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Background Oral human papillomavirus (HPV) infections are a leading cause of oropharyngeal cancers. In 2015 and 2016, HPV vaccines became publicly funded for gay, bisexual, and other men who have sex with men (GBM) under 27 years of age in most Canadian provinces. Methods Between 2017 and 2019, sexually active GBM in Montreal, Toronto, and Vancouver were recruited through respondent-driven sampling. Participants aged 16–30 years were invited to self-collect oral rinse specimens for HPV testing. We estimated HPV prevalence in the oral tract overall and compared these by vaccination status. Results Among the 838 GBM with a valid oral specimen, 36.9% reported receiving ≥1 dose of HPV vaccine. Overall, oral HPV prevalence was 2.6% (95% confidence interval [CI], 1.5%–3.7%) for at least 1 HPV type and 1.2% (95% CI,.5%–1.9%) for any high-risk type. We detected quadrivalent (HPV 6/11/16/18) vaccine-preventable types in 0.3% (95% CI,.0%–1.0%) of vaccinated individuals and 1.1% (95% CI,.1%–2.0%) of unvaccinated individuals. Conclusions Oral HPV prevalence was low in a population of young urban GBM in Canada, of whom 37% were vaccinated. Findings serve as a benchmark for monitoring of vaccination impacts on oral HPV infection within this priority population. [ABSTRACT FROM AUTHOR]

: Introduction: People living with HIV (PLWH) and/or who inject drugs may experience lower vaccine effectiveness (VE) against SARS‐CoV‐2 infection. Methods: A validated algorithm was applied to population‐based, linked administrative datasets in the British Columbia COVID‐19 Cohort (BCC19C) to ascertain HIV status and create a population of PLWH and matched HIV‐negative individuals. The study population was limited to individuals who received an RT‐PCR laboratory test for SARS‐CoV‐2 between 15 December 2020 and 21 November 2021 in BC, Canada. Any history of injection drug use (IDU) was ascertained using a validated administrative algorithm. We used a test‐negative study design (modified case−control analysis) and multivariable logistic regression to estimate adjusted VE by HIV status and history of IDU. Results: Our analysis included 2700 PLWH and a matched population of 375,043 HIV‐negative individuals, among whom there were 351 and 103,049 SARS‐CoV‐2 cases, respectively. The proportion of people with IDU history was much higher among PLWH compared to HIV‐negative individuals (40.7% vs. 4.3%). Overall VE during the first 6 months after second dose was lower among PLWH with IDU history (65.8%, 95% CI = 43.5–79.3) than PLWH with no IDU history (80.3%, 95% CI = 62.7–89.6), and VE was particularly low at 4–6 months (42.4%, 95% CI = −17.8 to 71.8 with IDU history vs. 64.0%; 95% CI = 15.7–84.7 without), although confidence intervals were wide. In contrast, overall VE was 88.6% (95% CI = 88.2–89.0) in the matched HIV‐negative population with no history of IDU and remained relatively high at 4–6 months after second dose (84.6%, 95% CI = 83.8–85.4). Despite different patterns of vaccine protection by HIV status and IDU history, peak estimates were similar (≥88%) across all populations. Conclusions: PLWH with a history of IDU may experience lower VE against COVID‐19 infection, although findings were limited by a small sample size. The lower VE at 4–6 months may have implications for booster dose prioritization for PLWH and people who inject drugs. The immunocompromising effect of HIV, substance use and/or co‐occurring comorbidities may partly explain these findings., INTRODUCTION People living with HIV (PLWH) and people who inject drugs (PWID) are two populations that often overlap and may experience lower vaccine effectiveness (VE) against COVID‐19 infection. Injection drug [...]

Background: Sustained and significant increases in Canadian rates of infectious syphilis prompted the National Advisory Committee on Sexually Transmitted and Blood-Borne Infections (NAC-STBBI) to update the existing screening recommendation for non-pregnant adults and adolescents. Methods: These guidelines were developed following the 2014 World Health Organization Handbook. The research question was: "What is the clinical utility of syphilis screening using risk-based versus population-wide approaches for adolescents and adults?" The evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: The environmental scan included 11 guidelines on syphilis screening published between 2014 and January 2023. Two systematic reviews were identified and included. In the updated literature search from November 6, 2019, to January 17, 2023, there were no published systematic reviews on the effectiveness of risk-based screening or the comparison of risk-based and interval screening; however, one recent randomized control trial in Canada was published. Evidence for outcomes, patient values and preferences, resources, acceptability, equity, cost and cost effectiveness and feasibility were reviewed. Conclusion: This statement provides two screening recommendations for adults and adolescents. Recommendation 1: NAC-STBBI recommends syphilis screening in all sexually active persons with a new or multiple partners and/or upon request of the individual. They also recommend screening every three to six months in individuals with multiple partners. Recommendation 2: NAC-STBBI recommends that targeted "opt-out" screening programs should be considered as frequently as every three months when serving population groups and/or communities experiencing a high prevalence of syphilis (and other STBBI). Both are strong recommendations with moderate certainty of evidence. [ABSTRACT FROM AUTHOR]

Background Real-world evidence of human papillomavirus (HPV) vaccine effectiveness (VE) against longitudinal outcomes is lacking among gay, bisexual, and other men who have sex with men (GBM). We compared 12-month incidence and persistence of anal HPV infection between vaccinated and unvaccinated GBM. Methods We recruited GBM aged 16–30 years in Montreal, Toronto, and Vancouver, Canada, from 2017 to 2019. Participants were followed over a median of 12 months (interquartile range, 12–13 months). Participants self-reported HPV vaccination and self-collected anal specimens for HPV DNA testing. We calculated prevalence ratios (PR) for 12-month cumulative incidence and persistence with ≥1 quadrivalent vaccine type (HPV 6/11/16/18) between vaccinated (≥1 dose at baseline) and unvaccinated participants using a propensity score-weighted, modified Poisson regression. Results Among 248 participants, 109 (44.0%) were vaccinated at baseline, of whom 62.6% received 3 doses. PRs for HPV 6/11/16/18 were 0.56 (95% confidence interval [CI],.24–1.31) for cumulative incidence and 0.53 (95% CI,.25–1.14) for persistence. PRs were 0.23 (95% CI,.05–1.03) and 0.08 (95% CI,.01–.59) for incidence and persistence, respectively, among participants who received their first dose at age ≤23 years and 0.15 (95% CI,.03–.68) and 0.12 (95% CI,.03–.54) among participants who were sexually active for ≤5 years before vaccination. Conclusions Findings support national recommendations for HPV vaccination at younger ages or soon after sexual debut. [ABSTRACT FROM AUTHOR]

The swabs contained within chlamydia and gonorrhea NAAT kits can be used on the cervix, urethra, vagina, throat or rectum; swabs from these sites can also be sent for gonorrhea culture. The incidence of chlamydia and gonorrhea, 2 common sexually transmitted infections, is increasing. In symptomatic patients, first-void urine and swabs of sites of reported symptoms should be collected for chlamydia and gonorrhea NAAT, and for gonorrhea culture and sensitivity testing. Gonorrhea Treatment of gonorrhea is challenging, as it readily develops antimicrobial resistance, and guidelines are not congruent in their recommendations. [Extracted from the article]

Background: Self-report of human papillomavirus (HPV) vaccination has ~80–90% sensitivity and ~75–85% specificity. We measured the effect of nondifferential exposure misclassification associated with self-reported vaccination on vaccine effectiveness (VE) estimates. Methods: Between 2017–2019, we recruited sexually active gay, bisexual, and other men who have sex with men aged 16–30 years in Canada. VE was derived as 1−prevalence ratio × 100% for prevalent anal HPV infection comparing vaccinated (≥1 dose) to unvaccinated men using a multivariable modified Poisson regression. We conducted a multidimensional and probabilistic quantitative bias analysis to correct VE estimates. Results: Bias-corrected VE estimates were relatively stable across sensitivity values but differed from the uncorrected estimate at lower values of specificity. The median adjusted VE was 27% (2.5–97.5th simulation interval = −5–49%) in the uncorrected analysis, increasing to 39% (2.5–97.5th simulation interval = 2–65%) in the bias-corrected analysis. Conclusion: A large proportion of participants erroneously reporting HPV vaccination would be required to meaningfully change VE estimates. [ABSTRACT FROM AUTHOR]

Background: Whether treatment, engagement in partner notification (PN), and PN outcomes differ between clients of internet-based and clinic-based testing services is poorly understood. We compared these outcomes between people diagnosed with chlamydia and/or gonorrhea (CT/GC) through a sexually transmitted infection (STI) clinic service and GetCheckedOnline GCO), an internet based testing service in British Columbia (BC).Methods: We conducted a retrospective matched cohort study among CT/GC cases where each case diagnosed through GCO in 2016-2017 was matched to two STI clinic cases by diagnosis, gender, age group, and specimen collection date. Data was collected through chart review with outcomes compared using appropriate statistical tests.Results: Of 257 GCO and 514 matched clinic cases, case treatment was high and did not differ between GCO (254/257, 98.9%) and clinic (513/514, 99.8%) cases, as was engagement in partner notification (250/257 (97.2%) vs. 496/514 (96.5%)). There was no difference in the proportion of notified partners between GCO (159/270, 58.9%) and clinic cases (253/435, 58.2%) although a greater proportion of partners reported by clinic cases were notified by STI nurses (43/435, 9.9%) vs. GCO cases (6/270, 2.2%).Conclusions: GCO clients diagnosed with CT/GC demonstrated similar treatment uptake and engagement in PN to clinic clients, and PN outcomes did not differ. The greater reliance on STI clinic nurses for partner notification among clinic clients may be related to having had an initial in-person testing visit. [ABSTRACT FROM AUTHOR]

The article from the Canadian Medical Association Journal discusses the importance of anal cancer screening, particularly for high-risk populations such as HIV-positive men who have sex with men. It highlights the role of human papillomavirus (HPV) in causing anal cancer and emphasizes the effectiveness of HPV vaccination in preventing infection. The article also provides recommendations for annual screening methods, including digital anorectal examination, anal cytology, and HPV testing, starting at age 35 for the highest risk group. Treatment for biopsy-proven anal high-grade squamous intraepithelial lesion (HSIL) is crucial in preventing anal cancer, as shown by the ANCHOR study in HIV-positive individuals. [Extracted from the article]