Transgender women taking PrEP have lower levels of PrEP drugs than cisgender men

aidsmap/nam, November 9th 2018

A study presented at October’s HIV Research for Prevention conference (HIVR4P) in Madrid shows that transgender women who are taking feminising hormones and also taking pre-exposure prophylaxis (PrEP) have levels of the PrEP drugs tenofovir and emtricitabine in their blood that are about 25% lower than those in cisgender men, and levels in rectal tissue cells about 40% lower. Tenofovir levels in rectal tissue were 44% lower.

However, the study also confirmed that the interaction between hormones and PrEP did not appear to go the other way; blood levels of estradiol, the one hormone all of the transgender women took in one form or another, do not appear to be affected by PrEP.

 

Gonorrhoea: Drug Resistance in Australia

Australian Federation of AIDS Organisations (AFAO), 26 June 2018

There has long been concern globally about the potential emergence of drug resistant STIs. In response, the World Health Organisation released new treatment guidelines for three common STIs – chlamydia, gonorrhoea and syphilis – in 2016.

At present, strains resistant to first line treatment of syphilis and chlamydia are not common and not a concern in Australia. There is, however, a growing level of concern about gonorrhoea. This paper therefore focuses on the likelihood and implications of the emergence of drug resistant cases of gonorrhoea in Australia. It also highlights treatment options in Australia and current and emerging strategies for preventing drug resistant gonorrhoea.

Download paper: AFAO Brief – Gonorrhoea – Drug Resistance in Australia – 26 June 2018

MSM in London diagnosed with early syphilis are a priority group for PrEP

nam/aidsmap, 16 October 2017

Gay and other men who have sex with men (MSM) recently diagnosed with early syphilis are a priority group for HIV pre-exposure prophylaxis (PrEP), results of a study published in Sexually Transmitted Infections suggest.

Over two years of follow-up, 11% of men diagnosed with early syphilis subsequently became infected with HIV. Incidence of rectal sexually transmitted infections and syphilis re-infection was also high.

“Our study highlights early syphilis as a risk factor for HIV acquisition in MSM,” write the investigators. “Intensive risk reduction and PrEP would be beneficial for HIV-negative MSM with early syphilis by reducing their risk of HIV acquisition.”

New class of antibiotic raises hopes for urgently-needed gonorrhoea drug

The Guardian, Tuesday 8 August 2017 

A new class of antibiotic has been found to work in the lab against the sexually transmitted infection gonorrhoea, which can cause infertility and damage to babies and is fast becoming resistant to all existing drugs.

Although it is early days, because the antibiotic has yet to be tried in animals or humans, researchers say they are excited by its potential.

London data shows that hepatitis C is passed on during [sexual activity]

aidsmap/nam, 10 April 2017

Around one in five HIV-positive gay men who recently acquired hepatitis C report anal sex without a condom as the only behaviour that could explain their infection. At the same time, a third of people acquiring hepatitis C were gay men who did not have HIV, clinicians from the Mortimer Market Centre in London told the British HIV Association conference in Liverpool last week.

The data suggest that prevention messages around sexually transmitted hepatitis C need to change.

Read more here 

STI rates in PrEP users very high, but evidence that PrEP increases them is inconclusive

nam/aidsmap, Published: 22 February 2017
A study of PrEP users presented last week showed that PrEP users had very high rates of STI diagnosis – in the order of 20 times higher than among HIV-negative gay men in the general population. The evidence that STIs increased further while people were on PrEP was, however, a lot more ambiguous.
The problem in proving that PrEP has any causal relationship to STIs is that STIs among gay men were, in general, rising before well before PrEP, and also that PrEP usually involves regular testing for HIV and STIs. Since many STIs are asymptomatic and self-limiting, more tests will result in more diagnoses.
Read more here