Pre-exposure prophylaxis program in the Community of Madrid: Two years of experience.

INTRODUCTION: Pre-exposure prophylaxis (PrEP) against the human immunodeficiency virus (HIV) is an effective and safe preventive measure. However, it has not reached all target users who could benefit from it. The study aimed to understand the sociodemographic, clinical and behavioral baseline characteristics of PrEP users. As a secondary objective, the use of concomitant medication and drug consumption were described. METHODOLOGY: Observational, retrospective and descriptive study of the sociodemographic, clinical and behavioral characteristics of the users who were included in the PrEP program of the Community of Madrid during the first two years of experience. RESULTS: Two thousand two hundred fifty-six PrEP users were included, 99.0% men, with a mean age of 36.9 years (SD 8.68). 33.1% presented a sexually transmitted infection (STI) on the first visit, highlighting chlamydiasis and rectal gonococci. 70.4% reported using drugs associated with sex, and 42.4% participated in chemsex sessions in the last 3 months. A high percentage of users with concomitant medication was observed (37.6%), highlighting drugs related to mental health and alopecia. CONCLUSIONS: A multidisciplinary approach is required to cover all the needs of PrEP users, including mental health evaluation measures and addiction treatment with the clinical approach.

Encuesta de recursos diagnósticos de las ITS en España / Survey of diagnostic resources for STI in Spain

Introducción: Hay escasa información sobre los recursos disponibles tanto en las consultas como en el laboratorio para hacer frente a las infecciones de transmisión sexual (ITS). El objetivo es describir y conocer la realidad de las consultas y laboratorios que atienden las ITS en España. Métodos: Estudio observacional transversal con obtención de datos mediante una encuesta dirigida a los miembros del Grupo de ITS de la SEIMC (GEITS). Resultados: Se obtuvieron respuestas de 24 centros (tasa de respuesta, 38,1%) pertenecientes a 10comunidades autónomas. Respecto a las consultas de ITS, el 38% precisan que el paciente presente tarjeta sanitaria para proporcionar asistencia, y un 31,8% solo la prestan mediante derivación de otro médico. El 52,4% realizan métodos diagnósticos en la propia consulta. El 18,2% de los laboratorios no ofrecen pruebas diagnósticas de respuesta inmediata, aunque el 100% disponen de PCR frente a Neisseria gonorrhoeae y Chlamydia trachomatis, el 47,8% frente a Mycoplasma genitalium y el 65% detectan genotipos del linfogranuloma venéreo. El 20% realizan técnicas de detección molecular de resistencias antimicrobianas. Todos los laboratorios realizan cultivo y técnicas de sensibilidad a gonococo. Conclusiones: Existe una gran variabilidad en las dotaciones de medios humanos y materiales en las consultas y en los laboratorios que atienden ITS. En un número importante de centros existen limitaciones para el acceso de los pacientes. Todos los laboratorios disponen de técnicas de biología molecular y detectan la infección de N.gonorrhoeae mediante PCR y cultivo, lo que permite la realización de pruebas de sensibilidad en todos los centros.(AU)

Background: Scarce information is available on the resources to deal with the Sexually Transmitted Infections (STIs), both in the clinic and in the laboratory. The objective is to describe and know the reality of the clinics and laboratories that treat these infections in Spain. Methods: Cross-sectional observational study with data collection through a survey aimed at the members of the GEITS Group. Results: Responses were obtained from 24 centers (response rate 38.1%) belonging to 10Autonomous Communities. Regarding STI consultations, 38% require that the patient present a health card to provide assistance, and 31.8% only provide it by referral from another doctor. The 52.4% perform diagnostic methods in the care center. Regarding laboratories, 18.2% do not offer immediate response diagnostic tests, although 100% have PCR against Neisseria gonorrhoeae and Chlamydia trachomatis, 47.8% against Mycoplasma genitalium and 65% detect lymphogranuloma venereum genotypes. All laboratories continue to perform culture and gonococcal sensitivity techniques, and 20% perform molecular methods for detection of MG antimicrobial resistance. Conclusion: There is great variability in the provision of human and material resources both in the clinics and in the laboratories that attend STIs. In a significant number of centers there are limitations for patient access. Although laboratories have molecular biology technologies, not all of them offer immediate response tests. All laboratories detect N.gonorrhoeae infection by PCR and also by culture, which allows sensitivity testing in all centers.(AU)

Hepatitis C: nuevos diagnósticos y seroconversiones en una clínica de infecciones de transmisión sexual en Madrid / Hepatitis C: New diagnosis and seroconversions in a Madrid sexually transmitted diseases clinic

OBJETIVO: El objetivo es evaluar las nuevas infecciones por el virus de la hepatitis C (VHC) en función de su orientación sexual, situación serológica respecto al virus de la inmunodeficiencia humana (VIH), región geográfica de origen y la coinfección con otras infecciones de transmisión sexual (ITS). MATERIAL Y MÉTODOS: Estudio realizado en el Centro Sanitario Sandoval clínica de referencia de ITS en Madrid. Se incluyeron todas las personas seronegativas al VHC que fueron reanalizadas para este virus, entre enero de 2010 y diciembre de 2016. RESULTADOS: Se diagnosticaron 59 nuevos diagnósticos de infección por el VHC. La proporción de hombres que tienen sexo con hombres (HSH) dentro de los nuevos diagnósticos fue del 37% en 2010 y del 75% en 2016 y, fue aún mayor, en el grupo de coinfectados por el VIH/VHC (94%). Se detectaron 67 seroconvertores al VHC (1,2%). El 100% eran HSH. El 89% de los seroconvertores al VHC eran seropositivos para el VIH. CONCLUSIONES: La infección por el VHC sigue siendo un problema de salud vigente, especialmente en colectivos de riesgo, como los HSH seropositivos para el VIH

INTRODUCTION: The aim of this study was to evaluate the incidence of new hepatitis C virus (HCV) infections, based on their sexual orientation, human immunodeficiency virus (HIV) status, geographical regions and coinfection with other sexually transmitted diseases (STDs). MATERIAL AND METHODS: This study was carried out at the Sandoval Health Center, reference clinic of Sexually Transmitted Diseases (STDs) in Madrid. All HCV seronegative individuals who were reanalyzed for this virus were included, between January 2010 and December 2016. RESULTS: A total of 59 new diagnoses of HCV were diagnosed. The proportion of men who have sex with men (MSM) diagnosed with HCV was 37% in 2010 and 75% in 2016 and was even higher in the group of coinfected with HIV/HCV (94%). A total of 67 seroconverters for HCV were detected (1.2%) of which 100% were MSM. The proportion of HCV seroconverters with HIV was 89%. CONCLUSIONS: HCV infection continues to be a current health problem, especially in HIV-positive MSM

Jóvenes y VIH. Conocimientos y conductas de riesgo en un grupo de residentes en España / Young people and HIV. Knowledge and risk behaviours in a group of residents in Spain

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¿A quién proponer la profilaxis preexposición al virus de la inmunodeficiencia humana? / To whom is HIV pre-exposure prophylaxis proposed?

INTRODUCCIÓN: La profilaxis preexposición (PrEP) al VIH consiste en administrar fármacos antirretrovirales a personas negativas para el VIH con prácticas de riesgo. El objetivo del estudio fue describir las características de los serconvertores recientes al VIH para conocer el perfil de los candidatos a quienes proponer PrEP. MÉTODOS: Estudio descriptivo de todos los pacientes diagnosticados de VIH durante 2014, con serología negativa documentada en los 12 meses previos. Se pasó un cuestionario estructurado para conocer características sociodemográficas, conductuales y clínicas, y se realizó despistaje de otras ITS. RESULTADOS: El 98,4% de los 61 seroconvertores recientes eran hombres que tenían sexo con hombres, de 20 a 39 años (88,5%), con antecedentes de ITS (80,3%) y múltiples parejas con las que mantenían sexo sin preservativo (82,7%), bajo el efecto de drogas recreativas (87%). CONCLUSIONES: Evaluar el riesgo para el VIH de los pacientes seronegativos permite identificar a los candidatos idóneos a quienes proponer la PrEP

INTRODUCTION: HIV Pre-Exposure Prophylaxis (PrEP) consists of administering antiretroviral drugs to seronegative individuals with high risk practices. The aim of the study was to describe the characteristics of recent seroconverted HIV patients in order to determine the profile of the appropriate candidates for PrEP. METHODS: A descriptive study of all patients diagnosed with HIV infection in 2014, and who had achieved a documented negative serology over the previous 12 months. A specific form was completed to determine the sociodemographic, behavioural, and clinical features, with complementary tests being performed for other sexually transmitted infections. RESULTS: Almost all (98.4%) of the 61 recent seroconverted were men who have sex with men, and aged between 20 to 39 years (88.5%). They also had a background of sexually transmitted infections (80.3%), performed multiple and unprotected sexual practices (82.7%), and under the effect of recreational drugs (87%). CONCLUSIONS: The evaluation of the risk factors for HIV infection in seronegative patients should enable the appropriate candidates for PrEP to be identified