HIV positive men who have sex with men may be associated with high-risk-type HPV infections. Int J Infect Dis 2019; 84:75-79. [PMID: 31054966 DOI: 10.1016/j.ijid.2019.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/12/2019] [Accepted: 04/24/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE HIV positive individuals, particularly men having sex with men (MSM), are at increased risk of sexually transmitted infections (STIs) at genital and extra-genital sites. Data on anorectal Ureaplasma infections are lacking. The aim of our study was to characterize anal Ureaplasma positivity among a cohort of HIV positive MSM and evaluate possible association with papillomavirus infection at the same site. METHODS Anal swab samples, collected as part of routine screening for Chlamydia trachomatis and Neisseria gonorrhea, were additionally tested for HPV genotypes as well as for Ureaplasma and Mycoplasma using nucleic acid amplification method. RESULTS Out of a total of 222 study participants, 195 (89%, 95% CI (84.9-93.2)) were positive for HPV, approximately three quarter being high-risk genotypes. Forty three individuals (19.4%, 95% CI (14.4-24.3)) harbored Ureaplasma spp. Infection with high-risk HPV types was significantly associated with co-presence of Ureaplasma with an odds ratio (95% confidence-interval) of 2.59 (1.03-6.54), P = 0.04. CONCLUSION Besides a high predominance of HPV infection, asymptomatic HIV positive MSM had a high prevalence of anal Ureaplasma positivity. Concomitant infections with high-risk HPV genotypes were common and statistically significant. The role of this co-existence as a potential risk factor for anal carcinogenesis needs further elucidation.
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Affiliation(s)
- Wegene Borena
- Division of Virology, Medical University Innsbruck, Austria.
| | - Simon Kruis
- Division of Virology, Medical University Innsbruck, Austria
| | - Maria Kitchen
- Department of Dermatology and Venerology, Medical University Innsbruck, Austria
| | - Ninon Taylor
- Department of Internal Medicine (III), Paracelsus Medical University Salzburg, Austria
| | - Martin Gisinger
- Department of Dermatology and Venerology, Medical University Innsbruck, Austria
| | - Hannes Oberkofler
- Department of Laboratory Medicine, Paracelsus Medical University Salzburg, Austria
| | | | - Robert Zangerle
- Department of Dermatology and Venerology, Medical University Innsbruck, Austria
| | | | - Mario Sarcletti
- Department of Dermatology and Venerology, Medical University Innsbruck, Austria
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Phanuphak N, Pattanachaiwit S, Pankam T, Teeratakulpisarn N, Chamnan P, Pathipvanich P, Thongpaen S, Nonenoy S, Jantarapakde J, Pengnonyang S, Trachunthong D, Sungsing T, Parasate K, Seeneewong Na Ayutthaya S, Trairat K, Pussadee K, Lertpiriyasuwat C, Phanuphak P. Sexually transmitted infections and HIV RNA levels in blood and anogenital compartments among Thai men who have sex with men before and after antiretroviral therapy: implication for Treatment as Prevention programme. J Int AIDS Soc 2018; 21:e25186. [PMID: 30225927 PMCID: PMC6141901 DOI: 10.1002/jia2.25186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 08/13/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Sexually transmitted infections (STIs) are common among HIV-positive men who have sex with men (MSM). There have been concerns that undiagnosed and untreated STIs could undermine efforts to use antiretroviral therapy (ART) for prevention due to genital secretion infectiousness. We evaluated the correlation between STIs and HIV RNA in anogenital compartments among HIV-positive MSM before and after ART. METHODS MSM participants newly diagnosed with HIV were offered ART regardless of CD4 count during November 2012 to November 2015. Syphilis serology, oropharyngeal swab, rectal swab, urine collection for gonorrhoea and chlamydia nucleic acid amplification testing, and HIV RNA measurement in blood, semen and rectal samples were performed at baseline, 12 and 24 months thereafter. RESULTS Of 143 HIV-positive MSM, 16.1% had syphilis, 23.1% had gonorrhoea and 32.8% had chlamydia at baseline. Participants with STIs at baseline had higher median HIV RNA levels in blood plasma (p = 0.053), seminal plasma (p = 0.01) and rectal secretions (p = 0.002) than those without STIs. Multivariate models identified HIV RNA 100,000 to 500,000 (OR 6.74, 95% CI 2.24 to 20.28, p = 0.001) and >500,000 (OR 9.39, 95% CI 1.08 to 81.72, p = 0.04) copies/mL in blood, CD4 count <350 cells/mm3 (OR 4.20, 95% CI 1.05 to 16.70, p = 0.04) and having any STIs (OR 2.62, 95% CI 1.01 to 6.80 p = 0.047) to be associated with detectable (>40 copies/mL) seminal plasma HIV RNA. Having chlamydia at any sites (OR 3.17, 95% CI 1.07 to 9.44, p = 0.04) was associated with detectable rectal HIV RNA. Incidences of syphilis, gonorrhoea and chlamydia were 13.4, 16.4 and 18.1 per 100 person-years respectively. Nine participants had detectable HIV RNA (five in blood, one in semen, two in rectal samples and one in both blood and rectal samples) at 12 and/or 24 months after ART. CONCLUSIONS STIs were extremely common among HIV-positive MSM prior to and after ART. ART effectively reduced HIV RNA in all compartments. The correlation between STIs and anogenital HIV RNA, especially prior to ART and likely until complete HIV RNA suppression from ART is achieved, points to the importance of integrating asymptomatic STIs screening into Treatment as Prevention programme for MSM.
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Affiliation(s)
| | | | - Tippawan Pankam
- PREVENTIONThai Red Cross AIDS Research CentreBangkokThailand
| | | | - Parinya Chamnan
- Tawanghin Community Medical Care Center‐Sanpasitthiprasong HospitalUbonratchathaniThailand
| | | | | | | | | | | | | | | | - Kittiyaporn Parasate
- Tawanghin Community Medical Care Center‐Sanpasitthiprasong HospitalUbonratchathaniThailand
| | | | | | | | | | - Praphan Phanuphak
- PREVENTIONThai Red Cross AIDS Research CentreBangkokThailand
- HIV‐NATThai Red Cross AIDS Research CentreBangkokThailand
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