Biomedical subjects

N H T M Dukers

Publications and source records attributed to N H T M Dukers.

5 recordsLinked to original sources

PubMed2005

Increase of sexually transmitted infections, but not HIV, among young homosexual men in Amsterdam: are STIs still reliable markers for HIV transmission?

OBJECTIVES: The incidence of HIV and STIs increased among men who have sex with men (MSM) visiting our STI clinic in Amsterdam. Interestingly, HIV increased mainly among older (> or =35 years) MSM, whereas infection rates of rectal gonorrhoea increased mainly in younger men. To explore this discrepancy we compared trends in STIs and HIV in a cohort of young HIV negative homosexual men from 1984 until 2002. METHODS: The study population included 863 men enrolled at < or =30 years of age from 1984 onward in the Amsterdam Cohort Studies (ACS). They had attended at least one of the 6 monthly follow up ACS visits at which they completed a questionnaire (including self reported gonorrhoea and syphilis episodes) and were tested for syphilis and HIV. Yearly trends in HIV and STI incidence and risk factors were analysed using Poisson regression. RESULTS: Mean age at enrollment was 25 years. The median follow up time was 4 years. Until 1995 trends in HIV and STI incidence were concurrent, however since 1995 there was a significant (p<0.05) increase in syphilis (0 to 1.4/100 person years (PY)) and gonorrhoea incidence (1.1 to 6.0/100 PY), but no change in HIV incidence (1.1 and 1.3/100 PY). CONCLUSIONS: The incidence of syphilis and gonorrhoea has increased among young homosexual men since 1995, while HIV incidence has remained stable. Increasing STI incidence underscores the potential for HIV spread among young homosexual men. However, several years of increasing STIs without HIV, makes the relation between STI incidence and HIV transmission a subject for debate.

Adult↗

PubMed2002

[The 14th International Aids Conference: 'Knowledge, commitment and action'].

During the world AIDS conference in Barcelona it became clear that the worst-case scenario of 10 years ago has become a reality: the HIV epidemic is continuing to spread. Also in industrialised countries the incidence of HIV infections among homosexual men is once again increasing. An HIV vaccine is still not available. Although the development of antiretroviral therapy continues, HIV inhibitors do not result in an eradication of HIV. It is still not clear as to when therapy can best be started and what the consequences are of temporarily withdrawing therapy. In countries where HIV inhibitors are widely available, the life expectancy of HIV-infected persons is increasing. The life expectancy of HIV patients will possibly decrease again due to an increased resistance towards the currently available antiretroviral drugs.

Acquired Immunodeficiency Syndrome↗

PubMed2002

[Syphilis epidemic and an increase of the number of HIV infections among homosexual men attending the Amsterdam venereal disease clinic].

The registered number of cases of early infectious syphilis and of (ano)genital gonorrhoea among the attendees of the outpatient clinic for sexually transmitted diseases of the Amsterdam municipal health service shows a strong increase for both diagnoses in the period 1990-2001, notably in the last few years. Nearly all of this increase is accounted for by homosexual men. Syphilis increased mostly among men aged 35 years and over, gonorrhoea mostly among younger men. The population of older men also showed a distinct increase since 1997 in HIV incidence.

AIDS Serodiagnosis↗

PubMed2002

Decreasing STD incidence and increasing condom use among Chinese sex workers following a short term intervention: a prospective cohort study.

OBJECTIVE: To describe the impact of a repeating behavioural intervention focused on preventive education and provision of STD testing and treatment services to female sex workers. METHODS: A prospective cohort study of 966 sex workers (first of its kind in China) was conducted in Guangzhou from March 1998 to October 1999. At each visit information was collected on sexual behaviour, condom use and knowledge about HIV transmission and condom use, education was given, STD were diagnosed, and treatment was provided free of charge. We evaluated trends in condom use, knowledge about HIV transmission and condom use, and STD incidences. Generalised estimating equations were applied to control for repeated measurements. RESULTS: The proportion of consistent condom use increased from the intake through the third follow up visit (from 30% to 81%), as well as the proportion of having good knowledge on HIV transmission (4.3% to 98.6%) and condom use (23.6% to 79.3%). The incidence of gonorrhoea, trichomoniasis, and chlamydia decreased over each follow up visit; from 17.5/100 person years (PY), 22.4/100PY, 65.9/100PY at the first follow up visit to 5.1/100PY, 3.0/100PY, 16.1/100PY at the third follow up visit, for each STD respectively. CONCLUSIONS: STD care and prevention programmes targeting sex workers are feasible in China and, more importantly, intervention consisting of prevention education and STD care is likely to reduce unprotected sexual behaviour and STD incidence in this group at high risk for HIV and other STD infection.

Adult↗

PubMed2002

A summary report from Amsterdam: increase in sexually transmitted diseases and risky sexual behaviour among homosexual men in relation to the introduction of new anti-HIV drugs.

The worrying increase of sexually transmitted diseases (STDs) in Amsterdam was investigated in two studies carried out by the department of AIDS research of the municipal health service. The results indicate that the introduction of Highly Active Antiretroviral Therapies (HAART) may have had an influence on the increase of STDs and risky sexual behaviours in Amsterdam.

Acquired Immunodeficiency Syndrome↗