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Proportion of Incident Human Immunodeficiency Virus Cases Among Men Who Have Sex With Men Attributable to Gonorrhea

Jeb Jones, Kevin Weiss, Jonathan Mermin1

  • 1Centers for Disease Control and Prevention, Atlanta, GA.

Sexually Transmitted Diseases
|May 17, 2019
PubMed
Abstract

Insights

Bacterial sexually transmitted infections (STIs), specifically Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT), contribute to a significant proportion of new human immunodeficiency virus (HIV) infections among men who have sex with men (MSM). Targeted STI prevention can help reduce HIV transmission.

Area of Science:

  • Epidemiology
  • Public Health
  • Mathematical Modeling

Background:

  • Sexually transmitted infections (STIs) increase the risk of human immunodeficiency virus (HIV) acquisition and transmission.
  • Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) are common bacterial STIs.
  • Men who have sex with men (MSM) are a key population for understanding STI and HIV co-epidemics.

Purpose of the Study:

  • To estimate the proportion of HIV incidence among MSM attributable to co-infection with NG and CT.
  • To quantify the impact of common bacterial STIs on HIV transmission dynamics in MSM populations.

Main Methods:

  • Utilized a stochastic, agent-based model simulating a sexual network of MSM with co-circulating HIV, NG, and CT.
  • Incorporated relative risk (RR) multipliers, specific to infection site, to adjust HIV transmission and acquisition risk based on STI status.
  • Simulated scenarios for 10 years to calculate the population attributable fraction (PAF) for NG/CT on HIV incidence.

Main Results:

  • Overall, 10.2% of HIV infections among MSM were attributable to NG/CT co-infection.
  • Sensitivity analyses showed the population attributable fraction (PAF) for HIV transmission ranged from 3.1% to 20.4%.
  • The PAF for HIV acquisition ranged from 2.0% to 13.8% in sensitivity analyses.

Conclusions:

  • Mathematical modeling provides a valuable approach to estimate the impact of STIs on HIV risk, especially amid biological uncertainties.
  • Findings highlight the potential for STI prevention strategies to significantly reduce HIV incidence in MSM.
  • The study sets targets for public health interventions aimed at curbing STI and HIV transmission in MSM communities.

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