Title: Sexually Transmitted Infections

Title: Sexually Transmitted Infections

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? Yee, L.J. and Rhodes, S.D. (2002), Understanding correlates of hepatitis B virus vaccination in men who have sex with men: What have we learned? Sexually Transmitted Infections, 78 (5), 374-377.

Abstract: Objectives: Hepatitis B infection (HBV) is prevalent among men who have sex with men (MSM) and may lead to significant morbidity and death. Although an effective vaccine exists vaccination rates among MSM are low. We conducted a systematic review to synthesise the various findings from empirical correlational studies to understand HBV vaccination and series completion among MSM. Methods: We systematically searched the MEDLINE, PUBMED, EMBASE, CINAHL, ERIC, and Web of Science databases to identify the breadth of published studies pertaining to HBV vaccination among MSM and to synthesise findings from these studies to better identify common themes that may direct future research and intervention approaches. Results: Eight papers specifically addressed correlates of HBV vaccination among MSM. Six domains were identified as predictors of vaccination: (1) demographic variables such as younger age and higher education level; (2) knowledge of the vaccine; (3) access to health care, (4) level of “outness” regarding one’s same sex sexual orientation; (5) behavioural factors including sexual and drug use behaviour,- and (6) psychosocial variables. Three papers addressed predictors of vaccine series completion among MSM, observing two main domains: (1) demographic variables such as younger age and higher income level; and, (2) behavioural factors including sexual and health promotion behaviours. Conclusions: Continued educational efforts, creation of environments that facilitate proper risk factor evaluation, and access to low cost vaccine may facilitate vaccine uptake. Although we observed important trends in the studies we reviewed, there is a lack of empirical research regarding this important public health issue.

Keywords: Awareness, Community-Health-Center, Correlates, Databases, Drug, Drug Use, Education, Embase, Evaluation, Hbv, Health Care, Health Promotion, Hepatitis, Higher Education, Homosexual Men, Immunization, Income, Infection, Intervention, Knowledge, Lead, Men, Methods, Morbidity, National-Health, Nutrition Examination Surveys, Papers, Population, Promotion, Psychosocial, Public Health, Pubmed, Research, Review, Risk, Risk Factor, Science, Systematic, Systematic Review, Trends, United-States, Vaccination, Vaccination Rates, Vaccine, Web of Science, Young Men

? Degenhardt, L., Hall, W. and Warner-Smith, M. (2006), Using cohort studies to estimate mortality among injecting drug users that is not attributable to AIDS. Sexually Transmitted Infections, 82, 56-63.

Abstract: Background: Injecting drug use (IDU) and associated mortality appear to be increasing in many parts of the world. IDU is an important factor in HIV transmission. In estimating AIDS mortality attributable to IDU, it is important to take account of premature mortality rates from other causes to ensure that AIDS related mortality among injecting drug users (IDUs) is not overestimated. The current review provides estimates of the excess non-AIDS mortality among IDUs. Method: Searches were conducted with MEDLINE, PsycINFO, and the Web of Science. The authors also searched reference lists of identified papers and an earlier literature review by English et al (1995). Crude. mortality rates (CMRs) were derived from data on the number of deaths, period of follow UP, and number of participants. In estimating the all-cause mortality, two rates were calculated: one that included all cohort studies identified in the search, and one that only included studies that reported on AIDS deaths in their cohort. This provided lower and upper mortality rates, respectively. Results: The current paper derived weighted mortality rates based upon cohort studies that included 179 885 participants, 1 219 422 person-years of observation, and 16 593 deaths. The weighted crude AIDS mortality rate from studies that reported AIDS deaths was approximately 0.78% per annum. The median estimated non-AIDS mortality rate was 1.08% per annum. Conclusions: Illicit drug users have a greatly increased risk of premature death and mortality due to AIDS forms a significant part of that increased risk; it is, however, only part of that risk. Future work needs to examine mortality rates among IDUs in developing countries, and collect data on the relation between HIV and increased mortality due to all causes among this group.

Keywords: AID, AIDS, Authors, Cohort Studies, Developing Countries, Drug, Drug Use, HIV, Literature, Literature Review, Mortality, Observation, Papers, Review, Risk, Science, Web of Science

? Degenhardt, L., Hall, W. and Warner-Smith, M. (2006), Using cohort studies to estimate mortality among injecting drug users that is not attributable to AIDS. Sexually Transmitted Infections, 82, III56-III63.

Abstract: Background: Injecting drug use (IDU) and associated mortality appear to be increasing in many parts of the world. IDU is an important factor in HIV transmission. In estimating AIDS mortality attributable to IDU, it is important to take account of premature mortality rates from other causes to ensure that AIDS related mortality among injecting drug users (IDUs) is not overestimated. The current review provides estimates of the excess non-AIDS mortality among IDUs. Method: Searches were conducted with MEDLINE, PsycINFO, and the Web of Science. The authors also searched reference lists of identified papers and an earlier literature review by English et al (1995). Crude mortality rates (CMRs) were derived from data on the number of deaths, period of follow up, and number of participants. In estimating the all-cause mortality, two rates were calculated: one that included all cohort studies identified in the search, and one that only included studies that reported on AIDS deaths in their cohort. This provided lower and upper mortality rates, respectively. Results: The current paper derived weighted mortality rates based upon cohort studies that included 179 885 participants, 1 219 422 person-years of observation, and 16 593 deaths. The weighted crude AIDS mortality rate from studies that reported AIDS deaths was approximately 0.78% per annum. The median estimated non-AIDS mortality rate was 1.08% per annum. Conclusions: Illicit drug users have a greatly increased risk of premature death and mortality due to AIDS forms a significant part of that increased risk; it is, however, only part of that risk. Future work needs to examine mortality rates among IDUs in developing countries, and collect data on the relation between HIV and increased mortality due to all causes among this group.

Keywords: 22-Year Follow-Up, Active Antiretroviral Therapy, Aid, Aids, Authors, Cocaine Use, Cohort Studies, Developing Countries, Drug, Drug Use, Follow-up, Hepatitis-C-Virus, Heroin-Addicts, HIV, Hiv-Infection, Human-Immunodeficiency-Virus, Literature, Literature Review, Methadone-Maintenance, Mortality, Observation, Papers, Regular Amphetamine Users, Review, Risk, Science, Serious Suicide Attempts, Web of Science

? Lorenc, T., Marrero-Guillamon, I., Aggleton, P., Cooper, C., Llewellyn, A., Lehmann, A. and Lindsay, C. (2011), Promoting the uptake of HIV testing among men who have sex with men: systematic review of effectiveness and cost-effectiveness. Sexually Transmitted Infections, 87 (4), 272-278.

Abstract: What interventions are effective and cost-effective in increasing the uptake of HIV testing among men who have sex with men (MSM)? A systematic review was conducted of the following databases: AEGIS, ASSIA, BL Direct, BNI, Centre for Reviews and Dissemination, Cochrane Database of Systematic Reviews, CINAHL, Current Contents Connect, EconLit, EMBASE, ERIC, HMIC, MEDLINE, MEDLINE In-Process, NRR, PsychINFO, Scopus, SIGLE, Social Policy and Practice, Web of Science, websites, journal hand-searching, citation chasing and expert recommendations. Prospective studies of the effectiveness or cost-effectiveness of interventions (randomised controlled trial (RCT), controlled trial, one-group or any economic analysis) were included if the intervention aimed to increase the uptake of HIV testing among MSM in a high-income (Organization for Economic Co-operation and Development) country. Quality was assessed and data were extracted using standardised tools. Results were synthesised narratively. Twelve effectiveness studies and one cost-effectiveness study were located, covering a range of intervention types. There is evidence that rapid testing and counselling in community settings (one RCT), and intensive peer counselling (one RCT), can increase the uptake of HIV testing among MSM. There are promising results regarding the introduction of opt-out testing in sexually transmitted infection clinics (two one-group studies). Findings regarding other interventions, including bundling HIV tests with other tests, peer outreach in community settings, and media campaigns, are inconclusive. Findings indicate several promising approaches to increasing HIV testing among MSM. However, there is limited evidence overall, and evidence for the effectiveness of key intervention types (particularly peer outreach and media campaigns) remains lacking.

Keywords: Analysis, Behavior, Campaigns, Citation, Cochrane, Cost-Effectiveness, Database, Databases, Effectiveness, Embase, Gay Men, Guidelines, HIV, Infection, Intervention, Interventions, Journal, Men, Policy, Practice, Prospective Studies, Quality, Randomised Controlled Trial, Review, Risk, Science, Scopus, Settings, Strategies, Systematic, Systematic Review, Web of Science, Websites