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Shigellosis outbreak among MSM living with HIV: a case-control study in Taiwan, 2015-2016

Hao-Hsin Wu1, Yi-Ting Shen2, Chien-Shun Chiou3

  • 1Division of Infection Control and Biosafety, Centers for Disease Control, Taipei, Taiwan.

Sexually Transmitted Infections
|March 15, 2018
PubMed
Abstract

Insights

Chemsex, drug use, and sexual behaviors are new risk factors for shigellosis outbreaks in HIV-positive men who have sex with men. Public health efforts must address these emerging risks.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Epidemiology

Background:

  • Shigellosis outbreaks are increasingly reported among men who have sex with men (MSM), with HIV infection being a known risk factor.
  • The global shigellosis epidemic has intensified since 2014, necessitating an examination of novel risk factors.

Purpose of the Study:

  • To investigate chemsex as a potential new risk factor for shigellosis among MSM living with HIV.
  • To identify other behavioral and clinical risk factors associated with shigellosis in this population during a 2015 outbreak in Taiwan.

Main Methods:

  • A population-based case-control study was conducted comparing 75 acute shigellosis cases with 225 controls among MSM living with HIV.
  • Data on clinical factors (CD4+ count, plasma viral load) were obtained from surveillance systems.
  • Information on illicit drug use (including chemsex) and sexual behaviors was collected via questionnaires.

Main Results:

  • High plasma viral load, gonorrhea, and syphilis were independent clinical risk factors for shigellosis.
  • Behavioral risk factors included oral-to-anal sex, chemsex, and poppers use within the past 12 months.
  • Chemsex emerged as a significant new risk factor (adjusted OR: 5.6).

Conclusions:

  • Chemsex is identified as a novel and significant risk factor for shigellosis among MSM living with HIV.
  • Other contributing factors include poppers use, specific sexual practices, and high viral load.
  • Further research on chemsex is crucial due to its rising public health implications.
Keywords:
HIVamyl nitritebacillary dysenterymethamphetaminesexual behavioursodium oxybate

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