Proportion of incident human immunodeficiency virus cases among men who have sex with men attributable to gonorrhea and chlamydia: a modeling analysis.
Abstract
BACKGROUND: Sexually transmitted infections (STIs) are associated with an increased risk of human immunodeficiency virus (HIV) acquisition and transmission. We estimated the proportion of HIV incidence among men who have sex with men attributable to infection with the 2 most common bacterial STIs, Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT). METHODS: We used a stochastic, agent-based model of a sexual network of MSM with cocirculating HIV, NG, and CT infections. Relative risk (RR) multipliers, specific to anatomic site of infection, modified the risk of HIV transmission and acquisition based on STI status. We estimated the effect of NG and CT on HIV incidence overall and on HIV acquisition and HIV transmission separately. Each scenario was simulated for 10 years. The population attributable fraction (PAF) was determined for each combination of RRs by comparing the incidence in the final year of a scenario to a scenario in which the RRs associated with NG and CT were set to 1.0. RESULTS: Overall, 10.2% (interquartile range [IQR], 7.9-12.4) of HIV infections were attributable to NG/CT infection. Then in sensitivity analyses, the PAF for HIV transmission ranged from 3.1% (IQR, 0.5-5.2) to 20.4% (IQR, 17.8-22.5) and the PAF for HIV acquisition ranged from 2.0% (IQR, -0.7 to 4.3) to 13.8% (IQR, 11.7-16.0). CONCLUSIONS: Despite challenges in estimating the causal impact of NG/CT on HIV risk, modeling is an alternative approach to quantifying plausible ranges of effects given uncertainty in the biological cofactors. Our estimates represent idealized public health interventions in which STI could be maximally prevented, setting targets for real-world STI interventions that seek to reduce HIV incidence.
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Studies have documented the risk for HIV acquisition among MSM within 1 year after infection with rectal gonorrhea or chlamydia (one in 15 men), primary or secondary syphilis (one in 18), and among men with no rectal STI or syphilis infection (one in 53).
“Studies have documented the risk for HIV acquisition among MSM within 1 year after infection with rectal gonorrhea or chlamydia (one in 15 men), primary or secondary syphilis (one in 18), and among men with no rectal STI or syphilis infection (one in 53) (81–83).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [81]
An estimated 10% of new HIV infections were attributable to chlamydial or gonococcal infection.
“An estimated 10% of new HIV infections were attributable to chlamydial or gonococcal infection (81).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [81]
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- Authors
- Jones, J., Weiss, K., Mermin, J., Dietz, P., Rosenberg, E. S., Gift, T. L., Chesson, H., Sullivan, P. S., Lyles, C., Bernstein, K. T., & Jenness, S. M.
- Affiliations
- Emory University (US)
- Centers for Disease Control and Prevention (US)
- University at Albany, State University of New York (US)
- Corresponding author
- Jones, Jeb
- Weiss, Kevin
- Sullivan, Patrick S.
- Jenness, Samuel M.
- ORCID
- Venue
- Sexually Transmitted Diseases
- Published
- 2019-06
- Volume
- 46
- Issue
- 6
- Pages
- 357-363
- ISSN
- 0148-5717 (ISSN-L)
- 1537-4521
- OpenAlex
- W2945199957
- Cited by
- 94
- References
- 39
- Citations by year
- 2026: 5 · 2025: 13 · 2024: 16 · 2023: 11 · 2022: 17 · 2021: 17 · 2020: 9 · 2019: 6
- FWCI
- 9.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sexually Transmitted Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (CC999999)
- Centers for Disease Control and Prevention (U38PS004646)
- National Institute of Mental Health (R21MH112449)
- National Institute of Allergy and Infectious Diseases (R01AI138783, P30AI050409)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD068395, R21HD075662, R24HD042828)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- HIV incidence, men who have sex with men, gonorrhea, chlamydia, sexually transmitted infections, HIV transmission, HIV acquisition, population attributable fraction, Neisseria gonorrhoeae, Chlamydia trachomatis, agent-based modeling, sexual networks, STD prevention
- MeSH terms
- Sexual and Gender Minorities, Chlamydia Infections, Gonorrhea, Humans, Male, Risk, Sexual Behavior, United States, Models, Statistical, HIV Infections, Incidence, Homosexuality, Male
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