Risk factors associated with sexually transmitted infections among HIV infected men who have sex with men

Abstract

To investigate the factors associated with sexually transmitted infection and Human Immunodeficiency Virus (STI-HIV) co-infection among men who have sex with men (MSM). A total of 357 HIV-infected participants (84 STI-HIV co-infection and 273 HIV infections only) were recruited from Jiangsu, China. Logistic regression analyses were used to estimate the related factors associated with STI-HIV co-infection. Marginal structural models were adopted to estimate the effect of transmission drug resistance (TDR) on STI-HIV co-infection. For all participants, logistic regression analyses revealed that those who diagnosed with HIV-1 for longer duration (≥1.8 years) were significantly associated with reduced STI-HIV co-infection risk (OR = 0.55, 95%CI: 0.32–0.96, P = 0.036). In further stratification analysis by antiretroviral therapy (ART), individuals with longer duration showed consistent significant associations with STI-HIV co-infection risk (OR = 0.46, 95%CI: 0.26–0.83, P = 0.010) among MSM with ART-naïve status. In addition, significant reduced risk for STI-HIV co-infection (OR = 0.98, 95%CI: 0.96–0.99, P = 0.010) were observed in younger (under the average age of 31.03) MSM of the same group. Interestingly, we also found TDR was significantly associated with an increased risk of STI-HIV co-infection risk (OR = 3.84, 95%CI: 1.05–14.03, P = 0.042) in ART-naïve group. Our study highlights a pattern of STI-HIV co-infection among MSM in China and indicates that targeted interventions aimed at encouraging TDR monitoring in MSM with early HIV infection are warranted.

High Prevalence of Sexually Transmitted Infections and Risk Factors Among HIV-Positive Individuals in Yunnan, China

“…In the present study, a rather high STI prevalence among HIVpositive individuals was con rmed, namely, 47.0% (191/406) in total,45.1% (91/204) in ART-naive individuals and 49.0% (99/202) in ART individuals. This prevalence is much higher than the 5.3% observed in the HIVpositive individuals in Nepal [19], the 11.1% detected in the women living with HIV/AIDS (WLHA) in Uganda [20] and the 23.5% of HIV-infected MSM in China [21], but the prevalence was less than the 60.6% of female sex workers in Peru [22] and the 60.5% of HIV-infected Women in Zimbabwe [23]. The prevalence of genital tract discomfort was 0.5%…”

High prevalence of sexually transmitted infections and risk factors among HIV-positive individuals in Yunnan, China

“…In the present study, a rather high STI prevalence among HIV-positive individuals was confirmed, namely, 47.0% (191/406) in total, 45.1% (91/204) in ART-naive individuals and 49.0% (99/202) in individuals receiving ART. This prevalence is much higher than the observed prevalence of 5.3% in HIV-positive individuals in Nepal [ 19 ], 11.1% in women living with HIV/AIDS (WLHA) in Uganda [ 20 ] and 23.5% in HIV-infected men who have sex with men (MSM) in China [ 21 ], but the prevalence was less than that of 60.6% in female sex workers in Peru [ 22 ] and 60.5% in HIV-infected women in Zimbabwe [ 23 ]. The prevalence of genital tract discomfort was 0.5% (2/406), which was lower than the STI prevalence.…”

Prevalence of co-infections with other sexually transmitted infections in patients newly diagnosed with anogenital warts in Guangzhou, China

“…Opportunistic screening for other STIs during medical visits for anogenital warts helps doctors identify common yet asymptomatic co-infecting diseases that would have otherwise been overlooked and under-reported by patients. While opportunistic screening is oftentimes applied for patients from high-risk groups, [21][22][23][24][25][26][27][28][29]33,34 expanding this procedure for men and women newly diagnosed with anogenital warts can improve treatment and care for patients in China. This approach enables Chinese doctors to follow international protocols of screening non-high-risk populations consistent with other low-and-middle 8,37 as well as highincome 5,9,31,36 countries.…”

“…Much of the available clinical research from China is based on studies of high-risk groups such as FSWs, 26,27 MSM, 22,24,25 HIV-positive patients, 29 and migrants, 28 and only on a limited range of common STI co-infections. In reviewing research conducted in China from data collected between 1998 and 2017 on STI co-infections, we find that the majority of studies target MSM, FSWs, HIV-positive, and HIV high-risk populations.…”

“…1,7,13,21 Yet, the range of common STIs makes identifying the prevalence of STI co-infections problematic in the effective treatment of newly diagnosed patients. Furthermore, much of the co-infection literature for China are based on studies focused on one or two common STIs for high-risk populations such as men who have sex with men (MSM), female sex workers (FSWs), and migrant communities; [22][23][24][25][26][27][28][29] do not provide the same panel of STI co-infection assessments for men and for women; 23,[25][26][27]29 or only provide opportunistic screening for STI co-infection as part of intervention studies of high-risk populations and not for non-high-risk populations in all health-care settings. 2,22,[25][26][27]29 Our study addresses these gaps in research and clinical knowledge by investigating the prevalence of co-infecting STIs in male and female patients initially presenting to our clinic with anogenital warts in Guangzhou, China.…”