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Xie N, Hu X, Yan H, Ruan L, Liu C, Hu R, Ma H, Luo Y, Liu L, Wang X. Effects of Case Management on Risky Sexual Behaviors and Syphilis Among HIV-Infected Men Who Have Sex With Men in China: A Randomized Controlled Study. Sex Transm Dis 2022; 49:22-28. [PMID: 34192724 PMCID: PMC8663520 DOI: 10.1097/olq.0000000000001502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/07/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The prevalence of syphilis is very high in human immunodeficiency virus (HIV)-positive men who have sex with men (MSM), and effective interventions are needed to educate HIV-positive individuals about behavioral and biological risk factors. Therefore, we developed a standard case management process and conducted a randomized controlled study to investigate the impact on risky sexual behaviors and syphilis in HIV-positive MSM. METHODS Men who have sex with men (n = 220) were enrolled and randomized to the case management intervention group and the control group between May 2016 and January 2017. The control group received routine HIV-related care. In addition to routine HIV-related care, those in the intervention group regularly received extended services from a well-trained case manager. Epidemiological information was collected during the baseline face-to-face interviews by a trained investigator. Serological tests for syphilis and assessments of risky sexual behaviors were performed at baseline and 6 and 12 months after the initiation of treatment. RESULTS The syphilis incidence rates in the intervention and control groups were 11.3 per 100 person-years and 20.6 per 100 person-years, respectively. The multivariable-adjusted hazard ratio (95% confidence inter) for syphilis in case management group was 0.34 (0.14-0.87). The percentages of participants who resumed risky sexual behaviors in both groups were significantly reduced (P < 0.05) but did not significantly differ between the 2 groups. CONCLUSIONS A case management intervention reduced the incidence of syphilis in HIV-positive MSM. We should further increase the content of case management on the basis of providing routine HIV-related care to those people.
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Affiliation(s)
- Nianhua Xie
- From the Department of HIV/AIDS Prevention and Control, Wuhan Center for Disease Control and Prevention
| | - Xuejiao Hu
- From the Department of HIV/AIDS Prevention and Control, Wuhan Center for Disease Control and Prevention
| | - Han Yan
- From the Department of HIV/AIDS Prevention and Control, Wuhan Center for Disease Control and Prevention
| | - Lianguo Ruan
- Department of Infectious Diseases, Wuhan Jin Yin-tan Hospital, Wuhan, Hubei, China
| | - Cong Liu
- From the Department of HIV/AIDS Prevention and Control, Wuhan Center for Disease Control and Prevention
| | - Rong Hu
- From the Department of HIV/AIDS Prevention and Control, Wuhan Center for Disease Control and Prevention
| | - Hongfei Ma
- From the Department of HIV/AIDS Prevention and Control, Wuhan Center for Disease Control and Prevention
| | - Yanhe Luo
- Department of Infectious Diseases, Wuhan Jin Yin-tan Hospital, Wuhan, Hubei, China
| | - Li Liu
- Department of Infectious Diseases, Wuhan Jin Yin-tan Hospital, Wuhan, Hubei, China
| | - Xia Wang
- From the Department of HIV/AIDS Prevention and Control, Wuhan Center for Disease Control and Prevention
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Edwards RJ, John I, Todd S, Lavia LO, Musa D, Edwards J, Boyce G. Syphilis among men who have sex with men attending a large HIV clinic in Trinidad. Int J STD AIDS 2021; 32:830-836. [PMID: 33890834 DOI: 10.1177/0956462421997193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A chart review study was conducted to determine the prevalence of syphilis and explore the associated risk factors among men who have sex with men (MSM) who attended a large HIV clinic in Trinidad during the period January-December 2019. Patients were routinely screened for syphilis annually, and demographic, clinical, and laboratory data were extracted from the medical records. Descriptive and bivariate analyses were performed, and factors significantly associated with a syphilis diagnosis were assessed using multivariate logistic regression. During the period, 218 MSM were seen, age range 19-67 years, and median age 34.0 years. The prevalence of syphilis was 41.3% (90/218), and 71.1% (64//90) of these infections were asymptomatic. Multivariate analysis using logistic regression showed that MSM living with HIV in the 30-34 years old-age group (OR, 4.32; 95% CI, 1.04-18.02), and those with a previous history of treated syphilis (OR, 10.18; 95% CI, 4.60-22.53) were more likely to be diagnosed with syphilis. The prevalence of syphilis is high among MSM attending the HIV clinic in Trinidad, and most of these infections were asymptomatic; hence, targeted and sustained interventions to reduce syphilis transmission are urgently required. Repeat episodes of syphilis may play a role in the transmission dynamics of syphilis in MSM.
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Affiliation(s)
- Robert Jeffrey Edwards
- 199168Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad
- Department of Paraclinical Sciences, University of the West Indies, St Augustine, Trinidad
| | - Isshad John
- 199168Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad
| | - Selena Todd
- 199168Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad
| | - Leon-Omari Lavia
- 199168Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad
| | - David Musa
- 199168Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad
| | - Jonathan Edwards
- 199168Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad
| | - Gregory Boyce
- 199168Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad
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Huang S, Tang W, Zhu Z, Lu H, Tan X, Zhang B, Best J, Yang L, Zheng H, Jiang N, Yin Y, Yang B, Chen X. Higher prevalence of sexual transmitted diseases and correlates of genital warts among heterosexual males attending sexually transmitted infection clinics (MSCs) in Jiangmen, China: implication for the up-taking of STD related service. PLoS One 2015; 10:e0121814. [PMID: 25811185 PMCID: PMC4374714 DOI: 10.1371/journal.pone.0121814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 02/04/2015] [Indexed: 01/28/2023] Open
Abstract
Background Increasing burden of STDs is one of China’s major public health concerns. However, only a limited number of studies have ever investigated the prevalence of these STDs, particular for genital warts and its correlates among heterosexual males attending STD clinics in China. In order to fill this gap, we conducted a cross-sectional study among MSCs in Jiangmen, China, between the years of 2009 and 2010. Method The eligible participants were recruited from several STD-clinics in public hospitals. We collected demographic information and behaviors of the participants. After HIV and syphilis testing, we further checked whether the participants had genital warts and genital herpes. In addition, urine samples were collected from part of the participants for CT and NG testing. Results Of the 533 eligible participants, over three-fifths were aged 35 or below, nearly three quarters had no college degree, over three-fifths were residence of Jiangmen. The prevalence of HIV, syphilis, genital warts, genital herpes, CT and NG were 0.19%, 7.50%, 7.32%, 5.25%, 9.73% and 6.19%, respectively. Living with family members (versus living alone), no STD-related service in past year, experiencing STDs related symptoms in past year, and sex with FSWs in last three months were positively associated with genital warts, with adjusted ORs of 5.54 (95% CI 1.94–15.81), 2.26 (95% CI 1.08–4.74), 1.99 (95% CI 1.00–3.99) and 2.01 (95% CI 1.00–4.04), respectively. Conclusion Our study indicates that the prevalence of STDs among MSCs in Jiangmen was high, which may further spread HIV among MSCs. Targeted interventions that focused on STDs related services uptake should be implemented urgently.
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Affiliation(s)
- Shujie Huang
- Guangdong Provincial Center for Skin Diseases and STI Control, No. 2 Lujing Road, Guangzhou, 510095, China
| | - Weiming Tang
- Guangdong Provincial Center for Skin Diseases and STI Control, No. 2 Lujing Road, Guangzhou, 510095, China
- University of North Carolina Project-China, No. 2 Lujing Road, Guangzhou, 510095, China
| | - Zhengjun Zhu
- Jiangmen Dermatology Hospital, No. 62 Yuejin Road, Jiangmen, 529000, China
| | - Hekun Lu
- Jiangmen Dermatology Hospital, No. 62 Yuejin Road, Jiangmen, 529000, China
| | - Xueling Tan
- Jiangmen Dermatology Hospital, No. 62 Yuejin Road, Jiangmen, 529000, China
| | - Baoyuan Zhang
- Jiangmen Dermatology Hospital, No. 62 Yuejin Road, Jiangmen, 529000, China
| | - John Best
- Department of Medicine, Medical School, University of California San Francisco, San Francisco, CA, 94143, United States of America
| | - Ligang Yang
- Guangdong Provincial Center for Skin Diseases and STI Control, No. 2 Lujing Road, Guangzhou, 510095, China
| | - Heping Zheng
- Guangdong Provincial Center for Skin Diseases and STI Control, No. 2 Lujing Road, Guangzhou, 510095, China
| | - Ning Jiang
- National Center for STD Control, China CDC. No. 12, Jiangwangmiao, Nanjing, Jiangsu, 210000, China
| | - Yueping Yin
- National Center for STD Control, China CDC. No. 12, Jiangwangmiao, Nanjing, Jiangsu, 210000, China
| | - Bin Yang
- Guangdong Provincial Center for Skin Diseases and STI Control, No. 2 Lujing Road, Guangzhou, 510095, China
- * E-mail: (BY); (XC)
| | - Xiangsheng Chen
- National Center for STD Control, China CDC. No. 12, Jiangwangmiao, Nanjing, Jiangsu, 210000, China
- * E-mail: (BY); (XC)
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