Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-13 (of 13 Records) |
Query Trace: de Voux A[original query] |
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Vaccine value profile for Neisseria gonorrhoeae
Lyu Y , Choong A , Chow EPF , Seib KL , Marshall HS , Unemo M , de Voux A , Wang B , Miranda AE , Gottlieb SL , Mello MB , Wi T , Baggaley R , Marshall C , Abu-Raddad LJ , Abara WE , Chen XS , Ong JJ . Vaccine 2023 Neisseria gonorrhoeae infection (gonorrhoea) is a global public health challenge, causing substantial sexual and reproductive health consequences, such as infertility, pregnancy complications and increased acquisition or transmission of HIV. There is an urgency to controlling gonorrhoea because of increasing antimicrobial resistance to ceftriaxone, the last remaining treatment option, and the potential for gonorrhoea to become untreatable. No licensed gonococcal vaccine is available. Mounting observational evidence suggests that N. meningitidis serogroup B outer membrane vesicle-based vaccines may induce cross-protection against N. gonorrhoeae (estimated 30%-40% effectiveness using the 4CMenB vaccine). Clinical trials to determine the efficacy of the 4CMenB vaccine against N. gonorrhoeae are underway, as are Phase 1/2 studies of a new gonococcal-specific vaccine candidate. Ultimately, a gonococcal vaccine must be accessible, affordable and equitably dispensed, given that those most affected by gonorrhoea are also those who may be most disadvantaged in our societies, and most cases are in less-resourced settings. This vaccine value profile (VVP) provides a high level, holistic assessment of the current data to inform the potential public health, economic and societal value of pipeline vaccines. This was developed by a working group of subject matter experts from academia, non-profit organizations, public private partnerships and multi-lateral organizations. All contributors have extensive expertise on various elements of the N. gonorrhoeae VVP and collectively aimed to identify current research and knowledge gaps. The VVP was developed using published data obtained from peer-reviewed journals or reports. |
Factors associated with syphilis transmission and acquisition among men who have sex with men: Protocol for a multisite egocentric network study
Copen CE , Rushmore J , De Voux A , Kirkcaldy RD , Fakile YF , Tilchin C , Duchen J , Jennings JM , Spahnie M , Norris Turner A , Miller WC , Novak RM , Schneider JA , Trotter AB , Bernstein KT . JMIR Res Protoc 2022 11 (11) e40095 BACKGROUND: In the United States, the rates of primary and secondary syphilis have increased more rapidly among men who have sex with men (MSM) than among any other subpopulation. Rising syphilis rates among MSM reflect changes in both individual behaviors and the role of sexual networks (eg, persons linked directly or indirectly by sexual contact) in the spread of the infection. Decades of research examined how sexual networks influence sexually transmitted infections (STIs) among MSM; however, few longitudinal data sources focusing on syphilis have collected network characteristics. The Centers for Disease Control and Prevention, in collaboration with 3 sites, enrolled a prospective cohort of MSM in 3 US cities to longitudinally study sexual behaviors and STIs, including HIV, for up to 24 months. OBJECTIVE: The Network Epidemiology of Syphilis Transmission (NEST) study aimed to collect data on the factors related to syphilis transmission and acquisition among MSM. METHODS: The NEST study was a prospective cohort study that enrolled 748 MSM in Baltimore, Maryland; Chicago, Illinois; and Columbus, Ohio. NEST recruitment used a combination of convenience sampling, venue-based recruitment, and respondent-driven sampling approaches. At quarterly visits, participants completed a behavioral questionnaire and were tested for syphilis, HIV, gonorrhea, and chlamydia. The participants also provided a list of their sexual partners and described their 3 most recent partners in greater detail. RESULTS: The NEST participants were enrolled in the study from July 2018 to December 2021. At baseline, the mean age of the participants was 31.5 (SD 9.1) years. More than half (396/727. 54.5%) of the participants were non-Hispanic Black, 29.8% (217/727) were non-Hispanic White, and 8.8% (64/727) were Hispanic or Latino. Multiple recruitment strategies across the 3 study locations, including respondent-driven sampling, clinic referrals, flyers, and social media advertisements, strengthened NEST participation. Upon the completion of follow-up visits in March 2022, the mean number of visits per participant was 5.1 (SD 3.2; range 1-9) in Baltimore, 2.2 (SD 1.6; range 1-8) in Chicago, and 7.2 (SD 2.9; range 1-9) in Columbus. Using a community-based participatory research approach, site-specific staff were able to draw upon collaborations with local communities to address stigma concerning STIs, particularly syphilis, among potential NEST participants. Community-led efforts also provided a forum for staff to describe the NEST study objectives and plans for research dissemination to the target audience. Strategies to bolster data collection during the COVID-19 pandemic included telehealth visits (all sites) and adaptation to self-collection of STI specimens (Baltimore only). CONCLUSIONS: Data from NEST will be used to address important questions regarding individual and partnership-based sexual risk behaviors among MSM, with the goal of informing interventions to prevent syphilis in high-burden areas. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/40095. |
Detection of Lymphogranuloma Venereum- associated Chlamydia trachomatis L2 Serovars in Remnant Rectal Specimens Collected from Seven United States Public Health Laboratories
Chi KH , de Voux A , Morris M , Katz SS , Pillay A , Danavall D , Bowden KE , Gaynor AM , Kersh EN . Sex Transm Dis 2021 49 (1) e26-e28 The frequency of lymphogranuloma venereum (LGV) or invasive Chlamydia trachomatis (CT) infection with serovar L1, L2 or L3 is unknown in the United States. While no diagnostic test is commercially available, we used a laboratory-developed test and detected LGV-associated serovar L2 in 14% of 132 remnant CT-positive rectal swabs. |
Genital mycoplasma, shigellosis, Zika, pubic lice, and other sexually transmitted infections: Neither gone nor forgotten
Torrone E , Lewis F , Kirkcaldy RD , Bernstein K , Ryerson AB , de Voux A , Oliver S , Quilter L , Weinstock H . Sex Transm Dis 2021 48 (4) 310-314 Most estimates of the combined burden and cost of sexually transmitted infections (STIs) in the United States have focused on eight common STIs with established national surveillance strategies (chlamydia, gonorrhea, syphilis, trichomoniasis, genital herpes, human papillomavirus, and sexually transmitted HIV and hepatitis B). However, over 30 STIs are primarily sexually transmitted or sexually transmissible. In this manuscript, we review what is known about the burden of "other STIs" in the United States, including those where sexual transmission is not the primary transmission route of infection. Although the combined burden of these other STIs may be substantial, accurately estimating their burden due to sexual transmission is difficult due to diagnostic and surveillance challenges. Developing better estimates will require innovative strategies, such as leveraging existing surveillance systems, partnering with public health and academic researchers outside of the STI field, and developing methodology to estimate the frequency of sexual transmission, particularly for new and emerging STIs.Monitoring the burden of sexually transmitted infections (STIs) in the United States is critical to inform and evaluate interventions and guide public health action. Most estimates of the combined burden of STIs in the United States have focused on eight common STIs with established national surveillance strategies (chlamydia, gonorrhea, syphilis, trichomoniasis, genital herpes, human papillomavirus [HPV], and sexually-transmitted HIV and hepatitis B); (1-5) however, there are over 30 pathogens that are sexually transmitted or transmissible (6-8) and these combined estimates underestimate the total burden and economic impact of STIs. "Other STIs" include infections that are primarily sexually transmitted in adults, but their public health significance has not been well established or there are no specific prevention or control programs for them (e.g., pubic lice, Mycoplasma genitalium) and infections where sexual transmission is not the primary transmission route (e.g., shigella, Zika). In this manuscript, we describe what is known about the burden (e.g., prevalence or incidence) of "other STIs" in the US based on a review of published manuscripts and surveillance reports and identify strategies that could be used to better estimate their burden. |
Syphilis testing among sexually active men who have sex with men and who are receiving medical care for human immunodeficiency virus in the United States: Medical Monitoring Project, 2013-2014
de Voux A , Bernstein KT , Bradley H , Kirkcaldy RD , Tie Y , Shouse RL . Clin Infect Dis 2019 68 (6) 934-939 BACKGROUND: Guidelines recommend that sexually active men who have sex with men (MSM) including human immunodeficiency virus (HIV)-positive MSM be tested at least annually for syphilis, with testing every 3-6 months for MSM at elevated risk. We examined the proportion of HIV-positive MSM tested for syphilis in the past 3, 6, and 12 months by their HIV care provider during 2013-2014. METHODS: Using data from the Medical Monitoring Project, a population-based HIV surveillance system, we evaluated the proportion of MSM who had documentation of being tested for syphilis by their HIV care provider in the past 3, 6, and 12 months. RESULTS: During 2013-2014, 71% (95% confidence interval [CI]: 69%-73%) of sexually active HIV-positive MSM were tested for syphilis in the past year. This proportion was higher among MSM reporting condomless sex: (75%; 95% CI: 72%-78%), and among MSM reporting >/= 2 sex partners (77%; 95% CI: 74%-79%), in the past 12 months. Among MSM reporting condomless sex, 49% (95% CI: 45%-53%) were tested in the past 6 months, and 26% (95% CI: 22%-30%) in the past 3 months. Among MSM reporting >/= 2 sex partners, 49% (95% CI: 44%-54%) were tested in the past 6 months and 26% (95% CI: 22%-29%) in the past 3 months. CONCLUSIONS: Nearly one-third of sexually active HIV-positive MSM were not tested annually, and many at increased risk were not tested at recommended frequencies. Efforts to improve compliance with screening guidelines for high-risk HIV-positive MSM are warranted. |
Prevalence of self-reported neurologic and ocular symptoms in early syphilis cases
Quilter LAS , de Voux A , Amiya RM , Davies E , Hennessy RR , Kerani RP , Madera R , Matthias J , Pearson VM , Walters JK , Wilson C , Kidd S , Torrone E . Clin Infect Dis 2020 72 (6) 961-967 BACKGROUND: Neurosyphilis, a complication of syphilis, can occur at any stage of infection. Measuring the prevalence of neurosyphilis is challenging and there are limited data on the prevalence of neurologic or ocular symptoms among patients with syphilis. We sought to describe the prevalence of neurologic and/or ocular symptoms among early syphilis (ES) cases and the clinical management of symptomatic cases enrolled in the STD Surveillance Network (SSuN) Neuro/Ocular Syphilis Surveillance project. METHODS: Persons diagnosed with ES were selected for interviews based on current health department protocols in five participating SSuN jurisdictions from November 2016-October 2017. All interviewed ES cases were screened for self-reported neurologic and/or ocular symptoms. Additional clinical information on diagnostic testing and treatment for cases concerning for neurosyphilis/ocular syphilis was obtained from providers. RESULTS: Among 9,123 patients with ES who were interviewed, 151 (1.7%, 95% CI: 1.4-1.9) reported >/=1 neurologic or ocular symptom. Of the 53 (35%) who underwent lumbar puncture (LP), 22 (42%) had documented abnormal cerebrospinal fluid, of which 21 (95%) were treated for neurosyphilis/ocular syphilis. Among the remaining 98 symptomatic patients with no documented LP (65%), 12 (12%) were treated for and/or clinically diagnosed with neurosyphilis/ocular syphilis. CONCLUSIONS: We observed a low prevalence of self-reported neurologic and/or ocular symptoms in interviewed ES cases. Approximately one-third of ES cases who self-reported symptoms underwent further recommended diagnostic evaluation. Understanding barriers to appropriate clinical evaluation is important to ensuring appropriate management of patients with possible neurologic and/or ocular manifestations of syphilis. |
Self-reported extragenital chlamydia and gonorrhea testing in the past 12 months among men who have sex with men in the United States - American Men's Internet Survey, 2017
deVoux A , Bernstein KT , Kirkcaldy RD , Zlotorzynska M , Sanchez T . Sex Transm Dis 2019 46 (9) 563-570 BACKGROUND: Current guidelines recommend that sexually active men who have sex with men (MSM) be screened at least annually for bacterial sexually transmitted infections (STIs) at sites of sexual contact regardless of condom use. Extragenital (rectal and pharyngeal) STI are common in MSM and associated with an increased risk of HIV. We describe the prevalence of MSM who reported any STI test and an extragenital STI test in the past 12 months (p12m) in the United States. METHODS: Data were obtained from the 2017 American Men's Internet Survey (AMIS), an annual cross-sectional behavioral internet survey of MSM in the United States. We examined the prevalence of MSM who reported any STI test and an extragenital STI test in the p12m and compared the prevalence across demographic, clinical, and behavioral factors. RESULTS: Of 10, 049 sexually-active MSM who participated in AMIS 2017, 42% reported any STI test in the p12m and 16% reported an extragenital (rectal or pharyngeal) STI test in the p12m. Among those who reported getting an extragenital STI test in the p12m, 19% reported providing a throat swab only, 14% reported providing a rectal swab only, and 68% reported providing both a rectal and throat swab for STI testing. CONCLUSION: In a large sample of internet-using MSM in the United States, levels of STI screening were sub-optimal, with fewer than half (42%) of MSM reporting any STI test and even fewer reporting an extragenital STI test in the p12m. Increased efforts are needed to ensure annual STI screening guidelines among MSM are implemented. |
Self-reported extragenital chlamydia and gonorrhea testing in the past 12 months among men who have sex with men in the United States - American Men's Internet Survey, 2017
de Voux A , Bernstein KT , Kirkcaldy RD , Zlotorzynska M , Sanchez T . Sex Transm Dis 2019 46 (9) 563-570 BACKGROUND: Current guidelines recommend that sexually active men who have sex with men (MSM) be screened at least annually for bacterial sexually transmitted infections (STIs) at sites of sexual contact regardless of condom use. Extragenital (rectal and pharyngeal) STI are common in MSM and associated with an increased risk of HIV. We describe the prevalence of MSM who reported any STI test and an extragenital STI test in the past 12 months (p12m) in the United States. METHODS: Data were obtained from the 2017 American Men's Internet Survey (AMIS), an annual cross-sectional behavioral internet survey of MSM in the United States. We examined the prevalence of MSM who reported any STI test and an extragenital STI test in the p12m and compared the prevalence across demographic, clinical, and behavioral factors. RESULTS: Of 10, 049 sexually-active MSM who participated in AMIS 2017, 42% reported any STI test in the p12m and 16% reported an extragenital (rectal or pharyngeal) STI test in the p12m. Among those who reported getting an extragenital STI test in the p12m, 19% reported providing a throat swab only, 14% reported providing a rectal swab only, and 68% reported providing both a rectal and throat swab for STI testing. CONCLUSION: In a large sample of internet-using MSM in the United States, levels of STI screening were sub-optimal, with fewer than half (42%) of MSM reporting any STI test and even fewer reporting an extragenital STI test in the p12m. Increased efforts are needed to ensure annual STI screening guidelines among MSM are implemented. |
Geographic correlates of primary and secondary syphilis among men who have sex with men in the United States
Leichliter JS , Grey JA , Cuffe KM , de Voux A , Cramer R , Hexem S , Chesson HW , Bernstein KT . Ann Epidemiol 2019 32 14-19 e1 PURPOSE: Primary and secondary (P&S) syphilis in men who have sex with men (MSM) has been increasing; however, there is a lack of research on geographic factors associated with MSM P&S syphilis. METHODS: We used multiple data sources to examine associations between social and environmental factors and MSM P&S syphilis rates at the state- and county-level in 2014 and 2015, separately. General linear models were used for state-level analyses, and hurdle models were used for county-level models. Bivariate analyses (P < .25) were used to select variables for adjusted models. RESULTS: In 2014 and 2015 state models, a higher percentage of impoverished persons (2014 beta = 1.24, 95% confidence interval, 0.28-2.20; 2015 beta = 1.19; 95% confidence interval, 0.42-1.97) was significantly associated with higher MSM P&S syphilis rates. In the 2015 county model, policies related to sexual orientation (marriage, housing, hate crimes) were significant correlates of MSM P&S syphilis rates (P < .05). CONCLUSIONS: Our state-level findings that poverty is associated with MSM P&S syphilis are consistent with research at the individual level across different subpopulations and various sexually transmitted diseases. Our findings also suggest that more research is needed to further evaluate potential associations between policies and sexually transmitted diseases. Geographic-level interventions to address these determinants may help curtail the rising syphilis rates and their sequelae in MSM. |
Reported cases of neurosyphilis among early syphilis cases - United States, 2009 to 2015
de Voux A , Kidd S , Torrone EA . Sex Transm Dis 2017 45 (1) 39-41 The surveillance of neurosyphilis, an uncommon but severe consequence of syphilis, is complex; surveillance classification of neurosyphilis requires a lumbar puncture and cerebrospinal fluid analysis. We examined the prevalence of reported neurosyphilis among primary, secondary, and early latent syphilis cases reported in the United States from 2009 to 2015. Overall, the prevalence of reported neurosyphilis from 2009 to 2015 was low (0.84%); however, this is likely an underestimate of the true burden in the United States. |
Laboratory processes for confirmation of lymphogranuloma venereum infection during a 2015 investigation of a cluster of cases in the United States
Kersh EN , Pillay A , de Voux A , Chen C . Sex Transm Dis 2017 44 (11) 691-694 ABSTRACT: In September 2015, the Centers for Disease Control and Prevention were notified of a suspected outbreak investigation of lymphogranuloma venereum (LGV) cases by the Michigan Department of Health and Human Services. The Centers for Disease Control and Prevention offered support with a laboratory-developed polymerase chain reaction test for LGV. This note describes the laboratory workflow and procedures used for the laboratory confirmation of LGV infection. |
State-specific rates of primary and secondary syphilis among men who have sex with men - United States, 2015
de Voux A , Kidd S , Grey JA , Rosenberg ES , Gift TL , Weinstock H , Bernstein KT . MMWR Morb Mortal Wkly Rep 2017 66 (13) 349-354 In 2015, the rate of reported primary and secondary syphilis in the United States was 7.5 cases per 100,000 population, nearly four times the previous lowest documented rate of 2.1 in 2000. In 2015, 81.7% of male primary and secondary syphilis cases with information on the sex of the sex partner were among gay, bisexual, and other men who have sex with men (collectively referred to as MSM) (1). These data suggest a disproportionate incidence of disease among MSM. However, attempts to quantify this disparity have been hindered by limited data on the size of the MSM population at the state level. To produce the first estimates of state-specific rates of primary and secondary syphilis among MSM, CDC used MSM population estimates based on a new methodology and primary and secondary syphilis case counts reported in 2015 to the National Notifiable Diseases Surveillance System. Among 44 states reporting information on the sex of sex partners for ≥70% of male cases, the overall rate of primary and secondary syphilis among all men (aged ≥18 years) in the United States in 2015 was 17.5 per 100,000, compared with 309.0 among MSM and 2.9 among men who reported sex with women only. The overall rate of primary and secondary syphilis among MSM was 106.0 times the rate among men who have sex with women only and 167.5 times the rate among women.* These data highlight the disproportionate impact of syphilis among MSM and underscore the need for innovative and targeted syphilis prevention measures at the state and local level, especially among MSM. It is important that health care providers recognize the signs and symptoms of syphilis, screen sexually active MSM for syphilis at least annually, and provide timely treatment according to national sexually transmitted diseases treatment guidelines. |
Notes from the field: cluster of lymphogranuloma venereum cases among men who have sex with men - Michigan, August 2015-April 2016
de Voux A , Kent JB , Macomber K , Krzanowski K , Jackson D , Starr T , Johnson S , Richmond D , Crane LR , Cohn J , Finch C , McFadden J , Pillay A , Chen C , Anderson L , Kersh EN . MMWR Morb Mortal Wkly Rep 2016 65 (34) 920-921 Lymphogranuloma venereum (LGV) is a sexually transmitted disease (STD) caused by infection with invasive Chlamydia trachomatis serovars L1-L3. LGV is characterized by inguinal and/or femoral lymphadenopathy, typically following a transient, self-limited genital ulcer or papule that might go unnoticed. Rectal infection can result in proctocolitis that can present with mucoid and/or hemorrhagic rectal discharge, anal pain, constipation, fever, and tenesmus, and signs of granulomas and/or ulcerations on anoscopy. LGV can be an invasive, systemic infection, and if it is not treated early, LGV proctocolitis can lead to chronic colorectal fistulas and strictures. In Europe, outbreaks of LGV have been reported among men who have sex with men (MSM), often in association with human immunodeficiency virus (HIV) coinfection. The prevalence of LGV in the United States is unknown because diagnostic tests to differentiate LGV from non-LGV Chlamydia trachomatis are not widely available (6), and providers might not know that they should report cases that are presumptively treated. |
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