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Carvalho TMDS, Laurindo PDSDODC, de Araújo DO, Fonseca RRDS, Laurentino RV, Monteiro JC, Feitosa RNM, da Costa FAM, dos Santos LM, Oliveira-Filho AB, Machado LFA. Exposure to Treponema pallidum among Female Sex Workers: A Retrospective Study Conducted in the State of Pará, Brazilian Amazon. Pathogens 2024; 13:559. [PMID: 39057786 PMCID: PMC11279634 DOI: 10.3390/pathogens13070559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/10/2024] [Accepted: 06/14/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Syphilis remains a significant global public health issue, and female sex workers (FSWs) are highly vulnerable to the etiological agent of this disease. This study aimed to describe the prevalence of exposure to Treponema pallidum, as well as the vulnerability factors among FSWs in the state of Pará, Brazilian Amazon. METHODS A cross-sectional, retrospective study involving 360 FSWs from five cities in Pará was conducted from 2005 to 2007. Blood samples were collected for treponemal and non-treponemal testing, and epidemiological information was obtained through interviews. RESULTS The exposure rate to T. pallidum was 37.7% (136/360), and the majority of FSWs had serological results indicating past exposure (21.1%). Among the FSWs exposed to T. pallidum, most of them were single, aged 23 to 42 years old, had less than 8 years of schooling, and had a family income of between 1 and 3 minimum wages. They reported using condoms during sexual intercourse and had no history of sexually transmitted infection (STI). Furthermore, many of the FSWs exposed to T. pallidum reported having more than 20 sexual partners per month, and had partners from other Brazilian states, but not from other countries. An age over 42 years and a reduced level of education were factors associated with exposure to T. pallidum. Finally, a high rate of exposure to T. pallidum among FSWs in the Brazilian state of Pará (from 2005 to 2007) was detected. In later years, epidemiological studies conducted with FSWs recorded that this rate remained high. Measures to control, treat, and prevent syphilis among FSWs were necessary between 2005 and 2007, and they are still imperative today. Actions related to educational programs and STI control, treatment, and prevention measures contained in Brazilian policies aimed at women's health have not changed the vulnerability scenario of FSWs regarding their exposure to T. pallidum, even after 16 years, and must be reviewed and adapted to the conditions of the Brazilian Amazon.
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Affiliation(s)
- Thaís Mayara da Silva Carvalho
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil; (T.M.d.S.C.); (P.d.S.d.O.d.C.L.); (D.O.d.A.)
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Paula do Socorro de Oliveira da Costa Laurindo
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil; (T.M.d.S.C.); (P.d.S.d.O.d.C.L.); (D.O.d.A.)
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Diogo Oliveira de Araújo
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil; (T.M.d.S.C.); (P.d.S.d.O.d.C.L.); (D.O.d.A.)
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Ricardo Roberto de Souza Fonseca
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Rogério Valois Laurentino
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Jacqueline Cortinhas Monteiro
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Rosimar Neris Mantins Feitosa
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
| | - Fernando Augusto Miranda da Costa
- Bacteriology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (F.A.M.d.C.); (L.M.d.S.)
| | - Leonardo Miranda dos Santos
- Bacteriology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (F.A.M.d.C.); (L.M.d.S.)
| | - Aldemir Branco Oliveira-Filho
- Study and Research Group on Vulnerable Populations, Institute for Coastal Studies, Federal University of Pará, Bragança 68600-000, PA, Brazil;
| | - Luiz Fernando Almeida Machado
- Biology of Infectious and Parasitic Agents Post-Graduate Program, Federal University of Pará, Belém 66075-110, PA, Brazil; (T.M.d.S.C.); (P.d.S.d.O.d.C.L.); (D.O.d.A.)
- Virology Laboratory, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, PA, Brazil; (R.R.d.S.F.); (R.V.L.); (J.C.M.); (R.N.M.F.)
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Dah TTE, De Baetselier I, Cuer B, Anoma C, Mensah E, Koné A, Diandé S, Dagnra CA, Faye-Kette HY, Yeo A, Yaya I, Spire B, Keita BD, Crucitti T, Vuylsteke B, Laurent C. Frequent chlamydia and gonorrhoea but very infrequent syphilis among men who have sex with men using HIV pre-exposure prophylaxis in West Africa. Sex Transm Infect 2024; 100:201-207. [PMID: 38604698 DOI: 10.1136/sextrans-2023-056000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/13/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVES Although oral pre-exposure prophylaxis (PrEP) for HIV is being rolled out in West Africa, data on sexually transmitted infections (STIs) in PrEP users are scarce. We assessed the prevalence, incidence and determinants of bacterial STIs in men who have sex with men (MSM) taking PrEP in Burkina Faso, Côte d'Ivoire, Mali and Togo. METHODS A prospective cohort study among MSM initiating PrEP as part of a comprehensive HIV prevention package was conducted between 2017 and 2021 in community-based clinics in the four study countries. Molecular screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) was performed at months 0, 6 and 12. Serological testing for syphilis was performed every 3 months over the first year of follow-up. Determinants of CT and/or NG incidence were identified using Poisson generalised linear mixed models. RESULTS A total of 598 participants with a median age of 24.7 years were included. Prevalence of CT and/or NG was 24.4% (95% CI 21.0 to 28.1), 22.4% (95% CI 18.4 to 26.8) and 29.0% (95% CI 24.2 to 34.1) at months 0, 6 and 12, respectively. The prevalence of syphilis ranged from 0.2% (95% CI 0.0 to 0.9) at month 0 to 0.8% (95% CI 0.2 to 2.4) at month 12. Ninety incident CT and/or NG infections occurred during a total follow-up time of 280.6 person-years (incidence rate 32.1 per 100 person-years, 95% CI 25.8 to 39.4). Three incident syphilis infections were detected during a total follow-up time of 459.7 person-years (incidence rate 0.7 per 100 person-years, 95% CI 0.1 to 1.9). CT and/or NG incidence was associated with condomless insertive anal sex (adjusted incidence rate ratio 1.96, 95% CI 1.04 to 3.71, p=0.038). CONCLUSIONS CT and NG were frequent but syphilis was very infrequent in MSM using HIV PrEP in West Africa. HIV programme managers should integrate STI services into PrEP programmes.
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Affiliation(s)
- Ter Tiero Elias Dah
- Université de Ouahigouya, Ouahigouya, Burkina Faso
- Association African Solidarité, Ouagadougou, Burkina Faso
| | - Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Benjamin Cuer
- TransVIHMI, University of Montpellier, IRD, Inserm, Montpellier, France
| | | | | | - Amadou Koné
- University of Sciences Technics and Technologies, Bamako, Mali
| | - Souba Diandé
- Laboratoire National de Recherche sur la Tuberculose et les Mycobactéries, Ouagadougou, Burkina Faso
| | | | - Hortense Yaobla Faye-Kette
- Département de Bactériologie-Virologie, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Laboratoire Central, CHU Yopougon, Abidjan, Côte d'Ivoire
| | - Alain Yeo
- Institut Pasteur Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Issifou Yaya
- TransVIHMI, University of Montpellier, IRD, Inserm, Montpellier, France
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, ISSPAM Marseille France, Marseille, France
| | | | - Tania Crucitti
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Bea Vuylsteke
- Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Christian Laurent
- TransVIHMI, University of Montpellier, IRD, Inserm, Montpellier, France
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Prevalence of HIV and syphilis and their co-infection among men having sex with men in Asia: A systematic review and meta-analysis. Heliyon 2023; 9:e13947. [PMID: 36895383 PMCID: PMC9988516 DOI: 10.1016/j.heliyon.2023.e13947] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 02/23/2023] Open
Abstract
Background Studies found that the group of men who have sex with men (MSM) is at a very high level of risk of HIV and sexually transmitted infections (STIs) in Asian regions due to multiple reasons. Although the prevalence of HIV among general people in Asia is considered low, the prevalence of HIV and Syphilis among MSM in this region was found very high and usually, it goes unnoticed. This study aimed to inspect the prevalence of and trends in HIV, Syphilis, and their co-infection among MSM in Asia. Methods A systematic search was performed on January 5, 2021, in PubMed, Web of Science, and Google Scholar databases. To evaluate the heterogeneity, Q-tests, and I 2 were used. To explore the publication bias, Eggers' test and funnel plot were used. The random-effect model and subgroup analysis were performed due to the significant heterogeneity. Results A total of 2872 articles were identified, and 66 articles were included in the final analysis. The overall prevalence of HIV and Syphilis among MSM was estimated considering 69 estimates from 66 studies whereas 19 estimates of co-infection were found in 17 studies. The pooled HIV prevalence was 8.48% (CI: 7.01-9.95) and the pooled Syphilis prevalence was 9.86% (CI: 8.30-11.41) with significant heterogeneity and publication bias. The pooled prevalence of HIV and Syphilis co-infection was 2.99% (CI: 1.70-4.27) with significant heterogeneity and no publication bias. The HIV, Syphilis, and HIV-Syphilis co-infection prevalence estimates exhibited an upward trend during 2002-2017. Conclusions HIV, Syphilis, and their co-infection are quite prevalent among MSM in the Asia-Pacific region. Integrated and intensified intervention strategies, HIV testing, and improved access to antiretroviral treatment as well as increased awareness are needed to reduce HIV, Syphilis, and their co-infection among the discussed vulnerable group.
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Barba A, Bati F, Tura JB, Addis B, Abrahim S. Magnitude and Determinants of Syphilis and HIV Co-Infection Among Female Sex Workers in Ethiopia: Evidence from Respondent Driven Samples, 2019-2020. HIV AIDS (Auckl) 2022; 14:473-485. [PMID: 36337317 PMCID: PMC9635310 DOI: 10.2147/hiv.s384213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/08/2022] [Indexed: 11/08/2022] Open
Abstract
Background Female sex workers (FSWs) play an important role in transmitting Human Immunodeficiency Virus (HIV) and syphilis from high-risk groups to the general population. Syphilis and HIV infections are generally more prevalent among FSWs. However, in Ethiopia, up-to-date evidence about Syphilis-HIV co-infections among FSWs was lacking. Objective To determine the magnitude and determinants of Syphilis-HIV co-infection among FSWs in Ethiopia, 2019-2020. Methods A cross-sectional HIV and other sexually transmitted infections Bio-Behavioral Survey (HSBS) was conducted using respondent-driven sampling (RDS) among 6,085 FSWs in Ethiopia from August 2019 to January 2020. Data was collected, merged with laboratory data, and analyzed in R software using the RDS package. The odds ratio was calculated at 95% CI to measure associations between the dependent and independent variables. Variables that yield p<0.25 in univariate analysis were included in multivariate analysis. In multivariate analysis, variables with p<0.05 were declared as statistically significant. Results were presented in frequency tables and charts. Results The prevalence of Syphilis-HIV co-infection among FSWs was 2.9% [95% CI=2.6-3.2]. Age of the FSWs (15-19 years old (AOR=0.03; 95% CI=0.01-0.12)), non-formal educational level (AOR=3.18; 95% CI=1.78-5.68), monthly income <2,500 ETB (AOR=3.05; 95% CI=1.45-6.42), major depression (AOR=1.85; 95% CI=1.18-2.89), forced first sex experience (AOR=1.71; 95% CI=1.2-2.44), condom breakage (AOR=1.62; 95% CI=1.14-2.30), Hepatitis B seropositivity (AOR=2.32; 95% CI=1.10-4.90), and Hepatitis C seropositivity (AOR=5.37; 95% CI=1.70-16.93) were strongly associated with Syphilis-HIV co-infection among FSWs in Ethiopia. Conclusion The prevalence of Syphilis-HIV co-infection among FSWs in Ethiopia was high. To ward off Syphilis-HIV co-infection among FSWs, a special FSWs-targeted HIV and Syphilis/STIs prevention program and treatment approach needs to be devised. An outreach approach to address the sexual and reproductive health needs of FSWs has to be part of the strategy.
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Affiliation(s)
- Ammar Barba
- Director General Office, Ethiopian Public Health Institute, Addis Ababa, Ethiopia,Correspondence: Ammar Barba, Director General Office, Ethiopian Public Health Institute, Addis Ababa, Ethiopia, Tel +251 925 229 205, Email
| | - Fayiso Bati
- Tuberculosis and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Jaleta Bulti Tura
- Tuberculosis and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Beza Addis
- Director General Office, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Saro Abrahim
- Tuberculosis and HIV/AIDS Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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