Sexually transmitted infections in Western Europe among HIV-Positive men who have sex with men
Sexually transmitted infections in Western Europe among HIV-Positive men who have sex with men
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DOI：
10.1097/01.olq.0000260919.34598.5b
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发表时间：
2007-10-01
影响因子：
3.1
通讯作者：
Elford, Jonathan
中科院分区：
文献类型：
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作者：
Dougan, Sarah;Evans, Barry G.;Elford, Jonathan
背景。自 1996 年以来，西欧男男性行为者 (MSM) 中的性传播感染 (STI) 再次出现。与此同时，采用高效抗逆转录病毒疗法 (HAART) 后，与 HIV 相关的死亡率显着下降，而感染 HIV 的 MSM 人数也相应增加。无保护肛交的比例也有所增加。在本文中，我们利用一些西欧国家的性传播感染监测数据，以更好地了解 HIV 阳性 MSM 对近期性传播感染增加的贡献。方法：对西欧 HIV 阳性 MSM 中 HIV 流行趋势和性传播感染相关的已发表文献、监测报告和特别出版物进行了回顾。结果：HAART 后，MSM 社区样本中的 HIV 流行率为 5% 至 18%。被诊断患有性传播感染的男男性行为者中的艾滋病毒感染率要高得多。平均而言，11 个国家诊断出梅毒的 MSM 中的艾滋病毒感染率为 42%（范围为 14%-59%）。大多数患有梅毒的 HIV 阳性 MSM 都知道自己的 HIV 状况。 2004 年，在英格兰和威尔士，32% 的淋病男男性行为者 HIV 呈阳性。有 9 个国家记录了性病淋巴肉芽肿的爆发； HIV 阳性 MSM 平均占病例的 75%（范围 0%-92%）。在鹿特丹、巴黎、阿姆斯特丹和英国，性传播丙型肝炎病例主要在 HIV 阳性 MSM 中发现。结论：在西欧，HAART 后 HIV 阳性 MSM 中诊断出性传播感染的比例不成比例。 HIV 阳性 MSM 中生存率的提高以及血清分选似乎解释了患有性传播感染的 MSM 中 HIV 感染率高的原因。自 1996 年以来，HIV 阳性男性中的性传播感染将极大地促进西欧 MSM 中性传播感染趋势的增加。这些发现强调了 HIV 阳性 MSM 中进行常规性传播感染检测的必要性，以及强调性传播感染合并感染影响的安全性行为信息的必要性。
Background. Since 1996, there has been a resurgence in sexually transmitted infections (STIs) among men who have sex with men (MSM) in Western Europe. This has coincided with a significant decrease in HIV-associated mortality following the introduction of highly active antiretroviral therapies (HAART) and a corresponding increase in the number of MSM living with HIV. Levels of unprotected anal intercourse have also increased. In this article, we use STI surveillance data from a number of Western European countries to better understand the contribution of HIV-positive MSM to the recent increase in STIs.Methods: Published literature, surveillance reports, and ad hoc publications relating to HIV prevalence trends and STIs among HIV-positive MSM in Western Europe were reviewed.Results: Post-HAART, HIV prevalence among community samples of MSM ranged from 5% to 18%. HIV prevalence among MSM diagnosed with an STI was substantially higher. On average, HIV prevalence among MSM diagnosed with syphilis in 11 countries was 42% (range 14%-59%). Most HIV-positive MSM with syphilis were aware of their HIV status. In England and Wales, 32% of MSM with gonorrhea were HIV-positive in 2004. Outbreaks of lymphogranuloma venereum have been documented in 9 countries; HIV-positive MSM accounted for 75% of cases on average (range 0%-92%). Cases of sexually transmitted hepatitis C have been predominantly identified among HIV-positive MSM in Rotterdam, Paris, Amsterdam, and the United Kingdom.Conclusions: In Western Europe, STIs have been disproportionately diagnosed among HIV-positive MSM post-HAART. Improved survival coupled with serosorting among HIV-positive MSM appears to explain the high prevalence of HIV among MSM with STIs. STI transmission among HIV-positive men will have contributed substantially to increasing STI trends seen among MSM in Western Europe, since 1996. These findings highlight the need for routine STI testing among HIV-positive MSM as well as safer sex messages highlighting the implications of STI coinfection.