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We estimated the prevalence of syphilis and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections, as well as human immunodeficiency virus (HIV) coinfection among cisgender men who have sex with cisgender men (MSM) and transgender women (TW) in Tijuana, Mexico. MSM and TW (N = 212) recruited via respondent-driven and venue-based sampling for HIV testing underwent sexually transmitted infection (STI) testing and completed interviewer-administered surveys in this study (2017–2018). Treponemal rapid tests were used at the point-of-care with positives undergoing confirmatory testing following the reverse syphilis-testing algorithm. Nucleic acid amplification testing of urine and swabs (rectal and pharyngeal) was used to detect CT/NG at three anatomic sites. Chi-squared tests were used to compare STI prevalence by HIV status. Sexually transmitted infection prevalence was 39.6% overall but higher for newly diagnosed HIV-positive (55.7%; N = 88) than HIV-negative (28.2%; N = 124) participants (p -value < 0.0001). Among newly diagnosed HIV-positive participants, the prevalence of syphilis was 35.2% (31/88), CT infection was 27.3% (24/88; nine urethral; 16 rectal; four pharyngeal), and NG infection was 26.1% (23/88; six urethral; 19 rectal; nine pharyngeal). Among HIV-negative participants, the prevalence of syphilis was 12.1% (15/124), CT infection was 13.7% (17/124; seven urethral; nine rectal; two pharyngeal), and NG infection was 9.7% (12/124; three urethral; seven rectal; seven pharyngeal). Over 60% of all CT (25/41) and NG (26/35) infections in the full sample occurred extragenitally in the absence of urethral infections, and over 80% of rectal (30/37) and pharyngeal (16/18) infections were asymptomatic. The high prevalence of syphilis, CT, and NG infections among MSM and TW in Tijuana suggests STI screening that includes extragenital tests, particularly at HIV diagnosis, may help curb HIV/STI transmission. [ABSTRACT FROM AUTHOR]

Given the disproportionate HIV burden faced by female sex workers FSWs and limited data regarding their engagement in the HIV cascade of care in conflict-affected settings, we characterized the cascade of care and examined associations with new HIV diagnoses and antiretroviral therapy (ART) use in a community-based cohort of FSWs in conflict-affected Northern Uganda. Data were collected via FSW/peer-led time-location sampling and outreach, interview-administered questionnaires, and voluntary HIV testing. Of 400 FSWs, 33.5% were living with HIV, of whom 33.6% were new/previously undiagnosed infections and 32.8% were on ART. Unstable housing and heavy alcohol/drug use were independently associated with increased odds of new HIV diagnoses, whereas exposure to condom demonstrations and number of lifetime pregnancies were negatively associated. In subanalysis among known HIV-positive women, age and time since diagnosis were associated with ART use, whereas sexually transmitted infections were negatively associated. Findings suggest the need for FSW-tailored, peer-based, and integrated HIV and sexual and reproductive health programs to address gaps in HIV testing and treatment for FSWs in conflict-affected communities. [ABSTRACT FROM AUTHOR]

The aims of this study were to observe trends in testing for HIV between 2004 and 2007 in one London, UK, hospital and to observe the seroprevalence of HIV within subgroups. Tests were grouped according to source and reason for testing. A total of 58,720 tests were considered (HIV-1 seroprevalence 0.9%). The majority (75.4%) of tests were performed as part of routine and opt-out protocols including antenatal and genitourinary (GU) screening. Among people specifically seeking HIV testing, the HIV seroprevalence was 3.5%. Medical specialties performed fewer tests but a high HIV seroprevalence was observed, including infectious disease (seroprevalence 4.4%) and other medical specialties (seroprevalence 3.4%). A small number of specialties performed few HIV tests. HIV testing was cost-effective in virtually all settings. This study suggests that more HIV tests could be performed, for example, in acute medicine, and training might increase the number of tests offered in some settings. The most effective way of increasing testing appears to be opt-out testing. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the trends of initial CD4+ T-cell counts (CD4+) at HIV diagnoses and to identify the factors influencing the annual changes of CD4+ cell counts in Korea during 1988-2006. As a retrospective study, 2613 individuals (⩾15 years at diagnosis, their CD4+ counts were measured within six months) were selected from all 4580 HIV-infected Koreans diagnosed between 1985 and 2006. The mean CD4+ cell counts in all the selected individuals was 312 cells/mm3, and this value decreased significantly by 20.3 cells/mm3/year over the 19 year study period. Men had lower CD4+ cell count than women by 22.7 cells/mm3, and age at HIV diagnosis had an inverse relationship with CD4+ cell counts of 23.5 cells/mm3 lower per 10 years advancing age. Cases diagnosed in hospitals showed CD4+ cell count levels 33.9 cells/mm3 lower than public institutions by 33.9 cells/mm3. Gender and age seemed to affect trends of CD4+ count; however the institution where cases were diagnosed had the strongest effect on decreasing CD4+ cell counts. The results suggest that HIV diagnoses in recent years are being made in later stages of HIV infection and that it is imperative to develop more efficient programmes for early HIV diagnosis to prevent transmission. [ABSTRACT FROM AUTHOR]

Screening for HIV in patients with tuberculosis (TB) is essential, as HIV/TB co-infection has an adverse prognosis. We compared HIV testing practices in 2005 and 2008/09 in the Birmingham and Solihull region of the UK and evaluated the trends before and after the implementation of the British HIV Association (BHIVA) HIV testing guidelines (2008). A total of 371 TB patients in 2005 and 407 in 2008/09 were included. Demographics across both cohorts were similar. HIV testing increased from 14% in 2005 to 43% in 2008/09. Patients aged ⩾55 years and Asian patients were less likely to be tested in 2005 and those aged ⩾35 years in 2008/09. An increased rate of HIV testing was seen in all patient categories in 2008/09 compared with 2005. The odds of being tested was high in black African patients (compared with white ethnicity) in both years and increased among black Africans and African Caribbeans between both time points, albeit with wide confidence intervals (CIs). No significant difference in HIV testing was found in 2008/09 before and after the publication of the BHIVA guidelines. This study underlines the importance of continued efforts to minimize the significant gaps in HIV testing rates in TB services. [ABSTRACT FROM AUTHOR]

The article focuses on the existence of hepatitis as the presenting feature of human immunodeficiency virus (HIV) infection. Patients with HIV remained undiagnosed until they presented opportunistic infection and there was recent interest in the early diagnosis of HIV with the recognition of an acute mononucleosis-like seroconversion illness.