Mohsen Malekinejad1, Erin K Barker, Rikita Merai, Cynthia M Lyles, Kyle T Bernstein, Theresa Ann Sipe, Julia B DeLuca, Alison D Ridpath, Thomas L Gift, Amrita Tailor, James G Kahn. 1. Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, USA Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA Consortium to Assess Prevention Economics, University of California, San Francisco, San Francisco, California, USA Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Atlanta, Georgia, USA Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, Georgia, USA.
Abstract
BACKGROUND: Men who have sex with men (MSM) who have bacterial sexually transmitted infections (STIs) are at increased risk for HIV infection. We enhanced and updated past summary risk estimates. METHODS: We systematically reviewed (PROSPERO #CRD42018084299) peer-reviewed studies assessing risk of HIV infection among MSM attributable to: Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and/or Trichomonas vaginalis (TV). We searched three databases through December 2017. We excluded studies with self-reported data or simultaneous STI and HIV assessment. We conducted dual screening and data extraction, meta-analytically pooled risk ratios (RR), and assessed potential risk of bias. RESULTS: We included 26 studies yielding 39 RR (k) for HIV acquisition due to one of TP, NG, or CT. We did not identify eligible data for MG or TV nor for HIV transmission. HIV acquisition risk increased among MSM infected with TP (k=21, RR 2.68, 95% CI 2.00-3.58), NG (k=11, RR 2.38, 95% CI 1.56-3.61), and CT (k=7, RR 1.99, 95% CI 1.59-2.48). Sub-analysis RR for all three pathogens were >= 1.66 and remained statistically significant across geography and methodological characteristics. Pooled RR increased for data with the lowest risk of bias for NG (k=3, RR 5.49, 95% CI 1.11-27.05) and TP (k=4, RR 4.32, 95% CI 2.20-8.51). We observed mostly moderate to high heterogeneity and moderate to high risk of bias. CONCLUSION: MSM infected with TP, NG, or CT have twice or greater risk of HIV acquisition, although uncertainties exist due to data heterogeneity and risk of bias.
BACKGROUND:Men who have sex with men (MSM) who have bacterial sexually transmitted infections (STIs) are at increased risk for HIV infection. We enhanced and updated past summary risk estimates. METHODS: We systematically reviewed (PROSPERO #CRD42018084299) peer-reviewed studies assessing risk of HIV infection among MSM attributable to: Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and/or Trichomonas vaginalis (TV). We searched three databases through December 2017. We excluded studies with self-reported data or simultaneous STI and HIV assessment. We conducted dual screening and data extraction, meta-analytically pooled risk ratios (RR), and assessed potential risk of bias. RESULTS: We included 26 studies yielding 39 RR (k) for HIV acquisition due to one of TP, NG, or CT. We did not identify eligible data for MG or TV nor for HIV transmission. HIV acquisition risk increased among MSM infected with TP (k=21, RR 2.68, 95% CI 2.00-3.58), NG (k=11, RR 2.38, 95% CI 1.56-3.61), and CT (k=7, RR 1.99, 95% CI 1.59-2.48). Sub-analysis RR for all three pathogens were >= 1.66 and remained statistically significant across geography and methodological characteristics. Pooled RR increased for data with the lowest risk of bias for NG (k=3, RR 5.49, 95% CI 1.11-27.05) and TP (k=4, RR 4.32, 95% CI 2.20-8.51). We observed mostly moderate to high heterogeneity and moderate to high risk of bias. CONCLUSION: MSM infected with TP, NG, or CT have twice or greater risk of HIV acquisition, although uncertainties exist due to data heterogeneity and risk of bias.
Authors: Erin K Barker; Mohsen Malekinejad; Rikita Merai; Cynthia M Lyles; Theresa Ann Sipe; Julia B DeLuca; Alison D Ridpath; Thomas L Gift; Amrita Tailor; James G Kahn Journal: Sex Transm Dis Date: 2022-01-13 Impact factor: 3.868
Authors: Nicole H T M Dukers-Muijrers; Ymke J Evers; Christian J P A Hoebe; Petra F G Wolffs; Henry J C de Vries; Bernice Hoenderboom; Marianne A B van der Sande; Janneke Heijne; Jeffrey D Klausner; Jane S Hocking; Jan van Bergen Journal: BMC Infect Dis Date: 2022-03-14 Impact factor: 3.090