Syphilis
Patients With HIV May Have High Prevalence Of Long COVID
Although the association between HIV and long COVID was inconclusive, the prevalence of long COVID in patients with HIV was high.
The prevalence of long COVID was high in patients living with HIV, according to a review published in eClinicalMedicine.1 Further research is needed to establish the association between HIV and long COVID in these patients.
The World Health Organization (WHO) has defined long COVID as experiencing symptoms of COVID-19 for at least 12 weeks after first contracting the virus without an alternative diagnosis. Shortness of breath, cognitive impairment, and fatigue are among the more common symptoms of long COVID. Approximately 39 million people live with HIV in the world, all of whom are more susceptible to long-term infection due to a weakened immune system.2 Although patients with HIV who are receiving antiretroviral therapy had reduced risk of poor outcomes of COVID-19, the effects of long COVID in patients with HIV remains understudied. This review aimed to collect data on prevalence of long COVID in patients living with HIV.
The researchers used EMBASE, MEDLINE, CINHAL, PubMed, and CENTRAL to search for studies to populate their review. All databases were searched from their inception through June 14, 2024. Studies that included adults living with HIV with a COVID-19 infection were included in the review. Adults who were not living with HIV were used as a comparator group. The prevalence of long COVID and the odds of long COVID in adults living with HIV acted as the primary outcomes.
Patients with HIV had a high prevalence of long COVIDImage credit: RAJCREATIONZS - stock.Adobe.Com
There were 8 studies included in this review, of which 3 were from Europe, 2 were from North America, 2 were from Africa, and 1 was from Asia. The median (IQR) number of participants was 267 (94-383). The median age of the participants was 50 (45-51) years and the mean (SD) percentage of women included was 35% (23%) overall. Participants who were previously diagnosed with COVID-19 were included in most of the studies.
The prevalence estimates of the 8 studies were synthesized to estimate the prevalence of long COVID in adults living with HIV, with 6 studies using the 12-week cut off as defined by WHO and 2 studies using a 4-week cut off. The prevalence of long COVID in adults living with HIV was estimated to be 43% (95% CI, 32% to 54%). Sensitivity analysis found similar results with a high heterogeneity. When only using the studies that included the 12-week cut off, the prevalence remained consistent at 42% (95% CI, 27% to 58%).
The association between HIV and long COVID was only assessed in 4 of the included studies. This cohort of participants had a median age of 45 (41-49) years and had a mean percentage of women of 34% (25%). The 12-week cut off was used in all studies to define long COVID. The results of this analysis were inconclusive with an estimated OR of 1.16 (95% CI, 0.58-2.29) for the association between HIV and long COVID. When adjusting for confounding factors, the odds of an adult with HIV developing long COVID increased (OR, 2.21; 95% CI, 1.12-4.36). The certainty of evidence was rated low for both analyses.
There were some limitations to this review. The generalizability of the results may be limited due to the demographics of the included studies, as most of the participants were virally suppressed and were part of surveillance cohorts. CD4 counts in the included participants were also higher than the healthy cut off, which did not allow for evaluating patients with low CD4 counts and their association with poor health outcomes. Sex and gender were also hard to collect due to unclear definitions.
The researchers concluded that "prevalence of long COVID in adults living with HIV could be high (43%)." However, further research is needed to establish the relationship between HIV and long COVID as well as addressing long COVID in patients living with HIV.
References
Signs And Symptoms Of STIs In Men
In some cases, sexually transmitted infections (STIs) cause no noticeable symptoms. When they do occur, STI symptoms in males can include discharge, bleeding, painful blisters, and more.
Knowing the signs and symptoms of STIs can be important. Early treatment can help prevent complications and prevent the infection from spreading to others.
STIs often cause no noticeable symptoms, so it is possible to have one without knowing it. It may also be easy to mistake STI symptoms for those of another issue.
A note about sex and genderSex and gender exist on spectrums. This article will use the terms "male," "female," or both to refer to sex assigned at birth. Click here to learn more.
Chlamydia is a bacterial STI that passes from person to person through anal, oral, or vaginal sex without a condom or other barrier method. In a male, chlamydia can develop in the urethra, rectum, or throat.
Some call chlamydia a "silent" infection because people are often unaware that they have it. The majority of these infections in males cause no symptoms.
If symptoms do occur in males, they arise several weeks after the infection develops.
Common symptoms of chlamydia in the urethra include:
Chlamydia in the rectum is less common and usually causes no symptoms, but it can cause:
Oral chlamydia is generally asymptomatic, but may cause a sore throat.
Treatment
Treating chlamydia involves antibiotics. It may involve taking a single dose or a 7-day course of an antibiotic. Repeat infections are common so it is a good idea to have another test after completing the treatment.
Men's health resourcesFor more research-backed information and resources, visit our dedicated men's health hub.
Herpes is an infection with the herpes simplex virus (HSV). There are two types of the virus, and they tend to affect different parts of the body:
Many people with herpes have no symptoms, and others may have difficulty identifying their symptoms. Mild herpes blisters can resemble insect bites, ingrown hairs, or razor burn.
If they do arise, the symptoms typically appear 2 days to 3 weeks after exposure to the infection.
Common symptoms of herpes in males include:
Treatment
There is no cure for herpes, and outbreaks of symptoms can reoccur over time. Treatments focus on managing the symptoms and extending the time between outbreaks.
Gonorrhea is an infection with Neisseria gonorrhoeae bacteria. It often develops in the urethra, rectum, or throat, and the bacteria can transmit through vaginal, anal, or oral sex without a condom.
Most males with gonorrhea have no symptoms. When gonorrhea in the urethra does cause symptoms, they usually appear within a week after the infection has developed.
Symptoms of gonorrhea in the urethral area in males include:
Symptoms of a rectal infection may include:
Treatment
Healthcare professionals can treat gonorrhea with antibiotics. These can stop the infection from progressing, but they cannot reverse any damage already done.
For this reason, anyone with symptoms of the infection or likely exposure to it should see a healthcare professional for testing right away.
The medical community is becoming increasingly concerned about the rise of antibiotic-resistant gonorrhea. This resistance makes successful treatment much more difficult, if not impossible.
Bacteria are also responsible for syphilis, which transmits through vaginal, anal, or oral sex without a condom or other barrier method. It can also transmit through contact with an infected area.
Men who have sex with men (MSM) have a higher risk of contracting syphilis. According to WHO, 7.5% of MSM have syphilis compared to 0.5% of males in the general population.
Many people with primary syphilis do not notice symptoms. When symptoms do occur, they usually appear 10 to 90 days after infection, with 21 days being the average.
The symptoms of syphilis progress in stages known as primary, secondary, latent, and tertiary. Each stage has its own unique set of symptoms that can last for weeks, months, or even years.
The symptoms of primary syphilis include:
Secondary syphilis can cause the following signs and symptoms:
The latent, or "hidden," stage of syphilis, during which there are no visible symptoms, can last for several years.
Tertiary syphilis is very rare. It can cause severe health complications that affect multiple organ systems. The symptoms of tertiary syphilis include:
Treatment
A healthcare professional may recommend an antibiotic called benzathine penicillin G to treat primary, secondary, and early latent syphilis. People who are allergic to penicillin will need to use a different antibiotic, such as doxycycline or ceftriaxone.
Although antibiotics will prevent the infection from progressing, they cannot repair any permanent damage resulting from the infection.
HPV generally does not cause any symptoms. However, it can cause serious health issues even without symptoms.
According to the Centers for Disease Control and Prevention (CDC), 9 out of 10 cases of HPV clear on their own within 2 years without any adverse health issues. When it does not go away on its own, it can cause issues, such as warts or even certain types of cancer.
The type of HPV that causes warts is not linked with cancer, however.
Individuals should speak with a healthcare professional if they notice the following symptoms around their genitals, mouth, or throat:
HPV can spread without penetrative sex. It can also spread through skin-to-skin contact with infected areas and sharing sex toys.
Treatment
There is no specific treatment for the HPV virus. However, treatment is available for the health issues it can cause. For example, genital warts are treatable with prescription medications.
HPV can also be preventable through getting vaccinated. The CDC recommends all children between the ages of 11 and 12 years old receive 2 doses of the HPV vaccine. If an individual is between the ages of 19 and 26, and has not received the vaccine, they can speak to their healthcare professional about getting it.
HIV is a virus that attacks the body's immune cells. It spreads through some, but not all, bodily fluids, including semen, vaginal and anal fluids, and blood.
The most common methods of transmission in the U.S. Are through anal or vaginal sex, or sharing needles, syringes, or other drug-related equipment.
Many people with HIV experience flu-like symptoms within 2 to 4 weeks of developing the infection and may be mild or difficult to distinguish from conditions like the common cold. Common symptoms of HIV in males are:
Other symptoms may include:
Treatment
While there is no cure for HIV, treatments can prevent symptoms and transmission. They can also keep the infection from progressing to stage 3 HIV (AIDS).
The treatments are called antiretroviral therapy, and they reduce the amount of the virus in the body. When the amount is so low that a test cannot detect it, this eliminates the risk of transmitting HIV.
Hepatitis is inflammation of the liver, often due to a viral infection. One of the most common hepatitis viruses is the hepatitis B virus (HBV). It can pass on through blood, semen, and some other bodily fluids.
Healthcare professionals classify each HBV infection as either acute, meaning that it is temporary and will last for a few weeks and resolve on its own, or chronic, in which case it is a severe, long term condition.
Most people with hepatitis B have no symptoms. People with symptoms may easily mistake them for those of cold or flu, and they tend to appear about 90 days after the HBV infection develops.
Hepatitis B signs and symptoms include:
A vaccine can prevent hepatitis B, and the WHO recommends that all infants receive 2 to 3 doses of this vaccine.
Treatment
There is currently no treatment for acute hepatitis B. Medications can treat chronic hepatitis B, and research in this area is ongoing.
People with chronic hepatitis B need regular checkups for signs of liver disease.
STIs often cause no symptoms in males.
Many STIs are treatable, and almost all are preventable.
People can prevent STIs by using barrier protection, such as condoms or dental dams, during sex. Also, vaccines can prevent some strains of HPV and hepatitis B.
Anyone who is sexually active and believes they may have ben exposed to an STI should seek medical attention.
New Report Shows Link Between Ending HIV And Upholding Human Rights
KAMPALA, UGANDA - DECEMBER 01: A group of Ugandan citizens create the symbol of AIDS, a ribbon, by ... [+] standing and holding lit candles within the events of December 1 World AIDS Day in Kampala, Uganda on December 01, 2022. (Photo by Nicholas Kajoba/Anadolu Agency via Getty Images)
Anadolu Agency via Getty ImagesIn January 2021, European Union representatives gathered in Accra, Ghana to celebrate the opening of a new local community center. The venue was designed to be a haven for LGBTQIA+ individuals, many of whom were silently battling HIV in a country where being gay is now a crime.
Weeks later, the building was stormed by the Ghana Police Service and the center shuttered.
"The police may have raided our office and closed it down but the real office is in our hearts, and minds," Alex Kofi Donkor, the Center's founder wrote on Facebook. Since the raid, Donkor has channeled his advocacy in other ways while the Ghanaian government continues its crackdown on LGBTQIA+ individuals.
Donkor's story, and the plight of LGBTQIA+ individuals battling HIV, is one of many stories highlighted in the new Joint United Nations Programme on HIV/AIDS (UNAIDS) report titled "Take The Rights Path To End AIDS" urging leaders to combat HIV by protecting human rights.
Here are some of the report's most important findings and what they could mean for the fight against AIDS, a disease which claims one life every minute.
The Nexus Between Human Rights & HIVThe new year is always a time for optimism, so first, let's start with some good news. The resources that are available today to fight AIDS are better than ever. HIV acquisition rates are now at their lowest point since the late 1980s. And not only are fewer people contracting the virus, fewer people are dying. In 2023, AIDS-related deaths reached their lowest level since 2004.
Despite this remarkable progress, the world is off track to achieve its goal of ending AIDS as a public health threat by 2030. Millions of people annually continue to miss out on life-saving testing, treatment, and care that are essential to stamping out the epidemic. According to the new report, addressing this problem requires an acknowledgement of the connection between health and human rights.
After World War II, measures including the United Nations-led Universal Declaration of Human Rights ushered in new efforts to promote global human rights. Between 1970 and 2020, the number of people living in global poverty fell by 80% while the average global life expectancy rose by 16 years. However, in recent years, we've seen many governments turn away from prioritizing human rights.
Experts warn that prohibitive laws are exacerbating existing gaps in the HIV/AIDS response, imperiling our hopes for an AIDS-free future. There are now at least 67 countries with laws criminalizing same-sex relations between consenting adults, according to the Human Rights Watch. Stigma and discrimination towards people who inject drugs are hindering access to HIV treatment. And globally, women have only 75% of the legal rights as men, making it harder for them to make their own health decisions.
LGBTQIA+ CommunityIn 2023, Uganda passed one of the harshest anti-LGBTQIA+ laws in the world. The country is one of thirty African nations that have laws overtly penalizing this community. These measures have had an adverse impact on the HIV fight.
After Uganda passed its anti-homosexuality law, the country experienced a drop in the availability of HIV services. Beyond Uganda, one study in sub-Saharan Africa showed HIV prevalence is 500% higher in countries that criminalize same-sex relations. And a study of 194 countries revealed that people are less likely to know their status and are less likely to be virally suppressed in countries where same-sex sexual acts are criminalized.
In recent decades, advancements in testing and treatment have transformed HIV/AIDS from a death sentence to a manageable, treatable condition. But innovation can only do so much to end the threat of AIDS so long as injustice exists.
"I know the feeling of shame and what it can do. As long as HIV is seen as a disease for the 'others', not so-called 'decent people', AIDS will not be beaten" wrote musician Elton John, who founded the Elton John AIDS Foundation, in the report. "Science, medicine and technology may be the 'what' in ending AIDS, but inclusion, empathy and compassion are the 'how'."
Women & GirlsToo often are women denied equal access to healthcare services. Nearly half of all women between the ages of 15-49 who are married or in a union are unable to make their own sexual and reproductive health decisions. As a result, in 22 eastern and southern African countries, HIV prevalence among adolescent girls and young women is 300% higher than their male counterparts.
One of the ways to address this problem is through schooling. Education puts girls and young women on a stronger path to economic opportunity and financial independence, making it one of the best tools available to fight AIDS. Young women and girls with higher school attendance and education levels are less likely to contract HIV. But according to the United Nations, 130 million girls are denied access to education.
The report cites additional investments in women-led networks as necessary to ensure women and girls have full access to HIV-related services. Efforts to educate boys and men about their role in promoting safe-sex and pushing back against harmful gender norms are also essential.
"Upholding the rights of women and girls is vital because gender is an inextricable aspect of HIV," Irish President Michael D. Higgins wrote in the report. "Gender inequality and poor respect for the human rights of women and girls are key factors in the HIV epidemic, from the point of view of effectiveness and from the perspective of social justice."
People Who Inject DrugsWhen Adeeba Kamarulzaman, a professor of medicine and infectious diseases at Monash University was getting her medical training in Australia, she encountered many people with HIV, but few had acquired the virus by injecting drugs. When she began practicing medicine in Malaysia, she found the opposite to be true. The difference, she says, was that Australia treated drug use as a public health epidemic while Malaysia applied punitive laws that kept people from accessing harm reduction services that can help protect them from acquiring HIV.
"The evidence is clear. Without protecting everyone's human rights, we will not be able to end AIDS as a public health threat," Kamarulzaman wrote in the report. "Protecting public health requires that we leave no one behind, understanding that none of us is safe and secure until all of us are. It is not for us to judge others but to take care of each other."
Research suggests there is a better, more empathetic path forward. Studies have shown that safe needle exchange programs have proven effective at lowering-HIV transmission. Community-led dialogues with law enforcement can reduce police-instigated violence and harassment. And non-incarceration alternatives can also help curtail HIV infections and overdoses.
Why It MattersThe UNAIDS report concludes more HIV funding should go to the populations who are most at risk of acquiring the virus. The organization recommends a target of roughly 20% of HIV resources going to key populations in low- and middle-income countries. Currently, only less than 3% of HIV spending is directed toward prevention programs for these key groups.
By 2050, Africa's population is expected to nearly double to 2.5 billion people. Nearly one in three people will live in Africa in 2100. The window for ending the threat of AIDS is finite. And prohibitive and punitive laws continue to hinder humanity's hope for an AIDS-free future.
"Despite huge progress made in the HIV response, human rights violations are still preventing the world from ending AIDS," said Winnie Byanyima, the Executive Director of UNAIDS. "To protect everyone's health, we need to protect everyone's rights."
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