The Swiss STAR trial - an evaluation of target groups for sexually transmitted infection screening in the sub-sample of men.
| Autor: | Schmidt AJ; Division of Infectious Diseases and Infection Control, Cantonal Hospital St Gallen, Switzerland / Communicable Diseases Division, Swiss Federal Office of Public Health, Bern, Switzerland., Rasi M; Division of Infectious Diseases and Infection Control, Cantonal Hospital St Gallen, Switzerland., Esson C; PROFA - Consultations in Sexual Health, Renens, Switzerland., Christinet V; Checkpoint Vaud, Lausanne, Switzerland., Ritzler M; Risch Medical Laboratories, Buchs, Switzerland., Lung T; labormedizinisches zentrum Dr Risch AG, Buchs, Switzerland., Hauser CV; Department of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland., Stöckle M; Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel and University Basel, Switzerland., Jouinot F; Checkpoint Vaud, Lausanne, Switzerland., Lehner A; Swiss AIDS Federation, Zurich, Switzerland., Lange K; Checkpoint Basel, Switzerland., Konrad T; Department of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland., Vernazza PL; Division of Infectious Diseases and Infection Control, Cantonal Hospital St. Gallen, Switzerland. |
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| Jazyk: | angličtina |
| Zdroj: | Swiss medical weekly [Swiss Med Wkly] 2020 Dec 31; Vol. 150, pp. w20392. Date of Electronic Publication: 2020 Dec 31 (Print Publication: 2020). |
| DOI: | 10.4414/smw.2020.20392 |
| Abstrakt: | Objectives: In Switzerland, universal health insurance does not cover any routine testing for sexually transmitted infections (STIs), not even in individuals at high risk, and extra-genital swabbing is not standard of care. We determined the prevalence and incidence of human immunodeficiency virus (HIV), viral hepatitis and non-viral STIs in a multicentre prospective observational cohort of multi-partner men who have sex with men (MSM) and other men. Materials and Methods: Between January 2016 and June 2017, we offered free STI testing to all men with multiple sexual partners (three or more in the previous 12 months), with follow-up examinations every 6 months. We used multiplex polymerase chain-reaction testing (for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma genitalium) on pooled swabs (pharynx, urethra/vagina, anus), and antibody tests for HIV and Treponema pallidum at every visit, and for hepatitis B/C at baseline. Results: We screened 779 multi-partner MSM and 92 other men. Previously undiagnosed HIV was found in 0.5% vs 0.0%, respectively and T. pallidum antibodies in 15.3% vs 1.1%. STIs requiring antibiotic treatment comprised: active syphilis 1.7% vs 0.0%; N. gonorrhoeae 10.3% vs 0.0%; C. trachomatis 8.7% vs 1.1%. One in four MSM versus 1 in 100 other multi-partner men had any of these three STIs at baseline. 10.4% vs 1.3% had a history of hepatitis B, 31.9% vs 47.3% had no immunity (HBs-AB <10 IU/l). Ten MSM had HCV antibodies (1.4%), with 8 out of the 10 being MSM with HIV; HCV seroprevalence was 0.3% among HIV-negative MSM. In MSM, incidence of the three bacterial STIs was 25.5 per year over 333 person years of follow-up, HIV incidence was 0.3%. Non-condom-use (in the last 3 months) for anal/vaginal sex was not associated with STIs. Independent risk factors were sex with men (adjusted odds ratio [aOR] 16.4) and the number of sexual partners (aOR 2.3 for >20). Conclusion: Among MSM, but not among other multi-partner men, STIs, mostly asymptomatic, are common. Given the high risk of onward transmission, low-cost or free routine screening of multi-partner MSM is a public health priority. |
| Databáze: | MEDLINE |
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