Determining the screening frequency for sexually transmitted infections for people who use HIV pre-exposure prophylaxis: a systematic review and meta-analysis

Kim, Cham-mill; Zhao, Victor; Mello, Maeve B.; Baggaley, Rachel; Johnson, Cheryl; Spielman, Erica; Fairley, Christopher K; Zhang, Lei; Vries, Henry De; Klausner, Jeffrey D.; Zhao, Rui; Ong, Jason J.

doi:10.1016/j.ijid.2023.01.007

Cited by 4 publications

(2 citation statements)

References 39 publications

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“…It is important to recognise regional and national STI epidemics in order to promote STI prevention and control interventions considering the test and treat approach as opposed to syndromic management (Ngobese & Abbai, 2021). Although more frequent STI screening could reduce delayed diagnoses and incidence, there remain significant knowledge gaps regarding the optimal STI screening frequency (Kim et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Sexually transmitted infections: a narrative review with a note on prevalence in Nigeria

Oduvwu

2024

JOHASAM

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Sexually transmitted infections (STIs) are a group of infections in which the principal way of transmission is sexual contact. This article is a narrative review on STIs. The aim is to synthesize information on various aspects of STIs with a note on current prevalence in Nigeria, in order to provide an update for public enlightenment and so stimulate appropriate actions both individually and collectively. Information from research articles written in English published in international peer-reviewed journals that investigated STIs as well as official publications and books related to the topic were included. Google search engine was used. It was found that STIs may be classified by causative organism or by type of lesion. Most risk factors for STIs emanate from lifestyle and personal behaviour. More than 1 million STIs are acquired everyday worldwide. Each year there are an estimated 374 million new infections with 1 of 4 curable STIs. A recent survey in Southern Nigeria found that the prevalence of STIs among a sexually active population is 27.7%. Signs and symptoms are many but vary depending on the particular STI. Effective treatment is available for several STIs. Methods of prevention and control are also available. The burden of STIs globally is enormous. The prevalence in Nigeria remains high. A gap in knowledge and practice of prevention exits. Therefore, there is need for more health education, including community sensitization, to improve the knowledge and practice of prevention and to reduce the prevalence of STIs in Nigeria and globally.

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Section: Introductionmentioning

confidence: 99%

Sexually transmitted infections: a narrative review with a note on prevalence in Nigeria

Oduvwu

2024

JOHASAM

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“…11 They have largely based this call on modelling studies, some of whom have found that two-to threemonthly screening reduces incidence, and the finding that more frequent screening detects more infections which, if treated, will reduce the population prevalence. 11,12 Partly as a response to these arguments and evidence of increasing incidence of these infections in many countries, numerous guidelines have increased the recommended intensity of screening for NG/CT to 3-monthly, 3-site (anorectum, urethra and pharynx) testing in MSM taking HIV pre-exposure prophylaxis (PrEP). 13 We have shown that screening MSM for NG/CT results in high levels of macrolide, cephalosporin and tetracycline consumption.…”

Section: Introductionmentioning

confidence: 99%

Does screening forNeisseria gonorrhoeaeandChlamydia trachomatisaffect the incidence of these infections in men who have sex with men taking HIV pre-exposure prophylaxis (PrEP)Results from a randomized, multicentre controlled trial (the Gonoscreen study)

Vanbaelen,

Tsoumanis,

Florence

et al. 2023

Preprint

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Background Guidelines recommend three-site (urine, anal, pharynx) three-monthly (3X3 screening) screening for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) in men who have sex with men (MSM) taking HIV pre-exposure prophylaxis (PrEP). We present the first randomized controlled trial to compare the effect of screening versus non-screening for NG/CT on the incidence of these infections in MSM taking PrEP. Methods A multicenter, randomized, controlled trial of 3X3 screening for NG/CT versus non-screening was conducted among MSM taking PrEP in five HIV reference centers in Belgium. Participants attended the PrEP clinics quarterly for 12 months. NG/CT was tested at each visit in both arms, but results were not provided to the non-screening arm. The primary outcome was the incidence rate (IR) of NG/CT infections in each arm, assessed in the per-protocol population. Non-inferiority of the non-screening arm was proven if the upper limit of the 95% confidence interval of the IR ratio (IRR) was lower than 1.25. The trial protocol was registered at clinicaltrials.gov (NCT04269434). Findings Between September 2020 and June 2021, 508 subjects were randomized to the 3X3 screening arm and 506 to the non-screening arm. The overall IR of NG/CT was 0.155 cases/100 person-days (95%CI 0.128-0.186) in the 3x3 screening arm and 0.205 (95%CI 0.171-0.246) in the non-screening arm. The IR was significantly higher in the non-screening arm (IRR 1.318, 95%CI 1.068-1.627). Participants in the non-screening arm had a higher incidence of CT infections and symptomatic CT infections. There were no significant differences in NG infections. Participants in the non-screening arm consumed significantly less antimicrobials. No serious adverse events were reported. Interpretation We failed to show that non-screening for NG/CT is non-inferior to 3-site 3-monthly screening in MSM taking PrEP in Belgium. However, screening was associated with higher antibiotic consumption and had no effect on the incidence of NG. Therefore, our findings do not provide strong support for screening for NG/CT in this population.

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Optimising HIV pre-exposure prophylaxis and testing strategies in men who have sex with men in Australia, Thailand, and China: a modelling study and cost-effectiveness analysis

Zhao,

Fairley,

Cook

et al. 2024

The Lancet Global Health

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Determining the screening frequency for sexually transmitted infections for people who use HIV pre-exposure prophylaxis: a systematic review and meta-analysis

Cited by 4 publications

References 39 publications

Sexually transmitted infections: a narrative review with a note on prevalence in Nigeria

Sexually transmitted infections: a narrative review with a note on prevalence in Nigeria

Does screening forNeisseria gonorrhoeaeandChlamydia trachomatisaffect the incidence of these infections in men who have sex with men taking HIV pre-exposure prophylaxis (PrEP)Results from a randomized, multicentre controlled trial (the Gonoscreen study)

Optimising HIV pre-exposure prophylaxis and testing strategies in men who have sex with men in Australia, Thailand, and China: a modelling study and cost-effectiveness analysis

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