Incidence and time-varying predictors of HIV and sexually transmitted infections among male sex workers in Mexico City

Background Male sex workers are at high-risk for acquisition of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). We quantified incidence rates of STIs and identified their time-varying predictors among male sex workers in Mexico City. Methods From January 2012 to May 2014, male sex workers recruited from the largest HIV clinic and community sites in Mexico City were tested for chlamydia, gonorrhea, syphilis, hepatitis, and HIV at baseline, 6-months, and 12-months. Incidence rates with 95% bootstrapped confidence limits were calculated. We examined potential time-varying predictors using generalized estimating equations for a population averaged model. Results Among 227 male sex workers, median age was 24 and baseline HIV prevalence was 32%. Incidence rates (per 100 person-years) were as follows: HIV [5.23; 95% confidence interval (CI): 2.15–10.31], chlamydia (5.15; 95% CI: 2.58–9.34), gonorrhea (3.93; 95% CI: 1.88–7.83), syphilis (13.04; 95% CI: 8.24–19.94), hepatitis B (2.11; 95% CI: 0.53–4.89), hepatitis C (0.95; 95% CI: 0.00–3.16), any STI except HIV (30.99; 95% CI: 21.73–40.26), and any STI including HIV (50.08; 95% CI: 37.60–62.55). In the multivariable-adjusted model, incident STI (excluding HIV) were lower among those who reported consistently using condoms during anal and vaginal intercourse (odds ratio = 0.03, 95% CI: 0.00–0.68) compared to those who reported inconsistently using condoms during anal and vaginal intercourse. Conclusions Incidence of STIs is high among male sex workers in Mexico City. Consistent condom use is an important protective factor for STIs, and should be an important component of interventions to prevent incident infections

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI 2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining https://researchonline.ljmu.ac.uk/images/research_banner_face_lab_290.jpgunderweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesity

Detección de anticuerpos contra VIH a partir de muestras de sangre seca en papel filtro

Señor editor: En los últimos años se ha incrementado el uso de muestras de sangre seca en papel filtro (dried blood spots, DBS) para detectar anticuerpos contra virus de la hepatitis C (VHC), virus dengue y VIH, entre otros..

College women, HPV genotyping and sexual behavior before HPV vaccination: Results from samples stored for a long time

HPV is the sexually transmitted agent most common among young people, like college students. The aim of study was to associate sexual behavior characteristics of women with HPV, detected in genital samples taken before the introduction of the HPV vaccine. Female students during 2001–2005 donated genital samples and the samples were re-analyzed in 2013 for HPV genotyping by RT-PCR. The frozen storage of the students’ genital samples allowed the detection of HPV DNA and its genotyping after years of sample collection. HPV prevalence was 22%, HPV16 3.9%, and HPV18 1.1%. Age, multiple sexual partners and the partner’s age at first sexual intercourse were significantly associated to HPV. Students with ≥ 3 sexual partners and who did not use condom had 12.8 higher odds of being HPV positive. These results made possible the analysis of HPV prevalence changes, before HPV vaccine introduction. Keywords: HPV, Women, Sexual behaviors, Condom, Vaccinatio

Análisis de la tendencia de sífilis adquirida en México durante el periodo 2003-2013

Objetivo. Identificar el grupo poblacional en el que se concentra el incremento de sífilis ocurrido durante los últimos años. Material y métodos. A partir de información obtenida de los Anuarios de Morbilidad de la Secretaría de Salud, se conformaron diversas bases de datos con información desagregada por sexo, grupo de edad y entidad federativa durante el periodo de 2003 a 2013. Mediante análisis de regresión lineal, se estimó el incremento con intervalos de confianza a 95%; se evaluaron los cambios a través del tiempo en los diversos grupos poblacionales analizados. Resultados. A partir de 2010 hay un incremento de 0.67 casos por 100 000 habitantes (IC95% 0.30-1.04) entre los hombres, que se concentra en individuos de 20 a 24 y de 25 a 44 años. Las mayores incidencias de sífilis adquirida se reportaron en los dos últimos años: 2012 y 2013; este último año registró una incidencia 1.85 veces mayor a la reportada en el año 2003. Entidades como Aguascalientes, Distrito Federal, Durango, México, Oaxaca, Puebla, Quintana Roo, Yucatán y Zacatecas reportaron incrementos de sífilis adquirida durante el periodo de estudio. Conclusión. La sífilis adquirida aparentemente está reemergiendo en México entre hombres jóvenes, incremento que no es homogéneo en el país, por lo que es necesario focalizar medidas de intervención para esta infección de transmisión sexual

Avidity of Antibodies against HSV-2 and Risk to Neonatal Transmission among Mexican Pregnant Women

Objective. To determine HSV-2 seroprevalence, risk factors, and antibody avidity among a sample of Mexican pregnant women. Material and Methods. The avidity test was standardized with different urea concentrations and incubation times; the cut-off point was calculated to determine the low avidity (early infection). IgG antibodies against HSV-2 were detected from pregnant and postpartum women from Morelos, Mexico, and the avidity test was performed to positive samples. Multivariate regression logistic analysis was employed to evaluate demographic and sexual behavior characteristics associated with HSV-2 infection. Results. HSV-2 seroprevalence among Mexican women analyzed was 14.5% (333/2300), demographic factors (location of General Hospital, age, education level, and civil status), and risky sexual behaviors (STI self-report and number of sexual partners during last year) were associated with HSV-2 infection. Seventeen women were detected with low avidity antibodies (early infection) with a cut-off point of 66.1%. Conclusions. HSV-2 infection was common among this group of women from Mexico; the avidity test detected women with recent infections, and these women were more likely to transmit HSV-2 to their neonates. Neonatal herpes has no epidemiological surveillance, the disease could be overlooked, and so more studies are needed to estimate the magnitude of neonatal infection

Performance of ELISA and Western blot to detect antibodies against HSV-2 using dried blood spots

Background and aims: Herpes simplex virus type 2 (HSV-2) is a sexually transmitted agent and is detected worldwide. HSV-2 is the main cause of genital ulcers and is diagnosed mainly with serological tests. The objective of current study was to evaluate the use of DBS samples to detect HSV-2 antibodies using commercial ELISA and Western blot tests. Materials and methods: IgG-G2 ELISA (Human® Diagnostics, Germany) and Western blot IgG/IgM (EUROLINE-WB, Euroimmun® Germany) tests were modified to use DBS samples. Samples were processed by both methods to determine ELISA cutoff points using ROC curves. ELISA was performed with 100 μl and the Western blot with 200 μl of eluted DBS. A 1:5 dilution was used and the incubation times were increased for the Western blot. Results: 908 DBS samples were processed and the following cutoff points were determined: negative (0–3.79), undetermined (3.8–4.6) and positive (≥4.61), with sensitivity and specificity close to 95%. Conclusion: Modifications of the cutoff points of the ELISA test were obtained with technical adjustments done to detect HSV-2 antibodies by ELISA and Western blot using DBS samples. Keywords: Herpes simplex virus type 2, Dried blood spots, Western blot, ELIS

Alta seroprevalencia de sífilis y herpes genital en migrantes en tránsito en Chiapas, México

Objetivos. Determinar la prevalencia de anticuerpos contra Treponema pallidum y virus herpes simple tipo 2 (VHS-2), así como identificar los factores asociados a dichas infecciones entre migrantes en tránsito en Chiapas, México.
 Métodos. Estudio transversal realizado durante 2021-2022, en tres albergues para migrantes en Chiapas, México. Las personas contestaron un cuestionario y proporcionaron una muestra de sangre para la detección de anticuerpos contra Treponema pallidum y VHS-2. Se calculó la seroprevalencia y se evaluaron los factores asociados mediante pruebas de χ2 y razones de momios.
 Resultados. Participaron 462 migrantes, con edad promedio de 31,2 años, 56,9 % eran mujeres, 41,1 % provenían de Honduras. La seroprevalencia de VHS-2 fue 29,9 % mientras que la de sífilis fue 4,5 %, siendo mayor en hombres (8,0 %) que en mujeres (1,9 %). El 15,4 % de las embarazadas presentaban anticuerpos contra sífilis. Entre las variables asociadas a sífilis destacan el ser hombre, antecedente de lesiones genitales, así como tener parejas del mismo sexo y la seropositividad a VHS-2. Con relación al VHS-2, factores como ser mujer, edad, escolaridad, dormir en la calle, antecedente de prueba de VIH, debut sexual temprano, número de parejas sexuales y sífilis estuvieron asociados a la infección.
 Conclusiones. Se encontró una prevalencia elevada de sífilis y VHS-2 entre la población migrante evaluada. La sífilis se confirma como una infección reemergente, incluso en las mujeres. Los migrantes presenta vulnerabilidades asociadas al comportamiento sexual, por lo que se deben enfocar medidas de prevención, diagnóstico y tratamiento para este grupo poblacional