Sorokopud-Jones Megan, Sharp Alexander, Haworth-Brockman Margaret, Kasper Ken, MacKenzie Lauren, Ireland Laurie, Gawlik Kathy, Lopez Lucelly, Vanegas Johanna Marcela, Bullard Jared, Boodman Carl, Sanguins Julianne, Payne Mike, Templeton Kimberly, Keynan Yoav, Rueda Zulma Vanessa
Department of Internal Medicine, University of Manitoba, Winnipeg, Canada.
Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
IJID Reg. 2024 Sep 7;13:100433. doi: 10.1016/j.ijregi.2024.100433. eCollection 2024 Dec.
Describe the proportion of people newly living with HIV with sexually transmitted and blood-borne infections (STBBIs) before, at, and after HIV diagnosis in Manitoba, Canada.
A retrospective cohort study reviewed clinical charts of all 404 people ≥18 years old newly diagnosed with HIV in Manitoba, Canada between 2018 and 2021. Syphilis, hepatitis C and B, gonorrhea, and chlamydia infections before, at, and after HIV diagnosis were recorded and analyzed by sex at birth, injection drug use status, use of methamphetamines, and housing status.
A total of 53% of people were diagnosed with syphilis, 44.1% with gonorrhea, 42.8% with chlamydia, and 40.6% with hepatitis C at least once. Among females, 64.1% had at least one or more STBBIs diagnoses before HIV diagnosis compared with 44.8% of males. Over 70% of people experiencing houselessness had at least one STBBI diagnosis before their HIV diagnosis compared with 43.9% of people not houseless. Among people who used methamphetamines, 68.3% had one or more STBBIs before HIV diagnosis compared with 28.9% of people who do not use methamphetamines. In a multivariable analysis houselessness, methamphetamine use, and younger age were associated with increased risk of any STBBIs.
In our Manitoba cohort of people living with HIV, disproportionately more females, people experiencing houselessness, and those who use methamphetamine were diagnosed with STBBIs. The proportion of new infections before HIV diagnoses highlights a missed opportunity to provide prevention modalities, including pre-exposure prophylaxis, and the proportion after HIV diagnosis emphasizes the importance of enhancing engagement, repeated testing, and educational strategies to ameliorate ongoing exposures.
描述加拿大曼尼托巴省新感染艾滋病毒者在艾滋病毒诊断前、诊断时及诊断后患有性传播和血源感染（STBBIs）的比例。
一项回顾性队列研究对2018年至2021年期间在加拿大曼尼托巴省新诊断出感染艾滋病毒的所有404名18岁及以上患者的临床病历进行了审查。记录并按出生时性别、注射吸毒状况、甲基苯丙胺使用情况和住房状况分析了艾滋病毒诊断前、诊断时及诊断后梅毒、丙型和乙型肝炎、淋病和衣原体感染情况。
共有53%的人至少被诊断出患过一次梅毒，44.1%患过淋病，42.8%患过衣原体感染，40.6%患过丙型肝炎。在女性中，64.1%在艾滋病毒诊断前至少有一次或多次STBBIs诊断，而男性为44.8%。超过70%的无家可归者在艾滋病毒诊断前至少有一次STBBI诊断，而非无家可归者为43.9%。在使用甲基苯丙胺的人群中，68.3%在艾滋病毒诊断前有一次或多次STBBIs诊断，而不使用甲基苯丙胺的人群为28.9%。在多变量分析中，无家可归、使用甲基苯丙胺和年龄较小与任何STBBIs风险增加相关。
在我们曼尼托巴省的艾滋病毒感染者队列中，女性、无家可归者和使用甲基苯丙胺者被诊断出患有STBBIs的比例过高。艾滋病毒诊断前的新感染比例凸显了提供预防措施（包括暴露前预防）的错失机会，而艾滋病毒诊断后的比例强调了加强参与、重复检测和教育策略以改善持续暴露情况的重要性。
