Confirmed new HIV diagnoses in men who have sex with men after episodes of rectal gonorrhoea

Garvey, Lucy; Roberts, Colin; Smith, Allison G.

doi:10.1258/ijsa.2008.008426

Cited by 2 publications

(3 citation statements)

References 3 publications

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“…A visit at an STI clinic is also an excellent opportunity for the nurse or physician to discuss safer sex practices and to update the client of the current local STI situation and the importance of STIs, especially rectal infections and syphilis for HIV transmission [21,98].…”

Section: Discussionmentioning

confidence: 99%

Sexually Transmitted Infections (STI) in Men Who Have Sex with Men (MSM)

Bratt¹,

Edlund²,

Cullberg³

et al. 2009

TOIDJ

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Abstract:The impact of increasingly efficient antiretroviral therapy (ART) on survival and general well-being has contributed to a "business as usual" attitude to sex among men who have sex with men (MSM). There has been a recent marked increase of sexually transmitted infections (STI) including syphilis, LGV and Hepatits C among MSM. STIs located in the oral cavity or rectum are asymptomatic in over 80% and 50%, respectively and these sites must be seen as important reservoirs. On the other hand severe proctitis may be mistreated as inflammatory bowel disease without adequate medical history and testing. Due to the reappearance of syphilis, all genital ulcers, non-itching exanthema and severe disease symptoms (e.g. fever, fatigue, lymphadenopathy, hepato-splenomegaly, increased liver enzymes, neurological and ophthalmologic symptoms without other explanations) should lead to testing for syphilis. There is a marked association between STIs and HIV. Syphilis, LGV and Hepatits C are strongly overrepresented in HIV positive MSM, while gonorrhoea, LGV and syphilis increase the HIV susceptibility. Syphilis leads to increased viral load in HIV positive. The major risk factors for Hepatitis B are number of sex partners and receptive anal intercourse. High grade Human Papilloma Virus (HPV) anal lesions can progress to cancer. There is a 30 fold increase risk for anal cancer among MSM, a risk that is doubled in HIV infection, making anal cancer one of the most common non-AIDS tumours. All MSM should be offered Hepatitis A and B vaccination and the inclusion of boys in HPV vaccination programs must be considered. The aim of this article is to describe asymptomatic and symptomatic bacterial and viral STIs of the oral cavity, penis/urethra and rectum and the sexually transmittable viral Hepatitis and HIV in MSM and to inspire the medical establishment to adhere to testing guidelines in this group. This article is built on a review of published findings, the presentation of own data on Gonorrhoea and chlamydia and our own experience in treating all STIs including HIV in MSM since 1982 at a Gay Men's Health Clinic (Venhälsan) at Stockholm South General Hospital, Sweden.

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Section: Discussionmentioning

confidence: 99%

Sexually Transmitted Infections (STI) in Men Who Have Sex with Men (MSM)

Bratt¹,

Edlund²,

Cullberg³

et al. 2009

TOIDJ

View full text Add to dashboard Cite

show abstract

“…To increase the knowledge about actual risk factors for becoming HIV positive detailed studies of the recently HIV infected MSM are crucial. Recently acquired HIV is associated with having had an STI the last years and often having a concurrent STI, especially syphilis and rectal and urethral Gonorrhoea [96][97][98]. In one study 23% of newly HIV diagnosed MSM were concomitantly co-infected with another STI, with syphilis as the greatest risk (OR=11,1 (95% CI:7,7-15,8)) [57].…”

Section: Hivmentioning

confidence: 99%

“…Concurrent chlamydia, Gonorrhoea and syphilis were significant predictors of new HIV in four US metropolitan areas 2002-2006 [101]. Ano-rectal Gonorrhoea is an independent risk factor for HIV seroconversion [102] and high rates of new HIV infections have been observed after ano-rectal Gonorrhoea [98]. Also chlamydia has been associated to HIV infection [103].…”

Section: Hivmentioning

confidence: 99%