Incidence of Gonorrhea and Chlamydia Following Human Immunodeficiency Virus Preexposure Prophylaxis Among Men Who Have Sex With Men: A Modeling Study
Samuel M. Jenness,Kevin M Weiss,Steven M. Goodreau,Thomas L. Gift,Harrell W. Chesson,Karen W. Hoover,Dawn K. Smith,Albert Y. Liu,Patrick S. Sullivan,Eli S. Rosenberg +9 more
TLDR
In this paper, a network-based mathematical model of HIV, Neisseria gonorrhoeae (NG), and Chlamydia trachomatis (CT) transmission dynamics among MSM in the United States is presented.Abstract:
Background Preexposure prophylaxis (PrEP) is highly effective for preventing human immunodeficiency virus (HIV) infection, but risk compensation (RC) in men who have sex with men (MSM) raises concerns about increased sexually transmitted infections (STIs). The Center for Disease Control and Prevention's (CDC's) PrEP guidelines recommend biannual STI screening, which may reduce incidence by treating STIs that would otherwise remain undiagnosed. We investigated these two counteracting phenomena. Methods With a network-based mathematical model of HIV, Neisseria gonorrhoeae (NG), and Chlamydia trachomatis (CT) transmission dynamics among MSM in the United States, we simulated PrEP uptake following the prescription indications and HIV/STI screening recommendations in the CDC guidelines. Scenarios varied PrEP coverage (the proportion of MSM indicated for PrEP who received it), RC (a reduction in the per-act probability of condom use), and the STI screening interval. Results In our reference scenario (40% coverage, 40% RC), 42% of NG and 40% of CT infections would be averted over the next decade. A doubling of RC would still result in net STI prevention relative to no PrEP. STIs declined because PrEP-related STI screening resulted in a 17% and 16% absolute increase in the treatment of asymptomatic and rectal STIs, respectively. Screening and timely treatment at quarterly vs biannual intervals would reduce STI incidence an additional 50%. Conclusions Implementation of the CDC PrEP guidelines while scaling up PrEP coverage could result in a significant decline in STI incidence among MSM. Our study highlights the design of PrEP not only as antiretroviral medication but as combination HIV/STI prevention incorporating STI screening.read more
Citations
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Sexually Transmitted Infections Treatment Guidelines,2021
Kimberly A. Workowski,Laura H. Bachmann,Philip A. Chan,Christine Johnston,Christina A. Muzny,Ina U. Park,Hilary Reno,Jonathan M. Zenilman,Gail Bolan +8 more
TL;DR: These guidelines for the treatment of persons who have or are at risk for sexually transmitted infections (STIs) were updated by CDC after consultation with professionals knowledgeable in the field of STIs who met in Atlanta, Georgia, June 11-14, 2019.
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A separable model for dynamic networks
TL;DR: A discrete time generative model for social network evolution that inherits the richness and flexibility of the class of exponential family random‐graph models and facilitates separable modelling of the tie duration distributions and the structural dynamics of tie formation is developed.
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Association of HIV Preexposure Prophylaxis With Incidence of Sexually Transmitted Infections Among Individuals at High Risk of HIV Infection.
Michael W Traeger,Vincent J Cornelisse,Jason Asselin,Brian Price,Norman Roth,Jeff Willcox,B K Tee,Christopher K Fairley,Christina C. Chang,Jude Armishaw,Olga Vujovic,Matthew Penn,Pauline Cundill,George Forgan-Smith,John Gall,Claire Pickett,Luxi Lal,Luxi Lal,Anne Mak,Tim Spelman,Tim Spelman,Tim Spelman,Long Nguyen,Dean Murphy,Dean Murphy,Kathleen E Ryan,Kathleen E Ryan,Carol El-Hayek,Michael West,Simon Ruth,Colin Batrouney,John T. Lockwood,Jennifer F Hoy,Margaret Hellard,Margaret Hellard,Mark Stoove,Mark Stoove,Edwina J. Wright,Edwina J. Wright,Edwina J. Wright +39 more
TL;DR: Among gay and bisexual men using PrEP, STIs were highly concentrated among a subset, and receipt of PrEP after study enrollment was associated with an increased incidence of STIs compared with preenrollment, highlighting the importance of frequent STI testing.
Journal ArticleDOI
Epidemiology and prevention of sexually transmitted infections in men who have sex with men at risk of HIV.
TL;DR: If control of STIs is to be improved, then a far greater emphasis on increased use of existing effective STI control strategies will be required, in addition to the investigation of new interventions.
Journal ArticleDOI
Global Epidemiologic Characteristics of Sexually Transmitted Infections Among Individuals Using Preexposure Prophylaxis for the Prevention of HIV Infection: A Systematic Review and Meta-analysis.
Jason J. Ong,Jason J. Ong,Rachel Baggaley,Teodora Wi,Joseph D. Tucker,Hongyun Fu,M. Kumi Smith,Sabrina Rafael,Vanessa Anglade,Jane Falconer,Richard Ofori-Asenso,Fern Terris-Prestholt,Ioannis Hodges-Mameletzis,Philippe Mayaud +13 more
TL;DR: Estimates indicate a high burden of sexually transmitted infections among individuals initiating preexposure prophylaxis and persistent users of preex exposures for the prevention of HIV infection, highlighting the opportunities for active integration of services for sexual transmitted infections and HIV preex Exposure Prophylactic.
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