PrEP introduction for adolescent girls and young women

Pre-exposure prophylaxis PrEP use in the sexually active females prevents HIV acquisition.

The International AIDS Conference in Durban, South Africa, in July 2016, has renewed interest and momentum around HIV prevention. High and sustained HIV incidence rates—about 2 million people acquiring HIV every year for the past 5 years—highlight the need for new prevention technologies for populations at substantial risk of HIV.1 As many as 7000 new infections a week are occurring in the most vulnerable adolescent girls and young women in eastern and southern Africa.1 75% of young people in sub-Saharan Africa living with HIV are adolescent girls and young women age 15–24 years; AIDS is the leading cause of death for girls age 10–19 years in Africa.1 To date, prevention efforts have not had sufficient effect on risk of HIV in adolescent girls and young women.

Oral pre-exposure prophylaxis (PrEP)—the use of antiretroviral medications by HIV-negative people to avoid getting HIV—is a new biomedical intervention that has the potential to substantially reduce HIV acquisition in the people at greatest risk. Recent evidence suggests that PrEP was effective among several populations in reducing the risk of HIV infection by 70%.2 Less is known about the effectiveness of PrEP for young women,2 but the intervention could greatly increase the ability of adolescent girls and young women to protect themselves from HIV if they are able to access and use it effectively.

Read whole article

Project on chlamydia wins prize

Infection by Chlamydia trachomatis the commonest bacterial sexually transmitted infection in the UK and can result in long term complications such as pelvic inflammatory disease and infertility in women.gabriel schembri prize

Once treatment is given to the patient and their partner(s) a test of cure is recommended. However when this should be done is unclear. A similar question hangs over another common sexually transmitted bacterial infection, gonorrhoea.

Dr Gabriel Schembri and his colleagues in Manchester in collaboration with researchers in London have completed a study, part co-funded by STIRF (in conjunction with BASHH)  in an effort to answer these questions:

STIRF-015: Testing for chlamydia and gonorrhoea: persistence of a positive test result after successful treatment.

The study has now finished and was presented at the British Association for sexual Health and HIV (BASHH) meeting in Oxford (July 2016) and won the prize for the best oral presentation.TOC-BASHH presentation

The investigators showed that the site of infection may have an effect on time to clearance of infection, with pharyngeal gonorrhoea infections and vaginal chlamydia infections taking longer to clear than other sites.

 

The results of this study will help guide clinicians to the timing for tests of cure.

Invitation to apply for research Funds – 2016 Round

Applications are invited from researchers in various fields related to sexual health, HIV and other sexually transmitted viruses.

Sexually Transmitted Infections Research Foundation (STIRF) was set up to pump prime research projects relating to the epidemiology, pathophysiology, management, and health care delivery of sexually transmitted infections and HIV in the East and West Midland, the North East and North West Regions.

The primary aim is to provide initial funding to allow promising projects from young researchers to obtain preliminary results as a prelude to acquire further funds from larger funding bodies.

We invite applications from researchers in the above regions on projects relating to sexually transmitted diseases and HIV. All projects will be initially screened by the Scientific Committee of STIRF and those considered suitable will be sent for peer review by experts in the field.

The following fields of research will be considered in relation to STIs and HIV

  • Epidemiology of HIV and other sexually transmitted diseases
  • Research on HPV and other sexually transmissible malignancies
  • Health care delivery including views of clients
  • Issues relating to deprived or marginalised communities.
  • Pathophysiology of diseases and syndromes
  • Inter-relationship between diseases
  • Treatment modalities
  • Complications of treatment and co-morbidities

Applications should not exceed £50,000 in the first year. Depending on satisfactory reports a further £25,000 may be available for the second year. Joint funding with other grant giving bodies will be considered.

For further information and guidance on how to apply visit

How to apply for grants

Deadline for applications is 30th June 2016

Applications using the appropriate form downloaded from the STIRF web site should be sent by email to:

Dr Mohsen Shahmanesh,(Hon Secretary STIRF)

Stirfweb@gmail.com

Access to Sexual Health Services for the Somali Community in Birmingham UK

The UK, hosts a large number of refugees from Somalia.

Somalis are absent from much of the official statistics largely because ‘Somali’ is rarely recognised as a distinct ethnic category. Therefore, when decisions are being made in relation to addressing the needs of recently arrived refugees the needs of those who originate from Somalia may be neglected.

Somalis are known to have a high level of need but low uptake of health care services. This included sexual health.

Earlier STIRF funded a project which looked at issues and problems relating to access for sexual health services. The project is now completed and is presented in a meeting held on:

Date: April 27
Venue: Birmingham City University
Time: 16.00 – 18.00

Meeting on Sexual Health needs of Somali Community

Risks for pelvic inflammatory disease in students

In the latest issue of the Sexually Transmitted Infections, Phillip Hay and colleagues in the UK report on a prospective study of female students attending 11 universities and 9 further education colleges in London.

At the start, the students were asked to fill a questionnaire and provide a self taken vaginal sample for infection screening. After 12 months, they were assessed for pelvic inflammatory disease (PID), a condition that can lead to infertility and other complications.

PID was found in 1.6% of the particpants. Unsurprisingly the strongest predictor of PID was the presence of Chlamydia trachomatis at the first visit (relative risk (RR) 5.7).

However, adjusting for this, the authors reported that significant predictors of PID were ≥2 sexual partners (RR 4.0) or a new sexual partner during follow-up (RR 2.8), and age <20 years (RR 3.3). Somewhat surprisingly recruitment from a further education college rather than a university also increased the relative risk of PID 2.6 fold, perhaps reflecting different health protection behaviors (eg condom use) between the two groups.

The study concluded that in addition to known risk factors such as multiple or new partners in the last 12 months and younger age, attending a further education college rather than a university were risk factors for PID.

They recommended that sexual health education and screening programs could be targeted at these high-risk groups.

The perils of chemsex

The term “Chemsex” is used in the United Kingdom to describe intentional sex under the influence of psychoactive drugs, mostly among men who have sex with men. The main drugs are mephedrone, γ-hydroxybutyrate (GHB), γ-butyrolactone (GBL), and crystallised methamphetamine. These drugs are often used in combination to facilitate sexual sessions lasting several hours or days with multiple sexual partners.

Mephedrone and crystal meth are physiological stimulants, increasing heart rate and blood pressure, as well as triggering euphoria and sexual arousal. GHB (and its precursor GBL) is a powerful psychological disinhibitor and also a mild anaesthetic.

Anecdotal reports and some small qualitative studies in the UK find that people engaging in chemsex report better sex, with these drugs reducing inhibitions and increasing pleasure.

Unfortunately use of chemsex can lead to mental health problems which can be permanent. Moreover Casual sex, particularly if under the influence of alcohol or drugs can lead to the acquisition of sexually transmitted infections and even such bugs as shigella, an infection causing severe bacillary dysentery and diarrhoea usually associated with travel to regions such as Indian subcontinent, North and East Africa and South America.

See trailer for Chemsex, a film ChemsexOfficial directed by William Fairman and Max Gogarty (a Peccadillo Pictures)  in the medical journal Lancet.

Sexually abused children should be offered HPV vaccination

Should children exposed to sexual abuse be offered human papillomavirus (HPV) vaccination alongside screening for sexually transmitted infections? A recent article in the Lancet argues for a yes answer.

The WHO defines childhood sexual abuse  as the involvement in sexual activity of a child under the age of 18 years who did not give informed consent or is not developmentally prepared.

The global prevalence of childhood sexual abuse is estimated to be 8–31% for girls and 3–17% for boys. The true figures are probably nearer the upper figure.

According to a review, parents were the perpetrators of about 45% of cases of childhood sexual abuse in the USA, and other relatives were responsible for a further 19%.  Others included figures of authority such as priests and teachers. Survivors of such abuse are often hesitant to report such incidents because of shame and fear of retribution. Thus, the incidence and prevalence of childhood sexual abuse is almost certainly underestimated. Read more

Daily pri-exposure prophylaxis (PrEP) prevents HIV infection in high risk gay men

Daily HIV medicine taken by men who have sex with men (MSM) reduces risk of HIV infection by 86% as was reported by Molina J-M, and colleagues in the ANRS Ipergay trial  at the Conference on Retroviruses and Opportunistic Infections held in Seattle, USA in 2015 (23LB.).

Molina et al reported the final results of a three year study which randomised MSM who were negative for HIV to either take daily HIV prophylaxis with two anti-retroviral drugs in a single tablet immediately or deferred for 1 year.

The study showed that those taking the drugs on a daily basis have a 86% reduction in the risk of being infected by HIV than MSM not taking the drug (p=0.0001). The trial was stopped in October of 2014 and all participants in the  deferred group were offered pre-exposure prophylaxis (PrEP)

As a Lancet editorial commented:

The science is now clear: oral pre-exposure prophylaxis (PrEP) with a coformulation of tenofovir disoproxil fumarate and emtricitabine (Truvada) significantly reduces the risk of HIV infection among individuals at high risk of HIV infection.

The news that PrEP has shown consistent efficacy among those who take it as prescribed should be a cause for celebration, and galvanise action to ensure access to PrEP for those who could benefit the most. But almost 3 years since the US Food and Drug Administration approved tenofovir–emtricitabine for PrEP little is being done on implementation.

With more than 2 million new HIV infections every year worldwide, it is time for that to change.

Invitation to workshop: role of stigma and shame in the access to sexual health clinics

A workshop on philosophical aspects of sexual health is being held at

Seminar Room 3.28, New Business School, Manchester Metropolitan University Manchester, United Kingdom

The workshop is run by Dr Phil Hutchinson and was part funded by a research grant from Sexually Transmitted Infections Research Foundation (STIRF). Project STIRF-026

Workshop 1: The Problem of Selection Bias in Biomedical & Public Health Research. Wednesday September 16

Workshop 2: Shame, Stigma and HIV. Thursday September 17

Venue: Seminar Room 3.28, New Business School, Manchester Metropolitan University, Manchester, UK

Mandatory registration: contact: marie.chollier@stu.mmu.ac.uk

Further information can be obtained from Phil Hutchinson p.hutchinson@mmu.ac.uk