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%).

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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.

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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.

Sexually active men in Pennsylvania need to get tested for Syphilis

Pennsylvania is experiencing an alarming increase in Syphilis cases, primarily among men who have sex with men (MSM). The State Department of Health reports that new Syphilis infections are primarily among minority MSM under the age of 25. Furthermore, the Centers for Disease Control and Prevention (CDC) recently reported that cases of new STDs are at record highs nationwide, including an 18 percent increase in Syphilis infections.

what-is-syphillisSyphilis is a sexually transmitted infection. If it goes untreated, it can lead to serious health problems including paralysis, blindness, and dementia. However, Syphilis is 100% curable with simple antibiotics.

Syphilis is spread through direct contact with a Syphilis sore during vaginal, anal, or oral sex. You can get Syphilis and not have any symptoms so the only way to know for sure you’re not infected is to get tested.

Several locations around the state have free Syphilis testing. Click on this link to find testing near you.

To find out more about Syphilis, go to www.cdc.gov/std/syphilis/stdfact-syphilis.htm

Research: Lung cancer deaths higher among HIV+ smokers

According to the U.S. National AIDS Strategy report, about 1 in 5 American adults smoke. Among adults living with HIV, the number of people who smoke is 2 to 3 times greater. The report also states that smoking can cause health risks specifically for people who are living with HIV. For example, smokers with HIV are at higher risk (as compared to nonsmokers with HIV) of developing smoking-related cancers, bacterial pneumonia, COPD, heart disease, and oral candidiasis (thrush).

Furthermore, previous research found that HIV-positive smokers lose years of life to cigarettes as compared to nonsmokers with HIV.

If all of that wasn’t enough to convince gay and bi men with HIV to kick the habit, a new study published in The Journal of the American Medical Association narrows the range of research, focusing specifically on projected lung cancer deaths.

The researchers found that nearly 25 percent of people who adhere well to anti-HIV medications but continue to smoke will die from lung cancer. Among smokers who quit at age 40, only about 6 percent will die of lung cancer. The authors also found that people with HIV who take antiviral medicines but who also smoke are from 6 to 13 times more likely to die from lung cancer than from HIV/AIDS.

“Quitting smoking is one of the most important things that people with HIV can do to improve their health and live longer,” Travis Baggett, MD, MPH, of the MGH Division of General Internal Medicine and coauthor of the study, said in a recent press release. “Quitting will not only reduce their risk of lung cancer but also decrease their risk of many other diseases, such as heart attack, stroke and emphysema.”

To read a press release about the study, click here. To find out more about how you can quit smoking, click here and here.  For more information about Health Alerts, go to the Pitt Men’s Study Website at https://pittmensstudy.com/health-alerts/. To subscribe to the Pitt Men’s Study Health Alerts, send an email to rgy2@Pitt.edu, with the word subscribe in the subject line.

Health Alerts are presented by the HIV Prevention and Care Project and the Pitt Men’s Study at the University of Pittsburgh Graduate School of Public Health, with funding from the Pennsylvania Department of Health.

Does PrEP use lead to higher STI rates among gay and bi men?

From POZ.com

Rates of new sexually transmitted infections (STIs) are much higher among men who have sex with men (MSM) taking Truvada (tenofovir disoproxil fumarate/emtricitabine) as pre-exposure prophylaxis (PrEP) than among other MSM. More research is needed, however, to determine whether starting PrEP leads to higher STI rates among MSM.

Publishing their findings in the journal AIDS, researchers conducted a meta-analysis of 18 studies of MSM in which new STI diagnoses were reported. Five of the studies included MSM given PrEP, and 14 were conducted with MSM who were not given PrEP. (One study, the PROUD study, included both a group given PrEP immediately and a group given PrEP on a deferred basis and thus fell into both the PrEP and the non-PrEP categories of studies.)

The researchers found that the rates of new diagnoses of STIs among MSM given PrEP were 25.3 times greater for gonorrhea, 11.2 times greater for chlamydia and 44.6 times greater for syphilis, compared with the rates among MSM not given PrEP. After repeating the analysis but excluding studies conducted before 1999, the researchers found that the results were similar.

Looking to parse apart the contributing factors to the higher rate of STI diagnoses among MSM given PrEP, the meta-analysis’s authors theorized that the regular STI testing that is part of taking PrEP might have led to a higher rate of STI detection. A greater number of sex partners and a higher rate of condomless sex among those given PrEP might also have contributed to their higher STI diagnosis rate.

The study is limited by the fact that, except in the case of PROUD, the researchers compared different populations of MSM from study to study. They also compared groups that tested for STIs at different frequencies and used different variations of STI tests. Additionally, the PrEP studies specifically sought out participants engaging in high-risk sexual behaviors, while the other studies might have had different criteria with regard to sexual risk taking. However, participants in many of the non-PrEP studies were indeed recruited based on some level of reported sexual risk taking.

 

Read the full article.