Frequent chlamydia and gonorrhoea but very infrequent syphilis among men who have sex with men using HIV pre-exposure prophylaxis in West Africa

IF 3.6 3区医学 Q2 INFECTIOUS DISEASES

Sexually Transmitted Infections Pub Date : 2024-04-11 DOI:10.1136/sextrans-2023-056000

Ter Tiero Elias Dah, Irith De Baetselier, Benjamin Cuer, Camille Anoma, Ephrem Mensah, Amadou Koné, Souba Diandé, Claver Anoumou Dagnra, Hortense Yaobla Faye-Kette, Alain Yeo, Issifou Yaya, Bruno Spire, Bintou Dembélé Keita, Tania Crucitti, Bea Vuylsteke, Christian Laurent

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引用次数: 0

Abstract

Objectives Although oral pre-exposure prophylaxis (PrEP) for HIV is being rolled out in West Africa, data on sexually transmitted infections (STIs) in PrEP users are scarce. We assessed the prevalence, incidence and determinants of bacterial STIs in men who have sex with men (MSM) taking PrEP in Burkina Faso, Côte d’Ivoire, Mali and Togo. Methods A prospective cohort study among MSM initiating PrEP as part of a comprehensive HIV prevention package was conducted between 2017 and 2021 in community-based clinics in the four study countries. Molecular screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) was performed at months 0, 6 and 12. Serological testing for syphilis was performed every 3 months over the first year of follow-up. Determinants of CT and/or NG incidence were identified using Poisson generalised linear mixed models. Results A total of 598 participants with a median age of 24.7 years were included. Prevalence of CT and/or NG was 24.4% (95% CI 21.0 to 28.1), 22.4% (95% CI 18.4 to 26.8) and 29.0% (95% CI 24.2 to 34.1) at months 0, 6 and 12, respectively. The prevalence of syphilis ranged from 0.2% (95% CI 0.0 to 0.9) at month 0 to 0.8% (95% CI 0.2 to 2.4) at month 12. Ninety incident CT and/or NG infections occurred during a total follow-up time of 280.6 person-years (incidence rate 32.1 per 100 person-years, 95% CI 25.8 to 39.4). Three incident syphilis infections were detected during a total follow-up time of 459.7 person-years (incidence rate 0.7 per 100 person-years, 95% CI 0.1 to 1.9). CT and/or NG incidence was associated with condomless insertive anal sex (adjusted incidence rate ratio 1.96, 95% CI 1.04 to 3.71, p=0.038). Conclusions CT and NG were frequent but syphilis was very infrequent in MSM using HIV PrEP in West Africa. HIV programme managers should integrate STI services into PrEP programmes. Data are available on reasonable request. Data may be obtained from a third party and are not publicly available. All data relevant to the study are included in the article or uploaded as supplementary information. Not applicable.

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在西非使用艾滋病毒暴露前预防疗法的男男性行为者中，衣原体和淋病频发，但梅毒极少发生

目的虽然口服暴露前预防艾滋病 (PrEP) 正在西非推广，但有关 PrEP 使用者性传播感染 (STI) 的数据却很少。我们评估了布基纳法索、科特迪瓦、马里和多哥服用 PrEP 的男男性行为者 (MSM) 中细菌性 STI 的流行率、发病率和决定因素。方法 2017 年至 2021 年期间，在这四个研究国家的社区诊所对作为艾滋病综合预防一揽子方案一部分启动 PrEP 的男男性行为者进行了一项前瞻性队列研究。在第0、6和12个月进行沙眼衣原体（CT）和淋病奈瑟菌（NG）的分子筛查。在随访的第一年中，每 3 个月进行一次梅毒血清学检测。采用泊松广义线性混合模型确定了CT和/或NG发病率的决定因素。结果共纳入 598 名参与者，中位年龄为 24.7 岁。在第0、6和12个月时，CT和/或NG的患病率分别为24.4%（95% CI 21.0至28.1）、22.4%（95% CI 18.4至26.8）和29.0%（95% CI 24.2至34.1）。梅毒发病率从第0个月的0.2%（95% CI 0.0至0.9）到第12个月的0.8%（95% CI 0.2至2.4）不等。在总计 280.6 人年的随访时间内，共发生了 90 例 CT 和/或 NG 感染（发病率为每 100 人年 32.1 例，95% CI 为 25.8 至 39.4）。在总计 459.7 人/年的随访时间内，发现了 3 例梅毒感染病例（发病率为每 100 人/年 0.7 例，95% CI 为 0.1 至 1.9 例）。CT 和/或 NG 的发病率与无套插入式肛交有关（调整后的发病率比为 1.96，95% CI 为 1.04 至 3.71，P=0.038）。结论在西非使用 HIV PrEP 的男男性行为者中，CT 和 NG 的发病率很高，但梅毒的发病率很低。艾滋病项目管理人员应将性传播感染服务纳入 PrEP 项目。如有合理要求，可提供数据。数据可能来自第三方，不对外公开。与研究相关的所有数据均包含在文章中或作为补充信息上传。不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sexually Transmitted Infections 医学-传染病学

CiteScore

5.70

自引率

8.30%

发文量

审稿时长

4-8 weeks

期刊介绍： Sexually Transmitted Infections is the world’s longest running international journal on sexual health. It aims to keep practitioners, trainees and researchers up to date in the prevention, diagnosis and treatment of all STIs and HIV. The journal publishes original research, descriptive epidemiology, evidence-based reviews and comment on the clinical, public health, sociological and laboratory aspects of sexual health from around the world. We also publish educational articles, letters and other material of interest to readers, along with podcasts and other online material. STI provides a high quality editorial service from submission to publication.