المؤلفون: Sonali Wayal, Tyrone Curtis, Fiona Burns, Andrew Copas, Alison Rodger, Anthony Nardone

المصدر: Sexually transmitted infections

مصطلحات موضوعية: Adult, Male, Adolescent, Substance-Related Disorders, Cross-sectional study, Sexual Behavior, Sexually Transmitted Diseases, Dermatology, Hiv testing, Article, Men who have sex with men, Sexual and Gender Minorities, Young Adult, Risk-Taking, London, Prevalence, Humans, Medicine, Aged, Reproductive health, Risk behaviour, Illicit Drugs, business.industry, virus diseases, Behavioural intervention, Middle Aged, Recreational drug use, Cross-Sectional Studies, Infectious Diseases, Hiv status, business, Facilities and Services Utilization, Demography

الوصف: ObjectiveLondon has one of the highest identified prevalence of chemsex (sexualised recreational drug use) among men who have sex with men (MSM) in Europe. We examine MSM’s patterns of chemsex and its association with HIV/STI risk behaviours, STI diagnoses and sexual healthcare-seeking behaviours, including if HIV testing behaviour met UK national guidelines (three monthly if engaging in chemsex).MethodsCross-sectional survey data from 2013 (n=905) and 2016 (n=739) were collected using anonymous, self-administered questionnaires from MSM recruited in commercial gay venues in London, UK. Descriptive and multivariable analyses, stratified by self-reported HIV status, were conducted. Adjusted prevalence ratios (aPR) with 95% CIs were calculated.ResultsComparing the 2013 and 2016 surveys, chemsex prevalence in the past year remained stable, in both HIV-negative/unknown-status MSM (20.9% in 2013 vs 18.7% in 2016, p=0.301) and HIV-positive MSM (41.6% in 2013 vs 41.7% in 2016, p=0.992). Combined 2013–2016 data showed that compared with other MSM, those reporting chemsex were more likely to report HIV/STI risk behaviours, including condomless anal intercourse with serodifferent HIV-status partners (HIV-negative/unknown-status men: aPR 2.36, 95% CI 1.68 to 3.30; HIV-positive men: aPR 4.19, 95% CI 1.85 to 9.50), and STI diagnoses in the past year (HIV-negative/unknown-status men: aPR 2.10, 95% CI 1.64 to 2.69; HIV-positive men: aPR 2.56, 95% CI 1.57 to 4.20). 68.6% of HIV-negative/unknown-status men reporting chemsex attended sexual health clinics and 47.6% had tested for HIV more than once in the past year.ConclusionsChemsex in London MSM remained stable but high, particularly among HIV-positive men. Irrespective of HIV status, chemsex was associated with engagement in HIV/STI risk behaviours. Frequency of HIV testing in the past year among HIV-negative/unknown-status men was below national recommendations. Promoting combination prevention strategies, including three monthly HIV/STI testing, access to pre-exposure prophylaxis/antiretroviral treatment and behavioural interventions among MSM reporting chemsex, remains vital to address sexual health inequalities in MSM.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ebb9a82a17ad2a0008daa12b8b8ff8abTest
https://doi.org/10.1136/sextrans-2019-054139Test

المؤلفون: Christa Smolarchuk, Hamish Mohammed, Katy Town, Andrew Lee, Anthony Nardone, Janet Wilson, Gwenda Hughes, Martina Furegato, Helen Fifer

المصدر: Sexually Transmitted Infections. 95:594-601

مصطلحات موضوعية: Descriptive statistics, business.industry, Outbreak, Media coverage, Dermatology, Azithromycin, medicine.disease_cause, Interrupted Time Series Analysis, Infectious Diseases, medicine, Neisseria gonorrhoeae, Medical diagnosis, business, Reproductive health, Demography, medicine.drug

الوصف: ObjectivesTo determine if media coverage of an outbreak of high-level azithromycin-resistant Neisseria gonorrhoeae (HL-AziR) impacted online search interest or was temporally associated with health-seeking behaviours in several English cities.MethodsA descriptive analysis of outbreak-related online media articles and relative search interest (RSI) using Google and an interrupted time series analysis using routine surveillance data from sexual health clinics (SHCs) in England (GUMCAD STI surveillance system). The main outcomes were adjusted incidence rate ratios (IRRs) of weekly attendances, gonorrhoea tests and diagnoses of gonorrhoea or ‘any STI’ in selected cities after media coverage of the outbreak in 2015 and 2016.ResultsRSI for outbreak-related terms peaked during media coverage in September 2015 with smaller peaks coinciding with subsequent coverage. The greatest increase in RSI was in Leeds, which coincided with a 63% rise (n=1932; IRR 1.26, 95% CI 1.12 to 1.43) in SHC attendances by women. There was only a 7% (n=1358; IRR 1.01, 95% CI 0.91 to 1.11) increase in attendances by men. Modest increases in outcomes occurred in four other cities with a high RSI. There was no evidence of increases in outcomes in cities, other than Leeds, after subsequent media coverage of the outbreak.ConclusionsNational and local media coverage of the HL-AziR outbreak coincided with peak RSI for related terms, and a transient increase in attendances, gonorrhoea tests and diagnoses of gonorrhoea or ‘any STI’ in some cities with a high RSI. Our analysis demonstrates the potential for media coverage to influence health-seeking behaviours during high-profile STI outbreaks.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::6b723bb1927d2953fc8990c79e62d603Test
https://doi.org/10.1136/sextrans-2019-053986Test

المؤلفون: Marta Checchi, Lesley A Wallace, Anthony Nardone, Martina Furegato, D Thomas, Stephen Duffell, J Kevin Dunbar, Dana Ogaz, Paula Blomquist, Neil Irvine, Hamish Mohammed, Gwenda Hughes

المصدر: Sexually Transmitted Infections. 94:553-558

مصطلحات موضوعية: Male, 0301 basic medicine, medicine.medical_specialty, Sexual Behavior, 030106 microbiology, Population, Sexually Transmitted Diseases, HIV Infections, Dermatology, urologic and male genital diseases, History, 21st Century, Genital warts, Men who have sex with men, Gonorrhea, Sexual and Gender Minorities, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Humans, Medicine, Syphilis, 030212 general & internal medicine, Homosexuality, Male, Epidemics, education, Reproductive health, education.field_of_study, business.industry, Transmission (medicine), Public health, virus diseases, Chlamydia Infections, History, 20th Century, medicine.disease, female genital diseases and pregnancy complications, United Kingdom, Infectious Diseases, Condylomata Acuminata, Epidemiological Monitoring, Female, Public Health, business, Demography

الوصف: ObjectivesThe 1916 Royal Commission on Venereal Diseases was established in response to epidemics of syphilis and gonorrhoea in the UK. In the 100 years since the Venereal Diseases Act (1917), the UK has experienced substantial scientific, economic and demographic changes. We describe historical and recent trends in STIs in the UK.MethodsWe analysed surveillance data derived from STI clinics’ statistical returns from 1917 to 2016.ResultsSince 1918, gonorrhoea and syphilis diagnoses have fluctuated, reflecting social, economic and technological trends. Following spikes after World Wars I and II, rates declined before re-emerging during the 1960s. At that time, syphilis was more common in men, suggestive of transmission within the men who have sex with men (MSM) population. Behaviour change following the emergence of HIV/AIDS in the 1980s is thought to have facilitated a precipitous decline in diagnoses of both STIs in the mid-1980s. Since the early 2000s, gonorrhoea and syphilis have re-emerged as major public health concerns due to increased transmission among MSM and the spread of antimicrobial-resistant gonorrhoea. Chlamydia and genital warts are now the most commonly diagnosed STIs in the UK and have been the focus of public health interventions, including the national human papillomavirus vaccination programme, which has led to substantial declines in genital warts in young people, and the National Chlamydia Screening Programme in England. Since the 1980s, MSM, black ethnic minorities and young people have experienced the highest STI rates.ConclusionAlthough diagnoses have fluctuated over the last century, STIs continue to be an important public health concern, often affecting more marginalised groups in society. Prevention must remain a public health priority and, as we enter a new era of sexual healthcare provision including online services, priority must be placed on maintaining prompt access for those at greatest risk of STIs.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d40229f85914729182171b8c30404d10Test
https://doi.org/10.1136/sextrans-2017-053273Test

المؤلفون: Aseel Hegazi, Catherine M Lowndes, Marcus Pond, Anthony Nardone, Emma M. Harding-Esch, S Tariq Sadiq, Phillip Hay, Olanike Okolo, Achyuta V Nori

المصدر: Sexually Transmitted Infections

مصطلحات موضوعية: Male, 0301 basic medicine, Cost-Benefit Analysis, Gonorrhea, Ambulatory Care Facilities, CLINICAL STI CARE, 0302 clinical medicine, Clinical pathway, London, 030212 general & internal medicine, TRICHOMONAS, GeneXpert MTB/RIF, Vaginosis, Bacterial, 3. Good health, Reproductive Health, Infectious Diseases, Female, Bacterial vaginosis, Trichomonas Vaginitis, Nucleic Acid Amplification Techniques, Adult, medicine.medical_specialty, SERVICE DELIVERY, Sexual health clinic, Point-of-Care Systems, Sexual Behavior, Point-of-care testing, 030106 microbiology, Dermatology, DIAGNOSIS, Clinical, 03 medical and health sciences, Internal medicine, medicine, Humans, Urethritis, business.industry, Reproducibility of Results, Nucleic acid amplification technique, Chlamydia Infections, Patient Acceptance of Health Care, medicine.disease, BACTERIAL INFECTION, Surgery, Patient Outcome Assessment, Feasibility Studies, business, Program Evaluation

الوصف: OBJECTIVES: To assess clinical service value of STI point-of-care test (POCT) use in a 'sample first' clinical pathway (patients providing samples on arrival at clinic, before clinician consultation). Specific outcomes were: patient acceptability; whether a rapid nucleic acid amplification test (NAAT) for Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG) could be used as a POCT in practice; feasibility of non-NAAT POCT implementation for Trichomonas vaginalis (TV) and bacterial vaginosis (BV); impact on patient diagnosis and treatment. METHODS: Service evaluation in a south London sexual health clinic. Symptomatic female and male patients and sexual contacts of CT/NG-positive individuals provided samples for diagnostic testing on clinic arrival, prior to clinical consultation. Tests included routine culture and microscopy; CT/NG (GeneXpert) NAAT; non-NAAT POCTs for TV and BV. RESULTS: All 70 (35 males, 35 females) patients approached participated. The 'sample first' pathway was acceptable, with >90% reporting they were happy to give samples on arrival and receive results in the same visit. Non-NAAT POCT results were available for all patients prior to leaving clinic; rapid CT/NG results were available for only 21.4% (15/70; 5 males, 10 females) of patients prior to leaving clinic. Known negative CT/NG results led to two females avoiding presumptive treatment, and one male receiving treatment directed at possible Mycoplasma genitalium infection causing non-gonococcal urethritis. Non-NAAT POCTs detected more positives than routine microscopy (TV 3 vs 2; BV 24 vs 7), resulting in more patients receiving treatment. CONCLUSIONS: A 'sample first' clinical pathway to enable multiple POCT use was acceptable to patients and feasible in a busy sexual health clinic, but rapid CT/NG processing time was too long to enable POCT use. There is need for further development to improve test processing times to enable POC use of rapid NAATs.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::35e11eab11042d27fb1d1e1e244ae380Test
https://doi.org/10.1136/sextrans-2016-052988Test

المؤلفون: Gavin Dabrera, Martina Furegato, Hamish Mohammed, Z Yin, Gwenda Hughes, Anthony Nardone

المصدر: Sexually Transmitted Infections. 93:217-220

مصطلحات موضوعية: Adult, Male, Pediatrics, medicine.medical_specialty, Adolescent, Ethnic group, Black People, HIV Infections, Dermatology, Hiv testing, Logistic regression, Men who have sex with men, Treatment Refusal, Young Adult, 03 medical and health sciences, Risk-Taking, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), medicine, Humans, Mass Screening, 030212 general & internal medicine, Aged, Reproductive health, Aged, 80 and over, 030505 public health, business.industry, Middle Aged, medicine.disease, Partner notification, Test (assessment), Sexual Partners, Infectious Diseases, England, Female, 0305 other medical science, business, Demography

الوصف: Objectives Black Africans are one of the key risk groups for HIV in the UK and, among those living with HIV, an estimated 16% and 12% of black African heterosexual men and women, respectively, are undiagnosed and at risk of unknowingly transmitting HIV to their sex partners. Increased HIV test uptake is needed to address this, but there is limited information on how frequently HIV test refusal occurs among those attending sexual health clinics (SHCs). We identified factors associated with HIV test refusal among black African SHC attendees. Methods Data on all SHC attendances in England in 2014 were obtained from the genitourinary medicine clinic activity dataset, the mandatory surveillance system for STIs. Analyses were restricted to attendances by HIV-negative black Africans, and bivariate and multivariable associations between demographic and clinical characteristics and HIV test refusal were assessed. All associations were determined using generalised estimating equations logistic regression, and adjusted ORs (aORs) with 95% CIs are reported. Results Black Africans made 80 743 attendances at SHCs in 2014 and refused an HIV test on 9021 (11.2%) occasions. HIV test refusal was significantly more likely in women (aOR (95% CI) 1.54 (1.46 to 1.62) vs heterosexual men), and those living in the most deprived areas (1.44 (1.24 to 1.67)), diagnosed with a new STI (1.26 (1.18 to 1.34)) or living in London (1.06 (1.01 to 1.12)). Test refusal was significantly less likely with increasing age (0.99 (0.99 to 0.99)) and men who have sex with men (0.52 (0.43 to 0.63) vs heterosexual men), and in those tested for HIV in the past year (0.85 (0.81 to 0.89)), born outside the UK (0.73 (0.69 to 0.77)) or those attending following partner notification (0.11 (0.03 to 0.38)). Conclusions Targeted interventions are needed to improve HIV testing uptake and reduce undiagnosed HIV infection among black Africans attending SHCs, especially heterosexuals residing in deprived areas.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8b7b7c8b798746010a923df5e2995656Test
https://doi.org/10.1136/sextrans-2016-052737Test

المؤلفون: Prah, Philip, Hickson, Ford, Bonell, Chris, McDaid, Lisa M, Johnson, Anne M, Wayal, Sonali, Clifton, Soazig, Sonnenberg, Pam, Nardone, Anthony, Erens, Bob, Copas, Andrew J, Riddell, Julie, Weatherburn, Peter, Mercer, Catherine H

المصدر: Sexually Transmitted Infections

مصطلحات موضوعية: Adult, Male, GAY MEN, Health Knowledge, Attitudes, Practice, Adolescent, Unsafe Sex, Epidemiology, Substance-Related Disorders, Sexually Transmitted Diseases, virus diseases, Middle Aged, Health Surveys, Sampling Studies, United Kingdom, SEXUAL BEHAVIOUR, Young Adult, Reproductive Health, Sexual Partners, immune system diseases, Humans, Homosexuality, Male, SEXUAL HEALTH, Attitude to Health, reproductive and urinary physiology

الوصف: OBJECTIVE: To examine sociodemographic and behavioural differences between men who have sex with men (MSM) participating in recent UK convenience surveys and a national probability sample survey. METHODS: We compared 148 MSM aged 18-64 years interviewed for Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) undertaken in 2010-2012, with men in the same age range participating in contemporaneous convenience surveys of MSM: 15 500 British resident men in the European MSM Internet Survey (EMIS); 797 in the London Gay Men's Sexual Health Survey; and 1234 in Scotland's Gay Men's Sexual Health Survey. Analyses compared men reporting at least one male sexual partner (past year) on similarly worded questions and multivariable analyses accounted for sociodemographic differences between the surveys. RESULTS: MSM in convenience surveys were younger and better educated than MSM in Natsal-3, and a larger proportion identified as gay (85%-95% vs 62%). Partner numbers were higher and same-sex anal sex more common in convenience surveys. Unprotected anal intercourse was more commonly reported in EMIS. Compared with Natsal-3, MSM in convenience surveys were more likely to report gonorrhoea diagnoses and HIV testing (both past year). Differences between the samples were reduced when restricting analysis to gay-identifying MSM. CONCLUSIONS: National probability surveys better reflect the population of MSM but are limited by their smaller samples of MSM. Convenience surveys recruit larger samples of MSM but tend to over-represent MSM identifying as gay and reporting more sexual risk behaviours. Because both sampling strategies have strengths and weaknesses, methods are needed to triangulate data from probability and convenience surveys.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=pmid_dedup__::fbfedbc1318a12041e03e0f75b843976Test
http://europepmc.org/articles/PMC5013102Test

المؤلفون: Curtis, Tyrone J., Rodger, Alison J., Burns, Fiona, Nardone, Anthony, Copas, Andrew, Wayal, Sonali

المصدر: Sexually Transmitted Infections; May2020, Vol. 96 Issue 3, p197-203, 7p, 3 Charts

مصطلحات موضوعية: SEXUALLY transmitted disease diagnosis, EPIDEMIOLOGY of sexually transmitted diseases, SUBSTANCE abuse & psychology, RISK-taking behavior, RESEARCH, SUBSTANCE abuse, HUMAN sexuality, CROSS-sectional method, RESEARCH methodology, EVALUATION research, MEDICAL cooperation, COMPARATIVE studies, DISEASE prevalence, RESEARCH funding, DISEASE complications

مصطلحات جغرافية: ENGLAND

مستخلص: Objective: London has one of the highest identified prevalence of chemsex (sexualised recreational drug use) among men who have sex with men (MSM) in Europe. We examine MSM's patterns of chemsex and its association with HIV/STI risk behaviours, STI diagnoses and sexual healthcare-seeking behaviours, including if HIV testing behaviour met UK national guidelines (three monthly if engaging in chemsex).Methods: Cross-sectional survey data from 2013 (n=905) and 2016 (n=739) were collected using anonymous, self-administered questionnaires from MSM recruited in commercial gay venues in London, UK. Descriptive and multivariable analyses, stratified by self-reported HIV status, were conducted. Adjusted prevalence ratios (aPR) with 95% CIs were calculated.Results: Comparing the 2013 and 2016 surveys, chemsex prevalence in the past year remained stable, in both HIV-negative/unknown-status MSM (20.9% in 2013 vs 18.7% in 2016, p=0.301) and HIV-positive MSM (41.6% in 2013 vs 41.7% in 2016, p=0.992). Combined 2013-2016 data showed that compared with other MSM, those reporting chemsex were more likely to report HIV/STI risk behaviours, including condomless anal intercourse with serodifferent HIV-status partners (HIV-negative/unknown-status men: aPR 2.36, 95% CI 1.68 to 3.30; HIV-positive men: aPR 4.19, 95% CI 1.85 to 9.50), and STI diagnoses in the past year (HIV-negative/unknown-status men: aPR 2.10, 95% CI 1.64 to 2.69; HIV-positive men: aPR 2.56, 95% CI 1.57 to 4.20). 68.6% of HIV-negative/unknown-status men reporting chemsex attended sexual health clinics and 47.6% had tested for HIV more than once in the past year.Conclusions: Chemsex in London MSM remained stable but high, particularly among HIV-positive men. Irrespective of HIV status, chemsex was associated with engagement in HIV/STI risk behaviours. Frequency of HIV testing in the past year among HIV-negative/unknown-status men was below national recommendations. Promoting combination prevention strategies, including three monthly HIV/STI testing, access to pre-exposure prophylaxis/antiretroviral treatment and behavioural interventions among MSM reporting chemsex, remains vital to address sexual health inequalities in MSM. [ABSTRACT FROM AUTHOR]

: Copyright of Sexually Transmitted Infections is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Smolarchuk, Christa, Mohammed, Hamish, Furegato, Martina, Town, Katy, Fifer, Helen, Wilson, Janet, Nardone, Anthony, Lee, Andrew, Hughes, Gwenda

المصدر: Sexually Transmitted Infections; Dec2019, Vol. 95 Issue 8, p594-601, 8p, 2 Charts, 2 Graphs

مستخلص: Objectives: To determine if media coverage of an outbreak of high-level azithromycin-resistant Neisseria gonorrhoeae (HL-AziR) impacted online search interest or was temporally associated with health-seeking behaviours in several English cities.Methods: A descriptive analysis of outbreak-related online media articles and relative search interest (RSI) using Google and an interrupted time series analysis using routine surveillance data from sexual health clinics (SHCs) in England (GUMCAD STI surveillance system). The main outcomes were adjusted incidence rate ratios (IRRs) of weekly attendances, gonorrhoea tests and diagnoses of gonorrhoea or 'any STI' in selected cities after media coverage of the outbreak in 2015 and 2016.Results: RSI for outbreak-related terms peaked during media coverage in September 2015 with smaller peaks coinciding with subsequent coverage. The greatest increase in RSI was in Leeds, which coincided with a 63% rise (n=1932; IRR 1.26, 95% CI 1.12 to 1.43) in SHC attendances by women. There was only a 7% (n=1358; IRR 1.01, 95% CI 0.91 to 1.11) increase in attendances by men. Modest increases in outcomes occurred in four other cities with a high RSI. There was no evidence of increases in outcomes in cities, other than Leeds, after subsequent media coverage of the outbreak.Conclusions: National and local media coverage of the HL-AziR outbreak coincided with peak RSI for related terms, and a transient increase in attendances, gonorrhoea tests and diagnoses of gonorrhoea or 'any STI' in some cities with a high RSI. Our analysis demonstrates the potential for media coverage to influence health-seeking behaviours during high-profile STI outbreaks. [ABSTRACT FROM AUTHOR]

: Copyright of Sexually Transmitted Infections is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Anthony Nardone, Nigel Field, Martina Furegato, Holly Mitchell, Gwenda Hughes

المصدر: Sexually transmitted infections. 93(3)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Sexual Behavior, Clinical Decision-Making, Human immunodeficiency virus (HIV), HIV Infections, Pilot Projects, Dermatology, medicine.disease_cause, Logistic regression, Men who have sex with men, 03 medical and health sciences, 0302 clinical medicine, Risk-Taking, Acquired immunodeficiency syndrome (AIDS), Risk Factors, Internal medicine, medicine, Ambulatory Care, Humans, 030212 general & internal medicine, Homosexuality, Male, Reproductive health, Gynecology, 030505 public health, Chlamydia, Unsafe Sex, business.industry, Proportional hazards model, virus diseases, Patient Acceptance of Health Care, medicine.disease, Infectious Diseases, Treatment Outcome, England, Practice Guidelines as Topic, Syphilis, 0305 other medical science, business, Post-Exposure Prophylaxis

الوصف: Objectives To explore the risk factors for, and clinical outcomes in men who have sex with men (MSM) prescribed HIV postexposure prophylaxis following sexual exposure (PEPSE) at sexual health clinics (SHCs) in England. Methods National STI surveillance data were extracted from the genitourinary medicine clinic activity dataset (GUMCADv2) for 2011–2014. Quarterly and annual trends in the number of episodes where PEPSE was prescribed were analysed by gender and sexual risk. Risk factors associated with being prescribed PEPSE among MSM attendees were explored using univariable and multivariable logistic regression. Subsequent HIV acquisition from 4 months after initiating PEPSE was assessed using multivariable Cox proportional hazards models, stratified by clinical risk profiles. Results During 2011–2014, there were 24 004 episodes where PEPSE was prescribed at SHCs, of which 69% were to MSM. The number of episodes where PEPSE was prescribed to MSM increased from 2383 in 2011 to 5944 in 2014, and from 1384 to 2226 for heterosexual men and women. 15% of MSM attendees received two or more courses of PEPSE. Compared with MSM attendees not prescribed PEPSE, MSM prescribed PEPSE were significantly more likely to have been diagnosed with a bacterial STI in the previous 12 months (adjusted OR (95% CI)—gonorrhoea: 11.6 (10.5 to 12.8); chlamydia: 5.02 (4.46 to 5.67); syphilis: 2.25 (1.73 to 2.93)), and were more likely to subsequently acquire HIV (adjusted HR (aHR) (95% CI)—single PEPSE course: 2.54 (2.19 to 2.96); two or more PEPSE courses: aHR (95% CI) 4.80 (3.69 to 6.25)). The probability of HIV diagnosis was highest in MSM prescribed PEPSE who had also been diagnosed with a bacterial STI in the previous 12 months (aHR (95% CI): 6.61 (5.19 to 8.42)). Conclusions MSM prescribed PEPSE are at high risk of subsequent HIV acquisition and our data show further risk stratification by clinical and PEPSE prescribing history is possible, which might inform clinical practice and HIV prevention initiatives in MSM.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::76e625de7494b2bc29ec012539baebb9Test
https://pubmed.ncbi.nlm.nih.gov/27884964Test

المؤلفون: Martina Furegato, Carina King, Anthony Nardone, Gwenda Hughes, John Were, Hamish Mohammed

المصدر: Sexually transmitted infections. 92(6)

مصطلحات موضوعية: Drug, Adult, Male, medicine.medical_specialty, Clinical variables, Recreational Drug, Substance-Related Disorders, media_common.quotation_subject, Drug misuse, Sexual Behavior, 030508 substance abuse, Dermatology, Ambulatory Care Facilities, Men who have sex with men, Drug Users, Health Risk Behaviors, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, 030212 general & internal medicine, Homosexuality, Male, media_common, Reproductive health, business.industry, Public health, Infectious Diseases, Sexual behavior, England, Family medicine, Female, Sexual Health, 0305 other medical science, business

الوصف: Recent evidence highlights an increase in ‘chemsex’, the use of recreational drugs during sex, in men who have sex with men (MSM) and an association with risky sexual behaviours and outbreaks of STIs.1 However, the extent of sexualised drug use in people attending sexual health clinics (SHCs) is unknown. STI surveillance in England is performed by Public Health England (PHE) using a disaggregated patient-level dataset of all diagnoses and services at SHCs.2 This is a minimum dataset with key demographic and clinical variables, but lacks behavioural data. To address this gap, PHE …

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4145bab29c18e93ebe19d271a46a642eTest
https://pubmed.ncbi.nlm.nih.gov/27543514Test