What is the overlap between HIV and shigellosis epidemics in England: further evidence of MSM transmission?
Open accessAbstract
Background Evidence suggests that sexual transmission between men has replaced foreign travel as the predominant mode ofShigellatransmission in England. However, sexuality and HIV status are not routinely recorded for laboratory-reportedShigella,and the role of HIV in theShigellaepidemic is not well understood. Methods The Modular Open Laboratory Information System containing allShigellacases reported to Public Health England (PHE) and the PHE HIV and AIDS Reporting System holding all adults living with diagnosed HIV in England were matched using a combination of Soundex code, date of birth and gender. Results From 2004 to 2015, 88 664 patients were living with HIV, and 10 269Shigellacases were reported in England; 9% (873/10 269) ofShigellacases were diagnosed with HIV, of which 93% (815/873) were in men.Shigellacases without reported travel history were more likely to be living with HIV than those who had travelled (14% (751/5427) vs 3% (134/4854); p<0.01). From 2004 to 2015, the incidence ofShigellain men with HIV rose from 47/100 000 to 226/100 000 (p<0.01) peaking in 2014 at 265/100 000, but remained low in women throughout the study period (0–24/100 000). AmongShigellacases without travel and with HIV, 91% (657/720) were men who have sex with men (MSM). HIV precededShigelladiagnosis in 86% (610/720), and 65% (237/362) had an undetectable viral load (<50 copies/mL). Discussion We observed a sustained increase in the national rate of shigellosis in MSM with HIV, who may experience more serious clinical disease. Sexual history, HIV status and STI risk might require sensitive investigation in men presenting with gastroenteritis.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Global increases in the incidence of shigellosis among adult MSM have been more recently observed.
“Global increases in the incidence of shigellosis among adult MSM have been more recently observed (252–256).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [255]
The Results and Discussion report rising Shigella incidence among MSM living with diagnosed HIV in England. The Introduction also describes reports of sexually transmitted Shigella in several countries, but the paper does not establish a global increase in incidence among adult MSM generally. The claim extends the finding beyond its geographic and HIV-status scope. (LLM, conf=0.88)
Experimental — accuracy not yet measuredHIV without viral suppression can be an independent risk factor that can contribute to transmission by increasing shedding of the enteric pathogen, increasing susceptibility of the host, or both.
“HIV without viral suppression can be an independent risk factor that can contribute to transmission by increasing shedding of the enteric pathogen, increasing susceptibility of the host, or both (255,263).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [255]
The Discussion (page unavailable) describes increased Shigella shedding and susceptibility in people living with HIV as plausible biological explanations for transmission. It does not establish HIV without viral suppression as an independent risk factor or link those mechanisms specifically to unsuppressed viral load. The Results (page unavailable) report that 65% of those with a viral-load measurement had an undetectable viral load. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSurveillance data in England during 2004-2015 demonstrated that 21% of nontravel-associated Shigella diagnoses among MSM were among persons with HIV infection.
“Surveillance data in England during 2004–2015 demonstrated that 21% of nontravel-associated Shigella diagnoses among MSM were among persons with HIV infection (255).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [255]
The Results and Table 1 report that 21% (720/3,481) of non-travel-associated Shigella diagnoses in men were among people with diagnosed HIV during 2004–2015. The paper does not establish that 21% applies specifically to MSM: it reports instead that 91% of those men with both diagnoses were MSM. Page numbers are not provided in our copy. (LLM, conf=0.90)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Hegazi, A., Lee, M., Whittaker, W., Green, S., Simms, R., Cutts, R., Nagington, M., Nathan, B., & Pakianathan, M. (2017) · International Journal of STD & AIDS · doi:10.1177/0956462416651229 · Cited by 231 · see citing works
Gilbart, V. L., Simms, I., Jenkins, C., Furegato, M., Gobin, M., Oliver, I., Hart, G., Gill, O. N., & Hughes, G. (2015) · Sexually Transmitted Infections · doi:10.1136/sextrans-2015-052014 · Cited by 170 · see citing works
Self-citationBourne, A., Reid, D., Hickson, F. C. I., Rueda, S. T., & Weatherburn, P. (2015) · LSHTM Research Online (London School of Hygiene and Tropical Medicine) · doi:10.17037/pubs.02197245 · Cited by 132 · see citing works
Aragon, T. J., Vugia, D. J., Shallow, S., Samuel, M. C., Reingold, A., Angulo, F. J., & Bradford, W. Z. (2007) · Clinical Infectious Diseases · doi:10.1086/510593 · Cited by 128 · see citing works
Hughes, G., & Field, N. M. (2015) · Future Microbiology · doi:10.2217/fmb.14.110 · Cited by 101 · see citing works
Self-citationSimms, I., Field, N., Jenkins, C., Childs, T., Gilbart, V. L., Dallman, T. J., Mook, P., Crook, P. D., & Hughes, G. (2015) · Eurosurveillance · doi:10.2807/1560-7917.es2015.20.15.21097 · Cited by 95 · see citing works
Self-citationShigellosis linked to sex venues, Australia.
O'Sullivan, B., Delpech, V., Pontivivo, G., Karagiannis, T., Marriott, D., Harkness, J., & McAnulty, J. M. (2002) · Emerging infectious diseases · doi:10.3201/eid0808.010534 · Cited by 77 · see citing works
Self-citation'Soundex' codes of surnames provide confidentiality and accuracy in a national HIV database.
Mortimer, J. Y., & Salathiel, J. A. (1995) · PubMed · Cited by 76 · see citing works
Letter: Shigella enteritis venereally transmitted.
Dritz, S. K., & Back, A. F. (1974) · PubMed · Cited by 70 · see citing works
Borg, M.-L., Modi, A., Tostmann, A., Gobin, M., Cartwright, J., Quigley, C., Crook, P., Boxall, N., Paul, J., Cheasty, T., et al. (2012) · Eurosurveillance · doi:10.2807/ese.17.13.20137-en · Cited by 65 · see citing works
Self-citationMarcus, U., Zucs, P., Bremer, V, Hamouda, O., Prager, R., Tschaepe, H., Futh, U., & Kramer, M. (2004) · International Journal of STD & AIDS · doi:10.1258/0956462041558221 · Cited by 59 · cited 1× · see citing works
“These are; (1) sex parties and the use of chemsex, which might influence decision-making about risky sexual behaviour19,20,20 , (2) use of social media apps to meet previously unknown partners, which might facilitate serosorting practices9, and (3) acceptability of sexual practices leading to faecal-oral contact7,9.”
BackgroundShigella Enteritis Venereally Transmitted
(1974) · New England Journal of Medicine · doi:10.1056/nejm197411282912223 · Cited by 56 · see citing works
Cresswell, F. V., Ross, S., Booth, T., Pinto-Sander, N., Alexander, E., Bradley, J., Paul, J., & Richardson, D. (2015) · Sexually Transmitted Diseases · doi:10.1097/olq.0000000000000295 · Cited by 29 · see citing works
Shigella enteritis venereally transmitted.
Dritz, S., & Back, A. F. (1974) · New England Journal of Medicine · Cited by 27 · see citing works
Hughes, G., Silalang, P., Were, J., Patel, H., Childs, T., Alexander, S., Duffell, S., Saxon, C., Ison, C., Mitchell, H., et al. (2018) · Sexually Transmitted Infections · doi:10.1136/sextrans-2016-053057 · Cited by 27 · see citing works
Self-citationThe Syndemic of AIDS and STDS among MSM
O’Leary, D. (2014) · The Linacre Quarterly · doi:10.1179/2050854913y.0000000015 · Cited by 26 · see citing works
Wani, R. L. S., Filson, S. A., Chattaway, M. A., & Godbole, G. (2015) · International Journal of STD & AIDS · doi:10.1177/0956462415610275 · Cited by 17 · see citing works
Horwitz, J., Furman, G., Nussbaum, M., & Shenker, I. R. (1974) · New England Journal of Medicine · doi:10.1056/nejm197411282912224 · Cited by 10 · see citing works
Safer chemsex: consideration of Shigella
Bains, M., Crook, P., Field, N. M., & Hughes, G. (2016) · British Journal of General Practice · doi:10.3399/bjgp16x683929 · Cited by 7 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 2,759 · see citing works
Confronting Rising STIs in the Era of PrEP and Treatment as Prevention
Ramchandani, M. S., & Golden, M. R. (2019) · Current HIV/AIDS Reports · doi:10.1007/s11904-019-00446-5 · Cited by 84 · see citing works
- Authors
- Mohan, K., Hibbert, M., Rooney, G., Canvin, M., Childs, T., Jenkins, C., Simms, I., Kirwan, P., Delpech, V., Yin, Z., Hughes, G., & Field, N.
- Affiliations
- Public Health England (GB)
- Corresponding author
- Mohan, Keerthi
- ORCID
- Venue
- Sexually Transmitted Infections
- Publisher
- BMJ
- Published
- 2017-05-10
- Volume
- 94
- Issue
- 1
- Pages
- 67-71
- ISSN
- 0007-134X (ISSN-L)
- 1368-4973
- 1472-3263
- OpenAlex
- W2614065094
- Cited by
- 34
- References
- 21
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 3 · 2022: 4 · 2021: 3 · 2020: 5 · 2019: 6 · 2018: 6 · 2017: 1
- FWCI
- 5.54
- Type
- journal article
- Language
- en
- Open access
- Locations
- Sexually Transmitted Infections (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Liverpool John Moores University (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Institute for Health and Care Research (CL-2010-18-010)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Escherichia coli research studies
- Keywords
- shigellosis, HIV, men who have sex with men, sexual transmission, incidence trends, undetectable viral load, gastroenteritis, England
- MeSH terms
- Sexual and Gender Minorities, Adolescent, Adult, Dysentery, Bacillary, England, Humans, Male, Middle Aged, Risk Factors, Sexual Behavior, Sexual Partners, Shigella, Shigella flexneri, Shigella sonnei, Travel, HIV Infections, Incidence, Homosexuality, Male, Young Adult, Epidemics, Coinfection
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
