International Journal of STD & AIDS最新文献

Background: Previous studies found vaccination uptake of vaccine-preventable diseases (VPD) to be associated with race/ethnicity and medical mistrust among key populations, however, few studies examine Hepatitis A vaccination uptake.

Methods: This cross-sectional study used online survey data collected from NJ and NY residents identifying as lesbian, gay, bisexual, transgender, queer (LGBTQ+) from October 2021 through November 2022.

Results: This study used a subsample of 222 gay, bisexual, and other cisgender men, 66.7% White, with mean age 41.22 years (SD = 15.23), and 60% fully vaccinated for Hepatitis A. Overall, average group-based medical mistrust scores did not differ among non-vaccinated participants compared to fully or partially vaccinated participants. However, higher group-based medical mistrust scores were associated with non-White identifying participants, and were highest among Hispanic/Latinx (2.68, sd = 0.43) and Black non-Hispanic (2.58, sd = 0.50) participants (p < .001). Vaccination patterns did not differ among fear or vaccine confidence-based items.

Conclusions: Our results contribute to the limited knowledge of differences in Hepatitis A vaccination uptake among men who have sex with men, and support the need for targeted intervention programs that acknowledge the diverse population of LGBTQ + identifying individuals and their associated health behaviors.

Resistance to antiretroviral therapy is an increasing challenge in the management of HIV. We present the case of a woman living with HIV, with a history of multiple treatment regimens and resistances to antiretrovirals, who has been successfully treated with a combination of lenacapavir and fostemsavir for the past year, obtaining an undetectable viral load within one month of starting therapy and reporting no serious side effects. This case is amongst the first to document the combined use of lenacapivir and fostemsavir in treating multidrug-resistant HIV. It supports the potential of these novel agents in managing complex cases of HIV resistance.

Background: Data on the occurrence of cervical precancer and cancer among women living with HIV (WLHIV) in Latin American countries (LAC) are scarce and highly heterogeneous.

Methods: We conducted a systematic review summarizing data about the incidence/prevalence of invasive cervical cancer (CC) and high-grade precancerous lesions among WLHIV in LAC. Literature in PubMed and LILACS was searched. The primary outcome was invasive cancer incidence, and prevalence of high-grade lesions as key indicators for the WHO CC elimination strategy. Individual reports on invasive cancer incidence and prevalence of precancerous lesions were obtained, and a random effects meta-analysis was conducted for the latter.

Results: In total, 34,343 WLHIV from four studies reporting CC incidence in seven LAC were included, and 6079 WLHIV from 17 studies reporting prevalence of precancerous lesions in three LAC were included. CC incidence ranged between 136.0 and 398.4 per 100,000 WLHIV (with or without antiretroviral therapy). The weighted prevalence of high-grade lesions was 4.1% (95%CI: 3.8%-6.0%) with a double peak at ages 20-24 and 35-39 years. Differences in prevalence of high-grade lesions were also observed by screening approach: co-testing (11.9%), colposcopy (6.0%), cytology (4.2%), and HPV tests (3.2%).

Conclusions: The high incidence of invasive cancer and prevalence of high-grade lesions underline challenges to reach the WHO's elimination goal of CC incidence below four per 100,000 among WLHIV. Moreover, the high prevalence of high-grade lesions at younger ages than in the general population is a call to accelerate the implementation of the new WHO screening recommendations in WLHIV.

Pure erythroid leukemia (AML-M6) is a rare variant of acute myeloid leukemia (AML) with predominant erythroid lineage proliferation. The incidence of AIDS defining cancers including Kaposi sarcoma and non-Hodgkins lymphoma are on declining trends due to effective use of HAART (Highly Active Antiretroviral Therapy). Correspondingly, there have been increasing cases of leukemia in persons living with HIV. Our case is a 43 years old male living with HIV who was admitted with high grade fever and mucosal bleeds. On examination, he had periorbital swelling and ecchymosis with hepatosplenomegaly. The laboratory investigations revealed bicytopenia with high ferritin, low fibrinogen and hypertriglyceridemia. A diagnosis of hemophagocytic lymphohistiocytosis (HLH) with H score of 222 was made. Bone marrow examination revealed hypercellular marrow with more than 80% cells of erythroid lineage with 47% proerythroblasts. Suggesting pure erythroid leukemia (AML-M6). This diagnosis with secondary HLH carries a very poor prognosis in persons living with HIV.

Background: The emergence of ceftriaxone-resistant Neisseria gonorrhoeae poses a significant threat to existing treatment regimens. Our study aimed to assess the efficacy of antimicrobials that could be combined with ceftriaxone to reduce the probability of ceftriaxone resistance emerging and spreading in N. gonorrhoeae.

Methods and results: Broth microdilution was used to determine the minimal inhibitory concentrations (MICs) for a panel of ceftriaxone-resistant (WHO X, Y, Z) and ceftriaxone-susceptible (WHO L, N, P) N. gonorrhoeae WHO reference strains for the following antimicrobials: ceftriaxone, doxycycline, azithromycin, zoliflodacin, fosfomycin, pristinamycin, ramoplanin, gentamicin and NAI-107. The MICs for zoliflodacin and pristinamycin for all strains were lower than or equal to the available breakpoints. A checkerboard assay was used to determine the drug-drug combination effect, which showed either an indifferent or an additive effect for all the combinations tested with ceftriaxone.

Conclusions: The low MICs of zoliflodacin and pristinamycin for the three ceftriaxone-resistant strains suggest that these antimicrobials could be used as partner drugs with ceftriaxone to reduce the probability of ceftriaxone resistance spreading in areas with a high prevalence of ceftriaxone resistance.

This position statement is aimed at front-line clinical practitioners and public health authorities in WHO European Region providing services for people wishing to reduce their risk of acquiring sexually transmitted infections (STIs), including HIV.

Psoriasis, a chronic inflammatory skin disease, presents unique challenges when co-occurring with HIV. Tildrakizumab, an IL-23p19 inhibitor, has demonstrated efficacy in treating moderate-to-severe psoriasis. This retrospective case series reports three individuals living with HIV and psoriasis treated with tildrakizumab. Clinical outcomes, including Psoriasis Area and Severity Index (PASI) and HIV viral load, were recorded over a year. All three patients achieved significant clinical improvements with tildrakizumab, with PASI scores improving by over 95%. No adverse effects were reported, and HIV viral loads remained undetectable. Tildrakizumab appears to be a safe and effective treatment option for psoriasis in individuals living with HIV, providing significant benefits without compromising HIV control.

Candida lusitaniae is a vaginal commensal. Cases of vaginitis, vulvovaginitis and recurrent vulvovaginitis caused by this yeast are very rare. In the oral cavity, C. lusitaniae causes stomatitis in immunocompromised patients. We describe a case of stomatitis and angular cheilitis caused by C. lusitaniae in a female patient with type 2 diabetes. The infection was most likely transmitted following genital-oral intercourse with the patient's girlfriend, who was affected by C. lusitaniae vulvovaginitis.

Background: Despite widespread HIV testing in sub-Saharan Africa, regular testing among at-risk populations is crucial for effective prevention. However, reports increasingly indicate retesting among people living with HIV (PLHIV), a group that would not require additional testing since they would already have received a confirmed diagnosis. We describe the demographic characteristics of PLHIV retesters in Lesotho, report the average number of HIV tests post-diagnosis among PLHIV, and share motivations for retesting.

Methods: In August 2022, a nationally representative cohort in Lesotho participated in a cell phone survey about their HIV status and testing history. Study participants were recruited from a face-to-face survey conducted in 2020, Lesotho Population Based HIV Impact Assessment survey.

Results: Of the 1523 participants called, 1111 participants responded (72.9%) and 266 reported living with HIV. We found 18.8% of people living with HIV (PLHIV) reported retesting at least once for HIV, and 58% of PLHIV who reported retesting were likely or very likely to retest for HIV in the coming year. The main reason PLHIV reported retesting was because a health care worker offered the test (61.7%) followed by self-initiated testing to confirm their status (29.1%). Among male PLHIV who had a history of retesting, 92.0% were very likely or likely to retest, compared to only 30.6% of female PLHIV.

Conclusion: We found almost a fifth of PLHIV in Lesotho reported a history of retesting for HIV, and 58% of PLHIV were likely or very likely to retest for HIV in the coming year. Educating providers and men living with HIV could reduce retesting among PLHIV.

Background: Our study aimed to determine the role of sociodemographic characteristics on self-stigma among young men who have sex with men (MSM) living with HIV in Yogyakarta, Indonesia.

Methods: This cross-sectional observational study was conducted from August-November 2022. Participants were recruited from outpatient clinics at Dr. Sardjito, Yogyakarta, Indonesia. The Indonesian version of the Berger HIV Stigma Scale measured self-stigma. The statistical analysis utilized a 95% confidence level and determined significance by p-values <0.05.

Results: 72 young MSM were enrolled and completed questionnaires assessing sociodemographic and self-stigma. The average self-stigma score was 98.97. Education level was significantly associated with severe self-stigma in the bivariate analysis (p < .05). In the multivariate analysis, those with higher levels of education were significantly more likely to experience severe self-stigma (r = 2.938, p < .05). Employment status, family support, and education level were significantly associated with increased concerns in the disclosure, negative self-image, and public attitudes subscales (all p < .05).

Conclusions: The results demonstrate associations between sociodemographic and self-stigma levels among young MSM living with HIV in Yogyakarta, Indonesia. Further research regarding the educational level, employment status, and family support that can influence the perception and quality of life of PLHIV may need to be carried out.