Title : Sexually transmitted and blood-borne infections among people living with HIV in high-income countries: A systematic review and meta-analysis
Abstract:
Objective: People living with HIV (PLHIV) have been disproportionately impacted by the burden of sexually transmitted and blood-borne infections. In this study, we examine the prevalence and incidence of eleven sexually transmitted and bloodborne infections (STBBIs) in PLHIVIV in high-income countries.
Methods: This systematic review and meta-analysis was performed using PRISMA guidelines and registered in PROSPERO. Eligible studies consisted of those published from 2018 to 2023 that reported incidence or prevalence data of Treponema pallidum, Neisseria gonorrhea, Chlamydia trachomatis, Mycoplasma genitalium, Hepatitis A, B, and C, Human Papillomavirus, Herpes Simplex Virus 1 and 2, or Trichomonas vaginalis. Two independent and blinded reviewers screened the titles and abstracts, and full-text papers. Extracted data included study characteristics, population demographics, risk factors, and co- infections.
Results: The prevalence of STBBIs in PLHIV varied between 1.6% to 96% depending on infection type. Sample sizes varied between 82 and 23,361 individuals, with mean/median ages in the 30’s and 40’s. Among 30 included articles, 8 studies were conducted among men who have sex with men, and only one among women living with HIV. Contributing factors to the significant prevalence rate include the high proportion of substance use, particularly injection drug use (15.6%; 52.7%). Differences can be explained by the STBBI infection, testing and samples used, study design and region.
Conclusion: PLHIV have a significant prevalence of STBBIs coinfections. PLHIV remain at a heightened risk for STBBIs due to the intersection of biological, structural, and behavioral factors. Females and women are underrepresented in STBBI research. Along with medical treatment for HIV care, it is essential to incorporate STBBI testing, treatment and prevention, before, at, and after HIV diagnosis for the person living with HIV and for their sexual partners, and wraparound interventions and multi-disciplinary teams addressing social determinants of health to reduce co-infection rates and improve health.
