Corsi precongressuali

RNA viruses show a great potential for genetic variation, rapid evolution and adaptation. Genetic variability may affect pathogenesis, epidemiology and the success of antiviral therapy. In the past months, several SARS-CoV-2 variants of concern (VOCs) have emerged and an intense monitoring of their circulation worldwide plays a crucial role not only in surveillance but also as part of containment and mitigation strategies. Different molecular methods to detect and characterize a specific viral variant have been developed. Many of these assays can accurately identify the variants, while others require confirmation by sequencing. Viral genetic variability is also responsible for drug resistance, a well known phenomenon in HIV infection. Despite successful antiretroviral therapy, a minority of people living with HIV (PLWH) still have difficulty in achieving and maintaining virological suppression, mainly due to HIV drug resistance, and a small group of them harbor multi-drug resistant viruses. In this scenario, the emergence of drug resistance mutations to the latest antiretroviral drugs should be carefully investigated. Nowadays, more than 90% of PLWH have undetectable viral load. ART optimization or simplification in this clinical setting can be critical, especially when previous ART history is complex or unknown. The current transition from Sanger sequencing to Next Generation Sequencing to detect archived HIV drug resistance mutations could offer novel treatment-relevant insights and improve the management of virologically suppressed patients.

The syndromic approach for the management of sexually transmitted infections (STIs) relies on the assessment of patient’s general complaints: clinical evaluation represents the best and fastest way to choose the appropriate treatment. Laboratory tests provide the correct etiologic diagnosis but turn-around times could be an issue in a clinic dedicated to PrEP care, where a high burden of STIs and heavily interconnected sexual networks require a rapid handling. Overtreatment and spread of antimicrobial resistance are additional drawbacks if microbial diagnosis is not readily available. Point-of-care diagnostics could be helpful both in hospital- and community-based services for rapid diagnosis and epidemiological monitoring of people in PrEP.

Chemsex can be defined as the use of specific drugs (chems), in a sexualized context, by gay men and other men who have sex with men. Chemsex is associated with peculiar socio-cultural aspects of MSM sexuality. Chems use also varies in different geographical areas according to availability, affordability or other circumstances. Initially three substances only have been named as chems. Other substances now are added to chems. Chemsex adds ritual aspects, often driven by dating networks, to MSM sexual behavior. It is a complex phenomenon that involves different areas and can have different impact on different people and require different approaches. There is a need for more information about substances and how to reduce risks associated with their use, while for more problematic aspects (social, behavioral, psychologic, psychiatric, and medical), a therapeutic group’s experience - supervised by a psychotherapist – can be an opportunity to cope with abuse.