Pub Date : 2024-08-01DOI: 10.1136/sextrans-2023-056093
Kate Johnson, Ella Buluwela, Gemma McDonald, John Golden, Molly Dickinson, Rachael Jones, Nicolo Girometti, Gurmit Jagjitsingh, Michael Rayment
Objective: British guidelines advise treatment of Mycoplasma genitalium (Mgen) infection using the results of macrolide resistance-associated mutation (MRAM) assays. Limited data informs management when patients fail MRAM-guided treatment. This study evaluates current management strategies employed for cases of Mgen infection with MRAM-guided treatment failure.
Design: This retrospective analysis reviewed laboratory and clinical data pertaining to all positive Mgen results between 28 May 2020 and 05 November 2022 across three London sexual health clinics. Treatment failure was defined as microbiological or clinical failure, despite appropriate MRAM-guided treatment with full compliance and no re-infection risk. Where MRAM status was unable to be determined, samples were excluded.
Results: 340 samples were included from mostly male (74.4%) patients with a mean age of 30 years. The majority of tests were sent for urethritis (63.8%), and most infections were present without concurrent STIs (83.5%). 183 (53.8%) samples were MRAM positive; 157 (46.1%) were wild type. 152/183 (83.1%) received MRAM-guided treatment. 49/152 (32.2%) cases of MRAM-guided treatment failure were identified. 32/49 (65.3%) achieved either microbiological or clinical cure through a variety of treatment regimens. 66.6% of nine patients who received pristinamycin achieved microbiological cure; two patients were cured by minocycline. Many patients received multiple courses of moxifloxacin despite previous failures.
Conclusion: Whilst high compliance with recommended MRAM-guided therapy was identified, there were also high rates of quinolone therapy failure (32.2%). Barriers to appropriate treatment include a lack of quinolone resistance assays and the non-availability of sitafloxacin in Europe, along with the limited availability of pristinamycin and minocycline in the UK during the study dates. We recommend developing a standardised management pathway for treatment resistant cases.
{"title":"<i>Mycoplasma genitalium</i> treatment outcomes among a cohort failing macrolide resistance-guided treatment across three London sexual health clinics.","authors":"Kate Johnson, Ella Buluwela, Gemma McDonald, John Golden, Molly Dickinson, Rachael Jones, Nicolo Girometti, Gurmit Jagjitsingh, Michael Rayment","doi":"10.1136/sextrans-2023-056093","DOIUrl":"https://doi.org/10.1136/sextrans-2023-056093","url":null,"abstract":"<p><strong>Objective: </strong>British guidelines advise treatment of <i>Mycoplasma genitalium</i> (<i>Mgen</i>) infection using the results of macrolide resistance-associated mutation (MRAM) assays. Limited data informs management when patients fail MRAM-guided treatment. This study evaluates current management strategies employed for cases of <i>Mgen</i> infection with MRAM-guided treatment failure.</p><p><strong>Design: </strong>This retrospective analysis reviewed laboratory and clinical data pertaining to all positive <i>Mgen</i> results between 28 May 2020 and 05 November 2022 across three London sexual health clinics. Treatment failure was defined as microbiological or clinical failure, despite appropriate MRAM-guided treatment with full compliance and no re-infection risk. Where MRAM status was unable to be determined, samples were excluded.</p><p><strong>Results: </strong>340 samples were included from mostly male (74.4%) patients with a mean age of 30 years. The majority of tests were sent for urethritis (63.8%), and most infections were present without concurrent STIs (83.5%). 183 (53.8%) samples were MRAM positive; 157 (46.1%) were wild type. 152/183 (83.1%) received MRAM-guided treatment. 49/152 (32.2%) cases of MRAM-guided treatment failure were identified. 32/49 (65.3%) achieved either microbiological or clinical cure through a variety of treatment regimens. 66.6% of nine patients who received pristinamycin achieved microbiological cure; two patients were cured by minocycline. Many patients received multiple courses of moxifloxacin despite previous failures.</p><p><strong>Conclusion: </strong>Whilst high compliance with recommended MRAM-guided therapy was identified, there were also high rates of quinolone therapy failure (32.2%). Barriers to appropriate treatment include a lack of quinolone resistance assays and the non-availability of sitafloxacin in Europe, along with the limited availability of pristinamycin and minocycline in the UK during the study dates. We recommend developing a standardised management pathway for treatment resistant cases.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1136/sextrans-2023-056044
Carina Bjartling, Rebecca Kertes, Sinja Kristiansen, Annika Johnsson, Ola Forslund
Objectives: While Mycoplasma genitalium is reported as a common rectal infection among men who have sex with men (MSM), published data refer predominantly to urethral infections. Currently, most guidelines recommend M. genitalium testing from urine in men with symptomatic, non-gonococcal urethritis. Macrolide resistance-associated mutations (MRMs) among M. genitalium have increased during the last decade especially among MSM. We aim to demonstrate the prevalence and anatomical distribution of M. genitalium infection and MRM in urine and rectal specimens among MSM in Sweden.
Methods: In this cross-sectional study in 2019, paired urine and rectal samples from symptomatic and asymptomatic MSM attending a sexually transmitted infection clinic in the south of Sweden were screened for M. genitalium, presence of MRM, Neisseria gonorrhoeae, Chlamydia trachomatis, HIV and syphilis.
Results: The overall prevalence of M. genitalium was 10.5% (64 of 609), rectal samples 7.6% (46 of 609) and urine samples 3.9% (24 of 609) (p=0.007). Among M. genitalium-positive cases, single rectal and single urethral infection was detected in 62.5% (40 of 64) and 28.1% (18 of 64), respectively (p<0.0001). Infection at both sites was seen in 9.4% (6 of 64). The prevalence of MRM was 67.9% (19 of 28). M. genitalium was significantly associated with HIV (OR 2.60, 95% CI 1.14 to 5.88, p=0.02). Among the MSM, 7.4% (45 of 609) were infected with N. gonorrhoeae, 6.7% (41 of 609) with C. trachomatis, 7.1% (43 of 609) with HIV and 0.7% (4 of 609) with syphilis.
Conclusions: In this study, among MSM, most infections with M. genitalium were detected as rectal mono infections. The prevalence of M. genitalium among MSM was almost twofold higher in rectal samples (7.6%) compared with urine samples (3.9%). The prevalence of macrolide resistance was high with no difference between urine and rectal samples.
{"title":"Prevalence of <i>Mycoplasma genitalium</i> and macrolide resistance in rectal and urine samples among men who have sex with men in Sweden.","authors":"Carina Bjartling, Rebecca Kertes, Sinja Kristiansen, Annika Johnsson, Ola Forslund","doi":"10.1136/sextrans-2023-056044","DOIUrl":"https://doi.org/10.1136/sextrans-2023-056044","url":null,"abstract":"<p><strong>Objectives: </strong>While <i>Mycoplasma genitalium</i> is reported as a common rectal infection among men who have sex with men (MSM), published data refer predominantly to urethral infections. Currently, most guidelines recommend <i>M. genitalium</i> testing from urine in men with symptomatic, non-gonococcal urethritis. Macrolide resistance-associated mutations (MRMs) among <i>M. genitalium</i> have increased during the last decade especially among MSM. We aim to demonstrate the prevalence and anatomical distribution of <i>M. genitalium</i> infection and MRM in urine and rectal specimens among MSM in Sweden.</p><p><strong>Methods: </strong>In this cross-sectional study in 2019, paired urine and rectal samples from symptomatic and asymptomatic MSM attending a sexually transmitted infection clinic in the south of Sweden were screened for <i>M. genitalium</i>, presence of MRM, <i>Neisseria gonorrhoeae</i>, <i>Chlamydia trachomatis</i>, HIV and syphilis.</p><p><strong>Results: </strong>The overall prevalence of <i>M. genitalium</i> was 10.5% (64 of 609), rectal samples 7.6% (46 of 609) and urine samples 3.9% (24 of 609) (p=0.007). Among <i>M. genitalium</i>-positive cases, single rectal and single urethral infection was detected in 62.5% (40 of 64) and 28.1% (18 of 64), respectively (p<0.0001). Infection at both sites was seen in 9.4% (6 of 64). The prevalence of MRM was 67.9% (19 of 28). <i>M. genitalium</i> was significantly associated with HIV (OR 2.60, 95% CI 1.14 to 5.88, p=0.02). Among the MSM, 7.4% (45 of 609) were infected with <i>N. gonorrhoeae,</i> 6.7% (41 of 609) with <i>C. trachomatis</i>, 7.1% (43 of 609) with HIV and 0.7% (4 of 609) with syphilis.</p><p><strong>Conclusions: </strong>In this study, among MSM, most infections with <i>M. genitalium</i> were detected as rectal mono infections. The prevalence of <i>M. genitalium</i> among MSM was almost twofold higher in rectal samples (7.6%) compared with urine samples (3.9%). The prevalence of macrolide resistance was high with no difference between urine and rectal samples.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1136/sextrans-2023-055916
Sara Louise Day, Gemma McDonald, Chris Kellett
Objectives: The UK signed up to the 2016 global health strategy to eliminate viral hepatitis as a public health problem. Effective monitoring of hepatitis testing outcomes is required to track progress against targets. National reporting does not include hepatitis B and hepatitis C infections (HBV/HCV) detected by online sexually transmitted infection (STI) testing services (e-services). We identify HBV/HCV infection rates among individuals using Sexual Health London (SHL), a large e-service.
Methods: SHL e-records of individuals receiving reactive HBsAg and/or HepCAb screening results between 1 January 2021 and 1 January 2022 were reviewed. Only at-risk groups are offered HBV/HCV testing, with risks captured via an online triage/consultation. Roche Cobas e801 HBV/HCV screening assay uses a cut-off index of reactivity (COI) to categorise results: low reactive (COI >1-9) and reactive (COI ≥10). SHL refers individuals with any reactive result for confirmatory testing (CT) at a sexual health clinic that provides hepatitis outpatient management. Clinic staff performing the CT access the shared SHL e-record and electronically take over the patient's care.
Results: 67, 718 HBV and 61 064 HCV tests were performed, representing 16% of all kit returns. HBV reactivity was 1.4% (922/67 718): 474 low-reactive, 302 reactive and 146 unconfirmed-reactive. HCV reactivity was 0.3% (163/61 064): 53 low-reactive, 99 reactive and 11 unconfirmed-reactive.Among individuals with reactive (COI ≥10) screening HBV results, 85% results confirmed, 12% negative and 3% unknown. For HCV, 79% results confirmed, 13% negative and 8% unknown. 57 out of 57 new HBV/HCV infections were electronically transferred. HBV prevalence was 299/67 718 (0.4%). The rate of previously undiagnosed cases detected was 40 out of 67 338 (0.06%) for HBV and 17 out of 61 016 (0.03%) for HCV.
Conclusions: 16% of SHL service users received targeted testing for hepatitis in 2021. Testing volumes significantly exceeded and new HBV/HCV diagnosis rates were similar to those reported by sentinel laboratory surveillance. 100% new infections transitioned to care, demonstrating effective integration between online and local sexual health services.
{"title":"Hepatitis B and hepatitis C testing outcomes among service users of Sexual Health London: an online sexually transmitted infection testing service for London residents.","authors":"Sara Louise Day, Gemma McDonald, Chris Kellett","doi":"10.1136/sextrans-2023-055916","DOIUrl":"10.1136/sextrans-2023-055916","url":null,"abstract":"<p><strong>Objectives: </strong>The UK signed up to the 2016 global health strategy to eliminate viral hepatitis as a public health problem. Effective monitoring of hepatitis testing outcomes is required to track progress against targets. National reporting does not include hepatitis B and hepatitis C infections (HBV/HCV) detected by online sexually transmitted infection (STI) testing services (e-services). We identify HBV/HCV infection rates among individuals using Sexual Health London (SHL), a large e-service.</p><p><strong>Methods: </strong>SHL e-records of individuals receiving reactive HBsAg and/or HepCAb screening results between 1 January 2021 and 1 January 2022 were reviewed. Only at-risk groups are offered HBV/HCV testing, with risks captured via an online triage/consultation. Roche Cobas e801 HBV/HCV screening assay uses a cut-off index of reactivity (COI) to categorise results: low reactive (COI >1-9) and reactive (COI ≥10). SHL refers individuals with any reactive result for confirmatory testing (CT) at a sexual health clinic that provides hepatitis outpatient management. Clinic staff performing the CT access the shared SHL e-record and electronically take over the patient's care.</p><p><strong>Results: </strong>67, 718 HBV and 61 064 HCV tests were performed, representing 16% of all kit returns. HBV reactivity was 1.4% (922/67 718): 474 low-reactive, 302 reactive and 146 unconfirmed-reactive. HCV reactivity was 0.3% (163/61 064): 53 low-reactive, 99 reactive and 11 unconfirmed-reactive.Among individuals with reactive (COI ≥10) screening HBV results, 85% results confirmed, 12% negative and 3% unknown. For HCV, 79% results confirmed, 13% negative and 8% unknown. 57 out of 57 new HBV/HCV infections were electronically transferred. HBV prevalence was 299/67 718 (0.4%). The rate of previously undiagnosed cases detected was 40 out of 67 338 (0.06%) for HBV and 17 out of 61 016 (0.03%) for HCV.</p><p><strong>Conclusions: </strong>16% of SHL service users received targeted testing for hepatitis in 2021. Testing volumes significantly exceeded and new HBV/HCV diagnosis rates were similar to those reported by sentinel laboratory surveillance. 100% new infections transitioned to care, demonstrating effective integration between online and local sexual health services.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1136/sextrans-2023-055912
Marie Coessens, Jeoffrey Schouten, Tom Holvoet, Wim Verlinden
Objectives: To eliminate hepatitis B and C virus (HBV/HCV) as a public health threat by 2030, the WHO focuses on screening key populations, including men who have sex with men (MSM).This study aims to assess HBV and HCV knowledge and awareness and HCV prevalence in MSM in Belgium.
Methods: First, a questionnaire was designed to assess MSM's knowledge of HBV and HCV infection (disease process, vaccination, treatment and transmission routes). This questionnaire was conducted online, and by means of a tablet-based face-to-face questionnaire at the Antwerp and Belgian Pride. Second, HCV and HIV prevalence data were collected during outreach projects and office screening for sexually transmitted infections (STIs) organised by Sensoa and Exaequo, a Flemish and Walloon sexual health organisation.
Results: 300 MSM completed the questionnaire (median age 36 years; 7.7% HIV+). Mean overall survey scores were low (HBV: 41.1%; HCV: 39.8%). Few participants identified all transmission routes correctly (HBV: 15%; HCV 1%).The degree of education was significantly correlated with HBV knowledge and showed a trend towards correlation with HCV knowledge. HCV knowledge was significantly correlated with high-risk sexual behaviour.The prevalence of HCV and HIV was 0.3% and 1.0%, respectively, in MSM attending commercial gay venues and 0% and 1.9% in MSM attending office STI screening.
Conclusions: Knowledge of HBV and HCV infection in MSM is poor. More awareness campaigns are needed, focusing on frequent HCV risk factors (group sex, chemsex, receptive fisting, and sharing of anal toys and anal douching devices), especially targeting low-educated MSM. HBV vaccination of MSM requires continued attention.The prevalence of HCV and HIV was remarkably low in commercial gay venues and may be higher in older MSM or in subcultures where risk factors coexist (eg, chemsex). The cost-effectiveness of internet-based approaches with subsequent at-home testing needs to be evaluated in the future.
目标:为在 2030 年前消除乙型肝炎病毒和丙型肝炎病毒(HBV/HCV)对公共卫生的威胁,世界卫生组织重点筛查重点人群,包括男男性行为者(MSM):首先,设计了一份调查问卷,以评估 MSM 对 HBV 和 HCV 感染(疾病过程、疫苗接种、治疗和传播途径)的了解程度。该问卷在安特卫普和比利时 Pride 通过在线和平板电脑面对面的方式进行。其次,在弗拉芒和瓦隆的性健康组织 Sensoa 和 Exaequo 组织的外展项目和办公室性传播感染(STIs)筛查中收集了 HCV 和 HIV 感染率数据:300 名男男性行为者完成了问卷调查(年龄中位数为 36 岁;7.7% 为 HIV 感染者)。调查的平均总分较低(HBV:41.1%;HCV:39.8%)。很少有参与者能正确识别所有传播途径(HBV:15%;HCV:1%)。受教育程度与 HBV 知识显著相关,与 HCV 知识呈相关趋势。HCV知识与高危性行为明显相关。在参加商业性同性恋场所的男男性行为者中,HCV和HIV的感染率分别为0.3%和1.0%,而在参加办公室性传播感染筛查的男男性行为者中,HCV和HIV的感染率分别为0%和1.9%:结论:男男性行为者对 HBV 和 HCV 感染的了解甚少。需要开展更多的宣传活动,重点关注常见的 HCV 风险因素(群交、化学性交、接受性握拳、共用肛门玩具和肛门冲洗设备),尤其是针对低教育程度的 MSM。在商业性同性恋场所,HCV 和 HIV 的流行率非常低,而在年龄较大的 MSM 或风险因素并存的亚文化(如化学性交)中,HCV 和 HIV 的流行率可能更高。基于互联网的方法以及随后的上门检测的成本效益需要在未来进行评估。
{"title":"Awareness of chronic hepatitis B and C in men who have sex with men in Belgium: epidemiological survey and on-site screening.","authors":"Marie Coessens, Jeoffrey Schouten, Tom Holvoet, Wim Verlinden","doi":"10.1136/sextrans-2023-055912","DOIUrl":"10.1136/sextrans-2023-055912","url":null,"abstract":"<p><strong>Objectives: </strong>To eliminate hepatitis B and C virus (HBV/HCV) as a public health threat by 2030, the WHO focuses on screening key populations, including men who have sex with men (MSM).This study aims to assess HBV and HCV knowledge and awareness and HCV prevalence in MSM in Belgium.</p><p><strong>Methods: </strong>First, a questionnaire was designed to assess MSM's knowledge of HBV and HCV infection (disease process, vaccination, treatment and transmission routes). This questionnaire was conducted online, and by means of a tablet-based face-to-face questionnaire at the Antwerp and Belgian Pride. Second, HCV and HIV prevalence data were collected during outreach projects and office screening for sexually transmitted infections (STIs) organised by Sensoa and Exaequo, a Flemish and Walloon sexual health organisation.</p><p><strong>Results: </strong>300 MSM completed the questionnaire (median age 36 years; 7.7% HIV+). Mean overall survey scores were low (HBV: 41.1%; HCV: 39.8%). Few participants identified all transmission routes correctly (HBV: 15%; HCV 1%).The degree of education was significantly correlated with HBV knowledge and showed a trend towards correlation with HCV knowledge. HCV knowledge was significantly correlated with high-risk sexual behaviour.The prevalence of HCV and HIV was 0.3% and 1.0%, respectively, in MSM attending commercial gay venues and 0% and 1.9% in MSM attending office STI screening.</p><p><strong>Conclusions: </strong>Knowledge of HBV and HCV infection in MSM is poor. More awareness campaigns are needed, focusing on frequent HCV risk factors (group sex, chemsex, receptive fisting, and sharing of anal toys and anal douching devices), especially targeting low-educated MSM. HBV vaccination of MSM requires continued attention.The prevalence of HCV and HIV was remarkably low in commercial gay venues and may be higher in older MSM or in subcultures where risk factors coexist (eg, chemsex). The cost-effectiveness of internet-based approaches with subsequent at-home testing needs to be evaluated in the future.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1136/sextrans-2024-056197
Christopher L Bennett, Carson Clay, M Kit Delgado, Janice A Espinola, Carlos A Camargo
{"title":"Hepatitis screening in a sampling of US emergency departments, 2022-2023.","authors":"Christopher L Bennett, Carson Clay, M Kit Delgado, Janice A Espinola, Carlos A Camargo","doi":"10.1136/sextrans-2024-056197","DOIUrl":"10.1136/sextrans-2024-056197","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1136/sextrans-2023-055961
Matthew W McGarrity, Ryan Lisk, Paul MacPherson, David Knox, Kevin S Woodward, Jeffrey Reinhart, John MacLeod, Isaac I Bogoch, Deanna Clatworthy, Mia J Biondi, Sean T Sullivan, Alan T W Li, Garfield Durrant, Andrew Schonbe, Fanta Ongoiba, Janet Raboud, Ann N Burchell, Darrell H S Tan
Objectives: Populations who seek HIV pre-exposure prophylaxis (PrEP) are disproportionately affected by hepatitis A virus (HAV), hepatitis B virus (HBV) and human papillomavirus (HPV). We examined immunity/vaccination against these infections among participants in the Ontario PrEP cohort study (ON-PrEP).
Methods: ON-PrEP is a prospective cohort of HIV-negative PrEP users from 10 Ontario clinics. We descriptively analysed baseline immunity/vaccination against HAV (IgG reactive), HBV (hepatitis B surface antibody >10) and HPV (self-reported three-dose vaccination). We further performed multivariable logistic regression to identify characteristics associated with baseline immunity/vaccination. We used cumulative incidence functions to describe vaccine uptake among participants non-immune at baseline.
Results: Of 633 eligible participants, 59.1% were white, 85.8% were male and 79.6% were gay. We found baseline evidence of immunity/vaccination against HAV, HBV and HPV in 69.2%, 81.2% and 16.8% of PrEP-experienced participants and 58.9%, 70.3% and 10.4% of PrEP-naïve participants, respectively. Characteristics associated with baseline HAV immunity were greater PrEP duration (adjusted OR (aOR) 1.41/year, 95% CI 1.09 to 1.84), frequent sexually transmitted and bloodborne infection (STBBI) testing (aOR 2.38, 95% CI 1.15 to 4.92) and HBV immunity (aOR 3.53, 95% CI 2.09 to 5.98). Characteristics associated with baseline HBV immunity were living in Toronto (aOR 3.54, 95% CI 1.87 to 6.70) or Ottawa (aOR 2.76, 95% CI 1.41 to 5.40), self-identifying as racialised (aOR 2.23, 95% CI 1.19 to 4.18), greater PrEP duration (aOR 1.39/year, 95% CI 1.02 to 1.90) and HAV immunity (aOR 3.75, 95% CI 2.19 to 6.41). Characteristics associated with baseline HPV vaccination were being aged ≤26 years (aOR 9.28, 95% CI 2.11 to 40.77), annual income between CAD$60 000 and CAD$119 000 (aOR 3.42, 95% CI 1.40 to 8.34), frequent STBBI testing (aOR 7.00, 95% CI 1.38 to 35.46) and HAV immunity (aOR 6.96, 95% CI 2.00 to 24.25). Among those non-immune at baseline, overall cumulative probability of immunity/vaccination was 0.70, 0.60 and 0.53 among PrEP-experienced participants and 0.93, 0.80 and 0.70 among PrEP-naïve participants for HAV, HBV and HPV, respectively.
Conclusions: Baseline immunity to HAV/HBV was common, and a sizeable proportion of non-immune participants were vaccinated during follow-up. However, HPV vaccination was uncommon. Continued efforts should be made to remove barriers to HPV vaccination such as cost, inclusion in clinical guidelines and provider recommendation.
目标:寻求艾滋病暴露前预防疗法(PrEP)的人群受到甲型肝炎病毒(HAV)、乙型肝炎病毒(HBV)和人类乳头瘤病毒(HPV)的影响尤为严重。我们研究了安大略省 PrEP 队列研究(ON-PrEP)参与者对这些感染的免疫/疫苗接种情况:方法:ON-PrEP 是一项前瞻性队列研究,研究对象是来自安大略省 10 家诊所的 HIV 阴性 PrEP 用户。我们对 HAV(IgG 反应性)、HBV(乙肝表面抗体 >10)和 HPV(自我报告的三剂疫苗接种)的基线免疫/疫苗接种情况进行了描述性分析。我们进一步进行了多变量逻辑回归,以确定与基线免疫/疫苗接种相关的特征。我们使用累积发生率函数来描述基线无免疫力参与者的疫苗接种情况:在 633 名符合条件的参与者中,59.1% 为白人,85.8% 为男性,79.6% 为同性恋。我们发现分别有69.2%、81.2%和16.8%的PrEP体验者和58.9%、70.3%和10.4%的PrEP未体验者基线免疫/接种HAV、HBV和HPV疫苗。与基线 HAV 免疫力相关的特征有:较长的 PrEP 持续时间(调整 OR (aOR) 1.41/年,95% CI 1.09 至 1.84)、频繁的性传播和血液传播感染 (STBBI) 检测(aOR 2.38,95% CI 1.15 至 4.92)和 HBV 免疫力(aOR 3.53,95% CI 2.09 至 5.98)。与基线 HBV 免疫相关的特征有:居住在多伦多(aOR 3.54,95% CI 1.87 至 6.70)或渥太华(aOR 2.76,95% CI 1.41 至 5.40)、自我认同为种族化(aOR 2.23,95% CI 1.19 至 4.18)、PrEP 持续时间较长(aOR 1.39/年,95% CI 1.02 至 1.90)和 HAV 免疫(aOR 3.75,95% CI 2.19 至 6.41)。与基线接种 HPV 疫苗相关的特征有:年龄小于 26 岁(aOR 9.28,95% CI 2.11 至 40.77)、年收入在 60 000 至 119 000 加元之间(aOR 3.42,95% CI 1.40 至 8.34)、经常进行 STBBI 检测(aOR 7.00,95% CI 1.38 至 35.46)和 HAV 免疫(aOR 6.96,95% CI 2.00 至 24.25)。在基线无免疫力的人群中,对于HAV、HBV和HPV,有PrEP经验的参与者免疫力/接种疫苗的总体累积概率分别为0.70、0.60和0.53,而对于PrEP无经验的参与者,免疫力/接种疫苗的总体累积概率分别为0.93、0.80和0.70:结论:对 HAV/HBV 的基线免疫很普遍,相当一部分无免疫力的参与者在随访期间接种了疫苗。然而,HPV 疫苗接种并不常见。应继续努力消除 HPV 疫苗接种的障碍,如成本、纳入临床指南和提供者推荐等。
{"title":"HIV pre-exposure prophylaxis and opportunities for vaccination against hepatitis A virus, hepatitis B virus and human papillomavirus: an analysis of the Ontario PrEP cohort study.","authors":"Matthew W McGarrity, Ryan Lisk, Paul MacPherson, David Knox, Kevin S Woodward, Jeffrey Reinhart, John MacLeod, Isaac I Bogoch, Deanna Clatworthy, Mia J Biondi, Sean T Sullivan, Alan T W Li, Garfield Durrant, Andrew Schonbe, Fanta Ongoiba, Janet Raboud, Ann N Burchell, Darrell H S Tan","doi":"10.1136/sextrans-2023-055961","DOIUrl":"10.1136/sextrans-2023-055961","url":null,"abstract":"<p><strong>Objectives: </strong>Populations who seek HIV pre-exposure prophylaxis (PrEP) are disproportionately affected by hepatitis A virus (HAV), hepatitis B virus (HBV) and human papillomavirus (HPV). We examined immunity/vaccination against these infections among participants in the Ontario PrEP cohort study (ON-PrEP).</p><p><strong>Methods: </strong>ON-PrEP is a prospective cohort of HIV-negative PrEP users from 10 Ontario clinics. We descriptively analysed baseline immunity/vaccination against HAV (IgG reactive), HBV (hepatitis B surface antibody >10) and HPV (self-reported three-dose vaccination). We further performed multivariable logistic regression to identify characteristics associated with baseline immunity/vaccination. We used cumulative incidence functions to describe vaccine uptake among participants non-immune at baseline.</p><p><strong>Results: </strong>Of 633 eligible participants, 59.1% were white, 85.8% were male and 79.6% were gay. We found baseline evidence of immunity/vaccination against HAV, HBV and HPV in 69.2%, 81.2% and 16.8% of PrEP-experienced participants and 58.9%, 70.3% and 10.4% of PrEP-naïve participants, respectively. Characteristics associated with baseline HAV immunity were greater PrEP duration (adjusted OR (aOR) 1.41/year, 95% CI 1.09 to 1.84), frequent sexually transmitted and bloodborne infection (STBBI) testing (aOR 2.38, 95% CI 1.15 to 4.92) and HBV immunity (aOR 3.53, 95% CI 2.09 to 5.98). Characteristics associated with baseline HBV immunity were living in Toronto (aOR 3.54, 95% CI 1.87 to 6.70) or Ottawa (aOR 2.76, 95% CI 1.41 to 5.40), self-identifying as racialised (aOR 2.23, 95% CI 1.19 to 4.18), greater PrEP duration (aOR 1.39/year, 95% CI 1.02 to 1.90) and HAV immunity (aOR 3.75, 95% CI 2.19 to 6.41). Characteristics associated with baseline HPV vaccination were being aged ≤26 years (aOR 9.28, 95% CI 2.11 to 40.77), annual income between CAD$60 000 and CAD$119 000 (aOR 3.42, 95% CI 1.40 to 8.34), frequent STBBI testing (aOR 7.00, 95% CI 1.38 to 35.46) and HAV immunity (aOR 6.96, 95% CI 2.00 to 24.25). Among those non-immune at baseline, overall cumulative probability of immunity/vaccination was 0.70, 0.60 and 0.53 among PrEP-experienced participants and 0.93, 0.80 and 0.70 among PrEP-naïve participants for HAV, HBV and HPV, respectively.</p><p><strong>Conclusions: </strong>Baseline immunity to HAV/HBV was common, and a sizeable proportion of non-immune participants were vaccinated during follow-up. However, HPV vaccination was uncommon. Continued efforts should be made to remove barriers to HPV vaccination such as cost, inclusion in clinical guidelines and provider recommendation.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Although hepatitis A virus (HAV) and hepatitis B virus (HBV) immunisation is recommended in the UK for gay, bisexual and other men who have sex with men (GBMSM), data on immunisation coverage are limited. We aimed to determine the seroprevalence of HAV and HBV immunity among a sample of GBMSM attending sexual health services (SHS) in England.
Methods: Residual serum samples from HIV/syphilis testing for adult GBMSM attending eight SHS in London and one in Leeds were tested for markers of HAV immunity (HAV IgG) and HBV immunity (anti-HBs) using an unlinked anonymous approach. We estimated seroprevalence of HAV and HBV immunity overall and stratified by individuals' characteristics, which we obtained from the Genitourinary Medicine Clinic Activity Dataset Sexually Transmitted Infection (STI) Surveillance System. We used logistic regression to calculate crude and adjusted ORs between seropositivity and demographic and clinical characteristics.
Results: Seroprevalence of immunity to HAV (74.5% of 2577) and HBV (77.1% of 2551) was high. In adjusted analysis, HAV IgG seroprevalence varied by clinic and WHO region of birth (global p<0.001 for each), increased with older age (ORs of 1.50 (95% CI 1.18 to 1.86), 2.91 (2.17 to 3.90) and 3.40 (2.44 to 4.75) for ages 26-35, 36-45 and >46 vs 18-25 years (global p<0.001), was higher in those with an STI in the past year (1.58 (1.25 to 2.00); p<0.001) and those who were living with HIV (1.82 (1.25 to 2.64); p<0.001). Anti-HBs seroprevalence varied by clinic (global p<0.001), increased with older age (global p<0.001) and was higher in those with an STI in the past year (1.61 (1.27 to 2.05); p<0.001).
Conclusion: Our findings provide a baseline seroprevalence from which to monitor serial levels of immunity to HBV and HAV in GBMSM accessing SHS. Levels of immunity for both viruses are high, noting samples were taken after recent widespread outbreaks and vaccination campaigns. High vaccine coverage in all GBMSM should be maintained to prevent further outbreaks.
{"title":"Seroprevalence of immunity to hepatitis A and hepatitis B among gay, bisexual and other men who have sex with men (GBMSM) attending sexual health clinics in London and Leeds, England, 2017-2018.","authors":"Rachel Roche, Ruth Simmons, Hester Allen, Megan Glancy, Anca-Maria Balan, Maria Bolea, Ross Harris, Monica Desai, Hamish Mohammed, Caroline Sabin, Samreen Ijaz, Sema Mandal","doi":"10.1136/sextrans-2024-056134","DOIUrl":"10.1136/sextrans-2024-056134","url":null,"abstract":"<p><strong>Objectives: </strong>Although hepatitis A virus (HAV) and hepatitis B virus (HBV) immunisation is recommended in the UK for gay, bisexual and other men who have sex with men (GBMSM), data on immunisation coverage are limited. We aimed to determine the seroprevalence of HAV and HBV immunity among a sample of GBMSM attending sexual health services (SHS) in England.</p><p><strong>Methods: </strong>Residual serum samples from HIV/syphilis testing for adult GBMSM attending eight SHS in London and one in Leeds were tested for markers of HAV immunity (HAV IgG) and HBV immunity (anti-HBs) using an unlinked anonymous approach. We estimated seroprevalence of HAV and HBV immunity overall and stratified by individuals' characteristics, which we obtained from the Genitourinary Medicine Clinic Activity Dataset Sexually Transmitted Infection (STI) Surveillance System. We used logistic regression to calculate crude and adjusted ORs between seropositivity and demographic and clinical characteristics.</p><p><strong>Results: </strong>Seroprevalence of immunity to HAV (74.5% of 2577) and HBV (77.1% of 2551) was high. In adjusted analysis, HAV IgG seroprevalence varied by clinic and WHO region of birth (global p<0.001 for each), increased with older age (ORs of 1.50 (95% CI 1.18 to 1.86), 2.91 (2.17 to 3.90) and 3.40 (2.44 to 4.75) for ages 26-35, 36-45 and >46 vs 18-25 years (global p<0.001), was higher in those with an STI in the past year (1.58 (1.25 to 2.00); p<0.001) and those who were living with HIV (1.82 (1.25 to 2.64); p<0.001). Anti-HBs seroprevalence varied by clinic (global p<0.001), increased with older age (global p<0.001) and was higher in those with an STI in the past year (1.61 (1.27 to 2.05); p<0.001).</p><p><strong>Conclusion: </strong>Our findings provide a baseline seroprevalence from which to monitor serial levels of immunity to HBV and HAV in GBMSM accessing SHS. Levels of immunity for both viruses are high, noting samples were taken after recent widespread outbreaks and vaccination campaigns. High vaccine coverage in all GBMSM should be maintained to prevent further outbreaks.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11287524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1136/sextrans-2024-056169
Kris Hage, Anders Boyd, Eline L M Op de Coul, Danja Sarink, Elske Hoornenborg, Maria Prins
Objectives: Studies showed that men who have sex with men (MSM), including those using pre-exposure prophylaxis (PrEP), are at increased risk of hepatitis C virus (HCV) infection. We evaluated HCV prevalence and incidence, along with their associated determinants, in a cohort of PrEP-using individuals in the Netherlands.
Methods: In 2019, the Netherlands launched a 5-year national programme that offers subsidised PrEP to eligible individuals. We used prospectively collected data from individuals registered in this programme between 2019 and 2022. Individuals underwent annual testing for HCV antibodies and additional HCV-RNA testing when antibodies were present. We calculated the prevalence of past/current HCV infection at first visit and overall incidence rate (IR) during follow-up. Univariable logistic and Poisson regression models were used to identify determinants associated with past/current prevalent or incident HCV infection, respectively. Behavioural factors referred to those occurring in the previous 6 months.
Results: A total of 10 563 (n=10 319, 97.7% MSM) were included. At first visit, 66 of 10 563 (0.6%) had a past/current HCV infection, which was associated with older age [odds ratio (OR) per 10 years=1.57, 95% confidence interval (CI)=1.31 to 1.88], the use of PrEP before first visit (OR=3.03, 95% CI=1.79 to 5.13), receptive condomless anal sex (CAS) (OR=2.73, 95% CI=1.25 to 5.98), chemsex (OR=2.44, 95% CI=1.49 to 3.99) and injecting drug use (IDU) (OR=6.61, 95% CI=2.35 to 18.61). Among 9851 individuals contributing to 17 150 person-years (PYs) of follow-up, 64 incident HCV infections (IR=0.37 per 100 PYs, 95% CI=0.29 to 0.48) were identified. Factors associated with incident HCV infection were receptive CAS [incidence rate ratio (IRR)=2.59, 95% CI=1.12 to 6.02], chemsex (IRR=1.78, 95% CI=1.06 to 2.98), sexually transmitted infection diagnosis (IRR=2.30, 95% CI=1.23 to 4.31) and IDU (IRR=6.15, 95% CI=2.20 to 17.18).
Conclusions: Past/current prevalence and incidence of HCV were low among individuals in the Dutch PrEP programme. Infections were associated with behaviour known to be associated with HCV. Instead of annual HCV testing, as stated in most PrEP care guidelines, testing frequency for HCV could be based on behaviours associated with HCV acquisition.
{"title":"Hepatitis C virus infection is uncommon at baseline and during follow-up among individuals using PrEP in the Dutch national PrEP programme between 2019 and 2022.","authors":"Kris Hage, Anders Boyd, Eline L M Op de Coul, Danja Sarink, Elske Hoornenborg, Maria Prins","doi":"10.1136/sextrans-2024-056169","DOIUrl":"10.1136/sextrans-2024-056169","url":null,"abstract":"<p><strong>Objectives: </strong>Studies showed that men who have sex with men (MSM), including those using pre-exposure prophylaxis (PrEP), are at increased risk of hepatitis C virus (HCV) infection. We evaluated HCV prevalence and incidence, along with their associated determinants, in a cohort of PrEP-using individuals in the Netherlands.</p><p><strong>Methods: </strong>In 2019, the Netherlands launched a 5-year national programme that offers subsidised PrEP to eligible individuals. We used prospectively collected data from individuals registered in this programme between 2019 and 2022. Individuals underwent annual testing for HCV antibodies and additional HCV-RNA testing when antibodies were present. We calculated the prevalence of past/current HCV infection at first visit and overall incidence rate (IR) during follow-up. Univariable logistic and Poisson regression models were used to identify determinants associated with past/current prevalent or incident HCV infection, respectively. Behavioural factors referred to those occurring in the previous 6 months.</p><p><strong>Results: </strong>A total of 10 563 (n=10 319, 97.7% MSM) were included. At first visit, 66 of 10 563 (0.6%) had a past/current HCV infection, which was associated with older age [odds ratio (OR) per 10 years=1.57, 95% confidence interval (CI)=1.31 to 1.88], the use of PrEP before first visit (OR=3.03, 95% CI=1.79 to 5.13), receptive condomless anal sex (CAS) (OR=2.73, 95% CI=1.25 to 5.98), chemsex (OR=2.44, 95% CI=1.49 to 3.99) and injecting drug use (IDU) (OR=6.61, 95% CI=2.35 to 18.61). Among 9851 individuals contributing to 17 150 person-years (PYs) of follow-up, 64 incident HCV infections (IR=0.37 per 100 PYs, 95% CI=0.29 to 0.48) were identified. Factors associated with incident HCV infection were receptive CAS [incidence rate ratio (IRR)=2.59, 95% CI=1.12 to 6.02], chemsex (IRR=1.78, 95% CI=1.06 to 2.98), sexually transmitted infection diagnosis (IRR=2.30, 95% CI=1.23 to 4.31) and IDU (IRR=6.15, 95% CI=2.20 to 17.18).</p><p><strong>Conclusions: </strong>Past/current prevalence and incidence of HCV were low among individuals in the Dutch PrEP programme. Infections were associated with behaviour known to be associated with HCV. Instead of annual HCV testing, as stated in most PrEP care guidelines, testing frequency for HCV could be based on behaviours associated with HCV acquisition.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1136/sextrans-2023-056089
Yu Ri Im, Khadija Said Mohammed, Emily Martyn, Sheila Lumley, Joy Ko, Jolynne Mokaya, Stuart Flanagan, Philippa Clare Matthews
Optimising treatment outcomes for people living with hepatitis B virus (HBV) is key to advancing progress towards international targets for the elimination of viral hepatitis as a public health threat. Nucleos/tide analogue agents (most commonly tenofovir or entecavir) are well-tolerated and suppress viraemia effectively in the majority of those who are offered therapy. However, outcomes are not consistent, and we explore the factors that may contribute to incomplete therapeutic responses. We discuss situations in which therapy is not accessible, affordable or acceptable, reflecting the impact of social, cultural and economic barriers, stigma and discrimination, low awareness, poor access to health systems and comorbidity. These challenges are amplified in certain vulnerable populations, increasing the risk of adverse outcomes-which include liver cirrhosis and hepatocellular carcinoma-among people who already experience marginalisation and health inequities. We also tackle the physiological and biological mechanisms for incomplete virological suppression in individuals receiving HBV treatment, considering the possible impact of inadequate tissue drug levels, poor drug-target avidity and genomic resistance. These factors are interdependent, leading to a complex landscape in which socioeconomic challenges increase the challenge of consistent daily therapy and set the scene for selection of drug resistance. By putting a spotlight on this neglected topic, we aim to raise awareness, prompt dialogue, inform research and advocate for enhanced interventions. As criteria for HBV treatment eligibility relax, the population receiving therapy will expand, and there is a pressing need to optimise outcomes and close the equity gap.
{"title":"Social, clinical and biological barriers to hepatitis B virus suppression with nucleos/tide analogue therapy: who is at risk and what should we do about it?","authors":"Yu Ri Im, Khadija Said Mohammed, Emily Martyn, Sheila Lumley, Joy Ko, Jolynne Mokaya, Stuart Flanagan, Philippa Clare Matthews","doi":"10.1136/sextrans-2023-056089","DOIUrl":"10.1136/sextrans-2023-056089","url":null,"abstract":"<p><p>Optimising treatment outcomes for people living with hepatitis B virus (HBV) is key to advancing progress towards international targets for the elimination of viral hepatitis as a public health threat. Nucleos/tide analogue agents (most commonly tenofovir or entecavir) are well-tolerated and suppress viraemia effectively in the majority of those who are offered therapy. However, outcomes are not consistent, and we explore the factors that may contribute to incomplete therapeutic responses. We discuss situations in which therapy is not accessible, affordable or acceptable, reflecting the impact of social, cultural and economic barriers, stigma and discrimination, low awareness, poor access to health systems and comorbidity. These challenges are amplified in certain vulnerable populations, increasing the risk of adverse outcomes-which include liver cirrhosis and hepatocellular carcinoma-among people who already experience marginalisation and health inequities. We also tackle the physiological and biological mechanisms for incomplete virological suppression in individuals receiving HBV treatment, considering the possible impact of inadequate tissue drug levels, poor drug-target avidity and genomic resistance. These factors are interdependent, leading to a complex landscape in which socioeconomic challenges increase the challenge of consistent daily therapy and set the scene for selection of drug resistance. By putting a spotlight on this neglected topic, we aim to raise awareness, prompt dialogue, inform research and advocate for enhanced interventions. As criteria for HBV treatment eligibility relax, the population receiving therapy will expand, and there is a pressing need to optimise outcomes and close the equity gap.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26DOI: 10.1136/sextrans-2024-056150
Wei Ai, Yewei Xie, Haidong Lu, Ting Ai, Dan Wu, Ye Zhang, Gifty Marley, Jason Ong, Joseph D Tucker, Weiming Tang
Objectives: Pay-it-forward incentives effectively promote hepatitis B virus (HBV) and hepatitis C virus (HCV) testing among men who have sex with men (MSM) by offering free testing and donation opportunities. This study aims to explore the interaction between pay-it-forward incentives and recreational drug use on HBV and HCV testing uptake among Chinese MSM.
Methods: We pooled data from two pay-it-forward studies that aimed to promote dual HBV and HCV testing among MSM in Jiangsu, China. We explored factors associated with hepatitis testing uptake in the two study groups and examined the interaction between pay-it-forward incentives and recreational drug use on hepatitis testing uptake.
Results: Overall, 511 MSM participated in these two studies, with 265 participants in the pay-it-forward incentives group and 246 participants in the standard-of-care group. Among these participants, 59.3% in the pay-it-forward incentive group and 24.8% in the standard-of-care group received dual HBV and HCV testing, respectively. In the pay-it-forward incentives group, participants who used recreational drugs in the past 12 months (adjusted OR (AOR)=1.83, 95% CI 1.09 to 3.06) were more likely to receive dual HBV and HCV testing, compared with those who never used recreational drugs, whereas in the standard-of-care group, those who used recreational drugs were less likely to receive dual HBC and HCV testing (AOR=0.38, 95% CI 0.18 to 0.78). MSM with higher community connectedness (AOR=1.10, 95% CI 1.00 to 1.21) were also more likely to receive hepatitis testing with pay-it-forward incentives. There was a synergistic interaction on both the multiplicative (ratio of ORs=4.83, 95% CI 1.98 to 11.7) and additive scales (the relative excess risk of interaction=2.97, 95% CI 0.56 to 5.38) of pay-it-forward incentives and recreational drug use behaviours on dual HBV and HCV testing uptake among MSM.
Conclusion: Pay-it-forward incentives may be particularly useful in promoting hepatitis testing among MSM who use recreational drugs.
目标:以奖代补激励机制通过提供免费检测和捐赠机会,可有效促进男男性行为者(MSM)接受乙肝病毒(HBV)和丙肝病毒(HCV)检测。本研究旨在探讨中国男男性行为者中,以奖代补激励机制和娱乐性吸毒对HBV和HCV检测率的影响:我们汇集了来自两项有偿研究的数据,这两项研究的目的是在中国江苏的 MSM 中推广 HBV 和 HCV 双重检测。我们探讨了这两项研究中与肝炎检测率相关的因素,并研究了 "以奖代补 "激励机制和娱乐性吸毒对肝炎检测率的交互作用:共有511名男男性行为者参加了这两项研究,其中265人参加了 "按劳取酬 "激励机制组,246人参加了 "标准护理 "组。在这些参与者中,有偿激励组和标准护理组分别有 59.3% 和 24.8% 的人接受了 HBV 和 HCV 双重检测。与从未使用过娱乐性毒品的参与者相比,在有偿奖励组中,在过去12个月中使用过娱乐性毒品的参与者(调整OR(AOR)=1.83,95% CI 1.09至3.06)更有可能接受HBV和HCV双重检测,而在标准护理组中,使用过娱乐性毒品的参与者接受HBV和HCV双重检测的可能性较低(AOR=0.38,95% CI 0.18至0.78)。社区关联度较高的 MSM(AOR=1.10,95% CI 1.00 至 1.21)也更有可能接受有偿奖励的肝炎检测。在乘法量表(ORs 比率=4.83,95% CI 1.98 至 11.7)和加法量表(交互作用的相对超额风险=2.97,95% CI 0.56 至 5.38)上,有偿激励和娱乐性吸毒行为对 MSM 接受 HBV 和 HCV 双重检测都有协同交互作用:结论:以奖代补激励措施可能对促进使用娱乐性毒品的 MSM 接受肝炎检测特别有用。
{"title":"Synergistic interaction between pay-it-forward incentives and recreational drug use on hepatitis B virus and hepatitis C virus testing among men who have sex with men in China.","authors":"Wei Ai, Yewei Xie, Haidong Lu, Ting Ai, Dan Wu, Ye Zhang, Gifty Marley, Jason Ong, Joseph D Tucker, Weiming Tang","doi":"10.1136/sextrans-2024-056150","DOIUrl":"10.1136/sextrans-2024-056150","url":null,"abstract":"<p><strong>Objectives: </strong>Pay-it-forward incentives effectively promote hepatitis B virus (HBV) and hepatitis C virus (HCV) testing among men who have sex with men (MSM) by offering free testing and donation opportunities. This study aims to explore the interaction between pay-it-forward incentives and recreational drug use on HBV and HCV testing uptake among Chinese MSM.</p><p><strong>Methods: </strong>We pooled data from two pay-it-forward studies that aimed to promote dual HBV and HCV testing among MSM in Jiangsu, China. We explored factors associated with hepatitis testing uptake in the two study groups and examined the interaction between pay-it-forward incentives and recreational drug use on hepatitis testing uptake.</p><p><strong>Results: </strong>Overall, 511 MSM participated in these two studies, with 265 participants in the pay-it-forward incentives group and 246 participants in the standard-of-care group. Among these participants, 59.3% in the pay-it-forward incentive group and 24.8% in the standard-of-care group received dual HBV and HCV testing, respectively. In the pay-it-forward incentives group, participants who used recreational drugs in the past 12 months (adjusted OR (AOR)=1.83, 95% CI 1.09 to 3.06) were more likely to receive dual HBV and HCV testing, compared with those who never used recreational drugs, whereas in the standard-of-care group, those who used recreational drugs were less likely to receive dual HBC and HCV testing (AOR=0.38, 95% CI 0.18 to 0.78). MSM with higher community connectedness (AOR=1.10, 95% CI 1.00 to 1.21) were also more likely to receive hepatitis testing with pay-it-forward incentives. There was a synergistic interaction on both the multiplicative (ratio of ORs=4.83, 95% CI 1.98 to 11.7) and additive scales (the relative excess risk of interaction=2.97, 95% CI 0.56 to 5.38) of pay-it-forward incentives and recreational drug use behaviours on dual HBV and HCV testing uptake among MSM.</p><p><strong>Conclusion: </strong>Pay-it-forward incentives may be particularly useful in promoting hepatitis testing among MSM who use recreational drugs.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}