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      Sex, drugs and smart phone applications: findings from semistructured interviews with men who have sex with men diagnosed with Shigella flexneri 3a in England and Wales.

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          Abstract

          To inform control strategies undertaken as part of an outbreak of Shigella flexneri 3a among men who have sex with men (MSM).

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          Sexual transmission of HIV according to viral load and antiretroviral therapy: systematic review and meta-analysis.

          Suzanna Attia, Matthias Egger, Monika Müller … (2009)
          To synthesize the evidence on the risk of HIV transmission through unprotected sexual intercourse according to viral load and treatment with combination antiretroviral therapy (ART). Systematic review and meta-analysis. We searched Medline, Embase and conference abstracts from 1996-2009. We included longitudinal studies of serodiscordant couples reporting on HIV transmission according to plasma viral load or use of ART and used random-effects Poisson regression models to obtain summary transmission rates [with 95% confidence intervals, (CI)]. If there were no transmission events we estimated an upper 97.5% confidence limit. We identified 11 cohorts reporting on 5021 heterosexual couples and 461 HIV-transmission events. The rate of transmission overall from ART-treated patients was 0.46 (95% CI 0.19-1.09) per 100 person-years, based on five events. The transmission rate from a seropositive partner with viral load below 400 copies/ml on ART, based on two studies, was zero with an upper 97.5% confidence limit of 1.27 per 100 person-years, and 0.16 (95% CI 0.02-1.13) per 100 person-years if not on ART, based on five studies and one event. There were insufficient data to calculate rates according to the presence or absence of sexually transmitted infections, condom use, or vaginal or anal intercourse. Studies of heterosexual discordant couples observed no transmission in patients treated with ART and with viral load below 400 copies/ml, but data were compatible with one transmission per 79 person-years. Further studies are needed to better define the risk of HIV transmission from patients on ART.
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            Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study.

            Timothy J Dallman, Philip M Ashton, Martin Day … (2015)
            Shigellosis is an acute, severe bacterial colitis that, in high-income countries, is typically associated with travel to high-risk regions (Africa, Asia, and Latin America). Since the 1970s, shigellosis has also been reported as a sexually transmitted infection in men who have sex with men (MSM), in whom transmission is an important component of shigellosis epidemiology in high-income nations. We aimed to use sophisticated subtyping and international sampling to determine factors driving shigellosis emergence in MSM linked to an outbreak in the UK.
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              Comparison of the prevalence and changing resistance to nalidixic acid and ciprofloxacin of Shigella between Europe-America and Asia-Africa from 1998 to 2009.

              Bing Gu, Yan Cao, Shiyang Pan … (2012)
              Shigella is becoming an increasing public health problem due to development of multiple antimicrobial resistance, frequently resulting in treatment failure. A systematic review was conducted based on a literature search of computerised databases. Random or fixed-effects models were used, based on the P-value considering the possibility of heterogeneity between studies, for meta-analysis. Statistical analyses were performed using STATA 10.0. In the area of Asia-Africa, resistance rates to nalidixic acid and ciprofloxacin were 33.6% [95% confidence interval (CI) 21.8-46.6%] and 5.0% (95% CI 2.8-7.8%), respectively, 10.5 and 16.7 times those of Europe-America. Moreover, resistance to nalidixic acid and ciprofloxacin in Asia-Africa progressively increased each year, reaching 64.5% (95% CI 13.8-99.3%) and 29.1% (95% CI 0.9-74.8%), respectively, in 2007-2009, whilst isolates in Europe-America remained at low levels of resistance (<5.0% and <1.0%, respectively). All Shigella flexneri strains showed higher resistance than Shigella sonnei in Europe-America: overall, 3.5% (95% CI 1.4-6.4%) vs. 2.6% (95% CI 1.0-5.0%) resistant to nalidixic acid and 1.0% (95% CI 0.3-2.2%) vs. 0.1% (95% CI 0.0-0.3%) resistant to ciprofloxacin. In Asia-Africa, a similar trend was found for ciprofloxacin [3.0% (95% CI 1.4-5.3%) vs. 0.5% (95% CI 0.2-0.8%)], whereas the trend was reversed for nalidixic acid [32.6% (95% CI 14.5-53.9%) vs. 44.3% (95% CI 26.9-62.5%). In conclusion, quinolone resistance in Shigella has increased at an alarming speed, reinforcing the importance of continuous monitoring of antimicrobial resistance in Shigella. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
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                Author and article information

                Journal
                Journal ID (iso-abbrev): Sex Transm Infect
                Title: Sexually transmitted infections
                ISSN (Electronic): 1472-3263
                ISSN (Print): 1368-4973
                Publication date (Electronic): Dec 2015
                Volume: 91
                Issue: 8
                Affiliations
                [1 ] HIV and STI Department, PHE Health Protection Services, London, UK.
                [2 ] Gastrointestinal Bacteria Reference Unit, PHE Reference Microbiology Services, London, UK.
                [3 ] PHE Health Protection Field Epidemiology Services, Bristol, UK.
                [4 ] Division of Population Health, University College London, London, UK.
                Article
                Publisher Item ID: sextrans-2015-052014
                DOI: 10.1136/sextrans-2015-052014
                PubMed ID: 25921020
                SO-VID: 5e309b1e-6f05-4a7d-bbc2-c379d9af7116
                Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
                History

                Keywords: GAY MEN,HIV,SEXUAL BEHAVIOUR
                Data availability:
                Keywords: GAY MEN, HIV, SEXUAL BEHAVIOUR

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