Bacterial sexually transmitted infections among men who have sex with men and transgender women using oral pre exposure prophylaxis in Latin America (ImPrEP): a secondary analysis of a prospective, open-label, multicentre study

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dc.contributor.affiliationInstituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, Brazil
dc.contributor.emailgbeatriz@ini.fiocruz.br (Beatriz Grinsztejn)
dc.creatorTorres Silva, Mayara Secco
dc.creatorSilva Torres, Thiago
dc.creatorCoutinho, Carolina
dc.creatorIsmério Moreira, Ronaldo
dc.creatorLeite, Iuri da
dc.creatorCunha, Marcelo
dc.creatorAmparo da Costa Leite, Pedro Henrique
dc.creatorCáceres, Carlos F.
dc.creatorVega-Ramírez, Hamid
dc.creatorKonda, Kelika A.
dc.creatorGuanira, Juan
dc.creatorValdez Madruga, José
dc.creatorWagner Cardoso, Sandra
dc.creatorBenedetti, Marcos
dc.creatorPimenta, Maria Cristina
dc.creatorHoagland, Brenda
dc.creatorGrinsztejn, Beatriz
dc.creatorGonçalves Veloso, Valdilea
dc.creatorImPrEP Study Group
dc.creatorLacerda, Marcus Vinicius
dc.creatorValdez Madruga, José
dc.creatorFarias, Alessandro
dc.creatorLima, Josué N.
dc.creatorZonta, Ronaldo
dc.creatorLauria, Lilian
dc.creatorUrbaez-Brito, J. David
dc.creatord'Albuquerque, Polyana
dc.creatorPalombo, Claudio
dc.creatorAlencastro, Paulo Ricardo de
dc.creatorLuca Ito, Raquel Keiko de
dc.creatorMoreira, Julio
dc.creatorBenedetti, João L. de
dc.creatorMaria, Fabio V.
dc.creatorLuz, Paula M.
dc.creatorFreitas, Lucilene
dc.creatorGeraldo, Kim
dc.creatorDerrico, Monica
dc.creatorNazer, Sandro
dc.creatorKristic, Tania
dc.creatorGirade, Renato
dc.creatorLima, Renato
dc.creatorCarvalho, Antônio R.
dc.creatorRocha, Carla
dc.creatorLeite, Pedro
dc.creatorLessa, Marcio
dc.creatorSantini, Marilia
dc.creatorBezerra, Daniel R. B.
dc.creatorOliveira Souza, Cleo de
dc.creatorCorrêa, Jacinto
dc.creatorAlves, Marcelo
dc.creatorSouza, Carolina
dc.creatorPortugal, Camilla
dc.creatorSantos Valões, Mônica dos
dc.creatorLima Mota, Gabriel
dc.creatorAlves Gomes, Joyce
dc.creatorLima Falcão, Cynthia Ferreira
dc.creatorFalcão Riberson, Fernanda
dc.creatorMelo, Luciano
dc.creatorAndrade Oliva, Talita
dc.creatorMoreira de Oliveira Júnior, Agnaldo
dc.creatorFonseca, Bruna
dc.creatorHenriette de Lannoy, Leonor
dc.creatorSantiago Carlos, Ludymilla Anderson
dc.creatorCunha, João Paulo da
dc.creatorAlencastro Coracini, Sonia Maria de
dc.creatorOliveira Rodrigues, Thiago Oliveira
dc.creatorScharf Mettrau, Emília Regina
dc.creatorVieira Meira, Kelly
dc.creatorTavares, Heder
dc.creatorNunes Viveiros Valeiras, Ana Paula
dc.creatorAlves de Carvalho Rocha, Taiane Miyake
dc.creatorAmorim, Alex
dc.creatorSabadini, Patrícia
dc.creatorGustavo Córdoba, Luiz
dc.creatorGusmão, Caio
dc.creatorFaustino, Erika
dc.creatorSilva Hansen, Julia Soares da
dc.creatorMirian Cunha, Agatha
dc.creatorUchiyama Nishimura, Neuza
dc.creatorFlygare Razo Prereira Santos, Jaime Eduardo
dc.creatorBarnabé Cano, Aline
dc.creatorMagnum Telles Dias, Willyam
dc.creatorTonhon, Magô
dc.creatorRezende, Tania Regina
dc.creatorGomes, Alex
dc.creatorSantos Rodrigues, Eloá dos
dc.creatorDores Aires Carneiro, Maria das
dc.creatorCastilho, Alexandre
dc.creatorCarvalho, Mariana
dc.creatorBautista-Aredondo, Sergio
dc.creatorVermandere, Heleen
dc.creatorDiaz, Steven
dc.creatorDiaz-Sosa, Dulce
dc.creatorDiaz-Barriga, Centli Guillen
dc.creatorRobles, Rebeca
dc.creatorMedina-Mora, Maria Elena
dc.creatorGonzález, Marcela
dc.creatorHuerta Icelo, Ivonne
dc.creatorMartinez Davalos, Araczy
dc.creatorGomez Castro, José
dc.creatorOcampo Valdez, Luis Obed
dc.creatorRamírez Barajas, Fernanda
dc.creatorRuiz González, Verónica
dc.creatorVargas Guadarrama, Galileo
dc.creatorMacías, Israel
dc.creatorTena Sánchez, Jehovani
dc.creatorOsuna Noriega, Juan Pablo
dc.creatorMoheno M., H. Rodrigo
dc.creatorBernal Ramírez, Jorge M.
dc.creatorGalicia Juarez, Víctor Dante
dc.creatorVizcaíno, Gerardo
dc.creatorArjona, Francisco Javier
dc.creatorVidal Osco Tamayo, Cesar
dc.creatorSalvatierra Flores, Hector Javier
dc.creatorCabrera Santa Cruz, Yovanna Margot
dc.creatorMoreno Aguayo, Ricardo Martín
dc.creatorCalvo, Gino
dc.creatorVargas, Silver
dc.creatorElorreaga, Oliver
dc.creatorGutierrez, Ximena
dc.creatorOlivos, Fernando
dc.creatorCaviedes, Damaris
dc.creatorAdriazola, Daniella
dc.creatorJuárez, Eduardo
dc.creatorMariño, Gabriela
dc.creatorQquellon, Jazmin
dc.creatorVasquez, Francesca
dc.creatorPierre Jiron, Jean
dc.creatorFlores, Sonia
dc.creatorCampos, Karen
dc.date2024
dc.date.accessioned2026-05-20T20:40:23Z
dc.date.issued2024
dc.date.published2024
dc.descriptionBackground: The global burden of sexually transmitted infections (STIs) poses a challenge in the context of HIV pre-exposure prophylaxis (PrEP) programmes. We aimed to explore factors associated with prevalent, incident, and recurrent STIs in men who have sex with men (MSM) and transgender women on PrEP in Brazil, Mexico, and Peru. Methods: ImPrEP was a prospective, single-arm, open-label, multicentre study that enrolled MSM and transgender women in the context of the public health systems of Brazil (14 sites), Mexico (four sites), and Peru (ten sites) between February, 2018, and June, 2021. Eligibility criteria followed regional PrEP guidelines at the study start, including participants aged 18 years and older, not living with HIV, and reporting at least one of the following in the previous 6 months: condomless anal sex (CAS), anal sex with partner(s) living with HIV, any bacterial STI, or transactional sex. Eligible participants were screened and enrolled on the same day to receive daily oral PrEP (tenofovir disoproxil fumarate 300 mg and emtricitabine 200 mg). We assessed three outcomes: prevalent bacterial STIs, incident bacterial STIs, and recurrent bacterial STIs. Testing occurred at baseline and quarterly for syphilis, anorectal chlamydia, and anorectal gonorrhoea. Behavioural data were collected at baseline and quarterly. The study was registered with the Brazilian Registry of Clinical Trials, U1111-1217-6021. Findings: Among all 9509 participants included in the ImPrEP study (3928 [41·3%] in Brazil, 3288 [34·6%] in Mexico, and 2293 [24·1%] in Peru), 8525 (89·7%) had available STI results at baseline and were included in the prevalent STI analysis, and 7558 (79·5%) had available STI results during follow-up and were included in the incident and recurrent STI analyses. 2184 (25·6%) of 8525 participants had any bacterial STI at baseline. STI incidence during follow-up was 31·7 cases per 100 person-years (95% CI 30·7-32·7), with the highest rate for anorectal chlamydia (11·6 cases per 100 person-years, 95% CI 11·0-12·2), followed by syphilis (10·5 cases per 100 person-years, 9·9-11·1) and anorectal gonorrhoea (9·7 cases per 100 person-years, 9·2-10·3). Although only 2391 (31·6%) of 7558 participants had at least one STI during follow-up, 915 (12·1%) participants had recurrent diagnoses, representing 2328 (61·2%) of 3804 incident STI diagnoses. Characteristics associated with prevalent, incident, and recurrent STIs included younger age, multiple sex partners, receptive CAS, substance use, and previous STI diagnoses at baseline (incident or recurrent only). Interpretation: Our findings underscore the nuanced dynamics of STI transmission among MSM and transgender women across Latin America, highlighting an urgent need for tailored interventions to mitigate STI burden effectively, especially among the most susceptible individuals. Funding: Unitaid, WHO, and ministries of health (Brazil, Mexico, and Peru).
dc.formatPDF
dc.identifierJC12DIEP24
dc.identifier.doi10.1016/S2352-3018(24)00211-X
dc.identifier.eissn2405-4704
dc.identifier.issn2352-3018
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz
dc.identifier.placePaíses Bajos
dc.identifier.urihttps://repositorio.inprf.gob.mx/handle/123456789/24
dc.identifier.urihttps://doi.org/10.1016/S2352-3018(24)00211-X
dc.language.isoeng
dc.publisherElsevier
dc.relation11(10):e670-e679
dc.relation.jnabreviadoLANCET HIV
dc.relation.journalLancet HIV
dc.rightsAcceso Cerrado
dc.titleBacterial sexually transmitted infections among men who have sex with men and transgender women using oral pre exposure prophylaxis in Latin America (ImPrEP): a secondary analysis of a prospective, open-label, multicentre study
dc.typeArtículo

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