Why STDs are on the rise in America

From the Economist online

Much of the increase in STDs has come from gay and bisexual men. Although a relatively small share of the population, they accounted for 81% of male syphilis cases in 2016, according to the Centres for Disease Control. As with heterosexuals, this seems to be because sex is now seen as less risky. That is due to the advent of PrEP, a prophylactic drug cocktail which gay men can take to nearly inoculate themselves from HIV. The reduced chances of catching HIV—along with the fact that a positive diagnosis is no longer a death sentence—seems to encourage men to drop their guard. A recent study of gay and bisexual men, published in the Lancet, a medical journal, found that as more began taking PrEP, rates of consistent condom usage dropped from 46% to 31%. Recent studies have shown that uptake of PrEP is strongly associated with increased rates of STD infection.

All this shows that changing sexual mores, and a reduced fear of the risks of unprotected sex, seem to be at fault—especially since the problem is not just limited to America. England experienced a 20% increase in syphilis diagnoses in 2017 and a 22% increase in those of gonorrhoea. Other countries in western Europe have seen ever worse outbreaks, sometimes exceeding 50%. Dwindling public spending on STD prevention—which in America has fallen by 40% in real terms since 2003—is not helping matters. Yet the chief methods of prevention, abstinence and condoms, are tried and true. Should these options seem too chaste or chaffing, then prospective partners ought to get an STD test (especially since most infections can be cleared up with a simple course of antibiotics). Verified testing is vital since verbal assurances, especially on the cusp of a liaison, can be misleading.

Read the full article.

High numbers of HIV-positive MSM not being tested for syphilis

From healio.com

Nearly one-third of sexually active HIV-positive men who have sex with men are not tested for syphilis at least annually, researchers reported in a recent study, calling the finding “concerning.”

Alex de Voux, PhDan Epidemiologist in the CDC’s Division of STD Prevention, and colleagues sought to examine the proportion of sexually active HIV-positive men who have sex with men (MSM) currently in care who were tested for syphilis in the past 3, 6 and 12 months by their HIV care provider.

A 2017 study showed that MSM accounted for more than 60% of syphilis cases nationwide in 2015. In that study, researchers determined that the rate of primary and secondary syphilis in the United States among MSM was 106 times that of men who have sex with women only.

In the current study, the authors noted that guidelines recommend that sexually active MSM, including HIV-positive MSM, be tested at least annually for syphilis, with testing every 3 to 6 months for MSM at elevated risk, and used this timeline to evaluate the group.

De Voux and colleagues used the most recent medical record and interview data collected by the Medical Monitoring Project, a population-based HIV surveillance system, from 2013 to 2014. The data showed that 71% of all sexually active HIV-positive MSM had at least one test for syphilis in the past 12 months. In the past 6 months, only 43% had been tested, and the number dropped to 22% in the past 3 months.

Researchers also examined the frequency of testing in MSM who reported risk factors, including having condomless sex and having sex with two or more partners.

Read the full article.

To find free syphilis testing near you, search by zip code on the CDC testing Website: gettested.cdc.gov

For more information about syphilis, its symptoms and treatment, click here.

Bisexual men have higher risk of heart disease

From Medical Daily

The research team analyzed data on 7,731 male participants between the ages of 20 to 59. They were divided into four groups based on their sexual identities: gay men, heterosexual men, bisexual men, and heterosexual men who have sex with men.

The two objectives of the study were to examine heart disease diagnoses among men of different sexual orientations and also measure their modifiable risk factors for heart disease.

While no correlation was found between sexual identities and heart disease diagnoses, bisexual men were found to have higher rates of several risk factors for heart disease compared to heterosexual men. These included mental distress, obesity, elevated blood pressure, etc.

The other three groups were found to have similar heart disease risk. The only difference observed in health behavior was that gay men reported lower binge drinking than straight men.

“Our findings highlight the impact of sexual orientation, specifically sexual identity, on the cardiovascular health of men and suggest clinicians and public health practitioners should develop tailored screening and prevention to reduce heart disease risk in bisexual men,” said lead author Billy Caceres, an adjunct faculty member at Rory Meyers College of Nursing, New York University.

Read the full article.

Increasing Incidence of Syphilis in People With HIV

From Infectious Disease Adviser

The incidence rate of syphilis in people with HIV increased through 2015, according to new research published in Clinical Infectious Diseases.

Since 2000, the incidence of syphilis has increased among gay, bisexual, and other men who have sex with men (MSM) in the United States. This represents an ongoing sexual risk, and temporal trends and associated risk factors for newly diagnosed syphilis infections among people with HIV were therefore investigated.

Data from HIV Outpatient Study cohort participants visiting 10 clinics in the United States from 1999 to 2015 were analyzed. A total of 6888 participants with HIV were included, and 641 had one or more new syphilis diagnoses during a median follow period of 5.2 years. Participants were mostly male, age 31 to 50 years (78%), and the majority were MSM (56%).

Read the full article.

Health Alert: HIV rate among gay and bi men between the age of 25 to 34 rose 45% between 2008 and 2015

During that time, the rate dropped 15 percent nationally and rose 25 percent among Latino men who have sex with men.

From Poz Magazine online

While the national annual HIV infection rate dropped by an estimated 15 percent between 2008 and 2015, a few key subgroups saw a rise in yearly new HIV infections, also known as HIV incidence. During this period, HIV incidence among 25- to 34-year-old men who have sex with men (MSM) increased by an estimated 45 percent while the rate increased 25 percent among Latino MSM.

These figures come from the Centers for Disease Control and Prevention’s (CDC) new, in-depth analysis of epidemic trends in the United States. Published in the Annals of Internal Medicine, the report is a more precise and granular version of reports on epidemic trends that CDC officials presented at the 2017 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle a year ago.

At that time, the agency estimated that HIV incidence declined 18 percent between 2008 and 2014. This new estimate, therefore, represents a disappointing reduction in that hopeful figure.

Prior to 2008, HIV incidence was essentially stable in the United States for the two decades since the beginning of the modern era of combination antiretroviral (ARV) treatment.

Read the full article.

 

Health Alert: Beaver County has “notable increases” in new HIV and gonorrhea diagnoses

From thetimesonline.com

The PA Department of Health is reporting an increase in HIV and gonorrhea diagnoses in Beaver County.

However, a lack of willingness to test — combined with the potential spread of the diseases through illegal drug use — raises more questions than answers.

From 2017 through this year so far, the number of new HIV cases has increased “nearly threefold” in county residents compared to the average number of new diagnoses in previous years, according to a Pennsylvania Department of Health advisory issued earlier this month to local medical offices. The increases in HIV infection were predominantly identified in males with the risk factor of men who have sex with men. According to the state health department, four cases of HIV diagnoses were made in 2013, five in 2014 and three in 2015. Zero cases were reported in 2016, but the count may be incomplete because of reporting delays. The state has not yet shared the exact number of new diagnoses for 2017.

Individuals identified with new HIV infections also had a high rate of co-infection with other sexually transmitted diseases (STDs), such as syphilis and gonorrhea.

In nearby Allegheny County, 119 new HIV diagnoses were made in 2013, followed by 128 in 2014, 142 in 2015 and 127 in 2016. In Lawrence County, there were three new cases in 2013, five in 2014, five in 2015 and zero in 2016. The latter also may be incomplete because of reporting delays.

Read the full article.

CDC identifies clusters of rapidly transmitting HIV nationwide

 

From Poz Magazine

Using routine genetic analyses of viral strains seen among those newly diagnosed with HIV, the Centers for Disease Control and Prevention (CDC) has identified scores of rapidly expanding transmission clusters nationwide. These clusters, in which HIV is apparently spreading quickly among sexual networks, disproportionately affect young men who have sex with men (MSM), in particular Latinos.

According to a CDC analysis released in 2017, the HIV infection rate among Latino MSM has increased in recent years while it has decreased among Black and white MSM.

CDC researcher Anne Marie France, PhD, presented findings from the new study on transmission clusters at the 2018 Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.

Read the full article.