Incidence of sexually transmitted infections and association with behavioural factors: Time-to-event analysis of a large pre-exposure prophylaxis (PrEP) cohort.

OBJECTIVES: Our objective was to obtain long-term data on the incidence of sexually transmitted infections (STIs) and their association with behavioural factors after widespread pre-exposure prophylaxis (PrEP) implementation. METHODS: This was a time-to-event analysis of a national PrEP cohort in Switzerland (SwissPrEPared study). Participants were people without HIV interested in taking PrEP with at least two STI screening visits. Primary outcomes were incidence rate of gonorrhoea, chlamydia, and syphilis. The association between behavioural factors and STI diagnosis was expressed using hazard ratios. We adjusted for testing frequency and calendar year. RESULTS: This analysis included 3907 participants enrolled between April 2019 and April 2022, yielding 3815.7 person-years of follow-up for gonorrhoea (15 134 screenings), 3802.5 for chlamydia (15 141 screenings), and 3858.6 for syphilis (15 001 screenings). The median age was 39 years (interquartile range [IQR] 32-47), 93.8% (n = 3664) identified as men who have sex with men (MSM). The incidence was 22.8 (95% confidence interval [CI] 21.3-24.4) per 100 person-years for gonorrhoea, 26.3 (95% CI 24.7-28.0) for chlamydia, and 4.4 (95% CI 3.8-5.1) for syphilis. Yearly incidence rates decreased between 2019 (all bacterial STIs: 81.6; 95% CI 59.1-109.9) and 2022 (all bacterial STIs: 49.8; 95% CI 44.6-55.3). Participants reporting chemsex substance use were at higher risk of incident STIs, as were those reporting multiple sexual partners. Younger age was associated with a higher risk of gonorrhoea and chlamydia. CONCLUSIONS: Incidence rates of bacterial STIs decreased over time. Young MSM, those with multiple partners, and those using chemsex substances were at increased risk of STIs.

Changes in mental and sexual health among MSM using HIV pre-exposure prophylaxis during the SARS-CoV-2 pandemic: longitudinal analysis of the SwissPrEPared cohort study.

BACKGROUND: Changes in mental and sexual health among men having sex with men (MSM) due to the SARS-CoV-2 pandemic remain unclear. METHODS: Design: Longitudinal analysis of an ongoing, multicentre, pre-exposure prophylaxis (PrEP) cohort (NCT03893188) in Switzerland. Participants: HIV-negative MSM aged ≥18 who completed at least one questionnaire before and one after the start of the SARS-CoV-2 pandemic. Outcomes: Primary: mental health, defined as anxiety and depression scores assessed by the Patient Health Questionnaire-4. Secondary: sexual behaviour, well-being, PrEP use and disruption of care. Outcomes were assessed over seven periods corresponding to different SARS-CoV-2 prevention measures in Switzerland. We performed pairwise comparisons between periods (Wilcoxon signed rank test). RESULTS: Data from 1,043 participants were included. Whilst anxiety scores remained stable over time, depression scores worsened in the second wave and the second lockdown period compared to pre-pandemic scores. This was confirmed by pairwise comparisons (pre-SARS-CoV-2/second wave and pre-SARS-CoV-2/second lockdown: p <0.001). Downward trends in sexual activity,sexualized substance use, and a switch from daily to "event-driven" PrEP were found. Disruption of care affected 42.6% (790/1856) of daily PrEP users' follow-up visits. CONCLUSION: In this longitudinal analysis of a PrEP cohort enrolling MSM, depression scores worsened in the second wave and the second lockdown compared to the pre-pandemic period.

Repetitive tactile stimulation changes resting-state functional connectivity-implications for treatment of sensorimotor decline.

Neurological disorders and physiological aging can lead to a decline of perceptual abilities. In contrast to the conventional therapeutic approach that comprises intensive training and practicing, passive repetitive sensory stimulation (RSS) has recently gained increasing attention as an alternative to countervail the sensory decline by improving perceptual abilities without the need of active participation. A particularly effective type of high-frequency RSS, utilizing Hebbian learning principles, improves perceptual acuity as well as sensorimotor functions and has been successfully applied to treat chronic stroke patients and elderly subjects. High-frequency RSS has been shown to induce plastic changes of somatosensory cortex such as representational map reorganization, but its impact on the brain's ongoing network activity and resting-state functional connectivity has not been investigated so far. Here, we applied high-frequency RSS in healthy human subjects and analyzed resting state Electroencephalography (EEG) functional connectivity patterns before and after RSS by means of imaginary coherency (ImCoh), a frequency-specific connectivity measure which is known to reduce over-estimation biases due to volume conduction and common reference. Thirty minutes of passive high-frequency RSS lead to significant ImCoh-changes of the resting state mu-rhythm in the individual upper alpha frequency band within distributed sensory and motor cortical areas. These stimulation induced distributed functional connectivity changes likely underlie the previously observed improvement in sensorimotor integration.

How ongoing neuronal oscillations account for evoked fMRI variability.

Variability of evoked single-trial responses despite constant input or task is a feature of large-scale brain signals recorded by fMRI. Initial evidence signified relevance of fMRI signal variability for perception and behavior. Yet the underlying intrinsic neuronal sources have not been previously substantiated. Here, we address this issue using simultaneous EEG-fMRI and real-time classification of ongoing alpha-rhythm states triggering visual stimulation in human subjects. We investigated whether spontaneous neuronal oscillations-as reflected in the posterior alpha rhythm-account for variability of evoked fMRI responses. Based on previous work, we specifically hypothesized linear superposition of fMRI activity related to fluctuations of ongoing alpha rhythm and a visually evoked fMRI response. We observed that spontaneous alpha-rhythm power fluctuations largely explain evoked fMRI response variance in extrastriate, thalamic, and cerebellar areas. For extrastriate areas, we confirmed the linear superposition hypothesis. We hence linked evoked fMRI response variability to an intrinsic rhythm's power fluctuations. These findings contribute to our conceptual understanding of how brain rhythms can account for trial-by-trial variability in stimulus processing.

Oscillatory brain states interact with late cognitive components of the somatosensory evoked potential.

The question of interaction between ongoing neuronal activity and evoked responses has been addressed for different species, sensory systems and measurement modalities. Among other findings, there is converging evidence for an interaction of occipital alpha-rhythm amplitude with the visual evoked potential. Here, we test the hypothesis that the modulatory role of an ongoing rhythm might not be confined to the visual system and the occipital alpha rhythm, but instead may be generalized to other sensory systems. Using an online EEG analysis approach, we investigated the influence of the Rolandic alpha-rhythm on the somatosensory evoked potential (SEP). We triggered vibrotactile stimulation during periods of high Rolandic alpha-rhythm amplitude. Analysis revealed significant effects of pre-stimulus Rolandic alpha amplitude on the amplitude of the N140 and P260 components of the SEP, known to be linked to cognitive processing, but not on early sensory components. The N140-P260 complex shows a different focus in topography than the early sensory components and the pre-stimulus Rolandic alpha rhythm. These results indicate an involvement of Rolandic alpha-rhythm in higher cognitive processing. In more general terms--and in the context of similar studies in the visual system--our findings suggest that modulation of late EP components by ongoing rhythms might be a characteristic and possibly universal feature of sensory systems.