Travel-associated STI amongst HIV and non-HIV infected travellers

Abstract Background The incidence of sexually transmitted infections (STI) is increasing in Western countries whilst travel plays a major role in STI dissemination worldwide. However, there is no study distinguishing HIV-positive and HIV-negative travellers. Methods We retrospectively evaluated the...

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Published in:	Journal of travel medicine Vol. 26; no. 8
Main Authors:	Nouchi, Agathe, Caby, Fabienne, Palich, Romain, Monsel, Gentiane, Caumes, and Eric
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 23-12-2019
Subjects:	Chlamydia Condoms Epidemiology Exposure Geographical distribution Gonorrhea Health risks Hepatitis Hepatitis C HIV Human immunodeficiency virus Identification methods Infections Men Prophylaxis Sexually transmitted diseases STD Syphilis Travel Travellers Gonorrhoea primary HIV infection syphilis Chlamydia trachomatis lymphogranuloma venereum genital herpes Hepatitis C
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Summary:	Abstract Background The incidence of sexually transmitted infections (STI) is increasing in Western countries whilst travel plays a major role in STI dissemination worldwide. However, there is no study distinguishing HIV-positive and HIV-negative travellers. Methods We retrospectively evaluated the epidemiological, clinical and biological characteristics of the patients diagnosed with a travel-related STI between 2008 and 2016. We describe and compare the spectrum of STI diagnosed amongst HIV-positive and negative travellers. Methods Overall, 163 travel-related STI were identified in 140 patients (89% male, 54% men having sex with men, 40% HIV-positive). Symptoms occurred during travel in 39% of them, otherwise the median time between return and symptoms’ onset was 13 days. Amongst the 84 HIV-negative travellers, the main STI were primary HIV infections (n = 36, 38%), Neisseria gonorrhoeae (NG) infections (17%) and primary herpes infection (14, vs 1.5% amongst HIV-positive travellers, P = 0.01). The regions of exposure to HIV were concordant with the known geographical distribution of HIV subtypes. Amongst the 56 HIV-positive travellers, the main STI were syphilis (43, vs 6% amongst HIV-negative travellers, P = 0.01), Chlamydia trachomatis (CT) infections (22, vs 13% amongst HIV-negative travellers, P = 0.08), NG infections (13%) and acute hepatitis C (12, vs 1% amongst HIV-negative travellers, P = 0.01), with a predominance of anal forms for both CT and NG infections. Conclusions The spectrum of STI diagnosed in returning travellers is broad with important differences according to HIV status. In our setting, primary HIV infection was the leading STI in non-HIV infected patients, which suggests that pre-exposure prophylaxis may have a role in HIV prevention in at-risk travellers.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1708-8305 1195-1982 1708-8305
DOI:	10.1093/jtm/taz090