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van Wees D, Coyer L, van den Elshout M, de Coul EO, van Aar F. The Best Predictor of Future Behavior May Be the Past: Exploring Behavior Change in Men Who Have Sex with Men Using Pre-exposure Prophylaxis in the Netherlands. Arch Sex Behav 2024:10.1007/s10508-024-02863-z. [PMID: 38709341 DOI: 10.1007/s10508-024-02863-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/01/2024] [Accepted: 03/26/2024] [Indexed: 05/07/2024]
Abstract
Pre-exposure prophylaxis (PrEP) use prevents HIV transmission, and may lead to changes in sexual behavior. We aimed to explore sexual behavior over time, and identify predictors of behavior change in men who have sex with men (MSM) using PrEP at sexual health centers (SHC) in the Netherlands. We used longitudinal data from the national STI surveillance database (January 2018-June 2021) of HIV-negative MSM who first initiated PrEP in the national PrEP pilot. We modelled behavior change after PrEP initiation, and identified predictors of behavior change using multi-state Markov models. The probability of stopping group sex, chemsex, use of poppers or erection stimulants, and having ≥ 10 partners in the past 6 months among included MSM (n = 4,349, n SHC visits = 21,820) was higher compared to the probability of starting with these behaviors after PrEP initiation. However, MSM who used condoms consistently during anal sex had a high probability of changing to inconsistent condom use (0.8) at the next visit, and inconsistent condom users mostly remained inconsistent (0.8). First visit, visiting the SHC more often (vs. regular), and STI diagnosis were predictors of starting or continuing with most of the behaviors associated with increased risk. Behavior change was less likely among older participants (> 34 compared to ≤ 34 years), and during COVID-19 lockdown and post-lockdown periods compared to pre-COVID-19. Although condom use decreased over time, transitions towards stopping with other behaviors associated with increased likelihood of acquiring an STI after PrEP initiation were common. This may suggest increased sexual empowerment, especially among younger MSM. Predictors of behavior change may help to identify MSM who are likely to start with or continue to engage in these behaviors in the near future and to provide suitable and timely counselling about behavior and PrEP adherence.
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Affiliation(s)
- Daphne van Wees
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O Box 1, 3720 BA, Bilthoven, The Netherlands.
| | - Liza Coyer
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Mark van den Elshout
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands
- Municipal Health Service for the Utrecht Region, Utrecht, The Netherlands
| | - Eline Op de Coul
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O Box 1, 3720 BA, Bilthoven, The Netherlands
| | - Fleur van Aar
- Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O Box 1, 3720 BA, Bilthoven, The Netherlands
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Thomadakis C, Gountas I, Duffell E, Gountas K, Bluemel B, Seyler T, Pericoli FM, Kászoni-Rückerl I, El-Khatib Z, Busch M, Schmutterer I, Vanwolleghem T, Klamer S, Plettinckx E, Mortgat L, Van Beckhoven D, Varleva T, Kosanovic Licina ML, Nemeth Blazic T, Nonković D, Theophanous F, Nemecek V, Maly M, Christensen PB, Cowan S, Rüütel K, Brummer-Korvenkontio H, Brouard C, Steffen G, Krings A, Dudareva S, Zimmermann R, Nikolopoulou G, Molnár Z, Kozma E, Gottfredsson M, Murphy N, Kondili LA, Tosti ME, Ciccaglione AR, Suligoi B, Nikiforova R, Putnina R, Jancoriene L, Seguin-Devaux C, Melillo T, Boyd A, van der Valk M, Op de Coul E, Whittaker R, Kløvstad H, Stępień M, Rosińska M, Valente C, Marinho RT, Popovici O, Avdičová M, Kerlik J, Klavs I, Maticic M, Diaz A, del Amo J, Lundberg Ederth J, Axelsson M, Nikolopoulos G. Prevalence of chronic HCV infection in EU/EEA countries in 2019 using multiparameter evidence synthesis. Lancet Reg Health Eur 2024; 36:100792. [PMID: 38188273 PMCID: PMC10769889 DOI: 10.1016/j.lanepe.2023.100792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 01/09/2024]
Abstract
Background Epidemiological data are crucial to monitoring progress towards the 2030 Hepatitis C Virus (HCV) elimination targets. Our aim was to estimate the prevalence of chronic HCV infection (cHCV) in the European Union (EU)/European Economic Area (EEA) countries in 2019. Methods Multi-parameter evidence synthesis (MPES) was used to produce national estimates of cHCV defined as: π = πrecρrec + πexρex + πnonρnon; πrec, πex, and πnon represent cHCV prevalence among recent people who inject drugs (PWID), ex-PWID, and non-PWID, respectively, while ρrec, ρex, and ρnon represent the proportions of these groups in the population. Information sources included the European Centre for Disease Prevention and Control (ECDC) national operational contact points (NCPs) and prevalence database, the European Monitoring Centre for Drugs and Drug Addiction databases, and the published literature. Findings The cHCV prevalence in 29 of 30 EU/EEA countries in 2019 was 0.50% [95% Credible Interval (CrI): 0.46%, 0.55%]. The highest cHCV prevalence was observed in the eastern EU/EEA (0.88%; 95% CrI: 0.81%, 0.94%). At least 35.76% (95% CrI: 33.07%, 38.60%) of the overall cHCV prevalence in EU/EEA countries was associated with injecting drugs. Interpretation Using MPES and collaborating with ECDC NCPs, we estimated the prevalence of cHCV in the EU/EEA to be low. Some areas experience higher cHCV prevalence while a third of prevalent cHCV infections was attributed to PWID. Further efforts are needed to scale up prevention measures and the diagnosis and treatment of infected individuals, especially in the east of the EU/EEA and among PWID. Funding ECDC.
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Affiliation(s)
| | - Ilias Gountas
- Medical School, University of Cyprus, Nicosia, Cyprus
| | - Erika Duffell
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | | | - Benjamin Bluemel
- European Centre for Disease Prevention and Control, Stockholm, Sweden
| | - Thomas Seyler
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | | | - Irene Kászoni-Rückerl
- VII/A/11 Communicable Diseases and Disease Control, Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Vienna, Austria
| | - Ziad El-Khatib
- Institute for Surveillance & Infectious Disease Epidemiology, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Martin Busch
- Addiction Competence Center, Austrian National Public Health Institute, Vienna, Austria
| | - Irene Schmutterer
- Addiction Competence Center, Austrian National Public Health Institute, Vienna, Austria
| | - Thomas Vanwolleghem
- Viral Hepatitis Research Group, Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium
- Department of Gastroenterology and Hepatology, University Hospital Antwerp, Antwerp, Belgium
| | - Sofieke Klamer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Els Plettinckx
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Laure Mortgat
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | | | - Tonka Varleva
- Scientific Research Institute, Medical University, Pleven, Bulgaria
| | | | - Tatjana Nemeth Blazic
- Department for HIV, Sexual and Blood Transmitted Diseases, Reference Center of the Epidemiology of the Ministry of Health, Croatian Institute of Public Health, Zagreb, Croatia
| | - Diana Nonković
- Teaching Institute of Public Health Split and Dalmatia County, Split, Croatia
- Department of Health Studies, University of Split, Split, Croatia
| | | | - Vratislav Nemecek
- National Reference Laboratory for Viral Hepatitis, National Institute of Public Health, Prague, Czech Republic
| | - Marek Maly
- Department of Biostatistics, National Institute of Public Health, Prague, Czech Republic
| | - Peer Brehm Christensen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Susan Cowan
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Kristi Rüütel
- National Institute of Health Development, Tallinn, Estonia
| | | | - Cécile Brouard
- Santé Publique France, The National Public Health Agency, Saint-Maurice, France
| | - Gyde Steffen
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Amrei Krings
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Sandra Dudareva
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Ruth Zimmermann
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | | | - Zsuzsanna Molnár
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Emese Kozma
- National Center for Public Health and Pharmacy, Budapest, Hungary
| | - Magnús Gottfredsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavík, Iceland
- Landspitali University Hospital, Reykjavík, Iceland
| | - Niamh Murphy
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | - Loreta A. Kondili
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
- UniCamillus-Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Maria Elena Tosti
- National Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
| | - Anna Rita Ciccaglione
- Viral Hepatitis, Oncovirus and Retrovirus Disease Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Barbara Suligoi
- National AIDS Unit, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - Renate Putnina
- The Centre for Disease Prevention and Control, Riga, Latvia
| | - Ligita Jancoriene
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Carole Seguin-Devaux
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Tanya Melillo
- Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Department of Health Regulation, Ministry for Health, Gwardamangia, Malta
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- stichting hiv monitoring, Amsterdam, the Netherlands
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Marc van der Valk
- stichting hiv monitoring, Amsterdam, the Netherlands
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Eline Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Robert Whittaker
- Section for Respiratory, Blood-borne and Sexually Transmitted Infections, Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Hilde Kløvstad
- Section for Respiratory, Blood-borne and Sexually Transmitted Infections, Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Małgorzata Stępień
- Department of Infectious Disease Epidemiology and Surveillance, National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Magdalena Rosińska
- Department of Infectious Disease Epidemiology and Surveillance, National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Cristina Valente
- Department of Infectious Diseases, Hospitais da Universidade de Coimbra, Directorate General of Health, Coimbra, Portugal
| | - Rui Tato Marinho
- Centro Hospitalar Universitário Lisboa Norte, Medical School of Lisbon, Directorate General of Health, Ministry of Health, Lisbon, Portugal
| | - Odette Popovici
- National Centre for Surveillance and Control of Communicable Diseases, National Institute of Public Health Romania, Bucharest, Romania
| | - Mária Avdičová
- Department of Epidemiology, Regional Authority of Public Health in Banská Bystrica, Banská Bystrica, Slovakia
| | - Jana Kerlik
- Department of Epidemiology, Regional Authority of Public Health in Banská Bystrica, Banská Bystrica, Slovakia
| | - Irena Klavs
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mojca Maticic
- Clinic for Infectious Diseases, University Medical Centre Ljubljana and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Asuncion Diaz
- National Centre of Epidemiology, Carlos III Health Institute, CIBER in Infectious Diseases (CIBERINFEC), Madrid, Spain
| | - Julia del Amo
- Division for HIV, STI, Viral Hepatitis and Tuberculosis Control, Ministry of Health, Madrid, Spain
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Uusküla A, Rannap J, Weijler L, Abagiu A, Arendt V, Barrio G, Barros H, Brummer-Korvenkontio H, Casabona J, Croes E, Jarlais DD, Seguin-Devaux C, Dudás M, Eritsyan K, Folch C, Hatzakis A, Heimer R, Heinsbroek E, Hope V, Jipa R, Ķīvīte-Urtāne A, Levina O, Lyubimova A, Malczewski A, Matser A, McAuley A, Meireles P, Mravčík V, Op de Coul E, Ojavee SE, Parés-Badell O, Prins M, Pulido J, Romanyak E, Rosinska M, Seyler T, Stone J, Sypsa V, Talu A, Tarján A, Taylor A, Vickerman P, Vorobjov S, Dolan K, Wiessing L. Incarceration history is associated with HIV infection among community-recruited people who inject drugs in Europe: A propensity-score matched analysis of cross-sectional studies. Addiction 2023; 118:2177-2192. [PMID: 37991429 DOI: 10.1111/add.16283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 05/22/2023] [Indexed: 11/23/2023]
Abstract
AIMS We measured the association between a history of incarceration and HIV positivity among people who inject drugs (PWID) across Europe. DESIGN, SETTING AND PARTICIPANTS This was a cross-sectional, multi-site, multi-year propensity-score matched analysis conducted in Europe. Participants comprised community-recruited PWID who reported a recent injection (within the last 12 months). MEASUREMENTS Data on incarceration history, demographics, substance use, sexual behavior and harm reduction service use originated from cross-sectional studies among PWID in Europe. Our primary outcome was HIV status. Generalized linear mixed models and propensity-score matching were used to compare HIV status between ever- and never-incarcerated PWID. FINDINGS Among 43 807 PWID from 82 studies surveyed (in 22 sites and 13 countries), 58.7% reported having ever been in prison and 7.16% (n = 3099) tested HIV-positive. Incarceration was associated with 30% higher odds of HIV infection [adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.09-1.59]; the association between a history of incarceration and HIV infection was strongest among PWID, with the lowest estimated propensity-score for having a history of incarceration (aOR = 1.78, 95% CI = 1.47-2.16). Additionally, mainly injecting cocaine and/or opioids (aOR = 2.16, 95% CI = 1.33-3.53), increased duration of injecting drugs (per 8 years aOR = 1.31, 95% CI = 1.16-1.48), ever sharing needles/syringes (aOR = 1.91, 95% CI = 1.59-2.28) and increased income inequality among the general population (measured by the Gini index, aOR = 1.34, 95% CI = 1.18-1.51) were associated with a higher odds of HIV infection. Older age (per 8 years aOR = 0.84, 95% CI = 0.76-0.94), male sex (aOR = 0.77, 95% CI = 0.65-0.91) and reporting pharmacies as the main source of clean syringes (aOR = 0.72, 95% CI = 0.59-0.88) were associated with lower odds of HIV positivity. CONCLUSIONS A history of incarceration appears to be independently associated with HIV infection among people who inject drugs (PWID) in Europe, with a stronger effect among PWID with lower probability of incarceration.
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Affiliation(s)
- Anneli Uusküla
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Jürgen Rannap
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Lisa Weijler
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - Adrian Abagiu
- National Institute for Infectious diseases 'Professor Dr Matei Bals', Bucharest, Romania
| | - Vic Arendt
- Service National des Maladies Infectieuses, Centre Hospitalier de Luxembourg, Luxembourg
| | - Gregorio Barrio
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
| | - Henrique Barros
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | | | - Jordi Casabona
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalonia Public Health Agency (ASPCAT), Badalona, Spain
- Biomedical Research Networking Centre in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Don Des Jarlais
- School of Global Public Health, New York University, New York, NY, 10012, USA
| | - Carole Seguin-Devaux
- Department of Infection and Immunity, Luxembourg Institute of Health, Luxembourg
| | - Mária Dudás
- National Public Health Center, Budapest, Hungary
| | - Ksenia Eritsyan
- National Research University Higher School of Economics, St Petersburg, Russia
| | - Cinta Folch
- Centre for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS of Catalonia (CEEISCAT), Catalonia Public Health Agency (ASPCAT), Badalona, Spain
- Biomedical Research Networking Centre in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Robert Heimer
- Department of the Epidemiology of Microbial Diseases, Center for Interdisciplinary Research on AIDS, Yale School of Public Health, New Haven, CT, USA
| | - Ellen Heinsbroek
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, London, UK
| | - Vivian Hope
- Blood Safety, Hepatitis, STI & HIV Division, UK Health Security Agency, London, UK
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Raluca Jipa
- National Institute for Infectious diseases 'Professor Dr Matei Bals', Bucharest, Romania
| | | | - Olga Levina
- National Research University Higher School of Economics, St Petersburg, Russia
- Acuity Systems, Herndon, VA, USA
| | - Alexandra Lyubimova
- National Research University Higher School of Economics, St Petersburg, Russia
| | - Artur Malczewski
- EMCDDA Polish National Focal Point, National Bureau for Drug Prevention, Warsaw, Poland
| | - Amy Matser
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Infectious Diseases, Amsterdam Infection andd Immunity Institute, Amsterdam, the Netherlands
| | - Andrew McAuley
- Public Health Scotland, Meridian Court, Glasgow, Scotland, UK
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Paula Meireles
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - Viktor Mravčík
- Department of Addictology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Společnost Podané ruce, Brno, Czech Republic
- Klinika Podané ruce, Brno, Czech Republic
| | - Eline Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Sven E Ojavee
- Department of Computational Biology, University of Lausanne, Lausanne, Switzerland
| | | | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Infectious Diseases, Amsterdam Infection andd Immunity Institute, Amsterdam, the Netherlands
| | - José Pulido
- National School of Public Health, Carlos III Health Institute, Madrid, Spain
- Biomedical Research Networking Centre in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain
| | | | - Magdalena Rosinska
- Department of Infectious Diseases Epidemiology and Surveillance, National Institute of Public Health NIH, National Research Institute, Warsaw, Poland
| | - Thomas Seyler
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - Jack Stone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Ave Talu
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Anna Tarján
- Hungarian Reitox National Focal Point, Budapest, Hungary
| | - Avril Taylor
- Emeritus Professor of Public Health, School of Education and Social Sciences, University of West Scotland, Paisley, Scotland, UK
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sigrid Vorobjov
- Department of Drug and Infectious Diseases Epidemiology, National Institute for Health Development, Tallinn, Estonia
| | - Kate Dolan
- National Drug and Alcohol Research Centre, the University of New South Wales, Sydney, NSW, Australia
| | - Lucas Wiessing
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
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Xiridou M, Miura F, Adam P, Op de Coul E, de Wit J, Wallinga J. The fading of the mpox outbreak among men who have sex with men: a mathematical modelling study. J Infect Dis 2023:jiad414. [PMID: 37740556 DOI: 10.1093/infdis/jiad414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/28/2023] [Accepted: 09/20/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND In the Netherlands, the number of mpox cases started declining before mpox vaccination was initiated. Most cases were men who have sex with men (MSM). We investigated whether the decline in mpox could be attributed to infection-induced immunity or behavioural adaptations. METHODS We developed a transmission model and accounted for possible behavioural adaptations: less casual partners and shorter time until MSM with mpox refrain from sexual contacts. RESULTS Without behavioural adaptations, the peak in modelled cases matched observations, but the decline was less steep than observed. With behavioural adaptations in the model, we found a decline of 16-18% in numbers of casual partners in June and 13-22% in July 2022. Model results showed a halving of the time before refraining from sex. When mpox vaccination started, 57% of MSM with very high sexual activity in the model had been infected. Model scenarios revealed that the outbreak could have waned by November 2022 even without vaccination. CONCLUSIONS The limited duration of the mpox outbreak in the Netherlands can be ascribed primarily to infection-induced immunity among MSM with high sexual activity levels. The decline was accelerated by behavioural adaptations. Immunity among those most sexually active is essential to impede mpox resurgence.
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Affiliation(s)
- Maria Xiridou
- Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
| | - Fuminari Miura
- Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
- Center for Marine Environmental Studies, Ehime University, Ehime, Japan
| | - Philippe Adam
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
- Institute for Prevention and Social Research, Utrecht, the Netherlands
| | - Eline Op de Coul
- Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
| | - John de Wit
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
- Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands
| | - Jacco Wallinga
- Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center (LUMC), Leiden, the Netherlands
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Kandil C, Hugtenburg J, Heijman T, Bos H, Teichert M, Finkenflügel R, de Coul EO. Availability and accessibility of HIV self-tests and self-sample kits at community pharmacies in the Netherlands. AIDS Res Ther 2023; 20:39. [PMID: 37349835 PMCID: PMC10288660 DOI: 10.1186/s12981-023-00529-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND In 2016 the WHO declared HIV self-testing and self-sampling an effective and safe test option that can reduce testing barriers. HIV self-tests and self-sampling kits (HIVST/HIVSS) are available for purchase at Dutch community pharmacies since 2019. We investigated the availability and accessibility of HIVST/HIVSS in community pharmacies, and factors associated with test availability. METHODS An online survey among all Dutch community pharmacies (n = 1,987) was conducted between April and June 2021. Availability of HIVST/HIVSS and experiences of pharmacists with the test offer were analyzed with descriptive statistics. The association of pharmacy and pharmacists' characteristics with HIVST/HIVSS availability was explored by logistic regression analysis. RESULTS In total, 465 pharmacists completed the questionnaire. Of the responding pharmacists, 6.2% (n = 29) offered HIVST/HIVSS. The majority (82.8%) sold between 0 and 20 tests per year. In total, pharmacies sold an estimated 370 HIVST/HIVSS per year. Pharmacies having HIVST/HIVSS available were less often located in moderately-urbanized to rural neighborhoods (OR 0.35, 95%CI 0.16-0.77 versus highly-urbanized), and were less often located in moderate-to-low SES neighborhoods (OR 0.40, 95%CI 0.18-0.88 versus high-SES). Reasons for not offering HIVST/HIVSS by pharmacists were no or little demand (69.3%), and not being familiar with these tests (17.4%). 52% of the pharmacists provided information about testing to test buyers. Reported options to improve the test offer were giving advice about (performing) the test to test buyers (72.4%), placing tests visible on the counter (51.7%), and advertisement (37.9%). CONCLUSION HIVST/HIVSS have a limited practical availability in Dutch community pharmacies since their introduction in 2019, especially in lower-urbanized and lower-SES areas. Further research is needed to explore how to expand access to HIVST/HIVSS through community pharmacies in the Netherlands, and how to tailor it to the needs of pharmacy clients.
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Affiliation(s)
- Chaima Kandil
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, P.O. Box 1, Bilthoven, 3720 BA, the Netherlands
| | | | - Titia Heijman
- Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - Hanna Bos
- STI Aids Netherlands, Amsterdam, the Netherlands
| | - Martina Teichert
- Royal Dutch Pharmacists Association (KNMP), the Hague, the Netherlands
- Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Renee Finkenflügel
- Dutch Association of People with HIV (the HIV vereniging), Amsterdam, the Netherlands
| | - Eline Op de Coul
- National Institute for Public Health and the Environment, Center for Infectious Disease Control, P.O. Box 1, Bilthoven, 3720 BA, the Netherlands.
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van Ewijk CE, Miura F, van Rijckevorsel G, de Vries HJ, Welkers MR, van den Berg OE, Friesema IH, van den Berg PR, Dalhuisen T, Wallinga J, Brandwagt D, van Cleef BA, Vennema H, Voordouw B, Koopmans M, van der Eijk AA, Swaan CM, Te Wierik MJ, Leenstra T, Op de Coul E, Franz E. Mpox outbreak in the Netherlands, 2022: public health response, characteristics of the first 1,000 cases and protection of the first-generation smallpox vaccine. Euro Surveill 2023; 28. [PMID: 36951783 PMCID: PMC10037659 DOI: 10.2807/1560-7917.es.2023.28.12.2200772] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
In early May 2022, a global outbreak of mpox started among persons without travel history to regions known to be enzootic for monkeypox virus (MPXV). On 8 August 2022, the Netherlands reported its 1,000th mpox case, representing a cumulative incidence of 55 per million population, one of the highest cumulative incidences worldwide. We describe characteristics of the first 1,000 mpox cases in the Netherlands, reported between 20 May and 8 August 2022, within the context of the public health response. These cases were predominantly men who have sex with men aged 31-45 years. The vast majority of infections were acquired through sexual contact with casual partners in private or recreational settings including LGBTQIA+ venues in the Netherlands. This indicates that, although some larger upsurges occurred from point-source and/or travel-related events, the outbreak was mainly characterised by sustained transmission within the Netherlands. In addition, we estimated the protective effect of first-generation smallpox vaccine against moderate/severe mpox and found a vaccine effectiveness of 58% (95% CI: 17-78%), suggesting moderate protection against moderate/severe mpox symptoms on top of any possible protection by this vaccine against MPXV infection and disease. Communication with and supporting the at-risk population in following mitigation measures remains essential.
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Affiliation(s)
- Catharina E van Ewijk
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Fuminari Miura
- Centre for Marine Environmental Studies, Ehime University, Matsuyama, Japan
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Gini van Rijckevorsel
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Henry Jc de Vries
- Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands
- Centre for Sexual Health, Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Institute for Infection and Immunology, Infectious Diseases, Amsterdam, the Netherlands
- Amsterdam UMC location University of Amsterdam, Department of Dermatology, Amsterdam, the Netherlands
| | - Matthijs Ra Welkers
- Amsterdam UMC location AMC, University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - Oda E van den Berg
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Ingrid Hm Friesema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Patrick R van den Berg
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Thomas Dalhuisen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Jacco Wallinga
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Diederik Brandwagt
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Brigitte Agl van Cleef
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Harry Vennema
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Bettie Voordouw
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Marion Koopmans
- Department of Viroscience, Erasmus Medical Centre, Rotterdam, the Netherlands
| | | | - Corien M Swaan
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Margreet Jm Te Wierik
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Tjalling Leenstra
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Eline Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Eelco Franz
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
- Department of Viroscience, Erasmus Medical Centre, Rotterdam, the Netherlands
- Amsterdam UMC location AMC, University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Amsterdam, the Netherlands
- Centre for Marine Environmental Studies, Ehime University, Matsuyama, Japan
- Amsterdam Institute for Infection and Immunology, Infectious Diseases, Amsterdam, the Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands
- Centre for Sexual Health, Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC location University of Amsterdam, Department of Dermatology, Amsterdam, the Netherlands
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Wang H, Daas CD, de Coul EO, Jonas KJ. MSM with HIV: Improving prevalence and risk estimates by a Bayesian small area estimation modelling approach for public health service areas in the Netherlands. Spat Spatiotemporal Epidemiol 2023. [DOI: 10.1016/j.sste.2023.100577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Blenkinsop A, Monod M, Sighem AV, Pantazis N, Bezemer D, Op de Coul E, van de Laar T, Fraser C, Prins M, Reiss P, de Bree GJ, Ratmann O. Estimating the potential to prevent locally acquired HIV infections in a UNAIDS Fast-Track City, Amsterdam. eLife 2022; 11:76487. [PMID: 35920649 PMCID: PMC9545569 DOI: 10.7554/elife.76487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background: More than 300 cities including the city of Amsterdam in the Netherlands have joined the UNAIDS Fast-Track Cities initiative, committing to accelerate their HIV response and end the AIDS epidemic in cities by 2030. To support this commitment, we aimed to estimate the number and proportion of Amsterdam HIV infections that originated within the city, from Amsterdam residents. We also aimed to estimate the proportion of recent HIV infections during the 5-year period 2014–2018 in Amsterdam that remained undiagnosed. Methods: We located diagnosed HIV infections in Amsterdam using postcode data (PC4) at time of registration in the ATHENA observational HIV cohort, and used HIV sequence data to reconstruct phylogeographically distinct, partially observed Amsterdam transmission chains. Individual-level infection times were estimated from biomarker data, and used to date the phylogenetically observed transmission chains as well as to estimate undiagnosed proportions among recent infections. A Bayesian Negative Binomial branching process model was used to estimate the number, size, and growth of the unobserved Amsterdam transmission chains from the partially observed phylogenetic data. Results: Between 1 January 2014 and 1 May 2019, there were 846 HIV diagnoses in Amsterdam residents, of whom 516 (61%) were estimated to have been infected in 2014–2018. The rate of new Amsterdam diagnoses since 2014 (104 per 100,000) remained higher than the national rates excluding Amsterdam (24 per 100,000), and in this sense Amsterdam remained a HIV hotspot in the Netherlands. An estimated 14% [12–16%] of infections in Amsterdan MSM in 2014–2018 remained undiagnosed by 1 May 2019, and 41% [35–48%] in Amsterdam heterosexuals, with variation by region of birth. An estimated 67% [60–74%] of Amsterdam MSM infections in 2014–2018 had an Amsterdam resident as source, and 56% [41–70%] in Amsterdam heterosexuals, with heterogeneity by region of birth. Of the locally acquired infections, an estimated 43% [37–49%] were in foreign-born MSM, 41% [35–47%] in Dutch-born MSM, 10% [6–18%] in foreign-born heterosexuals, and 5% [2–9%] in Dutch-born heterosexuals. We estimate the majority of Amsterdam MSM infections in 2014–2018 originated in transmission chains that pre-existed by 2014. Conclusions: This combined phylogenetic, epidemiologic, and modelling analysis in the UNAIDS Fast-Track City Amsterdam indicates that there remains considerable potential to prevent HIV infections among Amsterdam residents through city-level interventions. The burden of locally acquired infection remains concentrated in MSM, and both Dutch-born and foreign-born MSM would likely benefit most from intensified city-level interventions. Funding: This study received funding as part of the H-TEAM initiative from Aidsfonds (project number P29701). The H-TEAM initiative is being supported by Aidsfonds (grant number: 2013169, P29701, P60803), Stichting Amsterdam Dinner Foundation, Bristol-Myers Squibb International Corp. (study number: AI424-541), Gilead Sciences Europe Ltd (grant number: PA-HIV-PREP-16-0024), Gilead Sciences (protocol numbers: CO-NL-276-4222, CO-US-276-1712, CO-NL-985-6195), and M.A.C AIDS Fund.
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Affiliation(s)
| | - Mélodie Monod
- Department of Mathematics, Imperial College London, London, United Kingdom
| | | | - Nikos Pantazis
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens, Athens, Greece
| | | | - Eline Op de Coul
- Center for Infectious Diseases Prevention and Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, Netherlands
| | - Thijs van de Laar
- Department of Donor Medicine Research, Sanquin, Amsterdam, Netherlands
| | - Christophe Fraser
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Maria Prins
- Academic Medical Center, Amsterdam, Netherlands
| | - Peter Reiss
- Department of Global Health, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Godelieve J de Bree
- Department of Global Health, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Oliver Ratmann
- Department of Mathematics, Imperial College London, London, United Kingdom
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9
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Wang H, Shobowale O, den Daas C, Op de Coul E, Bakker B, Radyowijati A, Vermey K, van Bijnen A, Zuilhof W, Jonas KJ. Determinants of PrEP Uptake, Intention and Awareness in the Netherlands: A Socio-Spatial Analysis. IJERPH 2022; 19:ijerph19148829. [PMID: 35886681 PMCID: PMC9315833 DOI: 10.3390/ijerph19148829] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/24/2022]
Abstract
PrEP uptake in the Netherlands is growing but remains at suboptimal levels. Hence, the analysis of hurdles is paramount. Given the initial focus of PrEP provision among men-who-have-sex-with-men (MSM) via a demonstration project that was launched in June 2015, AmPrEP in Amsterdam, and pharmacies in the main urban areas (so called “Randstad”, entailing Amsterdam, Utrecht, Leiden, The Hague and Rotterdam), investigating regional differences is necessary. This study seeks to unravel regional differences jointly with the psycho-social determinants of PrEP uptake. This cross-sectional study included 3232 HIV-negative MSM recruited via the Dutch subsample of the European-MSM-Internet-Survey in late 2017 (EMIS-2017), which aimed to inform interventions for MSM who are highly affected by infections with HIV and other sexually transmitted infections. Prevalence and the standardised prevalence ratio (SPR) of PrEP awareness, intention and uptake were measured on a regional level (Randstad vs. the rest of the country). Multi-level logistic modelling was conducted to identify the association of PrEP uptake with PrEP awareness and intention, socio-demographic, psycho-social determinants and random effects from regional differences. MSM from the Randstad used more PrEP (SPR = 1.4 vs. 0.7) compared to the rest of the country, but there were minor differences for awareness and intention. The regional distinction was estimated to explain 4.6% of the PrEP use variance. We observed a greater influence from PrEP intention (aOR = 4.5, 95% CI 2.0–10.1), while there was limited influence from the awareness of PrEP (aOR = 0.4, 95% CI 0.04–4.4). Lower education (aOR = 0.4, 95% CI 0.2–0.9) was negatively associated with PrEP uptake; however, no significant difference was found between middle (aOR = 1.2, 95% CI 0.7–2.0) and high education. We showed that regional differences—MSM in non-urban regions—and other psycho-social determinants account for lower PrEP uptake. Based on these findings, more fine-tuned PrEP access with a focus on non-urban regions can be implemented, and tailored campaigns increasing intention/use can be conducted among target populations.
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Affiliation(s)
- Haoyi Wang
- Department of Work and Social Psychology, Maastricht University, 6200 ER Maastricht, The Netherlands; (H.W.); (O.S.)
| | - Oladipupo Shobowale
- Department of Work and Social Psychology, Maastricht University, 6200 ER Maastricht, The Netherlands; (H.W.); (O.S.)
| | - Chantal den Daas
- Health Psychology, University of Aberdeen, Aberdeen AB24 3 FX, UK;
| | - Eline Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands;
| | | | | | - Koenraad Vermey
- Soa Aids Netherlands, 1014 AX Amsterdam, The Netherlands; (K.V.); (A.v.B.); (W.Z.)
| | - Arjan van Bijnen
- Soa Aids Netherlands, 1014 AX Amsterdam, The Netherlands; (K.V.); (A.v.B.); (W.Z.)
| | - Wim Zuilhof
- Soa Aids Netherlands, 1014 AX Amsterdam, The Netherlands; (K.V.); (A.v.B.); (W.Z.)
| | - Kai J. Jonas
- Department of Work and Social Psychology, Maastricht University, 6200 ER Maastricht, The Netherlands; (H.W.); (O.S.)
- Correspondence: ; Tel.: +31-43-38-84068
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10
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Xiridou M, Adam P, Meiberg A, Visser M, Matser A, de Wit J, Op de Coul E. The impact of the COVID-19 pandemic on hepatitis B virus vaccination and transmission among men who have sex with men: a mathematical modelling study. Vaccine 2022; 40:4889-4896. [PMID: 35810058 PMCID: PMC9250904 DOI: 10.1016/j.vaccine.2022.06.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022]
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Maria Xiridou
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Philippe Adam
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia; Institute for Prevention and Social Research, Utrecht, the Netherlands.
| | - Annemarie Meiberg
- National Coordination Centre for Communicable Disease Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Maartje Visser
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
| | - Amy Matser
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; Department of Infectious Diseases, Amsterdam Infection and Immunity (AII), Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
| | - John de Wit
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia; Interdisciplinary Social Science, Utrecht University, Utrecht, the Netherlands.
| | - Eline Op de Coul
- Department of Epidemiology and Surveillance, Centre for Infectious Diseases Control, National Institute of Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
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Miura F, van Ewijk CE, Backer JA, Xiridou M, Franz E, Op de Coul E, Brandwagt D, van Cleef B, van Rijckevorsel G, Swaan C, van den Hof S, Wallinga J. Estimated incubation period for monkeypox cases confirmed in the Netherlands, May 2022. Euro Surveill 2022; 27:2200448. [PMID: 35713026 PMCID: PMC9205160 DOI: 10.2807/1560-7917.es.2022.27.24.2200448] [Citation(s) in RCA: 92] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 11/20/2022] Open
Abstract
In May 2022, monkeypox outbreaks have been reported in countries not endemic for monkeypox. We estimated the monkeypox incubation period, using reported exposure and symptom-onset times for 18 cases detected and confirmed in the Netherlands up to 31 May 2022. Mean incubation period was 9.0 [corrected] days (5th-95th percentiles: 4.2-17.3), underpinning the current recommendation to monitor or isolate/quarantine case contacts for 21 days. However, as the incubation period may differ between different transmission routes, further epidemiological investigations are needed.
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Affiliation(s)
- Fuminari Miura
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Center for Marine Environmental Studies (CMES), Ehime University, Ehime, Japan
| | - Catharina E van Ewijk
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Jantien A Backer
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Maria Xiridou
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Eelco Franz
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Eline Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Diederik Brandwagt
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Brigitte van Cleef
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Gini van Rijckevorsel
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Corien Swaan
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Jacco Wallinga
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center (LUMC), Leiden, the Netherlands
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12
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Xiridou M, Heijne J, Adam P, Op de Coul E, Matser A, de Wit J, Wallinga J, van Benthem B. How the Disruption in Sexually Transmitted Infection Care Due to the COVID-19 Pandemic Could Lead to Increased Sexually Transmitted Infection Transmission Among Men Who Have Sex With Men in The Netherlands: A Mathematical Modeling Study. Sex Transm Dis 2022; 49:145-153. [PMID: 34475357 DOI: 10.1097/olq.0000000000001551] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, the disruption in care for sexually transmitted infections (STIs) and the social distancing measures have led to reductions in STI testing and sexual behavior. We assessed the impact of these COVID-19-related changes on transmission of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) among men who have sex with men (MSM) in The Netherlands. METHODS We developed a mathematical model for CT and NG transmission among MSM, accounting for COVID-19-related changes in sexual behavior and testing in 2020 to 2021. Changes in 2020 were estimated from data from the Dutch COVID-19, Sex, and Intimacy Survey among MSM and the National Database of STI Clinics. Because of the lack of data for 2021, we examined several scenarios covering a range of changes. RESULTS A reduction of 10% and 40% in STI testing of symptomatic and asymptomatic, respectively, individuals with a 10% to 20% reduction in numbers of casual partners (according to partner status and activity level) during the second lockdown, resulted in a 2.4% increase in CT prevalence, but a 2.8% decline in NG prevalence in 2021. A 5% and 30% reduction in STI testing of symptomatic and asymptomatic, respectively, individuals with the same reduction in casual partners resulted in a 0.6% increase in CT prevalence and a 4.9% decrease in NG prevalence in 2021. CONCLUSIONS The disruption in STI care due to COVID-19 might have resulted in a small increase in CT prevalence, but a decrease in NG prevalence. Scaling up STI care is imperative to prevent increases in STI transmission.
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Affiliation(s)
- Maria Xiridou
- From the Centre for Infectious Diseases Control, Department of Epidemiology and Surveillance, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Janneke Heijne
- From the Centre for Infectious Diseases Control, Department of Epidemiology and Surveillance, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | | | - Eline Op de Coul
- From the Centre for Infectious Diseases Control, Department of Epidemiology and Surveillance, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | | | | | | | - Birgit van Benthem
- From the Centre for Infectious Diseases Control, Department of Epidemiology and Surveillance, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
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Krabbenborg N, Spijker R, Żakowicz AM, de Moraes M, Heijman T, de Coul EO. Community-based HIV testing in The Netherlands: experiences of lay providers and end users at a rapid HIV test checkpoint. AIDS Res Ther 2021; 18:34. [PMID: 34162401 PMCID: PMC8220118 DOI: 10.1186/s12981-021-00357-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The AIDS Healthcare Foundation (AHF-Checkpoint) in The Netherlands offers rapid HIV testing for key populations by lay providers. We explored the experiences and needs of lay providers and end users of HIV testing at AHF-Checkpoint, taking into account the WHO 5C-(consent, confidentiality, counselling, correct-results, connection-to-care) criteria for HIV test services. METHODS Qualitative evaluation with 15 semi-structured interviews conducted during 2020 with ten lay providers and five gay or bisexual end users. Recorded interviews were thematically analysed, taking data triangulation into account. RESULTS Four domains were identified: (1) accessibility of HIV testing, (2) quality of test procedures, (3) bridging (transitional care), and (4) future strategies for service delivery. AHF-Checkpoint fills a gap for key populations including LGBTQ and refugees, who experience HIV testing barriers at sexual health centres or general practices. The level of trust between lay providers and end users was highly valued by end users. They appreciated the low threshold to test at no costs, and the absence of waiting lists or triaging. Needs expressed by lay providers included more preparedness for emotionally charged situations, and extra training to improve STI knowledge. End users expressed a need for a full STI test package. Of the 5Cs, consent, counselling, and correct results were realised but confidentiality was sometimes difficult to achieve at pop-up locations, and referral barriers for confirmation testing (connection-to-care) were occasionally experienced by lay providers during weekends. CONCLUSION AHF-Checkpoint was described as a convenient and easily accessible service by end users and lay providers. Of the WHO 5Cs, connection-to-care could be optimised to ensure HIV confirmation and STI testing through a liaison approach with professionals from the regular healthcare sector.
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Vourli G, Noori T, Pharris A, Porter K, Axelsson M, Begovac J, Cazein F, Costagliola D, Cowan S, Croxford S, d'Arminio Monforte A, Delpech V, Díaz A, Girardi E, Gunsenheimer-Bartmeyer B, Hernando V, Leierer G, Lot F, Nunez O, Obel N, Op de Coul E, Paraskeva D, Patrinos S, Reiss P, Schmid D, Sonnerborg A, Suligoi B, Supervie V, van Sighem A, Zangerle R, Touloumi G. Human Immunodeficiency Virus Continuum of Care in 11 European Union Countries at the End of 2016 Overall and by Key Population: Have We Made Progress? Clin Infect Dis 2021; 71:2905-2916. [PMID: 32960957 PMCID: PMC7778352 DOI: 10.1093/cid/ciaa696] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 08/21/2020] [Indexed: 12/18/2022] Open
Abstract
Background High uptake of antiretroviral treatment (ART) is essential to reduce human immunodeficiency virus (HIV) transmission and related mortality; however, gaps in care exist. We aimed to construct the continuum of HIV care (CoC) in 2016 in 11 European Union (EU) countries, overall and by key population and sex. To estimate progress toward the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 target, we compared 2016 to 2013 estimates for the same countries, representing 73% of the population in the region. Methods A CoC with the following 4 stages was constructed: number of people living with HIV (PLHIV); proportion of PLHIV diagnosed; proportion of those diagnosed who ever initiated ART; and proportion of those ever treated who achieved viral suppression at their last visit. Results We estimated that 87% of PLHIV were diagnosed; 92% of those diagnosed had ever initiated ART; and 91% of those ever on ART, or 73% of all PLHIV, were virally suppressed. Corresponding figures for men having sex with men were: 86%, 93%, 93%, 74%; for people who inject drugs: 94%, 88%, 85%, 70%; and for heterosexuals: 86%, 92%, 91%, 72%. The proportion suppressed of all PLHIV ranged from 59% to 86% across countries. Conclusions The EU is close to the 90-90-90 target and achieved the UNAIDS target of 73% of all PLHIV virally suppressed, significant progress since 2013 when 60% of all PLHIV were virally suppressed. Strengthening of testing programs and treatment support, along with prevention interventions, are needed to achieve HIV epidemic control.
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Affiliation(s)
- Georgia Vourli
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Teymur Noori
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | | | | | - Josip Begovac
- Department of Infectious Diseases, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Francoise Cazein
- Santé publique France, the French national public health agency, Saint-Maurice, France
| | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | | | | | | | | | - Asunción Díaz
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrico Girardi
- Istituto Nazionale Malattie Infettive 'L. Spallanzani, Roma, Italy
| | | | - Victoria Hernando
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Florence Lot
- Santé publique France, the French national public health agency, Saint-Maurice, France
| | - Olivier Nunez
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | - Niels Obel
- Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Eline Op de Coul
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Dimitra Paraskeva
- Hellenic Center for Disease Control and Prevention, Amarousio, Greece
| | - Stavros Patrinos
- Hellenic Center for Disease Control and Prevention, Amarousio, Greece
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, The Netherlands.,Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Daniela Schmid
- Austrian Agency for Health and Food Safety, Vienna, Austria
| | - Anders Sonnerborg
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Barbara Suligoi
- National AIDS Unit, Istituto Superiore di Sanita, Rome, Italy
| | - Virginie Supervie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | | | | | - Giota Touloumi
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Slurink I, van Aar F, Parkkali S, Heijman T, Götz H, Kampman K, van Weert Y, van Benthem B, van de Laar T, Op de Coul E. Recently acquired HIV infections and associated factors among men who have sex with men diagnosed at Dutch sexual health centres. Int J STD AIDS 2021; 32:946-956. [PMID: 33910415 DOI: 10.1177/09564624211008071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Surveillance for recent HIV infections was implemented at Dutch sexual health centres (SHCs) for planning and evaluation of HIV prevention initiatives. The study objective is twofold: (1) to explore trends in recent HIV infections and associated socio-demographic and behavioural risk factors among men who have sex with men (MSM )attending SHCs, to gain insight into subgroups at risk for acquiring HIV and(2) to illustrate how comparison with different reference groups affect associations with these risk factors. METHODS Residual plasma or serum samples from MSM newly HIV diagnosed at SHCs in 2014-2017 were tested with an avidity assay. Multinomial regression was used to analyse risk factors for recent HIV infections among MSM with established HIV infections among MSM and with HIV-negative MSM as reference groups. RESULTS Of newly diagnosed MSM, 33% were classified as recent HIV infection with avidity testing. Combining HIV-negative test results with avidity outcomes resulted in 54% recent infections. Recent infection was associated with having an STI in the past, multiple partners and condom use for both reference groups of MSM. Additionally, relative to the HIV-negative MSM, recent infection was associated with education and having a non-Western origin. In contrast, relative to MSM with established HIV infections, recent infection was associated with Western origin. CONCLUSION Our results suggest ongoing but declining transmission of HIV and high uptake of HIV testing among MSM visiting SHCs. The identification of risk factors for recent infections can help healthcare professionals to target subgroups eligible for PrEP or condom use promotion. Differentiation by the reference group in explanatory models for recent infections is important as different risk factors were identified. Likely, associations relative to HIV-negative MSM follow those of acquiring HIV infection in general, whereas the comparison with the established HIV infection reference rather reflects the frequent testing behaviour of subgroups of MSM.
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Affiliation(s)
- Isabel Slurink
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Fleur van Aar
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Saara Parkkali
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Titia Heijman
- Department of Infectious Diseases, 1221Public Health Service (GGD), Amsterdam, The Netherlands
| | - Hannelore Götz
- Department of Infectious Disease Control, 6993Public Health Service, Rotterdam-Rijnmond, The Netherlands
| | - Karlijn Kampman
- 26095Public Health Service Twente, Enschede, The Netherlands
| | - Yolanda van Weert
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Birgit van Benthem
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | - Eline Op de Coul
- Centre for Infectious Disease Control, 10206National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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16
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Boender TS, Op de Coul E, Arends J, Prins M, van der Valk M, van der Meer JT, van Benthem B, Reiss P, Smit C. Acute hepatitis C infection among adults with HIV in the Netherlands between 2003 and 2016: a capture-recapture analysis for the 2013 to 2016 period. Euro Surveill 2020; 25:1900450. [PMID: 32098641 PMCID: PMC7043050 DOI: 10.2807/1560-7917.es.2020.25.7.1900450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BackgroundWith regards to the global strategy towards eliminating viral hepatitis, reliable surveillance systems are essential to assess the national response for eliminating hepatitis C virus (HCV).AimWe aimed to assess the completeness of the two national registries with data on acute HCV infection in people with HIV, and estimated the number of acute HCV infections among adults (aged ≥ 18 years) with HIV in the Netherlands.MethodsIn this observational study, cases of HCV infection and reinfection among adults with a positive or unknown HIV-serostatus were identified from 2003 to 2016 in two national registries: the ATHENA cohort and the National Registry for Notifiable Diseases. For 2013-2016, cases were linked, and two-way capture-recapture analysis was carried out.ResultsDuring 2013-2016, there were an estimated 282 (95% confidence interval (CI): 264-301) acute HCV infections among adults with HIV. The addition of cases with an unknown HIV-serostatus increased the matches (from n = 107 to n = 129), and subsequently increased the estimated total: 330 (95%CI: 309-351). Under-reporting was estimated at 14-20%.ConclusionUnder-reporting of acute HCV infection among people with HIV could partially be explained by an unknown HIV-serostatus, or by differences in HCV stage (acute or chronic) at first diagnosis. Surveillance data should ideally include both acute and chronic HCV infections, and enable to distinguish these as well as initial- and re-infections. National surveillance of acute HCV can be improved by increased notification of infections.
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Affiliation(s)
| | - Eline Op de Coul
- National Institute for Public Health and the Environment (RIVM); Centre for Infectious Disease Control, Epidemiology and Surveillance, Bilthoven, the Netherlands
| | - Joop Arends
- Department of Internal Medicine, Division of Infectious Diseases, UMCU University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Maria Prins
- Public Health Service of Amsterdam, Department of Infectious Diseases, Research and Prevention, Amsterdam, the Netherlands,Department of Internal Medicine and Division of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Marc van der Valk
- Department of Internal Medicine and Division of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Jan T.M. van der Meer
- Department of Internal Medicine and Division of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Birgit van Benthem
- National Institute for Public Health and the Environment (RIVM); Centre for Infectious Disease Control, Epidemiology and Surveillance, Bilthoven, the Netherlands
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, the Netherlands,Department of Internal Medicine and Division of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, the Netherlands,Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands
| | - Colette Smit
- Stichting HIV Monitoring, Amsterdam, the Netherlands
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Op de Coul E, den Daas C, Spijker R, Heijman T, de Vos M, Götz H, Vermey K, Zuilhof W, Van den Boogaard J, Davidovich U, Zuure F. Web-Supported Social Network Testing for HIV Among Men Who Have Sex With Men With a Migration Background: Protocol for a Mixed Methods Pilot Study. JMIR Res Protoc 2020; 9:e14743. [PMID: 32039817 PMCID: PMC7055807 DOI: 10.2196/14743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 07/24/2019] [Accepted: 08/30/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Of newly diagnosed HIV positive men who have sex with men (MSM) in the Netherlands, 29% have a non-Western migration background (MSM-NW). Among MSM-NW, HIV positivity rates are high (0.8%-2.0%), as is the proportion of late stage infections (39%). Factors such as HIV and sexual orientation-related stigma may form barriers for timely testing. Innovative approaches for HIV testing are needed to better reach MSM-NW. Social network testing (SNT) for HIV is an evidence-supported approach where peer recruiters identify persons (network associates) who could benefit from testing in their social or sexual networks. Web-supported SNT might be particularly promising for reaching people who may not be reached by regular care. OBJECTIVE The purpose of this paper is to describe the design of our pilot PREVENT (Peer-Empowered Voluntary Extended Network Testing). In this pilot, we will explore whether SNT using HIV self-tests is feasible and acceptable among MSM-NW in the Netherlands and whether it reaches those who were never or not recently tested for HIV (>1 year ago). METHODS The project aims to include 50 to 60 MSM and MSM-NW peers who will distribute 4 to 5 oral HIV self-tests each aiming to reach 200 network associates (NAs). Enrollment of peers includes 4 steps: (1) fostering interest in becoming a peer by health care professionals at sexual health clinics, HIV treatment clinics, and community settings; (2) sending peer contact information to the peer coordinator; (3) registering peers and giving program instructions by the peer coordinator and referring to the Web-based training at time2test; and (4) receiving precoded HIV self-tests for distribution in the peers' networks. NAs who receive the self-test will log in with their test package code in the time2test application for step-by-step test instructions. After testing is complete, NAs receive tailored follow-up information depending on their test result. RESULTS Between January and May 2019, 10 STI clinics and 7 HIV treatment clinics started recruiting peers. Results of the PREVENT pilot are expected in December 2020. CONCLUSIONS This is the first Web-supported peer-driven SNT pilot using HIV self-tests in the Netherlands and one of the first in Europe. Implementation is considered successful if it reaches MSM-NW who were never or not recently tested for HIV. Additionally, it may encourage conversations within the networks about risk behavior and barriers to HIV testing, potentially contributing to the Joint United Nations Programme on HIV/AIDS goal of zero HIV infections. TRIAL REGISTRATION Netherlands Trial Registry NL7424; https://www.trialregister.nl/trial/7424. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14743.
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Affiliation(s)
- Eline Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Chantal den Daas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands.,Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | - Ralph Spijker
- Aidsfonds-Soa Aids Nederland, Amsterdam, Netherlands
| | - Titia Heijman
- Public Health Service of Amsterdam, Amsterdam, Netherlands
| | - Marvin de Vos
- Aidsfonds-Soa Aids Nederland, Amsterdam, Netherlands
| | - Hannelore Götz
- Public Health Service Rotterdam-Rijnmond, Rotterdam, Netherlands
| | | | - Wim Zuilhof
- Aidsfonds-Soa Aids Nederland, Amsterdam, Netherlands
| | - Jossy Van den Boogaard
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Udi Davidovich
- Public Health Service of Amsterdam, Amsterdam, Netherlands.,Department of Social Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Freke Zuure
- Public Health Service of Amsterdam, Amsterdam, Netherlands
| | -
- Please see Authors' Contribution section for more information,
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de Vries G, van den Hof S, Op de Coul E, van Crevel R. Closing the gap in surveillance of tuberculosis and HIV co-infection, and the need for clinician-public health alliances. Eur Respir J 2018; 51:51/3/1702671. [PMID: 29567723 DOI: 10.1183/13993003.02671-2017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 01/01/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Gerard de Vries
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands .,KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - Susan van den Hof
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.,Dept of Global Health, Academic Medical Center, Amsterdam, The Netherlands.,Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | | | - Reinout van Crevel
- Dept of Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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Arnoldussen M, Schimmel H, Op de Coul E, van den Hof S, de Vries G. Tuberculosis patients with unknown HIV status in the Netherlands: analysing underreporting and lack of testing. Eur Respir J 2017; 50:50/5/1701257. [DOI: 10.1183/13993003.01257-2017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 08/24/2017] [Indexed: 11/05/2022]
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20
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Gourlay A, Noori T, Pharris A, Axelsson M, Costagliola D, Cowan S, Croxford S, d'Arminio Monforte A, Del Amo J, Delpech V, Díaz A, Girardi E, Gunsenheimer-Bartmeyer B, Hernando V, Jose S, Leierer G, Nikolopoulos G, Obel N, Op de Coul E, Paraskeva D, Reiss P, Sabin C, Sasse A, Schmid D, Sonnerborg A, Spina A, Suligoi B, Supervie V, Touloumi G, Van Beckhoven D, van Sighem A, Vourli G, Zangerle R, Porter K. The Human Immunodeficiency Virus Continuum of Care in European Union Countries in 2013: Data and Challenges. Clin Infect Dis 2017; 64:1644-1656. [PMID: 28369283 PMCID: PMC5447871 DOI: 10.1093/cid/cix212] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/13/2017] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a "90-90-90" target to curb the human immunodeficiency virus (HIV) epidemic by 2020, but methods used to assess whether countries have reached this target are not standardized, hindering comparisons. METHODS. Through a collaboration formed by the European Centre for Disease Prevention and Control (ECDC) with European HIV cohorts and surveillance agencies, we constructed a standardized, 4-stage continuum of HIV care for 11 European Union countries for 2013. Stages were defined as (1) number of people living with HIV in the country by end of 2013; (2) proportion of stage 1 ever diagnosed; (3) proportion of stage 2 that ever initiated ART; and (4) proportion of stage 3 who became virally suppressed (≤200 copies/mL). Case surveillance data were used primarily to derive stages 1 (using back-calculation models) and 2, and cohort data for stages 3 and 4. RESULTS. In 2013, 674500 people in the 11 countries were estimated to be living with HIV, ranging from 5500 to 153400 in each country. Overall HIV prevalence was 0.22% (range, 0.09%-0.36%). Overall proportions of each previous stage were 84% diagnosed, 84% on ART, and 85% virally suppressed (60% of people living with HIV). Two countries achieved ≥90% for all stages, and more than half had reached ≥90% for at least 1 stage. CONCLUSIONS. European Union countries are nearing the 90-90-90 target. Reducing the proportion undiagnosed remains the greatest barrier to achieving this target, suggesting that further efforts are needed to improve HIV testing rates. Standardizing methods to derive comparable continuums of care remains a challenge.
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Affiliation(s)
| | - Teymur Noori
- European Centre for Disease Prevention and Control, and
| | | | | | - Dominique Costagliola
- Sorbonne Universites, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'Epidemiologie et de Sante Publique (IPLESP UMR_S 1136), Paris, France
| | | | | | | | - Julia Del Amo
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Asunción Díaz
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | - Enrico Girardi
- Istituto Nazionale Malattie Infettive 'L. Spallanzani', Rome, Italy
| | | | - Victoria Hernando
- Centro Nacional de Epidemiologia, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Georgios Nikolopoulos
- Medical School, University of Cyprus, Nicosia
- Hellenic Center for Disease Control and Prevention, Amarousio, Greece
| | - Niels Obel
- Rigshospitalet, Copenhagen University, Denmark
| | - Eline Op de Coul
- National Institute for Public Health and the Environment, Bilthoven
| | - Dimitra Paraskeva
- Hellenic Center for Disease Control and Prevention, Amarousio, Greece
| | - Peter Reiss
- Stichting HIV Monitoring, Amsterdam, and
- Academic Medical Center, Amsterdam, The Netherlands
| | | | - André Sasse
- Scientific Institute of Public Health, Brussels, Belgium
| | | | - Anders Sonnerborg
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | | | - Barbara Suligoi
- National AIDS Unit, Istituto Superiore di Sanita, Rome, Italy; and
| | - Virginie Supervie
- Sorbonne Universites, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'Epidemiologie et de Sante Publique (IPLESP UMR_S 1136), Paris, France
| | - Giota Touloumi
- Medical School, National and Kapodistrian University of Athens, Greece
| | | | | | - Georgia Vourli
- Medical School, National and Kapodistrian University of Athens, Greece
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Abstract
OBJECTIVES Men who have sex with men (MSM) who are unaware of their HIV infection are more likely to infect others, and unable to receive treatment. Therefore, we aimed to identify the proportion and characteristics of Dutch MSM who never tested for HIV. METHODS In 2010, the European MSM Internet Survey (EMIS) recruited 174,209 men from 38 countries through an anonymous online questionnaire in 25 languages. We analysed data from participants living in the Netherlands (N=3787). The outcome we investigated was having never (lifetime) been tested for HIV. RESULTS A total of 770 MSM (20.4%) had never been tested for HIV. In multivariate regression analyses, not being from Amsterdam (adjusted OR, aOR 1.54, CI 1.17 to 2.03), with low education (aOR 1.28, CI 1.04 to 1.57) and low knowledge on HIV-testing (aOR 2.23, CI 1.37 to 3.64) were significantly associated with never having tested. Lower sexual risk (including having fewer sexual partners (aOR 2.19, CI 1.57 to 3.04) and no anal intercourse (aOR 5.99, CI 3.04 to 11.77)), and less social engagement (including being less out (aOR 1.93, CI 1.55 to 2.40)) were also associated with having never been tested. Additionally, 36.1% of MSM who never tested for HIV reported high-risk sexual behaviour that may have put them at HIV risk. CONCLUSIONS MSM make their own risk assessments that inform their choices about HIV-testing. Nevertheless, MSM who were never tested may have been at risk for HIV, and remain important to target for HIV interventions.
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Affiliation(s)
- Chantal den Daas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Martine Doppen
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Axel J Schmidt
- Sigma Research, Department of Social & Environmental Health Research, London School of Hygiene and Tropical Medicine, UK
| | - Eline Op de Coul
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Chemtob D, Op de Coul E, van Sighem A, Mor Z, Cazein F, Semaille C. Impact of Male Circumcision among heterosexual HIV cases: comparisons between three low HIV prevalence countries. Isr J Health Policy Res 2015; 4:36. [PMID: 26244087 PMCID: PMC4524174 DOI: 10.1186/s13584-015-0033-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 07/11/2015] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Studies performed in high-HIV prevalence countries showed a strong epidemiological association between male circumcision (MC) and the prevention of HIV transmission. We estimated the potential impact of MC on the general heterosexual population in low-HIV prevalence countries. METHODS Cross-national comparisons, including data on newly diagnosed HIV cases among heterosexuals living in Israel (where almost all males undergo MC), to similar data from the Netherlands and France (where <10 % of males are circumcised) were performed. National data from HIV registers and Bureaus of Statistics for the period of 2004-2010, global rates, rates by sex, age, and year of HIV-diagnosis were compared. MC and potential biases were examined. RESULTS Annual rates of new HIV diagnoses per 100,000 were significantly lower in Israel compared to the Netherlands and France (for men: 0.26-0.70, 1.91-2.28, and 2.69-3.47, respectively; for women: 0.10-0.34, 1.10-2.10 and 2.41-3.08, respectively). Similarly, HIV-rates were much lower in Israel when comparing by age groups. Although Gross National Income per capita in 2010 was lower in Israel compared to the Netherlands and France, access to HIV testing and treatment were not different between countries. Also, the number of sexual-partners and condom-use in the general population showed a high similarity between the countries. CONCLUSIONS The lower rate of HIV among heterosexuals in Israel compared to the Netherlands and France might be explained by MC routinely practiced in Israel, since other parameters of influence on HIV transmission were rather similar between the countries. However, recommendation for systematic MC in low HIV prevalence countries requires further investigations.
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Affiliation(s)
- Daniel Chemtob
- />Department of Tuberculosis and AIDS, Ministry of Health, P.O.B. 1176, Jerusalem, 944727 Israel
| | - Eline Op de Coul
- />Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | | | - Zohar Mor
- />Department of Tuberculosis and AIDS, Ministry of Health, P.O.B. 1176, Jerusalem, 944727 Israel
| | - Françoise Cazein
- />HIV/AIDS-STI-Hepatitis B and C Unit, Department of Infectious Diseases, Institut de Veille Sanitaire, Saint Maurice, France
| | - Caroline Semaille
- />HIV/AIDS-STI-Hepatitis B and C Unit, Department of Infectious Diseases, Institut de Veille Sanitaire, Saint Maurice, France
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van Aar F, van Weert Y, Spijker R, Götz H, Op de Coul E. Partner notification among men who have sex with men and heterosexuals with STI/HIV: different outcomes and challenges. Int J STD AIDS 2014; 26:565-73. [PMID: 25141854 DOI: 10.1177/0956462414547398] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 07/17/2014] [Indexed: 11/17/2022]
Abstract
Partner notification effectiveness among index clients diagnosed with HIV, syphilis and/or gonorrhoea at sexually transmitted infection (STI) clinics was evaluated between 2010 and 2012. We explored percentages of identifiable, notified and tested partners by sexual preference and gender. Partner notification trends were studied using the national STI database. Men who have sex with men (n = 304), heterosexual men (n = 33) and women (n = 35) reported, respectively, 6.7, 3.8 and 2.3 partners per index. Percentages of identifiable partners differed between groups (men who have sex with men: 46%, heterosexual men: 63%, women: 87%, p < 0.001). The percentage of notified partners (of those identifiable) was lowest for heterosexual men (76%; men who have sex with men: 92%; women: 83%; p < 0.001). STI positivity rates among notified partners were high: 33%-50% depending on sexual preference. Among men who have sex with men, having HIV was associated with not notifying all identifiable partners. Percentages of notified clients at STI clinics increased between 2010 and 2012: from 13% to 19% among men who have sex with men, from 13% to 18% among heterosexual men and from 8% to 11% among women (p < 0.001 for all groups). The percentage of STI/HIV detected through partner notification increased among men who have sex with men (from 22% to 30%) and women (from 25% to 29%; p < 0.001). Unidentifiable partners among men who have sex with men, lower partner notification effectiveness for HIV and the relative large proportion of heterosexual men not notifying their partners appear to be important partner notification challenges.
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Affiliation(s)
- Fleur van Aar
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Yolanda van Weert
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Hannelore Götz
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands Department Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | - Eline Op de Coul
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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Sane J, Heijman T, Hogema B, Koot M, Veen MV, Götz H, Fennema J, Op de Coul E. Identifying recently acquired HIV infections among newly diagnosed men who have sex with men attending STI clinics in The Netherlands. Sex Transm Infect 2014; 90:414-7. [DOI: 10.1136/sextrans-2013-051420] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Götz HM, van Rooijen MS, Vriens P, Op de Coul E, Hamers M, Heijman T, van den Heuvel F, Koekenbier R, van Leeuwen AP, Voeten HACM. Initial evaluation of use of an online partner notification tool for STI, called 'suggest a test': a cross sectional pilot study. Sex Transm Infect 2014; 90:195-200. [PMID: 24391062 DOI: 10.1136/sextrans-2013-051254] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Partner notification is crucial for sexually transmitted infection (STI) control. We developed Suggestatest.nl (SAT), an internet-based notification system for verified diagnoses of STI/HIV. METHODS SAT uses email, short message service, postal letter or a gay dating site to notify sexual contacts. SAT was piloted at the Public Health STI clinics in two major cities in the Netherlands. We evaluated SAT from March to July 2012 by analysing SAT notifications linked with epidemiological data. Determinants for SAT use were assessed using multivariable logistic regression analysis. RESULTS Of 988 index clients receiving a SAT code, overall 139 (14%) notified through SAT, sending 505 notifications (median 2), 84% by text messaging and 15% by email; 88% non-anonymously. Of those intending to use SAT, 23% notified with SAT. Intention to use SAT was the only independent determinant of SAT use in heterosexuals and men who have sex with men. Among the 67 SAT users in Rotterdam, 56% (225/402) of their partners at risk were contactable, and 95% (213/225) of those were notified using SAT. 58% of SAT-notified partners accessed the SAT-website and 20% of them subsequently consulted the STI clinics. STI positivity in partners was lower in those notified by SAT (28% (32/116)) than in those with contact cards (45% (68/152); p<0.001). CONCLUSIONS Although the challenges posed by non-contactable partners are not solved by SAT, it is a valuable novel tool for notification of verified STI diagnoses by index patients and providers. In addition to current standard partner notification practice it suits a small number of clients, especially those reporting more than one partner.
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Affiliation(s)
- Hannelore M Götz
- Department Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, , Rotterdam, The Netherlands
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van Aar F, Schreuder I, van Weert Y, Spijker R, Götz H, Op de Coul E. Current practices of partner notification among MSM with HIV, gonorrhoea and syphilis in the Netherlands: an urgent need for improvement. BMC Infect Dis 2012; 12:114. [PMID: 22583517 PMCID: PMC3472393 DOI: 10.1186/1471-2334-12-114] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 05/14/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Partner notification (PN) among individuals newly diagnosed with HIV/STI is seen as a vital tool to identify others at risk of infection. However, hardly any data are available on the effectiveness of PN on HIV/STI transmission in the Netherlands. This study aims to fill this gap by assessing current PN practices, case-finding effectiveness, and determinants of being notified among men having sex with men (MSM) in the Netherlands. METHODS Nurses from five STI centers participated in a prospective pilot study on PN outcomes (partners being: at risk, notifiable, notified, and tested) for HIV/STI, by completing a newly developed PN registration form (PN database). PN outcomes including case-finding effectiveness (number of newly diagnosed cases in partners/number of partners being tested) for HIV, syphilis, and gonorrhoea were studied among MSM. Furthermore, the national STI database was analyzed to identify determinants of being notified. The number of infections that remained undetected was estimated based on these two databases. RESULTS In total 105 MSM, newly diagnosed with HIV/STI, reported 612 sexual partners at risk of whom 41% were notifiable and 31% were notified. Patient referral was the predominant PN method (90%). The overall case-finding percentage was 36% (HIV: 15-33%, gonorrhoea: 17-50% and syphilis: 4-11%). Case-finding percentages were lower in the national STI database: 21% (5%, 28%, 12%). Persons with one or more sexual partners, known HIV positives, and IDU were more likely to be notified to the STI clinic. Notified clients were more likely to have HIV/STI than unnotified clients (OR 1.7-2.5). Based on these two databases, an estimated 75 to 133 infections remained undetected (HIV: 12-90; gonorrhoea: 28-97; syphilis: 5-12 infections). CONCLUSIONS Partner notification among MSM in the Netherlands is suboptimal; an extensive number of STI/HIV infections remained undetected mainly due to unnotifiable partners. To enhance PN practices, combined and innovative PN interventions such as Internet-based PN will be implemented for hard-to-reach MSM and other risk groups.
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Affiliation(s)
- Fleur van Aar
- Epidemiology & Surveillance department, Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
| | - Imke Schreuder
- Department of Virology, Erasmus MC, Rotterdam, the Netherlands
| | - Yolanda van Weert
- Epidemiology & Surveillance department, Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
| | | | - Hannelore Götz
- Department of Infectious Disease Control – division STI/HIV, GGD Rotterdam-Rijnmond, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | - Eline Op de Coul
- Epidemiology & Surveillance department, Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, the Netherlands
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