Perspectives Sex Transm Infect: first published as 10.1136/sextrans-2020-054855 on 16 April 2021. Downloaded from

the implementation of universal access to Research news in clinical context DAAs in 2015. Relative to 2015, in 2019, the overall incidence of primary infec- Marina Daskalopoulou ‍ ‍ ,1 Rayner Kay Jin Tan ‍ ‍ ,2 tion and reinfection declined by 61% and 3 79%, respectively. However, following Danielle Solomon ‍ ‍ a sharp decline in 2016, the incidence of primary remained stable in 2017–2019 at 4.1–4.9 cases per 1000 QUADRIVALENT HUMAN post-­onset of COVID-19 symptoms, three person-­years. Findings indicate a signif- showed persistent HIV-1 RNA detection PAPILLOMAVIRUS (HPV) icant treatment-­as-­prevention effect for (median HIV-1 RNA 2.0 copies/mL). SUBSTANTIALLY REDUCES THE RISK OF HCV among MSM with HIV. Persistent Given the small sample size, data are to INVASIVE CERVICAL HCV incidence in the DAA era points to be considered preliminary. Larger studies Randomised controlled trials show that ongoing HCV transmission networks and are needed. human papillomavirus (HPV) vaccination indicates that other prevention strategies Peluso MJ, Bakkour S, Busch MP, et is protective against HPV infection, genital are needed, including increased HCV al. A high percentage of people with and high-­grade precancerous cervical testing, prompt initiation of DAA therapy, 1 HIV on antiretroviral therapy expe- lesions. However, such trials cannot eval- and reducing behaviours associated with rience detectable low-level­ plasma uate vaccine effectiveness against inva- HCV acquisition. HIV-1 RNA following sive due to a long lead Smit C, Boyd A, Rijnders BJA, et al. Disease 2019 (COVID-19). Clin Infect time. This Swedish registry-based­ cohort HCV micro-­elimination in individuals Dis 2020;ciaa1754. doi:10.1093/cid/ study followed up 1.7 million women with HIV in the Netherlands 4 years after ciaa1754. aged 10–30 years without previous HPV universal access to direct-acting­ antivi- vaccination or invasive cervical cancer rals: a retrospective cohort study. Lancet from 2006 to 2017. The adjusted risk of ANOGENITAL WARTS ARE A RISK HIV 2021;8:e96–105. doi:10.1016/ cervical cancer among women who were FACTOR FOR ANAL CANCER AMONG S2352-3018(20)30301-5. vaccinated before 17 years of age was 88% PEOPLE WITH HIV lower than among those who had never The incidence of anal cancer and associ- been vaccinated. These findings support PENICILLIN SHORTAGES ASSOCIATED ated mortality are on the rise, especially the effectiveness of the quadrivalent HPV WITH INCREASED INCIDENCE OF among high-risk­ groups,2 and a better vaccine in conferring protection against CONGENITAL (CS) understanding of risk factors is warranted. invasive cervical cancer. CS has potentially devastating sequelae In this cohort study of 6515 adults with Lei J, Ploner A, Elfström KM, et al. HPV and can be prevented with a single dose HIV (72% male) enrolled in 2011–2017, vaccination and the risk of invasive cervical of prenatal benzathine penicillin (BP). 383 (6%) developed anogenital warts over cancer. N Engl J Med 2020;383:1340–8. This ecological study analysed incidence 1781 person-­years of follow-­up. The inci- doi:10.1056/nejmoa1917338. of CS in Rio de Janeiro (2013–2017) at dence of anal cancer was 4.4% among the neighbourhood level. The data were those with a diagnosis of warts, compared related to the benzathine penicillin supply COVID-19 MAY MODULATE with 0.3% among those without a diag- (BPS), using a scale where ≥1 represented http://sti.bmj.com/ VIROLOGICAL HIV SUPPRESSION nosis (adjusted OR 12.79, 95% CI 6.19 DURING ANTIRETROVIRAL THERAPY adequate supply and 0–0.99 represented a to 26.45). A nadir CD4 of <200/μL was shortage. The average CS incidence rate (ART) also a (aOR 5.73, 95% CI 2.18 was 19.6 cases per 1000 live births and The marked effects of SARS-CoV­ -2 on to 15.10). The findings strengthen the the average BPS was 0.81 during the study immunity and suggest that evidence that people with HIV who have period. Penicillin shortages were associ- COVID-19 may influence HIV control anogenital warts have an elevated risk for ated with increased incidence of neonatal despite effective ART. This US study used on September 28, 2021 by guest. Protected copyright. anal cancer and emphasise the importance syphilis (RR=2.17, 95% CI 1.13 to 4.18), a single-copy­ HIV-1 RNA assay to inves- of HPV vaccination in people with HIV. highlighting the importance of ensuring tigate 12 individuals sampled a median of Arnold JD, Byrne ME, Monroe AK, adequate drug supply as part of the CS 37 days post-­onset of COVID-19 symp- et al. The risk of anal carcinoma after prevention arsenal. toms and 17 individuals whose plasma anogenital warts in adults living with Ueleres Braga J, Araujo RS, Souza ASS samples were collected prior to the HIV. JAMA Dermatol 2021;e205252. de. The shortage of benzathine penicillin COVID-19 pandemic. The proportion doi:10.1001/jamadermatol.2020.5252. and its impact on congenital syphilis inci- with detectable plasma HIV-1 RNA was dence: an ecologic study in the city of Rio 83% in the COVID-19 group (median de Janeiro. Clin Infect Dis 2020;72:e79– HIV-1 RNA 1.6 copies/mL) and 59% in SIGNIFICANT BUT INCOMPLETE 87. doi:10.1093/cid/ciaa1716 the pre-­COVID-19 group. Among four IMPACT OF UNRESTRICTED ACCESS individuals retested a median of 75 days TO DIRECT-ACTING ANTIVIRALS (DAAS) ON (HCV) STI EDITOR’S CHOICE: MENTAL HEALTH 1Institute for Global Health, University College London, INFECTION AND REINFECTION AMONG INTERVENTION DOES NOT London, UK INCREASE HELP-SEEKING BEHAVIOUR 2 MSM WITH HIV Saw Swee Hock School of Public Health, National This large retrospective study evaluated IN AT-RISK MSM University Singapore, Singapore 3Infection & Population Health, Mortimer Market the incidence of primary HCV infection MSM are at increased risk of STIs and 3 Centre, London, UK and HCV reinfection after spontaneous mental disorders. As psychosocial issues or treatment-­induced clearance among may influence sexual risk behaviour, Correspondence to Dr Marina Daskalopoulou, Institute for Global Health, University College London, HIV-diagnosed­ men who have sex with psychosocial issue identification, referral London, UK; m.​ ​daskalopoulou@ucl.​ ​ac.uk​ men (MSM) in the Netherlands, following and management might reduce risk

174 Daskalopoulou M, et al. Sex Transm Infect May 2021 Vol 97 No 3 Perspectives Sex Transm Infect: first published as 10.1136/sextrans-2020-054855 on 16 April 2021. Downloaded from behaviour. This Dutch clinic-based,­ have sex with men at risk for sexually Sex Transm Infect 2021;97:174–175. open-­label randomised trial used vali- transmitted : The syn.​ ​bas.​in doi:10.1136/sextrans-2020-054855 dated questionnaires to screen MSM on randomised controlled trial. Sex Transm ORCID iDs multiple psychosocial domains, revealing Infect 2021;97:11–7. doi:10.1136/ Marina Daskalopoulou http://orcid.​ ​org/0000-​ ​0001-​ a high prevalence of problems related sextrans-2020–054438. 9927-0358​ to mental health and substance use. A Rayner Kay Jin Tan http://orcid.​ ​org/0000-​ ​0002-9188-​ ​ 3368 total of 155 individuals were randomly Handling editor Anna Maria Geretti Danielle Solomon http://orcid.​ ​org/0000-​ ​0003-4177-​ ​ assigned to receive either a tailored Twitter Marina Daskalopoulou @drdaska and Danielle 1832 session of face-­to-­face feedback, advice Solomon @df_solomon and referral, or no intervention. There Competing interests None declared. REFERENCES was no difference between groups in 1 Arbyn M, Xu L, Simoens C, et al. Prophylactic Provenance and peer review Not commissioned; vaccination against human papillomaviruses to prevent the primary outcome of self-­reported internally peer reviewed. and confirmed help-­seeking behaviour. cervical cancer and its precursors. Cochrane Database © Author(s) (or their employer(s)) 2021. No commercial Syst Rev 2018;5:CD009069. Other interventions are needed to re-­use. See rights and permissions. Published by BMJ. 2 Hoff PM, Coudry R, Moniz CMV. Pathology of anal support mental well-being­ in at-risk­ cancer. Surg Oncol Clin N Am 2017;26:57–71. MSM populations. 3 Mercer CH, Prah P, Field N, et al. The health and well-­ Achterbergh RCA, Van Rooijen MS, being of men who have sex with men (MSM) in Britain: evidence from the third national survey of sexual Van Den Brink W, et al. Enhancing help-­ To cite Daskalopoulou M, Tan RKJ, Solomon D. attitudes and lifestyles (Natsal-3). BMC Public Health seeking behaviour among men who Sex Transm Infect 2021;97:174–175. 2016;16:525. http://sti.bmj.com/ on September 28, 2021 by guest. Protected copyright.

Daskalopoulou M, et al. Sex Transm Infect May 2021 Vol 97 No 3 175