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Shanley A, O’Donnell K, Weatherburn P, Gilmore J, Witzel TC. Understanding sexual health service access for gay, bisexual and other men who have sex with men in Ireland during the COVID-19 crisis: Findings from the EMERGE survey. PLoS One 2024; 19:e0306280. [PMID: 38950031 PMCID: PMC11216565 DOI: 10.1371/journal.pone.0306280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 06/12/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND In the Republic of Ireland, the COVID-19 crisis led to sexual health service closures while clinical staff were redeployed to the pandemic response. Gay, bisexual and other men who have sex with men (gbMSM) face pre-existing sexual health inequalities which may have been exacerbated. The aim of this study is to understand sexual health service accessibility for gbMSM in Ireland during the COVID-19 crisis. METHODS EMERGE recruited 980 gbMSM in Ireland (June-July 2021) to an anonymous online survey investigating well-being and service access through geo-location sexual networking apps (Grindr/Growlr), social media (Facebook/Instagram/Twitter) and collaborators. We fit multiple regression models reporting odds ratios (ORs) to understand how demographic and behavioural characteristics (age, sexual orientation, HIV testing history/status, region of residence, region of birth and education) were associated with ability to access services. RESULTS Of the respondents, 410 gbMSM accessed sexual health services with some or no difficulty and 176 attempted but were unable to access services during the COVID-19 crisis. A further 382 gbMSM did not attempt to access services and were excluded from this sample and analysis. Baseline: mean age 35.4 years, 88% gay, 83% previously tested for HIV, 69% Dublin-based, 71% born in Ireland and 74% with high level of education. In multiple regression, gbMSM aged 56+ years (aOR = 0.38, 95%CI:0.16, 0.88), not previously tested for HIV (aOR = 0.46, 95%CI:0.23, 0.93) and with medium and low education (aOR = 0.55 95%CI:0.35, 0.85) had lowest odds of successfully accessing services. GbMSM with HIV were most likely to be able to access services successfully (aOR = 2.68 95%CI:1.83, 6.08). Most disrupted services were: STI testing, HIV testing and PrEP. CONCLUSIONS Service access difficulties were found to largely map onto pre-existing sexual health inequalities for gbMSM. Future service development efforts should prioritise (re)engaging older gbMSM, those who have not previously tested for HIV and those without high levels of education.
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Affiliation(s)
| | - Kate O’Donnell
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | - Peter Weatherburn
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - T. Charles Witzel
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- University College London, London, United Kingdom
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Nyasani DK, Ondora OM, Lunani LL, Ombati GO, Mutisya EM, Mutua GN, Price MA, Osero JO. Sexually transmitted infection knowledge among men who have sex with men in Nairobi, Kenya. PLoS One 2023; 18:e0281793. [PMID: 37683033 PMCID: PMC10490897 DOI: 10.1371/journal.pone.0281793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 08/02/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND High rates of sexually transmitted infections (STIs) among men who have sex with men (MSM) have been reported, but there is little research on their STI knowledge. Our study sought to determine participants' characteristics that contribute to either high or low STI knowledge among MSM in Nairobi, Kenya. METHODS We mobilized MSM aged ≥18 years from Nairobi into a cross-sectional study. To determine their understanding of STIs, a pre-tested structured questionnaire was administered. Knowledge score was generated by summing up the number of responses answered correctly by a participant. We dichotomized scores as "low" and "high", by splitting the group at <12 and ≥12 which was the mean. RESULTS A total of 404 participants were interviewed between March and August 2020. The mean age was 25.2 (SD = 6.4) years. Majority were single (80.4%) and Christians (84.2%). All participants had some formal education ranging from primary to tertiary; the majority (92.3%) had secondary education or more. Most (64.0%) were employed and their monthly income ranged from <50->150 USD. Almost all (98.5%) were Kenyans. Of the 404 (90.6%) self-identified as male and (47.5%) reported to be exclusively top partners. Many (39.9%) reported being versatile, while those reporting to be bottom partners were, (12.6%). The last 12 months, (55.4%) of the participants reported having sex with men only and (88.6%) reported to have had multiple sexual partners. Participants scored an average of 12.2, SD 4.5. Multivariable backward elimination logistic regression revealed that participants who had tertiary education (aOR = 0.50, 95% CI 0.32-0.77), a higher income (aOR = 0.40, 95% CI 0.22-0.75) and were engaging in vaginal sex (aOR = 1.86, 95% CI 1.25-2.78) predicted significantly higher odds of high knowledge in the final multivariable model. CONCLUSION Participant's knowledge level regarding STIs was low. We recommend health care workers to continue educating patients about STIs.
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Affiliation(s)
- Delvin Kwamboka Nyasani
- Kenyatta University Department of Community Health and Epidemiology, Nairobi, Kenya
- KAVI Institute of Clinical Research, University of Nairobi, Nairobi, Kenya
| | | | | | | | | | | | - Matt. A. Price
- IAVI, New York, New York, United States of America
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
| | - Justus Osano Osero
- Kenyatta University Department of Community Health and Epidemiology, Nairobi, Kenya
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Bonfim FFDO, Villar LM, Croda J, Silva SRD, Gonçalves CCM, de Castro VDOL, de Rezende Romeira GR, Cesar GA, Dos Santos Weis-Torres SM, Horta MA, Simionatto S, Motta-Castro ARC, de Paula VS. Epidemiological Survey of Human Alphaherpesvirus 2 (HSV-2) Infection in Indigenous People of Dourados Municipality, Central Brazil. Trop Med Infect Dis 2023; 8:tropicalmed8040197. [PMID: 37104324 PMCID: PMC10143357 DOI: 10.3390/tropicalmed8040197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/10/2023] [Accepted: 01/23/2023] [Indexed: 04/28/2023] Open
Abstract
Sexually transmitted Human alphaherpesvirus 2 (HSV-2) causes genital ulcers, especially among sexually active adolescents and adults. We estimated the exact prevalence of anti-HSV-2 antibodies and correlated it with the demographic and behavioral aspects of the Indigenous population of the Jaguapirú and Bororó villages (Dourados, Mato Grosso do Sul (MS), Brazil). In total, 1360 individuals (>18 years old) were administered serologic tests. The prevalence of anti-HSV-2 IgM was 12.9%, that of anti-HSV-2 IgG was 57.2%, and 8.5% cases tested positive for both HSV-2 IgM and IgG. The prevalence of anti-HSV-2 antibodies was higher in females (59.5%) compared to males (49%), with an OR of 0.64 (0.49-0.83). Anti-HSV-2 antibodies were found in 14.2%, 12.3%, 15.4%, and 14.5% of participants with urinary problems, genital wounds, genital warts, and urethral discharge, respectively. In summary, the seroprevalence of HSV-2 in the Indigenous population was five times higher than that reported in the general adult Brazilian population. Educational level, income level, smoking, condom use, incarceration, illicit drug abuse, the sharing of used needles and syringes without adequate disinfection, homosexual relationships, prostitution, the sexual practices among drug users, and avoidance of contraceptive methods could contribute to the facilitation of HSV-2 transmission in the Indigenous population. Our results may help develop culturally appropriate intervention programs that eliminate health-access barriers and improve the implementation of public health policies aimed at promoting information regarding and preventing, treating, and controlling HSV-2 infection in Brazilian Indigenous populations.
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Affiliation(s)
| | - Livia Melo Villar
- Viral Hepatitis Laboratory, Oswaldo Cruz Foundation, Rio de Janeiro 21040360, Brazil
| | - Julio Croda
- Brazilian Society of Tropical Medicine, Campo Grande 79070900, Brazil
| | | | - Crhistinne Cavalheiro Maymone Gonçalves
- Center for Biological and Health Sciences, Blood Center Sector, Federal University of Mato Grosso do Sul, Campo Grande 79070900, Brazil
- State Department of Health of Mato Grosso do Sul, Campo Grande 79031350, Brazil
| | | | | | - Gabriela Alves Cesar
- Center for Biological and Health Sciences, Blood Center Sector, Federal University of Mato Grosso do Sul, Campo Grande 79070900, Brazil
| | | | - Marco Aurélio Horta
- Biosafety Level 3 Platform (NB3), Oswaldo Cruz Foundation, Rio de Janeiro 21040360, Brazil
| | - Simone Simionatto
- College of Biological and Environmental Sciences, Federal University of Grande Dourados, Dourados 79070900, Brazil
| | - Ana Rita Coimbra Motta-Castro
- Center for Biological and Health Sciences, Blood Center Sector, Federal University of Mato Grosso do Sul, Campo Grande 79070900, Brazil
- Center for Health and Biological Sciences, Oswaldo Cruz Foundation, Rio de Janeiro 79070900, Brazil
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Chinbunchorn T, Thaneerat N, Howell S, Sowaprux T, Phiphatkunarnon P, Lujintanon S, Kaewpoowat Q, Phanuphak P, Phanuphak N, Ramautarsing RA. Assessment of U=U understanding, PrEP awareness, HIV risk behaviours and factors associated with low HIV knowledge among users of Hornet, an online dating application for LGBTQ, in Thailand. Sex Transm Infect 2023; 99:21-29. [PMID: 35260436 DOI: 10.1136/sextrans-2021-055300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/23/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Over 50% of HIV infections in Thailand annually occur among men who have sex with men (MSM) and transgender women who use online applications to meet their sexual partners. We conducted a cross-sectional study assessing undetectable=untransmittable (U=U) understanding, pre-exposure prophylaxis (PrEP) awareness, sexual behaviours and factors associated with HIV knowledge among users of Hornet in Thailand. METHODS From November 2019 to January 2020, a survey was conducted using convenience sampling on Hornet in Thailand. HIV literacy was assessed via 22 questions, and multivariable linear regression was performed. RESULTS 960 responses were assessed; median age was 34 years, the majority were MSM (80.4%), Thai (83.8%), had at least bachelor's degree (74.9%). Regarding the risk profiles, 39.1% reported inconsistent condom use, 15.0% used amphetamine-type stimulants, 56.9% had not taken PrEP in the last six months and 20.5% never had an HIV test. Only 22.8% thought that U=U was completely accurate. Lower HIV knowledge was associated with being from Africa (β -8.13, 95% CI -14.39 to -1.87), age of 25 years or younger (β -2.6, 95% CI -4.37 to -0.82), education less than bachelor's degree (β -2.58, 95% CI -3.98 to -1.19), having more than one sexual partners (β -2.41, 95% CI -4.13 to -0.69), paying three or more people to have intercourse (β -2.5, 95% CI -4.26 to -0.74), not knowing one's HIV status (β -3.56, 95% CI -5.45 to -1.68) and not answering about previous PrEP use (β -4.11, 95% CI -7.86 to -0.36). Higher HIV knowledge was associated with being from Europe (β 2.54, 95% CI 0.46 to 4.61), the Americas (β 3.37, 95% CI 0.44 to 6.30) and previous PrEP use (β 2.37, 95% CI 0.94 to 3.81). CONCLUSION Among Hornet users in Thailand, the U=U message was unclear, and PrEP use was suboptimal. Large HIV knowledge gaps and high-risk behaviours were concerning. Educational campaigns in online spaces are needed to promote awareness and HIV prevention strategies.
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Affiliation(s)
- Tanat Chinbunchorn
- Institute of HIV Research and Innovation (IHRI), Bangkok, Thailand .,Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Natapong Thaneerat
- Institute of HIV Research and Innovation (IHRI), Bangkok, Thailand.,Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
| | | | | | | | - Sita Lujintanon
- Institute of HIV Research and Innovation (IHRI), Bangkok, Thailand
| | - Quanhathai Kaewpoowat
- Faculty of Medicine and Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Parenti ABH, Ignácio MADO, Buesso TS, Almeida MASD, Parada CMGDL, Duarte MTC. Knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. CIENCIA & SAUDE COLETIVA 2023. [DOI: 10.1590/1413-81232023281.09882022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Abstract This article aims to study the knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. Cross-sectional study of 260 women, 81 women who either have sex with women or with men and women (WSW) and 179 women who have sex exclusively with men (WSM). Data were collected in 2019/2020 by means of a form and validated instruments. To study the association between sexual partnership and level of knowledge about Sexually Transmitted Infections and AIDS, multiple Cox regression models were adjusted, producing significant associations of p<0,05. The median percentage of correct answers was lower among WSW when compared to WSM [68% (18-96) vs 75% (14-96); p=0.023]. Having sex with woman [PR=2.36 (1.07-5.21); p=0.033] and less than 11 years of schooling [PR=2.64 (1.12-6.21); p=0.026] were independently associated with low knowledge. WSW had a lower level of knowledge about Sexually Transmitted Infections and AIDS than WSM, and lower education was independently associated with this finding.
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Kareem YO, Dorgbetor CI, Ameyaw EK, Abubakar Z, Adelekan B, Goldson E, Mueller U, Adegboye O. Assessment and associated factors of comprehensive HIV knowledge in an at-risk population: a cross-sectional study from 19,286 young persons in Nigeria. Ther Adv Infect Dis 2023; 10:20499361231163664. [PMID: 37051440 PMCID: PMC10084550 DOI: 10.1177/20499361231163664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/24/2023] [Indexed: 04/07/2023] Open
Abstract
Background: The prevalence of HIV among young people aged 15–19 years in Nigeria is estimated as 3.5%, the highest among West and Central African countries. Comprehensive knowledge of HIV is associated with increased awareness of preventive interventions and a reduction in the spread of HIV. Therefore, this article seeks to assess and determine the associated factors of comprehensive HIV knowledge among youths in Nigeria. Methods: The study used the 2018 Nigerian Demographic Health Survey, a cross-sectional survey that employed a two-stage cluster sampling method. Comprehensive knowledge of HIV was assessed based on five questions. The data were analysed separately for men and women aged 15–24 years. A multivariable log-binomial regression model was used to determine factors associated with comprehensive HIV knowledge. All analysis was performed using Stata 15.0 and adjusted for weighting, clustering and stratification. Results: A total of 15,267 women and 4019 men aged 15–24 years were included in this study. The prevalence of comprehensive knowledge of HIV was higher among women than among men (42.6% versus 33.7%; p < 0.001) and lower among younger ages 15–17 years compared with other ages. The findings revealed that age, ethnicity, wealth, education and exposure to mass media were statistically significant factors associated with comprehensive knowledge of HIV. In addition, religion, place of residence, phone ownership, internet use, currently working and having initiated sex were significant factors among women and modern contraceptive use among men. Conclusion: Key findings from this study imply that public health programmes in Nigeria should focus on providing information on HIV/AIDS using different approaches, including comprehensive sex education as well as health promotion and education strategies in the formal and informal sectors. Because media exposure is a common and cost-effective way of public health promotion and education in modern times, emphasis could also be placed on using this channel to reach the target population.
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Affiliation(s)
| | | | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong
| | | | | | | | | | - Oyelola Adegboye
- Public Health and Tropical Medicine, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Douglas, Queensland 4814, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, 1 James Cook Drive, Douglas, Queensland 4814, Australia
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Parenti ABH, Ignácio MADO, Buesso TS, Almeida MASD, Parada CMGDL, Duarte MTC. Knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. CIENCIA & SAUDE COLETIVA 2023; 28:303. [PMID: 36629574 DOI: 10.1590/1413-81232023281.09882022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/12/2022] [Indexed: 01/10/2023] Open
Abstract
This article aims to study the knowledge of women who have sex with women about Sexually Transmitted Infections and AIDS. Cross-sectional study of 260 women, 81 women who either have sex with women or with men and women (WSW) and 179 women who have sex exclusively with men (WSM). Data were collected in 2019/2020 by means of a form and validated instruments. To study the association between sexual partnership and level of knowledge about Sexually Transmitted Infections and AIDS, multiple Cox regression models were adjusted, producing significant associations of p<0,05. The median percentage of correct answers was lower among WSW when compared to WSM [68% (18-96) vs 75% (14-96); p=0.023]. Having sex with woman [PR=2.36 (1.07-5.21); p=0.033] and less than 11 years of schooling [PR=2.64 (1.12-6.21); p=0.026] were independently associated with low knowledge. WSW had a lower level of knowledge about Sexually Transmitted Infections and AIDS than WSM, and lower education was independently associated with this finding.
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Affiliation(s)
- Ana Beatriz Henrique Parenti
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
| | - Mariana Alice de Oliveira Ignácio
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
| | - Thayná Santos Buesso
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
| | | | - Cristina Maria Garcia de Lima Parada
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
| | - Marli Teresinha Cassamassimo Duarte
- Departamento de Enfermagem, Faculdade de Medicina, Universidade Estadual Paulista (Unesp). Av. Prof. Mário Rubens Guimarães Montenegro s/n, Campus de Botucatu. 18618-687 Botucatu SP Brasil.
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Rotsaert A, Nöstlinger C, Van Landeghem E, Vanbaelen T, Wouters E, Buffel V, Scheerder G, Schim van der Loeff M, Vuylsteke B, Reyniers T. Pre-Exposure Prophylaxis Users' Attitudes About Sexually Transmitted Infections and Its Influence on Condom Use: A Mixed-Method Study in Belgium. AIDS Patient Care STDS 2022; 36:483-492. [PMID: 36484763 DOI: 10.1089/apc.2022.0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Incidence rates of sexually transmitted infections (STIs) are rising among men who have sex with men (MSM). Since the rollout of HIV pre-exposure prophylaxis (PrEP), promoting condom use to prevent the spread of STIs has become more challenging. Using a mixed-method design, we explored MSM PrEP users' attitudes toward STIs, condoms, and condom use with nonsteady partners to prevent STIs. We triangulated data from 22 in-depth interviews conducted at a large HIV/STI clinic between August 2021 and January 2022 and an online survey among 326 PrEP users between September 2020 and January 2022. Interviews were analyzed iteratively using a thematic analysis approach. We used bivariate and multi-variate ordered logistic regression to analyze the online survey data. Themes identified in the qualitative data influencing condom use decisions to prevent STIs were as follows: (1) awareness (i.e., perceived severity of and susceptibility to STIs, condom counseling), (2) motivation (i.e., concerns about STIs, sexual pleasure and protection of own health), and (3) perceived social norms and practices (e.g., reduced condom use at community level). Overall, 10.7% of survey respondents consistently used condoms with nonsteady partners. Survey respondents who reported high or moderate levels of willingness to use condoms to prevent acquiring STIs were significantly more likely to use condoms for anal sex with nonsteady partners; those who initiated PrEP 6-12 months ago were less likely to use condoms. We found a wide variation in attitudes toward condom use for the prevention of STIs among MSM using PrEP. We recommend client-centered approaches, taking into account PrEP users' values and priorities toward STI prevention to help reduce the spread of STIs.
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Affiliation(s)
- Anke Rotsaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Ella Van Landeghem
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thibaut Vanbaelen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Edwin Wouters
- Department of Sociology, University of Antwerp, Antwerp, Belgium
| | - Veerle Buffel
- Department of Sociology, University of Antwerp, Antwerp, Belgium
| | - Gert Scheerder
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Maarten Schim van der Loeff
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Department of Internal Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Institute for Infection and Immunity (AII), Amsterdam, The Netherlands.,Amsterdam Public Health Research Institute (APH), Amsterdam, The Netherlands
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thijs Reyniers
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Geretti AM, Mardh O, de Vries HJC, Winter A, McSorley J, Seguy N, Vuylsteke B, Gokengin D. Sexual transmission of infections across Europe: appraising the present, scoping the future. Sex Transm Infect 2022; 98:sextrans-2022-055455. [PMID: 35537800 DOI: 10.1136/sextrans-2022-055455] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/24/2022] [Indexed: 01/13/2023] Open
Abstract
Objectives: Our journal partnered with the Europe section of the International Union against STI (IUSTI) at a workshop held at the 18th European AIDS Conference in London on 30 October 2021. The workshop reviewed epidemiological trends and discussed STI care provision within HIV services across Europe. Methods and Results: We started by highlighting trends in bacterial STIs reported to the European Centre for Disease Prevention and Control from countries in the European Union/European Economic Area. This showed that notifications of bacterial STIs reached an all-time high in 2019, but are expected to be impacted by the COVID-19 pandemic in 2020-2021. We then reviewed the evolving relationship between STIs and HIV and pointed out how antiretroviral treatment and pre-exposure prophylaxis remain highly effective against HIV transmission despite the rising incidence of STIs. Within emerging concepts in STIs, we appraised the benefits and risks of asymptomatic screening for chlamydia, and also considered the potential perils of routinely testing for agents that lack a defined role in disease. Finally, we discussed standards of STI care for people living with HIV, informed by a brief survey of IUSTI Europe country representatives and members of the Euroguidelines in Central and Eastern Europe network. Conclusions: The survey indicated substantial variability and identified key improvement targets: fighting barriers to effective service provision and access, increasing diagnostic capability and taking leadership in driving up the quality of care. We must not forget the STI-related needs of the many people who will be living with HIV for decades into the future.
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Affiliation(s)
- Anna Maria Geretti
- Dept. of Infectious Diseases, Fondazione PTV and University of Rome Tor Vergata, Rome, Italy
- School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Otilia Mardh
- HIV/STI & Hepatitis, European Centre for Disease Prevention & Control (ECDC), Solna, Sweden
| | - Henry J C de Vries
- Dept. of Dermatology, University of Amsterdam and Public Health Service, Amsterdam, The Netherlands
| | - Andrew Winter
- Sandyford Sexual Health, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - John McSorley
- The Patrick Clements Centre, London North West Healthcare NHS Trust, London, UK
| | - Nicole Seguy
- Regional Office for Europe, World Health Organization (WHO), Copenhagen, Denmark
| | - Bea Vuylsteke
- Dept. of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Deniz Gokengin
- Dept. of Infectious Diseases, Ege University, İzmir, Turkey
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