Adolescents have a higher incidence of sexually transmitted infections (STIs) than persons of older age groups. The WHO emphasises the need to adopt specific and comprehensive prevention programmes ...aimed at this age group. The objective of this work was to analyse the prevalence of HIV/STIs among adolescents and to identify the sociodemographic, clinical and behavioural markers associated with these infections, in order to promote specific preventive strategies.
Retrospective descriptive study of adolescents, aged 10-19 years, who were attended to for the first consultation between 2016 and 2018 in a reference STI clinic in Madrid. All adolescents were given a structured epidemiological questionnaire where information on sociodemographic, clinical and behavioural characteristics was collected. They were screened for human inmmunodeficiency virus (HIV) and other sexually transmitted infections (STIs). The processing and analysis of the data was done using the STATA 15.0 statistical package.
The frequency of HIV/STIs detected among all adolescents was: gonorrhoea 21.7%, chlamydia 17.1%, syphilis 4.8% and HIV 2.4%. After conducting a multivariate analysis, the independent and statistically significant variables related to the presence of an STI were having first sexual relations at a young age and having a history of STIs. Latin American origin was just below the level of statistical significance (p = 0.066).
Adolescents who begin sexual relations at an early age or those who have a history of HIV/STIs are at higher risk of acquiring STIs. Comprehensive prevention programmes aimed specifically at adolescents should be implemented, especially before the age of 13 years.
Since the recent introduction of preexposure prophylaxis (PrEP), several studies have reported a decrease in the use of condoms and a rise in STIs among users. This rise in risk behavior associated ...with the advent of PrEP is known as "risk compensation." The aim of this study is to measure clinical and behavioral changes associated with the introduction of PrEP by analyzing condom use for anal intercourse, number of sexual partners, sexualized drug use and STI incidence.
We performed a retrospective descriptive study of PrEP users followed every 3months over a 2-year period spanning 2017-2019 in a referral clinic specializing in STI/HIV in Madrid, Spain. One hundred ten men who have sex with men and transgender women underwent regular screening for STIs and hepatitis C virus (HCV) infection. Sociodemographic, clinical, and behavioral data were gathered for all subjects studied.
The risk compensation observed in this study consisted primarily of a lower rate of condom use, while the number of sexual partners and recreational drug consumption remained stable. We observed a very high incidence of STIs in this sample, particularly rectal gonorrhea and chlamydia. The factors shown to be independently associated with the presence of an STI on multivariate analysis were age below 30 years and over 10 sexual partners/month.
The incidence of STI acquisition was higher than expected, indicating a need for strategies to minimize this impact, particularly among younger individuals with a higher number of sexual partners.
IntroductionKnowing the factors associated with HIV transmission is necessary in order to design preventive programmes tailored to the epidemiological situation in each region and population.AimOur ...objective was to study the sociodemographic, clinical and behavioural characteristics of men who have sex with men (MSM) who were newly diagnosed with HIV infection.MethodsWe carried out an observational, descriptive, study on all MSM newly diagnosed with HIV infection in one clinic for sexually transmitted infections (STI) and HIV clinic in Madrid between 2014 and 2019. Information on sociodemographic, clinical, and behavioural characteristics of participants per year of diagnosis was collected.ResultsWe detected a total of 1,398 people with HIV infection, 253 of whom were recent seroconverters (rSCV) with a median duration of documented seroconversion of 6 months. From the total, 97.9% infections were sexually transmitted and 2.1% involved injected drugs, i.e. slam practices. The average age was 32.9 years (range: 15.6-74.9), 51.8% were Spanish and 40% Latin American. These diagnoses decreased in Spanish people and increased in Latin Americans during the study period. Of the rSCV, 73.9% had condomless sex under the influence of drugs and 28.9% participated in chemsex sessions. Apps were used by 92.6% rSCV for sexual encounters and 70.4% of them attributed HIV transmission to their use.ConclusionsCombination of HIV prevention strategies, as pre-exposure prophylaxis, should be reinforced among young MSM, especially those born in Latin America, those who use drugs for sex, and those who use apps in search of sexual contacts.
La profilaxis pre-exposición (PrEP) frente al virus de la inmunodeficiencia humana (VIH) es una medida preventiva eficaz y segura. Sin embargo, no se ha alcanzado a todos los usuarios objetivo que ...podrían beneficiarse de la misma.
El objetivo del estudio fue conocer las características basales sociodemográficas, clínicas y conductuales de las personas al iniciar la PrEP. Como objetivo secundario, se describió el uso de medicación concomitante y el consumo de drogas.
Estudio observacional, retrospectivo y descriptivo de las características sociodemográficas, clínicas y conductuales de los usuarios que se incluyeron en el programa de PrEP de la Comunidad de Madrid durante los 2 primeros años de experiencia.
Se incluyeron 2.256 usuarios en PrEP, el 99,0% hombres, con una edad media de 36,9 años (DE: 8,68). El 33,1% presentó alguna infección de transmisión sexual (ITS) en la primera visita, destacando las clamidiasis y gonococias rectales. El 70,4% refirió consumir drogas asociadas al sexo, y el 42,4% participó en sesiones de chemsex en los últimos 3 meses. Se observó un alto porcentaje de usuarios con medicación concomitante (37,6%), destacando fármacos relacionados con salud mental y alopecia.
Se requiere un abordaje multidisciplinar para cubrir todas las necesidades de los usuarios de PrEP, incluyendo al abordaje clínico medidas de evaluación de salud mental y tratamiento de adicciones.
Pre-exposure prophylaxis (PrEP) against the human immunodeficiency virus (HIV) is an effective and safe preventive measure. However, it has not reached all target users who could benefit from it.
The study aimed to understand the sociodemographic, clinical and behavioral baseline characteristics of PrEP users. As a secondary objective, the use of concomitant medication and drug consumption were described.
Observational, retrospective and descriptive study of the sociodemographic, clinical and behavioral characteristics of the users who were included in the PrEP program of the Community of Madrid during the first two years of experience.
Two thousand two hundred fifty-six PrEP users were included, 99.0% men, with a mean age of 36.9 years (SD: 8.68). 33.1% presented a sexually transmitted infection (STI) on the first visit, highlighting chlamydiasis and rectal gonococci. 70.4% reported using drugs associated with sex, and 42.4% participated in chemsex sessions in the last 3 months. A high percentage of users with concomitant medication was observed (37.6%), highlighting drugs related to mental health and alopecia.
A multidisciplinary approach is required to cover all the needs of PrEP users, including mental health evaluation measures and addiction treatment with the clinical approach.
Serological test for primary syphilis could be negative the first 5–15 days. The aim of this study was to evaluate the benefit of including dark field microscopy (DFM) in the diagnosis algorythm for ...primary syphilis.
Patients attended to a sexual transmission diseases clinic of Madrid, from 2015 to 2019, for a genital ulcer with clinical suspicion of primary syphilis. They were tested for DMF and serological test (EIA/TPPA/RPR).
Over the total amount of samples (806), 53.2% (429) were positive for DFM. Thus, the 48% of the 429 patients had negative serological test (EIA/RPR) of which the 77.6% were positive at TPPA.
DFM allows primary syphilis early diagnosis, even without serological test. If no direct detection methods are available, for patients without history of syphilis, TPPA could help to diagnose primary syphilis.
La serología luética en la sífilis primaria puede ser negativa los primeros 5–15 días. El objetivo de este trabajo fue evaluar los beneficios de incluir la microscopia de campo oscuro (MCO) en el algoritmo diagnóstico de la sífilis primaria.
Se incluyó a todos los pacientes que acudieron a una clínica de infecciones de transmisión sexual de la Comunidad de Madrid entre 2015 y 2019 que presentaban una úlcera genital sospechosa de sífilis primaria. Se les realizó MCO y serología (EIA/TPPA/RPR).
De las 806 muestras, el 53,2% (429) fueron positivas para MCO. De los 429, el 48% presentaba screening serológico negativo (EIA/RPR) y de ellos en el 77,6% el TPPA fue positivo.
La MCO permite un diagnóstico de sífilis primaria precoz, incluso sin confirmación serológica. Si no se dispone de técnicas directas, en primoinfección, la TPPA es de gran ayuda en el diagnóstico.
Serological test for primary syphilis could be negative the first 5-15 days. The aim of this study was to evaluate the benefit of including dark field microscopy (DFM) in the diagnosis algorythm for ...primary syphilis.
Patients attended to a sexual transmission diseases clinic of Madrid, from 2015 to 2019, for a genital ulcer with clinical suspicion of primary syphilis. They were tested for DMF and serological test (EIA/TPPA/RPR).
Over the total amount of samples (806), 53.2% (429) were positive for DFM. Thus, the 48% of the 429 patients had negative serological test (EIA/RPR) of which the 77.6% were positive at TPPA.
DFM allows primary syphilis early diagnosis, even without serological test. If no direct detection methods are available, for patients without history of syphilis, TPPA could help to diagnose primary syphilis.
The aim of this study was to evaluate the incidence of new hepatitis C virus (HCV) infections, based on their sexual orientation, human immunodeficiency virus (HIV) status, geographical regions and ...coinfection with other sexually transmitted diseases (STDs).
This study was carried out at the Sandoval Health Center, reference clinic of Sexually Transmitted Diseases (STDs) in Madrid. All HCV seronegative individuals who were reanalyzed for this virus were included, between January 2010 and December 2016.
A total of 59 new diagnoses of HCV were diagnosed. The proportion of men who have sex with men (MSM) diagnosed with HCV was 37% in 2010 and 75% in 2016 and was even higher in the group of coinfected with HIV/HCV (94%). A total of 67 seroconverters for HCV were detected (1.2%) of which 100% were MSM. The proportion of HCV seroconverters with HIV was 89%.
HCV infection continues to be a current health problem, especially in HIV-positive MSM.
Pre-exposure prophylaxis (PrEP) against the human immunodeficiency virus (HIV) is an effective and safe preventive measure. However, it has not reached all target users who could benefit from it.
The ...study aimed to understand the sociodemographic, clinical and behavioral baseline characteristics of PrEP users. As a secondary objective, the use of concomitant medication and drug consumption were described.
Observational, retrospective and descriptive study of the sociodemographic, clinical and behavioral characteristics of the users who were included in the PrEP program of the Community of Madrid during the first two years of experience.
Two thousand two hundred fifty-six PrEP users were included, 99.0% men, with a mean age of 36.9 years (SD 8.68). 33.1% presented a sexually transmitted infection (STI) on the first visit, highlighting chlamydiasis and rectal gonococci. 70.4% reported using drugs associated with sex, and 42.4% participated in chemsex sessions in the last 3 months. A high percentage of users with concomitant medication was observed (37.6%), highlighting drugs related to mental health and alopecia.
A multidisciplinary approach is required to cover all the needs of PrEP users, including mental health evaluation measures and addiction treatment with the clinical approach.
La profilaxis pre-exposición (PrEP) frente al virus de la inmunodeficiencia humana (VIH) es una medida preventiva eficaz y segura. Sin embargo, no se ha alcanzado a todos los usuarios objetivo que podrían beneficiarse de la misma.
El objetivo del estudio fue conocer las características basales sociodemográficas, clínicas y conductuales de las personas al iniciar la PrEP. Como objetivo secundario, se describió el uso de medicación concomitante y el consumo de drogas.
Estudio observacional, retrospectivo y descriptivo de las características sociodemográficas, clínicas y conductuales de los usuarios que se incluyeron en el programa de PrEP de la Comunidad de Madrid durante los dos primeros años de experiencia.
Se incluyeron 2.256 usuarios en PrEP, 99,0% hombres, con una edad media de 36,9 años (DE 8,68). El 33,1% presentó alguna infección de transmisión sexual (ITS) en la primera visita, destacando las clamidiasis y gonococias rectales. El 70,4% refirió consumir drogas asociadas al sexo, y el 42,4% participó en sesiones dechemsex en los últimos 3 meses. Se observó un alto porcentaje de usuarios con medicación concomitante (37,6%), destacando fármacos relacionados con salud mental y alopecia.
Se requiere un abordaje multidisciplinar para cubrir todas las necesidades de los usuarios de PrEP, incluyendo al abordaje clínico medidas de evaluación de salud mental y tratamiento de adicciones.
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