Trends and determinants of condomless sex in gonorrhoea patients diagnosed in France through the sentinel surveillance network ResIST, 2005-2014

Background

Gonorrhoea is increasing in France since its resurgence in the late 1990’s. Understanding trends of condomless sex is a requirement to tailor prevention toward most exposed individuals. This study aims to analyse trends and determinants of condomless penetrative sex (PS) in MSM and heterosexuals diagnosed with gonorrhoea in France.

Methods

A standardized self-administered questionnaire filled by 3453 patients was used to monitor condomless sex through the sentinel surveillance network ResIST between 2005 and 2014. Trends were used to describe consistent condom use for penetrative sex (PS). A logistic regression model analysed patients’ characteristics associated with condomless PS.

Results

Between 2005 and 2014, condomless PS increased regardless of sexual orientation. Condomless PS was particularly common among HIV positive men who have sex with men (MSM (65%)). People living in metropolitan regions outside Paris area (adjusted odds-ratio (AOR) [95% CI] =1.33[1.12–1.58]) were more likely to engage in condomless PS. Conversely, MSM (AOR [95% CI] =0.21 [0.16–0.29]), HIV seronegative patients (AOR [95% CI] =0.68 [0.51–0.89]), patients diagnosed in hospital (AOR [95% CI] = 0.66 [0.45–0.97]) and multi-partners (≥ 10 partners, AOR [95% CI] = 0.54 [0.40–0.74]) were more likely to use condoms.

Conclusions

These findings highlight a decreasing use of condom in MSM and heterosexuals diagnosed with gonorrhoea. Prevention strategies should take in account drivers of condomless sex in a context of uncontrolled STI epidemics.

Anaphylactic shock secondary to intravenous administration of folinic acid: a first report

BACKGROUND

Folates, components of the B-complex vitamins, have numerous pharmacological effects. In oncology combining folates with 5-fluorouracil (5-FU) enhances the cytotoxic effects of chemotherapy in colon cancer patients. Folic acid has been rarely involved in adverse allergic reactions. To the best of our knowledge no anaphylactic reaction secondary to folinic acid (FA) administration has ever been reported before.

PATIENTS AND METHODS

An 80-year-old patient had adjuvant chemotherapy for colon cancer including FA and 5-FU and irinotecan as a second line agent after multiple metastases.

RESULTS

Following FA administration anaphylactic shock occurred. Diagnosis was made according to the French method of adverse reactions monitoring.

CONCLUSION

Anaphylactic shock may be an adverse reaction of FA in patients receiving chemotherapy for colon cancer.

[Herpetiform ulceration: 5 cases]

BACKGROUND

Mouth ulcers are frequently observed, mostly caused by trauma and aphthae. We report five cases of herpetiform ulceration, a rare clinical form of aphthae often mistaken for herpetic stomatitis because of the similar clinical presentation.

CASE REPORTS

All patients were men with late age at onset (44.8 years). All had numerous tiny very painful ulcers covering all parts of the oral cavity. Consequences were sometimes severe (weight loss and general weakness in two patients, requiring hospitalization in one). Diverse clinical courses were observed (from no recurrence to monthly recurrence). Systemic steroids resulted in dramatic improvement in two patients, colchicine prevented recurrences in three of them.

DISCUSSION

These observations illustrate well this rare disease: herpetiform ulceration. We found oral corticosteroids provide effective cure and observed the preventive action of colchicine. Both findings should be confirmed in larger series.