Human PREP blocking peptide

Objectives Recent evidence shows that patients using HIV pre-exposure prophylaxis (PrEP) have an increased rate of bacterial STIs, including syphilis, chlamydia and gonorrhoea. Our study aimed to describe the acquisition and the susceptibility for macrolides ofMycoplasma genitaliumin men who have sex with men (MSM) on PrEP. Methods We studied all MSM who started PrEP in the AZ Sint-Jan Hospital Bruges from 1 June 2017 to 31 March 2019 with at least one follow-up visit. Patients were screened forM. genitaliumand other STIs with pooled rectal swabs, pharyngeal swabs and first-voided urine, and blood samples at baseline and quarterly intervals after initiating PrEP. TaqMan Array Card technology was used to detectM. genitaliumand determine macrolide-resistance mediating mutations in region V of the 23S rRNA gene (A2058G, A2059G, A2058C and others). Patients with an STI were treated based on a national guideline. Results 131 MSM (median age 40 years, range 20-79) were included in the study. The median follow-up time was 12 months (IQR 6.1-17). Baseline prevalence ofM. genitaliumwas 6.9% and incidence rate after PrEP initiation was 28.8 per 100 person-years (95% CI 21.7 to 37.2), without significant differences in proportions between the first four quarterly intervals. All but one acquisitions were asymptomatic. Younger age and positivity forM. genitaliumat baseline were significantly associated with incidentM. genitaliumacquisition. The observed proportion of macrolide resistance increased not significantly from 44% at baseline to 57%-86% after PrEP initiation. None of the 27 macrolide-resistantM. genitaliumacquisitions could be linked to azithromycin exposure in the three preceding months. Conclusions After initiation of PrEP, we found a stable incidence of almost exclusively asymptomaticM. genitalium. However, a non-significant trend of an increased percentage of macrolide-resistant strains was observed.

Background Pre-exposure prophylaxis (PrEP) can sharply reduce HIV transmission risk, yet has not been widely adopted among those at highest risk for HIV, including Black men who have sex with men (BMSM). To better understand the evolving landscape of PrEP uptake in this at-risk population, we sought to examine psychosocial factors associated with PrEP uptake in a sample of BMSM residing in the Atlanta, GA, area. Method BMSM were recruited through online social media, LGBT venues, and participant referral, and self-reported demographic and psychosocial information via computer-assisted self-interview. Multivariate logistic regression was used to examine psychosocial factors associated with PrEP uptake. Results In 293 BMSM, most (N = 260; 88.7%) reported awareness of PrEP yet few (N = 30; 10.1%) reported ever having taken PrEP. BMSM reporting more syndemic conditions were less likely to be current PrEP users (OR = 0.59; 95% CI: 0.36, 0.96). BMSM reporting recent condomless anal sex (CAS) with a partner met online (adjusted odds ratio (aOR) = 2.53; 95% CI: 1.07, 5.93), or who reported having chlamydia (aOR = 8.21; 95% CI: 1.42, 47.67) or STI-related symptoms (aOR = 4.35; 95% CI: 1.32, 14.37) in the past 3 months, or genital warts in their lifetime (aOR = 7.74; 95% CI: 2.47, 24.21) were more likely to have ever used PrEP. Sexual orientation stigma from health care providers was negatively associated with PrEP uptake (OR = 0.81, 95% CI: 0.68, 0.95) among BMSM reporting recent CAS and multiple partners. Conclusion Syndemic and stigma theories may inform strategies for improving PrEP uptake in BMSM.