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Corma-Gómez A, Real LM, Fernández-Fuertes M, González-Serna A, Oliver N, Ortega J, Rincón P, Rodríguez-Pineda E, Santos M, Trigo-Rodríguez M, Macías J, Pineda JA. Poor increase on HAV vaccination coverage among people living with HIV after an immunization-based intervention. Enferm Infecc Microbiol Clin (Engl Ed) 2023; 41:144-148. [PMID: 36870731 DOI: 10.1016/j.eimce.2022.01.006] [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: 09/11/2021] [Accepted: 01/12/2022] [Indexed: 03/06/2023]
Abstract
OBJECTIVES To assess HAV serologic and vaccination status among people who live with HIV (PLWH), and to evaluate the impact of a vaccination-based strategy on HAV-negative patients in Seville, Spain. METHODS Study with two time-overlapping phases: (i) cross-sectional study of HAV immunity prevalence among PLWH followed at a Spanish hospital between August 2019 and March 2020. (ii) Patients seronegative for HAV, reliably unvaccinated were included in a before-and-after quasi-experimental study, with an intervention focused on HAV vaccination according to national recommendations in force. RESULTS Six hundred and fifty-six patients were included, of which 111 [17%, 95% confidence interval (95% CI) 14-20%] were seronegative for HAV. Of these, 48 [43% (95% CI, 34-53%)] individuals were MSM. The absence of HAV immunity was attributed in 69 [62% (95% CI, 52-71%)] patients to non-referral to vaccination, followed by lack of achievement of a correct vaccination scheme [n=26; 23% (95% CI, 16-32%)]. After the program implementation, 96 [15% (95% CI, 12-18%)] individuals were seronegative (17% vs. 15%, p=0.256), of whom 42 [41% (95% CI, 32-51%)] were MSM. The absence of immunity after the intervention was mainly attributed to: adherence failure in 23 [24.0% (95% CI, 15.8-33.7%)] patients, on-course immunization scheme in 34 [33% (95% CI, 24-43%)] individuals and pending appointment at the vaccine delivery unit in 20 [20.8% (95% CI, 13.2-30.3%)] patients. CONCLUSIONS A sizeable proportion of PLWH remains susceptible for HAV infection in future outbreaks. A program based on referral to the vaccine delivery unit yields poor results, largely due to program adherence failures. New strategies are needed to increase HAV vaccination coverage.
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Affiliation(s)
- Anaïs Corma-Gómez
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Luis M Real
- Unit of Immunology, Biochemistry, Molecular Biology and Surgery, Faculty of Medicine, Universidad de Málaga, Spain
| | | | | | - Noemi Oliver
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Jesús Ortega
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Pilar Rincón
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | | | - Marta Santos
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Marta Trigo-Rodríguez
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain
| | - Juan Macías
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain; Unit of Medicine, Faculty of Medicine, Universidad de Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC.
| | - Juan A Pineda
- Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Spain; Unit of Medicine, Faculty of Medicine, Universidad de Sevilla, Spain; Instituto de Biomedicina de Sevilla (IBiS), Spain; CIBERINFEC
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Agustí C, Muñoz R, González V, Villegas L, Fibla J, Meroño M, Capitán A, Fernàndez-López L, Platteau T, Casabona J. Outreach HIV testing using oral fluid and online consultation of the results: Pilot intervention in Catalonia. Enferm Infecc Microbiol Clin 2020; 39:3-8. [PMID: 32151468 DOI: 10.1016/j.eimc.2020.01.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 10/03/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The aim of the intervention was to describe the feasibility and cost-effectiveness of offering HIV testing in outreach interventions and subsequent consultation of the results through a secure web page. METHODS The HIV test was offered "in situ" to men who have sex with men (MSM), migrant sex workers and trans women recruited in places of leisure and sex. Four collaborating NGOs recruited the participants and assisted them to register on the study website (www.swab2know.eu) through a tablet or the smartphone of the same participant. The samples were sent to the reference laboratory and the results were published on the website. RESULTS 834 participants (612 MSMs, 203 women sex workers and 19 trans women) were recruited. In total 22 reagent results (2.6%) were detected: 21 among MSMs (3.4%) and 1 in a trans women (5.3%). While 82.6% of MSMs consulted their outcome, only 39.9% and 26.3% of women sex workers and trans women respectively consulted their outcome CONCLUSIONS: Providing self-sampling in outreach activities, dispatch and analysis in a reference laboratory as well as online communication of test results is feasible. A high proportion of participants with a HIV reactive result were detected among MSMs and trans women.
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Affiliation(s)
- Cristina Agustí
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España.
| | - Rafael Muñoz
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España
| | - Victoria González
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | | | - Joan Fibla
- Associació Antisida Lleida, Lleida, España
| | | | | | - Laura Fernàndez-López
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España
| | - Tom Platteau
- Institute of Tropical Medicine, Department of Clinical Sciences, Antwerp, Bélgica
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Departament de Salut, Generalitat de Catalunya, Badalona, Barcelona, España; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, España; Departament de Pediatria, Obstetricia i Ginecologia i de Medicina Preventiva, Universitat Autònoma de Barcelona, Badalona, Barcelona, España
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Muñoz R, Agustí C, González V, Villegas L, Fernàndez-López L, Platteau T, Casabona J. [HIV screening in leisure spaces in Barcelona and Sitges in men who have sex with men]. Gac Sanit 2020; 34:208-210. [PMID: 31472946 DOI: 10.1016/j.gaceta.2019.05.013] [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] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 05/24/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
Description of the implementation of the field work of a pilot intervention whose objective was to promote the early diagnosis of HIV infection by offering a screening test for HIV in gay venues and cruising areas (outdoor sexual contact areas) frequented by men who have sex with men (MSM) in the city of Barcelona and Sitges, and consulting the result through the project website. The pilot intervention was viable and counted with the acceptability of the target group.
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Affiliation(s)
- Rafael Muñoz
- Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT) - Agència de Salut Pública de Catalunya (ASPCAT), Badalona (Barcelona), España; Stop Sida, Barcelona, España.
| | - Cristina Agustí
- Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT) - Agència de Salut Pública de Catalunya (ASPCAT), Badalona (Barcelona), España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Victoria González
- Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT) - Agència de Salut Pública de Catalunya (ASPCAT), Badalona (Barcelona), España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Servicio de Microbiología, Laboratori Clínic Metropolitana Nord, Hospital Universitari Germans Trias i Pujol, Badalona (Barcelona), España
| | | | - Laura Fernàndez-López
- Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT) - Agència de Salut Pública de Catalunya (ASPCAT), Badalona (Barcelona), España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Tom Platteau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Bélgica
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics sobre les ITS i Sida de Catalunya (CEEISCAT) - Agència de Salut Pública de Catalunya (ASPCAT), Badalona (Barcelona), España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva, Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
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Arando M, Caballero E, Curran A, Armengol P, Barberá MJ, Vall-Mayans M. The Epidemiological and Clinical Characteristics of the Epidemic of Syphilis in Barcelona. Actas Dermosifiliogr (Engl Ed) 2019; 110:841-849. [PMID: 31587806 DOI: 10.1016/j.ad.2019.03.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 10/16/2018] [Revised: 03/09/2019] [Accepted: 03/13/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Since 2000, substantial increases in syphilis have been reported in metropolitan areas of Western countries, with increases noted among men who have sex with men (MSM). Clinical manifestations of syphilis might be influenced by concomitant VIH infection and previous episodes of syphilis. The objectives of this study were to describe the epidemiological and clinical characteristics of the cases of syphilis diagnosed in Barcelona. METHODS Retrospective study of cases with early syphilis diagnosed in the referral STI Unit of Barcelona from January 2003 to December 2013. Revision of medical records with structured collection of epidemiological and clinical data. Univariate and multivariate statistical analyses comparing the characteristics of MSM cases with and without VIH infection and with and without previous syphilis. RESULTS A total of 1702 cases of syphilis (37% primary, 48% secondary and 14% early latent) were diagnosed, 93% of them in MSM. Among MSM 40% were coinfected with VIH, VIH-positive cases were associated with a previous syphilis (aOR, 5.2 [95% CI, 3.32-8.24]) and with unprotected anal intercourse (aOR, 1.75 [95%CI, 1.17-2.63]). Cases with a history of syphilis presented less often with primary syphilis compared to those without it (27.5% vs. 40%) (aOR, 0.58 [95% CI, 0.44-0.77]). One year after treatment, the clinical and serological evolution were similar between VIH-positive and VIH-negative cases. CONCLUSION The epidemic of syphilis in Barcelona disproportionately affects MSM and is closelly linked to VIH infection. The presentation of syphilis is influenced by VIH infection and by previous history of syphilis, without significant differences in their evolution after one year of treatment.
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Affiliation(s)
- M Arando
- Unidad de ITS de Vall d'Hebron-Drassanes, Departamento de Enfermedades Infecciosas, Hospital Vall d'Hebron, Barcelona, España; Departamento de Medicina, Universidad Autónoma de Barcelona, Barcelona, España.
| | - E Caballero
- Departamento de Microbiología, Hospital Vall d'Hebron, Barcelona, España
| | - A Curran
- Departamento de Enfermedades Infecciosas, Hospital Vall d'Hebron, Barcelona, España
| | - P Armengol
- Unidad de ITS de Vall d'Hebron-Drassanes, Departamento de Enfermedades Infecciosas, Hospital Vall d'Hebron, Barcelona, España
| | - M J Barberá
- Unidad de ITS de Vall d'Hebron-Drassanes, Departamento de Enfermedades Infecciosas, Hospital Vall d'Hebron, Barcelona, España
| | - M Vall-Mayans
- Unidad de ITS de Vall d'Hebron-Drassanes, Departamento de Enfermedades Infecciosas, Hospital Vall d'Hebron, Barcelona, España
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Ayerdi Aguirrebengoa O, Vera García M, Portocarrero Nuñez JA, Puerta López T, García Lotero M, Escalante Garcia C, Raposo Utrilla M, Estrada Pérez V, Del Romero Guerrero J, Rodríguez Martín C. Implementing pre-exposure prophylaxis could prevent most new HIV infections in transsexual women and men who have sex with men. Rev Clin Esp 2019; 219:360-366. [PMID: 30982539 DOI: 10.1016/j.rce.2019.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 09/17/2018] [Revised: 02/08/2019] [Accepted: 02/09/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP) consists of administering antiretroviral drugs to HIV-seronegative individuals who engage in high-risk practices, with the aim of reducing the probability of acquiring the infection. Despite its safety and efficacy, PrEP is still not available within Spain's public healthcare system. The aim of this study was to estimate the preventive impact of adding PrEP to the other preventive measures. We estimated the number of HIV seroconversions that could have been prevented (if PrEP had been available) among initially seronegative transsexual women and men who have sex with men. METHODS We conducted a descriptive study of recent HIV seroconverters between 2014-2016 in a reference HIV/sexually transmitted infection clinic in Madrid. We analysed the individuals who were indicated PrEP, according to the guidelines of the 2016 AIDS Study Group. The statistical analysis to estimate the HIV infections that could have been prevented (if PrEP had been available) was conducted using Stata 14. RESULTS We estimated that 195 of the 228 men who have sex with men and transsexual women, with documented HIV seroconversion, were indicated for PrEP. Considering the preventive efficacy reported in European studies, we estimated that 168 HIV seroconversions could have been prevented, which represents 73.7% of the diagnosed infections. CONCLUSIONS The results confirm the need to promote combined preventive programs against HIV that integrate all possible measures, including PrEP.
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Affiliation(s)
- O Ayerdi Aguirrebengoa
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, España; Universidad Complutense de Madrid, Madrid, España.
| | - M Vera García
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, España
| | | | - T Puerta López
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, España
| | - M García Lotero
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, España
| | - C Escalante Garcia
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, España
| | - M Raposo Utrilla
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, España
| | - V Estrada Pérez
- Universidad Complutense de Madrid, Madrid, España; Hospital Clínico San Carlos, IdISSC, Madrid, España
| | | | - C Rodríguez Martín
- Centro Sanitario Sandoval, IdISSC, Hospital Clínico San Carlos, Madrid, España; Universidad Complutense de Madrid, Madrid, España
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Hoyos J, Fernández-Balbuena S, Guerras JM, Pulido J, Sordo L, Belza MJ. Factors associated with poor linkage to HIV care and related barriers among men who have sex with men. Enferm Infecc Microbiol Clin 2019; 37:521-4. [PMID: 30948138 DOI: 10.1016/j.eimc.2018.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/07/2018] [Accepted: 12/15/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION We assessed poor linkage to HIV care in a sample of HIV positive men who have sex with men (MSM) diagnosed in Spain. METHODS From 2012 to 2013 we recruited a sample of MSM mainly through gay-dating websites. Poor linkage to care was defined as receiving the first CD4 count >3 months after HIV diagnosis. We performed a logistic regression analysis to estimate factors associated with poor linkage to care and analyzed the underlying reasons. RESULTS Some 9.4% self-reported poor linkage to care. Those diagnosed in clinical settings other than sexual health clinics or in non-clinical settings presented increased odds of poor linkage to care. The most common reason was being assigned an appointment for first CD4 count >3 months after initial HIV diagnosis. CONCLUSION Poor linkage to care was very low, but for further improvements fast-track referral pathways should be created, especially in contexts outside sexual health clinics.
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Jiménez-Vázquez V, Onofre-Rodríguez DJ, Benavides-Torres RA, Garza-Elizondo ME, Torres-Obregon R. [Use of online sexual material and safe sex in men who have sex with men]. Rev Int Androl 2018; 17:88-93. [PMID: 30177459 DOI: 10.1016/j.androl.2018.05.004] [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: 12/11/2017] [Revised: 02/19/2018] [Accepted: 05/07/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Sexual material online has represented, from its origins, an important role in the life of men who have sex with men. Internet, which has become a vehicle without restriction for its access, has favored an increase in the use of this material, and has had an impact on the sexual behavior of these men. OBJECTIVE To determine if the use of online sexual material influences safe sexual behavior in men who have sex with men. MATERIAL AND METHOD An analytical observational study was conducted, with a sample of 251 men who have sex with men from a city in northeastern Mexico. The respondent driven sampling was used, an ad hoc sociodemographic and sexuality data questionnaire was applied, and a questionnaire to measure the use of online sexual material and questionnaire on safe sexual behavior. RESULTS The simple linear regression model shows that the use of online sexual material negatively influences safe sexual behavior (R2=0.062; F[1,249]=16.937; p<0.01). CONCLUSIONS The findings provide the guideline to continue with studies in the investigation of said sociocultural variable and its consideration is proposed in the programs focused on the prevention of HIV in this population.
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Affiliation(s)
- Vicente Jiménez-Vázquez
- Facultad de Enfermería, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Dora Julia Onofre-Rodríguez
- Facultad de Enfermería, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, México.
| | - Raquel Alicia Benavides-Torres
- Facultad de Enfermería, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, México
| | - María Eugenia Garza-Elizondo
- Facultad de Enfermería, Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Reyna Torres-Obregon
- Facultad de Enfermería, Unidad Saltillo, Universidad Autónoma de Coahuila, Saltillo, México
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Morgado-Carrasco D, Alsina Gibert M, Bosch Mestres J, Álvarez Martínez M, Blanco Arévalo JL, Fuertes de Vega I. Sexually transmitted diseases of the anus and rectum: Causal agents, coinfections, HIV infection and high-risk sexual behaviour. Med Clin (Barc) 2018; 152:98-101. [PMID: 29680458 DOI: 10.1016/j.medcli.2018.02.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 11/25/2017] [Revised: 02/06/2018] [Accepted: 02/09/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION AND OBJECTIVE Sexually transmitted infections of the rectum and anus (STI-RA) mainly affect men who have sex with men (MSM). The incidence of STI-RA among them has increased in recent years. MATERIAL AND METHODS Retrospective study in patients with diagnoses of STI-RA in an STI unit during the years 2014 and 2015. Epidemiological, clinical and microbiological data were collected. RESULTS We included 95 patients, all of whom were MSM; 88.42% were HIV+; 67.17% did not use a condom during their most recent sexual intercourse; 17.91% had had sex with sex workers and 72.22% had used drugs during sexual intercourse during the previous year. A percentage of 32.92 reported symptoms that had lasted longer than 30 days. Lymphogranuloma venereum (LGV) was diagnosed in 54.73% of the patients. All patients who presented with proctitis and perianal ulcers were diagnosed with LGV infection. All those who presented perianal ulcers without proctitis were diagnosed with syphilis. CONCLUSIONS All the patients affected by STI-RA were MSM, most of them HIV+, had engaged in high-risk sexual behaviour and had suffered prolonged symptomatology. Clinical and microbiological characteristics of STI-AR could help adjust the empiric therapy.
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Affiliation(s)
- Daniel Morgado-Carrasco
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - Mercè Alsina Gibert
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España
| | - Jordi Bosch Mestres
- Servicio de Microbiología, Hospital Clínic de Barcelona, Universitat de Barcelona, ISGlobal, Barcelona, España
| | - Miriam Álvarez Martínez
- Servicio de Microbiología, Hospital Clínic de Barcelona, Universitat de Barcelona, ISGlobal, Barcelona, España
| | - José Luís Blanco Arévalo
- Servicio de Infectología, Hospital Clínic de Barcelona, Universitat de Barcelona, ISGlobal, Barcelona, España
| | - Irene Fuertes de Vega
- Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, España.
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Espinel M, Belza MJ, Cabeza-de-Vaca C, Arranz B, Guerras JM, Garcia-Soltero J, Hoyos J. Indicator condition based HIV testing: Missed opportunities for earlier diagnosis in men who have sex with men. Enferm Infecc Microbiol Clin 2017; 36:465-471. [PMID: 28993068 DOI: 10.1016/j.eimc.2017.07.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Contact with the healthcare system by a sample of seropositive men who have sex with men (MSM) prior to their HIV diagnosis are analysed, and missed opportunities (MO) for an earlier HIV diagnosis are identified. METHODOLOGY Between 2012-2013, an online survey was conducted among HIV-positive MSM, mainly recruited from gay websites. Those who were diagnosed with HIV between 2010-2013 were analysed. MO were defined as episodes prior to the HIV diagnosis in which the healthcare system was contacted due to an indicator condition of HIV infection and the test was not suggested. The proportion of missed opportunities were compared according to the type of indicator condition, the department consulted and the healthcare professional's knowledge that the patient was MSM. RESULTS Overall, 639 participants (66% of 966) reported 1,145 episodes with some indicator condition, the majority of these being identified in primary care (n=527; 46%). The highest percentage of MOs is also observed in primary care (63%). Although the indicator condition with the highest number of MOs was STIs (n=124), the highest percentage of MOs was observed in consultations due to diarrhoea with no known cause (69.8%). The percentage of MOs when the doctor knew that the patient was MSM was 40 vs. 70% when the doctor did not know. CONCLUSION The majority of HIV-positive MSM analysed in this study went to healthcare services for HIV-infection indicator conditions prior to their HIV diagnosis. Primary care was the most-frequently-visited department and is also where the most opportunities were missed to perform an HIV test, even when it was known that the patient was a MSM.
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Affiliation(s)
| | - María José Belza
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España.
| | | | - Beatriz Arranz
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
| | - Juan Miguel Guerras
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
| | | | - Juan Hoyos
- Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, España; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, España
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10
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Prieto P, Imaz A, Calatayud L, García O, Saumoy M, Podzamczer D. Extracutaneous atypical syphilis in HIV-infected patients. Med Clin (Barc) 2017; 149:488-92. [PMID: 28739269 DOI: 10.1016/j.medcli.2017.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/26/2017] [Accepted: 06/08/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION AND OBJETIVE We describe a series of cases of syphilis with atypical extracutaneous clinical presentation diagnosed in HIV-infected patients. METHODS Retrospective observational study. All cases of syphilis diagnosed in HIV-infected patients during the period between June 2013 and June 2016 in a tertiary hospital of the Barcelona metropolitan area were analysed. RESULTS A total of 71 cases of syphilis were diagnosed, 32 of them presenting with clinical signs or symptoms. Seven of these cases (9.8% of the total and 21.8% of the symptomatic cases) had atypical presentations with extracutaneous involvement: ocular (4), gastric (1), multiple hepatic abscesses (1) and generalised adenopathies (1). Patients were treated with intramuscular or intravenous penicillin and the clinical and serological evolution was good in all of them. CONCLUSIONS Extracutaneous atypical clinical presentations were observed in 21.8% of symptomatic cases of syphilis in HIV+ patients with ocular involvement being the most freqent.
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Abstract
OBJECTIVE To analyze the construct validity and the internal consistency of the 12-item Bem Sex Role Inventory (BSRI-12) questionnaire and to study the association between gender stereotypes and sexual risk practices in men who have sex with men (MSM). METHODS Cross-sectional study of 601 MSM who voluntarily and anonymously responded to an online survey on risk practices and gender stereotypes. The BSRI-12 was used to obtain gender stereotypes (masculine, feminine, undifferentiated and androgynous). For data analysis, exploratory factor analysis (EFA) of the BSRI-12 and logistic regression were performed. RESULTS Two main factors (Cronbach alpha 0.95 and 0.81) were obtained from the EFA. Using the androgynous roles as the reference category, we found lower odds of engaging in unprotected anal intercourse (UAI) among those who endorse feminine roles (OR: 0.53; 95%CI: 0.29-0.95). Endorsing masculine roles with alcohol consumption (OR: 1.92; 95%CI: 1.15-3.20) or the undifferentiated when not knowing the partner's serological status (OR: 1.55; 95%CI: 1.02-2.35) were associated with higher odds of UAI compared to those endorsing the androgynous roles. Undifferentiated participants also perform receptive UAI using poppers (OR: 2.19; 95%CI: 1.24-3.87), and insertive UAI not knowing the serological status of the sexual partner (OR: 1.69; 95%CI: 1.04-2.76) compared to androgynous participants. CONCLUSION The BSRI is a valid and consistent instrument for identifying gender stereotypes in MSM. A greater proportion of participants within the undifferentiated and the masculine category engage in risk practices with the influence of substance consumption and unawareness of their sexual partner's serological status. The information obtained may be useful to define intervention and prevention programs.
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Affiliation(s)
- Ángel Gasch Gallén
- Pyschiatry and Nursing Department, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
| | - Concepción Tomás Aznar
- Pyschiatry and Nursing Department, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Encarnación Rubio Aranda
- Microbiology, Preventive Medicine and Public Health Department, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
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12
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Gállego-Lezáun C, Arrizabalaga Asenjo M, González-Moreno J, Ferullo I, Teslev A, Fernández-Vaca V, Payeras Cifre A. Syphilis in Men Who Have Sex With Men: A Warning Sign for HIV Infection. Actas Dermosifiliogr 2015; 106:740-5. [PMID: 26188931 DOI: 10.1016/j.ad.2015.05.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 03/09/2015] [Revised: 05/14/2015] [Accepted: 05/21/2015] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To describe the clinical and epidemiological characteristics of syphilis in men who have sex with men (MSM) in an area of Mallorca, Spain. METHODS We performed a retrospective analysis of syphilis cases in MSM seen at a hospital in Mallorca between January 2005 and June 2013. RESULTS Fifty-five cases of syphilis were recorded in MSM during the study period (34.3% of all cases diagnosed), and 74.5% of these patients had human immunodeficiency virus (HIV) coinfection. The two diseases had been diagnosed simultaneously in 70.7% of this population. Patients with HIV coinfection had a median CD4 count of 456cells/μL (range, 29-979 cells/μL). Syphilis was diagnosed clinically in 49.1% of cases and by screening in the remaining 50.9%. The most common form of syphilis was late latent or indeterminate syphilis (41.9% of cases). In the group of men with syphilis, MSM had a higher risk of HIV infection. CONCLUSIONS A majority of MSM with syphilis had HIV coinfection. HIV screening is therefore essential in this population and could even result in early diagnosis.
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Affiliation(s)
- C Gállego-Lezáun
- Medicina Interna, Hospital Son Llàtzer, Palma de Mallorca, España.
| | | | | | - I Ferullo
- Medicina Interna, Hospital Son Llàtzer, Palma de Mallorca, España
| | - A Teslev
- Medicina Interna, Hospital Son Llàtzer, Palma de Mallorca, España
| | - V Fernández-Vaca
- Medicina Interna, Hospital Son Llàtzer, Palma de Mallorca, España
| | - A Payeras Cifre
- Medicina Interna, Hospital Son Llàtzer, Palma de Mallorca, España
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13
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Culqui DR, García-de-Olalla-Rizo P, Alva-Chavez KP, Lafuente S, Rius C, de Simón M, Sabater S, Caylá JA. [Analysis of the epidemiological pattern of Shigellosis in Barcelona between 1988 and 2012: Is it an emerging sexually transmitted infection?]. Enferm Infecc Microbiol Clin 2014; 33:379-84. [PMID: 25487603 DOI: 10.1016/j.eimc.2014.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 05/02/2014] [Revised: 08/19/2014] [Accepted: 09/11/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The aim of this study was to describe the evolution and epidemiologic characteristics of shigellosis patients over a 25 year period in a large city. METHODS Shigellosis is a notifiable disease in Spain since 1988. Cases are analyzed in Barcelona residents included in the registry between 1988-2012. A descriptive analysis by sex, age, mode of transmission and Shigella species is presented. Trend analysis and time series were performed. RESULTS Of the 559 cases analyzed, 60.15% were males. A sustained increase was observed in the trend since 2008 in males (p<0,05), especially at the expense of males who had no history of food poisoning or travel to endemic areas. The increasing tendency was greater in males from 21 to 60 years, both for S. flexneri (since 2009), and for S. sonnei (since 2004). In 2012 it was noted that in the men with S. flexneri, the 63% were men who have sex with men. CONCLUSIONS An increased trend was detected in men who had no history of food poisoning or travel to endemic areas. This increase points to a change in the pattern of shigellosis, becoming predominantly male and its main mechanism probably by sexual transmission.
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Affiliation(s)
- Dante R Culqui
- Departamento de Epidemiología, Agencia de Salud Pública de Barcelona (ASPB), Programa de Epidemiología de Campo PEAC-Centro Nacional de Epidemiología-Instituto de Salud Carlos III; Programa de Doctorado en Medicina Preventiva y Salud Pública, Universidad Autónoma de Madridorg, Madrid, España
| | - Patricia García-de-Olalla-Rizo
- Departamento de Epidemiología, Agencia de Salud Pública de Barcelona (ASPB), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España.
| | - Kenedy Pedro Alva-Chavez
- Centro de Ciencias Humanas y Sociales, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, España
| | - Sarah Lafuente
- Departamento de Epidemiología, Agencia de Salud Pública de Barcelona (ASPB), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
| | - Cristina Rius
- Departamento de Epidemiología, Agencia de Salud Pública de Barcelona (ASPB), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
| | - Mercè de Simón
- Servicio de Microbiología, Agencia de Salud Pública de Barcelona (ASPB), Barcelona, España
| | - Sarah Sabater
- Servicio de Microbiología, Agencia de Salud Pública de Barcelona (ASPB), Barcelona, España
| | - Joan A Caylá
- Departamento de Epidemiología, Agencia de Salud Pública de Barcelona (ASPB), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, España
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14
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González-Domenech CM, Antequera Martín-Portugués I, Clavijo-Frutos E, Márquez-Solero M, Santos-González J, Palacios-Muñoz R. [Syphilis and human immunodeficiency virus infection: an endemic infection in men who have sex with men]. Enferm Infecc Microbiol Clin 2014; 33:32-6. [PMID: 25444048 DOI: 10.1016/j.eimc.2014.07.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [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: 02/25/2014] [Revised: 07/18/2014] [Accepted: 07/31/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE to analyse epidemiological, clinical, and analytical features of HIV-infected men who have sex with men (MSM) diagnosed with syphilis in the Infectious Diseases Unit (Hospital Virgen de la Victoria, Málaga, Spain) during 2004-2013. PATIENTS AND METHODS An observational study was conducted on 196 syphilis episodes in 167 MSM infected with HIV (2004-2013). Epidemiological, clinical, and analytical data were collected. Annual syphilis incidence among HIV-MSM is calculated as the number of syphilis episodes among MSM in one year divided by the number of MSM followed up in that year. RESULTS Incidence ranged from 1.2% (2007) to 7.8% (2012). There were asymptomatic episodes in 42.8% cases, and an HIV-syphilis coincident diagnosis in 28.5%. CONCLUSIONS The annual incidence of syphilis has increased within HIV infected MSM. One third of the syphilis episodes were simultaneous to HIV diagnosis and near half of them were asymptomatic.
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Affiliation(s)
- Carmen M González-Domenech
- Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología Clínica, Hospital Virgen de la Victoria, Málaga, España
| | | | - Encarnación Clavijo-Frutos
- Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología Clínica, Hospital Virgen de la Victoria, Málaga, España
| | - Manuel Márquez-Solero
- Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología Clínica, Hospital Virgen de la Victoria, Málaga, España; Instituto de investigación biomédica de Málaga (IBIMA), España
| | - Jesús Santos-González
- Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología Clínica, Hospital Virgen de la Victoria, Málaga, España; Instituto de investigación biomédica de Málaga (IBIMA), España
| | - Rosario Palacios-Muñoz
- Unidad de Gestión Clínica de Enfermedades Infecciosas y Microbiología Clínica, Hospital Virgen de la Victoria, Málaga, España; Instituto de investigación biomédica de Málaga (IBIMA), España.
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15
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Fernández de Mosteyrín S, del Val Acebrón M, Fernández de Mosteyrín T, Fernández Guerrero ML. [Practices and perception of risk in human immunodeficiency virus infected males who have sex with other males]. Enferm Infecc Microbiol Clin 2013; 32:219-24. [PMID: 23896320 DOI: 10.1016/j.eimc.2013.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 09/30/2012] [Revised: 03/23/2013] [Accepted: 04/17/2013] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The incidence of human immunodeficiency virus (HIV) and other sexually transmitted diseases increases in males who have sex with males (MSM), despite the knowledge on how to prevent them. To determine the mechanisms that are driving this lack of prevention is important to reverse the trend. PATIENTS AND METHODS An anonymous, voluntary and self-reporting questionnaire was completed by HIV+ MSM patients who were seen in a hospital clinic, with the aim of finding out the sexual risk practices and behaviour, as well as their perceptions and assessment as regards this risk. The questionnaire included 58questions, divided into 10sections, to explore the knowledge, attitudes, and behaviour as regards HIV. The questionnaires were also given to the physicians, with the aim of exploring their perceptions, attitudes and opinions as regards the situation of the epidemic, prevention, perception of the diseases and the patient, and values in clinical practice. RESULTS A total of 495 questionnaires from the patients were analysed. Most of them (87%) said they knew how HIV was acquired, and 97% knew how to prevent it, but 69% knew they were in a risk situation, and 43% had little concern of contracting HIV. Almost two-thirds (65%) had sex with ≥2persons on the same day, 47% met on the Internet and 26% had group sex. The same percentage of those surveyed considered that they acted impulsively. They highlighted a lack of information (33%), bad luck (32%), assumed excessive risk (36%), and lake of concern (25%), as the main reasons for acquiring the infection. When confronted with diagnosis 41% of patients answered «I never thought that it would happen to me», and 32% said «I had bad luck». Of the 121 physicians who completed the questionnaire, 24% considered that infection due to HIV/AIDS was out of control in Spain, and 65% responded that there was an image that HIV/AIDS was a controlled disease and of little concern. A large majority (71%) of those surveyed, considered that the increase in new infections showed that there was no suitable preventive plan. CONCLUSIONS The management of the risk of acquiring HIV maintains a low level of concern, due to the optimism produced by the advances in the fight against the disease and the current toning down of the discussion. The trivialisation of the risk, on distorting the idea of risky behaviour, is a determining factor of attitudes that makes it impossible to adopt effective preventive behaviour and to take sensible and anticipated decisions.
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Affiliation(s)
- Sol Fernández de Mosteyrín
- División de Enfermedades Infecciosas, Departamento de Medicina, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España
| | - María del Val Acebrón
- División de Enfermedades Infecciosas, Departamento de Medicina, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España
| | - Teresa Fernández de Mosteyrín
- División de Enfermedades Infecciosas, Departamento de Medicina, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España
| | - Manuel L Fernández Guerrero
- División de Enfermedades Infecciosas, Departamento de Medicina, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España.
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