Entity

Time filter

Source Type


Verhaegh-Haasnoot A.,Infectious Diseases and Environmental Health | Dukers-Muijrers N.H.T.M.,Infectious Diseases and Environmental Health | Dukers-Muijrers N.H.T.M.,Maastricht University | Hoebe C.J.P.A.,Infectious Diseases and Environmental Health | Hoebe C.J.P.A.,Maastricht University
BMC Infectious Diseases | Year: 2015

Background: Male sex work in the western countries has changed, including now a subculture of male sex workers who have paid sex with men arranged for via the internet. The men involved in this subculture do not easily identify themselves as sex workers nor as homosexual, and are therefore missed by regular health care and public health interventions. These male sex workers may form a hidden key population for sexually transmitted infections (STIs) and HIV, bridging towards other persons outside this context. Methods: This clinic-based observational study included consultations by male sex workers (n = 212), female sex workers (n = 801) and in men having sex with men who did not report being paid for sexual contacts (MSM, n = 2703) who received STI and HIV testing and counselling at our clinic during the study period. In this study we compare the consultations in male sex workers to those in in female sex workers and MSM. Demographic characteristics and sexual behaviour of the male sex workers, female sex workers and MSM were compared using chi-square tests and non-parametric tests. Using univariate and multivariate regression analyses, determinants for STI positivity in male sex workers were evaluated. Results: Male sex workers tested positive for STI (including HIV) in 40 % of the consultations; female sex workers and MSM respectively in 9 and 14 % of the consultations. A new HIV infection was found in 8 % of the consultations of male sex workers. Male sex workers were a young population of migrant sex workers from Eastern Europe. They reported more often to also have sex contacts with women and other sex workers. Male sex workers are at a higher risk for one or more new STI than female sex workers and other MSM, even after correction for age, ethnicity, known HIV positivity and behavioural variables. Conclusions: Male sex workers form a hidden key population that impacts the transmission of STI and HIV within the MSM population and, possibly, to the heterosexual population. They require specific targeted interventions. Although targeting male sex workers is labour intensive it is feasible and important to reduce STI transmission. © 2015 Verhaegh-Haasnoot et al. Source


Hoebe C.J.P.A.,Infectious Diseases and Environmental Health | Hoebe C.J.P.A.,Maastricht University | Vermeiren A.P.A.,Infectious Diseases and Environmental Health | Dukers-Muijrers N.H.T.M.,Infectious Diseases and Environmental Health | Dukers-Muijrers N.H.T.M.,Maastricht University
Vaccine | Year: 2012

Because non-response (<10IU/l anti-HBs) after revaccination for hepatitis B occurs frequently (50%), this study aimed to provide evidence for a more effective revaccination regimen by comparing four different revaccinations: (1) three revaccinations with Engerix-B® (n=201); (2) one revaccination with Engerix-B® (n=37); (3) one revaccination with HBVaxPro-40® (n=108); (4) one revaccination with Fendrix® (n=39). The level of anti-HBs antibodies was determined with the AXSYM-MEIA system (Abbott, Chicago, USA). Using linear and logistic regression, the efficacy (antibody response) after the four revaccinations was compared. Analyses were corrected for age, sex, primary titre and time lag between last revaccination and the titre measurement. The height of the primary titre independently predicted antibody response. Compared to the revaccination scheme using three Engerix-B® doses, revaccination with a single dose of HBVaxPro-40® or Fendrix® performed significantly better. The use of these highly potent vaccines should be considered when revaccinating hepatitis B vaccine non-responders. © 2012 Elsevier Ltd. Source


Vermeiren A.P.A.,Infectious Diseases and Environmental Health | Hoebe C.J.P.A.,Infectious Diseases and Environmental Health | Hoebe C.J.P.A.,Maastricht University | Dukers-Muijrers N.H.T.M.,Infectious Diseases and Environmental Health | Dukers-Muijrers N.H.T.M.,Maastricht University
Journal of Clinical Virology | Year: 2013

Background: Hepatitis B virus infection is a major health problem. Although non-response is known to increase with age, hepatitis B vaccinations are considered to have only minor non-response rates (anti-HBs. <. 10. IU/L) in healthy subjects. Objectives: The aim of this study was to quantify immunosenescence in a large retrospective cohort of 11,439 healthy adults who received HBV immunisation according to the standard vaccination regime. Study design: We evaluated the response to the standard three-dose vaccination regimen, consisting of 20-μg doses of the HbsAg recombinant DNA hepatitis B vaccine, among 11,439 healthy employees using a retrospective cohort design. Logistic regression was applied to predict the non-response rate, and multivariate regression analysis was applied to predict antibody response. Predictors of responsiveness included sex, age and time between the last vaccination and antibody titre measurement. Results: From the age of 29 on in men and 43 on in women, more than 5% of subjects did not respond. Compared with women, men had a higher risk of non-response and exhibited a steeper decline in antibody titres produced with increasing age. Conclusions: This retrospective cohort study demonstrates that immunosenescence starts at young age, especially among men, underlining the importance of vaccination at a young age to achieve long-lasting immunity. Moreover, HBV vaccination should always include testing for antibodies to facilitate the performance of necessary interventions to prevent long-term fatal complications. © 2013 Elsevier B.V. Source


Dukers-Muijrers N.H.T.M.,Infectious Diseases and Environmental Health | Dukers-Muijrers N.H.T.M.,Maastricht University | Morre S.A.,VU University Amsterdam | Morre S.A.,Maastricht University | And 5 more authors.
PLoS ONE | Year: 2012

Current test-of-cure practice in patients with Chlamydia trachomatis (Ct) infection is to confirm cure with a single test taken at least 3 weeks after treatment. Effectiveness of single-time-point testing however lacks a scientific evidence basis and the high sensitivity of laboratory assays nowadays in use for this purpose may compromise the clinical significance of their results. Prospectively following 59 treated Ct infections, administering care as usual, the presence of Ct plasmid DNA and rRNA was systematically assessed by multiple time-sequential measurements, i.e. on 18 samples taken per patient during 8 weeks following treatment with a single dose of 1000 mg Azythromycin. A high proportion (42%) of Ct infections tested positive on at least one of the samples taken after 3 weeks. Patients' test results showed substantial inter-individual and intra-individual variation over time and by type of NAAT used. We demonstrated frequent intermittent positive patterns in Ct test results over time, and strongly argue against current test-of-cure practice. © 2012 Dukers-Muijrers et al. Source


Spauwen L.W.L.,Infectious Diseases and Environmental Health | Niekamp A.-M.,Infectious Diseases and Environmental Health | Niekamp A.-M.,Maastricht University | Hoebe C.J.P.A.,Infectious Diseases and Environmental Health | And 3 more authors.
Sexually Transmitted Infections | Year: 2015

Objectives: Recreational drug use has been found to be associated with high-risk sexual behaviour and with sexually transmitted infections (STI). This study is the first to assess the prevalence of drug use among swingers (heterosexuals who, as a couple, practise mate swapping or group sex, and/or visit sex clubs for couples), and its association with high-risk sexual behaviour and STI. Methods: We recruited individuals who self-identified as swingers and visited our STI clinic (from 2009 to 2012, South Limburg, The Netherlands). Participants (n=289; median age 45 years; 49% female) filled in a self-administered questionnaire on their sexual and drug use behaviour while swinging, over the preceding 6 months. We assessed associations between sexual behaviour, drug use and STI diagnoses (Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), syphilis, HIV and hepatitis B) using logistic regression analyses. Results: Overall, the prevalence of CT and/or NG was 13%. No other STIs were observed. Seventy-nine percent of swingers reported recreational drug use (including alcohol and use of erectile dysfunction drugs); 46% of them reported multiple drug use. Recreational drug use excluding alcohol and erectile dysfunction drugs (reported by 48%) was associated with high-risk behaviours in men and women. Drug use was independently associated with STI in female swingers, especially those who practice group sex. Conclusions: High rates of multiple drug use, as well as risky sexual behaviour and STIs among swingers, warrant paying more attention to this key population in prevention and care, as they are a risk group that is generally underrecognised and underserved in care. Source

Discover hidden collaborations