Risk of sexually transmitted infections among US military service members in the setting of HIV pre-exposure prophylaxis use

被引：0

作者：

Blaylock, Jason M. ^{[1
]}

Ewers, Evan C. ^{[2
]}

Bianchi, Elizabeth J. ^{[3
,4
,5
]}

King, David B. ^{[3
]}

Casimier, Rosemary O. ^{[3
,4
]}

Erazo, Hector ^{[3
,4
]}

Grieco, Stephen ^{[3
,6
]}

Lay, Jenny ^{[3
,5
,7
]}

Peel, Sheila A. ^{[8
]}

Modjarrad, Kayvon ^{[5
]}

Beckett, Charmagne G. ^{[9
]}

Okulicz, Jason F. ^{[10
]}

Scott, Paul T. ^{[5
]}

Hakre, Shilpa ^{[3
,4
,5
]}

机构：

[1] Walter Reed Natl Mil Med Ctr, Infect Dis Serv, Bethesda, MD USA

[2] Ft Belvoir Community Hosp, Infect Dis Serv, Ft Belvoir, VA 22060 USA

[3] Henry M Jackson Fdn Advancement Mil Med Inc, Bethesda, MD USA

[4] Walter Reed Army Inst Res, US Mil HIV Res Program, Silver Spring, MD USA

[5] Walter Reed Army Inst Res, Emerging Infect Dis Branch, Silver Spring, MD USA

[6] Level One Personnel, Columbia, MD USA

[7] Walter Reed Army Inst Res, Prevent Med Branch, Silver Spring, MD USA

[8] Walter Reed Army Inst Res, Diagnost & Countermeasures Branch, Silver Spring, MD USA

[9] Navy Bloodborne Infect Management Ctr, Bethesda, MD USA

[10] Infect Dis Serv, San Antonio Mil Med Ctr, Ft Sam Houston, TX USA

来源：

PLOS ONE | 2023年 / 18卷 / 12期

关键词：

MEN; SEX; SURVEILLANCE; WOMEN;

D O I：

10.1371/journal.pone.0296054

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

BackgroundThe evidence for an increased incidence of sexually transmitted infections (STIs) among patients utilizing HIV pre-exposure prophylaxis (PrEP) has been inconsistent. We assessed the risk of incident STI while on PrEP compared to periods off PrEP among military service members starting PrEP.MethodsIncidence rates of chlamydia, gonorrhea, syphilis, hepatitis C virus, and HIV were determined among military service members without HIV prescribed daily oral tenofovir disoproxil fumarate and emtricitabine for HIV PrEP from February 1, 2014 through June 10, 2016. Hazard ratios for incident STIs were calculated using an Anderson-Gill recurrent event proportional hazard regression model.ResultsAmong 755 male service members, 477 (63%) were diagnosed with incident STIs (overall incidence 21.4 per 100 person-years). Male service members had a significantly lower risk of any STIs (adjusted hazard ratio (aHR) 0.21, 95% CI 0.11-0.40) while using PrEP compared to periods off PrEP after adjustment for socio-demographic characteristics, reasons for initiating PrEP, surveillance period prior to PrEP initiation, and the effect of PrEP on site and type of infection in multivariate analysis. However, when stratifying for anatomical site and type of infection, the risk of extragenital gonorrhea infection (pharyngeal NG: aHR 1.84, 95% CI 0.82-4.13, p = 0.30; rectal NG: aHR 1.23, 95% CI 0.60-2.51, p = 1.00) and extragenital CT infection (pharyngeal CT: aHR 2.30, 95% CI 0.46-11.46, p = 0.81; rectal CT: aHR 1.36, 95% CI 0.81-2.31, p = 0.66) was greater on PrEP compared to off PrEP although these values did not reach statistical significance.ConclusionsThe data suggest entry into PrEP care reduced the overall risk of STIs following adjustment for anatomical site of STI and treatment. Service members engaged in PrEP services also receive more STI prevention counseling, which might contribute to decreases in STI risk while on PrEP.

引用

页数：12

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