HIV: STIs more prevalent with alcohol use, partners on PrEP

  • Hojilla JC & al.
  • Sex Transm Infect
  • 23 Aug 2019

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • People living with HIV (PLWH) with histories of unhealthy alcohol use, especially those with partners using preexposure prophylaxis (PrEP), have elevated sexually transmitted infection (STI) risk.

Why this matters

  • Frequent STI screening, discussions around STI prevention are especially important in HIV-infected men who have sex with men (MSM).
  • Conduct enhanced outreach, targeted screening, sexual health counseling in MSM with unhealthy alcohol use history, partners on PrEP.

Key results

  • 465 PLWH included.
  • 32% (147) had HIV-positive partners only, 31% had ≥1 HIV-negative partner using PrEP (145), and 37% (173) had HIV-negative partners without reported PrEP use.
  • 8% prevalence of any bacterial STI in past year.
  • Multivariate: prevalence of STI was higher among PLWH with ≥1 partner on PrEP than those with HIV-negative partners not on PrEP (adjusted prevalence ratio [aPR], 2.99; 95% CI, 1.11-8.08).
  • STI prevalence was higher among PLWH reporting abuse of alcohol (aPR, 1.53; 95% CI, 0.61-3.83), drugs (aPR, 1.97; 95% CI, 0.71-5.51), or both (aPR, 1.93; 95% CI, 1.75-4.97) before sex.

Study design

  • Analysis of bacterial STI prevalence, associated correlates in a primary-care-based cohort of PLWH with unhealthy alcohol use history.
  • Funding: NIH, Kaiser Permanente Northern California.

Limitations

  • Inability to characterise sexual networks, assess exposures/outcome temporality.
  • Recall bias.
  • Limited generalisability.