INCIDENCE AND RISK FACTORS FOR SEXUALLY TRANSMITTED DISEASES FOLLOWING SOLID ORGAN TRANSPLANT, HEMATOPOIETIC STEM CELL TRANSPLANTATION, AND CAR T-CELL THERAPY
Author(s)
Yihua Lee, MPH1, CHIA-YU CHIU, MD2;
1UT Austin College of Pharmacy, Student, Austin, TX, USA, 2University of Colorado, Denver, CO, USA
1UT Austin College of Pharmacy, Student, Austin, TX, USA, 2University of Colorado, Denver, CO, USA
OBJECTIVES: To estimate the incidence of sexually transmitted diseases following solid organ transplant, hematopoietic stem cell transplantation, and CAR T-cell therapy, and to identify demographic and clinical factors associated with post-transplant infection risk.
METHODS: We conducted a retrospective cohort study using the TriNetX Research Network, a global federated database comprising over 100 million patients, queried in December 2024. Adult recipients of SOT, HSCT, or CAR T-cell therapy were included. Patients with HIV infection or documented sexual dysfunction were excluded. Outcomes included the incidence of post-transplant STDs (chlamydia, gonorrhea, syphilis, and trichomonas) and associated demographic and clinical risk factors. Multivariable Cox proportional hazards models were used to evaluate factors associated with post-intervention STD risk.
RESULTS: The study included 244,612 SOT recipients, 57,077 HSCT recipients, and 1,438 CAR T-cell therapy recipients. Overall incidence of post-transplant STDs was low: 4 per 100,000 recipients for chlamydia, 17 for gonorrhea, 150 for syphilis, and 53 for trichomonas. In multivariable analyses, male sex and increasing age were associated with lower risk. Higher risks were observed among Black and Hispanic recipients, individuals with medical comorbidities, urinary tract infection symptoms, urogenital disorders, and those with a history of STDs prior to transplant or immune intervention. The median time from transplant or immune intervention to STD diagnosis was 493 days (interquartile range, 77-1,256).
CONCLUSIONS: In this large, multi-center cohort, post-transplant STD incidence was extremely low but mirrored demographic and clinical risk patterns seen in the general population. Clinicians should remain attentive to sexual health, particularly among recipients presenting with urinary or urogenital symptoms or a prior STD history. These findings underscore the importance of routine sexual health discussions in all patients, including those who have undergone life-saving transplant or CAR T-cell therapy.
METHODS: We conducted a retrospective cohort study using the TriNetX Research Network, a global federated database comprising over 100 million patients, queried in December 2024. Adult recipients of SOT, HSCT, or CAR T-cell therapy were included. Patients with HIV infection or documented sexual dysfunction were excluded. Outcomes included the incidence of post-transplant STDs (chlamydia, gonorrhea, syphilis, and trichomonas) and associated demographic and clinical risk factors. Multivariable Cox proportional hazards models were used to evaluate factors associated with post-intervention STD risk.
RESULTS: The study included 244,612 SOT recipients, 57,077 HSCT recipients, and 1,438 CAR T-cell therapy recipients. Overall incidence of post-transplant STDs was low: 4 per 100,000 recipients for chlamydia, 17 for gonorrhea, 150 for syphilis, and 53 for trichomonas. In multivariable analyses, male sex and increasing age were associated with lower risk. Higher risks were observed among Black and Hispanic recipients, individuals with medical comorbidities, urinary tract infection symptoms, urogenital disorders, and those with a history of STDs prior to transplant or immune intervention. The median time from transplant or immune intervention to STD diagnosis was 493 days (interquartile range, 77-1,256).
CONCLUSIONS: In this large, multi-center cohort, post-transplant STD incidence was extremely low but mirrored demographic and clinical risk patterns seen in the general population. Clinicians should remain attentive to sexual health, particularly among recipients presenting with urinary or urogenital symptoms or a prior STD history. These findings underscore the importance of routine sexual health discussions in all patients, including those who have undergone life-saving transplant or CAR T-cell therapy.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH100
Topic
Epidemiology & Public Health
Disease
SDC: Infectious Disease (non-vaccine), SDC: Reproductive & Sexual Health