Sexuallytransmitted diseases (STDs) are the most common infectious diseases worldwide, with over 350 million new cases occurring each year, and have far-reaching health, social, and economic consequences. Failure to diagnose and treat STDs at an early stage may result in serious complications and sequelae. STDs are passed from person to person primarily by sexual contact and are classified into varied groups. Some cause mild, acute symptoms and some are life-threatening. They are caused by many different infectious organisms and are treated in different ways. Syphilis and gonorrhea are ancient afflictions. Now, however, Chlamydia is prevalent and has become the most common bacterial STD. Antimicrobial resistance of several sexuallytransmitted pathogens is increasing, rendering some regimens ineffective, adding to therapeutic problems. A standardized treatment protocol for STDs is recommended to ensure that all patients receive adequate treatment. Appropriate treatment of STDs is an important public health measure. PMID:22025952
The three direct determinants of the rate of spread of sexuallytransmitted diseases (STDs) are sexual behaviors, the mean duration of infectiousness, and the mean efficiency of sexual transmission of each STD. Underlying ecological and behavioral factors that operate through one or more of these direct determinants lie on a continuum, ranging from those most proximate back to those more remote (in time or mechanism) from the direct determinants. Most remote and least modifiable are the historical stages of economic development that even today conspicuously influence patterns of sexual behavior. Next are the distribution and changing patterns of climate, hygiene, and population density; the global population explosion and stages of the demographic transition; and ongoing changes in human physiology (e.g., menarche at younger age) and culture (e.g., later marriage). More proximate on the continuum are war, migration, and travel; and current policies for economic development and social welfare. Most recent or modifiable are technologic and commercial product development (e.g., oral contraceptives); circumcision, condom, spermicide, and contraception practices; patterns of illicit drug use that influence sexual behaviors; and the accessibility, quality, and use of STD health care. These underlying factors help explain why the curable bacterial STDs are epidemic in developing countries and why the United States is the only industrialized country that has failed to control bacterial STDs during the AIDS era. PMID:8146138
Bacterial infections of the genital tract (gonorrhea, chlamydia, chancroid, syphilis) are common and cause significant morbidity. Their importance is heightened by recent appreciation of their roles in facilitation of transmission of the human immunodeficiency virus (HIV). Each is capable of causing repeated infections, suggesting lack of permanent broadly effective immunity. An effective vaccine has yet to be developed for any
P. Frederick Sparling; Christopher Elkins; Priscilla B. Wyrick; Myron S. Cohen
BackgroundSexuallytransmitted infections (STI) are a significant public health problem both worldwide and in Europe. This article reviews trends in the epidemiology of the major bacterial STI in eastern European countries, their key determinants, as well as challenges and opportunities for enhancing STI control in the region.Search strategyPublications were sought through computerised searches in PubMed from 1995 to 2008 using
... Centers for Disease Control and Prevention. Resurgent bacterialsexuallytransmitted disease among men who have sex with men — King ... al. Continuing increases in sexual risk behavior and sexuallytransmitted diseases among men who have sex with men: San ...
\\u000a Sexuallytransmitted infections (STI) constitute a major burden of disease for women globally and include bacterial infections\\u000a (syphilis, gonorrheal infection, chlamydial infection, and chancroid) and viral infections [herpes simplex virus (HSV), human\\u000a papillomavirus (HPV), and hepatitis B virus (HBV)]. Rates of STIs in developing countries, especially those in Sub-Saharan\\u000a Africa, far exceed those found in industrialized countries and STIs have
The discouraging results of early efforts to educate the public about sexuallytransmitted diseases indicated that the goals of STD preventive action must be longer term and must change attitudes and behaviour as well as educate. They must also avoid an ostrich mentality about the sexual involvement of young people. This article examines more recent approaches to teaching about sexuality in general and STD prevention in particular. PMID:21221351
Kieren, Dianne; Cumming, Ceinwen E.; Cumming, David C.
KidsHealth > Teens > Sexual Health > STDs & Other Infections > About SexuallyTransmitted Diseases (STDs) Print A A A Text Size What's ... STDs Spread Preventing and Treating STDs More Information Sexuallytransmitted diseases (STDs) are infectious diseases that spread from person ...
We hypothesized that neighborhoods with drug markets, as compared to those without, have a greater concentration of infected sex partners, i.e. core transmitters, and that in these areas, there is an increased risk environment for STIs. This study determined if neighborhood drug markets were associated with a high-risk sex partnership and, separately, with a current bacterial STI (chlamydia and/or gonorrhea) after controlling for individual demographic and sexual risk factors among a household sample of young people in Baltimore City, MD. Analyses also tested whether links were independent of neighborhood socioeconomic status. Data for this study were collected from a household study, systematic social observations and police arrest, public health STI surveillance and U.S. census data. Nonlinear multilevel models showed that living in neighborhoods with household survey-reported drug markets increased the likelihood of having a high-risk sex partnership after controlling for individual level demographic factors and illicit drug use and neighborhood socioeconomic status. Further, living in neighborhoods with survey-reported drug markets increased the likelihood of having a current bacterial STI after controlling for individual level demographic and sexual risk factors and neighborhood socioeconomic status. The results suggest that local conditions in neighborhoods with drug markets may play an important role in setting-up risk environments for high-risk sex partnerships and bacterial STIs. Patterns observed appeared dependent on the type of drug market indicator used. Future studies should explore how conditions in areas with local drug markets may alter sexual networks structures and whether specific types of drug markets are particularly important in determining STI risk. PMID:22386616
Jennings, Jacky M.; Taylor, Ralph B.; Salhi, Rama A.; Furr-Holden, C.Debra M.; Ellen, Jonathan M.
Sexuallytransmitted infections (STIs), also referred to as sexuallytransmitted diseases, remain a growing worldwide problem and public health issue. This article covers the epidemiology of STIs, the history and physical findings, screening guidelines, and the general plan to combat STIs. Prevention is discussed using the latest information from the Centers for Disease Control and Prevention and other references. Infections discussed from the standpoint of cause, epidemiology, risk factors, clinical disease, diagnosis, and treatment include gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, syphilis, chancroid, Herpes simplex, lymphogranuloma venereum, granuloma inguinale, Herpes papilloma virus, Molluscum contagiosum, and pubic lice. PMID:23958358
... STDs) Share Compartir Prevention How You Can Prevent SexuallyTransmitted Diseases This page includes information about STD prevention, testing, ... 4636) TTY: (888) 232-6348 Contact CDC–INFO SexuallyTransmitted Diseases Diseases & Related Conditions STDs & Infertility Other STDs Archive ...
The SexuallyTransmitted Disease Surveillance System presents statistics and trends for sexuallytransmitted diseases (STDs). Data demonstrate details which provide information about STD morbidity in the United States, STD prevalence with subgroups and populations which are the f...
Find links to various topics below: CDC = Center for Disease Control and Prevention CDC- A-Z Index CDC- Diesease and Conditions writeInsertLink('projectBody','CDC- Diesease and Conditions'); CDC - HIV/AIDS STDs CDC - HIV Basic Information CDC - HIV - LInks to other resources CDC - STD Picture Cards Herpes-Coldsores Kids Health MedlinePlus - SexuallyTransmitted Diseases Teen Health Wellness real life real answers ...
This study explored the relationship between the social organization of neighborhoods including informal social control and social cohesion and a current bacterialsexuallytransmitted infection (STI) among adolescents and young adults in one U.S. urban setting. Data for the current study were collected from April 2004 to April 2007 in a cross-sectional household study. The target population included English-speaking, sexually-active persons between the ages of 15 and 24 years who resided in 486 neighborhoods. The study sample included 599 participants from 63 neighborhoods. A current bacterial STI was defined as diagnosis of a chlamydia and/or gonorrhea infection at the time of study participation. Participants reported on informal social control (i.e. scale comprised of 9 items) and social cohesion (i.e. scale comprised of 5 items) in their neighborhood. In a series of weighted multilevel logistic regression models stratified by gender, greater informal social control was significantly associated with a decreased odds of a current bacterial STI among females (AOR 0.53, 95% CI 0.34, 0.84) after controlling for individual social support and other factors. The association, while in a similar direction, was not significant for males (AOR 0.73, 95% CI 0.48, 1.12). Social cohesion was not significantly associated with a current bacterial STI among females (OR 0.85, 95% CI 0.61, 1.19) and separately, males (OR 0.98, 95% CI 0.67, 1.44). Greater individual social support was associated with an almost seven-fold increase in the odds of a bacterial STI among males (AOR 6.85, 95% CI 1.99, 23.53), a finding which is in contrast to our hypotheses. The findings suggest that neighborhood social organizational factors such as informal social control have an independent relationship with sexual health among U.S. urban youth. The causality of the relationship remains to be determined. PMID:25089964
Jennings, Jacky M; Hensel, Devon J; Tanner, Amanda E; Reilly, Meredith L; Ellen, Jonathan M
This paper summarizes what is known about, and research needs on, the transmissibility to sexually abused children of the following sexuallytransmitted diseases: gonorrhea, chlamydia trachomatis, human papillomavirus genital warts, condylomata acuminata, syphilis, bacterial vaginosis, trichomonas vaginalis, herpes simplex, and human…
According to the Centers for Disease Control and Prevention (CDC), sexuallytransmitted infections (STIs) are a group of contagious\\u000a diseases most commonly transmitted “from person to person by close, intimate contact.” Although most of this contact has traditionally\\u000a been sexual intercourse, many categories of sexual practices permit transmission from “person to person.” Vertical transmission\\u000a from mother to newborn is also
... Diseases (STDs), 2012 National Profile National Profile Chlamydia Gonorrhea Syphilis Other SexuallyTransmitted Diseases Special Focus Profiles ... Have Sex with Men Tables National Summary Chlamydia Gonorrhea Syphilis Chancroid Selected STDs Appendix Appendix Interpreting STD ...
... health policy and practice: the contribution of other sexuallytransmitted diseases to sexual transmission of HIV infection. Sex Transm ... 17. 4 Centers for Disease Control and Prevention. Sexuallytransmitted diseases treatment guidelines, 2010 ; No.59(RR-12):1- ...
... health policy and practice: the contribution of other sexuallytransmitted diseases to sexual transmission of HIV infection. Sex Transm ... 21:245-252. 3 American Social Health Association. Sexuallytransmitted diseases in America: how many cases and at what ...
Adolescents and young adults continue to have the highest rates of sexuallytransmitted diseases. New chlamydia and gonorrhea\\u000a diagnostic tests are being used in innovative ways to increase the number of infections that are detected. Nevertheless, challenges\\u000a such as gonorrhea resistance and partner notification and treatment continue to hinder efforts to reduce the prevalence of\\u000a these two bacterial infections. Although
The link between different methods of contraception and the risk of acquiring sexuallytransmitted infections (STIs) raises several questions. Do the risks differ according to type of STI? Which methods reduce the risk of acquiring STIs and which, if any, increase the risk? How should people use such information when choosing a method of contraception? These questions have major public
Objective: Sexuallytransmitted infections (STIs) remain a public health problem of major significance in most parts of the world. This study aimed to detect the most prevalent pathogens in patients with signs and symptoms of STI referring to a group of university clinics in Tehran. Materials and methods: In this cross-sectional study using randomized cluster sampling, 507 consecutive male and
This contribution considers links between different methods of contraception and the risk of acquiring sexuallytransmitted infections (STIs). This is a major public health issue, because STIs cause a huge disease burden that affects women disproportionately. Worldwide each year, there are 340 million new cases of curable STIs in 15–49-year-olds. In developing countries, STIs, even excluding HIV, are second only
Prevention of sexuallytransmitted diseases (STDs) is a low priority among travel clinic services, despite increasing evidence that travelers have an increased risk of acquiring such infections. A proportion of 5%-50% of short-term travelers engage in casual sex while abroad, and this rate is even higher among long-term travelers. Few publications are available on STD preventive interventions among travelers. Education
Sexuallytransmitted infections (STI) occur during pregnancy and can have serious consequences for women and infants. National guidelines include recommendations for STI screening in all pregnant women; however women continue to be underscreened, and risks related to infection during pregnancy persist. Nurses caring for women of childbearing age should be aware of screening guidelines and approaches for testing. This column reviews two recent studies: The first examines compliance with recommended prenatal STI testing and the second highlights a novel concept to reduce the female-gender-specific approach to STI testing during pregnancy. PMID:24548498
Sexuallytransmitted infections (STIs) are highly prevalent and cause a wide spectrum of disease. However, the majority of these infections may be unrecognized due to lack of overt signs or symptoms of infection. Asymptomatic infections remain significant as a result of the potential for long-term sequelae, predominately in women, and the risks of complications during pregnancy as well as mother-to-child transmission. Laboratory diagnostics play an important role in identifying infection and in public health efforts to reduce the prevalence of these diseases. Serologic diagnosis is appropriate for syphilis and, in some settings, for herpes infections. However, the organisms that cause discharge such as Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium are best diagnosed using molecular assays. Currently available molecular assays are suitable for use with non-invasively collected sample types, most notably vaginal swabs for women thus expanding the potential reach of STI control programs to include non-clinic based screening. PMID:25083897
Vaginal bacterial communities are thought to help prevent sexuallytransmitted infections. Bacterial vaginosis (BV) is a common clinical syndrome in which the protective lactic acid–producing bacteria (mainly species of the Lactobacillus genus) are supplanted by a diverse array of anaerobic bacteria. Epidemiologically, BV has been shown to be an independent risk factor for adverse outcomes including preterm birth, development of pelvic inflammatory disease, and acquisition of sexuallytransmitted infections. Longitudinal studies of the vaginal microbiome using molecular techniques such as 16S ribosomal DNA analysis may lead to interventions that shift the vaginal microbiota toward more protective states. PMID:22133886
Vaginal bacterial communities are thought to help prevent sexuallytransmitted infections. Bacterial vaginosis (BV) is a common clinical syndrome in which the protective lactic acid-producing bacteria (mainly species of the Lactobacillus genus) are supplanted by a diverse array of anaerobic bacteria. Epidemiologically, BV has been shown to be an independent risk factor for adverse outcomes including preterm birth, development of pelvic inflammatory disease, and acquisition of sexuallytransmitted infections. Longitudinal studies of the vaginal microbiome using molecular techniques such as 16S ribosomal DNA analysis may lead to interventions that shift the vaginal microbiota toward more protective states. PMID:22133886
\\u000a \\u000a Chlamydia trachomatis serovars D-K and Neisseria gonorrhoeae are the major sexuallytransmitted bacteria worldwide. Genital mycoplasmas, in particular Mycoplasma genitalium, are thought to be important causes of sexuallytransmitted non-gonococcal, non-chlamydial urethritis and cervicitis, more\\u000a commonly termed, non-specific genital infection (NSGI). In tropical countries sexuallytransmitted infections also include\\u000a lymphogranuloma venereum caused by Chlamydia trachomatis serovars L1, L2 and L3,
The semen-derived enhancer of viral infection (SEVI) is a positively charged amyloid fibril that is derived from a self-assembling proteolytic cleavage fragment of prostatic acid phosphatase (PAP248-286). SEVI efficiently facilitates HIV-1 infection in vitro, but its normal physiologic function remains unknown. In light of the fact that other amyloidogenic peptides have been shown to possess direct antibacterial activity, we investigated whether SEVI could inhibit bacterial growth. Neither SEVI fibrils nor the unassembled PAP248-286 peptide had significant direct antibacterial activity in vitro. However, SEVI fibrils bound to both Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli and Neisseria gonorrhoeae) bacteria, in a charge-dependent fashion. Furthermore, SEVI fibrils but not the monomeric PAP248-286 peptide promoted bacterial aggregation and enhanced the phagocytosis of bacteria by primary human macrophages. SEVI also enhanced binding of bacteria to macrophages and the subsequent release of bacterially induced proinflammatory cytokines (tumor necrosis factor alpha [TNF-?], interleukin-6 [IL-6], and IL-1?). Finally, SEVI fibrils inhibited murine vaginal colonization with Neisseria gonorrhoeae. These findings demonstrate that SEVI has indirect antimicrobial activity and that this activity is dependent on both the cationic charge and the fibrillar nature of SEVI. PMID:23507280
Easterhoff, David; Ontiveros, Fernando; Brooks, Lauren R.; Kim, Yoel; Ross, Brittany; Silva, Jharon N.; Olsen, Joanna S.; Feng, Changyong; Hardy, Dwight J.; Dunman, Paul M.
Objectives:A population-based sexual network study was used to identify sexual network structures associated with sexuallytransmitted infection (STI) risk, and to evaluate the degree to which the use of network-level data furthers the understanding of STI risk.Methods:Participants (n = 655) were from the baseline and 12-month follow-up waves of a 2001–2 population-based longitudinal study of sexual networks among urban African–American
C M Fichtenberg; S Q Muth; B Brown; N S Padian; T A Glass; J M Ellen
The HIV epidemic has dramatically altered the field of sexuallytransmitted diseases (STDs). HIV infection is unique among sexuallytransmitted diseases because it can modify the clinical presentation and features of other STDs. Conversely, other STDs can affect the transmission of HIV. This review is the third part of a series that has provided a general overview of STDs. In
Adam Czelusta; Angela Yen-Moore; Melody Van der Straten; Daniel Carrasco; Stephen K. Tyring
Evolutionary approaches are particularly valuable for studies of sexuallytransmitted diseases. Methods for tracing evolutionary phylogenies have powerful new applications that use genetic data to trace the history of pathogens across millions of years, within outbreaks lasting years, and even within individuals. Equally valuable are less widely appreciated evolutionary methods for analyzing how host-pathogen co-evolution shapes extreme traits whose costs can be substantial. These and other applications of Darwinian medicine will improve understanding and treatment of sexuallytransmitted diseases. PMID:21824161
Despite being part of one of the few remaining primitive areas of the world, both Sabah and Sarawak are provided with adequate, though simple, urban and rural general medical services. At present no reliable data on the incidence of sexuallytransmitted diseases in these areas have been collected and no organised treatment services are available. Gonorrhoea appears to be the commonest notifiable infectious disease in Sarawak, and beta-lactamase-producing strains have been isolated. Because of the rapidly expanding economy and the encouragement of the tourist trade, sexuallytransmitted disease is likely to prove an increasing problem, for which a specialised service for diagnosis and treatment is badly needed. PMID:6895709
Sexuallytransmitted infections (STIs) are often associated with chronic diseases and can have severe impacts on host reproductive success. For airborne or socially transmitted pathogens, patterns of contact by which the infection spreads tend to be dispersed and each contact may be of very short duration. By contrast, the transmission pathways for STIs are usually characterized by repeated contacts with a small subset of the population. Here we review how heterogeneity in sexual contact patterns can influence epidemiological dynamics, and present a simple model of polygyny/polyandry to illustrate the impact of biased mating systems on disease incidence and pathogen virulence. PMID:23339239
BackgroundThe microbiome of the male urogenital tract is poorly described but it has been suggested that bacterial colonization of the male urethra might impact risk of sexuallytransmitted infection (STI). Previous cultivation-dependent studies showed that a variety of non-pathogenic bacteria colonize the urethra but did not thoroughly characterize these microbiomes or establish links between the compositions of urethral microbiomes and
David E. Nelson; Barbara van der Pol; Qunfeng Dong; Kashi V. Revanna; Baochang Fan; Shraddha Easwaran; Erica Sodergren; George M. Weinstock; Lixia Diao; J. Dennis Fortenberry; Raphael H. Valdivia
The structures of sexual networks are essential for understanding the dynamics of sexuallytransmitted infections. Standard epidemiological models largely disregard the complex patterns of intimate contacts. Social network analysis offers important insight into how to conceptualize and model social interaction and has the potential to greatly enhance the understanding of disease epidemics.
Fredrik Liljeros; Christofer R. Edling; Luis A. Nunes Amaral
This survey covers periodical literature published in the field of research on sexuallytransmitted diseases during 1985. The articles cover the following diseases: (1) genital chlamydial infection; (2) gonorrhea; (3) genital herpes infection; (4) human papillomavirus infection; (5) acquired immunodeficiency syndrome (AIDS); (6) genital…
Centers for Disease Control (DHHS/PHS), Atlanta, GA.
Women under 25 years of age have higher rates of sexuallytransmitted infections (STIs) than other populations. Providing follow-up for adolescents with an STI is especially challenging in emergency departments (EDs). In our ED, we discovered that a significant number of adolescents with an STI did not receive adequate treatment, and 25% of those with an STI who were treated
AIM: To review the epidemiology of and data collection for sexuallytransmitted diseases (STDs) in South Africa. METHODS: Literature published since 1980 on STDs in South Africa were complied and evaluated. Historical reports and salient unpublished literature were also used in the literature review. Studies were critically reviewed in the light of sample populations and study methods, and a baseline
... Affairs Teen Talk #2 Commonly Asked Questions About SexuallyTransmitted Diseases (STDs) The Basics What is an STD? STD stands for "sexuallytransmitted disease." STDs are infections that are passed from person ...
In this article, we review recent evidence indicating that people over the age of 50 years are increasingly at risk of HIV\\u000a and sexuallytransmitted infections, and that—thanks to the success of highly active antiretroviral therapies—those infected\\u000a with HIV are now living into older age. We show that health professionals and society in general have been reluctant to acknowledge\\u000a sexuality in
Sexuallytransmitted diseases (STDs) may be transmitted during sexual assault. In children, the isolation of a sexuallytransmitted organism may be the first indication that abuse has occurred. Although the presence of a sexually transmissible agent from a child beyond the neonatal period is suggestive of sexual abuse, exceptions do exist. In this review I discuss the issues of the
Older adults continue to be sexually active in their later years. A range of sexuallytransmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, and HIV have been reported among older adults. Risk factors for STIs in older populations include (a) normal sexual changes associated with aging (e.g., increased time to attain an erection, decreased vaginal lubrication, decreases in sexual hormones); (b) psychosocial changes (e.g., loss of partner or spouse and re-entering the dating scene); and (c) risky sexual behaviors, including no or infrequent use of condoms. Screening of adults for STIs should occur regardless of age based on guidelines such as those from the Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force. As discussed in this article, nurses can use assessment guides and engage in interventions such as counseling and education with older adults to reduce STI risk or refer for treatment. Numerous online resources exist for both nurses and older adults to increase knowledge of STIs. PMID:24066789
Sexuallytransmitted diseases (STD) are now the commonest group of notifiable infectious diseases in most countries, particularly in the age group of 15 to 50 years and in infants. Their control is important considering the high incidence of acute infections, complications and sequelae, their socioeconomic impact, and their role in increasing transmission of the human immunodeficiency virus (HIV). The worldwide incidence of major bacterial and viral STD is estimated at over 125 million cases yearly. STD are hyperendemic in many developing countries. In industrialized countries, the bacterial STD (syphilis, gonorrhoea, chancroid) declined from the peak during the Second World War till up to the late fifties, then increased during the sixties and early seventies, and they have been decreasing again from the late seventies till the present. In the industrialized world, diseases due to Chlamydia trachomatis, genital herpes virus, human papillomaviruses and human immunodeficiency virus are now more important than the classical bacterial ones; both groups remain major health problems in most developing countries. Infection rates are similar in both women and men, but women and infants bear the major burden of complications and serious sequelae. Infertility and ectopic pregnancies are often a consequence of pelvic inflammatory disease, and are preventable. Sexuallytransmitted diseases in pregnant women can result in prematurity, stillbirth and neonatal infections. In many areas 1-5% of newborns are at risk of gonococcal ophthalmia neonatorum, a blinding disease; congenital syphilis causes up to 25% of perinatal mortality. Genital and anal cancers (especially cervical cancer) are associated with viral sexuallytransmitted diseases (genital human papillomavirus and herpes virus infections). Urethral stricture and infertility are frequent sequelae in men. PMID:2289300
As adolescents progress through puberty, many biological changes occur and, for young women, this includes the onset of menses and the capability for reproduction. During this time, sexual identity is developed and expressions of sexuality become more frequent. Adolescent women engage in a variety of sexual behaviours, both non-coital and coital. As teens begin dating relationships, they are at risk
Sexuallytransmitted infections (STIs) have plagued humans for millennia and can result in chronic disease, pregnancy complications, infertility, and even death. Recent technological advances have led to a better understanding of the causative agents for these infections as well as aspects of their pathogenesis that might represent novel therapeutic targets. The articles in this Review Series provide excellent updates on the recent advances in understanding of the pathogenesis of some very important and persistent STIs and discuss the importance of considering each pathogen in the broader context of the environment of the individual who it infects. PMID:22133882
Sexuallytransmitted infections (STIs) are common and costly, in part because they are asymptomatic and result in serious complications. Primary care clinicians can easily diagnose and effectively treat most STIs. Clinicians should screen patients for STIs based on high-risk behaviors, and consult with local public health officials to adapt national screening guidelines to local epidemiology. Clinical encounters involving STI screening are opportunities to counsel patients on risk behaviors, and vaccinate against human papillomavirus and hepatitis B. Electronic health records and mobile phone apps show promise for improving the clinical care of STIs. PMID:24830606
There is a rising incidence of several sexuallytransmitted infections (STIs), many of which can present with proctitis. Causative organisms include Neisseria gonorrhoeae, Chlamydia trachomatis, herpes simplex virus, Treponema pallidum (syphilis), Giardia lamblia (giardiasis) and Entamoeba histolytica (amoebiasis). This paper outlines important clinical discriminators and key investigations to distinguish these organisms from non-infective pathology that include inflammatory bowel disease, solitary rectal ulcer syndrome and Behçet's syndrome. Management of these infections is described and suggestions are made for successful gastroenterology clinical consultation when an STI is suspected. PMID:23914292
Lamb, Chris A; Lamb, Elizabeth Iris Mary; Mansfield, John C; Sankar, K Nathan
Sexuallytransmitted infections (STIs) have plagued humans for millennia and can result in chronic disease, pregnancy complications, infertility, and even death. Recent technological advances have led to a better understanding of the causative agents for these infections as well as aspects of their pathogenesis that might represent novel therapeutic targets. The articles in this Review Series provide excellent updates on the recent advances in understanding of the pathogenesis of some very important and persistent STIs and discuss the importance of considering each pathogen in the broader context of the environment of the individual who it infects. PMID:22133882
Background Female sex workers (FSWs) in India are provided a standardised package of clinical interventions for management of sexuallytransmitted infections (STIs). A study was conducted among FSWs at known high STI prevalence sites to determine the effectiveness of the service package. Methods A cohort of FSW clinic attendees in two cities, Hyderabad and Mumbai, were enrolled and followed up from October 2008 to November 2009. At each visit, behavioural and clinical data were obtained and vaginal swabs collected for laboratory testing of cervical infections (gonorrhoea and chlamydia). Results 417 participants were enrolled, of whom 360 attended at least a follow-up visit. Prevalence of cervical infections did not change between the baseline and final visits (27.7% and 21.3% respectively, p=0.08) in spite of presumptive treatment at baseline and syndromic management at all visits. The proportion of asymptomatic cervical infections increased from 36% at baseline to 77% at the final visit. Incidence rate of cervical infections was high (85.6/100 person years) and associated with a prevalent cervical infection at baseline (HR=2.7, p<0.001) and inconsistent condom use with non-commercial partners (HR=2.5, p=0.014). Conclusions High rates of STIs persisted despite the interventions due to poor condom use, minimal partner treatment, and high prevalence and incidence of STIs with a large proportion of asymptomatic infections. High-prevalence FSW sites in India need to design more effective partner treatment strategies and consider increasing the frequency of presumptive treatment as a temporary measure for quickly reducing STI prevalence, with renewed emphasis on consistent condom use with all partners. PMID:23196329
Background: Estimates suggest that about 48% of nearly 19 million cases of sexuallytransmitted diseases (STDs) occurring annually in the United States are acquired by persons aged 15-24 years. The purpose of this study was to test the hypothesis that adolescents' attitudes about protecting themselves from STDs predict their laboratory-confirmed…
Around 70% of female infertility in developing countries is caused by sexuallytransmitted diseases (STDs) that can be traced back to husbands or partners. STDs and reproductive tract infections cause 750,000 deaths and 75 million illnesses among women each year worldwide, and these deaths may more than double by the year 2000. Death rates are rising fastest in Africa, followed by Asia and Latin America. About 450,000 cases of potentially fatal reproductive tract cancers are diagnosed annually: an estimated 354,000 occur in Third World women, virtually all of whom die. Worldwide, roughly 250 million new infections of chlamydia, gonorrhea, and the human papillomavirus are sexuallytransmitted each year. Chlamydia and the human papillomavirus account for 50 million and 30 million new cases per year, respectively. The human immunodeficiency virus (HIV) infected 1 million people worldwide between April and December 1991, according to the World Health Organization. A study in the Indian state of Maharashtra revealed that 92% of the 650 rural women examined had an average of 3.6 infections of gynecological type or sexuallytransmitted type per women. Another study in 2 rural Egyptian villages found that half of 509 nonpregnant women aged 20 to 60 years had infections. Only 2 facilities for the diagnosis and treatment of STDs exist in all of Kenya. In Ibadan, Nigeria, with a population of 2 million, there is only 1 recognized STD clinic. The physical consequences of several STDs have been linked to increased risks of AIDS transmission. Early recognition and treatment of STDs in pregnant women would cut infant mortality. Maternal infections with chlamydia, gonorrhea, or herpes are transferred to infants at birth 25% to 50% of the time. In Africa, infant blindness caused by gonorrhea infection is 50 times more common than in industrial countries. The International Women's Health Coalition's March 1992 meeting of more than 50 Third World scientists, health advocates, and policymakers made suggestions to make universally available simple, inexpensive, rapid diagnostic tests for STDs and to develop vaginal microbicides that protect women against STDs. PMID:12159277
Objectives: To describe the prevalence of sexuallytransmitted infection (STIs) in a sample of women who have sex with women (WSW) and to identify risk factors for the acquisition of STI.Method: Cross sectional survey. Questionnaire for demographic, sexual history, and sexual practice data linked with the results of genitourinary examination. 708 new patients attending two sexual health clinics for lesbians
Sexuallytransmitted diseases (STDs) are a major public health problem now compounded by the advent of AIDS and HIV infection. The size of the problem represented by STDs and HIV is unknown however it is estimated that there are 333 million new cases of STD per annum and currently 15-20 million people infected worldwide with HIV. Control programmes for STDs must prevent the acquisition of STDs, their complications and sequelae and interrupt and reduce transmission. They can also reduce the incidence of HIV infection. Such programmes must place emphasis on health education, condom usage, altering health seeking behaviour and providing case management. The syndromic approach currently offers the most realistic, and cost effective, way in which to treat patients. Images PMID:8698372
We study the susceptible-infected-susceptible (SIS) epidemic model on bipartite graph. According to the difference of sex conception in western and oriental nations, we construct the Barabási Albert-Barabási Albert (BA-BA) model and Barabási-Albert Homogeneity (BA-HO) model for sexuallytransmitted diseases (STDs). Applying the rate equation approach, the positive equilibria of both models are given analytically. We find that the ratio between infected females and infected males is distinctly different in both models and the infected density in the BA-HO model is much less than that in the BA-BA model. These results explain that the countries with small ratio have less infected density than those with large ratio. Our numerical simulations verify these theoretical results.
Sexuallytransmitted diseases of insects: distribution, evolution, ecology and host behaviour) ABSTRACT Sexuallytransmitted diseases (STDs) of insects are known from the mites, nematodes, fungi have been reported. Whereas nearly all vertebrate STDs are viruses or bacteria, the majority of insect
Introduction to HIV, AIDS and SexuallyTransmitted Infection Surveillance Overview of the HIV in collaboration with: The World Health Organization (WHO), Department of HIV/AIDS, Geneva, Switzerland the World Diseases, AIDS and SexuallyTransmitted Diseases (ASD) Unit, Cairo, Egypt the World Health Organization
A condom skills educational program emphasizing how to use a condom was presented to groups of patients waiting to be seen in a public health sexuallytransmitted disease clinic. Compared to controls, patients exposed to the intervention were approximately half as likely to return within the subsequent 12 months with a new sexuallytransmitted disease. Other predictors of reinfection included
Sexuallytransmitted infections (STIs) are more dynamic than other diseases prevailing in the community. Their epidemiological profile varies from country to country and from one region to another within a country, depending upon ethnographic, demographic, socioeconomic and health factors. The clinical pattern is also a result of the interaction among pathogens, the behaviours that transmit them and the effectiveness of preventive and control interventions. We reviewed the changing patterns of different STIs (excluding HIV infection) in India and their various risk factors. A MEDLINE search was undertaken using the key words 'sexuallytransmitted infections, epidemiology, India'. Related articles were also searched. In addition, a manual search for many Indian articles, published in journals that are not indexed was also carried out. Wherever possible, the full article was reviewed. If the full article could not be traced, the abstract was used. Most of the published data are institution based. There is a paucity of community-based data, except for information obtained from high risk groups such as commercial sex workers, truck drivers, hotel workers and drug abusers. From the literature search undertaken, it was observed that during the 1960s and 1970s, bacterial infections including syphilis, chancroid and gonorrhoea were the major STIs, while viral infections caused by herpes simplex virus and human papillomavirus were so rare that they merited publication as case reports. Since the 1980s, the spread of human immunodeficiency virus (HIV) with subsequent behavioural (sexual and healthcare) change, the indiscriminate and prophylactic use of over-the-counter broad-spectrum antibiotics, upgradation of health services at the primary level and the success of 'syndromic' approach of treatment, has resulted in major changes in epidemiological patterns. As in developed countries, there has been a rise in viral and chlamydial infections and a relative fall in the incidence of traditional infections. This has forced a reappraisal of the importance of sexual and healthcare behaviours, since the control of incurable viral STIs depends to a great extent on societal efforts at primary prevention and counselling rather than their early diagnosis and treatment, which is an effective strategy against curable bacterial STIs. PMID:15736552
The relationship between sexual abuse and sexuallytransmitted disease (STD) represents an important and underinvestigated context of domestic violence. This study examined the association between sexual abuse, sexual risk behaviors, and risk for reinfection and HIV among minority women with STD. Mexican American and African American women (n = 617) with active STD entered a randomized study of behavioral intervention to reduce STD recurrence. Each underwent questioning at entry regarding sexual abuse and sexual risk behaviors. Comparisons of these behaviors using chi-square, t tests, and logistic regression were made by history of sexual abuse. Sexually abused women were more likely to have lower incomes, earlier coitus, STD history, currently abusive partners, new sex partners, anal sex, and bleeding with sex, placing them at increased risk for STD reinfection and HIV. Due to this association with sexual risk behavior, assessment for sexual abuse is essential in programs focusing on STD/HIV prevention. PMID:11291429
Sexuallytransmitted diseases (STDs) have shown a considerable resurgence in recent years both in number of cases and in spread of new infectious agents. The spread of STDs is favored by numerous factors including the liberalization of sexual behavior made possible by reliable contraception. Information on STDs has not been widely diffused. Changes in the status of women and the development of means of communication and transportation have encouraged less rigid control of sexual behavior. STDs themselves have often escaped diagnosis or not been cured despite treatment, increasing the risk of spread. Numerous organisms cause STDs, from external parasites to life-threatening viruses. 60% of upper genital tract infections that can lead to sterility, tubal alterations, ectopic pregnancy and pain result from STDs. Chlamydia infections are insidious and chronic, and cause greater damage with each recurrence. The risk of STDs should be considered in contraceptive choice along with other indications and contraindications. Combined oral contraceptives provide protection against acute upper genital tract infections. The protective role has been explained by scanty and highly viscous cervical mucus forming a barrier against germs and by reductions of menstrual flow, myometrial activity, and inflammation. It is actually uncertain whether combined oral contraceptives protect against latent chlamydia infections, since higher rates of cervicitis caused by chlamydia have been found in pill users. In situations carrying risk of STDs, pill users should be protected by a supplementary barrier method. IUDs have been implicated in numerous studies in acute pelvic infections. Possible explanations are the local trauma and inflammations due to the physical presence of the IUD, more abundant bleeding, absence of a cervical barrier to motile sperm that could be a vector for germs, and possible ascent of the infectious agent on the string. Other risk factors are involved. Epidemiologic studies indicate that the spermicides benzalkonium chloride and nonoxynol 9 have a protective effect against gonococcus, trichomonas, and chlamydia as well as cervical cancer. The protection is not absolute and is associated with the use of barrier methods. Condoms provide an excellent barrier against gonorrhea, chlamydia, cytomegalovirus, herpes, hepatitis B, and HIV infection. Use of spermicides may increase protection even more. PMID:12342583
Sexuallytransmitted diseases (STDs) cause infertility in nearly half of all women in parts of Africa. In addition to the personal cost of divorce and ostracism that African women may face, the public health repercussions are both serious and widespread. To deal with this problem, 16 STD experts from Africa, Europe, and the US met to develop a priority list for research and control of STDs in Africa. The most common STDs in Africa are gonorrhea, chlamydia, and syphilis. Other problems are papillomavirus, chancroid, lymphogranuloma, venereum, and Acquired Immune Deficiency Syndrome (AIDS). Africa's STD victims frequently do not go to doctors for treatment but instead buy antibiotics or get injections at a pharmacy. The infections often persist even though the symptoms may disappear. This self-treatment has contributed to the emergence of new strains of gonorrhea that resist penicillin and are difficult and expensive to treat. Additionally, the governments of Africa cannot afford to buy the more expensive antibiotics needed to combat the resistant strains of gonorrhea and require the assistance of international agencies to identify, treat, and control penicillin-resistant gonorrhea. Other costs are related to individuals' reduced ability to work. The magnitude of the problem is unknown because many STD victims are unaware they are infected and do not enter into official health care systems and statistics. The conference participants identified the need to integrate STD and family planning services as a priority. PMID:12268488
More than 42 million people worldwide are now infected with HIV, in spite of sustained prevention activities. Although the spread of HIV has been primarily sexual, epidemiological studies have indicated that the efficiency of the spread of HIV is poor, perhaps as infrequently as 1 in every 1,000 episodes of sexual intercourse. However, sexuallytransmitted diseases (STDs) that cause ulcers
The bacterialsexuallytransmitted infections (STIs) syphilis, gonorrhoea and chlamydia can all be cured with a single dose of antibiotic. Unfortunately, however, these infections often remain undiagnosed as many infected individuals have few if any symptoms. Diagnostic tests with high sensitivity and specificity are available for all three infections but, owing to their expense and the lack of laboratory capacity,
Rosanna W. Peeling; David Mabey; Alan Herring; Edward W. Hook
Background Violence against women has been associated with subsequent risky sexual behaviors and sexuallytransmitted infections. We explored whether sexual coercion or violence at first intercourse was associated with self-reported sexuallytransmitted infections (STIs). Methods Using nationally representative data from the 2006–2010 National Survey of Family Growth, we analyzed female respondents ages 18–44 (n=9,466) who answered questions on coercion at first intercourse (wantedness, voluntariness and types of force used) and STIs using logistic regression analyses. We explored degrees of coercion, which we label as neither, sexual coercion (unwanted or nonphysical force), or sexual violence (involuntary or physical force). Results Eighteen percent of US women reported sexual coercion and 8.4% experienced sexual violence at first intercourse. Compared with women who experienced neither, the odds of reporting a STI was significantly greater for women who experienced sexual coercion (OR: 1.27, 95% CI: 1.01–1.60), after controlling for all variables. The association between sexual violence at first intercourse and STIs (OR: 1.20, 95% CI: 0.91–1.57) appeared to be attenuated by subsequent sexual violence. Conclusions Understanding that women who reported a variety of coercive sexual experiences are more likely to have contracted an STI may indicate a need to focus on the broader continuum of sexual violence to fully understand the impact of even subtle forms of violence on women’s health. In addition, focusing on subsequent sexual behaviors and other negative consequences remains important in order to improve the sexual health of women who have experienced coercive sexual intercourse. PMID:24275726
Williams, Corrine M.; Clear, Emily R.; Coker, Ann L.
This commentary on a paper (EC 619 276) about the transmissiblity of sexuallytransmitted diseases in sexually abused children discusses two issues: (1) determining if a child is infected with a sexuallytransmitted disease (STD) agent; and (2) determining if the child's STD was acquired from the mother before or during the birth process through…
Summary These guidelines for the treatment of patients who have sexuallytransmitted diseases (STDs) were developed by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 19-21, 2005. The information in this report updates the 2002 Guidelines for Treatment of SexuallyTransmitted Diseases (MMWR 2002;51(No. RR- 6)). Included in
Provision of sexuallytransmitted disease (STD) care for sexually active adolescents has been neglected in developing countries, although this is changing. Available evidence indicates that STDs are a serious problem among adolescents (10–19 years), especially in rural areas where services are limited for any age group. Curative care is hampered by the inadequacy of the syndromic approach for identifying adolescents
The Centers for Disease Control and Prevention (CDC) recently published updated guide- lines that provide new strategies for the prevention and treatment of sexuallytransmit- ted diseases (STDs). Patient education is the first important step in reducing the number of persons who engage in risky sexual behaviors. Information on STD prevention should be individualized on the basis of the patient's
KARL E. MILLER; DAVID E. RUIZ; J. CHRISTOPHER GRAVES
Sexuallytransmitted diseases (STDs) are a significant health problem for adolescents. Each year approximately 3 million adolescents acquire an STD (Cates, 1999). Of adolescents who are sexually active, one in four will get an STD before the age of 18 (Cates, 1999). In general, adolescents have higher rates of STDs than adults. More specifically, adolescent girls have the highest rates
BETH A. AUSLANDER; MARY B. SHORT; SUSAN L. ROSENTHAL
Several vaccines for sexuallytransmitted infections (STI) are presently in development and the eventual availability of such vaccines is expected to result in the prevention of a significant number of burdensome conditions. Young adolescents are presumed to be likely targets for these vaccines since adolescents’ risk for STI increases as they age and become sexually active. It is unclear, however,
This article assesses the relationship between low marriage rates and racial disparities in sexuallytransmitted infection (STI) rates. Data from the 2002 National Survey of Family Growth was used to examine the prevalence of sexual risk behaviors by marital status. Logistic regression was used to examine whether racial differences in marriage…
Taylor, Eboni M.; Adimora, Adaora A.; Schoenbach, Victor J.
Reports on interviews of 48 sexually active adolescents concerning the possible secondary consequences of taking measures to reduce the risk of contracting a sexuallytransmitted disease (STD). Adolescents generated 134 consequences, suggesting that considering all the relevant consequences for a rational decision about STD prevention is not…
Continuing efforts to educate college students about the dangers of unprotected sexual intercourse have resulted in little evidence of positive change in sexual behavior. This clinical study examined the sexual behavior, perceived risk of human immunodeficiency virus, and pathology of 66 university men attending a health center's men's clinic for treatment of sexuallytransmitted disease (STD). The study demonstrated the existence of a high-risk group of men who, despite sexuallytransmitted disease pathology, high numbers of sexual partners, inconsistent condom use, and delays in seeking treatment, perceive their risk of contracting HIV/AIDS as being extremely low. This preliminary investigation suggests the need for specific education interventions and future in-depth studies of this population. PMID:8288833
... Anyone who has sexual contact—vaginal, anal, or oral sex—with another person may get an STD. People ... a latex condom every time you have vaginal, oral, or anal sex decreases the chances of infection. Condoms lubricated with ...
Recent trends in western Europe show an increase in sexuallytransmitted infections (STIs). Available surveillance data in Switzerland confirm this rising trend. Gonorrhoea rates more than doubled between 1996 and 2003, and for Chlamydia there was a 64% increase from 1999 to 2003. Notifications of syphilis cases almost doubled in the year 2002 and rose to 174% compared to the period of 1998-2001. The resurgence of syphilis in 2002 and 2003 was most important in Zurich and Geneva with 54 and 24% of all cases, respectively. Eighty-four percent occurred in males, 40% affecting males who had sex with males, and at least 17% were HIV co-infected. For 2004, further increases in these bacterial STIs are expected. Increased awareness of the symptoms and signs of acute infections is needed as well as considering the diagnosis of STIs in patients with vague symptoms. In addition, laboratory reporting or mandatory disease notifications are needed to monitor syphilis trends in Switzerland. PMID:15724096
Between November 1992 and April 1993, interviews were conducted with 400 patients (169 men, 231 women) aged 14-52 years at the sexuallytransmitted disease (STD) clinic of the Institut d'Hygiene Sociale in Antananarivo, Madagascar, to determine the pattern of STDs and to improve treatment of the leading STDs. The 400 patients presented with 434 syndromes. 124 men had urethral discharge. 210 women had cervicovaginal discharge. 43 men and 18 women had genital ulcers. Clinicians could not establish a diagnosis in 33 patients. 171 patients had more than one infection. Chlamydia infection was the most common infection associated with another STD (gonorrhea in 22% of men and 11% of women with discharge, trichomoniasis in 2.4% of men and 13% of women, candidiasis in 1.6% of men and 9% of women, and bacterial vaginosis in 15% of women with discharge). Gonorrhea was the most common etiology for male discharge (69%) while chlamydia infection was for female discharge (52%). Women with discharge were more likely than men with discharge to have chlamydia infection (52% vs. 42%), trichomoniasis (30% vs. 9%; p 0.00001), and candidiasis (32% vs. 12%; p 0.00001). 37% of women with discharge had bacterial vaginosis. Chlamydia infection was the most common STD in this population (45%). 32% of male and 71% of female gonorrhea cases also had chlamydia infection. 70 patients had syphilis. 36 of them had secondary stage syphilis. No one had HIV-1 or HIV-2 infection. The most efficacious antibiotics for gonorrhea were ampicillin, ciprofloxacin, and spectinomycin (100% susceptibility). 31% and 26% of isolates were susceptible to tetracycline and cotrimoxazole, respectively. Public facilities in Madagascar do not have the capabilities to diagnosis chlamydia, resulting in many untreated chlamydia cases. These findings stress the need to improve combined treatment of gonorrhea and chlamydia infection and for educational efforts to increase awareness of genital ulcer disease. PMID:7871444
The serious implications of the sexuallytransmitted disease (STD) pandemic that currently challenges educators, medical practitioners and governments suggest that prevention strategies, which primarily focus on barrier protection and the management of infection, must be reevaluated and that initiatives focusing on primary prevention of behaviors predisposing individuals to STD risk must be adopted. Human immunodeficiency virus/acquired immunodeficiency syndrome, human papillomavirus, genital herpes, and Chlamydia are used to illustrate the pervasive presence of STDs and their serious consequences for individuals and national infrastructures. Long-term sequelae are discussed, including the emerging link between various sexuallytransmitted infections and cancer, and the psychosexual and psychosocial factors which impact infected individuals. Although risk reduction and treatment of existing infection is critical, the promotion of optimal life-long health can be achieved most effectively through delayed sexual debut, partner reduction, and the avoidance of risky sexual behaviors. PMID:15507928
Sexuallytransmitted infections (STIs) are an important public health challenge in the United States. Primary care clinicians can contribute to decreasing these largely preventable causes of morbidity and mortality by integrating routine screening, testing, counseling, treatment, and partner management of STIs into their practice. Newer tests for chlamydia and gonorrhea that can be performed on urine specimens allow screening without a pelvic examination. The most recent edition of the Centers for Disease Control and Prevention sexuallytransmitted disease treatment guidelines provides an evidence-based, reliable, and convenient set of recommendations for treating and caring for patients who have STIs. PMID:18721654
Sexual transmission is an important mode of disease propagation, yet its mechanisms remain largely unknown in wild populations. Birds comprise an important model for studying sexuallytransmitted microbes because their cloaca provides a potential for both gastrointestinal pathogens and endosymbionts to become incorporated into ejaculates. We experimentally demonstrate in a wild population of kittiwakes (Rissa tridactyla) that bacteria are transmitted during copulation and affect the composition and diversity of female bacterial communities. We used an anti-insemination device attached to males in combination with a molecular technique (ARISA) that describes bacterial communities. After inseminations were experimentally blocked, the cloacal communities of mates became increasingly dissimilar. Moreover, female cloacal diversity decreased and the extinction of mate-shared bacteria increased, indicating that female cloacal assemblages revert to their pre-copulatory state and that the cloaca comprises a resilient microbial ecosystem. PMID:20961376
White, Joel; Mirleau, Pascal; Danchin, Etienne; Mulard, Herve; Hatch, Scott A.; Heeb, Philipp; Wagner, Richard H.
Ecology Letters (2010) 13: 1515-1524 ABSTRACT: Sexual transmission is an important mode of disease propagation, yet its mechanisms remain largely unknown in wild populations. Birds comprise an important model for studying sexuallytransmitted microbes because their cloaca provides a potential for both gastrointestinal pathogens and endosymbionts to become incorporated into ejaculates. We experimentally demonstrate in a wild population of kittiwakes (Rissa tridactyla) that bacteria are transmitted during copulation and affect the composition and diversity of female bacterial communities. We used an anti-insemination device attached to males in combination with a molecular technique (automated ribosomal intergenic spacer analysis) that describes bacterial communities. After inseminations were experimentally blocked, the cloacal communities of mates became increasingly dissimilar. Moreover, female cloacal diversity decreased and the extinction of mate-shared bacteria increased, indicating that female cloacal assemblages revert to their pre-copulatory state and that the cloaca comprises a resilient microbial ecosystem. PMID:20961376
White, Joël; Mirleau, Pascal; Danchin, Etienne; Mulard, Hervé; Hatch, Scott A; Heeb, Philipp; Wagner, Richard H
Sexuallytransmitted infections (STIs) are a significant health issue for lesbian and bisexual women. Older age and having a history of sexual intercourse with males are primary risk factors for STIs among this population. However, little research has been conducted to assess sexual risk among lesbian and bisexual college women exclusively. A cross-sectional Internet survey was conducted with 230 self-identified
Lisa L. Lindley; Molly B. Kerby; Thomas J. Nicholson; Ning Lu
Background: Victimization by intimate partner violence (IPV) may play an important role in sexual decision-making, increasing the risk for sexuallytransmitted diseases (STDs) and HIV. Goal: To explore the relationship between IPV and high- risk sexual behaviors, substance abuse, partners who had sex outside the relationship, and history of STD among women attending an STD clinic. Study Design: A self-administered
HEIDI M. BAUER; PAUL GIBSON; MARIA HERNANDEZ; CHARLOTTE KENT; JEFFREY KLAUSNER; GAIL BOLAN
Childhood sexual abuse (CSA) is associated with a wide range of negative outcomes. The authors investigated the relation between CSA and sexual risk behavior in 827 patients recruited from a sexuallytransmitted disease (STD) clinic. Overall, CSA was reported by 53% of women and 49% of men and was associated with greater sexual risk behavior,…
Senn, Theresa E.; Carey, Michael P.; Vanable, Peter A.; Coury-Doniger, Patricia; Urban, Marguerite A.
The potential health threat of AIDS to the native island-based populations in the Pacific is now widely appreciated by those working in the public-health sector throughout the region. Although several countries in the region are yet to identify any cases of AIDS or HIV seropositivity, there is reason to suspect that heterosexual contact may emerge as a predominant mode of spread of HIV infection into native Pacific island populations. Sexual networks and their relationship to potentially 'risky behaviours' are described for a single native Micronesian atoll community on the basis of ethnographic observation and interviewing. This description is combined with the investigation of historic-demographic dimensions of the epidemiology of sexually-transmitted diseases in the same population to draw some conclusions about the opportunities for HIV transmission and acquisition among the sexually-active portions of this community. Although sexually-transmitted diseases have not had an appreciable epidemiological or demographic impact on the population in the past, the sexual networks within the community and beyond provide ample opportunity for the introduction and spread of sexuallytransmitted diseases, including HIV and its sequel AIDS. PMID:10148657
Forty-eight sexually active adolescents participated in an open-ended interview about the possible secondary consequences (side effects) of implementing measures to reduce the risk of contracting a sexuallytransmitted disease (STD). These adolescents noted 134 different consequences, which were grouped into 15 substantive categories. When four prevention measures (using condoms, being selective about sex partner(s), being monogamous, and abstaining from sexual activity) were analyzed, different patterns of consequences that were salient to these adolescents emerged. The results are discussed in terms of their implications for understanding and improving adolescent decision making about STD prevention. PMID:9426804
Syphilis appeared in Sweden in 1497. It was recognized as a sexuallytransmitted disease that rapidly spread in the upper classes and later to the poor. It ravaged the country in the eighteenth and nineteenth centuries. At that time the concept of venereal disease included all sexuallytransmitted diseases. Preventive measures were introduced. They were based on information, medical intervention and elimination of risk factors. Registration of hospitalised patients was introduced in the eighteenth century. The highest incidence of syphilis occurred during the First World War. In the last decade the incidence of sexuallytransmitted disorders has abruptly decreased. Thus the yearly incidence of gonorrhoea has decreased from 40,000 to 500 cases. The law demands contact tracing with obligatory testing. People who deliberately expose others to risk may be condemned to isolation for an unrestricted time. This legislation has probably contributed less to the successful containment than the fact that information on aids and sexuallytransmitted diseases has reached all the population, and made it aware of the risks and produced changed behaviour, especially among prostitutes, homosexual men and drug addicts. PMID:8335310
... State and Territorial Data NCHS Home FastStats Home SexuallyTransmitted Diseases (STD) Data are for the U.S. Morbidity Number of ... Hepatitis National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention Print page Contact Us: National ...
One-quarter of the 3 million new cases of sexuallytransmitted diseases (STDs) each year occur in teenagers. Teens are at high risk because of biological, age, and behavioral factors. Education is the best weapon against STDs. As their children's first sex educators, parents must make every effort to promote STD education at home and school. (SM)
Sexuallytransmitted infections have long been associated with stigma and stereotypes due to their very nature. Throughout history sexuallytransmitted infections have been associated with female prostitution and deviant immoral behaviour making women who contract these infections particularly vulnerable to being stigmatised and stereotyped. Although the stigma attached to such infections has previously been documented in the literature, the aim of this research was to gain in depth insight into young Australian women's experiences of having a sexuallytransmitted infection from a feminist perspective. Findings from this study provide insight into the onerous effects stigma can have on women with these infections and sheds light on how these effects can influence self-perceptions, fear of rejection and feelings of unworthiness. These findings can provide nurses with greater understanding and insight into the effects of stigma on women's experiences of having a sexuallytransmitted infection. Having this understanding and insight has the potential to promote therapeutic care and minimise the stigma that may be felt among women who have contracted this type of infection. PMID:22482278
The rationale for providing in-reach services for sexuallytransmitted infections (STI) and bloodborne viruses (BBV) diagnosis and treatment to prisoners includes the principles underpinning the design and implementation of these services and understanding the special considerations needed to accommodate the effects of the prison regime and categories of prison. Recent literature on service delivery and standards were reviewed. There is
Sexuallytransmitted diseases (STDs) are known to exist in wild and domesticated animals, but little is know about behavioural defences that animals use to reduce the risk of acquiring STDs. Using comparative data and a phylogeny of primates, I investigated whether behaviours hypothesized to reduce STD transmission are correlated with measures of STD risk involving mating promiscuity and life-history traits.
Background: Sexuallytransmitted infections (STIs) remains a serious healthcare problem costing approximately 13 billion dollars annually to treat. Men and women who contract STIs have a higher risk for reinfection and for developing human immunodeficiency virus (HIV). Determining the risk factors associated with STIs in a community would be helpful in designing culturally appropriate tailored interventions to reduce spread of
Donna L. Gullette; Janet L. Rooker; Robert L. Kennedy
We describe the genome sequence of the protist Trichomonas vaginalis, a sexuallytransmitted human pathogen. Repeats and transposable elements comprise about two-thirds of the ~160-megabase genome, reflecting a recent massive expansion of genetic material. This expansion, in conjunction with the shaping of metabolic pathways that likely transpired through lateral gene transfer from bacteria, and amplification of specific gene families implicated
J. M. Carlton; R. P. Hirt; J. C. Silva; A. L. Delcher; Michael Schatz; Qi Zhao; J. R. Wortman; S. L. Bidwell; U. C. M. Alsmark; Sébastien Besteiro; Thomas Sicheritz-Ponten; C. J. Noel; J. B. Dacks; P. G. Foster; Cedric Simillion; Y. Van de Peer; Diego Miranda-Saavedra; G. J. Barton; G. D. Westrop; S. Muller; Daniele Dessi; P. L. Fiori; Qinghu Ren; Ian Paulsen; Hanbang Zhang; F. D. Bastida-Corcuera; Augusto Simoes-Barbosa; M. T. Brown; R. D. Hayes; Mandira Mukherjee; C. Y. Okumura; Rachel Schneider; A. J. Smith; Stepanka Vanacova; Maria Villalvazo; B. J. Haas; Mihaela Pertea; Tamara V. Feldblyum; T. R. Utterback; Chung-Li Shu; Kazutoyo Osoegawa; P. J. de Jong; Ivan Hrdy; Lenka Horvathova; Zuzana Zubacova; Pavel Dolezal; Shehre-Banoo Malik; J. M. Logsdon; Katrin Henze; Arti Gupta; Ching C. Wang; R. L. Dunne; J. A. Upcroft; Peter Upcroft; Owen White; S. L. Salzberg; Petrus Tang; Cheng-Hsun Chiu; Ying-Shiung Lee; T. M. Embley; G. H. Coombs; J. C. Mottram; Jan Tachezy; C. M. Fraser-Liggett; P. J. Johnson
The authors' objectives in this study were to describe the proportion of schools providing and the percentage of students with access to HIV and sexuallytransmitted disease (STD) education, treatment, and prevention services at 2-year and 4-year US colleges and universities. The authors mailed self-administered questionnaires to a stratified…
Koumans, Emilia H.; Sternberg, Maya R.; Motamed, Cathy; Kohl, Katrin; Schillinger, Julia A.; Markowitz, Lauri E.
OBJECTIVES: To describe and assess measures to control sexuallytransmitted diseases (STDs) among sex workers and their partners. METHODS: A review of medical, historical and social literature, focusing on selected cases. RESULTS: Measures to control disease in sex workers today are often prompted by concerns about HIV transmission. However, the literature shows that prostitution varies from one place and time
This report evaluates the 1995 US Air Force (USAF) SexuallyTransmitted Diseases (STD) Prevention and Control Program. The report analyzes data from 88 medical treatment facilities worldwide and compares 1995 data with that from 1992-94. The 1995 USAF act...
During the past two decades, an explosive growth in both the prevalence and types of sexuallytransmitted diseases has occurred. Up to 55 percent of homosexual men with anorectal complaints have gonorrhea; 80 percent of the patients with syphilis are homosexuals. Chlamydia is found in 15 percent of asymptomatic homosexual men, and up to one third of homosexuals have active
Compared with both industrialized countries and other less developed parts of the world, most of sub-Saharan Africa suffers inordinately from sexuallytransmitted diseases (STDs). It has high prevalence rates of traditional STDs, such as gonorrhea and syphilis, and if accurate seroprevalence surveys were to be done it would probably prove to have the highest HIV serropositive incidence in the world.
Context: Sexuallytransmitted diseases (STDs) are responsible for a variety of health problems, and can have especially serious consequences for adolescents and young adults. An interna- tional comparison of levels and trends in STDs would be useful to identify countries that are rel- atively successful in controlling the incidence of STDs, as a first step toward improving policies and programs
Christine Panchaud; Susheela Singh; Dina Feivelson; Jacqueline E. Darroch
to gain beneficial microbes via copulation given that the gastrointestinal tract harbours a substantial transmitted microbes because their cloaca provides a potential for both gastrointestinal pathogens bacteria, gastrointestinal microbiota, mating behaviour, sexual selection, sexuallytransmitted diseases
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Context: Women's and men's number of sexual partners and protective practices such as con- dom use can have a direct effect on their risk of contracting sexuallytransmitted diseases (STDs), including HIV. Methods: The 1988 and 1995 cycles of the National Survey of Family Growth and five rounds of the General Social Survey conducted from 1988 to 1996 are used
Lawrence B. Finer; Jacqueline E. Darroch; Susheela Singh
Two thirds of the people who have been infected by human immunodeficiency virus (HIV) in the world live in Sub-Saharan African countries. The results of a study measuring the degree distribu- tion of the network of sexual contacts in Burkina Fasoaredescribed.Suchanetworkisresponsible for the spread of sexuallytransmitted diseases, and in particular of HIV. It has been found that the number
Vito Latora; André Nyamba; Jacques Simpore; Bahiré Sylvette; Sandwidi Diane; Bukiki Sylvére; Salvatore Musumeci
We conducted a qualitative study to explore the pathways by which traditional gender roles may ultimately affect Vietnamese women's interpretation of sexuallytransmitted disease (STD) symptoms and health-seeking strategies. Data on gender roles, perceptions of types of sexual relationships, perceptions of persons with STDs, and STD patient experiences were gathered through in-depth interviews and focus groups with 18 men and
Vivian Fei-ling Go; Vu Minh Quan; A Chung; Jonathan Zenilman; Vu Thi Minh Hanh; David Celentano
Sexuallytransmitted infections (STIs) have occupied a central place in public health agendas for at least the past 500 years, but have been the subject of opinions, decrees and “moral positions” for much longer. Societies have long tried to control the sexual behaviors of their populations, not only for reasons of social control, but also with the objective of controlling
to explain high rates of sexuallytransmitted disease among inner city African American and Puerto Rican. All rights reserved. Keywords: Syndemics; Sexuallytransmitted diseases; Young adults; African intertwined epidemics in Hartford (and elsewhere) of two sexuallytransmitted diseases (STDs) in the study
OBJECTIVE: Our purpose was to investigate the association between douching (douching agents and timing) and sexuallytransmitted disease. STUDY DESIGN: A cross-sectional survey of sexuallytransmitted diseases and habits of vaginal douching was performed on 599 pregnant women who visited a prenatal clinic in Surabaya, Indonesia. RESULTS: Of the 599 pregnant women, 115 (19.2%) had at least one sexuallytransmitted
M. R. Joesoef; H. Sumampouw; M. Linnan; S. Schmid; A. Idajadi; M. E. St. Louis
Hungarian Preconceptional Care includes the preconceptional screening of sexuallytransmitted infections\\/disorders (STD) and\\u000a vaginal candidosis of potential mothers and pyospermia of potential fathers. The aim of this study was to evaluate the effect\\u000a of this screening and treatment for the rate of preterm births. Clinical and subclinical vaginal candidiasis (asymptomatic\\u000a candida colonisation), combination of STD and vaginal candidiasis, STD without
IntroductionMore new HIV-1 infections occur within stable HIV-1-discordant couples than in any other group in Africa, and sexuallytransmitted infections (STIs) may increase transmission risk among discordant couples, accounting for a large proportion of new HIV-1 infections. Understanding correlates of STIs among discordant couples will aid in optimizing interventions to prevent HIV-1 transmission in these couples.MethodsHIV-1-discordant couples in which HIV-1-infected
Brandon L. Guthrie; James N. Kiarie; Susan Morrison; Grace C. John-Stewart; John Kinuthia; William L. H. Whittington; Carey Farquhar; Etienne Joly
The gastrointestinal mucosa is a target of many sexuallytransmitted infections, and major advances have increased our understanding of the consequences of such infections within the gastrointestinal system. HIV-1 is associated with a marked loss of mucosal CD4+ T cells that express CC-chemokine receptor 5. This process seems to be more rapid and more severe in mucosa-associated lymphoid tissue than
The need to improve the function of public health services to control sexuallytransmitted disease (STD) is presented. Improved public health service function in the United Kingdom calls for an improved administrative structure; a 10 year programme of development is envisaged. The threat of a heterosexually based epidemic of infection with human immunodeficiency virus (HIV) offers an opportunity to improve the control of STD generally. PMID:3610166
We are living in a world that is suffering a pandemic of human immunodeficiency virus (HIV) infection, continued high levels\\u000a of other sexuallytransmitted infections (STIs), and an unsustainable population explosion. In the last 40 years, the number\\u000a of humans on this planet has doubled. The youth of the world’s population today ensures that all STIs will continue to increase
Patients having sexuallytransmitted diseases are at a higher risk of acquiring HIV infection. The present study attempts to analyze the trend of HIV infection and the risk factors among STD clinic attendees in central India. Of the 2264 patients tested, 36 were sero-positive for HIV, giving a prevalence rate of 1.6%. HIV sero-positivity was almost constant over the years
Atul Karkare; Anup R. Anvikar; Vikas G. Rao; Jyothi Bhat; Tapas Chakma; S. R. Qamra; V. Gadge; P. Dour; Mahendra Ukey; Canina Luke; Arvind Kavishwar
African Americans carry the largest disease burden for bacterialsexuallytransmitted diseases (STDs) in the United States. These infections can have a devastating impact on sexual and reproductive health if they are not diagnosed and treated. Traditionally, public health efforts to prevent and control bacterial STDs have been through surveillance, clinical services, partner management, and behavioral intervention strategies. However, the persistence of disparities in STDs indicates that these strategies are not achieving sufficient impact in African American communities. It may be that factors such as limited access, acceptability, appropriateness, and affordability of services reduce the efficacy of these strategies for African American communities. In this article we describe the STD prevention strategies and highlight the challenges and implications of these strategies in addressing disparities in African American communities. PMID:18955915
Barrow, Roxanne Y.; Berkel, Cady; Brooks, Lesley C.; Groseclose, Samuel L.; Johnson, David B.; Valentine, Jo A.
We have introduced recently a model for the spread of sexuallytransmitted diseases, in which the social behavior is incorporated as a key factor for the further propagation of the infection. The system may be regarded as a society of agents where in principle anyone can sexually interact with any other one in the population. The social behavior is taking into account by means of two parameters: the fraction of singles ?s and the promiscuity p. The promiscuity parameter defines the per individual daily probability of going out to look for a sexual partner, abandoning its eventual mate. In this contribution we show that the interaction between this two parameters give rise to a non-trivial epidemic threshold condition, when going from the homogeneous case ( ?s=1) to heterogeneous cases ( ?s<1). These results can have profound implication in the interpretation of real epidemic data.
Gonçalves, Sebastián; Kuperman, Marcelo; Ferreira da Costa Gomes, Marcelo
Background: Sexuallytransmitted diseases (STDs) in children can be acquired either by sexual, or non-sexual route. Sexuallytransmitted infection (STI) in children reflect the pattern of STI in adult population and the knowledge, attitude and practices of the society. They also serve as an indicator of STI control strategies. Aims: A retrospective study spanning over a period of 5 years from 2007 to 2011) was undertaken to make a detailed analysis of demographic, behavioral, epidemiological and clinical profile of STD among children (<19 years). Materials and Methods: The medical records of children attending the STI clinic of Smt. Sucheta Kriplani Hospital from year 2007 to 2011 were studied. Results of Gram's staining, KOH examination, Tzanck smear, culture and serological tests like Venereal Disease Research Laboratory for syphilis and ELISA for human immunodeficiency virus (HIV) wherever performed were recorded along with the final diagnosis. Results: The study showed a steady rise in the prevalence of STIs from 1% to 4.9% in the initial 4 years. STIs were more commonly observed in girls (M:F ratio - 1:1.13) and in adolescents >16 years of age. Homosexuality was present in 33.3% of males. History of sexual abuse was given by 4 children. 2 children were seropositive for HIV by ELISA technique. Viral STIs (Cyanea acuminata, molluscum contagiosum, herpes genitalis) were 1.5 times more common than bacterial infections. Conclusion: The societal sexual practices have undergone tremendous changes, which is reflected in a steady rise in STIs (predominantly viral), sexual abuse and homosexuality in children. There is an urgent need for strengthening of school health programs aiming at adolescent sexual health. PMID:24958982
According statistical data in Georgia sexuallytransmitted disorders represent one of the most important medical and social problems. Main causes of this are hard social and economic condition of the country, changing sexual-behavioral stereotypes, drugs and alcohol abuse, political perturbation, as well as unprecedented decrease in financing prevention programs of STD by government. The purpose of given research is statistical analysis of spread of sexuallytransmitted disorders in Georgia, in particular, among the people included in risk group; finding trends and in accordance with this, working out recommendations for improvement of situation in given field of medicine. Essays showed that through 2000-2012 years among STD revealed in the group of increased risk chlamidiosis was the most common. There is an objective trend of increasing the level of morbidity with chlamidiosis and trichomoniasis, however the speed of increasing morbidity with trichomoniasis probably does not correspond the reality. In the same time morbidity with gonorrhea and syphilis is decreasing, however in the result of significant decrease in STD prevention program scale data validity concerning syphilis might be doubtful. Coming out of this in the field of health care related to STD optimization of laboratory diagnostics management is essential; perfection of methods of epidemiologic control; increasing the scales of prevention programs as well as initiation of researches related to antimicrobial resistance of gonococci. Authors consider essential taking steps for optimization of management of laboratory diagnostics and perfection of methods of epidemiologic control and increasing scales of preventive programs. PMID:24743123
Chiokadze, Sh; Galdava, G; Kvlividze, O; Durglishvili, G
We describe the genome sequence of the protist Trichomonas vaginalis, a sexuallytransmitted human pathogen. Repeats and transposable elements comprise about two-thirds of the approximately 160-megabase genome, reflecting a recent massive expansion of genetic material. This expansion, in conjunction with the shaping of metabolic pathways that likely transpired through lateral gene transfer from bacteria, and amplification of specific gene families implicated in pathogenesis and phagocytosis of host proteins may exemplify adaptations of the parasite during its transition to a urogenital environment. The genome sequence predicts previously unknown functions for the hydrogenosome, which support a common evolutionary origin of this unusual organelle with mitochondria. PMID:17218520
Carlton, Jane M; Hirt, Robert P; Silva, Joana C; Delcher, Arthur L; Schatz, Michael; Zhao, Qi; Wortman, Jennifer R; Bidwell, Shelby L; Alsmark, U Cecilia M; Besteiro, Sébastien; Sicheritz-Ponten, Thomas; Noel, Christophe J; Dacks, Joel B; Foster, Peter G; Simillion, Cedric; Van de Peer, Yves; Miranda-Saavedra, Diego; Barton, Geoffrey J; Westrop, Gareth D; Müller, Sylke; Dessi, Daniele; Fiori, Pier Luigi; Ren, Qinghu; Paulsen, Ian; Zhang, Hanbang; Bastida-Corcuera, Felix D; Simoes-Barbosa, Augusto; Brown, Mark T; Hayes, Richard D; Mukherjee, Mandira; Okumura, Cheryl Y; Schneider, Rachel; Smith, Alias J; Vanacova, Stepanka; Villalvazo, Maria; Haas, Brian J; Pertea, Mihaela; Feldblyum, Tamara V; Utterback, Terry R; Shu, Chung-Li; Osoegawa, Kazutoyo; de Jong, Pieter J; Hrdy, Ivan; Horvathova, Lenka; Zubacova, Zuzana; Dolezal, Pavel; Malik, Shehre-Banoo; Logsdon, John M; Henze, Katrin; Gupta, Arti; Wang, Ching C; Dunne, Rebecca L; Upcroft, Jacqueline A; Upcroft, Peter; White, Owen; Salzberg, Steven L; Tang, Petrus; Chiu, Cheng-Hsun; Lee, Ying-Shiung; Embley, T Martin; Coombs, Graham H; Mottram, Jeremy C; Tachezy, Jan; Fraser-Liggett, Claire M; Johnson, Patricia J
We describe the genome sequence of the protist Trichomonas vaginalis, a sexuallytransmitted human pathogen. Repeats and transposable elements comprise about two-thirds of the ~160-megabase genome, reflecting a recent massive expansion of genetic material. This expansion, in conjunction with the shaping of metabolic pathways that likely transpired through lateral gene transfer from bacteria, and amplification of specific gene families implicated in pathogenesis and phagocytosis of host proteins may exemplify adaptations of the parasite during its transition to a urogenital environment. The genome sequence predicts previously unknown functions for the hydrogenosome, which support a common evolutionary origin of this unusual organelle with mitochondria. PMID:17218520
Carlton, Jane M.; Hirt, Robert P.; Silva, Joana C.; Delcher, Arthur L.; Schatz, Michael; Zhao, Qi; Wortman, Jennifer R.; Bidwell, Shelby L.; Alsmark, U. Cecilia M.; Besteiro, Sébastien; Sicheritz-Ponten, Thomas; Noel, Christophe J.; Dacks, Joel B.; Foster, Peter G.; Simillion, Cedric; Van de Peer, Yves; Miranda-Saavedra, Diego; Barton, Geoffrey J.; Westrop, Gareth D.; Müller, Sylke; Dessi, Daniele; Fiori, Pier Luigi; Ren, Qinghu; Paulsen, Ian; Zhang, Hanbang; Bastida-Corcuera, Felix D.; Simoes-Barbosa, Augusto; Brown, Mark T.; Hayes, Richard D.; Mukherjee, Mandira; Okumura, Cheryl Y.; Schneider, Rachel; Smith, Alias J.; Vanacova, Stepanka; Villalvazo, Maria; Haas, Brian J.; Pertea, Mihaela; Feldblyum, Tamara V.; Utterback, Terry R.; Shu, Chung-Li; Osoegawa, Kazutoyo; de Jong, Pieter J.; Hrdy, Ivan; Horvathova, Lenka; Zubacova, Zuzana; Dolezal, Pavel; Malik, Shehre-Banoo; Logsdon, John M.; Henze, Katrin; Gupta, Arti; Wang, Ching C.; Dunne, Rebecca L.; Upcroft, Jacqueline A.; Upcroft, Peter; White, Owen; Salzberg, Steven L.; Tang, Petrus; Chiu, Cheng-Hsun; Lee, Ying-Shiung; Embley, T. Martin; Coombs, Graham H.; Mottram, Jeremy C.; Tachezy, Jan; Fraser-Liggett, Claire M.; Johnson, Patricia J.
First noticed in Uganda in 1863 by a European explorer, sexuallytransmitted diseases (STDs) were cited as a major cause of morbidity and mortality throughout this century. In 1908 the venereal diseases campaign was launched marking the real introduction of western medicine. By the mid-1920s, the campaign was combined with the medical service but throughout the colonial period (1901-1962) venereal diseases were considered intractable. A 1991 survey revealed alarming incidence rates and in light of the importance of STDs as a co-factor in the transmission of HIV, it is of paramount importance to implement more effective control measures. PMID:8206475
Objective To determine the effectiveness of a brief cognitive behavioural intervention in reducing the incidence of sexuallytransmitted infections among gay men. Design Randomised controlled trial with 12 months' follow up. Setting Sexual health clinic in London. Participants 343 gay men with an acute sexuallytransmitted infection or who reported having had unprotected anal intercourse in the past year. Main
John Imrie; Judith M. Stephenson; Frances M. Cowan; Shamil Wanigaratne; Andrew J. P. Billington; Andrew J. Copas; Lesley French; Patrick D. French
Sexuallytransmitted diseases (STD) are one of the most prevalent infectious diseases in the world and important cause of morbidity and mortality. Especially STDs of viral etiology are difficult to cure. In many cases the antiviral therapy can relieve the symptoms but not eliminate the virus. During the past decades, considerable progress has been made in the development of antiviral drugs. One of the oldest antiviral medications is acyclovir (ACV). It is approved to treat initial and recurrent genital herpes and as a suppressive therapy in severe recurrent genital infections as well. Drug resistance to ACV and related drugs is seen among immunocompromised hosts, including human immunodeficiency virus HIV-infected patients. Resistant infections can be managed by second-line drugs - foscarnet or cidofovir- but they are more toxic than ACV. In case of HPV there is not known specific target for the medication and that is why the substances used in human papilloma virus HPV infection therapy are either antimitotics or immunomodulators. The Part I review focuses on mechanisms of actions and mechanisms of resistance to antiviral agents used in a treatment of the genital herpes and genital HPV infection. In Part II we will show the therapeutic options in other sexuallytransmitted infections: hepatitis B, C and HIV. PMID:24032509
This study examined relationship power as a possible mediator of the relationship between dating violence and sexuallytransmitted infections (STIs). The proposed mediation model was based on the theory of gender and power as well as previous research on intimate partner violence and STI risk. Survey results from a sample of 290 single, undergraduate women indicated that 85% experienced at
Christina Buelna; Emilio C. Ulloa; Monica D. Ulibarri
This study examined relationship power as a possible mediator of the relationship between dating violence and sexuallytransmitted infections (STIs). The proposed mediation model was based on the theory of gender and power as well as previous research on intimate partner violence and STI risk. Survey results from a sample of 290 single,…
Buelna, Christina; Ulloa, Emilio C.; Ulibarri, Monica D.
Data was collected on arrested youths processed at a centralized intake facility, including youths released back to the community and those placed in secure detention. This article reports the results of a test of a structural model involving newly arrested male and female youths' sexuallytransmitted diseases (STD) test results, urine analysis results for recent cocaine and marijuana use, and
Richard Dembo; Steven Belenko; Kristina Childs; Paul E. Greenbaum; Jennifer Wareham
The authors reviewed historical literature and hypothesized a relationship between epidemics of sexuallytransmitted diseases and foot fetishism. They tested this hypothesis by quantifying foot-fetish depictions in the mass-circulation pornographic literature during a 30-yr. interval. An exponential increase was noted during the period of the current AIDS epidemic. The authors offer reasons for this possible relationship. PMID:9819924
Giannini, A J; Colapietro, G; Slaby, A E; Melemis, S M; Bowman, R K
Among 284 African American girls aged 14 to 17 years, frequent family monitoring knowledge was associated with a reduced likelihood of sexuallytransmitted infections (STIs) and having a casual sex partner but was not associated with other partnership characteristics. Family monitoring may offer an additional STI prevention opportunity for this vulnerable population. PMID:25211255
Steiner, Riley J; Swartzendruber, Andrea L; Rose, Eve; DiClemente, Ralph J
Data was collected on arrested youths processed at a centralized intake facility, including youths released back to the community and those placed in secure detention. This article reports the results of a test of a structural model involving newly arrested male and female youths' sexuallytransmitted diseases (STD) test results, urine analysis…
Dembo, Richard; Belenko, Steven; Childs, Kristina; Greenbaum, Paul E.; Wareham, Jennifer
We introduce a model for the evolution of sexuallytransmitted diseases, in which the social behavior is incorporated as a determinant factor for the further propagation of the infection. The system may be regarded as a society of agents where in principle, anyone can sexually interact with any other one in the population, indeed, in this contribution only the homosexual case is analyzed. Different social behaviors are reflected in a distribution of sexual attitudes ranging from the more conservative to the more promiscuous. This is measured by what we call the promiscuity parameter. In terms of this parameter, we find a critical behavior for the evolution of the disease. There is a threshold below which the epidemic does not occur. We relate this critical value of promiscuity to what epidemiologists call the basic reproductive number, connecting it with the other parameters of the model, namely the infectivity and the infective period in a quantitative way. We consider the possibility of subjects to be grouped in couples.
Sexual violence is associated with women's risks for HIV infection. The current study investigated factors related to risks for sexuallytransmitted infections (STIs), including HIV, among South African women with a history of sexual assault. An anonymous street intercept survey of women (N=272) living in an African township in the Western Cape, South Africa assessed demographic characteristics, history of sexual
OBJECTIVE--Evaluation of teenagers' knowledge and understanding about sexuallytransmitted disease, conception and contraception. DESIGN--A questionnaire study. SETTING--Schools SUBJECTS--1025 teenagers aged 15\\/16 years (mean 16.00). MAIN OUTCOME MEASURES--Scores attained in response to questions about sexuallytransmitted disease related to the sources of information given as most helpful. RESULTS--Teenagers have an incorrect understanding of the risks of sexuallytransmitted diseases. CONCLUSIONS--Teenagers may
Objective: The purpose of this study was to assess presumptive sexuallytransmitted disease treatment on pregnancy outcome and HIV transmission. Study Design: In a randomized trial in Rakai District, Uganda, 2070 pregnant women received presumptive sexuallytransmitted disease treatment 1 time during pregnancy at varying gestations, and 1963 control mothers received iron\\/folate and referral for syphilis. Maternal-infant sexuallytransmitted disease\\/HIV
Ronald H. Gray; Fred Wabwire-Mangen; Godfrey Kigozi; Nelson K. Sewankambo; David Serwadda; Lawrence H. Moulton; Thomas C. Quinn; Katherine L. O’Brien; Mary Meehan; Carlos Abramowsky; Merlin Robb; Maria J. Wawer
ADOLESCENT SEXUALITY, SEXUALLYTRANSMITTED DISEASE AND PREGNANCYAdolescents and Children ADULT Terminated a Pregnancy PastAdolescents and Children ADULT SEXUALLYTRANSMITTED DISEASE TESTING, EMERGENCY CONTRACEPTION, PREGNANCY
Pourat, Nadereh; Nihalani, Jas; Razack, Natasha; Neiman, Romni; al., et
OBJECTIVE To determine whether men who perform recreational sounding are at increased risk of engaging in unsafe sexual behaviours, developing sexuallytransmitted infections (STIs) and lower urinary tract symptoms (LUTS). SUBJECTS AND METHODS In a cross-sectional, international, internet-based survey of the sexual practices of >2000 men who have sex with men, subjects were asked if they had engaged in urethral sounding for sexual gratification. We compared ethnodemographic and health-related variables between the sounding and non-sounding populations. The International Prostate Symptom Score and a modified validated version of the International Index of Erectile Function were used to quantify LUTS and erectile dysfunction (ED) in both populations. RESULTS There were 2122 respondents with complete data, 228 (10.7%) of whom had engaged in recreational sounding. Men who had engaged in sounding were more likely to report certain high risk sexual behaviours (e.g. multiple sexual partners and sex with partners who were not well known) and had increased odds of reporting STIs. Men who had engaged in sounding had a slight but statistically significant increase in LUTS but no significant difference in prevalence of ED. CONCLUSIONS Urethral sounding is a sexual practice that is associated with higher risk sexual behaviour and carries the potential for morbidity. Research on means for risk reduction for men who choose to engage in recreational sounding requires further study. PMID:22221824
The history of sexuallytransmitted diseases in Canada from 1800 to the present reflects the changing views and values of citizens, medical experts, politicians and bureaucrats. During the colonial period, the military devoted attention to the problem but strict moral codes and social conventions prevented public discussion. Although middle class reformers began to pressure the federal government for funding and direction after 1900, World War I was the catalyst for involvement. Health education through a voluntary group and federal-provincial cost-shared funding for treatment facilities across Canada were introduced to control STDs. Public perception of STD patients as marginalised or deviant limited the impact of these efforts. Social changes during the 1960s, new STDs appearing in the 1970s and the AIDS epidemic of the 1980s have redirected the STD campaign to focus on high risk groups and prevention rather than the moralistic curative efforts of the past. PMID:8300103
Sexuallytransmitted infections (STIs) represent a significant public health concern. Several STIs, once thought to be on the verge of extinction, have recently reemerged. This change is thought to be partially related to an increase in STIs of the anus and rectum. Importantly, the global human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) epidemic has contributed to the emergence of particular anorectal lesions that require specialized approaches. In this report, we review common anorectal STIs that are frequently referred to colorectal surgeons in the United States. Epidemiology, clinical presentation, and management are summarized, including the latest treatment recommendations. The particularity of anorectal diseases in HIV/AIDS is addressed, along with recent trends in anal cytology and human papillomavirus vaccination. PMID:25386074
Assi, Roland; Hashim, Peter W; Reddy, Vikram B; Einarsdottir, Hulda; Longo, Walter E
The Division of STD Prevention of the US Centers for Disease Control has recently released this update (MMWR 1998;47(No. RR-1)) to the 1993 set of guidelines with the same title. The guidelines were developed by CDC staff after consultation with a "group of invited experts" in early 1997. Included are sections on various sexuallytransmitted diseases, including HIV, Genital Ulcers, Epididymitis, Human Papillomavirus Infection, and vaccine preventable STDs, among others. Guideline evidence is briefly discussed in each section of the report, and the CDC is committed to providing "more comprehensive, annotated discussions of such evidence...in background papers that will be published in 1998." Note that in the HTML version of the report, some of the interior links within chapters are inaccurate. In those cases, it is prudent to click on the section headings to find the relevant information.
A study was undertaken in 670 long distance truck drivers to investigate prevalence of sexuallytransmitted infections--STI (HIV infection, syphilis, hepatitis-B infection and gonorrhoea) in Nagpur City, Central India. Standard laboratory procedures were followed for carrying out investigations i.e. ELISA for HIV infection, VDRL for syphilis, RPHA for hepatitis-B infection and gram staining for gonorrhoea. A total of 293 (43.7%) subjects had one or more sign/symptoms suggestive of STIs. The prevalence of HIV infection, syphilis, hepatitis-B infection and gonorrhoea was observed to be 15.2%, 21.9%, 5.1% and 6.7% respectively. In conclusion, this study recognized that long distance truck drivers were at high risk for getting STIs including HIV infection. PMID:11407008
Gawande, A V; Vasudeo, N D; Zodpey, S P; Khandait, D W
Background Sexually-transmitted pathogens often have severe reproductive health implications if treatment is delayed or absent, especially in females. The complex processes of disease progression, namely replication and ascension of the infection through the genital tract, span both extracellular and intracellular physiological scales, and in females can vary over the distinct phases of the menstrual cycle. The complexity of these processes, coupled with the common impossibility of obtaining comprehensive and sequential clinical data from individual human patients, makes mathematical and computational modelling valuable tools in developing our understanding of the infection, with a view to identifying new interventions. While many within-host models of sexually-transmitted infections (STIs) are available in existing literature, these models are difficult to deploy in clinical/experimental settings since simulations often require complex computational approaches. Results We present STI-GMaS (Sexually-Transmitted Infections – Graphical Modelling and Simulation), an environment for simulation of STI models, with a view to stimulating the uptake of these models within the laboratory or clinic. The software currently focuses upon the representative case-study of Chlamydia trachomatis, the most common sexually-transmittedbacterial pathogen of humans. Here, we demonstrate the use of a hybrid PDE–cellular automata model for simulation of a hypothetical Chlamydia vaccination, demonstrating the effect of a vaccine-induced antibody in preventing the infection from ascending to above the cervix. This example illustrates the ease with which existing models can be adapted to describe new studies, and its careful parameterisation within STI-GMaS facilitates future tuning to experimental data as they arise. Conclusions STI-GMaS represents the first software designed explicitly for in-silico simulation of STI models by non-theoreticians, thus presenting a novel route to bridging the gap between computational and clinical/experimental disciplines. With the propensity for model reuse and extension, there is much scope within STI-GMaS to allow clinical and experimental studies to inform model inputs and drive future model development. Many of the modelling paradigms and software design principles deployed to date transfer readily to other STIs, both bacterial and viral; forthcoming releases of STI-GMaS will extend the software to incorporate a more diverse range of infections. PMID:24923486
Sexuallytransmitted infections (STI) in HIV-infected people are of increasing concern. We estimated STI prevalence and sexual healthcare seeking behaviour in 224 sexually active HIV-infected people, including men who have sex with men (MSM, n = 112), heterosexual men (n = 65) and women (n = 47). Laboratory-diagnosed bacterial STI were more common in MSM (Chlamydia trachomatis 10.7%; 95% CI 6.2, 18.0%, lymphogranuloma venereum 0.9%; 95% CI 0.1, 6.2%, Neisseria gonorrhoeae 2.7%; 95% CI 0.9, 8.0%, syphilis seroconversion 5.4%; 95% CI 2.0, 11.3%) than heterosexual men (gonorrhoea 1.5%; 95% CI 0.2, 10.3%) or women (no acute infections). Combined rates of laboratory-diagnosed and self-reported bacterial STI in the year before the study were: MSM (27.7%; 95% CI 21.1, 36.7%); heterosexual men (1.5%; 95% CI 0.2, 10.3%); and women (6.4%; 95% CI 2.1, 21.0%). Antibodies to hepatitis C virus were least common in MSM. Antibodies to herpes simplex type 2 virus were least common in heterosexual men. Most MSM, but not heterosexual men or women, agreed that STI testing should be offered every year. In this study, combined rates of bacterial STI in MSM were high; a regular assessment of sexual health would allow those at risk of STI to be offered testing, treatment and partner management. PMID:25237598
Sprenger, Katharina; Evison, John Marc; Zwahlen, Marcel; Vogt, Cedric M; Elzi, Maria Verena; Hauser, Christoph; Furrer, Hansjakob; Low, Nicola
Sexuallytransmitted infections (STI) in HIV-infected people are of increasing concern. We estimated STI prevalence and sexual healthcare seeking behaviour in 224 sexually active HIV-infected people, including men who have sex with men (MSM, n = 112), heterosexual men (n = 65) and women (n = 47). Laboratory-diagnosed bacterial STI were more common in MSM (Chlamydia trachomatis 10.7%; 95% CI 6.2, 18.0%, lymphogranuloma venereum 0.9%; 95% CI 0.1, 6.2%, Neisseria gonorrhoeae 2.7%; 95% CI 0.9, 8.0%, syphilis seroconversion 5.4%; 95% CI 2.0, 11.3%) than heterosexual men (gonorrhoea 1.5%; 95% CI 0.2, 10.3%) or women (no acute infections). Combined rates of laboratory-diagnosed and self-reported bacterial STI in the year before the study were: MSM (27.7%; 95% CI 21.1, 36.7%); heterosexual men (1.5%; 95% CI 0.2, 10.3%); and women (6.4%; 95% CI 2.1, 21.0%). Antibodies to hepatitis C virus were least common in MSM. Antibodies to herpes simplex type 2 virus were least common in heterosexual men. Most MSM, but not heterosexual men or women, agreed that STI testing should be offered every year. In this study, combined rates of bacterial STI in MSM were high; a regular assessment of sexual health would allow those at risk of STI to be offered testing, treatment and partner management.
Sprenger, Katharina; Evison, John Marc; Zwahlen, Marcel; Vogt, Cedric M.; Elzi, Maria Verena; Hauser, Christoph
Human sexual behavior required for the continuation of humankind nevertheless has its downsides, among them sexuallytransmitted infections (STIs). The treatment of microbial STIs is challenging but not in itself essentially very difficult. Controlling STIs, on the other hand, is like the task of Sisyphus, a king in Greek mythology who was forced forever to roll a block of stone to the top of a steep hill, only to see it roll back to the valley, where he started the toilsome task again. This is how many a venereologist must view the day's practice, supervising patients with STIs. Yes, there are newcomers, many of them very young, but there are many others, the recidivists, whom the physician and health care staff know only too well. "You don't mind seeing me again, doc. You (collectively) were so good to me last time"--as though catching a chlamydial infection 3 or 4 times, gonorrhea 20 or 30 times, and syphilis on occasion were badges of virility or part of life's natural progression. This is the pattern of STIs in 2007. PMID:17786104
China has been experiencing pronounced changes in its sex ratio, but little research has explored the consequences of these changes for sexual behavior and health. We merge data from the 1999-2000 Chinese Health and Family Life Survey with community-level data from the 1982, 1990, and 2000 Chinese censuses to examine the relationship between the local sex ratio and several dimensions of men's sexual behavior and sexual health. Multilevel logistic regression models show that, when faced with a relative abundance of age-matched women in their community, Chinese men are slightly less likely to have intercourse with commercial sex workers, but are more likely to engage in premarital noncommercial intercourse and to test positive for a sexuallytransmitted infection. These findings are consistent with hypotheses derived from demographic-opportunity theory, which suggests that an abundance of opposite-sex partners will increase the risk of early, frequent, and multi-partner sex and, through this, sexuallytransmitted infection risk. PMID:21131616
ObjectiveTo compare the effects of polygyny (only men can form concurrent partnerships) and gender-symmetric concurrency (both genders can form concurrent partnerships) on prevalence of long-duration sexuallytransmitted infections (STIs) using a dynamic stochastic network model.MethodsWe modelled two pairs of scenarios: polygyny and gender symmetry at higher and lower levels of network concurrency (measured by the average number of concurrent partnerships
Shalini Santhakumaran; Katie OBrien; Roel Bakker; Toby Ealden; Leigh Anne Shafer; Rhian M Daniel; Ruth Chapman; Richard J Hayes; Richard G White
This paper was initiated as an effort to improve our understanding of health-seeking behaviour in individuals with sexuallytransmitted infections. It quickly became apparent that the social, cultural, economic, biological and political issues that influence health-seeking behaviour in individuals with sexuallytransmitted infections greatly differed from those who have or had other diseases. Through a critique of the most current
Jennifer L Joss; Heather L Pearcey; Tara V Postnikoff
Summary: Consistent condom use can prevent sexuallytransmitted infections (STIs), but few studies have measured how the prevalence of consistent use changes over time. We measured the prevalence and correlates of consistent condom use over the course of a year. We did a secondary analysis of data from an HIV prevention trial in three sexuallytransmitted disease clinics. We assessed
T A Peterman; L H Tian; L Warner; C L Satterwhite; C A Metcalf; K C Malotte; S M Paul; J M Douglas
Goal: Trichomonas vaginalis is the most common nonviral sexuallytransmitted infection in the United States and may be associated with adverse birth outcomes and may also increase susceptibility to or transmissibility of human immunodeficiency virus. The purpose of this analysis is to describe the epidemiology of T. vaginalis in SexuallyTransmitted Disease clinics and characterize the risk fac- tors associated
Donna J. Helms; Debra J. Mosure; Carol A. Metcalf; John M. Douglas; C Kevin Malotte; Sindy M. Paul; Thomas A. Peterman
Context: The prevalence of sexuallytransmitted diseases and associated risk behaviors among California farmworkers is not well described. Purpose: To estimate the prevalence of sexuallytransmitted diseases (STDs) and associated risk behaviors among California farmworkers. Methods: Cross-sectional analysis of population-based survey data from 6…
Brammeier, Monique; Chow, Joan M.; Samuel, Michael C.; Organista, Kurt C.; Miller, Jamie; Bolan, Gail
Background Bacterial vaginosis (BV) has been most consistently linked to sexual behaviour, and the epidemiological profile of BV mirrors that of established sexuallytransmitted infections (STIs). It remains a matter of debate however whether BV pathogenesis does actually involve sexual transmission of pathogenic micro-organisms from men to women. We therefore made a critical appraisal of the literature on BV in relation to sexual behaviour. Discussion G. vaginalis carriage and BV occurs rarely with children, but has been observed among adolescent, even sexually non-experienced girls, contradicting that sexual transmission is a necessary prerequisite to disease acquisition. G. vaginalis carriage is enhanced by penetrative sexual contact but also by non-penetrative digito-genital contact and oral sex, again indicating that sex per se, but not necessarily coital transmission is involved. Several observations also point at female-to-male rather than at male-to-female transmission of G. vaginalis, presumably explaining the high concordance rates of G. vaginalis carriage among couples. Male antibiotic treatment has not been found to protect against BV, condom use is slightly protective, whereas male circumcision might protect against BV. BV is also common among women-who-have-sex-with-women and this relates at least in part to non-coital sexual behaviours. Though male-to-female transmission cannot be ruled out, overall there is little evidence that BV acts as an STD. Rather, we suggest BV may be considered a sexually enhanced disease (SED), with frequency of intercourse being a critical factor. This may relate to two distinct pathogenetic mechanisms: (1) in case of unprotected intercourse alkalinisation of the vaginal niche enhances a shift from lactobacilli-dominated microflora to a BV-like type of microflora and (2) in case of unprotected and protected intercourse mechanical transfer of perineal enteric bacteria is enhanced by coitus. A similar mechanism of mechanical transfer may explain the consistent link between non-coital sexual acts and BV. Similar observations supporting the SED pathogenetic model have been made for vaginal candidiasis and for urinary tract infection. Summary Though male-to-female transmission cannot be ruled out, overall there is incomplete evidence that BV acts as an STI. We believe however that BV may be considered a sexually enhanced disease, with frequency of intercourse being a critical factor. PMID:20353563
Sexuallytransmitted diseases (STDs) represent a major public health problem in the world and the advent and increase of human immunodeficiency virus infection during the last decade has highlighted the importance of infections spread by the sexual route. The World Health Organization estimates that the global incidence in 1995 of new cases of selected curable STDs, which are gonorrhea, chlamydial
Background. Knowledge about the spread of HIV and safe sexual practices has a critical impact on the prevention of the acquired immunodeficiency syndrome (AIDS). We assessed the knowledge of and attitude towards AIDS, sexuallytransmitted diseases (STDs) and sexuality among college students in Thiruvananthapuram district, Kerala. Methods. We performed a community-based, cross-sectional survey of 625 randomly selected undergraduate college students
S. S. LAL; R. S. VASAN; P. SANKARA SARMA; K. R. THANKAPPAN
PURPOSE: To assess longitudinally the relationship between knowledge about sexuallytransmitted diseases (STDs) and sexual behaviour, contraceptive use, STD protection and social class in a group of Swedish teenage girls. METHODS: Girls starting their upper secondary school education were invited to attend a teenage clinic during a period of 2 years (5 visits). Questions were asked about family situation, sexual
This study examines the knowledge of sexuallytransmitted diseases (STDs) among male youths in Malaysia. A self-administered survey was carried out on a sample of 952 never-married males aged 15-24 years. The respondents were asked about their knowledge of STDs, how these diseases get transmitted and their sexual behaviours. The data showed that 92% of the respondents knew of at least one STD (syphilis, gonorrhoea, chlamydia, herpes, genital warts, yeast infection, trichomoniasis or HIV/AIDS). About 95% of them knew of at least one method of STD transmission. Urban and tertiary-educated male youths showed a substantially higher proportion of awareness of STDs and transmission methods compared with their rural and less-educated counterparts. The data also indicated that 10% of the study sample admitted to having had sexual experiences. There were still a large proportion of the respondents who were not aware of STDs other than syphilis and HIV/AIDS and the means of transmission, such as multiple sex partners, including those who claimed to be sexually active. Thus there is a need for more concerted efforts to disseminate information on STDs and transmission methods to a wider audience in Malaysia, especially youths in rural areas. PMID:23480474
Awang, Halimah; Wong, Li Ping; Jani, Rohana; Low, Wah Yun
Objective The burden of sexuallytransmitted infections (STIs) rests with young people, yet in Ireland there has been very little research into this population. The purpose of this study was to determine the incidence rate and establish risk factors that predict STI occurrence among adolescents in Ireland. Design Routine diagnostic, demographic and behavioural data from first-time visits to three screening centres in the southwest of Ireland were obtained. Univariate and multivariable logistic regression models were used to assess risk factors that predict STI occurrence among adolescents. Results A total of 2784 first-time patients, aged 13–19?years, received 3475 diagnoses between January 1999 and September 2009; 1168 (42%) of adolescents had notifiable STIs. The incidence rate of STIs is 225/100 000 person-years. Univariate analysis identified eligible risk factors (p<0.2) for inclusion in the multivariable model. Multivariable logistic regression showed the dominant risk factors for STI diagnosis to be: males who sometimes [odds ratio (OR) 2.02] or never (OR 1.83) use condoms; and females 18–19?years (OR 2.26) and 16–18?years (OR 1.8), with 2 (OR 1.33) or 3+ (OR 1.56) partners in the last 12?months, who are non-intravenous drug users (OR 0.72), are most likely to receive a positive STI diagnosis. Conclusions STI diagnosis has become increasingly common in Ireland. The proportion of notifications among those aged under 20?years is increasing. These data illustrate the significance of age, condom use and number of sexual partners as risk factors for STI diagnosis. Furthermore, providing data for the first time, we report on the high incidence rate of STIs among adolescents in Ireland. The high levels of risk-taking behaviour and STI acquisition are highlighted and suggest that there is a need for an integrated public health approach to combat this phenomenon in the adolescent population. PMID:24916479
Davoren, Martin P; Hayes, Kevin; Horgan, Mary; Shiely, Frances
Cell surface heparan sulfate (HS), a polysaccharide composed of alternating uronic acid and glucosamine residues, represents a common link that many sexuallytransmitted infections (STIs) require for infection. Variable modifications within the monomeric units of HS chains together with their unique structural conformations generate heterogeneity, which expands the ability of HS to bind a diverse array of host and microbial proteins. Recent advances made in the field of glycobiology have critically enhanced our understanding of HS and its interactions with microbes and their significance in important human diseases. The role of HS has been elaborated for several STIs to include those caused by herpes simplex virus, human immunodeficiency virus, human papillomavirus, and Chlamydia. In addition, gonorrhea, syphilis, and yeast infections are also dependent on the presence of HS on human target cells. Critical steps such as pathogen adhesion or binding to host cells followed by internalization to enhance intracellular survival and possible spread to other cells are mediated by HS. In addition, HS guided cell signaling plays a role in the development of angiogenesis and inflammation associated with many STIs. Past and ongoing investigations are providing new push for the development of HS-mimetics and analogs as novel prevention strategies against many different STIs. This review article summarizes the significance of HS in STIs and describes how emerging new products that target HS can be used to control the spread of STIs. PMID:22773448
Tiwari, Vaibhav; Maus, Erika; Sigar, Ira M; Ramsey, Kyle H; Shukla, Deepak
The number of new HIV-1 infections remains stable in Switzerland over the last years thanks to the effective prevention programs. However, the aim to halve the new HIV infection rate has not been reached. Early identification of patients at risk of acquiring HIV infection and counselling "safer sex" rules as well as treating HIV-infected patients plays a decisive role in this program. Studies are -ongoing to investigate additional preventive measures such as pre-exposure prophylaxis, microbicides and vaccines, but none of those approaches permit omitting "safer sex". Incidences of other sexualtransmitted infections are increasing rapidly, in particular the incidence of Syphilis. Transmission occurs more often orally or rectally than vaginally and patients are often asymptomatic. Condoms provide only limited protection. In addition antibiotic resistance emerges complicating the therapy, as for example for gonorrhea. Testing and treatment of infected patients is primordial as well as contact tracing. In this work, we discuss the different elements for preventing STIs with major emphasis on HIV. PMID:25093318
Stoliaroff-Pépin, Anna; Speck, Roberto F; Vernazza, Pietro
An ongoing resurgence of syphilis and continued transmission of other common sexuallytransmitted diseases (STDs) in HIV-infected patients is fueled by a number of factors, including "prevention burnout" resulting from fatigue with long-term, safer-sex behavior, use of recretional drugs (notably methamphetamine), and false sense of security associated with HIV serosorting and elevated CD4+ cell count. Annual screening for common STDs is recommended for HIV-infected patients. Issues in syphilis and herpes simplex virus-2 (HSV-2) diagnosis and treatment are discussed. New problems are briefly reviewed, which include the increased reporting of lymphogranuloma venereum and the increased frequency of fluoroquinolone-resistant gonorrhea. The recently revised Centers for Disease Control and Prevention guidelines for treatment of syphilis, HSV-2 infection, chlamydial infection, and gonorrhea are summarized. This article summarizes a presentation on syphilis and other STDs made by Jeanne Marrazzo, MD, MPH, at the International AIDS Society-USA Continuing Medical Education course in New York, in October 2006. The original presentation is available as a Webcast at www.iasusa.org. PMID:17406079
HIV and other sexuallytransmitted diseases (STDs) are spreading rapidly in China. However, little is known about HIV risk among STD patients. In October–November 1997, we recruited a consecutive sample of 1,371 STD clinic patients from 16 different provinces and municipalities across the country and examined their sexual practices and condom use. We found that the median age for sexual
Kyung-Hee Choi; Zheng Xiwen; Qu Shuquan; Kevin Yiee; Jeffrey Mandel
To determine association between acquisition of sexuallytransmitted infections (STIs) over a nine-month period among sexually experienced adolescents attending an urban, general HMO teen clinic and African American race, use of marijuana more than once or twice a week, and having had relationships with a sexual partner who is more than four years older.
Cherrie B. Boyer; Nadew S. Sebro; Charles Wibbelsman; Mary-Ann Shafer
Accurate and inexpensive point-of-care (POC) tests are urgently needed to control sexuallytransmitted infection (STI) epidemics, so that patients can receive immediate diagnoses and treatment. Current POC assays for Chlamydia trachomatis and Neisseria gonorrhoeae perform inadequately and require better assays. Diagnostics for Trichomonas vaginalis rely on wet preparation, with some notable advances. Serological POC assays for syphilis can impact resource-poor settings, with many assays available, but only one available in the U.S. HIV POC diagnostics demonstrate the best performance, with excellent assays available. There is a rapid assay for HSV lesion detection; but no POC serological assays are available. Despite the inadequacy of POC assays for treatable bacterial infections, application of technological advances offers the promise of advancing POC diagnostics for all STIs. PMID:24484215
Sexuallytransmitted diseases have often been suggested as a potential cost of multiple mating and as playing a major role in the evolution of mating systems. Yet there is little empirical data relating mating strategies to sexuallytransmitted microorganisms in wild populations. We investigated whether mating behaviour influences the diversity and composition of cloacal assemblages by comparing bacterial communities in the cloaca of monandrous and polyandrous female common lizards Zootoca vivipara sampled after the mating period. We found that polyandrous females harboured more diverse communities and differed more in community composition than did monandrous females. Furthermore, cloacal diversity and variability were found to decrease with age in polyandrous females. Our results suggest that the higher bacterial diversity found in polyandrous females is due to the sexual transmission of bacteria by multiple mates. The impact of mating behaviour on the cloacal microbiota may have fitness consequences for females and may comprise a selective pressure shaping the evolution of mating systems. PMID:21811590
A detailed appraisal of the British seafarer and his way of life is described and the prevailing management of sexuallytransmitted disease in the seafarer is outlined. It is shown that the available statistics on the incidence of sexuallytransmitted disease among seafarers are inadequate. Management at sea and ashore remains generally unsatisfactory. Suggestions are made to improve the management of venereal disease in foreign ports and a simple method is described of managing sexuallytransmitted disease at sea with trimethoprim/sulphamethoxazole. PMID:946784
This study describes associations of partner?specific relationship characteristics with consistent condom use among 297 young people (ages 13–24) with sexuallytransmitted diseases (STD). Relationship?specific variables were relationship quality, reasons for sex, relationship duration, duration of sexual relationship, coital frequency, “established” versus “new” sexual partner, cohabitation, children, sexual coercion, and drug or alcohol use associated with coitus. Relationship characteristics associated with
Barry P. Katz; J. Dennis Fortenberry; Gregory D. Zimet; Margaret J. Blythe; Donald P. Orr
Introduction More new HIV-1 infections occur within stable HIV-1-discordant couples than in any other group in Africa, and sexuallytransmitted infections (STIs) may increase transmission risk among discordant couples, accounting for a large proportion of new HIV-1 infections. Understanding correlates of STIs among discordant couples will aid in optimizing interventions to prevent HIV-1 transmission in these couples. Methods HIV-1-discordant couples in which HIV-1-infected partners were HSV-2-seropositive were tested for syphilis, chlamydia, gonorrhea, and trichomoniasis, and HIV-1-uninfected partners were tested for HSV-2. We assessed sociodemographic, behavioral, and biological correlates of a current STI. Results Of 416 couples enrolled, 16% were affected by a treatable STI, and among these both partners were infected in 17% of couples. A treatable STI was found in 46 (11%) females and 30 (7%) males. The most prevalent infections were trichomoniasis (5.9%) and syphilis (2.6%). Participants were 5.9-fold more likely to have an STI if their partner had an STI (P<0.01), and STIs were more common among those reporting any unprotected sex (OR?=?2.43; P<0.01) and those with low education (OR?=?3.00; P<0.01). Among HIV-1-uninfected participants with an HSV-2-seropositive partner, females were significantly more likely to be HSV-2-seropositive than males (78% versus 50%, P<0.01). Conclusions Treatable STIs were common among HIV-1-discordant couples and the majority of couples affected by an STI were discordant for the STI, with relatively high HSV-2 discordance. Awareness of STI correlates and treatment of both partners may reduce HIV-1 transmission. Trial Registration ClinicalTrials.gov NCT00194519 PMID:20011596
Guthrie, Brandon L.; Kiarie, James N.; Morrison, Susan; John-Stewart, Grace C.; Kinuthia, John; Whittington, William L. H.; Farquhar, Carey
The aim of the study was to determine the differences in sexual behaviour and condom use as a protection against sexuallytransmitted infections (STI) between the first-year and the last-year students. Data were collected by filling anonymous and consented questionnaire in June of 2011 at University of Josip Juraj Strossmayer in Osijek, Croatia. Out of 857 students in the planned sample, 462 (53.9%) filled out the questionnaire, and 353/462 (76.4%) were sexually active. Data from sexually active students were processed and statistically significant results between first-year and the last-year students were presented. Studied sample consisted of 192/353 (54.4%) first-year students and 161/353 (45.6%) last-year students. Average age of sexual initiation for the first-year students was 17.28 +/- 1.29 years, a for the last-year students 18.45 +/- 2.14 years, and the difference is significant (Man-Whitney test = 10335.00, p < 0.01). First-year students have lower number of sexual partners (chi2 = 28.005, p < 0.01), during relationship they had lower number of intercourses with the third person (2 = 17.947, p < 0.01), and feel that lower number of their friends were already sexually active at the time of their own sexual initiation (chi2 = 18.350, p < 0.01). First-year students more often inform their partners about existing or previous STI (chi2 = 14.476, p < 0.01) and curiosity significantly influenced their decision regarding sexual initiation (chi2 = 8.689, p < 0.05). First-year students more often used condom at their first sexual intercourse (chi2 = 7.275, p < 0.01), and more rarely used withdrawal (chi2 = 6.380, p < 0.05). At their last sexual intercourse, first-year students more often used any kind of protection (chi2 = 3.853, p < 0.05),more often used condom (chi2 = 11.110, p < 0.01) and withdrawal (chi2 = 5.156, p < 0.05), and more rarely used contraceptive pills (chi2 = 4.405, p < 0.05). First-year students more often use condom in a permanent relationship (chi2 = 13.384, p < 0.05), and also plan to use it during following intercourse in the permanent relationship (chi2 = 17.575, p < 0.01). Growing condom use and decreasing risky sexual behaviour among students, as well as other adolescents and young adults needs to be maintained. Youth should learn before sexual initiation that only correct condom use at every sexual intercourse protects them against STI and human immunodeficiency virus (HIV). Sexual education and STI/HIV prevention programmes, positive role of media (television) and civil organisations that communicate with the youth can help that. Such changes among adolescents and young adults should have to be seen in student population as well. PMID:24851594
A survey was conducted in four major urban centres in Somalia in 1983 to determine the etiology and distribution of sexuallytransmitted diseases (STDs). Results a serosurvey oof 1923 STD clinic patients and 553 healthy controls revealed positive serologi...
The authors describe the principles and underlying assumptions that have guided the design of their STD (sexuallytransmitted diseases) initiatives, drawing special attention to the implications for AIDS (Acquired Immune Deficiency Syndrome) health education efforts. (Author/CT)
There is a paucity of research on the risk for sexuallytransmitted infections (STIs) and sexual behavior among general populations of men. Research with male populations predominantly has focused on those subgroups considered to be at high risk of disease transmission, such as gay and bisexual men, injection drug users, and adolescents\\/young adults. Considerably fewer studies have examined factors among
Alcohol use is associated with risks for HIV\\/AIDS. The association between alcohol and sexual risk may be accounted for by sensation seeking personality. However, sensation seeking in relation to substance use and HIV risk has not been examined in Africa. In this study, 292 men and 219 women receiving sexuallytransmitted infection (STI) diagnostic and treatment services in Cape Town,
Seth C. Kalichman; Leickness C. Simbayi; Sean Jooste; Demetria Cain; Charsey Cherry
This paper examines the impacts of four abstinence-only education programs on adolescent sexual activity and risks of pregnancy and sexuallytransmitted diseases (STDs). Based on an experimental design, the impact analysis uses survey data collected in 2005 and early 2006 from more than 2,000 teens who had been randomly assigned to either a program group that was eligible to participate
Christopher Trenholm; Barbara Devaney; Kenneth Fortson; Melissa Clark; Lisa Quay; Justin Wheeler
This paper examines the impacts of four abstinence-only education programs on adolescent sexual activity and risks of pregnancy and sexuallytransmitted diseases (STDs). Based on an experimental design, the impact analysis uses survey data collected in 2005 and early 2006 from more than 2,000 teens who had been randomly assigned to either a…
We conducted a qualitative study to explore the pathways by which traditional gender roles may ultimately affect Vietnamese women's interpretation of sexuallytransmitted disease (STD) symptoms and health-seeking strategies. Data on gender roles, perceptions of types of sexual relationships, perceptions of persons with STDs, and STD patient experiences were gathered through in-depth interviews and focus groups with 18 men and 18 women in the general population of northern Vietnam. A framework integrating Andersen's behavioral model of health services use and Zurayk's multi-layered model was used to conceptualize women's health-seeking behavior for STD symptoms. Both men and women noted clear gender differences in sexual roles and expectations. According to participants, a woman's primary roles in northern Vietnam are socially constructed as that of a wife and mother-and in these roles, she is expected to behave in a faithful and obedient manner vis à vis her husband. It emerged that men's marital and sexual roles are less clearly defined by traditional norms and are more permissive in their tolerance of premarital and extramarital sex. For women, however, these activities are socially condemned. Finally, since STDs are associated with sexual promiscuity, both men and women expressed anxiety about telling their partners about an STD; women's expressions were characterized more by fear of social and physical consequences, whereas men expressed embarrassment. Community level interventions that work towards disassociating STDs from traditional social norms may enable Vietnamese women to report possible STD symptoms and promote diagnosis and care for STDs. PMID:12144153
Go, Vivian Fei-ling; Quan, Vu Minh; Chung, A; Zenilman, Jonathan; Hanh, Vu Thi Minh; Celentano, David
Molecular diagnostic tests are more sensitive and, in many cases, more specific than conventional laboratory methods for the\\u000a detection of sexuallytransmitted infections. Here, we review recently developed molecular methods for the diagnosis and subtyping\\u000a of the most common sexuallytransmitted infections: infections caused by Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus, Trichomonas vaginalis, and the agents of genital ulcer disease
Purpose: To examine the influence of sociodemographic characteristics, sexuallytransmitted disease (STD)\\/human immunodeficiency virus knowledge, and psychosocial and behavioral risk factors on sexual risk and STDs in adolescents using constructs from the Information, Motivation, and Behavioral Skills model (IMB).Methods: A convenience sample of 303 sexually experienced, racially diverse adolescents (mean age 16.7 years, 57.9% female) who were seeking health care
Cherrie B Boyer; Mary-Ann Shafer; Charles J Wibbelsman; Donald Seeberg; Eileen Teitle; Nydia Lovell
There are many insults that result in gastrointestinal tract inflammation. Infections can be particularly challenging because (1) only a limited number of organisms provoke a specific endoscopic and/or histologic appearance; and (2) although some organisms may be present on biopsies, the findings may be so subtle or organisms so few that they are easily missed if the reviewer is not performing a specific search for the offender. Sexuallytransmitted infections (STI) are rarely a consideration at the time of GI biopsy examination and clinicians rarely inquire about sexual behavior at the time of initial patient interview. Although establishing a definitive STI diagnosis is not possible on histology alone, these infections are associated with inflammatory patterns that may help raise this diagnostic possibility. Becoming familiar with these patterns is necessary as worldwide outbreaks of these infections are being reported. This review aims to provide the pathologist with histologic clues associated with the most frequently encountered bacterial pathogens in the setting of STI proctitis, namely, Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum. PMID:24508691
Voltaggio, Lysandra; Montgomery, Elizabeth A; Ali, M Aamir; Singhi, Aatur D; Arnold, Christina A
The claim that circumcision reduces the risk of sexuallytransmitted infections has been repeated so frequently that many believe it is true. A systematic review and meta-analyses were performed on studies of genital discharge syndrome versus genital ulcerative disease, genital discharge syndrome, nonspecific urethritis, gonorrhea, chlamydia, genital ulcerative disease, chancroid, syphilis, herpes simplex virus, human papillomavirus, and contracting a sexuallytransmitted infection of any type. Chlamydia, gonorrhea, genital herpes, and human papillomavirus are not significantly impacted by circumcision. Syphilis showed mixed results with studies of prevalence suggesting intact men were at great risk and studies of incidence suggesting the opposite. Intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexuallytransmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexuallytransmitted infections. Consequently, the prevention of sexuallytransmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexuallytransmitted infections is not supported by the evidence in the medical literature. PMID:23710368
Objectives: To review studies of sexuallytransmitted infection (STI) prevalence in South Africa between 1985 and 2003 in selected sentinel populations. To examine how STI prevalence varies between populations and to identify the limitations of the existing data. Methods: Studies of the prevalence of syphilis, chancroid, granuloma inguinale, lymphogranuloma venereum, gonorrhoea, chlamydia, trichomoniasis, bacterial vaginosis, candidiasis, and herpes simplex virus type 2 (HSV-2) were considered. Results were included if they related to women attending antenatal clinics or family planning clinics, commercial sex workers, individuals in the general population (household surveys), patients with STIs, patients with genital ulcer disease (GUD), or men with urethritis. Results: High STI prevalence rates have been measured, particularly in the case of HSV-2, trichomoniasis, bacterial vaginosis and candidiasis. The aetiological profile of GUD appears to be changing, with more GUD caused by HSV-2 and less caused by chancroid. The prevalence of gonorrhoea and syphilis is highest in "high risk" groups such as sex workers and attenders of STI clinics, but chlamydia and trichomoniasis prevalence levels are not significantly higher in these groups than in women attending antenatal clinics. Conclusions: The prevalence of STIs in South Africa is high, although there is extensive variability between regions. There is a need for STI prevalence data that are more nationally representative and that can be used to monitor prevalence trends more reliably. PMID:16061532
BackgroundDespite remarkable progress in the scientific understanding of the biological characteristics of the pathogens, pathogenesis and immunology, human sexual behaviour and population transmission dynamics, there are still considerable knowledge gaps regarding the heterogeneity and determinants of epidemics of sexuallytransmitted infections (STI) and HIV. To understand more fully the causes of STI and HIV epidemics it is necessary to reconcile
The effect of psychiatric disorders on human immunodeficiency virus/sexuallytransmitted infection (HIV/STI) risk behaviors in juvenile justice youths is examined. Prevalence, persistence and prediction are addressed among four mutually exclusive diagnostic groups and results show a high prevalence rate of many HIV/STI sexual risk behaviors that…
Elkington, Katherine; Teplin, Linda A.; Mericle, Amy A.; Welty, Leah J.; Romero, Erin G.; Abram, Karen M.
The aims of this exploratory qualitative study were to increase our understanding of hetero- sexual young adults' knowledge and beliefs about sexuallytransmitted infections (STIs) other than HIV, to explore their beliefs about the factors that influence condom use for STI prevention, and to explore their ideas about how best to promote condom use for STI prevention. Data came from
Purpose: To examine the sexual behaviors and related risk factors for sexuallytransmitted diseases and HIV among young adults who seek sex partners on the Inter- net. Methods: Study staff recruited participants in online chat rooms, bulletin boards, and other online venues. A total of 4507 participants responded to a 68-item, self- administered, online survey of Internet sex-seeking prac- tices.
Examined risk factors associated with acquisition of sexuallytransmitted diseases (STD) among adolescents. Found that demographic factors were associated with being sexually experienced, but few demographics were associated with specific STD-related risk behaviors. Knowledge was not associated with any risk behaviors. Use of alcohol and drugs was…
Boyer, Cherrie B.; Tschann, Jeanne M.; Shafer, Mary-Ann
Objectives: To examine the relationship between use of oral contraceptive pills or depot medroxyprogesterone acetate and sexuallytransmitted disease acquisition. Study Design: Prospective cohort included 948 Kenyan prostitutes. Multivariate Andersen-Gill proportional hazards models were constructed, adjusting for sexual behavioral and demographic variables. Results: When compared with women who were using no contraception, users of oral contraceptive pills were at increased
Jared M. Baeten; Patrick M. Nyange; Barbra A. Richardson; Ludo Lavreys; Bhavna Chohan; Harold L. Martin; Kishorchandra Mandaliya; Jeckoniah O. Ndinya-Achola; Job J. Bwayo; Joan K. Kreiss
Sexually transmissible diseases (STDs), the most common notifiable infectious conditions, remain major threats to repro- ductive and public health worldwide. Travelers are particularly vulnerable to STDs, because of voluntary or involuntary sexual behavior while abroad, and are significant vectors who introduce new pathogens and resistant strains to unaffected parts of the world. This article outlines some key issues that travel
Abu Saleh M. Abdullah; Shahul H. Ebrahim; Richard Fielding; Donald E. Morisky
Sexuallytransmitted diseases (STDs) occur often among sexually active persons with HIV infection. Incident STDs may complicate\\u000a the course of HIV infection and potentiate HIV transmission in the coinfected individual by mucosal disruption and an increase\\u000a in HIV concentration in ulcers and involved mucous membranes. Conducting ongoing periodic sexual risk assessments in HIV-positive\\u000a patients in routine medical care is critical
Diseases caused by sexuallytransmitted agents are among the most common infectious diseases in the United States. Sexuallytransmitted diseases (STDs) have serious sequelae including physical pain, emotional distress, adverse reproductive outcomes, and cancer. They also pose an economic burden on society. STDs are challenging to prevent and control due to a general reluctance to address sexual health issues in an open manner. Human papillomavirus infection, chlamydia, and gonorrhea have recently been addressed by the Centers for Disease Control and Prevention in their Grand Rounds series reflecting their high-profile status on the national prevention and control agenda. This Insights column will focus on these three STDs. PMID:25157329
Background Online social media, such as the microblogging site Twitter, have become a space for speedy exchange of information regarding sexuallytransmitted diseases (STDs), presenting a potential risk environment for how STDs are portrayed. Examining the types of “tweeters” (users who post messages on Twitter) and the nature of “tweet” messages is important for identifying how information related to STDs is posted in online social media. Objective The intent of the study was to describe the types of message emitters on Twitter in relation to two different STDs—chlamydia and human immunodeficiency virus (HIV)—as well as the nature of content tweeted, including how seriously the topic was treated. Methods We used the Twitter search engine to look for tweets posted worldwide from August 1-7, 2013, and from September 1-7, 2013, containing the words “chlamydia” or “HIV”, and the hashtags “#chlamydia” or “#HIV”. Tweeters were classified by two independent reviewers according to the type of avatar of the user (human, logo, or fantasy), the identification of the emitter (identifiable, semi-identifiable, or non-identifiable), and the source (private company, general media, scientific media, non-governmental, individual account, academic institution, government department, or undefined). Tweet messages were also independently classified according to their nature (serious or jokes/funny), and whether their main message was factual or of a personal nature/experience. Results A total of 694 tweets were posted by 426 different users during the first 7 days of August and September, containing the hashtags and/or simple words “chlamydia” and/or “HIV”. Jokes or funny tweets were more frequently posted by individual users (89%, 66/74), with a human avatar (81%, 60/74), from a non-identifiable user (72%, 53/74), and they were most frequently related to chlamydia (76%, 56/74). Serious tweets were most frequently posted by the general media (20.6%, 128/620), using a logo avatar (66.9%, 415/620), and with identifiable accounts (85.2%, 528/620). No government departments, non-governmental organizations, scientific media, or academic institutions posted a joke on STDs. A total of 104 of these analyzed tweets were re-tweeted messages, belonging to 68 unique tweets. The content was serious (99%, 67/68), factual (90%, 52/58), and about HIV (85%, 58/68). Conclusions Social media such as Twitter may be an important source of information regarding STDs provided that the topic is presented appropriately. Reassuringly, the study showed that almost 9/10 of tweets on STDs (chlamydia and HIV) were of serious content, and many of the tweets that were re-tweeted were facts. The jokes that were tweeted were mainly about chlamydia, and posted by non-identifiable emitters. We believe social media should be used to an even larger extent to disseminate correct information about STDs. PMID:25289463
Objective To measure associations among depression, sexual risk behaviors, and sexuallytransmitted infection (STI) among white and black youth in the United States. Design Analysis of prospective cohort study data. Wave I of the National Longitudinal Study of Adolescent Health occurred in 1995 when participants were in grades 7 through 12. Six years later, all Wave I participants who could be located were invited to participate in Wave III and provide a urine specimen for STI testing. Setting In-home interviews in the continental United States, Alaska, and Hawaii. Participants Population-based sample. Wave I (adolescence) and Wave III (adulthood) white and black respondents with sample weight variables (N=10,783). Main Exposures Chronic depression (adolescence and adulthood) and recent depression (adulthood only) versus no adult depression. Outcome Measures Multiple sexual partnerships and inconsistent condom use in the past year and a current positive test result for C trachomatis, N gonorrhoeae, or T vaginalis (adulthood). Results Recent or chronic depression in adulthood was more common among blacks (women: 19%, men: 12%) than whites (women: 13%, men: 8%). Among all groups, adult depression was associated with multiple partnerships but not with condom use. Among black men, depression was strongly associated with STI (recent: adjusted Prevalence Ratio (PR): 2.36, 95% Confidence Interval (CI): 1.26–4.43; chronic: adjusted PR: 3.05 95% CI: 1.48–6.28); multiple partnerships did not mediate associations between depression and STI. Conclusions Integration of youth mental health and STI programs is warranted. Further research is needed to elucidate how depression may influence infection among black men. PMID:19581548
Khan, Maria R; Kaufman, Jay S; Pence, Brian Wells; Gaynes, Bradley N; Adimora, Adaora A; Weir, Sharon S; Miller, William C
During the past 30 years, there has been re- markable progress in our understanding of the pathogenesis of squamous cell carcinoma of the anus. It is now accepted that anal cancer is a sexu- ally transmitted disease, which can be cured using a combination of chemo- and radiotherapy. The biology of anal cancer remains to be elucidated, as do the
Pascal Gervaz; Abdelkarim S. Allal; Peter Villiger; Léo Bühler; Philippe Morel
Objective: Measuring sexuallytransmitted infections (STIs) and sexual practices in injection drug users (IDUs) and their regular sex partners. Goal: Informing HIV intervention programs. Design: Cross-sectional. Results: One percent IDUs and 2% of their regular female sex partners were syphilis infected; 40% (84\\/211) and 38% respectively (81\\/211) were infected with HSV-2. 30% IDUs and 5% of their female regular sex
Samiran Panda; M. SURESH KUMAR; P. S. SARAVANAMURTHY; P. MAHALINGAM; A. VIJAYLAKSHMI; P. BALAKRISHNAN; B. KANTESH; P A Tamby; Syed Jabbar; G Rangaiyan; S Flessenkaemper; Heiner Grosskurth; Mohan D. Gupte
Objectives. This article explores the social context of the migration-related HIV epidemic in western Mexico. Methods. Data collection involved life histories and participant observation with mi- grant women in Atlanta and their sisters or sisters-in-law in Mexico. Results. Both younger and older women acknowledged that migrant men's sexual be- havior may expose them to HIV and other sexuallytransmitted diseases.Younger
Jennifer S. Hirsch; Jennifer Higgins; Margaret E. Bentley; Constance A. Nathanson
Purpose of review Sexuallytransmitted infections (STIs) remain a major global public health issue, with more than 448 million incident bacterial infections each year. We review recent advances in STI point-of-care (POC) testing and implications for STI prevention and control. Recent findings Accurate immunochromatographic assays to detect HIV, hepatitis C virus (HCV) and syphilis antibodies have made home or supervised self-testing possible. Several studies have demonstrated feasibility and excellent test characteristics for HIV, HCV and syphilis POC tests. Rapid oral HIV tests are now available for purchase at retail sites across the United States. Combined HIV and syphilis tests using a single finger prick blood sample are under evaluation. Summary Oral POC STI tests with comparable performance to blood-based POC tests are available for self-testing. POC tests can expand screening, improve syndromic management and reduce loss to follow up. POC STI tests have the potential to facilitate prompt treatment and partner services. POC STI tests create opportunities for new social and financial models of community-based testing services. Increasing equity and access to testing will create challenges in linkage to care, quality assurance, partner services and surveillance. These important developments warrant research to understand appropriate contexts for implementation. PMID:23242343
Tucker, Joseph D.; Bien, Cedric H.; Peeling, Rosanna W.
The American Academy of Pediatrics (AAP) male circumcision policy states that while there are potential medical benefits of newborn male circumcision, the data are insufficient to recommend routine neonatal circumcision. Since 2005, however, 3 randomized trials have evaluated male circumcision for prevention of sexuallytransmitted infections. The trials found that circumcision decreases human immunodeficiency virus acquisition by 53% to 60%, herpes simplex virus type 2 acquisition by 28% to 34%, and human papillomavirus prevalence by 32% to 35% in men. Among female partners of circumcised men, bacterial vaginosis was reduced by 40%, and Trichomonas vaginalis infection was reduced by 48%. Genital ulcer disease was also reduced among males and their female partners. These findings are also supported by observational studies conducted in the United States. The AAP policy has a major impact on neonatal circumcision in the United States. This review evaluates the recent data that support revision of the AAP policy to fully reflect the evidence of long-term health benefits of male circumcision. PMID:20048246
Tobian, Aaron A. R.; Gray, Ronald H.; Quinn, Thomas C.
Little is known about sexuallytransmitted infections (STIs), including HIV, among truck drivers in China. A cross-sectional study was conducted among truck drivers in Tongling of Anhui Province. A total of 550 truck drivers were interviewed with a structured questionnaire, and blood samples were collected and tested for HIV, syphilis, and herpes simplex virus 2 (HSV-2), and urine specimens for Neisseria gonorrhoeae and Chlamydia trachomatis. Prevalence was 10.6% for C. trachomatis and 8.1% for N. gonorrhoeae. Antibodies for syphilis were found in 0.7% and for HSV-2 in 4.4%, and none was positive for HIV. About 92 (17.4%) truck drivers had at least one STI. There was no statistically significant association between sociodemographic, occupation or behavioural variables and the presence of a positive test for any STI. Our study suggests a high prevalence of STIs, particularly bacterial infections, among the truck drivers, indicating the need for health education, behavioural change interventions and STI care services in this population. PMID:16643679
Describes how self-constructed models of the male and female reproductive systems are used to simulate sexual intercourse and the actions of contraceptive devices in preventing conception and sexuallytransmitted diseases. (Author/YDS)
Objectives We examined patterns of sexual behavior and risk for sexuallytransmitted infections (STIs) in young adulthood for Black, Hispanic, and White females. Methods We used a nationally representative sample of 7015 female young adults from Wave III of the National Longitudinal Study of Adolescent Health. Sexual risk items assessed behaviors occurring in the previous 6 years and past year to determine classes of sexual risk and links to STIs in young adulthood. Results Latent class analysis revealed 3 sexual risk classes for Black and Hispanic youths and 4 sexual risk classes for White youths. The moderate and high risk classes had the highest probabilities of risky sexual partners, inconsistent condom use, and early age of sexual initiation, which significantly increased odds for STIs compared with recent abstainers. Conclusions We found different classes of sexual behavior by race/ethnicity, with Black and Hispanic young women most at risk for STIs in young adulthood. Preventive efforts should target younger adolescents and focus on sexual partner behavior. PMID:23488501
Pflieger, Jacqueline C.; Cook, Emily C.; Niccolai, Linda M.; Connell, Christian M.
Delinquent girls are at elevated risk for unplanned pregnancy and sexuallytransmitted diseases when compared with non-delinquent peers. Participants—234 incarcerated female juveniles—completed demographic, individual, partner, peer, and family measures and were tested for sexuallytransmitted diseases. Disease rates were as follows: chlamydia (20%), gonorrhea (4%), and syphilis (1%). Stepwise multiple linear regression analysis assessed the relationship of the predictor variable sets with sexual risk. Demographic and individual variables had the strongest associations with risk. Peer, partner, or family variables did not account for significant additional variance. The results suggest that an intervention could be delivered during the window of opportunity during the girls’ incarceration, changing their knowledge, attitudes, and skills that are implicated in risky sexual behavior before they are released back into the community. PMID:20585415
ST LAWRENCE, JANET S.; SNODGRASS, C. EDWARD; ROBERTSON, ANGELA; BAIRD-THOMAS, CONNIE
BACKGROUND: As stigma is a socially constructed concept, it would follow that stigma related to sexual behaviours and sexuallytransmitted infections would carry with it many of the gender-based morals that are entrenched in social constructs of sexuality. In many societies, women tend to be judged more harshly with respect to sexual morals, and would therefore have a different experience
Melanie LA Rusch; Jean A Shoveller; Susan Burgess; Karen Stancer; David M Patrick; Mark W Tyndall
OBJECTIVES--To examine the effect of patient-defined non-regular heterosexual relationships on the incidence of sexuallytransmitted diseases and other genital infections in women and the role of condom use in the prevention of their spread. DESIGN--A cross-sectional study of sexual behaviour reported by a standardised self-administered questionnaire in new patients who presented for screening and diagnosis. SETTING--A genitourinary medicine clinic in
Russia is experiencing one of the fastest growing HIV epidemics in the world. Russian sexuallytransmitted disease (STD) clinic\\u000a patients are at elevated risk for infection with HIV and other STDs due to unsafe sexual behaviors. Future risk reduction\\u000a intervention efforts for this group must be grounded in a solid understanding of the factors associated with risky behaviors.\\u000a We collected
Eric G. Benotsch; Steven D. Pinkerton; Roman V. Dyatlov; Wayne DiFranceisco; Tatyana S. Smirnova; Valentina Y. Dudko; Andrei Kozlov
Most primary prevention research has attempted to explain sexual health outcomes, such as sexuallytransmitted infections, by focusing on individual characteristics (e.g. age), qualities (e.g. knowledge levels), and risk behaviour (e.g. unprotected intercourse). Emerging evidence indicates that population?level health outcomes are unlikely to be explained adequately as an aggregate of such individual?level factors. Rather, approaches that move beyond individualistic frameworks
Jean A. Shovellera; Joy L. Johnsona; Daphné M. Savoy; W. A. Wia Pietersmaa
Objectives:Measuring patient satisfaction is an important aspect of making services attractive to patients and improving service delivery, and outpatient-based clinics are increasingly assessing service quality using patient-based outcome measures. No systematic review of patient satisfaction in sexuallytransmitted infection clinics has previously been performed. The objectives of the review were: (1) to establish how patient satisfaction with sexual health services
Three hundred and six sexually experienced adolescents participated in a study on sexuallytransmitted infection (STI) prevalence and associated risk factors. The prevalence of Neisseria gonorrhoea (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV) and syphilis was 4.5%, 9%, 8% and 4% for females and 4.7%, 5.7%, 0% and 2.8% for males. HIV-seropositivity was found in 15.2% of females and 5.8%
OBJECTIVE--To present recent trends in sexuallytransmitted diseases (STDs) in France and to estimate the gonorrhoea incidence in 1990. METHODS--Trends were analysed from data of three surveillance systems: (1) STD clinics: number of diagnoses, (2) a sentinel voluntary General Practitioner (GP) network: mean number of acute male urethritis\\/week\\/GP, characteristics of the notified urethritis (age, presence of discharge, sexual orientation), (3)
Sexual contact is thought to be an inefficient mode of hepatitis C virus (HCV) transmission. However, reports of sexually\\u000a transmitted HCV infection among HIV-infected men who have sex with men (MSM) began to appear in 2004. The patients were of\\u000a early middle age with well-controlled HIV infection, participated in unprotected receptive sex, and frequently used noninjection\\u000a recreational drugs. Molecular studies
OBJECTIVE--To examine surveillance data for evidence of changing sexual behaviour and continuing transmission of HIV-1 among men who have sex with men. DESIGN--Analytic study of surveillance data on sexuallytransmitted diseases. SETTING--England and Wales. MAIN OUTCOME MEASURES--Number of cases of rectal gonorrhoea and newly diagnosed HIV infection in homosexual men. RESULTS--New cases of gonorrhoea among men attending genitourinary medicine clinics
B G Evans; M A Catchpole; J Heptonstall; J Y Mortimer; C A McCarrigle; A G Nicoll; P Waight; O N Gill; A V Swan
Objective: To examine the longitudinal associations between depressive symptoms and self-reported sexuallytransmitted disease (STD) diagnosis among adolescents. Setting and Participants: National Longitudinal Study of Adolescent Health data were analyzed for 7th through 12th graders who reported having sexual intercourse be- tween baseline (Wave 1) and 1-year follow-up (Wave 2) in-home interviews (N=4738 (2232 boys, 2506 girls)). The association between
Lydia A. Shrier; Sion Kim Harris; William R. Beardslee
Summary Background There has been an increase in high-risk sexual behaviour and sexuallytransmitted diseases (STD) during the time period when highly active antiretroviral therapy (HAART) became widely available. We examined whether taking HAART increased the risk of acquiring an STD—an epidemiological marker of unsafe sex—in people with AIDS. Methods We did a computerised match of people in the San
Susan Scheer; Priscilla Lee Chu; Jeffrey D Klausner; Mitchell H Katz; Sandra K Schwarcz
Results: An estimated two million STDs were self-reported in the previous year, and 22 million 18-59-year-olds self-reported lifetime STDs. Bacterial STDs (gonorrhea, chlamydia, nongono- coccal urethritis, pelvic inflammatory disease and syphilis) were more common than viral STDs (genital herpes, genital warts, hepatitis and HIV). Genital warts were the most commonly re- ported STD in the past year, while gonorrhea was
Robert M. Brackbill; Maya R. Sternberg; Martin Fishbein
ObjectiveThe main objective of this study is to better understand the associations between forced sex history and history of sexuallytransmitted disease (STD) infection. Three research questions are investigated. Is history of forced sex associated with risk-taking behaviors? Are these risk-taking behaviors associated with history of STD? Is history of forced sex independently associated with history of STD?
Researchers conducted a survey of 199 students enrolled 2 public high schools in Alberta in Canada to learn of their knowledge about sexuallytransmitted diseases (STDs) and knowledge, attitude, and behaviors about condoms and their use. 41% were sexually active. 41% of these students did not or rarely used condoms. 44% had =or+ 3 partners. 61% of those with =or+ 3 partners used condoms and 56% with 1 partner used them. Knowledge of STDs and condom use stood high regardless of sex or sexual activity. 93% of the boys, 80% of the girls, 88% of sexually active and 87% of nonsexually active students stated it was their responsibility to carry condoms if they are sexually active. Moreover 96% of the boys, 78% of the girls, 81% of sexually active and 91% of nonsexually active students said they would use a condom during sexual intercourse. Nevertheless males and sexually active students did express some negative attitudes towards condoms, such as reduce sensation and interference with sexual spontaneity. Nonsexually active students tended to view condom use as a negative stigma (p.05). Most students claimed to be more likely to buy condoms from condom vending machines in the rest rooms than from stores (p.05). Sexual partners had the largest influence on students, especially sexually active students, to have or not have sexual intercourse followed by concerns about STDs, friends, and family. Further, the large majority of all students, especially females and sexually active students, said they would choose their sexual partner carefully because of the concern for AIDS and other STDs. They also tended to be monogamous and avoided high risk groups. In conclusion, no reliable differences occurred between attitudes towards condoms and use or nonuse of condoms to explain behavior. Future studies should be designed to center on factors that influence sexual behavior. PMID:1892493
Varnhagen, C K; Svenson, L W; Godin, A M; Johnson, L; Salmon, T
The US Centers for Disease Control and Prevention recently updated its recommendations for treating sexuallytransmitted diseases (STDs). In this review we highlight new treatment recommendations for mitigating the increasing prevalence of antibiotic-resistant Neisseria gonorrhoeae, the emergence of azithromycin-resistant Treponema pallidum, and treatment options for bacterial vaginosis and venereal warts. We also cover epidemiologic trends for common STDs in Hawai‘i. PMID:22454816
Most STIs in adolescents are asymptomatic. Recent studies in adolescents have documented relatively short periods of time until reinfection occurs (median times 4.7-7.6 months), suggesting that sexually active adolescents should be screened for STI every 6 months. Evidence-based practice is exceedingly helpful in deciding when to test, whom to test, and which methodology to use. In a recent critical analysis regarding screening women for chlamydia, screening all women for chlamydia was more cost-effective than testing only symptomatic women. With the proliferation of highly sensitive and specific assays, and the usefulness of different specimen sources (such as urine or self-swabs), health care providers of adolescents should screen all patients at risk for STIs. Although these screening and diagnostic techniques provide greater accuracy than previously attainable, screening should be part of a comprehensive methodology designed to promote good health care decisions, such as encouraging abstinence, promoting safer sexual practices, and using the most appropriate methodology to detect and treat STIs. PMID:15449846
OBJECTIVES: To determine the prevalence of sexuallytransmitted infections (STIs) and other reproductive tract infections (RTIs) among pregnant women in Moshi, Tanzania and to compare the occurrence of STIs\\/RTIs among human immunodeficiency virus (HIV)-infected and uninfected women. METHODS: Pregnant women in their 3rd trimester (N = 2654) were recruited from two primary health care clinics between June 2002 and March
Sia E Msuya; Jacqueline Uriyo; Akhtar Hussain; Elizabeth M Mbizvo; Stig Jeansson; Noel E Sam; Babill Stray-Pedersen
The prevalence of sexuallytransmitted infections (STIs) and reproductive tract infections (RTIs) among hotel-based sex workers (HBSWs) in Dhaka, Bangladesh, was studied. A total of 400 HBSWs were enrolled in the study during April to July 2002. Endocervical swabs, high vaginal swabs, and blood samples from 400 HBSWs were examined for Neisseria gonorrhoeae (by culture), Chlamydia trachomatis (by PCR), Trichomonas
The World Health Organization estimates that 340 million new cases of curable sexuallytransmitted infections (STIs) occur every year, while 33 million individuals are estimated to be living with HIV. The AIDS and STI epidemics are not independent with untreated STIs increasing HIV acquisition and transmission. Female sex workers have increased prevalence of untreated STIs and have been hypothesized to
Rachel Rosenheck; David Ngilangwa; Rachael Manongi; Saidi Kapiga
Objectives: The objectives of this study were to identify sexuallytransmitted infection (STI) prevalence, assess behavioral and symptom correlates, and develop intervention strategies. Goal: The goal of this study was to conduct one of the first commu- nity-based surveys of STI prevalence and risk behaviors among married men in India. Study Design: In 2003, 2,408 randomly selected married men, aged
Stephen L. Schensul; Sarah Hawkes; Niranjan Saggurti; Ravi K. Verma; Sharad S. Narvekar; Bonnie K. Nastasi; Joseph A. Burleson; Arun Risbud
Heparan sulfate (HS) serves as a receptor for adherence of herpes simplex viruses, Chlamydia trachomatis, Neisseria gonorrhoeae, and, indirectly, human immunodeficiency virus. Using primary human culture systems, we identified sulfated carbohydrate compounds that resemble HS and competitively inhibit infection by these pathogens. These compounds are candidates for intravaginal formulations for the prevention of sexuallytransmitted diseases. PMID:9420059
Herold, B C; Siston, A; Bremer, J; Kirkpatrick, R; Wilbanks, G; Fugedi, P; Peto, C; Cooper, M
This research project aims to examine the idea of stigma attached to cervical cancer in light of its association with HPV, a sexuallytransmitted infection (STI). The public recognition of this relationship appears to be increasing due to the current media attention surrounding HPV's causative role in the development of cervical cancer, and the newly-released HPV vaccine. Thus, this study
BACKGROUND: The incidence and prevalence of sexuallytransmitted infection (STI) in China has been on the rise in the past decade. Delineation of epidemiologic pattern is often hampered by its uneven distribution. Spatial distribution is often a neglected aspect of STI research, the description of which may enhance epidemiologic surveillance and inform service development. METHODS: Over a one month-period, all
Surveillance and epidemiological studies are essential components of effective control programmes for sexuallytransmitted diseases. While other forms of basic biomedical research may add to our understanding of why an exposure or behaviour causes or prevents disease, only epidemiology allows the quantification of the magnitude of the exposure-disease relationship in humans. It is this measure of the association between risk
The aims of this exploratory qualitative study were to increase our understanding of heterosexual young adults knowledge and beliefs about sexuallytransmitted infections (STIs) other than HIV, to explore their beliefs about the factors that influence condom use for STI prevention, and to explore their ideas about how best to promote condom use…
Increased awareness of the medical and social costs of sexuallytransmitted diseases (STD) has resulted in greater attention to the control of these illnesses. STDs are responsible for a significant amount of morbidity in Morocco and have become a key target of the HIV control program. In 1996, the Ministry of Health conducted a qualitative study in order to enhance
Lisa E. Manhart; Abdessamad Dialmy; Caroline A. Ryan; Jaouad Mahjour
This paper employs syndemics theory to explain high rates of sexuallytransmitted disease among inner city African American and Puerto Rican heterosexual young adults in Hartford, CT, USA. Syndemic theory helps to elucidate the tendency for multiple co-terminus and interacting epidemics to develop under conditions of health and social disparity. Based on enhanced focus group and in-depth interview data, the
Merrill C. Singer; Pamela I. Erickson; Louise Badiane; Rosemary Diaz; Dugeidy Ortiz; Traci Abraham; Anna Marie Nicolaysen
Adolescent male prostitutes have variable backgrounds; blend of different psychological, behavioral, social, and economic factors. Study of these factors forms basis for understanding potential risks they may be exposed to, including sexuallytransmitted diseases (STDs) and infection with human immunodeficiency virus (HIV). Reported high incidence…
Sexuallytransmitted diseases in developing countries are causing concern to those responsible for their control and eradication. To gain a better understanding of the problems involved in a country struggling with development, the economic and psychosocial factors influencing the spread of STD in Ethiopia have been studied. Increased migration and urbanisation and the changing role of women have led to
Mycoplasma genitalium is an emerging sexuallytransmitted pathogen implicated in urethritis in men and several inflammatory reproductive tract syndromes in women including cervicitis, pelvic inflammatory disease (PID), and infertility. This comprehensive review critically examines epidemiologic studies of M. genitalium infections in women with the goal of assessing the associations with reproductive tract disease and enhancing awareness of this emerging pathogen.
Outcomes from sex education are shaped not only by the knowledge and attitudes of youth but also by groups influential in young people's lives. American youth bear one of the highest rates of sexuallytransmitted infections (STIs) in the industrialized world. Four constituencies with important roles in communicating about STIs are youth, parents, healthcare providers and policy advocates of sex
Outcomes from sex education are shaped not only by the knowledge and attitudes of youth but also by groups influential in young people's lives. American youth bear one of the highest rates of sexuallytransmitted infections (STIs) in the industrialized world. Four constituencies with important roles in communicating about STIs are youth, parents,…
Path analysis was used to investigate factors associated with self?reported sexuallytransmitted diseases among 569 homeless and runaway adolescents in four Midwestern states. Youth were interviewed by outreach workers directly on the streets, in shelters, and in drop?in centers. Results indicated that family abuse was positively related to substance use, affiliation with friends who sold sex, and time on own.
Kimberly A. Tyler; Les B. Whitbeck; Dan R. Hoyt; Kevin A. Yoder
Prevention and control of sexuallytransmitted infections (STIs) has proven effective in reducing HIV infection when treatment is available promptly for symptomatic persons in conditions of an emerging epidemic. Biologically, it is assumed that reduced genital tract inflammation reduces infectiousness for HIV as well as reducing susceptibility in HIV-uninfected persons. Male circumcision has been demonstrated effective in reducing risk for
ObjectivesFew studies have assessed the effect of syndromic management interventions on the prevalence of sexuallytransmitted infections (STIs) at a population level. This study aims to determine the effect of syndromic management protocols that have been introduced in South Africa since 1994.
Leigh F. Johnson; Rob E. Dorrington; Debbie Bradshaw; David J. Coetzee
Sexuallytransmitted infections (STIs) are of major public health concern in developing countries, not least because they facilitate transmission of human immunodeficiency virus (HIV). The present article presents estimates of the prevalence, on any given day, of STIs among women in rural South Africa and the proportion who are asympto- matic, symptomatic but not seeking care, and symptomatic and seeking
D. Wilkinson; S. S. Abdool Karim; A. Harrison; M. Lurie; M. Colvin; C. Connolly; A. W. Sturm
The study analysed the patterns of SexuallyTransmitted Infections (STIs) among students in a Nigerian University. It is a retrospective study of 38,933 students who attended the University Health Centre from 2001 to 2005. The results showed that 1.8% of all the students who attended the clinic had STIs. The study also revealed that 85.26% of the…
BACKGROUND: Prison populations are known to be at high risk of sexuallytransmitted infections (STIs) and blood borne viruses (BBVs). In accordance with State health guidelines, the Western Australian Department of Correctional Services' policy is to offer testing for STIs and BBVs to all new prison entrants. This audit was undertaken to assess the completeness and timeliness of STI and
BACKGROUND: The serious long-term complications of sexuallytransmitted infections (STI) in women and newborns are well-documented. Particularly, STI imply considerable social consequences for women. Low STI knowledge has been shown to be associated with unsafe sex. In Vietnam, misconceptions regarding STI exist, and rural women delay seeking care for STI. The aim of the study was to investigate knowledge of
Pham Thi Lan; Cecilia Stålsby Lundborg; Ingrid Mogren; Ho Dang Phuc; Nguyen Thi Kim Chuc
Incarcerated women are at high risk for sexuallytransmitted infections (STI). Left untreated, these infections can have severe adverse health effects. This study presents prevalence rates of Trichomonas, Chlamydia, and Gonorrhea, and factors related to having an STI in a sample of 245 hazardously-drinking incarcerated women who reported heterosexual intercourse in the previous 3 months. Vaginal swabs were collected following
Celeste M. Caviness; Bradley J. Anderson; Michael D. Stein
The relationships between commercial sex work, drug use, and sexuallytransmitted infections (STI) in St. Petersburg, Russia were assessed using qualitative research methods and an examination of existing research, surveillance and epidemiology data. The rapid assessment methodology included in-depth qualitative interviews with key informants, naturalistic observations of commercial sex work and drug use sites, geo-mapping, and a critical review of
Sevgi O. Aral; Janet S. St. Lawrence; Roman Dyatlov; Andrei Kozlov
Lately there has been increasing interest regarding the practice of traditional healers and their use of indigenous plants to treat illnesses. Twenty-three local healers (n’ganga) in Chiawa, rural Zambia, were interviewed about knowledge, practices, and their use of indigenous plants in the diagnosis and treatment of sexuallytransmitted illnesses (STIs) among male clients. They were also asked about their perceptions
This article reports the results of a study of the impact of quasi-market reforms on sexuallytransmitted disease (STD) services in one UK health region. An internal or quasi-market was introduced into UK health care in the 1991 reforms of the National Health Service (NHS). Health authorities (HAs) and general practitioner fundholders were given major new responsibilities for purchasing (later
Nucleic acid amplification tests (NAAT) offer enhanced sensitivity and excellent specificity for many sexuallytransmitted\\u000a diseases. For some pathogens for which a practical diagnostic test does not exist, such as human papillomavirus (HPV), NAAT\\u000a are also useful. Further, most NAAT can be applied to less \\
Persons rely on health care providers to make diagnostic and therapeutic decisions based on the most current information. With areas of practice changing rapidly, providers are challenged to keep abreast of new and changing treatment guidelines. The new Centers for Disease Control and Prevention (CDC) 2002 SexuallyTransmitted Disease (STD) Treatment Guidelines provide clinical guidance in the appropriate assessment and
This study presents the perspective of vulnerable Canadian (Quebecker) adolescents defined as such on account of their numerous experiences with potential or actual fatherhood or exposure to sexuallytransmitted infection. The interviews allowed youth to talk about their experiences with paternity, their sex lives and their views on sex education.…
Objective: The authors describe the cervical cytology and sexuallytransmitted infection (STI) testing patterns of US college health centers. Participants and Methods: A total of 128 self-selected US college health centers--representing more than 2 million college students--completed an online survey during February and March 2007. Results: Almost…
EveryBody is a curriculum that emphasizes prevention of human immunodeficiency virus (HIV) and other sexuallytransmitted diseases (STDs) among early adolescents. It fosters active learning and facilitates communication about HIV/STD prevention and promotes safer behaviors. EveryBody incorporates current research on adolescent development so it…
Data from 1,087 adolescent participants in three waves of the National Longitudinal Study of Adolescent Health were used to examine the effects of peer selection and socialization processes in adolescence on later reports of sexuallytransmitted infections (STI) and unintended pregnancies. Friends' attitudes and behavior were assessed with…
Henry, David B.; Deptula, Daneen P.; Schoeny, Michael E.
CONTEXT: Each year, millions of U.S. youth acquire sexuallytransmitted diseases (STDs). Estimates of the economic burden of STDs can help to quantify the impact of STDs on the nation's youth and on the payers of the cost of their medical care. METHODS: We synthesized the existing literature on STD costs to estimate the lifetime medical cost per case of
Harrell W. Chesson; John M. Blandford; Thomas L. Gift; Guoyu Tao; Kathleen L. Irwin
Objective. Adverse childhood experi- ences (ACEs) may have long-term consequences on at- risk behaviors that lead to an increased risk of sexuallytransmitted diseases (STDs) during adulthood. There- fore, we examined the relationship between ACEs and subsequent STDs for both men and women. Methods. A total of 9323 (4263 men and 5060 women) adults >18 years of age participated in
Susan D. Hillis; Robert F. Anda; Vincent J. Felitti; Dale Nordenberg; Polly A. Marchbanks
Since the onset of the AIDS epidemic, the Centers for Disease Control and Prevention (CDC) has allocated several billion dollars for the prevention of HIV and other sexuallytransmitted diseases (STDs) in the United States. Using state-level data from 1981 to 1998, the authors found that greater amounts of prevention funding in a given year are…
Chesson, Harrell W.; Harrison, Paul; Scotton, Carol R.; Varghese, Beena
This article describes a 1-hour behavioral intervention designed to promote female condoms and safer sex to women at a high risk for sexuallytransmitted diseases (STDs). The intervention includes a promotional videotape; a skills-oriented counseling session with a nurse clinician; assorted take-home items, including a videotape for men; and free…
Artz, Lynn; Macaluso, Maurizio; Kelaghan, Joseph; Austin, Harland; Fleenor, Michael; Robey, Lawrence; Hook, III, Edward W.; Brill, Ilene
Sexuallytransmitted diseases (STD) are an important contraindication for intrauterine device (IUD) insertion. Nevertheless, laboratory testing for STD is not possible in many settings. The objective of this study is to evaluate the use of risk assessment algorithms to predict STD and subsequent IUD-related complications among IUD candidates. Among 615 IUD users in Kenya, the following algorithms were evaluated: 1)
Charles S Morrison; Christine Sekadde-Kigondu; William C Miller; Debra H Weiner; Samuel K Sinei
Objective: The authors evaluated procedures for recruiting college students for sexuallytransmitted disease (STD) testing as part of a research study examining the impact of HSV serologic testing. Participants: A convenience sample of 100 students was drawn from students aged 18 to 35 years enrolled at one university in a mid-Atlantic state…
Williams, Jessica Roberts; Zenilman, Jonathan; Nanda, Joy P.; Mark, Hayley
The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of sexuallytransmitted disease (STD) prevention, covering the following topics (1) Health Education; and…
Objective: To determine the event-level associations between perceived risk of sexuallytransmitted disease (STD) acquisition/transmission and condom use during penile-vaginal intercourse (PVI) among STD clinic attendees. Method: A convenience sample (N = 622) completed daily electronic assessments. Two questions were proxies of perceived risk:…
Crosby, Richard A.; Milhausen, Robin R.; Graham, Cynthia A.; Yarber, William L.; Sanders, Stephanie A.; Charnigo, Richard; Shrier, Lydia A.
A wide range of communicable human diseases can be considered as spreading through a network of possible transmission routes. The implied network structure is vital in determining disease dynamics, especially when the average number of connections per individual is small as is the case for many sexuallytransmitted diseases (STDs). Here we develop an intuitive mathematical framework to deal with
Background Over three-quarters of new HIV infections in China during 2009 were estimated to be from sexual transmission. Over half of those living with HIV do not know their serostatus and identifying and treating individuals with sexuallytransmitted HIV infection has been challenging. Objective This global assessment explores Chinese systems for detecting and treating those with HIV infection with a particular focus on groups at increased risk of sexuallytransmitted HIV. Methods Published literature, grey sources and non-governmental reports were reviewed to describe HIV testing and care systems in China. Results HIV testing and care in China involve several parallel health systems and have been largely successful in reaching large numbers of vulnerable individuals. Provider-initiated testing and counselling has been more effective than voluntary counselling and testing programmes for expanding HIV testing efforts in China. Individuals with sexuallytransmitted HIV infection are underrepresented in the antiretroviral care system compared with other high-risk groups. Conclusions Comprehensive HIV testing and care bring together a number of Chinese health systems, but there are still gaps and challenges. Research and programmes focused on HIV testing and care for those with increased sexual risk are needed. PMID:22345024
Tucker, Joseph D; Wong, Frank Y; Nehl, Eric J; Zhang, Fujie
OBJECTIVES: To determine the importance of world region of birth as a risk factor for HIV-1 infection, the likelihood of having an HIV-1 infection diagnosed and the likelihood of having another coexisting acute sexuallytransmitted infection (STI) among attenders at genitourinary medicine clinics. SUBJECTS: Specimens from attenders having routine syphilis serology at 15 sexuallytransmitted disease clinics in England, Wales,
Recent trends in the behaviors of some groups with high sexual activity and of the general population in some countries suggest that sexual behavior profiles of high and low sexual activity categories may be converging and may call into question the assumptions around sexual mixing that are built into theoretical models of sexuallytransmitted infections (STIs)/human immunodeficiency virus (HIV) transmission dynamics. One category of high sexual activity, sex work, has been undergoing modification in many societies, becoming more acceptable, more dispersed, and larger in volume in some societies and shrinking in others. Concurrent with changes in the characteristics of sex work, the accumulating data on the sexual behaviors of the general population suggest a shift toward those of sex workers, including large numbers of sex partners and short-duration partnerships. The closing of the gap between behaviors associated with high and low sexual activity may have important implications for theories of sexual structure and models of transmission dynamics for STIs, including HIV infection. PMID:25381381
Objectives. We examined associations between childhood abuse and neglect and the risk in adulthood for sexuallytransmitted diseases. Methods. In a prospective cohort design, we matched children aged 0 to 11 years with documented cases of abuse or neglect during 1967 to 1971 with a control group of children who had not been maltreated (754 participants in all) and followed them into adulthood. Information about lifetime history of sexuallytransmitted diseases was collected as part of a medical status examination when participants were approximately 41 years old. Results. Childhood sexual abuse increased risk for any sexuallytransmitted disease (odds ratio [OR] = 1.94; 95% confidence interval [CI] = 1.00, 3.77; P = .05) and more than 1 type of sexuallytransmitted disease (OR = 3.33; 95% CI = 1.33, 8.22; P = .01). Physical abuse increased risk for more than 1 type of sexuallytransmitted disease (OR = 3.61; 95% CI = 1.39, 9.38; P = .009). Conclusions. Our results provided the first prospective evidence that child physical and sexual abuse increases risk for sexuallytransmitted diseases. Early screening and interventions are needed to identify and prevent sexuallytransmitted diseases among child abuse victims. PMID:19218173
Objective To determine the effectiveness of a brief cognitive behavioural intervention in reducing the incidence of sexuallytransmitted infections among gay men. Design Randomised controlled trial with 12 months' follow up. Setting Sexual health clinic in London. Participants 343 gay men with an acute sexuallytransmitted infection or who reported having had unprotected anal intercourse in the past year. Main outcome measures Number of new sexuallytransmitted infections diagnosed during follow up and self reported incidence of unprotected anal intercourse. Results 72% (361/499) of men invited to enter the study did so. 90% (308/343) of participants returned at least one follow up questionnaire or re-attended the clinic and requested a check up for sexuallytransmitted infections during follow up. At baseline, 37% (63/172) of the intervention group and 30% (50/166) of the control group reported having had unprotected anal intercourse in the past month. At 12 months, the proportions were 27% (31/114) and 32% ( 39/124) respectively (P=0.56). However, 31% (38/123) of the intervention group and 21% (35/168) of controls had had at least one new infection diagnosed at the clinic (adjusted odds ratio 1.66, 95% confidence interval 1.00 to 2.74). Considering only men who requested a check up for sexuallytransmitted infections, the proportion diagnosed with a new infection was 58% (53/91) for men in the intervention group and 43% (35/81) for men in the control group (adjusted odds ratio 1.84, 0.99 to 3.40). Using a regional database that includes information from 23 sexual health clinics in London, we determined that few participants had attended other sexual health clinics. Conclusions This behavioural intervention was acceptable and feasible to deliver, but it did not reduce the risk of acquiring a new sexuallytransmitted infection among these gay men at high risk. Even carefully designed interventions should not be assumed to bring benefit. It is important to evaluate their effects in randomised trials with objective clinical end points. What is already known on this topicThe need for effective HIV prevention strategies based on reducing sexual risk behaviour remains importantFew interventions to reduce sexual risk behaviour have been rigorously evaluated using randomised controlled trialsWhat this study addsThis is the first randomised controlled trial of an intervention addressing sexual behaviour in homosexual men that uses sexuallytransmitted infections and self reported behaviour as end pointsThe intervention was brief and feasible to use in a busy clinic, but it did not reduce the risk of participants acquiring new infectionsThe potential for behavioural interventions to do more harm than good needs to be taken seriously PMID:11408300
Imrie, John; Stephenson, Judith M; Cowan, Frances M; Wanigaratne, Shamil; Billington, Andrew J P; Copas, Andrew J; French, Lesley; French, Patrick D; Johnson, Anne M
OBJECTIVE--To investigate the risk factors for HIV infection in patients attending clinics for sexuallytransmitted diseases in India. DESIGN--Descriptive study of HIV serology, risk behaviour, and findings on physical examination. SUBJECTS--2800 patients presenting to outpatient clinics between 13 May 1993 and 15 July 1994. SETTING--Two clinics and the National AIDS Research Institute, in Pune, Maharashtra State, India. MAIN OUTCOME MEASURE--HIV status, presence of sexuallytransmitted diseases, and sexual behaviour. RESULTS--The overall proportion of patients infected with HIV was 23.4% (655/2800); 34% (184) of the women and 21% (459) of the men were positive for HIV infection. Of the 560 women screened, 338 (60%) had a reported history of sex working, of whom 153 (45%) were infected with HIV-1. The prevalence of HIV-1 infection in the 222 women who were not sex workers was 14%. The significant independent characteristics associated with HIV infection based on a logistic regression analysis included being a female sex worker, sexual contact with a sex worker, lack of formal education, receptive anal sex in the previous three months, lack of condom use in the previous three months, current or previous genital ulcer or genital discharge, and a positive result of a Venereal Disease Research Laboratory test. CONCLUSIONS--In India the prevalence of HIV infection is alarmingly high among female sex workers and men attending clinics for sexuallytransmitted diseases, particularly in those who had recently had contact with sex workers. A high prevalence of HIV infection was also found in monogamous, married women presenting to the clinics who denied any history of sex working. The HIV epidemic in India is primarily due to heterosexual transmission of HIV-1 and, as in other countries, HIV infection is associated with ulcerative and non-ulcerative sexuallytransmitted diseases. PMID:7633230
Rodrigues, J. J.; Mehendale, S. M.; Shepherd, M. E.; Divekar, A. D.; Gangakhedkar, R. R.; Quinn, T. C.; Paranjape, R. S.; Risbud, A. R.; Brookmeyer, R. S.; Gadkari, D. A.
and who are not minority group members are at risk of contracting iv viral infections with more frequency. Finally, a hidden epidemic among Chinese women was detected with respect to the bacterial infections. It is important to study..., and SexuallyTransmitted Infections. STIs are a problem of enormous import in the world today and are continuing to spread at alarming rates. Furthermore, they are increasingly affecting larger and larger populations. Specifically, there is a...
A lack of investigation in specific regions has impeded the understanding of epidemiological trends in the prevalence of sexuallytransmitted infections (STIs) in South Korea. To help fill this research gap, this study used multiplex polymerase chain reaction (mPCR) to determine the prevalence of STIs detected in clinical specimens collected from women in Cheonan, South Korea between August 2006 and November 2012, and analyzed the prevalence of STIs according to age, bacterial pathogen, and time period. Of the 1,618 specimens collected from 1,523 patients, 536 (35.2%) tested positive for at least 1 pathogen, with 407 (25.2%) testing positive for 1 pathogen, 103 (6.4%) for 2 pathogens, 20 (1.2%) for 3 pathogens, and 6 (0.4%) for 4 pathogens (n = 697 pathogens total). The median ages of all patients and of STI-positive patients were 37.8 and 33.3 years, respectively, and both decreased annually over the study period. Mycoplasma hominis (MH) was detected in 62.1% of the positive specimens, Ureaplasma urealyticum (UU) in 28.4%, Chlamydia trachomatis (CT) in 23.1%, Trichomonas vaginalis (TV) in 7.8%, Mycoplasma genitalium (MG) in 6.5%, and Neisseria gonorrhoeae (NG) in 2.1%. Whereas the prevalence of MH, MG, and TV infection did not vary greatly over the study period, that of UU decreased by one-fifth and that of both CT and NG increased 4-fold. The results indicate great variability in the rates of infection with each pathogen and a decreasing trend in overall STI prevalence, age of patients seeking STI testing, and age of STI-positive patients. PMID:23966022
Background To assess the covariates of alcohol abuse and the association between alcohol abuse, high-risk sexual behaviors and sexuallytransmitted infections (STIs). Methods 2,019 women aged 20–44 were randomly selected in a two-stage sampling from the Moshi urban district of northern Tanzania. Participant’s demographic and socio-economic characteristics, alcohol use, sexual behaviors and STIs were assessed. Blood and urine samples were drawn for testing of human immunodeficiency virus, herpes simplex virus, syphilis, chlamydia, gonorrhea, trichomonas and mycoplasma genitalium infections. Results Adjusted analyses showed that a history of physical (OR=2.05; 95% CI: 1.06–3.98) and sexual violence (OR=1.63; 95% CI: 1.05–2.51) was associated with alcohol abuse. Moreover, alcohol abuse was associated with number of sexual partners (OR=1.66; 95% CI: 1.01–2.73). Women who abused alcohol were more likely to report STIs symptoms (OR=1.61; 95% CI: 1.08–2.40). Women who had multiple sexual partners were more likely to have an STI (OR=2.41; 95% CI: 1.46–4.00) compared to women with one sexual partner. There was no direct association between alcohol abuse and prevalence of STIs (OR=0.86; 95% CI: 0.55–1.34). However, alcohol abuse was indirectly associated with STIs through its association with multiple sexual partners. Conclusions The findings of alcohol abuse among physically and sexually violated women as well as the association between alcohol abuse and a history of symptoms of STIs and testing positive for STIs have significant public health implications. In sub-Saharan Africa, where women are disproportionately affected by the HIV epidemic screening for alcohol use should be part of comprehensive STIs and HIV prevention programs. PMID:19060779
Risky sexual behavior can lead to pregnancy, sexuallytransmitted diseases (STDs), and human immunodeficiency virus (HIV). Our study of 300 adolescent females takes an integrative approach by incorporating these multiple outcomes to assess the influence of risk perceptions on sexual behavior by (1) identifying subgroups of perceived susceptibility…
Kershaw, Trace S.; Ethier, Kathleen A.; Milan, Stephanie; Lewis, Jessica B.; Niccolai, Linda M.; Meade, Christina; Ickovics, Jeannette R.
HIV and sexuallytransmitted infection (STI) are of concern in Mayan districts of Guatemala in which labor migration is common. This study assessed whether the migration status of men is associated with reported STI symptoms among their female primary partners. In a multivariate analysis of survey data taken from a larger Mayan sexual health study, the odds of reporting STI symptoms were twofold higher among women who reported that their partner migrated (OR 2.08, 95 % CI, 1.16-3.71), compared to women whose partners did not. Women from the Mam and Kaqchikel ethnolinguistic groups reported higher rates of STI symptoms after adjustment for their partners' migration status. PMID:23963499
Ikeda, Janet M; Schaffer, Jessica R; Sac Ixcot, Maria L; Page, Kimberly; Hearst, Norman
Our study objective was to determine the prevalence and pattern of sexuallytransmitted diseases (STDs) and to study sexual lifestyles of long-distance truck drivers and their assistants in south India. For this, a total of 263 truck drivers/assistants were recruited from the highway clinic from October 1999 to March 2001. All of them were sexually active and heterosexual contact was the predominant mode (99.2%). Two-thirds of them had contact with commercial sex workers (CSWs) and roughly 60% admitted alcohol consumption. One hundred and two participants (38.7%) had various STDs. The positivity rates of HIV, VDRL and HBsAg were 15.9%, 13.3% and 21.2% respectively. The higher median age, education less than primary school level, longer duration of occupation, longer duration of each trip and a previous history of genital ulcer disease were significant risk factors for the acquisition of HIV infection. PMID:12230925
Diagnostic advances do not generally receive the recognition given to prevention and treatment contributions, for the control and management of infectious diseases including sexuallytransmitted infections (STIs). In order to identify seminal diagnostic contributions over a half century (1950–2000), the Editorial Board of the WHO SexuallyTransmitted Diseases Diagnostics Initiative (SDI) Publication Review or “electronic journal club” were asked to nominate their choices of peer?reviewed publications for special recognition. From 43 nominations, 13 were voted by a panel of 25 “experts” as having made the most significant contributions. The 1964 article by Thayer and Martin, which identified a selective media for gonococcal culture, was chosen unanimously by all panel members and is identified as the classic STI diagnostic article for this era. PMID:17135329
Ronald, A; Kuypers, J; Lukehart, S A; Peeling, R W; Pope, V
We investigated prevalence of sexuallytransmitted infections (STI) in a cohort of HIV-1-infected pregnant women and described\\u000a factors associated with STI diagnosis, as a nested study within the European Collaborative Study (ECS). The ECS is a cohort\\u000a study in which HIV-infected pregnant women are enrolled and their children followed from birth, according to standard clinical\\u000a and laboratory protocols. Information on
Megan Landes; Claire Thorne; Patricia Barlow; Simona Fiore; Ruslan Malyuta; Pasquale Martinelli; Svetlana Posokhova; Valeria Savasi; Igor Semenenko; Andrej Stelmah; Cecilia Tibaldi; Marie-Louise Newell
Objective: To evaluate the use of self-collected vaginal swabs to test for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis, and to describe the acceptability of this technique to adolescents.Design: Comparison of a new protocol for sexuallytransmitted infection (STI) testing with the current standard of care, using the same subjects. Survey of attitudes regarding the self-collection technique.Setting: A juvenile correctional
Objective: The authors describe the cervical cytology and sexuallytransmitted infection (STI) testing patterns of US college health centers. Participants and Methods: A total of 128 self-selected US college health centers—representing more than 2 million college students—completed an online survey during February and March 2007. Results: Almost 13% of cervical cytology results were abnormal; most of these were atypical squamous
The Internet is a relatively new tool in the surveillance and prevention of sexuallytransmitted infections, and this review examines its global use in this regard. Much use has been made in the form of information collection and dissemination; targeted population engagement through chat rooms, partner notification and other mechanisms; and the provision of testing services and other products. Internet users may need education concerning reputable websites, and public health practitioners need proficiency in the use of social media and marketing. PMID:22207184
. ?We develop a moment closure approximation (MCA) to a network model of sexuallytransmitted disease (STD) spread through a\\u000a steady\\/casual partnership network. MCA has been used previously to approximate static, regular lattices, whereas application\\u000a to dynamic, irregular networks is a new endeavour, and application to sociologically-motivated network models has not been\\u000a attempted. Our goals are 1) to investigate issues relating
High rates of infection for chlamydia and gonorrhea have been noted among youths involved in the juvenile justice system.\\u000a Although both individual and community-level factors have been found to be associated with sexuallytransmitted disease (STD)\\u000a risk, their relative importance has not been tested in this population. A two-level logistic regression analysis was completed\\u000a to assess the influence of individual-level
Richard Dembo; Steven Belenko; Kristina Childs; Jennifer Wareham; James Schmeidler
Objective:To examine associations between migration and sexuallytransmitted infection (STI) prevalence among Mexican female sex workers (FSW).Methods:FSW aged 18 years and older in Tijuana, Baja California (BC) underwent interviews and testing for HIV, syphilis, gonorrhoea and chlamydia. Multivariate logistic regressions identified correlates of STI.Results:Of 471 FSW, 79% were migrants to BC. Among migrant FSW, prevalence of HIV, syphilis, gonorrhoea, chlamydia
V D Ojeda; S A Strathdee; R Lozada; M L A Rusch; M Fraga; P Orozovich; C Magis-Rodriguez; A De La Torre; H Amaro; W Cornelius; T L Patterson
OBJECTIVE--To understand whether barrier methods of contraception (BMC) and\\/or spermicides lower the risk of acquiring sexuallytransmitted disease (STD) and to quantify the protection. DESIGN--Review of published experimental studies, in vitro and in vivo evidence on the issue. SUBJECTS--We reviewed 22 papers that examined the impermeability of BMC in vitro against STD agents or the effect of spermicides, and 60
Sexuallytransmitted diseases (STDs) can present significant diagnostic difficulties when they occur in HIV-positive persons, and the appropriate treatment and follow-up of an HIV-pos- itive patient with an STD occasionally differs from the standard clinical approach to treating HIV-negative patients. Given our current understanding of the role of STDs in increasing the risk of HIV transmission (1-3), appropriate management of
\\u000a Farmworkers in the United States (US) have been disproportionately affected by the intersecting epidemics of tuberculosis\\u000a (TB), sexuallytransmitted diseases (STDs), and HIV. Furthermore, farmworkers tend to be politically, socially, and economically\\u000a disenfranchised, which contributes to their increased vulnerability to infectious diseases. This chapter examines the epidemiology\\u000a of infectious diseases, specifically TB, STDs, and HIV, among farmworkers; explores the risks
Health care professionals are a major source of risk communications, but their estimation of risks may be compromised by systematic biases. We examined fuzzy-trace theory's pre- dictions of professionals' biases in risk estimation for sexuallytransmitted infections (STIs) linked to: knowledge deficits (producing underestimation of STI risk, re-infection, and gender differences), gist-based mental representation of risk categories (producing overestimation of
The prevalence of venereal disease among homosexual men was investigated by looking at non-clinic patients from Sweden, Australia, Finland, and the Republic of Ireland. Results showed significant differences between nationalities in the incidence of syphilis, gonorrhoea, other sexuallytransmitted diseases (STD), number of variables of presentation to STD clinics, and number of infections. Data were interpreted as indicating that social and cultural factors may influence incidence of STD in male homosexuals. PMID:6546530
One hundred and ninety three consecutive pregnant women attending peripheral antenatal clinics attached to Ngwelezana Hospital, Empangeni, Kwa-Zulu, were examined for evidence of sexuallytransmitted pathogens. The following incidences were found: Trichomonas vaginalis 49.2% (95), Candida spp 38.3% (74), Chlamydia trachomatis 11.4% (22), Gardnerella vaginalis 6.2% (12), Neisseria gonorrhoeae 5.7% (11), positive syphilis serology results 11.9% (23), hepatitis B surface
N OFarrell; A A Hoosen; A B Kharsany; J van den Ende
Objectives: Syndromic sexuallytransmitted infection (STI) treatment remains a cost-saving HIV prevention intervention in many countries in Africa. We estimate the effectiveness of syndromic treatment for curable STIs in rural KwaZulu-Natal, South Africa, and the trend in STI prevalences before and after the introduction of syndromic treatment in 1995. Methods: Data were available from various clinical studies, surveys of public
R G White; P Moodley; N McGrath; V Hosegood; B Zaba; K Herbst; M Newell; W A Sturm; R J Hayes
ObjectivesTo propose a Bayesian approach to uncertainty analysis of sexuallytransmitted infection (STI) models, which can be used to quantify uncertainty in model assessments of policy options, estimate regional STI prevalence from sentinel surveillance data and make inferences about STI transmission and natural history parameters.MethodsPrior distributions are specified to represent uncertainty regarding STI parameters. A likelihood function is defined using
Leigh F Johnson; Leontine Alkema; Rob E Dorrington
ObjectivesThis study evaluated the role of single session counselling on partner referral among index cases diagnosed as having sexuallytransmitted infections (STIs) in Bangladesh.MethodsA quasirandomised trial was conducted in 1339 index cases with symptomatic STIs in 3 public and 3 non-government organisation operated clinics.ResultsOut of 1339 index cases, partner referral was achieved by 37% in the counselling group and 27%
Nazmul Alam; Peter Kim Streatfield; M. Shahidullah; Dipak Mitra; Sten H Vermund; Sibylle Kristensen
OBJECTIVE--To examine trends in some sexuallytransmitted diseases in Belgium and to discuss them in the light of the European background. DESIGN--Analysis of the time trends of C trachomatis and N gonorrhoeae infections diagnosed by a network of microbiological laboratories, and of male urethritis diagnosed by a network of general practitioners. SETTING--Belgium. SUBJECTS--Reports of C trachomatis and N gonorrhoeae infections
D Walckiers; P Piot; A Stroobant; J Van der Veken; E Declercq
Background. We aimed to assess the association between knowledge about sexuallytransmitted infections (STIs) and consistent condom use among university students controlling for selected socio-demographic factors.Method. An anonymous questionnaire survey was carried out among 720 undergraduate students (76% women) at the University of Tirana, Albania, in October–November 2002. The questionnaire included socio-demographic data, 10 multiple-choice test questions on knowledge about
Sexuallytransmitted infections (STIs) have shown to enhance the transmission of human immunodefi- ciency virus (HIV) and to be more common among female commercial sex workers (FSWs). A cross-sectional study was conducted among 625 FSWs in six cities of Argentina in 2000-2002. The seroprevalence of HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), human T-cell lymphotropic virus type I\\/II,
CAROLINA BERINI; MARIEL BIBINI; MAURO FERNÁNDEZ; ELENA REINAGA; SERGIO MAULEN; RUBÉN MARONE; MIRNA BIGLIONE; SILVIA M. MONTANO; CHRISTIAN T. BAUTISTA; MERCEDES WEISSENBACHER; JOSÉ L. SANCHEZ; MARÍA M. AVILA
Between 1977 and 1981, 3089 patients attended the sexuallytransmitted diseases (STD) clinic in Zaria, northern Nigeria. The male-to-female ratio of attenders was 6:1. Postpubertal gonorrhoea accounted for 28.1% of cases, non-specific genital infections for 22.4%, and syphilis for 1.2%. Illiteracy, polygamy, the purdah system, widespread prostitution, and inadequate facilities are factors aiding the spread of these diseases in northern Nigeria. PMID:6687822
In this paper, a sexuallytransmitted disease model is proposed on complex networks, where contacts between humans are treated as a scale-free social network. There are three groups in our model, which are dangerous male, non-dangerous male, and female. By mathematical analysis, we obtain the basic reproduction number for the existence of endemic equilibrium and study the effects of various immunization schemes about different groups. Furthermore, numerical simulations are undertaken to verify more conclusions.
OBJECTIVES--The aim of this study was to establish the prevalence of sexuallytransmitted infections including human immunodeficiency virus (HIV) infection in women with Bartholin's gland abscess. SETTING--Gynaecology Clinic of King Edward VIII Hospital, a large urban, referral hospital for the province of Kwa-Zulu Natal, serving an underprivileged population. METHODS--Thirty consecutive women presenting with unruptured Bartholin's gland abscesses were studied. Prior to surgical drainage, aspirates from the abscess cavity and swab specimens from the vagina and endocervix were collected for microbiological investigations. In addition peripheral venous blood samples were obtained for syphilis and HIV antibody testing. RESULTS--Antibody to HIV was detected in 9 of the 30 (30%) patients studied. Recognised sexuallytransmitted pathogens were detected in both aspirates and endocervical specimens: Chlamydia trachomatis was detected in 3 aspirate and 2 endocervical specimens whilst Neisseria gonorrhoeae was cultured in 5 aspirate and 7 endocervical specimens. When comparing microorganisms isolated from HIV antibody positive and negative women, only Bacteroides species yielded a significantly higher growth (p = 0.01) in the antibody positive women. CONCLUSION--Our findings show that women with Bartholin's gland abscesses have a high prevalence of HIV antibody. Furthermore, this is the only study that demonstrates a role for C trachomatis in the aetiology of Bartholin's gland abscesses. Health workers should be aware of the need for appropriate counselling, and comprehensive treatment of sexuallytransmitted infections including C trachomatis in women with Bartholin's gland abscesses. PMID:7635490
Background: Sexuallytransmitted infections (STIs) have a major negative impact on sexual and reproductive health globally. The most effective way to avoid STIs is to abstain from sexual contact or having sex only in a long-term, mutually monogamous relationship with an uninfected partner. Objectives: This study aimed to determine behavioral prevention regarding STIs. Patients and Methods: This analytic cross-sectional study was performed on 584 women aged 15-49 referring to health care centers of Tabriz-Iran in 2013 through multistage cluster sampling. Data collecting tool was a questionnaire which its validity and reliability were determined previously. Descriptive and inferential statistics (independent T-test, One-way ANOVA, and univariate and multivariate analyses) were used to analyze the data using SPSS 17. P < 0.05 was considered significant. Results: The mean ± SD score of behavioral prevention was 20.57 ± 2.8 ranging from 0 to 24. The weakest behavioral prevention was lack of consistent use of condom by husband during sex. The mean ± SD score of individuals’ awareness about STIs was as low as 17.08 ± 7.42. Multivariate analysis adjusting potential confounders showed a significant association between behavioral prevention and awareness, education, sex only with husband, anal, oral, and anal-oral sex. Conclusions: Prevention and care of sexuallytransmitted diseases are interventions able to promote public health. It is necessary to solve different factors affecting rapid spread of STDs and their transmission through an effective behavioral preventive plan.
Summary: Testing for sexuallytransmitted infections (STIs) in children presents a number of problems for the practitioner that are not usually faced when testing adults for the same infections. The identification of an STI in a child can have, in addition to medical implications, serious legal implications. The presence of an STI is often used to support the presence or allegations of sexual abuse, and conversely, the identification of an STI in a child will prompt an investigation of possible abuse. The purpose of this paper is to review the epidemiology of child sexual abuse, including the epidemiology of major STIs including Neisseria gonorrhoeae, Chlamydia trachomatis, syphilis, herpes simplex virus (HSV), Trichomonas vaginalis, and human papillomavirus, and the current recommendations for diagnostic testing in this population. PMID:20610820
SAFER SEX INFORMATION There are many ways to reduce the risk of acquiring a SexuallyTransmitted and consistently every time you have sex, can be a great safer sex strategy. The basic idea behind safer sex
These guidelines for the treatment of patients who have sexuallytransmitted diseases (STDs) were developed by the Centers for Disease Control and Prevention (CDC) after consultation with a group of professionals knowledgeable in the field of STDs who met...
Objective: To assess the impact of the sexual component of AIDS and HIV campaigns on transmission of HIV and other sexuallytransmitted infections (STIs). Design: Comparison of time series data. Setting: England, 1971–1999. Outcome measures: HIV transmission and diagnoses among men who have sex with men (MSMs), rates of attendances and specific STI diagnoses (per 100 000 total population) at genitourinary medicine (GUM) clinics. Results: Awareness of AIDS and campaigns in 1983–4 among homosexual men coincided with substantial declines in transmission of HIV and diagnoses of syphilis among MSMs. During general population campaigns in 1986-7 new GUM clinic attendances requiring treatment fell by 117/105 in men and 42/105 in women. Rates for gonorrhoea fell by 81/105 and 43/105 and genital herpes by 6/105 and 4/105, respectively. Previous rises in genital wart rates were interrupted, while rates of attendances not requiring treatment (the "worried well") increased by 47/105 and 58/105 for men and women, respectively. Since 1987 diagnoses of HIV among MSMs have not declined, averaging 1300–1400 annually. Following a period of unchanging rates there have been substantial increases in GUM attendances requiring treatment, notably for gonorrhoea, syphilis, and viral STIs since 1995. Conclusions: Self help initiatives and awareness among homosexual men in 1983–4 contributed significantly to a fall in HIV transmission among MSMs, and the general campaigns of 1986–7 were associated with similar effects on all STI transmission. Both effects seem to have occurred through changing sexual behaviour, and probably contributed to the UK's low national HIV prevalence. Bacterial STI incidence has increased significantly since 1995 and there is no evidence that recent prevention initiatives have reduced HIV transmission among MSMs, hence sexual health initiatives need to be comprehensively reinvigorated in England. Key Words: HIV; gonorrhoea; syphilis; interventions; health promotion; homosexual males; heterosexuals; England PMID:11463922
Nicoll, A.; Hughes, G.; Donnelly, M.; Livingstone, S.; De Angelis, D.; Fenton, K.; Evans, B.; Gill, O; Catchpole, M.
Background Previous cross-sectional studies involving adults suggest that sexuallytransmitted diseases (STD) such as cocaine use disorders and opioid use disorders are associated with the development of sexuallytransmitted diseases (STD). However, it is less clear whether cannabis use disorders (CUD) are associated with the development of STDs, or whether those associations extend to adolescent populations. Longitudinal studies examining those associations are particularly scarce. The current report provides findings from a longitudinal study that examined the relationship between STD and CUD among youth transitioning to young adulthood. Method The subjects in this longitudinal study were initially recruited when the index sons of these fathers were 10-12 years of age, and subsequent assessments were conducted at age 12-14, 16, 19, and 22. Multivariate logistic regression and path analyses were conducted. Results At age 22, of the 345 subjects, 30 subjects were diagnosed with one or more STD, and 105 were diagnosed with a CUD. STDs were almost four times as common among those with a CUD as among those without a CUD, which was a significant difference. Path analyses demonstrated that peer deviance mediated the association between a measure of risk for SUD knows as the TLI and CUD, and that peer deviance mediated the association between TLI and STD. Risky sexual behaviors were common. Conclusions These finding suggest that cannabis use disorders (CUD) predispose to the development of sexuallytransmitted disorders (STD) among youth. These findings also suggest that peer deviance mediates the development of STD and of CUD among teenagers making the transition to young adulthood.
Cornelius, Jack R.; Kirisci, Levent; Clark, Duncan B.
Inconsistent findings in the global literature regarding the effectiveness of condom use against sexuallytransmitted diseases (STDs) may result from variations in the measurement of condom use. In this study, we assess the sensitivity and specificity of six condom-use measures in predicting STD infection, and assess the difference in sensitivity and specificity by type of sexual partner (clients versus stable partners), type of STD, ethnicity (Han versus non-Han), years of formal schooling (?6 versus >6 years) and level of risk of STD exposure (high versus low). Cross-sectional data were obtained from 454 female sex workers (FSWs) in Guangxi, China. Measurements of condom use were created along types of use (any use, consistent use, correct use, or the combination of consistent and correct use) and periods of recall (life time, last month or recent three sexual episodes). Measures of consistent use had higher sensitivity and lower specificity than measures of any use in predicting STDs among FSWs, regardless of the recall period and type of sexual partner. Incorporating correct use improved the measures of consistent use. Measures of consistent use and the combination of consistent and correct use demonstrated high sensitivity in predicting particular STDs. They showed higher sensitivity in predicting STDs among FSWs who reported higher risk for STD exposure than among FSWs who reported lower risk of exposure to STDs. In conclusion, the findings suggest the superiority of consistent use and correct use of condoms in predicting STD infection. The findings also underscore the importance of considering the context of sexual risk such as type of sexual partner and risk of exposure to STD infection when we measure condom use. Future studies of condom effectiveness should collect and quantify these contextual and individual factors among the target population. PMID:23033533
Objectives: To document the prevalence of reproductive tract infections (RTI) and sexuallytransmitted infections (STI) among women attending a basic healthcare clinic in Dhaka, Bangladesh, to identify risk factors associated with the diseases and to estimate the incidence of syphilis, hepatitis C (HCV), hepatitis B (HBV), and herpes simplex type 2 (HSV-2) infection. Methods: A cross sectional sample of 2335 consecutive women was examined during 1996–8. Women were interviewed about risk factors for RTI/STI and tested for Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Treponema pallidum, HIV, HCV, HBV, HSV-1 and HSV-2 infection as well as vaginal candidosis and bacterial vaginosis. Women with antibodies to T pallidum were retested at regular intervals. One year after ending the study seroconversion for syphilis, HBV, HCV, and HSV-2 infection was detected among women initially negative for the respective diseases. Results: The overall prevalence rate of N gonorrhoeae, C trachomatis, T vaginalis, and T pallidum infection was 0.5%, 1.9%, 2.0%, and 2.9% respectively. Overall, 35% of the women had antibodies to hepatitis B core antigen, 0.9% had HCV, and 12% HSV-2 infection. Risk factors for gonorrhoea/C trachomatis infection were a husband not living at home or suspected of being unfaithful. HSV-2 infection was associated with the same risk factors and with a polygamous marriage. The prevalence of HSV-2 infection among women "at risk" was 23%. HIV infection was not diagnosed. Repeated serological examination indicated that only 32% of women with serological evidence of syphilis had active disease. The seroincidences of HBV, HCV, and HSV-2 were 0.03, 0.007, and 0.009 per person year. Seroconversion for syphilis was not observed. Key Words: sexuallytransmitted infections; genital herpes; Bangladesh PMID:11287690
Bogaerts, J; Ahmed, J; Akhter, N; Begum, N; Rahman, M; Nahar, S; Van Ranst, M; Verhaegen, J
BACKGROUND: Youth have been reported to be at a higher risk of acquiring STIs with significant adverse health and social consequences. Knowledge on the prevailing risky practices is an essential tool to guide preventive strategies. METHODS: Youth aged between 18 and 25 years attending an STI clinic were recruited. Social, sexual and demographic characteristics were elicited using a structured standard
Willy K Urassa; Candida Moshiro; G Chalamilla; Fred Mhalu; Eric Sandstrom
Objective: To determine the incidence of sexuallytransmitted infections (STI) among decriminalised and regulated sex workers in Victoria.Methods: The incidence of STI was calculated for individuals who attended the Melbourne Sexual Health Centre on more than one occasion. Results of initial screen specimens were not included. Follow up time was calculated in person months and used as the denominator with
In this article, we examine knowledge of contraceptives and sexuallytransmitted diseases (STDs) and contraceptive practices amongst young Vietnamese people. We conducted a qualitative study on sexuality and abortion with young people in Ho Chi Minh City, Vietnam. Twelve female and 4 male young people were individually interviewed using an in-depth interview technique. We found that condoms and pills were
Hoa Ngan Nguyen; Pranee Liamputtong; Gregory Murphy
Report evaluates whether policies requiring parental involvement in minors' decision to obtain an abortion can alter their sexual behavior and help reduce the rates of sexuallytransmitted infections (STIs) among teens. Using data from the STI surveillance system of the Centers for Disease Control and Prevention on cases of gonorrhea and chlamydia, the findings offer little evidence of a link
This paper reports on an exploratory, qualitative content analysis of the portrayal of the risk of sexuallytransmitted infections or diseases (STIs or STDs) and sexuality in the United States (US) versions of the most popular women's magazines in the world, the English language magazines for young women Cosmopolitan (Cosmo) and Glamour from 2000–2007. The data studied here demonstrate contradictory
This study aimed to assess associations between school HIV education and protective sexual behaviors and sexuallytransmitted disease (STD)/HIV diagnosis with a representative sample of male and female high school students. Data from male and female adolescent participants in the 1999, 2001 and 2003 Massachusetts Youth Risk Behavior Survey (n =…
Raj, Anita; Decker, Michele R.; Murray, Jessica E.; Silverman, Jay G.
Measurement of beliefs about sexuallytransmitted diseases (STDs) is important to understanding sexual health behaviors. The purpose of this study was to develop and test the psychometric properties of the Representations of STDs (RoSTD) Scale. The RoSTD was developed to measure young women's representations of STDs, and it is intended to be used to measure beliefs about any of the seven most common STDs. Confirmatory factor analysis indicated a four-factor structure for the 40-item RoSTD: Future Perspective, Cause, Psychosocial Consequence, and Identity. Internal consistency for the subscales (measured for each of seven different STDs) ranged from .67 to .93 and 2-week test-retest correlations ranged from .69 to .90. The RoSTD shows evidence of reliability and validity in young women. PMID:22109900
Royer, Heather R; Heidrich, Susan M; Brown, Roger L
Aim This study examined the association between functional social support and sexuallytransmitted infection (STI) based on data\\u000a from a cross-sectional survey in three Canadian provinces.\\u000a \\u000a \\u000a \\u000a \\u000a Subject and Methods We analyzed data from the Canadian Community Health Survey (CCHS), conducted in 2005. A total of 24,045 participants (12,581\\u000a women and 11,464 men) aged 15–49 years who answered questions about STI and completed the
Data are presented from an investigation designed to study market of medical services delivered to patients with sexuallytransmitted diseases (STD). A model of the purchaser's behaviour of consumers of medical services is developed, decisive factors affecting the choice of a medical institution when applying for a profile medical advice are determined. Submitted in the paper is also an algorythm of analysis of expediency of segmentation of market of medical services delivered to STD patients. The most optimal principles of market segmentation include the following--economic (solvency), territorial (place of residence), social (belonging to one or another stratum of society). PMID:15311716
Sexuallytransmitted diseases in developing countries are causing concern to those responsible for their control and eradication. To gain a better understanding of the problems involved in a country struggling with development, the economic and psychosocial factors influencing the spread of STD in Ethiopia have been studied. Increased migration and urbanisation and the changing role of women have led to a rise in prostitution. Thus changes in the social structure--particularly in relation to the education and employment of women--and improved medical services are essential for the long-term control of STD. PMID:6895708
In this paper a new model for the spread of sexuallytransmitted diseases (STDs) is presented. The dynamic behaviors of the model on a heterogenous scale-free (SF) network are considered, where the absence of a threshold on the SF network is demonstrated, and the stability of the disease-free equilibrium is obtained. Three immunization strategies, uniform immunization, proportional immunization and targeted immunization, are applied in this model. Analytical and simulated results are given to show that the proportional immunization strategy in the model is effective on SF networks.
Conducted by the Henry J. Kaiser Family Foundation (see the February 9, 1999 Scout Report for Social Sciences), this new national survey of 15- to 17-year-olds examines their knowledge, awareness, attitudes, and behavior in relation to sexuallytransmitted diseases (STDs). Despite national estimates claiming that about one in four teenagers contracts an STD every year, most teens underestimate their personal risk and underrate the overall incidence of STDs. Moreover, many teens are mis- or uninformed about treatment and health consequences. The report provides survey highlights and methodology, a summary of findings, detailed results, and the survey questionnaire. A supplementary chart pack clearly presents key findings.
Puerto Rico has one of the highest incidence rates of HIV in the U.S. Concurrent with increases in sexuallytransmitted infections (STI), an increasing share of the new infections in PR are associated with sexual transmission. Much of the available research on sexual risk in PR derives from STI/HIV surveillance data. There is limited social and epidemiological research on sexual risk in PR, particularly in hidden and often hard-to-reach populations at high risk. Despite the absence of substantial resources that most epidemiological studies require, a research collaboration was initiated in 2007 between researchers in the School of Public Health at the University of Puerto Rico and the Centro Latinoamericano de Enfermedades de Transmisión Sexual (CLETS), one of the largest publicly funded centers for STI/HIV screening and treatment in the San Juan metropolitan area. Structured as a case study in the development of community-based research collaborations, this paper describes the early history and development of the project, including formative research, recruitment and training of students, and evolution in the study design that contributed to the current configuration of the ongoing "Core" study. Preliminary data are presented, highlighting data from a number of subpopulations that may contribute to our understanding of the role of behavioral risk in the STI/HIV epidemics in PR. More generally, the paper may guide the development of similar collaboration elsewhere in the Caribbean where HIV risk is increasing but where resources for research in high risk settings and groups are scarce. PMID:21932709
Clatts, Michael C; Rodríguez-Díaz, Carlos E; García, Hermes; Vargas-Molina, Ricardo L; Colón-López, Vivian; Pérez-Rios, Naydi; Goldsamt, Lloyd; Jovet-Toledo, Gerardo G
OBJECTIVES: The authors analyzed interview responses of patients at a prenatal care clinic to explore whether women who had been victims of sexual and physical abuse were more likely than non-victimized women to have experienced a sexuallytransmitted disease (STD). METHODS: A consecutive sample of 774 prenatal patients of a large health department in North Carolina were interviewed concerning a variety of health issues, including violence and STDs. Logistic regression analysis was used to model the women's STD status as a function of their experiences of sexual and physical abuse, controlling for several potentially confounding factors. RESULTS: Thirty percent of the women reported having experienced at least one STD, with the most common infections being chlamydia and gonorrhea. Twenty-eight percent of the women reported having been victims of abuse; 16% reported physical abuse only, while 12% reported both physical and sexual abuse. The majority of violence was domestic in nature, perpetrated by the victims' husbands, boyfriends, male friends, and relatives. After controlling for confounding variables, the authors found that women who reported both physical and sexual abuse were significantly more likely to have experienced STDs than non-victims (odds ratio [OR] = 2.25; 95% confidence interval [CI] 1.37, 3.69). The logistic regression analysis also showed a relationship of borderline statistical significance between non-sexual physical abuse and STDs. CONCLUSIONS: Health care providers should routinely screen patients for both abuse and STDs, and they should assist identified women in accessing appropriate health, social, and legal services. PMID:10476996
Martin, S L; Matza, L S; Kupper, L L; Thomas, J C; Daly, M; Cloutier, S
Sexuallytransmitted infections (STIs) are, by definition, transmitted between sexual partners. For curable STIs an infected index case can potentially re-infect the same partner multiple times. Thus, R0, the average number of secondary infections one typical infected individual will produce during his or her infectious period is not necessarily the same as the average number of secondary cases (infected persons). Here we introduce the new concept of the case reproduction number (Rc). In addition, we define the partnership reproduction number (Rp) as the average number of secondary partnerships consisting of two infected individuals one typical infected individual will produce over his or her infectious lifetime. Rp takes into account clearance and re-infection within partnerships, which results in a prolongation of the duration of the infectious period. The two new reproduction numbers were derived for a deterministic pair model with serial monogamous partnerships using infection parameters for Chlamydia trachomatis, an example of a curable STI. We showed that re-infection within partnerships means that curable STIs can be sustained endemically even when the average number of secondary cases a person produces during his or her infectious period is below one. PMID:23608632
Heijne, Janneke C M; Herzog, Sereina A; Althaus, Christian L; Low, Nicola; Kretzschmar, Mirjam
OBJECTIVES--To determine the sexual risk behaviour and the incidence of sexuallytransmitted diseases (STD) among Dutch marines and naval personnel during a United Nations (UN) deployment. METHODS--Surveillance by post deployment questionnaire, administered to 2289 persons in three successive battalions who served for 6 months on a UN deployment in Cambodia during June 1992-November 1993. On site the medical history of all individuals was kept up to date in a database. All personnel received extra education on STD prevention prior to deployment. Condoms were freely obtainable during deployment. RESULTS--1885 persons (82%) handed in the questionnaire of whom 842 (45%) reported to have had sexual contacts with prostitutes or local population. Being younger and single were independent risk factors for having contact. Out of these 842 persons, 750 (89.1%) reported condom use at all times, while 82 (9.7%) reported inconsistent use and 10 persons (1.2%) reported not to have used condoms. Risk factors for inconsistent and non use were being 40 years or older and a higher number of contacts. From the 832 (750 + 82) condom users, 248 (30%) reported condom failure. Risk factors for failure were: inconsistent condom use, having had more than six contacts and being in the second battalion. The patient recording database showed 43 STD cases registered in the total population of 2289 persons (1.9%). CONCLUSIONS--A low STD incidence was found despite a considerable number of reported sexual contacts. The reported condom use was high but the failure rate was considerable and needs further attention. PMID:7635494
Hopperus Buma, A P; Veltink, R L; van Ameijden, E J; Tendeloo, C H; Coutinho, R A
Diez Roux has used the concept of complex systems to describe approaches for the incorporation of social factors into health research. These systems consist of heterogeneous interdependent units that also exhibit emergent properties. The latter embodies the concept that the interdependent units interact with and affect each other such that the resulting properties are not simple aggregates of the individual-level properties. This paper reviews research from Manitoba with a view towards conceptualising and phrasing the observed patterns within a complex system framework. A review of the temporal and spatial patterns seen within two large sexual network databases from Manitoba was undertaken and framed against the overlying patterns of sexuallytransmitted infection (STI) transmission within Manitoba. The review includes a summation of STI epidemiological patterns in Manitoba over a 5-year time frame, a comparison of temporal sexual network patterns, and an analysis of network patterns in relation to disparity in STI rates. Hypotheses are generated that focus on how individual-level behaviours and interactions create the observed complex system (network) patterns. PMID:20870675
Wylie, John L; Shaw, Souradet; DeRubeis, Emily; Jolly, Ann
Early sexual debut and premarital sex are increasingly common features of female adolescence in Kenya-putting girls at the risk of unwanted pregnancy and infection by sexuallytransmitted infections and HIV/AIDS. Levels of knowledge concerning the protective value of condoms and other contraceptives are high, but unprotected sex is still common. Against this background, this paper examines the strategies used by young women to deal with these risks. Qualitative data were obtained from eight focus group discussions conducted with school attending girls aged between 15 and 19 years in Makueni District of Eastern Kenya. Findings suggest that, despite knowledge of the protective value of condoms and other contraceptives, the use of these methods by girls is hampered by inability to access them, the fear of the side effects of contraceptives, and the desire by girls to remain faithful to their religious calling. Most girls also resort to the use of traditional methods such whose potency and efficacy is unproven. These findings suggest the need to make condoms more easily accessible to girls in rural areas, and also for education in the proper use of 'natural' family planning methods. Young women may also benefit from training in how to be more assertive in sexual negotiations. PMID:21972831
Background Providing reproductive and sexual health services is an important and challenging aspect of caring for displaced populations, and preventive and curative sexual health services may play a role in reducing HIV transmission in complex emergencies. From 1995, the non-governmental "Reproductive Health Group" (RHG) worked amongst refugees displaced by conflicts in Sierra Leone and Liberia (1989–2004). RHG recruited refugee nurses and midwives to provide reproductive and sexual health services for refugees in the Forest Region of Guinea, and trained refugee women as lay health workers. A cross-sectional survey was conducted in 1999 to assess sexual health needs, knowledge and practices among refugees, and the potential impact of RHG's work. Methods Trained interviewers administered a questionnaire on self-reported STI symptoms, and sexual health knowledge, attitudes and practices to 445 men and 444 women selected through multistage stratified cluster sampling. Chi-squared tests were used where appropriate. Multivariable logistic regression with robust standard errors (to adjust for the cluster sampling design) was used to assess if factors such as source of information about sexuallytransmitted infections (STIs) was associated with better knowledge. Results 30% of women and 24% of men reported at least one episode of genital discharge and/or genital ulceration within the past 12 months. Only 25% correctly named all key symptoms of STIs in both sexes. Inappropriate beliefs (e.g. that swallowing tablets before sex, avoiding public toilets, and/or washing their genitals after sex protected against STIs) were prevalent. Respondents citing RHG facilitators as their information source were more likely to respond correctly about STIs; RHG facilitators were more frequently cited than non-healthcare information sources in men who correctly named the key STI symptoms (odds ratio (OR) = 5.2, 95% confidence interval (CI) 1.9–13.9), and in men and women who correctly identified effective STI protection methods (OR = 2.9, 95% CI 1.5–5.8 and OR = 4.6, 95% CI 1.6–13.2 respectively). Conclusion Our study revealed a high prevalence of STI symptoms, and gaps in sexual health knowledge in this displaced population. Learning about STIs from RHG health facilitators was associated with better knowledge. RHG's model could be considered in other complex emergency settings. PMID:18947393
Chen, Mark I; von Roenne, Anna; Souare, Yaya; von Roenne, Franz; Ekirapa, Akaco; Howard, Natasha; Borchert, Matthias
Randomized trials have demonstrated that male circumcision (MC) reduces heterosexual acquisition of HIV, herpes simplex virus type 2, human papillomavirus (HPV), and genital ulcer disease among men, and it reduces HPV, genital ulcer disease, bacterial vaginosis, and trichomoniasis among female partners. The pathophysiology behind these effects is multifactorial, relying on anatomic and cellular changes. MC is cost effective and potentially cost saving in both the United States and Africa. The World Health Organization and Joint United Nations Program on HIV/AIDS proposed reaching 80% MC coverage in HIV endemic countries, but current rates fall far behind targets. Barriers to scale-up include supply-side and demand-side challenges. In the United States, neonatal MC rates are decreasing, but the American Academy of Pediatrics now recognizes the medical benefits of MC and supports insurance coverage. Although MC is a globally valuable tool to prevent HIV and other sexuallytransmitted infections, it is underutilized. Further research is needed to address barriers to MC uptake. PMID:24111891
Studies of disease in relation to animal mating systems have focused on sexual selection and the evolution of sexual reproduction. Relatively little work has examined other aspects of ecological and evolutionary relationships between host social and sexual behaviour, and dynamics and prevalence of infectious diseases; this is particularly evident with respect to sexuallytransmitted diseases (STDs). Here, we use a simulation approach to investigate rates of STD spread in host mating systems ranging from permanent monogamy to serial polygyny or polyandry and complete promiscuity. The model assumes that one sex (female) is differentially attracted to the other, such that groups of varying size are formed within which mating and disease transmission occur. The results show that equilibrium disease levels are generally higher in females than males and are a function of variance in male mating success and the likelihood of a female switching groups between mating seasons. Moreover, initial rates of disease spread (determining whether an STD establishes in a population) depend on patterns of host movement between groups, variance in male mating success and host life history (e.g. mortality rates). Male reproductive success can be reduced substantially by a sterilizing STD and this reduction is greater in males that are more 'attractive' to females. In contrast, females that associate with more attractive males have lower absolute fitness than females associating with less attractive males. Thus, the potential for STDs to act as a constraint on directional selection processes leading to polygyny (or polyandry) is likely to depend on the details of mate choice and group dynamics. PMID:11007332
Population-based research is enhanced by biological measures, but biological sampling raises complex ethical issues. The third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) will estimate the population prevalence of five sexuallytransmitted infections (STIs) (Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus (HPV), HIV and Mycoplasma genitalium) in a probability sample aged 16-44 years. The present work describes the development of an ethical approach to urine testing for STIs, including the process of reaching consensus on whether to return results. The following issues were considered: (1) testing for some STIs that are treatable and for which appropriate settings to obtain free testing and advice are widely available (Natsal-3 provides all respondents with STI and healthcare access information), (2) limits on test accuracy and timeliness imposed by survey conditions and sample type, (3) testing for some STIs with unknown clinical and public health implications, (4) how a uniform approach is easier to explain and understand, (5) practical difficulties in returning results and cost efficiency, such as enabling wider STI testing by not returning results. The agreed approach, to perform voluntary anonymous testing with specific consent for five STIs without returning results, was approved by stakeholders and a research ethics committee. Overall, this was acceptable to respondents in developmental piloting; 61% (68 of 111) of respondents agreed to provide a sample. The experiences reported here may inform the ethical decision making of researchers, research ethics committees and funders considering population-based biological sampling. PMID:22252417
Field, Nigel; Tanton, Clare; Mercer, Catherine H; Nicholson, Soazig; Soldan, Kate; Beddows, Simon; Ison, Catherine; Johnson, Anne M; Sonnenberg, Pam
Background Sexuallytransmitted infections constitute the main health risk among adolescents. In developing countries the diagnosis and treatment of cervical infections is based on the syndromic approach. In this study we estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae among female adolescents from a Health Sector of the city of Goiânia, Brazil, and validated cervicitis diagnosis using World Health Organization/Ministry of Health risk score and gynecological examination. Methods A cross-sectional community-based sample of 914 15- to 19-year-old female teenagers was randomly selected and referred to the local Family Health Program. Of these, 472 (51.6%) were sexually active and gynecological examinations were carried out for 427. Endocervical samples were collected to perform the polymerase chain reaction for C. trachomatis and N. gonorrhoeae. Performance of risk score, the presence of mucopurulent discharge, friability, ectopia and pain during cervical maneuver were compared with the presence of C. trachomatis or N. gonorrhoeae or both. Results The prevalence of C. trachomatis and N. gonorrhoeae was 14.5% and 2.1%, respectively. The risk score had a specificity of 31.9% (95% confidence interval, 21.2 to 44.2) and a positive predictive value of 20.8% (95% confidence interval, 13.5 to 29.7). Friability was the component of the gynecological examination that presented the best performance with a sensitivity of 43.5%, specificity of 81.0%, and 30.6% of positive predictive value. Conclusion The prevalence of infection by C. trachomatis and N. gonorrhoeae was high among these sexually active adolescents. The syndromic approach is clearly inadequate for screening and treating these infections in this population. Therefore, the implantation of other strategies to control these infections among adolescents is urgently required. PMID:19284575
Guimaraes, Eleuse MB; Guimaraes, Mark DC; Vieira, Maria Aparecida S; Bontempo, Nadia M; Seixas, Mirian SS; Garcia, Monica SD; Daud, Lyana ES; Cortes, Rejane LM; Alves, Maria de Fatima C
This cross-sectional study describes the baseline prevalence and correlates of common bacterial and viral sexuallytransmitted diseases (STDs) and risk behaviors among individuals at high risk for HIV recruited in five low- and middle-income countries. Correlations of risk behaviors and demographic factors with prevalent STDs and the association of STDs with HIV prevalence are examined. Between 2,212 and 5,543 participants were recruited in each of five countries (China, India, Peru, Russia, and Zimbabwe). Standard protocols were used to collect behavioral risk information and biological samples for STD testing. Risk factors for HIV/STD prevalence were evaluated using logistic regression models. STD prevalence was significantly higher for women than men in all countries, and the most prevalent STD was Herpes simplex virus-type 2 (HSV-2). HIV prevalence was generally low (below 5%) except in Zimbabwe (30% among women, 11.7% among men). Prevalence of bacterial STDs was generally low (below 5% for gonorrhea and under 7% for syphilis in all sites), with the exception of syphilis among female sex workers in India. Behavioral and demographic risks for STDs varied widely across the five study sites. Common risks for STDs included female gender, increasing number of recent sex partners, and in some sites, older age, particularly for chronic STDs (i.e., HSV-2 and HIV). Prevalence of HIV was not associated with STDs except in Zimbabwe, which showed a modest correlation between HIV and HSV-2 prevalence (Pearson coefficient = .55). These findings underscore the heterogeneity of global STD and HIV epidemics and suggest that local, focused interventions are needed to achieve significant declines in these infections.
Celentano, David D.; Mayer, Kenneth H.; Pequegnat, Willo; Abdala, Nadia; Green, Annette M.; Handsfield, H. Hunter; Hartwell, Tyler D.
Objective Characterization of HIV-1 sequences in newly infected individuals is important for elucidating the mechanisms of viral sexual transmission. We report the identification of transmitted/founder viruses in eight pairs of HIV-1 sexually-infected patients enrolled at the time of primary infection (“recipients”) and their transmitting partners (“donors”). Methods Using a single genome-amplification approach, we compared quasispecies in donors and recipients on the basis of 316 and 376 C2V5 env sequences amplified from plasma viral RNA and PBMC-associated DNA, respectively. Results Both DNA and RNA sequences indicated very homogeneous viral populations in all recipients, suggesting transmission of a single variant, even in cases of recent sexuallytransmitted infections (STIs) in donors (n?=?2) or recipients (n?=?3). In all pairs, the transmitted/founder virus was derived from an infrequent variant population within the blood of the donor. The donor variant sequences most closely related to the recipient sequences were found in plasma samples in 3/8 cases and/or in PBMC samples in 6/8 cases. Although donors were exclusively (n?=?4) or predominantly (n?=?4) infected by CCR5-tropic (R5) strains, two recipients were infected with highly homogeneous CXCR4/dual-mixed-tropic (X4/DM) viral populations, identified in both DNA and RNA. The proportion of X4/DM quasispecies in donors was higher in cases of X4/DM than R5 HIV transmission (16.7–22.0% versus 0–2.6%), suggesting that X4/DM transmission may be associated with a threshold population of X4/DM circulating quasispecies in donors. Conclusions These suggest that a severe genetic bottleneck occurs during subtype B HIV-1 heterosexual and homosexual transmission. Sexually-transmitted/founder virus cannot be directly predicted by analysis of the donor’s quasispecies in plasma and/or PBMC. Additional studies are required to fully understand the traits that confer the capacity to transmit and establish infection, and determine the role of concomitant STIs in mitigating the genetic bottleneck in mucosal HIV transmission. PMID:23874894
Association of attractiveness, sex, and sensation seeking with perceptions of sexuallytransmitted diseases were examined. Subjects (64 women and 56 men) were given a picture and brief description of a target and asked to rate the accuracy of statements based on information provided. Pictures depicted a man or woman previously rated as attractive or unattractive by volunteers. The hobbies listed skydiving and rock climbing for high sensation seekers and reading and listening to music for low sensation seekers. Analysis indicated a significant three-way interaction with the attractive male targets described as high sensation-seeking and being perceived by men as most likely to have a sexuallytransmitted disease. PMID:15154195
Zaromatidis, Katherine; Carlo, Regina; Racanello, Dennis
The global burden of sexuallytransmitted infections (STIs) is highest in the developing world where access to laboratory services is limited. Sophisticated laboratory diagnostic tests using noninvasive specimens have enabled developed countries to screen and diagnose curable STIs in a variety of settings, but control programs in resource-limited settings continue to struggle to find simple rapid tests that can provide adequate performance in the absence of laboratory services. While recent technological advances and investments in research and development may soon yield improved STI tests that can make an impact, these tests will need to be deployed within a health system that includes: regulatory oversight, quality assurance, good supply-chain management, effective training, information systems and a sound surveillance system to monitor disease trends, inform policy decisions and assess the impact of interventions. PMID:19995188
Sexuallytransmitted diseases (STDs) are a major health problem among adolescents. In 2000, adolescent females 15 to 19 years old had the highest reported rates of chlamydia and gonorrhea. Adolescent biologic, cognitive, social, and behavioral developmental circumstances contribute to the high rate of adolescent STDs. New sensitive and noninvasive STD tests greatly improve our ability to diagnose asymptomatic infections. In May 2002, the Centers for Disease Control and Prevention (CDC) published revised guidelines for the treatment of STDs. The CDC's is based on evidence from published literature and expert opinion. In this article, we review selected new recommendations that impact adolescent STD care. Providing care to adolescents can be a challenging but rewarding experience for primary care pediatric nurse practitioners. Nurses can be instrumental in reducing STD prevalence through screening interventions, prevention counseling, and health education. PMID:12629317
The adult film industry nowadays represents a legal multi-billion dollar business. The main health risks of adult performers are well known. They mainly include the transmission of sexuallytransmitted diseases such as HIV, hepatitis, gonorrhoea, Chlamydia, herpes and papillomavirus. However, despite regular follow-up, the frequency of STD remains significant in this high-risk population since a large part of the industry continues to reject systematic use of condoms. Besides, performers are also exposed to other physical and mental health issues often not known to the public. This article provides a comprehensive review of what is known about STD and other risks among the community of performers in the adult film industry. PMID:24507206
In the absence of a cure or vaccine for acquired immune deficiency syndrome (AIDS) educational and social marketing efforts to reduce the transmission of Human T-lymphotropic type III/lymphadenopathy-associated virus (HTLV-III/LAV) are currently our best hope for controlling the disease. Since 1983, the Centers for Disease Control (CDC) has funded a series of research studies to determine whether education efforts can successfully motivate the adoption of key behaviors relevant to the control of a variety of sexuallytransmitted diseases (STDs). Analysis of the first two studies which are now completed, and preliminary data from a third study, have documented dramatic changes in behavior, knowledge, and attitudes among clients in inner-city public health clinics. The authors describe the principles and underlying assumptions that have guided the design of their STD initiatives, drawing special attention to the implications for AIDS health education efforts. PMID:3781857
China has experienced an increasing epidemic of sexuallytransmitted infections (STIs), including HIV. High risk groups likely to be infected include female sex workers (FSWs) and their clients, men who have sex with men (MSM), drug users and migrant workers. Prevention can be achieved through education of the population, condom promotion, early detection of symptomatic and asymptomatic people, and effective diagnosis and treatment of these patients and their partners. This article aims to describe the profile of the epidemic in high-risk groups in China as well as to detail the contributing factors and the implications for control. Programmes for the control of STIs should be immediate priorities in China, and primary and secondary prevention strategies are vital to this process. PMID:21975019
ObjectivesThere has been a large influx of central and east European (CEE) migrants to the UK following the expansion of the European Union. This paper examines factors associated with genitourinary medicine (GUM) clinic attendance and sexuallytransmitted infection (STI) diagnosis among CEE migrants in London.MethodsA survey of sexual behaviour was conducted among CEE migrants attending two central London GUM clinics
Alison R Evans; Catherine H Mercer; Violetta Parutis; Graham J Hart; Richard Mole; Christopher J Gerry; Fiona M Burns
BackgroundModels of sexuallytransmitted infection (STI) transmission can offer insights as to why gonorrhoea and other STIs are disproportionately concentrated in epidemiologically distinct subpopulations.MethodsWe highlight two different constructs for modelling STIs by drawing on previously published work on pair and metapopulation models, and reanalysed partnership data from the National Survey of Sexual Attitudes and Lifestyles II (NATSAL II) in the
BackgroundThe potential for an expanded HIV epidemic in Papua New Guinea (PNG) demands an effective, evidence-based and locally-appropriate national response. As sexuallytransmitted infections (STIs) may be important co-factors in HIV transmission nationally, it is timely to conduct a systematic review of STI prevalences to inform national policy on sexual health and HIV\\/STI prevention.Methodology\\/Principal FindingsWe undertook a systematic review and
Andrew Vallely; Andrew Page; Shannon Dias; Peter Siba; Tony Lupiwa; Greg Law; John Millan; David P. Wilson; John M. Murray; Michael Toole; John M. Kaldor; Joseph S. Ross
Background To explore any association between the timing of the initiation of sexual activity and sexual behaviors and risks among university students in China. Methods Data were derived from a cross-sectional study on sexual behavior among university students conducted in Ningbo municipality, China, at the end of 2003. Students completed a self-administered, structured questionnaire. Of 1981 sexually active male students, 1908 (96.3%) completed the item for timing of the initiation of sexual activity and were included in bivariate trend analyses and multiple logistic regression analyses to compare the association between this timing and sexual behavior and risks. Results Male early sexual initiators had a significantly higher risk profile, including a significantly higher proportion reporting non-regular partners (i.e., casual or commercial partners), multiple partners, diagnosis with a sexuallytransmitted disease (STD), partner history of pregnancy, partner history of induced abortion, and less condom and oral contraceptive use, compared with late initiators. Multivariate analyses confirmed the increased likelihood of these risks in early initiators versus late initiators, other than partner type during the last year. Conclusion Our results showed that, compared to late initiators, people who initiated sexual activity early engaged in more risky behaviors that could lead to elevated risks of unwanted pregnancies and STDs or human immunodeficiency virus infection. Sex-education strategies should be focused on an earlier age, should include advice on delaying the age of first sexual activity, and should target young people who continue to take sexual risks. PMID:19383171
The sexual health of gay, bisexual, and other men who have sex with men (MSM) in the United States is not getting better despite\\u000a considerable social, political and human rights advances. Instead of improving, HIV and sexuallytransmitted infections (STIs)\\u000a remain disproportionately high among MSM and have been increasing for almost two decades. The disproportionate and worsening\\u000a burden of HIV
Objectives:To evaluate trends in the HIV epidemic among men who have sex with men (MSM) in San Francisco and the implications for HIV prevention.Methods:An ecological approach assessed temporal trends in sexual risk behaviour, sexuallytransmitted infections (STI), HIV incidence and prevalence from multiple data sources between 1998 and 2007.Results:By 2007, there were over 13 000 HIV-infected MSM living in San
S Scheer; T Kellogg; J D Klausner; S Schwarcz; G Colfax; K Bernstein; B Louie; J W Dilley; J Hecht; H-H M Truong; M H Katz; W McFarland
An estimated 499 million curable sexuallytransmitted infections (STIs; gonorrhea, chlamydia, syphilis, and trichomoniasis) occurred globally in 2008. In addition, well over 500 million people are estimated to have a viral STI such as herpes simplex virus type 2 (HSV-2) or human papillomavirus (HPV) at any point in time. STIs result in a large global burden of sexual, reproductive, and maternal-child health consequences, including genital symptoms, pregnancy complications, cancer, infertility, and enhanced HIV transmission, as well as important psychosocial consequences and financial costs. STI control strategies based primarily on behavioral primary prevention and STI case management have had clear successes, but gains have not been universal. Current STI control is hampered or threatened by several behavioral, biological, and implementation challenges, including a large proportion of asymptomatic infections, lack of feasible diagnostic tests globally, antimicrobial resistance, repeat infections, and barriers to intervention access, availability, and scale-up. Vaccines against HPV and hepatitis B virus offer a new paradigm for STI control. Challenges to existing STI prevention efforts provide important reasons for working toward additional STI vaccines. We summarize the global epidemiology of STIs and STI-associated complications, examine challenges to existing STI prevention efforts, and discuss the need for new STI vaccines for future prevention efforts. PMID:24581979
Gottlieb, Sami L; Low, Nicola; Newman, Lori M; Bolan, Gail; Kamb, Mary; Broutet, Nathalie
Although it is well known that mating increases the risk of infection, we do not know how females mitigate the fitness costs of sexuallytransmitted infections (STIs). It has recently been shown that female fruitflies, Drosophila melanogaster, specifically upregulate two members of the Turandot family of immune and stress response genes, Turandot M and Turandot C (TotM and TotC), when they hear male courtship song. Here, we use the Gal4/UAS RNAi gene knockdown system to test whether the expression of these genes provides fitness benefits for females infected with the entomopathogenic fungus, Metarhizium robertsii under sexual transmission. As a control, we also examined the immunity conferred by Dorsal-related immunity factor (Dif), a central component of the Toll signalling pathway thought to provide immunity against fungal infections. We show that TotM, but not TotC or Dif, provides survival benefits to females following STIs, but not after direct topical infections. We also show that though the expression of TotM provides fecundity benefits for healthy females, it comes at a cost to their survival, which helps to explain why TotM is not constitutively expressed. Together, these results show that the anticipatory expression of TotM promotes specific immunity against fungal STIs and suggest that immune anticipation is more common than currently appreciated. PMID:24174107
Zhong, Weihao; McClure, Colin D; Evans, Cara R; Mlynski, David T; Immonen, Elina; Ritchie, Michael G; Priest, Nicholas K
This research aimed to study the effect of premarital sex on sexuallytransmitted infections (STIs) and high risk behaviors among women in sub-Saharan Africa. It included 1393 women randomly selected from the Moshi urban district of northern Tanzania. Participants' demographic and socio-demographic characteristics, alcohol use, condom use, number of partners, symptoms of STIs and age at first sex and marriage were obtained. Moreover, blood and urine samples were tested for HIV-1, HSV-2, syphilis, chlamydia, gonorrhea, trichomonas and Mycoplasma genitalium infections. The average duration of premarital sex in the study participants was 1.66 years (SD of 2.61 years). Women with longer duration of premarital sex had higher odds of HIV-1, HSV-2 and other STIs. Moreover, women with longer duration of premarital sex were more likely to report multiple sexual partners. These findings highlight the importance of a lengthy period of premarital sex as a public health issue. STIs prevention programs in sub-Saharan Africa should address factors leading to a longer period of premarital sex in women. PMID:23626920
The Penna model is a computational model which can encompass the inheritance, mutation, evolution and ageing phenomena of population successfully. Some researchers considered social interactions in an asexual Penna model, got a complex network and found some interesting properties. We consider a sexual Penna model to study the transmission of sexuallytransmitted diseases (STD). Our model can also generate a complex network and we observed some properties in real networks, such as small-world and assortative mixing. In the real world, the fatality of STD is changing with the advancing of medicine and it can affect our life. In this paper, we uncover the effect induced by the fatality of STD. We found that fatality plays an important role in the transmission of STD because whether the STD will disappear or continue to exist depends on the fatality of STD. Also, the fatality of STD can affect the evolution of inherited diseases and average life span. Some properties found in the model should be useful for the prevention and control of STD.
Beyond the statistics of sex-based differences in infection rates, there are profound differences in the underlying causes and consequences of HIV infections in male and female which need to be examined. The study therefore examines; the gender differences in the STI knowledge and gender-related potential risks of HIV heterosexual transmission. Quantitative and qualitative data were collected. A multistage random sampling procedure was employed in administration of 1358 questionnaires. For qualitative data, four focus group discussions (FGD) were conducted to collect information from stakeholders within the study population, while In-depth interview was employed to collect information from 188 people living with HIV/AIDS through support groups in the State. The data collected were subjected to basic demographic analytical techniques. Combination of univariate, bivariate, and multivariate analysis were employed. Information from focus group discussions and in-depth interviews were transcribed and organized under broad headings that depict different aspects of the discussions. Majority of the respondents interviewed did not inform their partners about their infection in the study area. It was also discovered that stigmatization did not allow some women to disclose their status to their sexual partners. Some of the HIV-positive patients interviewed agreed that they did not attend the health facilities to treat the STI’s before they were finally confirmed positive. The study hypothesis revealed that communication between partners about STI’s was associated with an increase in risk reduction behaviour. The paper concluded that there is need for more information and education on communication about STI’s between the sexual partners; to reduce the spread of sexuallytransmitted diseases within the nation. PMID:24470905
Objectives To identify partner attributes associated with sexuallytransmitted infections (STIs) among adolescents and summarize implications for research and prevention. Design Systematic review. Methods We identified peer-reviewed studies published 1990–2010 which assessed ?1 partner attribute in relation to a biologically-confirmed STI among adolescents (15–24 years) by searching MEDLINE and included articles. Studies which included adolescents but >50% of the sample or with mean or median age ?25 years were excluded. Results Sixty-four studies met eligibility criteria; 59% were conducted in high-income countries; 80% were cross-sectional; 91% enrolled females and 42% males. There was no standard “partner” definition. Partner attributes assessed most frequently included: age, race/ethnicity, multiple sex partners and STI symptoms. Older partners were associated with prevalent STIs but largely unrelated to incidence. Black race was associated with STIs but not uniformly. Partners with multiple partners and STI symptoms appear to be associated with STIs predominantly among females. Although significant associations were reported, weaker evidence exists for: other partner sociodemographics; sexual and other behaviors (sexual concurrency, sex worker, intimate partner violence, substance use, travel) and STI history. There were no apparent differences by STI. Conclusions Partner attributes are independently associated with STIs among male and female adolescents worldwide. These findings reinforce the importance of assessing partner attributes when determining STI risk. Prevention efforts should continue to promote and address barriers to condom use. Increased efforts are needed to screen and treat STIs and reduce risky behavior among men. A standard “partner” definition would facilitate interpretation of findings in future studies. PMID:23588126
Swartzendruber, Andrea; Zenilman, Jonathan M.; Niccolai, Linda M.; Kershaw, Trace S.; Brown, Jennifer L.; DiClemente, Ralph J.; Sales, Jessica M.
Background Sexuallytransmitted infection (STI) diagnosis following diagnosis of acute HIV infection (AHI) indicates ongoing high-risk sexual behavior and possible risk of HIV transmission. We assessed predictors of STI acquisition and the effect of time since care entry on STI incidence in AHI patients in care and receiving consistent risk-reduction messaging. Methods Data on incident gonorrhea, chlamydia, trichomoniasis, primary/secondary syphilis, demographic, and clinical risk factors were abstracted from medical charts for patients diagnosed with AHI and engaged in care. Poisson regression models using generalized estimating equations were fit to estimate incidence rates (IR), incidence rate ratios (IRR), and robust 95% confidence intervals (CI). Results Among 185 AHI patients, 26 (14%) were diagnosed with ?1 incident STI over 709.4 person-years; 46 STIs were diagnosed during follow-up (IR=6.8/100 person-years). The median time from HIV care entry to first STI diagnosis was 609 days (range=168–1681). Men who have sex with men (MSM) (p=0.03), a shorter time between presentation to medical care and AHI diagnosis (p=0.06), and STI diagnosis prior to AHI diagnosis (p=0.0003) were predictors of incident STI. STI IR >1 year after entering care was double that of patients in care ?1 year (IRR=2.0 95% CI 0.8–4.9). HIV viral load was above the limits of detection within 1 month of 11 STI diagnoses in 6 patients (23.1%) (median=15,898 copies/mL, range=244–152,000 copies/mL). Conclusions Despite regular HIV care, STI incidence was high among this primarily young, MSM AHI cohort. Early antiretroviral initiation may decrease HIV transmission given ongoing risk behaviors despite risk-reduction messaging. PMID:24922104
Cope, Anna B.; Crooks, Amanda M.; Chin, Tammy; Kuruc, JoAnn D.; McGee, Kara S.; Eron, Joseph J.; Hicks, Charles B.; Hightow-Weidman, Lisa B.; Gay, Cynthia L.
Objectives: To define the incidence and characterise the clinical presentation of sexuallytransmitted infections (STI) in people aged ?16 years old attending a genitourinary clinic in south east London.Methods: Cross sectional analysis of clients aged ?16 years attending one genitourinary clinic. A subgroup was identified for priority treatment. Data collected included age, reason for presentation, diagnosis, contraceptive use, and adherence
Objective: Passive retrospective cohorts composed of persons who have tested 2 or more times for a sexuallytransmitted infection (STI) of interest during clinical visits have been used to estimate STI inci- dence. We hypothesized that the analytic period of a passive cohort might affect the estimate of STI incidence, with shorter periods yield- ing higher estimates of incidences of
Charlotte K. Kent; Janice K. Chaw; Robert P. Kohn; Ying Q. Chen; Jeffrey D. Klausner
Aims: The goal of this article is to introduce the Research on SexuallyTransmitted Diseases, Violence, and Pregnancy Prevention Project (RSVPP), which represents one response of the National Institutes of Health to reduce health disparities in racial and ethnic populations. Methods: As part of this effort, seven independent projects were funded to design, implement, and evaluate community-based intervention strategies aimed
Dorothy C. Browne; Patricia A. Clubb; Alison M. B. Aubrecht; Melvin Jackson
The phase specific model for the prevention and control of sexuallytransmitted infections (STI) offers new insights into the strategic planning of programmes. The model illustrates the importance of modifying the focus of prevention and control activities to different subpopulations as the epidemic evolves over time. However, the practical application of phase specific approaches will depend on an understanding of
Alcohol use is prevalent in South Africa and alcohol use may be associated with higher risk for HIV transmission. This paper reports a study of the association between alcohol use and HIV risk-related behavior among 134 men and 92 women receiving sexuallytransmitted infection (STI) clinic services in Cape Town, South Africa. Participants completed anonymous surveys of demographic information, substance
Leickness C. Simbayi; Seth C. Kalichman; Demetria Cain; Charsey Cherry; Sean Jooste; Vuyisile Mathiti
Objective: The aim of this study was to assess the patients’ knowledge and awareness of sexuallytransmitted infections (STIs). Subjects and Methods: A face-to-face interview was conducted among the patients visiting the Venereal Diseases Outpatient Department of the General Hospital of Pulau Pinang (Malaysia). A 19-item questionnaire was used. A total of 116 patients participated in the study and 107
Mudassir Anwar; Syed A. Syed Sulaiman; Tahir M. Khan
Sexuallytransmitted diseases, a source of widespread morbidity and sometimes mortality, are caused by a diverse group of infections with a common route of transmission. Existing vaccines against hepatitis B virus (HBV) and human papilloma virus 16, 18, 6 and 11 are highly efficacious and cost effective. In reviewing the potential role for other vaccines against sexuallytransmitted infections (STIs) a series of questions needs to be addressed about the burden of disease, the potential characteristics of a new vaccine, and the impact of other interventions. These questions can be viewed in the light of the population dynamics of sexuallytransmitted infections as a group and how a vaccine can impact these dynamics. Mathematical models show the potential for substantial impact, especially if vaccines are widely used. To better make the case for sexuallytransmitted infection vaccines we need better data and analyses of the burden of disease, especially severe disease. However, cost effectiveness analyses using a wide range of assumptions show that STI vaccines would be cost effective and their development a worthwhile investment. PMID:24606635
BACKGROUND: Sexuallytransmitted infection (STI) prevention programs can mitigate the health and economic burden of STIs. A tool to estimate the economic benefits of STI programs could prove useful to STI program personnel. METHODS: We developed formulas that can be applied to estimate the direct medical costs and indirect costs (lost productivity) averted by STI programs in the United States.
This paper shares some insights gained from undertaking a mixed methods study examining sexuallytransmitted infections (STIs) in a rural community. The study specifically aimed to gain an understanding of syphilis notifications in relation to rurality and disadvantage as well as how an individual's construction of rurality shaped the way in which he or she accessed community-based health services for
In Los Angeles County, the GIG intervention offers education to adolescents about pregnancy and sexuallytransmitted infections at a social event geared to the youth culture. Pre- and posttests completed by 609 Latino adolescents indicated an increase in knowledge and attitude changes. Use of peer educators was an important component of program…
Objective: The objective of this study was to determine the preva- lence and risk factors of HIV and other sexuallytransmitted infections (STIs) among female sex workers (FSWs) in Kinshasa, Democratic Republic of the Congo, in 2002. Study Design: A cross-sectional study was conducted among FSWs presenting for the first time at the STI clinic of Matonge, Kinshasa. The women
Judith M. Vandepitte; Faustin Malele; Samuel Edidi; Said Abdellati; Joelle Kabamba; Catherine Van Overloop
1 Toxoplasmosis can be a sexuallytransmitted infection with serious clinical consequences. Not all, Czech Republic b Department of General Anthropology, Faculty of Humanities, University in Prague, Prague, CZ-158 00, Prague 13, Czech Republic * Corresponding author: J. Flegr, Department of Philosophy
The incidence of sexuallytransmitted diseases (STDs) in the United States is among the highest in the western industrialized world. Nearly 19 million new STDs are diagnosed each year, and more than 65 million Americans live with an incurable STD, such as herpes and human papillomavirus (HPV). Young people, in particular, are at a heightened risk…
Wildsmith, Elizabeth; Schelar, Erin; Peterson, Kristen; Manlove, Jennifer
Examined key factors that influenced college students to seek screening for sexuallytransmitted diseases. Data from student interviews indicated that social stigmas and negative consequences (particularly the negative consequences of testing and perceived vulnerability to infection) represented significant barriers to being tested. Many students…
Sexuallytransmitted viruses cause chronic infections that have serious long-term health consequences. Based on the evidence from clinical and epidemiological studies, women carry a disproportionately higher burden of sexuallytransmitted diseases. The reasons for this are not well understood and possibly relate to a variety of social, behavioral and economic factors. In addition to these factors there are biological reasons
BACKGROUND: The effectiveness of provider-initiated HIV testing and counseling (PITC) for patients with sexuallytransmitted infection (STI) in resource-constrained settings are of particular concern for high HIV prevalence countries like South Africa. This study evaluated whether the PITC approach increased HIV testing amongst patients with a new episode of sexuallytransmitted infection, as compared to standard voluntary counseling and testing
Natalie Leon; Pren Naidoo; Catherine Mathews; Simon Lewin; Carl Lombard
Background: Antiretroviral therapies (ARTs) offer promising new avenues for HIV prevention. Unfortunately, people infected with HIV who have co-occurring sexuallytransmitted infections (STIs) are more infectious than suggested by the amount of virus in their peripheral blood. We examined the history of sexuallytransmitted coinfections in people living with HIV. Methods: People living with HIV\\/AIDS completed confidential computerized interviews that
Objectives To examine the prevalence and persistence of 20 HIV/sexuallytransmitted infection (STI) sexual and drug use risk behaviors and to predict their occurrence in 4 mutually exclusive diagnostic groups of delinquent youth: (1) major mental disorders (MMD); (2) substance use disorders (SUD); (3) comorbid MMD and SUD (MMD+SUD); and (4) neither disorder. Methods At the baseline interview, HIV/STI risk behaviors were assessed in 800 juvenile detainees, aged 10 to 18 years; youth were reinterviewed approximately 3 years later. The final sample (n = 689) includes 298 females and 391 males. Results The prevalence and persistence of HIV/STI risk behaviors was high in all diagnostic groups. Youth with SUD at baseline were over 10 times more likely to be sexually active and to have vaginal sex at follow-up than youth with MMD+SUD (AOR=10.86, 95% CI=1.43–82.32; AOR=11.63, 95% CI=1.49–90.89, respectively) and four times more likely to be sexually active and to have vaginal sex than youth with neither disorder (AOR=4.20, 95% CI=1.06–16.62; AOR=4.73, 95% CI=1.21–18.50, respectively). Youth with MMD at baseline were less likely to have engaged in unprotected vaginal and oral sex at follow-up compared with youth with neither disorder (AOR=0.11, 95% CI=0.02–0.50; AOR=0.07, 95% CI=0.01–0.34, respectively), and with youth with SUD (AOR=0.10, 95% CI=0.02–0.50; OR=0.10, 95% CI=0.02–0.47, respectively). Youth with MMD+SUD were less likely (AOR=0.28, 95% CI=0.09–0.92) to engage in unprotected oral sex compared with those with neither disorder. Conclusions Irrespective of diagnostic group, delinquent youth are at great risk for HIV/STIs as they age into adulthood. SUD increases risk. Because detained youth are released after approximately 2 weeks, their risk behaviors become a community health problem. Pediatricians and child psychiatrists must collaborate with corrections professionals to develop HIV/STI interventions and ensure that programs started in detention centers continue after youth are released. PMID:18645421
Elkington, Katherine S.; Teplin, Linda A.; Mericle, Amy A.; Welty, Leah J.; Romero, Erin G.; Abram, Karen M.
BACKGROUND: Since 2000, peer-mediated interventions among female sex workers (FSW) in Mombasa Kenya have promoted behavioural change through improving knowledge, attitudes and awareness of HIV serostatus, and aimed to prevent HIV and other sexuallytransmitted infection (STI) by facilitating early STI treatment. Impact of these interventions was evaluated among those who attended peer education and at the FSW population level.
Matthew F Chersich; Agnes Rinyiru; Mary-Stella Barasa; Nzioki King'ola; Kishorchandra Mandaliya; Wilkister Bosire; Sam Wambugu; Peter Mwarogo; Marleen Temmerman
Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexuallytransmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at…
Norton, Wynne E.; Fisher, Jeffrey D.; Amico, K. Rivet; Dovidio, John F.; Johnson, Blair T.
Background: The disparity in rates of sexuallytransmitted diseases (STDs), HIV/AIDS, and unplanned pregnancy between Alaska Native (AN) and non-AN populations, particularly among young adults and females, is significant and concerning. Focus groups were conducted to better understand the knowledge, attitudes, and beliefs of rural Alaska youth…
Leston, Jessica D.; Jessen, Cornelia M.; Simons, Brenna C.
The immune system in the female reproductive tract (FRT) does not mount an attack against HIV or other sexuallytransmitted infections (STI) with a single endogenously produced microbicide or with a single arm of the immune system. Instead, the body deploys dozens of innate antimicrobials to the secretions of the female reproductive tract. Working together, these antimicrobials along with mucosal antibodies attack many different viral, bacterial and fungal targets. Within the FRT, the unique challenges of protection against sexuallytransmitted pathogens coupled with the need to sustain the development of an allogeneic fetus have evolved in such a way that sex hormones precisely regulate immune function to accomplish both tasks. The studies presented in this review demonstrate that estradiol and progesterone secreted during the menstrual cycle act both directly and indirectly on epithelial cells and other immune cells in the reproductive tract to modify immune function in a way that is unique to specific sites throughout the FRT. As presented in this review, studies from our laboratory and others demonstrate that the innate immune response is under hormonal control, varies with the stage of the menstrual cycle, and as such is suppressed at mid-cycle to optimize conditions for successful fertilization and pregnancy. In doing so, a window of STI vulnerability is created during which potential pathogens including HIV enter the reproductive tract to infect host targets. PMID:20367623
Wira, Charles R.; Fahey, John V.; Ghosh, Mimi; Patel, Mickey V.; Hickey, Danica K.; Ochiel, Daniel O.
OBJECTIVE: To estimate the prevalence of sexuallytransmitted diseases (STDs) and determine their risk factors/markers among a rural population of women in the highlands of Papua New Guinea. METHODS: Community based random cluster sample of women of reproductive age were interviewed and examined and had specimens collected for laboratory confirmation of chlamydial and trichomonal infection, gonorrhoea, syphilis, and bacterial vaginosis. RESULTS: Chlamydia trachomatis was detected in 26%, Trichomonas vaginalis in 46%, Neisseria gonorrhoeae in 1%, syphilis in 4%, pelvic inflammatory disease (PID) (diagnosed clinically) in 14%, and bacterial vaginosis in 9% of 201 women. 59% of the women had at least one STD. In a multivariate logistic regression analysis taking the clustered sampling into account, independent risk factors for chlamydial infection were age < or = 25 years, < four living children, visualization of yellow mucopurulent endocervical secretions on a white swab, and bacterial vaginosis. Being married to a man who did not have other wives was protective. For trichomonal infection, independent risk factors were having no formal education, infertility, more than one sexual partner in the previous 12 months, treatment for genital complaints in the previous 3 months, abnormal vaginal discharge detected on examination, and chlamydial infection. Similar levels of trichomonal infection were found in all age groups. Among married women, rates of infection correlated with their perception of their husband having had other sexual partners in the previous 3 months, and this relationship was significant for chlamydial infection among women over 25. CONCLUSION: STDs are a major problem in this population, with the risk factors varying by outcome. Current treatment regimens are inappropriate given the high prevalence of trichomonal infection, and the available services are inadequate. Effective interventions are required urgently to reduce this burden and to prevent the rapid transmission of HIV. ??? PMID:9634324
Passey, M.; Mgone, C. S.; Lupiwa, S.; Suve, N.; Tiwara, S.; Lupiwa, T.; Clegg, A.; Alpers, M. P.
Sexuallytransmitted diseases, especially syphilis, gonorrhea, granuloma inguinale, and lymphogranuloma, are on the increase in the tropics. Several environmental factors contribute to disease transmission, including polygamy, high bride price, prostitution, civil war, urbanization, and economic development. Diagnosis is generally made on clinical grounds due to inadequate laboratoary facilities, and it is not possible to differentiate syphilis from yaws. This diagnostic inaccuracy has meant that there are no reliable data with which to assess epidemiologic trends, institute control measures, and evaluate their effects. Inadequate treatment, caused by a lack of drugs and poorly trained medical attendants, is also a major problem. Inappropriate treatment has caused over 80% of gonococcal strains in some areas to be penicillin-resistant. Late complications of gonorrhea, epididymitis, and salpingitis are frequently seen and lead to sterility in many cases. These complications are as prevalent in some areas today as they were in pre-sulfonamide days. A determined effort is needed to control the spread of these diseases. A central unit with modern facilities for diagnosis and treatment should be established. Diagnostic tests, such as culture and serology, should be introduced at the district and provincial levels. Rural health centers should employ a polyvalent microscopist who is trained to recognize gonococcus in stained smears. Given the high default rates, treatment should be simplified, using a single dose schedule where possible. The impracticality of follow-up requires epidemiologic treatment of contacts in many cases. If mass screening of pregnant women is not possible, Crede's silver nitrate eyedrops are recommended to prevent ophthalmia neonatorum. High risk populations, including bar girls, migrant workers, soldiers, and sailors, should be targeted for health education campaigns. Such education should focus on regulation of sexual behavior, condom use, and, when infection is present, the importance of avoiding self-medication, early treatment, and cooperation in contact tracing. PMID:577059
This paper reviews the scientific basis for trials exploring the relation between sexuallytransmitted diseases (STDs) and human immunodeficiency virus (HIV) infection in Mwanza in the United Republic of Tanzania and Rakai and Masaka in the Republic of Uganda. The importance of a study's location and explanations for the divergent results of these trials are discussed. The modest effect on STDs seen in the trial of syndromic management in Mwanza, in contrast to the 38% reduction in the incidence of HIV, casts doubt on the underlying hypothesis that treating STDs alone slows the transmission of HIV-1. According to the Piot-Fransen model, the trial in Rakai, which offered treatment of STDs to all subjects irrespective of symptoms ("mass" treatment), should have been more effective both in reducing the prevalence of STDs and the incidence of HIV. However, the Rakai trial was stopped because there was no difference in the incidence of HIV between the intervention and control arms. If Mwanza is seen as the trial that needs explaining, another paradigm becomes relevant. In rural East Africa, where all trials have been conducted, networks of concurrent sexual partnerships are a source of infection with both STDs and HIV. Because of their shorter latency periods, STDs may prompt attendance at a clinic before the early signs of HIV-1 infection appear. Part of the management of STDs is to recommend abstinence or the consistent use of condoms until treatment is completed. This recommendation may cover the earliest period of viraemia during primary HIV-1 infection. This paradigm appears to explain the results from Mwanza and Rakai, emphasizing behavioural aspects of syndromic management. PMID:11217667
Animals have a number of behavioral defenses against infection. For example, they typically avoid sick conspecifics, especially during mating. Most animals also alter their behavior after infection and thereby promote recovery (i.e., sickness behavior). For example, sick animals typically reduce the performance of energetically demanding behaviors, such as sexual behavior. Finally, some animals can increase their reproductive output when they face a life-threatening immune challenge (i.e., terminal reproductive investment). All of these behavioral responses probably rely on immune/neural communication signals for their initiation. Unfortunately, this communication channel is prone to manipulation by parasites. In the case of sexuallytransmitted infections (STIs), these parasites/pathogens must subvert some of these behavioral defenses for successful transmission. There is evidence that STIs suppress systemic signals of immune activation (e.g., pro-inflammatory cytokines). This manipulation is probably important for the suppression of sickness behavior and other behavioral defenses, as well as for the prevention of attack by the host's immune system. For example, the cricket, Gryllus texensis, is infected with an STI, the iridovirus IIV-6/CrIV. The virus attacks the immune system, which suffers a dramatic decline in its ability to make proteins important for immune function. This attack also hampers the ability of the immune system to activate sickness behavior. Infected crickets cannot express sickness behavior, even when challenged with heat-killed bacteria. Understanding how STIs suppress sickness behavior in humans and other animals will significantly advance the field of psychoneuroimmunology and could also provide practical benefits. PMID:24813461
Criminal justice involvement (CJI) disrupts social and sexual networks, and sexuallytransmitted infections (STIs) thrive on network disruption. Adolescent CJI may be a particularly important determinant of STI because experiences during adolescence influence risk trajectories into adulthood. We used Wave III (2001-2002: young adulthood) of the National Longitudinal Study of Adolescent Health (N?=?14,322) to estimate associations between history of adolescent (younger than 18 years) CJI and adult STI risk. Respondents who reported a history of repeat arrest in adolescence, adolescent conviction, and arrest both as an adolescent and an adult (persistent arrest) had between two to seven times the odds of STI (biologically confirmed infection with chlamydia, gonorrhea, or trichomoniasis) in adulthood and between two to three times the odds of multiple partnerships and inconsistent condom use in the past year in adulthood. In analyses adjusting for sociodemographic and behavioral factors, history of having six or more adolescent arrests was associated with more than five times the odds of STI (adjusted odds ratio (AOR) 5.44, 95 % confidence interval (CI) 1.74-17.1). Both adolescent conviction and persistent CJI appeared to remain independent correlates of STI (conviction: AOR 1.90, 95 % CI 1.02-3.55; persistent CJI: AOR 1.60, 95 % CI 0.99-2.57). Adolescents who have repeat arrests, juvenile convictions, and persist as offenders into adulthood constitute priority populations for STI treatment and prevention. The disruptive effect of adolescent CJI may contribute to a trajectory associated with STI in adulthood. PMID:22815054
Khan, Maria R; Rosen, David L; Epperson, Matthew W; Goldweber, Asha; Hemberg, Jordana L; Richardson, Joseph; Dyer, Typhanye Penniman
Background: Sexuallytransmitted infections (STIs) constitute major public health concern and enigma. A comprehensive knowledge of the modes of transmission is necessary to evolve an effective preventive strategy. Aim: The aim of the study is to assess the vulnerability, knowledge and prevention of STIs among female traders of reproductive age in Enugu, Southeast Nigeria. Subjects and Methods: This was a cross-sectional descriptive study carried out on female traders aged 15-49 years at Ogbete Main Market, Enugu, Southeast Nigeria. Data was analyzed using Epi-Info 2000 version 3.3.1 Centers for Disease Control and Prevention Atlanta USA) was used to analyze the data and results were presented in tabular form. Results: A total of 200 female traders of reproductive age participated in the study. The mean (standard deviation) age was 26 (7.4) years. 16% (32/200) were adolescents. Knowledge of specific STIs was highest for human immunodeficiency virus/acquired immune deficiency syndrome 90% (130/200). Parents were poor sources of information as only 28.5% (57/200) respondents heard about STIs from their parents compared with 46% (92/200) from friends and peers. Risk factors identified were multiple sexual partners 75.5% (151/200), non-use of condoms 62% (124/200) and early debut 58% (116/200). Majority 67.5% (135/200) were aware that STIs could be treated by a visit to the doctor while 21.5% (43/200) preferred traditional/herbal healers. Conclusion: The inclusion of health education in schools’ curricula to ensure that adolescents are adequately aware of STIs, their modes of transmission, prevention and treatment before embarking on any vocation out-of-school is advocated. PMID:24669343
Background To estimate the association between Trichomonas vaginalis infection (TV) and six sexuallytransmitted infections: chlamydia, gonorrhea, herpes simplex virus (Types 1 and 2), syphilis and HIV in a nationally representative sample. Methods We used data from the National Health and Nutrition Examination Survey (NHANES) combining the 2001–2002 and 2003–2004 waves to estimate the association between TV and STIs among women in the civilian, non-institutionalized US population. The final sample included data from 3,648 women, which when weighted, represents the experience of 65,563,298 US women between the ages of 14 and 49. Crude and adjusted relative risks were estimated using logistic regression for rare STIs (< 10%; chlamydia, syphilis and human immunodeficiency virus (HIV)) and Poisson regression for common STIs (herpes simplex virus (HSV) types 1 and 2). Statistical analyses were conducted using Stata (version 9.2). Results The prevalence of trichomoniasis was 3.2% with over 80% of cases asymptomatic in the past month. All STIs examined (chlamydia, gonorrhea, HSV-1, HSV-2, syphilis and HIV) were more common among women with a positive test for trichomoniasis. HSV-1 (RR = 1.20, 95% CI 1.09, 1.34) and HSV-2 (RR= 1.51, 95% CI 2.32, 3.23) were significantly associated with trichomoniasis after adjusting for race/ethnicity, age and recent sexual partners. In crude analyses, a positive treponemal test was 6 times (95% CI 2.07, 18.8) more common and HIV was 13 times (95% 2.88, 59.1) more common among women with trichomoniasis, but these estimates were greatly attenuated after adjustment for potential confounders. Conclusion Trichomoniasis is significantly associated with concurrent STI. PMID:19734826
Allsworth, Jenifer E.; Ratner, Jane Alyce; Peipert, Jeffrey F.
Bacterial infections are uncommon complications of the blood products transfusion but they are potentially serious. Many advances have been done over the past few years to guarantee the microbiological security of blood products as the donors selection with a medical talk, the derivation of the first 30 millilitres blood during the donation, the deleucocytation of blood products… But in spite of these advances, cases of bacterial infection always remain. The purpose of this study was to point out the platelet concentrate's transfusion-transmittedbacterial infection with Streptococcus gallolyticus and the unusual consequence for the donor by uncovering an asymptomatic rectal neoplastic tumor. This study as raised as to whether the usefulness of systematic bacterial inactivation in the platelets concentrates. PMID:24934685
Le Niger, C; Dalbies, F; Narbonne, V; Hery-Arnaud, G; Virmaux, M; Léostic, C; Hervé, F; Liétard, C
To generate insights into how migration shapes sexual risk and protection, we interviewed 36 female and 20 male West Indian (WI) immigrants attending a public sexuallytransmitted disease (STD) clinic in Brooklyn, NY between 2004 and 2005. Migration theory suggests that shifts in sexual partnership patterns, bi-directional travel, and changes in sexual norms may alter risk. We found evidence of sexual mixing across ethnic groups: a large proportion of participants’ partners were not born in the WIs, despite what is expected among first generation immigrants. Recent travel “home,” another potential source of risk, was uncommon. In open-ended interviews, two themes around sexual and social networks emerged. First, immigrants believed that access to wider, more anonymous sexual networks in NYC and the weakening of social controls that limit multiple partnerships (especially for women) promoted greater risk. Second, immigrants experienced greater opportunities for protection in NYC, both through exposure to safer sex messages and availability of condoms. Reported changes in their own condom use, however, were not attributed to migration. WI immigrants’ risk in NYC may be driven by access to wider sexual networks but failure to alter reliance on “networks of knowledge” for protection. PMID:21452091
Objectives. We sought to investigate independent contributions of risky sexual behaviors and bleeding caused by intimate partner violence to prediction of HCV infection. Methods. We conducted a case–control study of risk factors among patients of a sexuallytransmitted disease clinic with and without HCV antibodies, group-matched by age. Results. Multivariate analyses indicated that Black race (odds ratio [OR] = 2.4; 95% confidence interval [CI] = 1.3, 4.4), injection drug use (OR = 20.3; 95% CI = 10.8, 37.8), sharing straws to snort drugs (OR = 1.8; 95% CI = 1.01, 3.0), sharing razors (OR = 7.8; 95% CI = 2.0, 31.0), and exposure to bleeding caused by intimate partner violence (OR = 5.5; 95% CI = 1.4, 22.8) contributed significantly to the prediction of HCV infection; risky sexual behavior and exposure to blood or sores during sexual intercourse did not. Conclusions. HCV risk among patients of a sexuallytransmitted disease clinic can be explained by direct blood exposure, primarily through injection drug use. Exposure to bleeding caused by intimate partner violence may be a previously unrecognized mechanism for HCV transmission associated with risky sexual behavior. PMID:19218181
Chen, Meng-Jinn; Nochajski, Thomas H.; Testa, Maria; Zimmerman, Scott J.; Hughes, Patricia S.
Floral traits endowing high reproductive fitness can also affect the probability of plants contracting sexuallytransmitted diseases. We explore how variations in floral traits influence the fitness of Silene dioica females in their interactions with pollinators carrying pollen or spores of the sterilizing anther-smut fungus Microbotryum violaceum. We collected healthy and infected plants in a highly diseased population and grew them under conditions that 'cure' infected individuals, and used standard regression methods to detect natural selection on floral traits. Narrow-sense heritabilities, coefficients of additive genetic variation (CV(A)) and genetic correlations among traits were estimated from paternal half-sib groups. Pollinator preferences imposed strong direct and directional selection on traits affecting female attractiveness and pollen-/spore-capturing abilities. Levels of additive genetic variance were high in these traits, suggesting that rapid responses to selection are possible. By considering our results in the light of spatial and temporal heterogeneity resulting from the colonization dynamics typical for this species, we suggest that the conflicting selective effects of pollen/spore loads lead to the maintenance of genetic variation in these traits. PMID:16441754
Giles, Barbara E; Pettersson, Tor Mikael; Carlsson-Granér, Ulla; Ingvarsson, Pär K
The primordial objective of this study was to carry out an epidemiological analysis of sexuallytransmitted diseases (STD) in terms of sensed morbidity and real morbidity in the mining region of "Las Claritas", Bolivar State, Venezuela, during the third trimester of 1998. The epidemiological characteristics of time, people and place are interlaced, giving a relationship included within the Epidemiological Triad, that represents this work's conceptual framework; defining both, the determinant and the conditioning factors of the presence of STDs in the zone. The clinical interrogatory was partially steered towards the participant's sensed morbidity. A mostly feminine population is described (65%), with a low scholarly level in the general population and a high index of foreigners among the evaluated patients; with 48.72% of stable unions in the interviewees. From 166 evaluated patients, 27.70% referred to have had some STD episode, being syphilis and blenorrhagia the most frequently reported. In the survey, there was a general hush concerning the presence of STDs; but, key informants such as the medicine retailers, revealed a higher presence of these diseases, which are wrongly treated by automedication. These are important results, since they let opened a space for the epidemiological evaluation in the zone, in the various health, sanitary, environmental and social aspects and mainly, by the individual's quality of life expectations. PMID:10961044
In recent decades, sexuallytransmitted diseases (STDs) have reemerged and spread as a major public health problem in China. However, little effort has been made on promoting appropriate health-seeking behaviors among people living with STDs. A randomly selected sample of market vendors in Fuzhou (N = 4510) was recruited and assessed from 2003 to 2004 to examine their choice of pharmacy versus hospital, and folk remedy versus Western medicine when having STD symptoms. Approximately 11.3% of the sample (4.0% of men and 17.8% of women) reported having had abnormal genital discharge or genital ulcer during the past 6 months. More (over 60%) people chose Chinese folk remedy to treat symptoms or prevent transmission when they had genital discharge and/or genital ulcer. Approximately 30% of study participants with reported STD symptoms visited pharmacies only to seek treatment, and 17% visited neither hospital nor pharmacies. Visiting a pharmacy only for STD treatment was marginally significantly associated with being female (prevalence ratio [PR] = 1.665, confidence interval [CI] = 0.980, 2.831) and never married (PR = 1.984, CI = 1.098, 3.594) after controlling for other potential confounders. Education about appropriate health-seeking behaviors to obtain effective treatment of STD must be a top priority to control the rapid spread of STDs in China. PMID:19519228
The aim of this study was to evaluate staff perception of a nurse-led sexuallytransmitted infection (STI) clinical service. The staff at the Amsterdam STI clinic were interviewed using a standardized questionnaire. A series of eight questions was designed to determine the perceived advantages or disadvantages of nurse-led clinics, based on personal experience, using a Likert scale. After completion of the structured interview, the staff were offered the opportunity of providing comments. All 36 members of staff completed the survey. Twenty-seven (75%) agreed or strongly agreed that nurse-led clinics provided more time with patients. Sixty-four percent agreed or strongly agreed that such a service provided greater confidentiality and 94% agreed or strongly agreed that 'nurse-led clinics provided a high level of job satisfaction for nurses.' In contrast, only 64% agreed or strongly agreed that nurse-led clinics provided a high level of job satisfaction for doctors. When staff comments were evaluated, four common themes emerged. First, that this was an efficient way of providing services; second, that the clinic was a pleasant environment, there was excellent teamwork and greater job satisfaction; third, that a good deal of rivalry existed between doctors and nurses and finally, that there was a need for and importance of protocols, rules and staff training and development. In conclusion, there was a high level of staff satisfaction with the service. Nurse-led STI clinics may be a useful adjunct to existing STI facilities. PMID:19854883
Mindel, A; Fennema, J S A; Christie, E; van Leent, E
The objective of this study was to estimate the prevalence and identify correlates of four sexuallytransmitted infections (STIs) among HIV-infected Russians reporting heavy alcohol use and recent unprotected sex, we conducted a cross-sectional analysis of baseline data from the HERMITAGE study. The primary outcome was any current STI, based on urine tests for Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis and serological testing for infection with Treponema pallidum. Data on potential demographic and behavioural predictors of STI were obtained from surveys administered at study entry. Of 682 participants, 12.8% (95% confidence interval [CI] 10.3, 15.3) tested positive for at least one STI. In a multivariable model adjusted for gender, age and marital status, only sex trade involvement over the last three months was significantly associated with an increased odds of STI (adjusted odds ratio [AOR] 2.00, 95% CI 1.13, 3.55). Given that STIs were common in this HIV-infected cohort, and that few patient characteristics predicted STI, the current practice of screening HIV-infected Russians for syphilis alone merits re-evaluation. PMID:23258823
Pace, C A; Lioznov, D; Cheng, D M; Wakeman, S E; Raj, A; Walley, A Y; Coleman, S M; Bridden, C; Krupitsky, E; Samet, J H
There are certain special considerations in the management of sexuallytransmitted diseases (STDs) in homosexual men, with the impact of human immunodeficiency virus (HIV) infection on the presentation, diagnosis, and management of certain STDs just becoming apparent recently. Rectal and pharyngeal gonorrhea are usually asymptomatic and also more difficult to treat. The serological diagnosis of syphillis may be unreliable in acquired immunodeficiency syndrome (AIDS) patients, and HIV-seropositive homosexual men may be at risk of accelerated progression to neurosyphilis, despite treatment with benzathine penicillin. Chlamydia trachomatis is infrequently detected in patients with proctitis so therapy should be directed only at culture-positive cases. Herpes simplex is usually severe and persistent in immunosuppressed patients and may be further complicated by the development of acyclovir-resistance. Concurrent HIV infection may be associated with increased infectivity of homosexual chronic hepatitis B carriers, but milder hepatic injury and reduced efficacy of hepatitis B vaccines and immodulatory or antiviral agents. Although there is some concern regarding the possibility of increased risk of anal cancer in homosexual men, conservative management of human papilloma-virus-associated conditions is advised. The carriage of Entamoeba histolytica in this group is rarely associated with any deleterious effects and treatment should be directed only at symptomatic patients in whom other enteric pathogens have been excluded. PMID:2202414
OBJECTIVE--To assess the extent of the sexuallytransmitted diseases (STDs) problem in a rural area of Mozambique. METHODS--A cross sectional study among pregnant women and patients presenting with genital complaints. Laboratory confirmation was done for gonorrhoea, chlamydial infection, active syphilis, trichomoniasis and HIV infection. SETTING--A primary health care setting in Vilanculos, Inhambane province, Mozambique. RESULTS--Evidence of one or more of the above STDs was found in 51% of 201 pregnant women, 56% of 85 women and 62% of 77 men with genital complaints. Neisseria gonorrhoea or Chlamydia trachomatis were found in 16% of pregnant women, 23% of female patients and 28% of male patients; genital ulcer disease was present in 6%, 28% and 36%, of respectively pregnant women, female and male patients. The prevalence of active syphilis was about the same in the three groups of study subjects, that is 15%. HIV infection was found in 4% of the male patients; no HIV infection could be detected in the female groups. CONCLUSION--STDs were a major health problem in this rural area in Mozambique. Though HIV infection was still low, the high prevalence of STDs indicates that the potential is there for an explosive spread of the HIV/AIDS epidemic. PMID:8282293
Objective To examine the association between douching and four sexuallytransmitted infections (STIs). Study Design We followed 411 high-risk HIV-infected and uninfected female adolescents ages 12–19 over a median three-year period, both by time from study entry/first STI-free visit until an incident STI for participants who never, intermittently, and always douched, and also by reported douching at a given STI-free visit and incidence of STI at the next visit, using adjusted Cox proportional hazards models to calculate hazards ratios (HR). Results The time to STI was shorter for adolescents who always (HR=2.1; 95% CI, 1.2–3.4) and intermittently (HR=1.5; 95% CI:1.0–2.2) douched compared to never-douchers. An adjusted hazard for STI was 1.8 times larger for always-douchers (95%CI:1.1–3.1) and 1.4 times larger for intermittent-douchers (95%CI:0.9–2.0) compared to never-douchers. When classifying by follow-up post an STI-free visit, always-douchers had a shorter STI-free time than never-douchers (HRadj=2.1; 95%CI:1.5–3.1). Conclusion Counseling to discourage douching may reduce STI risk in adolescents. PMID:18667177
TSAI, Cynthia S.; SHEPHERD, Bryan E.; VERMUND, Sten H.
The “classical model” for sexuallytransmitted infections treats partnerships as instantaneous events summarized by partner change rates, while individual-based and pair models explicitly account for time within partnerships and gaps between partnerships. We compared predictions from the classical and pair models over a range of partnership and gap combinations. While the former predicted similar or marginally higher prevalence at the shortest partnership lengths, the latter predicted self-sustaining transmission for gonorrhoea (GC) and Chlamydia (CT) over much broader partnership and gap combinations. Predictions on the critical level of condom use (Cc) required to prevent transmission also differed substantially when using the same parameters. When calibrated to give the same disease prevalence as the pair model by adjusting the infectious duration for GC and CT, and by adjusting transmission probabilities for HIV, the classical model then predicted much higher Cc values for GC and CT, while Cc predictions for HIV were fairly close. In conclusion, the two approaches give different predictions over potentially important combinations of partnership and gap lengths. Assuming that it is more correct to explicitly model partnerships and gaps, then pair or individual-based models may be needed for GC and CT since model calibration does not resolve the differences. PMID:22761828
Ong, Jimmy Boon Som; Fu, Xiuju; Lee, Gary Kee Khoon; Chen, Mark I-Cheng
This pilot telephone survey sought to identify social barriers to treating sexuallytransmitted infections (STIs) in a socially conservative state (Alabama, USA). The sample consisted of 250 household residents aged 19-50 years, mostly African-American and White, who were drawn from the general population. The participants reported that infected persons, per se, should not be stigmatized. However, almost half of respondents stated that they would seek revenge against a partner who infected them. Feelings of embarrassment negatively affected willingness to seek health care; almost half of the respondents stated that, if infected, they would delay treatment or not seek treatment at all. Differences in responses emerged in relation to ethnicity and religiosity, with African-Americans and regular churchgoers being more likely than others to say they would delay or refuse treatment because of embarrassment. Gender differences also emerged: respondents reported that women would be more stigmatized than men if they were infected, even though men should be held responsible for spreading STIs. These findings suggest that stigma may be a compelling barrier to STI control in the American Deep South, and that ethnicity, gender and religiosity play an important role in attitudes toward treatment. PMID:16864187
Lichtenstein, Bronwen; Hook, Edward W; Sharma, Amit K
The sexuallytransmitted insect virus Helicoverpa zea nudivirus 2 (HzNV-2) was determined to have a circular double-stranded DNA genome of 231,621 bp coding for an estimated 113 open reading frames (ORFs). HzNV-2 is most closely related to the nudiviruses, a sister group of the insect baculoviruses. Several putative ORFs that share homology with the baculovirus core genes were identified in the viral genome. However, HzNV-2 lacks several key genetic features of baculoviruses including the late transcriptional regulation factor, LEF-1 and the palindromic hrs, which serve as origins of replication. The HzNV-2 genome was found to code for three ORFs that had significant sequence homology to cellular genes which are not generally found in viral genomes. These included a presumed juvenile hormone esterase gene, a gene coding for a putative zinc-dependent matrix metalloprotease, and a major facilitator superfamily protein gene; all of which are believed to play a role in the cellular proliferation and the tissue hypertrophy observed in the malformation of reproductive organs observed in HzNV-2 infected corn earworm moths, Helicoverpa zea. PMID:22355451
Burand, John P; Kim, Woojin; Afonso, Claudio L; Tulman, Edan R; Kutish, Gerald F; Lu, Zhiqiang; Rock, Daniel L
Prostate cancer (PC) is the second most incident cancer and the sixth cause of death by cancer in men worldwide. Despite extensive research efforts, no modifiable risk factors have been consistently identified for PC risk. A number of studies have focused on possible relationships between sexuallytransmitted infections (STIs) and PC. We performed a meta-analysis to explore the association between infection caused by Neisseria gonorrheae, Treponema pallidum, Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Herpes Simplex Virus types 1 and 2, Human Herpes Virus 8 and Cytomegalovirus, and PC. We conducted a comprehensive, systematic bibliographic search of medical literature to identify relevant studies. We calculated summary relative risk (SRR) and 95% confidence intervals (CI) for the association between each STI and PC through random effect models. Subgroup, meta-regression and sensitivity analyses were carried out to detect between-study heterogeneity and bias. We included 47 studies published between 1971 and 2011. Men who reported having ever had any STI in lifetime had an increased PC (SRR 1.49, 95% CI 1.19-1.92). We found a significantly increased PC risk in men having had gonorrhoea (SRR 1.20, 95% CI 1.05-1.37). No other single STI was significantly associated with PC. Due to high incidence of both STIs and PC worldwide, prevention of STIs may help preventing a considerable number of PC cases. PMID:24986642
Objectives. We examined the associations of local public health system organization and local health department resources with county-level sexuallytransmitted disease (STD) incidence rates in large US health jurisdictions. Methods. We linked annual county STD incidence data (2005–2008) to local health department director responses (n?=?211) to the 2006 wave of the National Longitudinal Study of Local Public Health Systems, the 2005 national Local Health Department Profile Survey, and the Area Resource File. We used nested mixed effects regression models to assess the relative contribution of local public health system organization, local health department financial and resource factors, and sociodemographic factors known to be associated with STD incidence to county-level (n?=?307) STD incidence. Results. Jurisdictions with local governing boards had significantly lower county-level STD incidence. Local public health systems with comprehensive services where local health departments shoulder much of the effort had higher county-level STD rates than did conventional systems. Conclusions. More integration of system partners in local public health system activities, through governance and interorganizational arrangements, may reduce the incidence and burden of STDs. PMID:22813090
The present study investigated perceptions of AIDS as a social problem relative to 10 other problems in a sample of 194 inner-city sexuallytransmitted disease (STD) clinic patients. Within-subjects analyses showed that AIDS was viewed as a more serious problem than housing, alcoholism, and child care, while AIDS was less of a problem than employment, drug abuse, crime, discrimination, and teen pregnancy, and no different from transportation and health care. Factor analysis was used to identify the interrelationships among social problems as perceived by STD patients. For men, factor analysis showed that AIDS was most closely related to crime, drug abuse, teen pregnancy, and discrimination, with these problems constituting the first factor and accounting for most of the variance in the analysis. Men also placed AIDS with alcoholism and child care on the third factor accounting for little variance. For women, however, AIDS clustered most closely with alcoholism and child care, accounting for a minimal amount of variance in the analysis. Results further showed that perceptions of social problems among women correlated with HIV-risk-related behaviors. The structural context of social problems, within which AIDS is embedded, is discussed with reference to HIV-AIDS-prevention interventions. PMID:7577306
Introduction: Genital ulcerative diseases are a major public health problem. The advert of human immunodeficiency virus (HIV)/AIDS over the past 25 years has deepened the scope of morbidity, mortality, and various forms of clinical presentations of sexuallytransmitted diseases (STDs). Materials and Methods: A total of 50 cases having Genital ulcerative diseases and STD reporting to STD clinic during the period of the year from November 2005 to December 2006 were included and detailed history and clinical examination were carried out and provisional diagnosis is made. Laboratory confirmation of clinically diagnosed cases was done using laboratory tests such as S. HIV, venereal disease research laboratory, Tzanck smear, gram stain, and Giemsa stain. Result: In the present study, the incidence of herpes progenitalis was (38%) followed by primary syphilis (32%), chancroid (26%), lymphogranuloma venereum (02%), and genital scabies (02%). HIV sero-positivity was detected in 12% (n = 6) cases. Conclusion: HIV was found to be more common among genital ulcer disease patients, especially syphilis and genital herpes. PMID:24958991
Background The aim of this study was to determine the prevalence of human papillomavirus (HPV) and 15 species that cause sexuallytransmitted infections (STIs) in negative cytology. In addition, we compared the diagnostic performance of multiplex polymerase chain reaction (PCR) with widely available techniques used to detect HPV. Methods We recruited 235 women of reproductive age who had negative cytology findings in a liquid-based cervical smear. STIs were identified by multiplex PCR, and HPV genotypes by multiplex PCR, hybrid capture 2, and DNA microaray; discordant results were analyzed by direct sequencing. Results Approximately 96.6% of patients with negative cytology results were positive for pathogens that cause STIs. The pathogens most frequently detected were Gardnerella vaginalis, Ureaplasma urealyticum. The incidence of HPV in negative cytology was 23.3%. Low-risk HPV infection was significantly correlated with Chalmaydia trachomatis, and high-risk HPV infection was significantly correlated with Group ? streptococcus. The analytical sensitivities of the multiplex PCR and DNA microarray were higher than 80%, and the analytical specificity was nearly 100% for all tests. Conclusions Multiplex PCR yielded results that most of patients with negative cytology were positive for pathogens that cause STIs, and were more similar to that of DNA microarray, than that of hybrid capture 2 in terms of analytical sensitivity and prediction value of HPV infection. PMID:20920170
This paper analyzes the relationship between same-sex marriage laws and sexuallytransmitted infections in the United States using state-level data from 1981 to 2008. We hypothesize that same-sex marriage laws may directly affect risky homosexual behavior; may affect or mirror social attitudes toward gays, which in turn may affect homosexual behavior; and may affect or mirror attitudes toward non-marital sex, which may affect risky heterosexual behavior. Our findings may be summarized as follows. Laws banning same-sex marriage are unrelated to gonorrhea rates, which are a proxy for risky heterosexual behavior. They are more closely associated with syphilis rates, which are a proxy for risky homosexual behavior. However, these estimates are smaller and less statistically significant when we exclude California, the state with the largest gay population. Also, laws permitting same-sex marriage are unrelated to gonorrhea or syphilis, but variation in these laws is insufficient to yield precise estimates. In sum, the findings point to a modest positive association--if any at all--between same-sex marriage bans and syphilis. PMID:22789462
Three causal processes have been proposed to explain associations between group income inequality and individual health outcomes, each of which implies health effects for different segments of the population. We present a novel conceptual and analytic framework for the quantitative evaluation of these pathways, assessing the contribution of: (i) absolute deprivation - affecting the poor in all settings - using family income; (ii) structural inequality - affecting all those in unequal settings - using the Gini coefficient; and (iii) relative deprivation - affecting only the poor in unequal settings - using the Yitzhaki index. We conceptualize relative deprivation as the interaction of absolute deprivation and structural inequality. We test our approach using hierarchical models of 11,183 individuals in the National Longitudinal Study of Adolescent Health (Add Health). We examine the relationship between school-level inequality and sexuallytransmitted infections (STI) - self-reported or laboratory-confirmed Chlamydia, Gonorrhoea or Trichomoniasis. Results suggest that increased poverty and inequality were both independently associated with STI diagnosis, and that being poor in an unequal community imposed an additional risk. However, the effects of inequality and relative deprivation were confounded by individuals' race/ethnicity. PMID:24565155
Harling, Guy; Subramanian, S V; Bärnighausen, Till; Kawachi, Ichiro
Summary While laboratory aetiological diagnosis is considered the gold standard for diagnosis and management of sexuallytransmitted infections (STIs), syndromic management has been presented as a simplified and affordable approach for STI management in limited resource settings. STI signs and symptoms were collected using staff-administered computer-assisted personal interview and audio computer-assisted self-interview. Participants underwent a medical examination and laboratory testing for common STIs. The performance of syndromic management was assessed on the agreement between interviewing methods as well as accurate diagnosis. We screened 846 participants, of whom 88 (10.4%) received syndromic STI diagnosis while 272 (32.2%) received an aetiological diagnosis. Agreement between syndromic and aetiological diagnoses was very poor (overall kappa?=?0.09). The most prevalent STI was herpes simplex virus type 2 and the percentage of persons with any STI was higher among women (48.6%) than men (15.6%, p?0.0001). Agreement between audio computer-assisted self-interview and computer-assisted personal interview interviewing methods for syndromic diagnosis of STIs ranged from poor to good. Our findings suggest that syndromic management of STIs is not a sufficient tool for STI diagnosis in this setting; development and improvement of STI diagnostic capabilities through laboratory confirmation is needed in resource-limited settings. PMID:24516075
The first multicentre survey of sexuallytransmitted diseases (STDs) performed in Papua New Guinea was conducted in STD clinics in five towns, Port Moresby, Goroka, Rabaul, Lae and Daru, from September 1989 to May 1990. Infections with Neisseria gonorrhoeae and Chlamydia trachomatis (alone or in combination) were common. Penicillinase-producing N. gonorrhoeae (PPNG) represented 44% of all gonococcal isolates but significant intrinsic resistance to penicillin was not found. Of the other antibiotics tested, significant elevation of minimum inhibitory concentration (MIC) was common only for tetracycline, although no high-level tetracycline resistance was detected. C. trachomatis was detected by direct immunofluorescence (DIF) in 26% of 210 males and 27% of 64 females. 10% (21/210) of males and 11% (7/64) of females were both DIF positive for C. trachomatis and culture positive for N. gonorrhoeae. Of 203 males and 78 females tested, 5% and 12%, respectively, had serological evidence of current syphilis infection. Clinically, genital ulcer disease was most commonly due to syphilis, donovanosis or genital herpes, while specific vaginal infections were commonly seen in female patients attending Port Moresby and Lae STD clinics. PMID:7668052
Hudson, B J; van der Meijden, W I; Lupiwa, T; Howard, P; Tabua, T; Tapsall, J W; Phillips, E A; Lennox, V A; Backhouse, J L; Pyakalyia, T
Background HIV/AIDS-related stigma and discrimination are significant determinants of HIV transmission in the Caribbean island nation of Trinidad and Tobago (T&T), where the adult HIV/AIDS prevalence is 2.5%. T&T is a spiritually-aware society and over 104 religious groups are represented. This religious diversity creates a complex social environment for the transmission of a sexuallytransmitted infection like HIV/AIDS. Religious leaders are esteemed in T&T's society and may use their position and frequent interactions with the public to promote HIV/AIDS awareness, fight stigma and discrimination, and exercise compassion for people living with HIV/AIDS (PWHA). Some religious groups have initiated HIV/AIDS education programs within their membership, but previous studies suggest that HIV/AIDS remains a stigmatized infection in many religious organizations. The present study investigates how the perception of HIV/AIDS as a sexuallytransmitted infection impacts religious representatives' incentives to respond to HIV/AIDS in their congregations and communities. In correlation, the study explores how the experiences of PWHA in religious gatherings impact healing and coping with HIV/AIDS. Methods Between November 2002 and April 2003, in-depth interviews were conducted with 11 religious representatives from 10 Christian, Hindu and Muslim denominations. The majority of respondents were leaders of religious services, while two were active congregation members. Religious groups were selected based upon the methods of Brathwaite. Briefly, 26 religious groups with the largest followings according to 2000 census data were identified in Trinidad and Tobago. From this original list, 10 religious groups in Northwest Trinidad were selected to comprise a representative sample of the island's main denominations. In-depth interviews with PWHA were conducted during the same study period, 2002–2003. Four individuals were selected from a care and support group located in Port of Spain based upon their perceived willingness to discuss religious affiliation and describe how living with a terminal infection has affected their spiritual lives. The interviewer, a United States Fulbright Scholar, explained the nature and purpose of the study to all participants. Relevant ethical procedures associated with the collection of interview data were adopted: interviews were conducted in a non-coercive manner and confidentiality was assured. All participants provided verbal consent, and agreed to be interviewed without financial or other incentive. Ethics approval was granted on behalf of the Caribbean Conference of Churches Ethics Committee. Interview questions followed a guideline, and employed an open-ended format to facilitate discussion. All interviews were recorded and transcribed by the interviewer. Results Religious representatives' opinions were grouped into the following categories: rationale for the spread of HIV/AIDS, abstinence, condom use, sexuality and homosexuality, compassion, experiences with PWHA, recommendations and current approach to addressing HIV/AIDS in congregations. Religious representatives expressed a measure of acceptance of HIV/AIDS and overwhelmingly upheld compassion for PWHA. Some statements, however, suggested that HIV/AIDS stigma pervades Trinidad's religious organizations. For many representatives, HIV/AIDS was associated with a promiscuous lifestyle and/or homosexuality. Representatives had varying levels of interaction with PWHA, but personal experiences were positively associated with current involvement in HIV/AIDS initiatives. All 4 PWHA interviewed identified themselves as belonging to Christian denominations. Three out of the 4 PWHA described discriminatory experiences with pastors or congregation members during gatherings for religious services. Nonetheless, PWHA expressed an important role for faith and religion in coping with HIV. Conclusion Religious groups in Trinidad are being challenged to promote a clear and consistent response to the HIV/AIDS epidemic; a response that may reflect personal experien
Background Sexuallytransmitted Infections (STIs) rank among the most important health issues for the people especially the young adults worldwide. Young people tend to engage in sexual activity at younger ages in the past decade than in the 1970s, and 1980s. Knowledge is an essential precursor of sexual risk reduction. A cross-sectional study was conducted in Pulau Pinang, Malaysia, to produce the baseline information about school students' awareness and perception about sexuallytransmitted Infections (STIs) and their sexual activity to help establish control and education programmes. Methods Students from form 4 (aged between 15 to 16 years), form 5 (aged between 16 to 17 years) and form 6 (aged between 18 to 20 years) in their class rooms were approached and asked to complete self administered and anonymous pre-validated questionnaires. SPSS for windows version 13 was used to analyze the results statistically and results were presented in tabular form. Results Data was collected from 1139 students aged between 15 to 20 years, 10.6% of which claimed that they never heard about STIs. Sexual experience related significantly with gender, race, and education level. Approximately 12.6% claimed to have sexual experience of which 75.7% had their sexual debut at 15-19 years and 38.2% were having more than 3 partners. Sexual experience was found to be significantly associated with gender (p = 0.003), ethnicity (p = 0.001) and education level (p = 0.030). However, multiple partner behaviour was significantly associated only with gender (p = 0.010). Mean knowledge score was 11.60 ± 8.781 and knowledge level was significantly associated with religion (p = 0.005) education level (p = 0.000), course stream (p = 0.000), socioeconomic class (p = 0.000) and sexual experience (p = 0.022). Conclusions It was concluded that school students have moderate level of knowledge about STIs although they are sexually active. Interventions such as reinforcing the link between STIs and HIV/AIDS, assessing the current status of sexuality education in schools and arranging public talks and seminars focusing on STIs prevention education are needed to improve their awareness. PMID:20113511
This study examines the psychological factors linking childhood abuse and HIV/sexuallytransmitted infection outcomes among 190 single homeless women in New York City. Participants were assessed for mental health symptoms, sexuallytransmitted infections, and exposure to childhood sexual and physical abuse. Findings indicate that the relationship between childhood abuse and HIV/sexuallytransmitted infection diagnoses during adulthood is mediated by a combination of posttraumatic stress disorder and borderline personality disorder symptoms. Screening single homeless women who report childhood abuse histories for symptoms of both disorders may aid in the identification of individuals particularly vulnerable for HIV infection. Implications for clinical interventions are discussed. PMID:23180873
Houston, Eric; Sandfort, Theo G M; Watson, Kalycia T; Caton, Carol L M
BackgroundThe Centers for Disease Control recommend screening for asymptomatic sexuallytransmitted infection (STI) among HIV-infected men when there is self-report of unprotected anal-receptive exposure. The study goals were: (1) to estimate the validity and usefulness for screening policies of self-reported unprotected anal-receptive exposure as a risk indicator for asymptomatic anorectal infection with Neisseria gonorrhoeae (GC) and\\/or Chlamydia trachomatis (CT). (2)
Edward R. Cachay; Amy Sitapati; Joseph Caperna; Kellie Freeborn; Joseph T. Lonergan; Edward Jocson; William C. Mathews; Johan K. Sandberg
Objectives: To determine the knowledge, attitudes, and practices regarding diagnosis and treatment of sexuallytransmitted infections (STIs) among specialists—that is, dermatologists, gynaecologists and urologists, and general practitioners (GPs) in Karachi, Pakistan.Methods: Interviewers administered structured questionnaires to doctors conducting outpatient clinics at tertiary hospitals and\\/or private clinics in Karachi. All private clinics within a 10 km radius of the Aga Khan
There is overwhelming and compelling evidence that control efforts for sexuallytransmitted infection (STI) have a major role\\u000a to play in the prevention of HIV transmission. Community-based randomized controlled trials are set as the highest standard\\u000a of evidence for showing the efficacy of STI interventions to prevent HIV transmission. The negative results of recent randomized\\u000a controlled trials have cast doubt
BackgroundTrichomonas vaginalis is the causative agent of human trichomoniasis, the most common non-viral sexuallytransmitted infection world-wide. Despite its prevalence, little is known about the genetic diversity and population structure of this haploid parasite due to the lack of appropriate tools. The development of a panel of microsatellite makers and SNPs from mining the parasite's genome sequence has paved the
Melissa D. Conrad; Andrew W. Gorman; Julia A. Schillinger; Pier Luigi Fiori; Rossana Arroyo; Nancy Malla; Mohan Lal Dubey; Jorge Gonzalez; Susan Blank; William E. Secor; Jane M. Carlton
ObjectivesA randomised controlled trial was conducted to assess and quantify the efficacy and acceptability of non-invasive testing (NIT) for sexuallytransmitted infections (STI) in asymptomatic patients within a genitourinary medicine clinic.MethodsPatients were randomly assigned to either standard of care (SOC—STI testing with genital examination) or NIT. The length of time patients spent in the clinic was recorded and patients were
L. Brown; S. Patel; N. J. Ives; C. McDermott; J. D. C. Ross
The distribution of Chlamydia trachomatis serovars among 157 heterosexual male patients with urethritis and the presence of coinfections with other sexuallytransmitted\\u000a infections were studied. One hundred seventeen (74.5%) patients, with a mean age of 33.7 years, were Italians, whereas 40\\u000a (25.5%) were immigrants coming from eastern European countries, Africa, and South America. All the immigrants and 82 (70.0%)\\u000a Italian patients
M. Donati; A. Di Francesco; A. D’Antuono; S. Pignanelli; A. Shurdhi; A. Moroni; R. Baldelli; R. Cevenini
Objectives: To investigate the determinants of delay in seeking healthcare for sexuallytransmitted infections (STIs) among Vietnamese women attending the National Institute of Dermatology and Venereology (NIDV), through assessing to what extent women’s sociodemographic backgrounds and their knowledge, attitudes and practices (KAP) relating to STIs\\/STI prevention influence their delay in seeking healthcare for STIs.Methods: A face-to-face semistructured interview of 60
BACKGROUND: Targeted outreach, counselling, and treatment of sexuallytransmitted infections (STIs) are among the most cost-effective interventions aimed at ameliorating the burden of HIV\\/STIs. Since many new HIV infections occur in people under the age of 25, youth, and especially most at risk adolescents (MARA), need to be able to access HIV\\/STI services. Starting in 2006, a programme targeting MARA
Nisso Kasymova; Benjamin Johns; Benusrat Sharipova
South Africa urgently needs HIV prevention interventions that can be disseminated for use in clinical and community settings. A brief theory-based HIV risk reduction counselling intervention originally developed in the USA has recently been adapted for use in a South African sexuallytransmitted infection clinic. The 60-minute risk reduction counselling intervention was grounded in the Information-Motivation-Behavioural Skills (IMB) model of
Vuyisile Mathiti; Leickness C. Simbayi; Sean Jooste; Queen Kekana; Xolani P. Nibe; Luvuyo Shasha; Philasande Bidla; Pamela Magubane; Demetria Cain; Charsey Cherry; Seth C. Kalichman
Background: Sexuallytransmitted infections (STIs) are known risk factors for HIV infection. Goal: The goal of this study was to assess the current and potential future role that community pharmacists in Western Cape, South Africa play in the treatment of STIs. Study Design: A cross-sectional survey of community pharmacists in the Western Cape region of South Africa. A face-to-face interview
Kim Ward; Nadine Butler; Pierre Mugabo; Jeffrey Klausner; Willi McFarland; Sanny Chen; Sandra Schwarcz
BackgroundClinicians in developing countries have had limited access to continuing education (CE) outside major cities, and CE strategies have had limited impact on sustainable change in performance. New educational tools could improve CE accessibility and effectiveness.Methodology\\/Principal FindingsThe objective of this study was to evaluate an interactive Internet-based CE course on SexuallyTransmitted Diseases (STDs) management for clinicians in Peru. Participants
Fredy A. Canchihuaman; Patricia J. Garcia; Stephen S. Gloyd; King K. Holmes; Vineet Gupta
An experimental components analysis of brief HIV risk-reduction counseling based on the information-motivation-behavioral skills (IMB) model was conducted with 432 men and 193 women receiving sexuallytransmitted infection (STI) clinic services. Following baseline assessments, participants were randomly assigned to 1 of 4 90-min risk-reduction counseling sessions that deconstructed the IMB model within a full factorial design. Participants were followed for
Seth C. Kalichman; Demetria Cain; Lance Weinhardt; Eric Benotsch; Kelly Presser; Allan Zweben; Bonnie Bjodstrup; Geoffrey R. Swain
The prevalence of antibodies to human immunodeficiency virus (anti-HIV-1) was determined in 924 outpatients attending a sexuallytransmitted disease clinic. The overall prevalence of anti-HIV-1 was 9 %. Six of 14 intravenous drug addicts and 4 of 34 patients of African origin were anti-HIV-1 positive. In the other 876 patients, the anti-HIV prevalence was 6.6 % in 467 heterosexual men,
A. Mele I; P. Verani; F. Caprilli; G. Gentili; M. A. Stazi; G. Rezza; L. Sernicola; E. Franco; G. Prignano; P. Pasquini
SummaryA randomised trial was done to evaluate the impact of improved sexuallytransmitted disease (STD) case management at primary health care level on the incidence of HIV infection in the rural Mwanza region of Tanzania. HIV incidence was compared in six intervention communities and six pair-matched comparison communities. A random cohort of about 1000 adults aged 15-54 years from each
H. Grosskurth; J. Todd; E. Mwijarubi; P. Mayaud; A. Nicoll; G. ka-Gina; J. Newell; D. Mabey; R. Hayes; F. Mosha; K. Senkoro; J. Changalucha; A. Klokke; K. Mugeye
Background With the advent of molecular techniques, self?collected specimens without a clinician's examination are often adequate to detect common genital infections. Objective To evaluate the additional information that speculum and bimanual examinations provides clinicians in the routine evaluation of genital infections among attendees of a sexuallytransmitted disease (STD) clinic. Methods Cross?sectional study from a database of all visit records to two STD clinics in Baltimore between 1996 and 2002. Women were stratified on the basis of reason for visit. Proportional and likelihood ratio estimates of the speculum examination in detecting clinically relevant cervicovaginal lesions (leading to a diagnosis of other infections or outside referral for further management) and bimanual examination in detecting abnormalities (leading to a diagnosis of pelvic inflammatory disease or referral) are presented. Results 15?918 of 21?703 records were included: 12?073 were symptomatic (SYM; discharge, rash, abdominal pain, dysuria, genital irritation or odour), 1676 were asymptomatic contacts of an infected partner (CON) and 2169 were asymptomatic and presented for checkup (ASYM). The median age was 26?years; 94% were black. 11.8% of SYM, 4.6% of CON and 3.9% of ASYM patients had clinically meaningful lesions detected on speculum examination. The bimanual examination detected clinically relevant abnormalities in 6.5% of SYM, 0.8% of CON and 0.6% of ASYM patients. Conclusion Symptomatic women are most likely to benefit from speculum and bimanual examinations. However, their yield in evaluating asymptomatic women is low. Prospective studies are needed to determine whether eliminating speculum and bimanual examinations in a subset of women would offer an operational advantage without compromising patient safety. PMID:17108005
Singh, Rameet H; Erbelding, Emily J; Zenilman, Jonathan M; Ghanem, Khalil G
The study attempts to define socioeconomic, clinical, and laboratory correlates in vaginitis and other sexuallytransmitted infections in rural southwestern Haiti. A convenience sample of subjects recruited from a rural women's health clinic and attending an established clinic at the Haitian Health Foundation (HHF) clinic was studied. A standardized history and physical examination, including speculum examination, and collection of blood, urine, and vaginal swabs were obtained from the women at the rural clinic. Additional vaginal swab samples only for Nucleic Acid Amplification Test (NAAT) testing were obtained from women at the HHF clinic in Jérémie. Laboratory results from Leon subjects were positive for Gardnerella vaginalis in 41% (41 of 100), Trichomonas vaginalis in 13.5% (14 of 104), Candida sp. in 9% (9 of 100), Mycoplasma genitalium in 6.7% (7 of 104), Chlamydia trachomatis in 1.9% (2 of 104), and Neisseria gonorrhea in 1% (1 of 104) of patients. Human immunodeficiency virus (HIV) antibody tests were negative in 100% (103 of 103) of patients, and syphilis antibody testing was positive for treponemal antibodies in 7.7% (8 of 104) patients. For subjects from the HHF, 19.9% were positive for T. vaginalis, 11.9% were positive for C. trachomatis, 10.1% were positive for M. genitalium, and 4.1% were positive for N. gonorrhea. Infections with G. vaginalis, T. vaginalis, and Candida were the most common. N. gonorrhea, C. trachomatis, Candida sp., T. vaginalis, and M. genitalium infections were associated with younger age (less than 31 years old). PMID:25200263
Jobe, Kathleen A; Downey, Robert F; Hammar, Donna; Van Slyke, Lori; Schmidt, Terri A
Objectives To determine the etiology and factors associated with genital ulcer disease (GUD) among patients presenting to a sexuallytransmitted infections clinic in Manaus, Brazil; and to compare a multiplex polymerase chain reaction (M-PCR) assay for the diagnosis of GUD with standard methods. Methods Ulcer swabs were collected and used for Tzanck test and processed in an M-PCR to detect herpes simplex virus (HSV-1/2), Treponema pallidum (T. pallidum), and Haemophilus ducreyi (H. ducreyi). Sera were tested for HIV and syphilis antibodies. Multivariable analysis was used to measure the association between clinical aspects and GUD. M-PCR results were compared with syphilis serology and Tzanck tests. Results Overall, 434 GUD samples were evaluated, 84.8% from men. DNA from HSV-2 was detected in 55.3% of GUD samples, T. pallidum in 8.3%, HSV-1 in 3.2%, and 32.5% of GUD specimens were negative for the DNA of all three pathogens. No cases of H. ducreyi were identified. HIV serology among GUD patients was 3.2%. Treponemal antibodies and Tzanck test positivity for genital herpes was detected in 25 (5.8%) and in 125 (30.3%) of GUD patients, respectively. In multivariable analysis genital herpes etiology by M-PCR was associated with the vesicular, multiple and recurrent lesions whereas T. pallidum with non-vesicular, non-recurrent lesions. Compared to M-PCR, syphilis serology was 27.8% sensitive and 96.2% specific whereas Tzanck test was 43.8% sensitive and 88.9% specific. Conclusions The predominance of genital herpes etiology suggests a revision of existing national syndromic treatment guidelines in Brazil to include antiherpetic treatment for all GUD patients. The use of M-PCR can significantly improve the diagnosis of GUD and provide a greater sensitivity than standard diagnostics. PMID:23704961
Introduction: The National AIDS Control Organization has designed multiple synergistic interventions to identify and control curable sexuallytransmitted infections (STIs). Objective: To assess the impact of services offered at designated STI clinics in the state of Himachal Pradesh, India and the profile of the attending clients. Materials and Methods: This was a two-year prospective study, conducted from April 2011 to March 2013. Training on delivering STI/RTI services was imparted to the staff of 16 designated STI clinics including recording of data. The staff in each STI clinic comprises of one doctor, one counselor, one nurse, and one laboratory technician. The clients attending these designated clinics were offered counseling, syndromic case management (SCM), and diagnostic services wherever possible. Monthly data of STI clinic attendees was collected, compiled, and analyzed. Results: A total of 65,760 clinic visits were reported, of which 32,385 (49%) visits were for index STI/RTI complaint(s). The ratio of male to female attendees was 1:2. The commonest age group accessing the STI clinics was 25-44 years (n = 38,966; 59.3%). According to SCM, 52.9% clients were managed. The commonest presenting syndrome was urethral discharge (n = 4,500; 41%) in males, and vaginal discharge (n = 13,305; 56%) in females. Genital ulcer disease was treated in 2099 cases. Laboratory tests were performed only in 6466 patients, and 39,597 antenatal mothers were screened for syphilis. Counseling services were provided to 51,298 (f = 34,804; 68%: m = 16,494; 32%) clients and of these, 48% (n = 25,056) of the clients were referred to integrated counseling and testing centers. Forty-three clients (m = 24: f = 19) were detected positive for HIV infection. Conclusion: Uniform and standardized services delivered to clients attending public health clinics can gather reliable data to monitor trends of STI infection. PMID:25165642
Objectives To assess preferences among students for sexuallytransmitted infection (STI) testing services, with a view to establishing strength of preference for different service attributes. Design Online discrete choice experiment (DCE) questionnaire. Setting South East of England. Participants A convenience sample of 233 students from two universities. Outcomes Adjusted ORs in relation to service characteristics. Results The study yielded 233 responses. Respondents’ ages ranged from 16 to 34?years with a mean age of 22 years. Among this sample, the respondents demonstrated strong preferences for a testing service which provided tests for all STIs including syphilis, herpes and HIV (OR 4.1; 95% CI 3.36 to 4.90) and centres staffed by a doctor or nurse with specialist knowledge of STIs (OR 2.1; 95% CI 1.78 to 2.37). Receiving all test results, whether positive or negative, was also significantly preferable to not being notified when tests were all negative (‘no news is good news’; OR 1.3; 95% CI 1.16 to 1.5). The length of time waiting for an appointment and the method by which results are received were not significant service characteristics in terms of preferences. Patient level characteristics such as age, sex and previous testing experience did not predict the likelihood of testing. Conclusions This study demonstrates that of the examined attributes, university students expressed the strongest preference for a comprehensive testing service. The next strongest preferences were for being tested by specialist STI staff and receiving negative as well as positive test results. However, it remains unclear how strong these preferences are in relation to characteristics which were not part of the study design and whether or not they are cost-effective. PMID:24165028
Background This study was conducted to determine the prevalence of HIV antibody testing and associated factors among heterosexual sexuallytransmitted disease (STD) clinic attendees in China. Methods A self-administered questionnaire was administered among 823 attendees of 4 STD clinics of Zhejiang Province, China in October to December 2007. Psychosocial and behavioural factors associated with HIV antibody testing were identified in both genders using univariate and multivariate analyses. Results Of all 823 STD clinic attendees, 9.3% of male and 18.0% of female attendees underwent HIV antibody testing in the most recent 6 months, and 60% of the participants had gotten no educational/behavioral intervention related to HIV prevention. The correlates for HIV antibody testing in the most recent 6 months as identified by multivariate analysis were ever condom use [odds ratio (OR), 10.37; 95% confidence interval (CI), 1.32–81.22]; ever anal/oral sex (OR, 3.13; 95% CI, 1.03–9.50) during their lifetime; having ever received three to seven types of behavioural interventions in the most recent 6 months (OR, 3.70; 95% CI, 1.32–10.36) among male subjects; and ever condom use (OR, 12.50; 95% CI, 2.20–71.01), STD history (OR, 3.86; 95% CI, 1.26–11.86) over their lifetime, or having ever received three to seven types of behavioural interventions in the most recent 6 months (OR, 8.68; 95% CI, 2.39–31.46) in female subjects. A lifetime experience of casual/commercial sex partners was strongly negatively associated with HIV testing in female subjects (OR, 0.08; 95% CI, 0.01–0.83). Conclusion The low prevalence of HIV antibody testing and behavioural intervention among STD clinic attendees indicates a need for more targeted, intensive behavioural interventions to promote HIV antibody testing in this population. PMID:23327359
Background Use of lubricant products is extremely common during receptive anal intercourse (RAI) yet has not been assessed as a risk for acquisition of sexuallytransmitted infections (STIs). Methods From 2006–2008 a rectal health and behavior study was conducted in Baltimore and Los Angeles as part of the UCLA Microbicide Development Program (NIAID IPCP# #0606414). Participants completed questionnaires and rectal swabs were tested for Neisseria gonorrhoeae and Chlamydia trachomatis with the Aptima Combo 2 assay and blood was tested for syphilis (for RPR and TPHA with titer) and HIV. Of those reporting lubricant use and RAI, STI results were available for 380 participants. Univariate and multivariate regressions assessed associations of lubricant use in the past month during RAI with prevalent STIs. Results Consistent lubricant use during RAI in the past month was reported by 36% (137/380) of participants. Consistent past month lubricant users had a higher prevalence of STI than inconsistent users (9.5% vs. 2.9%; p=0.006). In a multivariable logistic regression model testing positive for STI was associated with consistent use of lubricant during RAI in the past month (adjusted Odds Ratio (AOR) 2.98 (95%CI 1.09, 8.15) after controlling for age, gender, study location, HIV status, and numbers of RAI partners in the past month. Conclusions Findings suggest some lubricant products may increase vulnerability to STIs. Because of wide use of lubricants and their potential as carrier vehicles for microbicides, further research is essential to clarify if lubricant use poses a public health risk. PMID:22183849
Gorbach, Pamina M.; Weiss, Robert E.; Fuchs, Edward; Jeffries, Robin A.; Hezerah, Marjan; Brown, Stephen; Voskanian, Alen; Robbie, Edward; Anton, Peter; Cranston, Ross D.
Objective To estimate completion rate and acceptability of home screening for sexuallytransmitted infections (STIs) compared to clinic-based screening in a prospective cohort study. Methods The first 462 women enrolled in the Contraceptive CHOICE Project were screened at 12 months of follow-up for Chlamydia trachomatis and Neisseria gonorrhoeae using strand displacement analysis of self-collected vaginal swabs. In a telephone interview, participants were given a choice of no-cost screening with swabs mailed to the participant’s home (home-based) or screening that was available at area family planning clinics without an appointment (clinic-based). The clinic-based group also included women who elected to screen with their regular provider according to the clinician’s normal practice. We analyzed the rates of screening, including patient preference and the proportion of completed tests by testing method. Results Women were more likely to choose to screen for STIs at home than at a clinic or with their own medical provider (75.7% versus 16.1% versus 8.2%, p < 0.001). Women choosing clinic testing were more likely to be black than those choosing home testing. Black women comprised 42% of the clinic group compared to 28% of the home group (RR 1.63, 95% CI 1.14–2.31). The groups did not differ in other demographic characteristics, STI risk factors, or access to healthcare. Overall, 228 women (56.6%) completed screening. Women who chose home-based testing were more likely to complete a test compared to all clinic-based testers (64.6% versus 31.6%, RR 2.04, 95% CI 1.51–2.76). Conclusion Women overwhelmingly preferred to screen for STIs at home. Future interventions to increase screening rates in young women should consider alternative screening strategies such as home-based or patient-controlled testing. PMID:20308834
Graseck, Anna S.; Secura, Gina M.; Allsworth, Jenifer E.; Madden, Tessa; Peipert, Jeffrey F.
Background As stigma is a socially constructed concept, it would follow that stigma related to sexual behaviours and sexuallytransmitted infections would carry with it many of the gender-based morals that are entrenched in social constructs of sexuality. In many societies, women tend to be judged more harshly with respect to sexual morals, and would therefore have a different experience of stigma related to sexual behaviours as compared to men. While a variety of stigma scales exist for sexuallytransmitted infections (STIs) in general; none incorporate these female-specific aspects. The objective of this study was to develop a scale to measure the unique experience of STI-related stigma among women. Methods A pool of items was identified from qualitative and quantitative literature on sexual behaviour and STIs among women. Women attending a social evening program at a local community health clinic in a low-income neighbourhood with high prevalence of substance use were passively recruited to take part in a cross-sectional structured interview, including questions on sexual behaviour, sexual health and STI-related stigma. Exploratory factor analysis was used to identify stigma scales, and descriptive statistics were used to assess the associations of demographics, sexual and drug-related risk behaviours with the emerging scales. Results Three scales emerged from exploratory factor analysis – female-specific moral stigma, social stigma (judgement by others) and internal stigma (self-judgement) – with alpha co-efficients of 0.737, 0.705 and 0.729, respectively. In this population of women, internal stigma and social stigma carried higher scores than female-specific moral stigma. Aboriginal ethnicity was associated with higher internal and female-specific moral stigma scores, while older age (>30 years) was associated with higher female-specific moral stigma scores. Conclusion Descriptive statistics indicated an important influence of culture and age on specific types of stigma. Quantitative researchers examining STI-stigma should consider incorporating these female-specific factors in order to tailor scales for women. PMID:19021915
Rusch, Melanie LA; Shoveller, Jean A; Burgess, Susan; Stancer, Karen; Patrick, David M; Tyndall, Mark W
Introduction: One in four Indians is a juvenile. Sexual crimes, pre marital sex, sexuallytransmitted diseases and unwanted pregnancies are on the rise. It has been shown that lack of sexuality education can significantly contribute to the above. Aim: We conducted this study to determine the knowledge and awareness of college students regarding sex and related matters and the factors affecting the prevalent outlook and practices of youth towards the same. Methodology: A prospective cross-sectional survey was conducted amongst 500 students of the K.P.B. Hinduja College of Commerce from December 2012 to March 2013 as per the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Main Outcome Measures: 1. Sex knowledge scores of males and females regarding contraception, sexuallytransmitted diseases and HIV/AIDS. 2. Percentage response of males and females to questions depicting attitudes and perceptions regarding premarital sex and promiscuity, sexual fantasy and masturbation, unwanted pregnancies and contraception. 3. Responses depicting participant’s premarital and high risk sexual activities. Results: The mean age was 18.6 ±1.6 years, 46% of participants were female. The total sex related knowledge scores of males and females were 8.2±1.2 and 6.2±2.4 (p<0.0001), respectively. 84% males and 72% females disagree that virginity should be preserved till marriage. Premarital sex was reported by 48% males and 18% females. Out of those who had premarital sex, 68% males and none of the females had more than one sex partner and 21% males and 12% females had used a contraceptive during their sexual encounter. 87% males and 82% females disagree that sex education in secondary schools will cause a rise in premarital intercourse. 40% males and 13% females are of the view that birth control is primarily a female’s responsibility. 14% of males and 21% of females (p = 0.2) reported being forced to have sex. Conclusion: Participants, especially females, lacked basic information about sexuality and related concepts. Male participants had a very casual attitude towards having sex with multiple partners. Premarital sex is more common than once believed. In the light of our finds and the current scenario, sexuality education is indispensable in order to guide the youth to develop and adopt healthy and appropriate sexual practices. PMID:25302214
Mutha, Sonali A; Baghel, Paritosh J; Patil, Ramanand J; Bhagat, Sagar B; Patel, Sadiq B; Watsa, Mahinder C
Gender Relations Survey, 47% indicated that they or the offender were drinkinggender-imbalanced environment where a high prevalence of sexual risk behaviors such as binge drinking,drinking, illicit substance use, and unwanted sexual contact were associated with increased report of sexual partners among both genders.
This paper examines young people's perceived vulnerability to sexuallytransmitted infections (STIs) and their efforts to create a sense of personal safety within an environment in which risks may be high and where STIs are highly stigmatised. The paper reports on findings from research involving both Indigenous and non-Indigenous 16- to 25-year-olds from remote, rural and regional Australia, including communities in the Northern Territory, Western Australia and South Australia. The study used qualitative methods, including body mapping and scenario based interviewing, to explore how young people made decisions about potential sexual partners and how STIs were understood within the context of young people's everyday social worlds. The paper has important implications for the design and implementation of sexual-health education programmes by documenting the stigmatisation of young people with STIs and the protective mechanisms peer groups employ to create perceptions of personal safety. PMID:24592872
Senior, Kate; Helmer, Janet; Chenhall, Richard; Burbank, Victoria
Objective: Risk-prone personality dispositions are asso- ciated with alcohol use and high-nsk sexual behaviors; however, the na- ture of these associations and their implications for sexual risk reduction interventions are not clear. This study examined a conceptual model of sensation seeking personality and alcohol expectancies as correlates of sex-related alcohol use and sexual nsk behaviors. Method: Men (N= 350) seeking
SETH C. KALICHMAN; DEMETRIA CAIN; ALLAN ZWEBEN; GEOFF SWAIN
Background Sexuallytransmitted diseases (STDs), especially the Chlamydia trachomatis bacterial infection, a common cause of infertility, are highly prevalent in developed countries, and a worrying problem in North Norway, where the incidence of chlamydia twice the Norwegian average. Seventy percent of reported chlamydia cases are found in people below 25 years of age, and although its spread could be controlled with proper prevention, young people are more aware of the risks of unwanted pregnancy than their risk of acquiring a STD. Information and Communication Technologies, including, the Internet, social media and/or smartphones, should be valued for sexual health promotion for their potential to engage young audiences. And in these media, avatars guarantee anonymity to users when handling sensitive information. The main objective of this project is to achieve that North Norwegian youngsters become more aware of STDs through the use of popular technologies among young people. Methods A Virtual Clinic for SexuallyTransmitted Diseases (VCSTD) will be developed. The VCSTD will provide early guidance and reliable information sources concerning reproductive health, delivered in a novel and innovative way to the younger population. The VCSTD consists of an “avatar” supported intervention in a serious gaming and e-learning environment, which will bypass direct physical access (in person) to reliable medical information, as well as allowing the youngsters to share that information in social media, and thus helping the VCSTD to be disseminated to more people. Data analyses will be conducted on publically available health data relevant to STDs in Troms and Finnmark, like the absolute number of chlamydia tests, the amount of emergency contraception medication sold, and the number of abortions. Also, usage data of the system and experiences of usefulness will be explored through participants’ voluntary responses to a feedback form available in the VCSTD. Discussion This study will examine the usefulness of an online public health intervention that aims to promote healthy sexual practices among North-Norwegian youngsters. If shown to be effective, the intervention could prove to be an affordable and widely accessible intervention to decrease risky sexual practices in younger population. PMID:23110684
Background The incidence of STI is high and increasing in Bhutan. Poor understanding of risky sexual behavior could be a cause. Comprehensive community surveys have not been previously done. This study was conducted to assess local knowledge on STIs and sexual risk behaviour in two rural districts of Bhutan: Gasa and Zhemgang. Methods The study population included residents aged 15–49 years in the two districts. Health Assistants (HAs) visited all households to distribute questionnaires assessing understanding of knowledge on STIs and risk behaviour. Questionnaires were scored and analyzed. Results The average score was 61.6%. Respondents had highest knowledge about prevention and lowest about disease and complications. There was a positive correlation between level of education and knowledge on STI (P?0.05). Almost 37% of students scored low. Nearly one-third of the study population was practicing risky sexual behavior with 31.2% having sexual relationships with non-regular partners and 10.9% had extramarital sexual contacts. Regular use of condoms with non-regular partners was 49.1%. The most common reason for not using condom was unavailability during the sexual encounter. The study showed that despite increasing knowledge there was no reduction in risky sexual behaviour (p?>?0.05). Conclusions The study population had variable understanding of STIs and their complications. One in three persons practiced risky sexual behaviour, higher in men. Condom use was low. There was no reduction of risky sexual behaviour with increasing level of knowledge indicating that increasing level of knowledge does not necessarily reduce risky sexual behaviour.
Background In 1997, a survey in Kisumu found a prevalence of HIV infection among female sex workers (FSW) of 75%. Only 50% reported using a condom with the last client. In 2008, we conducted another survey to collect data to inform an intervention targeting FSW in Kisumu. Methods In 2008 FSW were recruited by respondent-driven sampling. Women completed a questionnaire and were tested for HIV and other sexuallytransmitted infections (STIs). Multiple logistic regression analysis was done to explore factors associated with HIV-infection, and with condom use. Prevalence of HIV infection was compared in the two surveys from 1997 and 2008. Multivariate analysis was used to assess whether a change in HIV prevalence between the two surveys could be explained by changes in socio-demographic characteristics and/or behavioral factors. Results 481 FSW participated in the 2008 study. HIV prevalence was 56.5% (95% CI 52.0–61.6). Factors independently associated with HIV were age older than 29 years; being a widow; STI treatment in the past year; herpes simplex virus Type-2 infection; bacterial vaginosis; and trichomoniasis. Condom use with last client was reported by 75.0% (95% CI 70.9–78.9). Predictors of condom use with the last client were age older than 29 years; higher price paid by last client; ever having been tested for HIV. Predictors of unprotected sex were being drunk during last sex act; usually having sex during menses; and STI treatment in the past year. The odds ratio of HIV infection associated with year of survey was 0.49 (95% CI 0.33–0.75) after adjusting for socio-demographic and behavioral factors. Conclusions The prevalence of HIV among FSW in Kisumu was found to be lower in 2008 than in 1997, while reported condom use was higher. However, access to HIV/STI prevention and care services needs to improve to further decrease HIV transmission between FSW and their clients. PMID:23372801
BackgroundHealth-related quality of life (HRQOL) has not been studied in Indian patients with viral sexuallytransmitted infections (STIs): herpes simplex virus-2 (HSV-2) and genital human papilloma virus (HPV) infections. Furthermore, there is no reported study that compares HRQOL among these two viral STIs and HIV.MethodsAll consenting adults with any of the three viral infections attending a sexuallytransmitted disease clinic
Introduction Sexuallytransmitted diseases (STDs) data collected in HIV+ patients could be used as indicator of risky sexual behaviour possibly linked to HIV transmission. We described the STDs incidence over time and identified higher incidence factors. Methodology All patients in the ICONA Foundation Study enrolled after 1998 were included. STDs considered: any-stage syphilis, human papilloma virus (HPV) diseases, gonococcal and non-gonococcal urethritis, herpes simplex virus (HSV) genital ulcers, vaginitis and acute hepatitis B virus (HBV), hepatitis A virus (HAV), and hepatitis C virus (HCV) infections (only for non-IVDU (intravenous drug user) patients). STDs incidence rate (IR): number of STDs divided by person years of follow-up (PYFU). Calendar periods: 1998–2002, 2003–2007 and 2008–2012. Predictors of STDs occurrence were identified using Poisson regression and sandwich estimates for the standard errors were used for multiple STD events. Results Data of 9,168 patients were analyzed (median age 37.3 (SD=9.3), 74% male, 30% MSM). Over 46,736 PYFU, 996 episodes of STDs were observed (crude IR 17.3/1,000 PYFU). Median (IQR) CD4/mmc and HIV-RNA/mL at STD: 433 (251–600) and 10,900 (200–63,000). Highest crude IRs were observed for any-stage syphilis (3.95, 95% CI 3.59–4.35), HPV diseases (1.96, 1.71–2.24) and acute hepatitis (1.72, 1.49–1.99). At multivariable analysis (variables of adjustment shown in Figure 1), age (IRR 0.82 per 10 years younger, 95% CI 0.77–0.89), MSM contacts (IRR 3.03, 95% CI 2.52–3.64 vs heterosexual) and calendar period (IRR 1.67, 95% CI 1.42–1.96, comparing 2008–2012 with 1998–2002) significantly increased the risk of acquiring STDs. Moreover, having a HIV-RNA >50 c/mL (IRR 1.44, 95% CI 1.19–1.74 vs HIV-RNA <50 c/mL) and current CD4+ cell count <100/mmc (IRR 4.66, 95% CI 3.69–5.89, p<0.001 vs CD4+ cell count >500) showed an increased risk of STDs. Being on ARV treatment significantly reduced the risk of developing an STD (IRR 0.37, 95% CI 0.32–0.43) compared to ART-naïve people, even in the situation of temporary interruption of treatment (IRR 0.51, 95% CI 0.39–0.43) (see Figure 1). Conclusions The overall incidence of STDs has been increasing in the recent years. Interventions to prevent STDs and potential further spread of HIV infection should target the recently HIV diagnosed, the young population and MSM. Being on ARV treatment (potentially an indicator of whether a person is regularly seen for care) seems to reduce the risk of acquiring STDs independently of its viro-immunological effect. PMID:25394157
Background Prison populations are known to be at high risk of sexuallytransmitted infections (STIs) and blood borne viruses (BBVs). In accordance with State health guidelines, the Western Australian Department of Correctional Services' policy is to offer testing for STIs and BBVs to all new prison entrants. This audit was undertaken to assess the completeness and timeliness of STI and BBV testing among recent prison entrants in Western Australia, and estimate the prevalence of STIs and BBVs on admission to prison. Methods A retrospective audit of prison medical records was conducted among 946 individuals admitted to prison in Western Australia after the 1st January 2005, and discharged between the 1st January and 31st December 2007 inclusive. Quota sampling was used to ensure adequate sampling of females, juveniles, and individuals from regional prisons. Main outcomes of interest were the proportion of prisoners undergoing STI and BBV testing, and the prevalence of STIs and BBVs. Results Approximately half the sample underwent testing for the STIs chlamydia and gonorrhoea, and almost 40% underwent testing for at least one BBV. Completeness of chlamydia and gonorrhoea testing was significantly higher among juveniles (84.1%) compared with adults (39.8%; p < 0.001), and Aboriginal prisoners (58.3%) compared with non-Aboriginal prisoners (40.4%; p < 0.001). Completeness of BBV testing was significantly higher among adults (46.5%) compared with juveniles (15.8%; p < 0.001) and males (43.3%) compared with females (33.1%; p = 0.001). Among prisoners who underwent testing, 7.3% had a positive chlamydia test result and 24.8% had a positive hepatitis C test result. Conclusion The documented coverage of STI and BBV testing among prisoners in Western Australia is not comprehensive, and varies significantly by age, gender and Aboriginality. Given the high prevalence of STIs and BBVs among prisoners, increased test coverage is required to ensure optimal use of the opportunity that prison admission presents for the treatment and control of STIs and BBVs among this high risk group. PMID:19825156
Watkins, Rochelle E; Mak, Donna B; Connelly, Crystal
Objectives We tested the efficacy of a sexual risk-reduction intervention for men in South Africa, where heterosexual exposure is the main mode of HIV transmission. Methods Matched-pairs of neighborhoods in Eastern Cape Province, South Africa, were randomly selected and within pairs randomized to 1 of 2 interventions based on social cognitive theory and qualitative research: HIV/sexuallytransmitted infection (STI) risk-reduction, targeting condom use, or attention-matched control, targeting health issues unrelated to sexual risks. Sexually active men aged 18 to 45 years were eligible. The primary outcome was consistent condom use in the past 3 months. Results Of 1181 participants, 1106 (93.6%) completed the 12-month follow-up. HIV and STI risk-reduction participants had higher odds of reporting consistent condom use (odds ratio [OR] = 1.32; 95% confidence interval [CI] = 1.03, 1.71) and condom use at last vaginal intercourse (OR = 1.40; 95% CI = 1.08, 1.82) than did attention-control participants, adjusting for baseline prevalence. No differences were observed on unprotected intercourse or multiple partnerships. Findings did not differ for sex with steady as opposed to casual partners. Conclusions Behavioral interventions specifically targeting men can contribute to efforts to reduce sexual risk behaviors in South Africa. PMID:24432923
Jemmott, John B.; Jemmott, Loretta S.; O'Leary, Ann; Ngwane, Zolani; Icard, Larry D.; Heeren, G. Anita; Mtose, Xoliswa; Carty, Craig
The association between neighborhood environment and prevalence of STIs, sexual partner variables and condom use among adolescents\\u000a with psychological disorders was examined. Cross-sectional data in three urban areas of the US (Southeast, Northeast and Midwest)\\u000a were obtained from 384 sexually active male and female participants who provided urine samples for laboratory-confirmed testing\\u000a of Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis.
Delia L. LangLaura; Laura F. Salazar; Richard A. Crosby; Ralph J. DiClemente; Larry K. Brown; Geri R. Donenberg
Alcohol is related to HIV risk behaviors in southern Africa and these behaviors are correlated with sensation seeking personality and alcohol outcome expectancies. Here we report for the first time the associations among sensation seeking, substance use, and sexual risks in a prospective study in Africa. Sexuallytransmitted infection clinic patients in Cape Town South Africa (157 men and 64
Seth C. Kalichman; Leickness Simbayi; Sean Jooste; Redwaan Vermaak; Demetria Cain
This study explored the relationships among personal factors, family structure and family function, adolescents’ self-efficacy for safe sex, and sexual behaviors among sexually active adolescents. A subset sample from the first three waves of the National Longitudinal Study of Adolescent Health (Add Health) was selected for this exploratory…
The objectives of this study were assessment of the prevalence of male circumcision (MC) among patients attending the Miami-Dade County (MDC) sexuallytransmitted diseases (STDs) clinic and exploration of attitudes of MC among Hispanic STD clinic attendees. Prevalence of MC was assessed by a review of 500 clinic records. Attitudes toward MC were explored during focus group sessions. The overall rate of MC was 27%. Men associated acceptability of MC with sexual performance, their partner’s anticipated responses to MC, and scientific proof of STD protection; whereas women focused on experiences with previous partners and hygiene. We found a low rate of circumcision in males attending the MDC STD clinic. Approximately half of the Hispanic men and women in focus groups also found MC acceptable or desirable. PMID:25152700
Castro, Jose G.; Jones, Deborah L.; Lopez, Maria R.; Weiss, Stephen M.
The high rates of sexuallytransmitted diseases (STDs) in the southeastern United States have been shaped by historic and contemporary social forces. More than other regions of the country, the South was defined by slavery, an extremely hierarchical relationship between whites and blacks. Emancipation left much of the racial hierarchy intact with whites as farm owners and blacks as hired workers or sharecroppers. Agricultural policies that favored mechanization caused blacks to leave farm work and move into segregated towns, leading to the advent of the rural ghetto. Post-World War II mass migration, mostly by young men, to the industrial north altered the sex ratio and social capital of the southern towns left behind. The cocaine epidemic of the 1990s, followed by the high incarceration rates of the "War on Drugs," disproportionately affected low-income blacks. Each of these forces led to sexual and care-seeking behaviors that favor transmission of STDs. PMID:16794556
Recent epidemiologic reports show that black women are at risk for HIV infection and other sexuallytransmitted diseases (STDs). In this report, we go beyond race and consider a number of social and economic trends that have changed the way many black women experience life. We discuss poverty, loss of status and support linked to declining marriage participation, and female-headed single-parent household structure-all of which influence sexual risks. We also discuss the Centers for Disease Control and Prevention-led national efforts to advance consideration of social determinants of health (SDH) and promotion of health equity in public health activities that may have impact on black and other women. PMID:22196231
Incarcerated women are disproportionately affected by HIV and sexuallytransmitted infections (STIs) due to risk factors before, during, and after imprisonment. This study assessed the behavioral, social, and contextual conditions that contribute to continuing sexual risk behaviors among incarcerated women to inform the adaptation of an evidenced-based behavioral intervention for this population. Individual, in-depth interviews were conducted with 25 current and 28 former women prisoners to assess HIV/STI knowledge, perceptions of risk, intimate relationships, and life circumstances. Interviews were independently coded using an iterative process and analyzed using established qualitative analytic methods. Major themes identified in the interviews involved three focal points: individual risk (substance abuse, emotional need, self-worth, perceptions of risk, and safer sex practices); interpersonal risk (partner pressure, betrayal, and violence); and risk environment (economic self-sufficiency and preparation for reentry). These findings highlight the critical components of HIV/STI prevention interventions for incarcerated women. PMID:25204565