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Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men.
Sex Transm Dis. 2007 Oct; 34(10):783-90.ST

Abstract

BACKGROUND

Since 1996, there has been a resurgence in sexually transmitted infections (STIs) among men who have sex with men (MSM) in Western Europe. This has coincided with a significant decrease in HIV-associated mortality following the introduction of highly active antiretroviral therapies (HAART) and a corresponding increase in the number of MSM living with HIV. Levels of unprotected anal intercourse have also increased. In this article, we use STI surveillance data from a number of Western European countries to better understand the contribution of HIV-positive MSM to the recent increase in STIs.

METHODS

Published literature, surveillance reports, and ad hoc publications relating to HIV prevalence trends and STIs among HIV-positive MSM in Western Europe were reviewed.

RESULTS

Post-HAART, HIV prevalence among community samples of MSM ranged from 5% to 18%. HIV prevalence among MSM diagnosed with an STI was substantially higher. On average, HIV prevalence among MSM diagnosed with syphilis in 11 countries was 42% (range 14%-59%). Most HIV-positive MSM with syphilis were aware of their HIV status. In England and Wales, 32% of MSM with gonorrhea were HIV-positive in 2004. Outbreaks of lymphogranuloma venereum have been documented in 9 countries; HIV-positive MSM accounted for 75% of cases on average (range 0%-92%). Cases of sexually transmitted hepatitis C have been predominantly identified among HIV-positive MSM in Rotterdam, Paris, Amsterdam, and the United Kingdom.

CONCLUSIONS

In Western Europe, STIs have been disproportionately diagnosed among HIV-positive MSM post-HAART. Improved survival coupled with serosorting among HIV-positive MSM appears to explain the high prevalence of HIV among MSM with STIs. STI transmission among HIV-positive men will have contributed substantially to increasing STI trends seen among MSM in Western Europe, since 1996. These findings highlight the need for routine STI testing among HIV-positive MSM as well as safer sex messages highlighting the implications of STI coinfection.

Authors+Show Affiliations

City University, Institute of Health Sciences, St. Bartholomew School of Nursing and Midwifery, London, United Kingdom. s.dougan@city.ac.ukNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17495592

Citation

Dougan, Sarah, et al. "Sexually Transmitted Infections in Western Europe Among HIV-positive Men Who Have Sex With Men." Sexually Transmitted Diseases, vol. 34, no. 10, 2007, pp. 783-90.
Dougan S, Evans BG, Elford J. Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Sex Transm Dis. 2007;34(10):783-90.
Dougan, S., Evans, B. G., & Elford, J. (2007). Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. Sexually Transmitted Diseases, 34(10), 783-90.
Dougan S, Evans BG, Elford J. Sexually Transmitted Infections in Western Europe Among HIV-positive Men Who Have Sex With Men. Sex Transm Dis. 2007;34(10):783-90. PubMed PMID: 17495592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sexually transmitted infections in Western Europe among HIV-positive men who have sex with men. AU - Dougan,Sarah, AU - Evans,Barry G, AU - Elford,Jonathan, PY - 2007/5/15/pubmed PY - 2008/1/18/medline PY - 2007/5/15/entrez SP - 783 EP - 90 JF - Sexually transmitted diseases JO - Sex Transm Dis VL - 34 IS - 10 N2 - BACKGROUND: Since 1996, there has been a resurgence in sexually transmitted infections (STIs) among men who have sex with men (MSM) in Western Europe. This has coincided with a significant decrease in HIV-associated mortality following the introduction of highly active antiretroviral therapies (HAART) and a corresponding increase in the number of MSM living with HIV. Levels of unprotected anal intercourse have also increased. In this article, we use STI surveillance data from a number of Western European countries to better understand the contribution of HIV-positive MSM to the recent increase in STIs. METHODS: Published literature, surveillance reports, and ad hoc publications relating to HIV prevalence trends and STIs among HIV-positive MSM in Western Europe were reviewed. RESULTS: Post-HAART, HIV prevalence among community samples of MSM ranged from 5% to 18%. HIV prevalence among MSM diagnosed with an STI was substantially higher. On average, HIV prevalence among MSM diagnosed with syphilis in 11 countries was 42% (range 14%-59%). Most HIV-positive MSM with syphilis were aware of their HIV status. In England and Wales, 32% of MSM with gonorrhea were HIV-positive in 2004. Outbreaks of lymphogranuloma venereum have been documented in 9 countries; HIV-positive MSM accounted for 75% of cases on average (range 0%-92%). Cases of sexually transmitted hepatitis C have been predominantly identified among HIV-positive MSM in Rotterdam, Paris, Amsterdam, and the United Kingdom. CONCLUSIONS: In Western Europe, STIs have been disproportionately diagnosed among HIV-positive MSM post-HAART. Improved survival coupled with serosorting among HIV-positive MSM appears to explain the high prevalence of HIV among MSM with STIs. STI transmission among HIV-positive men will have contributed substantially to increasing STI trends seen among MSM in Western Europe, since 1996. These findings highlight the need for routine STI testing among HIV-positive MSM as well as safer sex messages highlighting the implications of STI coinfection. SN - 0148-5717 UR - https://www.unboundmedicine.com/medline/citation/17495592/Sexually_transmitted_infections_in_Western_Europe_among_HIV_positive_men_who_have_sex_with_men_ L2 - https://doi.org/10.1097/01.olq.0000260919.34598.5b DB - PRIME DP - Unbound Medicine ER -