{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:21:56Z","timestamp":1789676516156,"version":"4.0.1"},"reference-count":30,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["T32 DA007250"],"award-info":[{"award-number":["T32 DA007250"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K01 AI122853"],"award-info":[{"award-number":["K01 AI122853"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kaiser Permanente Northern California Community Benefit Grant"},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["K24 AA025703"],"award-info":[{"award-number":["K24 AA025703"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U01 AA021997"],"award-info":[{"award-number":["U01 AA021997"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2019,8,12]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:sec>\n<jats:title>Objectives<\/jats:title>\n<jats:p>People with HIV (PWH) have a high burden of bacterial sexually transmitted infections (STIs). We examined the relationship of alcohol and drug use and partner pre-exposure prophylaxis (PrEP) use to STI prevalence in a cohort of PWH with a history of unhealthy alcohol use.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We analysed data from a primary care-based alcohol intervention study at Kaiser Permanente Northern California (KPNC). Participants were recruited between April 2013 and May 2015 and were followed for up to 24 months. We linked participant responses to questions from the 24\u2009month follow-up interview, including alcohol and drug use and partner PrEP use, with STI test results (ie, syphilis, chlamydia, gonorrhoea) in the KPNC electronic health record. Prevalence ratios (PR) were estimated using Poisson models fitted with robust variance estimators to evaluate the association of substance use and partner use of PrEP with STIs.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>In the analytic sample (n=465), the median age was 52 years (IQR 45\u201359); 67% were white; 95% were men who have sex with men. Thirty-two per cent of participants had HIV-positive partners only; 31% had HIV-negative partners with at least one on PrEP in the previous year and 37% had HIV-negative partners without any on PrEP. Twenty-three per cent reported alcohol and drug use prior to sex in the last 6\u2009months. Eight per cent of participants had an STI. Partner PrEP use (adjusted PR (aPR) 2.99 (95% CI 1.11 to 8.08)) was independently associated with higher STI prevalence. Participants who reported use of alcohol (aPR 1.53 (0.61 to 3.83)), drugs (aPR 1.97 (0.71 to 5.51)) or both (aPR 1.93 (0.75 to 4.97)) prior to sex had a higher STI prevalence.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The higher prevalence of STIs among PWH with unhealthy alcohol use who have partners on PrEP suggests that this subgroup may be a high-yield focus for targeted outreach, STI screening and sexual health counselling.<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/sextrans-2019-054049","type":"journal-article","created":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T21:25:25Z","timestamp":1566595525000},"page":"184-188","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Alcohol and drug use, partner PrEP use and STI prevalence among people with HIV"],"prefix":"10.1136","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8654-8445","authenticated-orcid":false,"given":"J Carlo","family":"Hojilla","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Marcus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan E","family":"Volk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Leyden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C Bradley","family":"Hare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rulin C","family":"Hechter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E Jennifer","family":"Edelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Silverberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek D","family":"Satre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,8,23]]},"reference":[{"key":"2024092304051569000_96.3.184.1","unstructured":"Centers for Disease Control and Prevention . Std diagnoses among key U.S. populations, 5-year trends. Available: https:\/\/www.cdc.gov\/nchhstp\/newsroom\/docs\/2018\/infographic_Experiencing-Steep-Sustained-Increases-in-STD.pdf [Accessed 1 Dec 2018]."},{"key":"2024092304051569000_96.3.184.2","unstructured":"Centers for Disease Control and Prevention . Diagnoses of HIV infection in the United States and dependent areas, 2017. Available: https:\/\/www.cdc.gov\/hiv\/pdf\/library\/reports\/surveillance\/cdc-hiv-surveillance-report-2017-vol-29.pdf [Accessed 3 Jul 2019]."},{"key":"2024092304051569000_96.3.184.3","unstructured":"Centers for Disease Control and Prevention . Sexually transmitted disease surveillance, 2017. 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Sexually transmitted infections among HIV-infected individuals in the district of Columbia and estimated HIV transmission risk: data from the DC cohort. Open Forum Infect Dis 2018;5.doi:10.1093\/ofid\/ofy017","DOI":"10.1093\/ofid\/ofy017"},{"key":"2024092304051569000_96.3.184.23","doi-asserted-by":"crossref","unstructured":"Mayer KH , Maloney KM , Levine K , et al . Sociodemographic and clinical factors associated with increasing bacterial sexually transmitted infection diagnoses in men who have sex with men accessing care at a Boston community health center (2005\u20132015). 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