The impact of HIV preexposure prophylaxis on bacterial sexually transmitted infection occurrence in MSM: a systematic review and meta-analysis.

Autor:	Georgiadis N; Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece., Papamichail D; Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece., Lytras T; School of Medicine, European University Cyprus, Nicosia, Cyprus., Halkitis PN; Department of Biostatistics & Epidemiology and Center for Health Identity, Behavior & Prevention Studies, School of Public Health, Rutgers University, Newark and New Brunswick, NJ, USA., Tzanakaki G; Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece., Kornarou E; Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece., Vassilakou NT; Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece., Sergentanis TN; Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece.
Jazyk:	angličtina
Zdroj:	AIDS (London, England) [AIDS] 2024 Jun 01; Vol. 38 (7), pp. 1033-1045. Date of Electronic Publication: 2024 Jan 11.
DOI:	10.1097/QAD.0000000000003837
Abstrakt:	Objective: To evaluate the effect of preexposure prophylaxis (PrEP) initiation on bacterial sexually transmitted infection (STI) occurrence (overall; chlamydia; gonorrhea; syphilis), in MSM. Design: Systematic review and meta-analysis. Methods: Systematic searches were performed in PubMed, Embase, and Scopus without language restrictions until 1 February 2023. We sought studies reporting data for the estimation of incidence rate ratios (IRR), prevalence ratios or cumulative incidence ratios (the latter in equal time periods before and after PrEP initiation) regarding bacterial STI occurrence. Separate analyses were performed overall for any STI, syphilis, chlamydia and gonorrhea (overall; rectal; urethral; pharyngeal for the two latter conditions); ratios greater than unity denoted increase in STI occurrence after PrEP initiation. Results: Twenty-three eligible studies with 11 776 participants (age range: 18-71 years) with a median follow-up of 12 months were included. Overall, PrEP initiation was associated with a significant increase in the occurrence of any STI (pooled effect size: 1.15, 95% confidence interval (CI): 1.04-1.26), any gonorrhea (pooled effect size: 1.17, 95% CI: 1.02-1.34), any chlamydia (pooled effect size: 1.31, 95% CI: 1.09-1.58) and rectal chlamydia (pooled effect size: 1.31, 95% CI: 1.05-1.64), whereas a borderline increase was found in urethral chlamydia (pooled effect size: 1.25, 95% CI: 0.99-1.60, P  = 0.064). Changes in pharyngeal chlamydia and site-specific gonorrhea occurrence did not reach statistical significance. Syphilis showed virtually no change after PrEP initiation (pooled effect size: 0.99, 95% CI: 0.72-1.37). Conclusion: These results highlight the need for more comprehensive, accessible STI testing to tackle bacterial STI infections in PrEP users. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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