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      Factores que determinan prácticas sexuales de riesgo en la adquisición de enfermedades de transmisión sexual en población de hombres que tienen sexo con hombres: revisión sistemática Translated title: Factors determining risk sex practices in the acquisition of sexually transmitted diseases among men who have sex with men: a systematic review

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          Abstract

          RESUMEN Fundamentos: Los casos de Enfermedades de Transmisión Sexual están aumentando en la actualidad, especialmente en hombres que tienen sexo con hombres. El objetivo principal de este estudio fue analizar los factores que se relacionan con conductas sexuales de riesgo en la adquisición de enfermedades de transmisión sexual en la población de hombres que tienen sexo con hombres. Metodología: Se realizó una revisión sistemática por medio de una búsqueda en las bases de datos Pubmed, CINAHL, Cuiden, Scopus y Biblioteca Cochrane. La herramienta de evaluación de métodos mixtos (MMAT) fue utilizada para evaluar la calidad de los artículos. Resultados: Se seleccionaron 29 estudios que cumplían con los criterios de inclusión. Los factores identificados se agruparon en 12 aspectos: abuso sexual infantil, consumo de alcohol, cruising, estigma, edad, país, medios de sexo explícito, programas de prevención de las Enfermedades de Transmisión Sexual, problemas psicosociales, tipo de pareja y rol sexual. Conclusiones: Los hombres jóvenes que tienen sexo con hombres participan en un mayor número de comportamientos de riesgo sexual debido a una serie de factores que los hacen más vulnerables; el uso indebido de internet a la hora de adquirir comportamientos sexuales de riesgo y la saturación respecto a las actuales intervenciones educativas en materia de prevención, son los principales factores asociados.

          Translated abstract

          ABSTRACT Background: Cases of Sexually Transmitted Diseases are increasing at present, especially in men who have sex with men. The main objective of this study was to analyze factors that are related to risky sexual behaviors in the acquisition of sexually transmitted diseases in the population of men who have sex with men. Methodology: A systematic review was carried out by searching the Pubmed, CINAHL, Cuiden, Scopus, and Cochrane Library databases. The mixed methods assessment tool (MMAT) was used to assess the quality of the articles. Results: A total of 29 studies met the inclusion criteria and were therefore included in this systematic review. The identified factors were grouped into 12 aspects: child sexual abuse, alcohol consumption, cruising, stigma, chemsex, age, country of origin, means of explicit sex, programs for the prevention of Sexually Transmitted Diseases, psychosocial problems, type of partner and sexual role. Conclusions: Young men who have sex with men participate in a greater number of sexual risk behaviors due to a series of factors that make them more vulnerable. The improper use of the internet when it comes to acquiring risky sexual behaviors and the saturation with respect to current educational interventions in prevention are the main associated factors.

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          Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.

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            Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): final results of a multicentre, prospective, observational study

            Summary Background The level of evidence for HIV transmission risk through condomless sex in serodifferent gay couples with the HIV-positive partner taking virally suppressive antiretroviral therapy (ART) is limited compared with the evidence available for transmission risk in heterosexual couples. The aim of the second phase of the PARTNER study (PARTNER2) was to provide precise estimates of transmission risk in gay serodifferent partnerships. Methods The PARTNER study was a prospective observational study done at 75 sites in 14 European countries. The first phase of the study (PARTNER1; Sept 15, 2010, to May 31, 2014) recruited and followed up both heterosexual and gay serodifferent couples (HIV-positive partner taking suppressive ART) who reported condomless sex, whereas the PARTNER2 extension (to April 30, 2018) recruited and followed up gay couples only. At study visits, data collection included sexual behaviour questionnaires, HIV testing (HIV-negative partner), and HIV-1 viral load testing (HIV-positive partner). If a seroconversion occurred in the HIV-negative partner, anonymised phylogenetic analysis was done to compare HIV-1 pol and env sequences in both partners to identify linked transmissions. Couple-years of follow-up were eligible for inclusion if condomless sex was reported, use of pre-exposure prophylaxis or post-exposure prophylaxis was not reported by the HIV-negative partner, and the HIV-positive partner was virally suppressed (plasma HIV-1 RNA <200 copies per mL) at the most recent visit (within the past year). Incidence rate of HIV transmission was calculated as the number of phylogenetically linked HIV infections that occurred during eligible couple-years of follow-up divided by eligible couple-years of follow-up. Two-sided 95% CIs for the incidence rate of transmission were calculated using exact Poisson methods. Findings Between Sept 15, 2010, and July 31, 2017, 972 gay couples were enrolled, of which 782 provided 1593 eligible couple-years of follow-up with a median follow-up of 2·0 years (IQR 1·1–3·5). At baseline, median age for HIV-positive partners was 40 years (IQR 33–46) and couples reported condomless sex for a median of 1·0 years (IQR 0·4–2·9). During eligible couple-years of follow-up, couples reported condomless anal sex a total of 76 088 times. 288 (37%) of 777 HIV-negative men reported condomless sex with other partners. 15 new HIV infections occurred during eligible couple-years of follow-up, but none were phylogenetically linked within-couple transmissions, resulting in an HIV transmission rate of zero (upper 95% CI 0·23 per 100 couple-years of follow-up). Interpretation Our results provide a similar level of evidence on viral suppression and HIV transmission risk for gay men to that previously generated for heterosexual couples and suggest that the risk of HIV transmission in gay couples through condomless sex when HIV viral load is suppressed is effectively zero. Our findings support the message of the U=U (undetectable equals untransmittable) campaign, and the benefits of early testing and treatment for HIV. Funding National Institute for Health Research.
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              Anal human papillomavirus infection and associated neoplastic lesions in men who have sex with men: a systematic review and meta-analysis.

              Men who have sex with men (MSM) are at greatly increased risk of human papillomavirus (HPV)-associated anal cancer. Screening for the presumed cancer precursor, high-grade anal intraepithelial neoplasia (AIN), followed by treatment in a manner analogous to cervical screening, has been proposed. We aimed to assess available data for anal HPV disease that can inform pre-cancer screening programmes. We searched PubMed, OVID Medline, and Embase for all studies published before Nov 1, 2011, that reported prevalence and incidence of anal HPV detection, AIN, and anal cancer in MSM. We calculated summary estimates using random-effects meta-analysis. 53 studies met the inclusion criteria, including 31 estimates of HPV prevalence, 19 estimates of cytological abnormalities, eight estimates of histological abnormalities, and nine estimates of anal cancer incidence. Data for incident HPV and high-grade AIN were scarce. In HIV-positive men, the pooled prevalence of anal HPV-16 was 35·4% (95% CI 32·9-37·9). In the only published estimate, incidence of anal HPV-16 was 13·0% (9·6-17·6), and clearance occurred in 14·6% (10·2-21·2) of men per year. The pooled prevalence of histological high-grade AIN was 29·1% (22·8-35·4) with incidences of 8·5% (6·9-10·4) and 15·4% (11·8-19·8) per year in two estimates. The pooled anal cancer incidence was 45·9 per 100,000 men (31·2-60·3). In HIV-negative men, the pooled prevalence of anal HPV-16 was 12·5% (9·8-15·4). Incidence of HPV-16 was 11·8% (9·2-14·9) and 5·8% (1·9-13·5) of men per year in two estimates. The pooled prevalence of histological high-grade AIN was 21·5% (13·7-29·3), with incidence of 3·3% (2·2-4·7) and 6·0% (4·2-8·1) per year in two estimates. Anal cancer incidence was 5·1 per 100,000 men (0-11·5; based on two estimates). There were no published estimates of high-grade AIN regression. Anal HPV and anal cancer precursors were very common in MSM. However, on the basis of restricted data, rates of progression to cancer seem to be substantially lower than they are for cervical pre-cancerous lesions. Large, good-quality prospective studies are needed to inform the development of anal cancer screening guidelines for MSM. Australian Government Department of Health and Ageing. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                resp
                Revista Española de Salud Pública
                Rev. Esp. Salud Publica
                Ministerio de Sanidad, Consumo y Bienestar social (Madrid, Madrid, Spain )
                1135-5727
                2173-9110
                2021
                : 95
                : e202106089
                Affiliations
                [1] Jaén orgnameServicio Andaluz de Salud España
                [3] Granada Andalucía orgnameUniversidad de Granada orgdiv1Facultad de Psicología orgdiv2Centro de Investigación Mente, Cerebro y Comportamiento Spain
                [4] Jaén Andalucía orgnameUniversidad de Jaén orgdiv1Facultad de Ciencias de la Salud orgdiv2Departamento de Enfermería Spain
                [2] Granada Andalucía orgnameUniversidad de Granada orgdiv1Facultad de Ciencias de la Salud orgdiv2Departamento de Enfermería Spain
                Article
                S1135-57272021000100505 S1135-5727(21)09500000505
                1e801a07-199b-499a-ae77-ffa2bd2afc4f

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 10 May 2021
                : 15 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 49, Pages: 0
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                SciELO Public Health


                Sexually transmitted diseases,Sexual minorities,Risk factors,Gender minorities,Enfermedades de transmisión sexual,Minorías de género,Minorías sexuales,Factores de riesgo

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