Sexual transmission of bacterial vaginosis (BV), a common syndrome in sexually active women, has not been previously established. Because no male counterpart for BV has been found, a population of lesbians is an ideal one in which to test the hypothesis that BV is sexually transmitted. We studied 103 homosexual women (lesbians) who sought gynecologic care at a community clinic and in a private gynecology practice in New York City. Participants were asked to refer their sexual partners for evaluation. In this cross-sectional prevalence study, all participants were evaluated for the presence of BV, and pairs of monogamous sexual partners were analyzed for concordance of their vaginal secretions. Twenty-nine (28.7%) of the 101 participants from whom satisfactory vaginal wash samples were available had BV. There were 21 pairs of monogamous partners. Of 11 index women who had BV, eight (72.7%) had partners who also had BV. Of 10 index women who did not have BV, only one (10%) had a partner with BV. The likelihood of a partner's having BV was 19.7 times greater if the index case had BV (P < .008; 95% CI, 2.1-588.0). We conclude that with respect to BV, lesbians in monogamous relationships usually have concordant vaginal secretions. This concordance probably reflects the sexual transmission of BV between lesbians. PMID:8749623
Berger, B J; Kolton, S; Zenilman, J M; Cummings, M C; Feldman, J; McCormack, W M
Sexually transmitted infections such as chlamydia, gonorrhoea, herpes simplex virus and syphilis commonly present with rectal symptoms. Recent outbreaks of lymphogranuloma venereum among homosexual men throughout Europe highlight the need to consider sexually transmitted infections in the differential diagnosis of proctitis. This article examines the causative organisms, clinical features, diagnosis and treatment of sexually transmitted proctitis.
Hamlyn, E; Taylor, C
... via sexual activities, such as vaginal intercourse, oral sex, or anal sex. Sexually transmitted diseases are caused by one of ... mouth or rectum, especially when oral and anal sex are practiced. Swabs from open sores or discharges ...
Study Objective Bacterial vaginosis (BV) is a common infection and has been associated with adverse health outcomes, including preterm birth, pelvic inflammatory disease (PID) and acquisition and transmission of HIV. There are limited data on recurrent BV in adolescents. A relationship between the frequency of BV recurrence and specific risk factors might shed light on the pathophysiology of BV and lead to targeted interventions. Methods Design: Record-based historical clinic study. Setting: Adolescent visits to two sexually transmitted disease (STD) clinics between 1990-2002. Participants: 254 girls who had ? 2 episodes of BV and at least 3 clinical visits, matched on clinic attendance frequency to 254 girls with only 1 documented BV episode and 254 girls with no history of BV. Main outcome measure: Risk factor differences between groups. Analysis: Multinomial logistic regression with robust estimator of the standard errors, accounting for repeated measures. Results 5,977 adolescent girls visited the clinics. 1509 (25%) had at least one episode of BV; of those, 303 (19.9%) had 2 or more BV episodes. Girls with a history of 1 BV episode and girls with a history of 2 or more BV episodes were more likely to be infected with Trichomonas vaginalis [OR 1.77, 95% CI: 1.17-2.67, OR 1.56, 95% CI: 1.05-2.34] and be diagnosed with PID [OR 1.50, 95% CI: 1.02-2.22, OR 2.05, 95% CI: 1.41-2.98] compared to girls with no BV history, respectively. Girls with a history of BV were also more likely to report active oral sex and lack of contraceptive use. Conclusion Adolescent girls who attend STD clinics have a high prevalence of BV. Although the association between BV and PID is not clearly causal, when one condition is diagnosed, evaluation and counseling for the other may reduce recurrence and sequelae.
Brotman, Rebecca M.; Erbelding, Emily J.; Jamshidi, Roxanne M.; Klebanoff, Mark A.; Zenilman, Jonathan M.; Ghanem, Khalil G.
Sexually transmitted infections (STIs), also referred to as sexually transmitted 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
Markle, William; Conti, Tracey; Kad, Manjusha
This paper consists of a briefing or lecture outline on sexually transmitted diseases to be used by medical personnel as an instructional tool for a wide variety of audiences. It is intended to be used in whole or broken down to specific disease groups. I...
W. M. Simmons
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.
Jennings, Jacky M.; Taylor, Ralph B.; Salhi, Rama A.; Furr-Holden, C.Debra M.; Ellen, Jonathan M.
... STDs) Share Compartir Prevention How You Can Prevent Sexually Transmitted Diseases This page includes information about STD prevention, testing, ... 4636) TTY: (888) 232-6348 Contact CDC-INFO Sexually Transmitted Diseases Diseases & Related Conditions STDs & Infertility Other STDs Archive ...
Sexually Transmitted Disease Surveillance, 2004 presents statistics and trends for sexually transmitted diseases (STDs) in the United States through 2004. This annual publication is intended as a reference document for policy makers, programmanagers, heal...
The Sexually Transmitted Disease Surveillance System presents statistics and trends for sexually transmitted 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...
Sexually Transmitted Disease Surveillance 2011 presents statistics and trends for sexually transmitted diseases (STDs) in the United States through 2011. This annual publication is intended as a reference document for policy makers, program managers, heal...
\\u000a Sexually transmitted diseases (STDs) affect an estimated 19 million people a year in the United States. Clinicians who may\\u000a encounter patients with STDs need to be aware of treatment guidelines and recent changes in treatment recommendations. For\\u000a example, due to increased resistance, fluoroquinolones are no longer recommended for the treatment of infections due to Neisseria gonorrhoeae. Recent new approaches also
Alice C. Thornton; Bojana Stevich; Janet N. Arno; Barbara Van Der Pol
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 - Sexually Transmitted Diseases Teen Health Wellness real life real answers ...
OBJECTIVETo establish the prevalence of sexually transmitted organisms and other genital organisms in potentially sexually abused children.DESIGNProspective study of children attending an inner London department of community paediatrics for evaluation of possible sexual abuse.SUBJECTSChildren under 16 referred for evaluation of possible sexual abuse.OUTCOME MEASURESPrevalence of sexually transmitted organisms in relation to age, symptoms, and type of abuse.RESULTSSwabs were taken from
A J Robinson; J E M Watkeys; G L Ridgway
This paper summarizes what is known about, and research needs on, the transmissibility to sexually abused children of the following sexually transmitted diseases: gonorrhea, chlamydia trachomatis, human papillomavirus genital warts, condylomata acuminata, syphilis, bacterial vaginosis, trichomonas vaginalis, herpes simplex, and human…
Hammerschlag, Margaret R.
... difference between STDs (sexually transmitted diseases) and STIs (sexually transmitted infections)? They are really the same thing. So why ... STIs) Symptoms of STDs (also called STIs or sexually transmitted infections) include itching, sores on the outside of your ...
KidsHealth > Teens > Sexual Health > STDs & Other Infections > About Sexually Transmitted Diseases (STDs) Print A A A Text Size What's in this ... of all ages and backgrounds who are having sex — it doesn't matter if they're rich or ... have become common among teens. Because teens are more at risk for getting ...
Incidence of sexually transmitted infections (diseases) has been already increasing again for more than one decade; the world number of 125-340 millions of new cases a year is estimated. Fifteen thousands of new HIV-positive persons daily present a substantial contribution to the total amount. Besides an increasing number of unplanned pregnancies, the huge spreading of sexually transmitted infections predominantly of the second generation is the main reason for a renewed interest in search of local contraceptives, i.e. spermicides. An urgent need for a new, non-detergent, synthetic or natural spermicide emerged to replace the traditional nonoxynol-9. New preparation of microbicidal spermicide should offer dual protection against both unplanned conception and sexually transmitted infections. PMID:23256629
Sexually transmitted infections (STIs) are very common in teenagers and young adults, with adolescents making up a disproportionate percentage of cases. This article reviews the epidemiology of STIs in North Carolina adolescents and summarizes current recommendations for screening, testing, and treatment. Successful strategies for maintaining confidentiality around screening, notification, billing, and treatment are also discussed. PMID:23530381
Matkins, Preeti Patel
Adolescents and young adults continue to have the highest rates of sexually transmitted 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
Diane R. Blake
Prevention of sexually transmitted 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
Alberto Matteelli; Giampiero Carosi
Sexually transmitted diseases (STDs) in children are not uncommon in India, though systematic epidemiological studies to determine the exact prevalence are not available. STDs in children can be acquired via sexual route or, uncommonly, via non-sexual route such as accidental inoculation by a diseased individual. Neonatal infections are almost always acquired intrauterine or during delivery. Voluntary indulgence in sexual activity is also an important factor in acquisition of STDs in childhood. Sexual abuse and sex trafficking remain the important problems in India. Surveys indicate that nearly half of the children are sexually abused. Most at risk children are street-based, homeless or those living in or near brothels. Last two decades have shown an increase in the prevalence of STDs in children, though most of the data is from northern part of the country and from major hospitals. However, due to better availability of antenatal care to majority of women, cases of congenital syphilis have declined consistently over the past two-three decades. Other bacterial STDs are also on decline. On the other hand, viral STDs such as genital herpes and anogenital warts are increasing. This reflects trends of STDs in the adult population. Concomitant HIV infection is uncommon in children. Comprehensive sex education, stringent laws to prevent sex trafficking and child sexual abuse, and antenatal screening of all the women can reduce the prevalence of STDs in children. PMID:20826987
Dhawan, Jyoti; Gupta, Somesh; Kumar, Bhushan
Vaginal bacterial communities are thought to help prevent sexually transmitted 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 sexually transmitted 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.
Brotman, Rebecca M.
Mycoplasma genitalium is a member of genital mycoplasmas, which is emerging as an important causative agent of sexually transmitted infections both in males and females. The advent of polymerase chain reaction and other molecular methods have made studies on M. genitalium more feasible, which is otherwise a difficult organism to isolate. Besides Chlamydia trachomatis, M. genitalium is now an important and established cause of non gonococcal urethritis (NGU) in men, more so in persistent and recurrent NGU. Multiple studies have also shown a positive association of M. genitalium with mucopurulent cervicitis and vaginal discharge in females as well. The evidences for M. genitalium pelvic inflammatory diseases and infertility are quite convincing and indicate that this organism has potential to cause ascending infection. Lack of clear association with M. genitalium has been reported for bacterial vaginosis and adverse pregnancy outcomes. Diagnosis of M. genitalium infections is performed exclusively using nucleic acid amplification tests (NAATs), owing to poor or slow growth of bacterium in culture. Although there are no guidelines available regarding treatment, macrolide group of antimicrobials appear to be more effective than tetracyclines. The present review provides an overview of the epidemiology, pathogenesis, clinical presentation and management of sexually transmitted infections due to M. genitalium. PMID:23391789
Sethi, Sunil; Singh, Gagandeep; Samanta, Palash; Sharma, Meera
From 1 January 1986 to 1 September 1989 124 women presented to the Ambrose King Centre (the department of genitourinary medicine of the London Hospital) alleging rape. Sexually transmitted diseases were found in 36 (29%) women (excluding candidosis and bacterial vaginosis). The commonest organisms detected were Neisseria gonorrhoeae and Trichomonas vaginalis, each being present in 15 patients. Eleven women had genital warts. Chlamydia trachomatis was isolated in six patients, two had herpes simplex virus infection and one patient had pediculosis pubis. Serological evidence of past hepatitis B infection was detected in five women and one patient had antibodies to human immunodeficiency virus. Eighteen of the 36 women (50%) had multiple infections. Six women had abnormal cervical cytology smears, three being suggestive of cervical intraepithelial neoplasia grades II-III. Although it is rarely possible to attribute infection to an assailant, these patients require further counselling, treatment and review. Rape victims are thus a population at risk of having sexually transmitted diseases and screening should be offered.
Estreich, S; Forster, G E; Robinson, A
\\u000a \\u000a Chlamydia trachomatis serovars D-K and Neisseria gonorrhoeae are the major sexually transmitted bacteria worldwide. Genital mycoplasmas, in particular Mycoplasma genitalium, are thought to be important causes of sexually transmitted non-gonococcal, non-chlamydial urethritis and cervicitis, more\\u000a commonly termed, non-specific genital infection (NSGI). In tropical countries sexually transmitted infections also include\\u000a lymphogranuloma venereum caused by Chlamydia trachomatis serovars L1, L2 and L3,
Sarah A. Wyllie; Geoffrey L. Ridgway
In the former West Germany, in specific venereal diseases legislation passed in 1953, only syphilis, gonorrhoea, ulcus molle, and lymphogranuloma venereum were defined as venereal diseases and subject to mandatory notification. The proportion of unreported cases was as high as 75% for syphilis and up to 90% for gonorrhoea. Epidemiological data for the past 10 years exist only on selected populations from research studies and are summarized in this article. In the former East Germany reporting of sexually transmitted infections (STIs) was mandatory and, due to the centralized organization, underreporting was considered to be low, although no specific studies have examined this. After the unification in 1990 of the two German states the West German laws were adopted in East Germany. Since 1982 - when the first AIDS case was reported in Germany - information on AIDS cases has voluntarily been collected at the national register at the AIDS Centre of the Robert Koch Institute in Berlin. The law governing the reporting of infectious diseases has recently been revised. Under the new Protection against Infection Act, which became effective on 1 January 2001, clinical diagnoses of STIs (with the exception of hepatitis B) are no longer notifiable diseases. Laboratory reporting of positive test results for Treponema pallidum has been introduced. With T. pallidum and HIV notifications, additional disaggregated data are collected. Since T. pallidum and HIV remain the only notifiable STIs, all other STIs have to be monitored through sentinel surveillance systems. These surveillance systems are currently being established. Under the new legislation, local health authorities have to provide adequate counselling and testing services for STIs, which may be provided free of charge if necessary. PMID:11886609
Petzoldt, D; Jappe, U; Hartmann, M; Hamouda, O
Few good strategies exist for preventing the spread of sexually transmitted diseases (STDs). Indeed, women currently have no way to protect themselves from STDs that does not require male cooperation. Topical microbicides could change this. If you have no...
Trichomonas vaginalis is the most prevalent nonviral sexually transmitted infection, affecting an estimated 3.7 million people in the United States. Although trichomoniasis is common, it has been considered a "neglected" sexually transmitted disease, due to limited knowledge of its sequelae and associated costs. This article reviews current epidemiology, pathophysiology, diagnostic methods, clinical management recommendations and special considerations, research on associated conditions and costs, prevention strategies, and controversies regarding trichomoniasis. PMID:24275268
The U.S. Public Health Service (PHS) health objectives for the nation in 1990 (established in 1979) included 11 goals relating to the control of sexually transmitted diseases (STD's). Control of STD's is now focused on prevention of all sexually transmitt...
This survey covers periodical literature published in the field of research on sexually transmitted 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.
AIM: To review the epidemiology of and data collection for sexually transmitted 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
G B Pham-Kanter; M H Steinberg; R C Ballard
This document contains an educational resource guide designed to help educators provide relevant education about sexually transmitted diseases (STDs) to secondary school students in compliance with the Texas State Board of Education Rules for Curriculum. The guide, taking a pragmatic approach that emphasizes a prevention/intervention strategy,…
Texas State Dept. of Health, Austin.
Semen-derived enhancer of viral infection (SEVI) binds bacteria, enhances bacterial phagocytosis by macrophages, and can protect against vaginal infection by a sexually transmitted bacterial pathogen.
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 (PAP(248-286)). 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 PAP(248-286) 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 PAP(248-286) 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; Dewhurst, Stephen
Sexually transmitted diseases (STDs) may be transmitted during sexual assault. In children, the isolation of a sexually transmitted 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
M. R. Hammerschlag
Urethral discharge (UD) in men is one of the most identifiable sexually transmitted infections (STI)-associated syndromes. UD performs very well, giving the possibility of an accurate diagnosis, a treatment at first encounter, a rapid cure with effective drugs, a modification of the risk behavior. Furthermore the patient is informed about the infectious nature of STDs, the transmission through sexual intercourse, the increased risks of infertility and other complications and, finally, the importance of completing treatment, even after improvement. Applying the syndromic approach to UD has resulted in effective case management of urethritis, as shown in different studies. Thus, there are numerous reasons why treatment of gonorrhea should include a regimen with complete in vivo activity against both N. gonorrhoeae and C. trachomatis. PMID:23007213
Di Carlo, A
Sexually transmitted 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
Hunter, Paul; Dalby, Jessica; Marks, Jaime; Swain, Geoffrey R; Schrager, Sarina
Background: Estimates suggest that about 48% of nearly 19 million cases of sexually transmitted 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…
Crosby, Richard A.; Danner, Fred
The incidence of sexually transmitted infections is rising in Europe and in Switzerland since the beginning of the third millenium. Many organisms may affect the perianal skin and the anorectum. While some of these infections are a result of contigous spread from genital infection, most result from receptive anal intercourse affecting males who have sex with males but is seen increasingly in females as well since there is evidence of the increasing popularity of anal sex among heterosexuals. The symptoms of specific infections are largely dependent on the route and site of inoculation. Organisms that cause typical genital symptoms - such as syphilis, chancroid, herpes simplex or HPV-infection - result in similar symptoms when the perianal skin, the anoderm or the distal anal canal are the site of infection. Patients with proctitis may have unspecific signs in various degrees including mucous discharge, rectal bleeding, anorectal pain, superficial ulcers and sometimes generalized lymphadenopathy and fever. It is of utmost importance to include STIs (e. g. lymphogranuloma venereum, gonorrhea, non-LGV-chlamydia and herpes simplex) in the differential diagnosis in these patients. Unfortunately rectal infection with chlamydia and gonorrhea is asymptomatic in the majority of cases of men having sex with men and in high-risk females. A careful history and physical examination is essential in establishing a correct diagnosis, usually supported by proctoscopy, culture, PCR, serology and histology. Certain organisms, more commonly thought of as food- or water-borne disease may be sexually transmitted by direct or indirect fecal-oral contact from various sexual practices. PMID:23798024
Objective: To examine the relationship between childhood experiences of sexual abuse, sexual coercion during adolescence, and the acquisition of sexually transmitted infections (STIs) in a population of homeless adolescents.Method: Homeless adolescent females (N = 216) from a northwestern United States city were recruited by street outreach workers for a longitudinal study of STI epidemiology. Baseline data on childhood abuse and
John Noell; Paul Rohde; John Seeley; Linda Ochs
Patterns of sexual mixing and heterogeneity in the number of sexual partners can have a huge effect on the spread of a sexually transmitted disease (STD). The sexual mixing network identifies all partnerships within a population over a given period and is a powerful tool in the study of such infections. Previous models assumed all links within the network to
Ken T. D. Eames; Matt J. Keeling
We study an SIS epidemiological model for a sexually transmitted infection in a monogamous population where the formation and breaking of couples is governed by individual preferences. The mechanism of couple recombination is based on the so-called bar dynamics for the marriage problem. We compare the results with those of random recombination - where no individual preferences exist - for which we calculate analytically the infection incidence and the endemic threshold. We find that individual preferences give rise to a large dispersion in the average duration of different couples, causing substantial changes in the incidence of the infection and in the endemic threshold. Our analysis yields also new results on the bar dynamics, that may be of interest beyond the field of epidemiological models.
Bouzat, Sebastián; Zanette, Damián H.
AIM: To review the epidemiology of and data collection for sexually transmitted 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 picture of the patterns of STD burden was developed. RESULTS: The STD burden in apparently asymptomatic study populations is significant. Ulcerative infections, primarily caused by syphilis and chancroid, are present in 5-15% of asymptomatic clinic attenders; prevalence rates of gonorrhoea average 8%, with up to 13% of gonococcal isolates resistant to penicillin antibiotics. In addition, on average, chlamydia and vaginal infections are detected in 16% and 20-49%, respectively, of antenatal and family planning clinic attenders. HIV seroprevalence rates have reached 7.6% in antenatal clinic attenders. Most South African STD data are derived from ad hoc surveys which have traditionally focused only on several major infections and particular urban centres. Almost all STD studies have been facility-based, with many studies based at STD clinics, thus reporting only relative frequencies and not population-based prevalences of STDs. With the possible exception of HIV, systematic surveillance data for STDs are conspicuously lacking. CONCLUSION: The disease burden of classic sexually transmitted infections has historically been heavy, and continues to be a serious public health problem in South Africa. Morbidity from both ulcerative and non-ulcerative infections, particularly in women, is significant. The body of STD data, although mostly sound, remains incomplete, and with the rapid emergence of HIV in South Africa, surveillance of STDs and focused STD policies will be critical.
Pham-Kanter, G B; Steinberg, M H; Ballard, R C
Background Female sex workers (FSWs) in India are provided a standardised package of clinical interventions for management of sexually transmitted 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.
Das, Anjana; Pathni, Anupam Khungar; Narayanan, Prakash; George, Bitra; Morineau, Guy; Saidel, Tobi; Prabhakar, Parimi; Deshpande, Gururaj Rao; Gangakhedkar, Raman; Mehendale, Sanjay; Risbud, Arun
Sexually transmitted infections (STI) include a group of diseases of diverse infectious etiology in which sexual transmission is relevant. The burden of disease that STI represent globally is unknown for several reasons. Firstly, asymptomatic infections are common in many STI; secondly, diagnostic techniques are not available in some of the most affected countries; finally, surveillance systems are inexistent or very deficient in many areas of the world. The Word Health Organization has estimated that in 1999 there were 340 million new cases of syphilis, gonorrhoea, chlamydia infection and trichomoniasis. An increasing trend in the incidence of gonorrhoea and syphilis has been noticed in the last years in the European Union, including Spain. Co-infection with other STI, especially HIV, should be ruled out in all STI patients. Chlamydia screening is also of particular importance since this is the most common STI in Europe and frequently goes unnoticed. STI prevention and control should be based on health education, early diagnosis and treatment, screening for asymptomatic infections, contact investigation and vaccination for those diseases for which a vaccine is available. PMID:21750856
Díez, M; Díaz, A
Sexually transmitted diseases are still highly prevalent worldwide and represent an important public health problem. Psychiatric patients are at increased risk of sexually transmitted diseases but there are scarce published studies with representative data of this population. We sought to estimate the prevalence and correlates of self-reported sexually transmitted diseases among patients with mental illnesses under care in a national representative sample in Brazil (n=2145). More than one quarter of the sample (25.8%) reported a lifetime history of sexually transmitted disease. Multivariate analyses showed that patients with a lifetime sexually transmitted disease history were older, had history of homelessness, used more alcohol and illicit drugs, suffered violence, perceived themselves to be at greater risk for HIV and had high risk sexual behavioral: practised unprotected sex, started sexual life earlier, had more than ten sexual partners, exchanged money and/or drugs for sex and had a partner that refused to use condom. Our findings indicate a high prevalence of self-reported sexually transmitted diseases among psychiatric patients in Brazil, and emphasize the need for implementing sexually transmitted diseases prevention programs in psychiatric settings, including screening, treatment, and behavioral modification interventions. PMID:23933407
Dutra, Maria Rita Teixeira; Campos, Lorenza Nogueira; Guimarães, Mark Drew Crosland
Crystal methamphetamine (MA) use is associated with sexual behaviors that increase the risk of HIV and other sexually transmitted infections (STIs). Sexual history-taking and screening for sexually transmitted infections can be a powerful way for primary care clinicians to identify and address crystal meth and other substance abuse problems. The reverse is also true: patients with known substance abuse or
Trichomoniasis is the most common, sexually transmitted infection. It is caused by the flagellated protozoan parasite Trichomonas vaginalis. Symptoms include vaginitis and infections have been associated with preterm delivery, low birth weight and increased infant mortality, as well as predisposing to HIV\\/AIDS and cervical cancer. Trichomoniasis has the highest prevalence and incidence of any sexually transmitted infection. The 5-nitroimidazole drugs,
Rebecca L DUNNE; Linda A DUNN; Peter UPCROFT; Peter J O'DONOGHUE; Jacqueline A UPCROFT
Objectives To determine the proportion of sexually experiencedAfrican American adolescents who report having been screened for sexually transmitted diseases and to determine the proportion who report having been screened for these diseases among adolescents who have had a preventive primary health care visit in the past 2 years. Methods A telephone survey of a population-based sample of African American adolescents aged 12 to17 years residing in a low-income neighborhood in San Francisco with a high prevalence of sexually transmitted diseases. Results Of the 302adolescents surveyed, 118 (39.1%) reported a history of sexual intercourse. Of these, 17 (26.2%) of 65 males and 31 (58.5%) of 53 females had been screened for a sexually transmitted disease in the previous 12 months. Twenty (30.8%)of the males and 32 (60.4%) of the females had been screened for a sexually transmitted disease in the previous 24 months. Of the 93 participants who had a preventive primary care visit since their first episode of sexual intercourse, 14 (26.4%) of the 53 males and 24 (60.0%) of the 40 females had been screened for a sexually transmitted disease in the previous 24 months.Conclusions Sexually experienced African American adolescents in SanFrancisco are being screened for sexually transmitted diseases at rates well below those recommended by current clinical guidelines. A low rate of screening was found even in adolescents who had been seen for a preventive primary care visit since they had first had sex. This suggests that the preventive primary care visit is not being used to its full potential as an opportunity to screen and treat adolescents for sexually transmitted diseases.Capitalizing on this opportunity to screen may increase the number of cases of sexually transmitted diseases diagnosed and, thus, decrease rates of these diseases in this population.
Ellen, Jonathan M; Lane, Margo A; McCright, Jacque
This cross-sectional study examined the odds of being diagnosed with a sexually transmitted infection (STI) or a sexual dysfunction disorder (SDD) among Operation Enduring Freedom\\/Operation Iraqi Freedom (OEF\\/OIF) American veterans receiving care in the Veterans Health Administration (VHA) in relation to whether or not they have experienced military sexual trauma (MST). Among those veterans who experienced MST, the influence of
Jessica A. Turchik; Joanne Pavao; Deborah Nazarian; Samina Iqbal; Caitlin McLean; Rachel E. Kimerling
Background Data on sexually transmitted infections (STIs) in Saudi Arabia (SA) and other Islamic countries are limited. This study describes the results of a five-year surveillance for STIs in SA. Methods This is a case series descriptive study of all confirmed STIs diagnosed in SA from January, 1995 through December, 1999. Results A total of 39049 STIs were reported to the Ministry of Health. Reported STIs included nongonococcal urethritis (14557 infections, 37.3%), trichomoniasis (10967 infections, 28.1%), gonococcal urethritis (5547 infections, 14.2%), syphilis (3385 infections, 8.7%), human immunodeficiency virus (2917 infections, 7.5%), genital warts (1382, 3.5%), genital herpes (216 infections, 0.6%), and chancroid (78 infections, 0.2%). The average annual incidence of STIs per 100,000 population for Saudis and non-Saudis, respectively, was as follows: 14.8 and 7.5 for nongonococcal urethritis, 9.4 and 10.4 for trichomoniasis, 5.2 and 4.2 for gonorrhea, 1.7 and 6.4 for syphilis, 0.6 and 8.0 for HIV, 1.4 and 0.7 for genital warts, 0.1 and 0.4 for genital herpes, and 0.1 and 0.1 for chancroid. The incidence of STIs was somewhat steady over the surveillance period except for nongonococcal urethritis which gradually increased. Conclusion Nongonococcal urethritis, trichomoniasis, and gonococcal urethritis were the most commonly reported STIs in SA. Even though the incidence of STIs in SA is limited, appropriate preventive strategies that conform to the Islamic rules and values are essential and should be of highest priority for policymakers because of the potential of such infections to spread particularly among the youth.
Madani, Tariq A
... Japanese (???) Korean (???) Oromo (Afaan Oromo) Portuguese (português) Russian (???????) Somali (af Soomaali) Spanish (español) Tagalog ( ... Minnesota Department of Health Return to top Portuguese (português) STDs (Sexually Transmitted Diseases) DSTs (Doenças Sexualmente Transmissíveis) - ...
Patterns of sexual mixing and heterogeneity in the number of sexual partners can have a huge effect on the spread of a sexually transmitted disease (STD). The sexual mixing network identifies all partnerships within a population over a given period and is a powerful tool in the study of such infections. Previous models assumed all links within the network to be concurrent active partnerships. We present a novel modelling approach in which we adapt the notion of a sexual contact network to a monogamous population by allowing the nature of the links to change. We use the underlying network to represent potential sexual partnerships, only some of which are active at any one time. Thus serial monogamy can be modelled while maintaining the patterns of mixing displayed by the population. PMID:15094315
Eames, Ken T D; Keeling, Matt J
Many adolescents are susceptible to negative outcomes associated with sexual behavior. This is particularly true for those who initiate sexual intercourse at an early age, have many sex partners, or engage in unprotected sex because these behaviors put one at risk for sexually transmitted infections (STIs), including HIV. This article reviews the…
Walcott, Christy M.; Meyers, Adena B.; Landau, Steven
Background: Victimization by intimate partner violence (IPV) may play an important role in sexual decision-making, increasing the risk for sexually transmitted 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
STDs represent a major public health problem for two reasons: their serious sequelae and the facts that they facilitate transmission of HIV. This article presents WHO estimates new cases of some of curable STDs, and italian data from national reporting system (published from ISTAT and ISS). The number of new reported cases decreases in Italy, but reported cases are not all cases. People with STDs tend not to seek treatment or to self-medicate, this behaviour is common in youths. In many cases STDs are asymptomatic in both sexes, particularly in women. Women are also much more vulnerable biologically, culturally, socioeconomically. There is also a lack of notification by physicians. Important social determinants of STDs diffusion are migration and travels. Prevention and control of STDs need collaboration between medical disciplines: gynaecology, urology, dermo-venerology, microbiology, epidemiology, public health. Contributions of nurses, laboratory technician and social workers are also required. The role of public health specialists in the prevention is strictly related to health education. Health education will promote responsible sexual behaviour and early recourse to health services by people with STDs and their sexual partners. PMID:12070901
Marin, V; Bertoncello, C
Background: To estimate the relative risk of sexually transmitted infections (STIs) among children identified as having learning disabilities through the special education system. Methods: This cross-sectional study used special education data and Medicaid data from Philadelphia, Pennsylvania, for calendar year 2002. The sample comprised 51,234…
Mandell, David S.; Eleey, Catharine C.; Cederbaum, Julie A.; Noll, Elizabeth; Hutchinson, M. Katherine; Jemmott, Loretta S.; Blank, Michael B.
Conducted unstructured interviews with 18 male street prostitutes between the ages of 13 and 22 to determine the extent of accurate knowledge they possessed concerning four common sexually transmitted diseases. Found that subjects possessed more factual information on gonorrhea and syphilis than on herpes and Acquired Immune Deficiency Syndrome.…
Calhoun, Thomas; Pickerill, Brian
... Data Related Links Accessibility NCHS Home FastStats Home Sexually Transmitted Diseases (STD) (Data are for the U.S.) Morbidity Number of ... Hepatitis National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention Email page link Print page ...
One-quarter of the 3 million new cases of sexually transmitted 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)
Context: Sexually transmitted 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
Sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) are gaining significant importance at present due to rapid spread of the diseases, high cost of treatment, and the increased risk of transmission of other STDs and AIDS. Current therapies available for symptomatic treatment of STDs and AIDS are quite expensive beyond the reach of common man and are associated with
Kavita Vermani; Sanjay Garg
The authors' objectives in this study were to describe the proportion of schools providing and the percentage of students with access to HIV and sexually transmitted 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.
Syphilis appeared in Sweden in 1497. It was recognized as a sexually transmitted 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 sexually transmitted 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 sexually transmitted 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 sexually transmitted 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.
Chlamydia: Chlamydia remains the sexually transmitted infection (STI) diagnosed most often among STI clinic attendees, with almost 10,000 new infections reported in 2009. Whilst there was an increase in the numbers of infections that occurred, the positivity rate remained stabile. Of the total heterosexual STI clinic attendees, 11 per cent had a chlamydia infection compared with 14 per cent in
H. J. Vriend; F. D. H. Koedijk; I. V. F. van den Broek; M. G. van Veen; E. L. M. Op de Coul; A. I. van Sighem; R. A. Verheij
We describe the genome sequence of the protist Trichomonas vaginalis, a sexually transmitted 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
Background: It has not been determined conclusively whether greater knowledge of sexually transmitted infections (STIs) is associated with lower rates of STIs. Purpose: This study sought to determine STI knowledge among high school students and factors associated with such knowledge, and to determine whether poor STI knowledge is associated with…
Nsuami, M. Jacques; Sanders, Ladatra S.; Taylor, Stephanie N.
Qualitative research was conducted with traditional healers in Manica Province, Mozambique to develop an empirical, culturally?appropriate strategy for communication between government and traditional healers related to the prevention of STDs including AIDS. Most Manica healers regard AIDS as a new disease for which they lack medicines. However, when questioned on other sexually transmitted diseases, as defined by healers themselves, relatively
Edward C. Green; Annemarie Jurg; Armando Dgedge
Male homosexual behaviour is not simply either "active" or "passive", since penile-anal, mouth-penile, and hand-anal sexual contact is usual for both partners, and mouth-anal contact is not infrequent. A simplified method for recording sexual behaviour--a "sexual behaviour record (SBR)"--can be of value in determining the sites to be investigated and as a basis for further epidemiological questioning. Mouth-anal contact is the reason for the relatively high incidence of diseases caused by bowel pathogens in male homosexuals. Trauma may encourage the entry of micro-organisms and thus lead to primary syphilitic lesions occurring in the anogenital area. Similarly, granuloma inguinale, condylomata acuminata, and amoebiasis may be spread from the bowel of the passive homosexual contact. In addition to sodomy, trauma may be caused by foreign bodies, including stimulators of various kinds, penile adornments, and prostheses. Images
Willcox, R R
High annual figures of sexually transmitted infections (STIs) are diagnosed in the Netherlands despite significant efforts to control them. Herein, we analyse trends and determinants of STI diagnoses, co-infections, and sexual risks among visitors of 26 STI clinics between 2007 and 2011. We recorded increased positivity rates of STIs (chlamydia, syphilis, gonorrhoea, and/or HIV) in women and heterosexual men up to 12.6% and 13.4%, respectively, in 2011, while rates in men having sex with men (MSM) were stable but high (18.8%) through the documented years. Younger age, origin from Surinam/Antilles, history of previous STI, multiple partners, or a previous notification are the identified risk factors for an STI in this population. Known HIV-infected men (MSM and heterosexuals) were at highest risk for co-infections (relative rate heterosexual men: 15.6; MSM: 11.6). STI positivity rates remained high (MSM) or increased over time (women and heterosexual men), a fact that highlights the importance of continuing STI prevention. Most importantly, the very high STI co-infection rates among HIV-positive men requires intensified STI reduction strategies to put an end to the vicious circle of re-infection and spread of HIV and other STIs. PMID:23970630
de Coul, E L M Op; Warning, T D; Koedijk, F D H
BACKGROUND: Factors determining human sexual behaviour are not completely understood, but are important in the context of sexually transmitted disease epidemiology and prevention. Being obese is commonly associated with a reduced physical attractiveness but the associations between body mass index, sexual behaviour and the risk of acquiring sexually transmitted infections has never been studied. METHODS: The National Health and Nutrition
Nico JD Nagelkerke; Sema K Sgaier; Prabhat Jha
Background\\/ObjectivesCommercial sex work is a primary context for heterosexual HIV\\/AIDS transmission. Violence victimisation is considered to compromise women's ability to protect against HIV and other sexually transmitted infections (STI); little research has investigated violence as it relates to sexual risk and STI among female sex workers (FSW). This study sought to compare sexual risk and STI symptoms among FSW based
Michele R Decker; Heather L McCauley; Dusita Phuengsamran; Surang Janyam; George R Seage; Jay G Silverman
OBJECTIVES--To assess the significance of inflammatory changes as a marker of sexually transmitted diseases and their use as a diagnostic aid. METHODS--363 patients attending a department of genito urinary medicine were examined prospectively. All underwent cervical cytology and full STD screening. Cervical cytology was assessed for evidence of the presence or absence of inflammatory changes. RESULTS--There was no significant association between inflammatory cytology and cervical ectropion or dyskaryosis. Infections with Chlamydia trachomatis and Trichomonas vaginalis were significantly associated with inflammatory changes but there was no significant association with chlamydia alone, and 91.1% of T. vaginalis infections were detected on cytology. CONCLUSION--The presence of inflammatory changes on cervical cytology seems a poor indicator of sexually transmitted diseases.
Dimian, C; Nayagam, M; Bradbeer, C
The development of new, safe, topical microbicides for intravaginal use for the prevention of sexually transmitted diseases is imperative. Previous studies have suggested that bile salts may inhibit human immu- nodeficiency virus infection; however, their activities against other sexually transmitted pathogens have not been reported. To further explore the potential role of bile salts in preventing sexually transmitted diseases, we
BETSY C. HEROLD; RISA KIRKPATRICK; DANIEL MARCELLINO; ANNA TRAVELSTEAD; VALENTINA PILIPENKO; HOLLY KRASA; JAMES BREMER; LI JIN DONG
Health care providers who evaluate persons who have or are at risk for sexually transmitted diseases (STDs) should be aware\\u000a of current national guidelines for STD treatment and should provide assessment and treatment according to these recommendations.\\u000a The Centers for Disease Control and Prevention STD Treatment Guidelines were developed by using an evidence-based approach\\u000a incorporating available scientific evidence, specialist knowledge,
Kimberly A. Workowski
The gastrointestinal mucosa is a target of many sexually transmitted 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
Siew C. Ng; Brian Gazzard
Dendritic cells (DCs) are major antigen presenting cells (APCs) that can initiate and control host immune responses toward either immunity or tolerance. These features of DCs, as immune orchestrators, are well characterized by their tissue localizations as well as by their subset-dependent functional specialties and plasticity. Thus, the level of protective immunity to invading microbial pathogens can be dependent on the subsets of DCs taking up microbial antigens and their functional plasticity in response to microbial products, host cellular components and the cytokine milieu in the microenvironment. Vaccines are the most efficient and cost-effective preventive medicine against infectious diseases. However, major challenges still remain for the diseases caused by sexually-transmitted pathogens, including HIV, HPV, HSV and Chlamydia. We surmise that the establishment of protective immunity in the female genital mucosa, the major entry and transfer site of these pathogens, will bring significant benefit for the protection against sexually-transmitted diseases. Recent progresses made in DC biology suggest that vaccines designed to target proper DC subsets may permit us to establish protective immunity in the female genital mucosa against sexually-transmitted pathogens.
Duluc, Dorothee; Gannevat, Julien; Joo, HyeMee; Ni, Ling; Upchurch, Katherine; Boreham, Muriel; Carley, Michael; Stecher, Jack; Zurawski, Gerard; Oh, SangKon
Sexually transmitted infections (STI) comprise a variety of infections transmissible through sexual contact. Mutually consenting sexual relationships have become commonplace in adolescence and sexual abuse or exploitation awareness has risen, resulting in increased presentations of children with sexual health concerns. Difficulties persist in diagnosing and managing STIs in children. With increased emphasis on paediatrician's involvement in transitional care, competence in sexual history taking and clinical presentation recognition remains essential. Additionally, an awareness of strengths and limitations of diagnostic modalities needs to be present. Furthermore, specific additional issues in this age group such as independent consent for diagnosis and treatment, fear of pregnancy and privacy and confidentiality concerns should be addressed carefully. Failure to address these issues may lead to disengagement with health services resulting in potentially adverse short- and long-term health and social consequences in young persons. This review aims to provide an overview of an approach to diagnosing and managing a pubertal child with an STI and the consideration of the unique issues surrounding children's care. PMID:22036714
Manikam, Logan; Rogstad, Karen; Singh, Gurdeep; Lakhanpaul, Monica
We have introduced recently a model for the spread of sexually transmitted 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
Accurate and inexpensive point-of-care (POC) tests are urgently needed to control sexually transmitted infection 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 sexually transmitted infections. PMID:24484215
Gaydos, Charlotte; Hardick, Justin
African Americans carry the largest disease burden for bacterial sexually transmitted 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.
Barrow, Roxanne Y.; Berkel, Cady; Brooks, Lesley C.; Groseclose, Samuel L.; Johnson, David B.; Valentine, Jo A.
Background: Sexually transmitted diseases (STDs) in children can be acquired either by sexual, or non-sexual route. Sexually transmitted 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.
Mendiratta, Vibhu; Agarwal, Soumya; Chander, Ram
According statistical data in Georgia sexually transmitted 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 sexually transmitted 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
This paper summarizes the historical experiences in venereal disease control in China during the 1950s. Venereal diseases had been all but eliminated in the whole country till 1964. However, along with the implementation of open-door policy and economic reform in the 1980s, the social environment was changed to a great extent in this country. Sexually transmitted diseases (STDs) were re-introduced in the Chinese mainland and new foci of infection established themselves in some cities. During the recent 8 years the national STD case-reporting and sentinel surveillance systems have been set up. The results of surveillance show that the annual incidence of STD has been on the increase. The existing factors associated with the increasing incidence of STD mainly are; population movement, increasing affluence in a part of population, the availability of multiple sexual partners (including the prostitution) and asymptomatic STD increased. Finally, the strategies for STD control are discussed in detail. PMID:9387394
Shao, C; Xu, W; Ye, G
The arctiid moth Utetheisa ornatrix is protected against predation by pyrrolizidine alkaloids (PA) that it sequesters as a larva from its food plant. Earlier work had shown that males transmit PA to the female with the sperm package and that the female bestows part of this gift on the eggs, protecting these against predation as a result. We now show that the female herself derives protection from the gift. Females deficient in PA are vulnerable to predation from spiders (Lycosa ceratiola and Nephila clavipes). If mated with a PA-laden male, the females become unacceptable as prey. The effect takes hold promptly and endures; females are unacceptable to spiders virtually from the moment they uncouple from the male and remain unacceptable as they age. Chemical data showed that the female allocates the received PA quickly to all body parts. We predict that other instances will be found of female insects being rendered invulnerable by receipt of sexually transmitted chemicals. PMID:10318925
González, A; Rossini, C; Eisner, M; Eisner, T
The arctiid moth Utetheisa ornatrix is protected against predation by pyrrolizidine alkaloids (PA) that it sequesters as a larva from its food plant. Earlier work had shown that males transmit PA to the female with the sperm package and that the female bestows part of this gift on the eggs, protecting these against predation as a result. We now show that the female herself derives protection from the gift. Females deficient in PA are vulnerable to predation from spiders (Lycosa ceratiola and Nephila clavipes). If mated with a PA-laden male, the females become unacceptable as prey. The effect takes hold promptly and endures; females are unacceptable to spiders virtually from the moment they uncouple from the male and remain unacceptable as they age. Chemical data showed that the female allocates the received PA quickly to all body parts. We predict that other instances will be found of female insects being rendered invulnerable by receipt of sexually transmitted chemicals.
Gonzalez, Andres; Rossini, Carmen; Eisner, Maria; Eisner, Thomas
Objective To determine predictors of completion of free annual sexually transmitted infection screening among sexually active young women 25 years of age and younger. Study Design We analyzed survey data from 2,607 sexually active women enrolled in the Contraceptive CHOICE Project, a prospective cohort study. We evaluated demographic characteristics, sexual risk behaviors, relationship characteristics, and contraceptive method. Receipt of a home or clinic-based test kit within 56 days of the 12-month survey constituted a completed screen. A multivariable model to predict screening completion was created using Poisson regression with robust error variance. Results Fifty-seven percent of women completed screening. Screening completion was most strongly associated with a college education or higher (RRadj=1.2, 95% CI: 1.1, 1.3) and home-based testing (RRadj=1.3, 95% CI: 1.2, 1.5). Conclusions Free and home-based testing increased screening rates among young women. To meet annual testing guidelines the availability and use of home testing kits should increase.
SKALA, Stephanie L.; SECURA, Gina M.; PEIPERT, Jeffrey F.
Services dealing with sexually transmitted infections (STIs) have been transformed in recent years with many Primary Care Trusts (PCTs) now commissioning a variety of STI services from different providers based on local needs. In recognition of these changes, and to ensure that quality is maintained throughout the NHS, the British Association for Sexual Health and HIV (BASHH), together with the Medical Foundation for AIDS and Sexual Health (MedFASH), have produced Standards for the Management of STIs. The nine standards cover all aspects of STI management, from diagnosis and treatment to the wider public health role of infection control. The standards apply to all those involved in providing STI care. For public health nurses the management of infection, as well as advice to help prevent unwanted pregnancy, are particularly relevant. Of the nine standards in the document, Standard 1: Principles of STI care is the core standard and is the most pertinent for advising clients on how to access care. It also contains background knowledge about sexual health services and what clients may expect from them. Through raising awareness of the standards among all those involved in providing STI care, it is hoped that universal implementation will bring about significant public health benefits through preventing reinfection, reducing transmission and making the utmost of the resources available. PMID:21319670
First noticed in Uganda in 1863 by a European explorer, sexually transmitted 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.
BackgroundAlthough recent recommendations for children after suspected sexual abuse incorporate nucleic acid amplification tests (NAATs) in algorithms that detect sexually transmitted infections (STIs), screening practices in the community remain uncertain.
Lisa S. Kresnicka; David M. Rubin; Kevin J. Downes; Jane M. Lavelle; Richard L. Hodinka; Karin L. McGowan; Robert Grundmeier; Cindy W. Christian
Sexual violence is associated with women's risks for HIV infection. The current study investigated factors related to risks for sexually transmitted 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
S. C. Kalichman; L. C. Simbayi
A Grounded Theory study has been used, based on its Theory of Symbolic Interactionism, to explore indigenous healers' beliefs and practices concerning sexually transmitted diseases amongst the Vhavenda. Initial data collection has been done, using purposive sampling and when categories started emerging, theoretical sampling was then used. Data were analysed by using three basic types of coding namely, open coding, axial coding and selective coding. The findings of the study revealed a variety of terms used to identify STDs. It then also became evident that there are similarities between gonorrhoea, syphilis and condylomata as shown in the orthodox sexually transmitted diseases posters used in orthodox medicine with some of the STDs that the indigenous healers are familiar with. In accordance with the Grounded Theory, the description of types of diseases, disease patterns as well as signs and symptoms culminated in the emergence of the Dirt Theory. Based on the above findings, it was recommended that guidelines for designing a module for teaching health professionals be formulated to assist nurses in understanding the beliefs and practices of the people they serve. PMID:16817492
Mulaudzi, F M; Makhubela-Nkondo, O N
Sexually Transmitted Diseases (STD) surveillance has caught the attention of the Italian public health authorities during the past decades. The spread of HIV infection increased the awareness of the need for a better STD surveillance system. This paper reports a retrospective survey of STD clinics in Italy, intended to form an epidemiological base for further development of STD surveillance. The data for 1986-87 and 1988 on a predefined set of diseases, all of them sexually transmitted, were collected from 85 of 127 centres contacted. The data obtained offer the first national figures for some STD not included in the statutory notification list, such as chlamydial infection, herpes and genital warts, as well as HIV infections. Those data show an increase in time frequencies. For gonorrhoea and syphilis, it was possible to compare our data with statutory notifications, showing a large gap between notified and reported cases. This gap is not stable in time (increasing in time) or in geographical area (increasing from north to south).
Greco, D; Giuliani, M; Suligoi, B; Panatta, M; Giannetti, A
OBJECTIVES. This study examined the prevalences of antibodies to Treponema pallidum, Chlamydia trachomatis, and herpes simplex virus type 2 in a sample of Peruvian adults. METHODS. Among adults seeking health certification in Lima, Peru, 600 were randomly selected to undergo interviews and serologic testing. RESULTS. Men's reported mean lifetime number of partners (10.6) far exceeded women's (1.1), yet antibody to sexually transmitted infection pathogens among sexually experienced participants was 2.8 times more prevalent among women than among men. Among men, female sex workers accounted for 37% of recent partners, and only sex with female sex workers while using condoms less than half of the time was independently associated with antibody (odds ratio = 3.6, 95% confidence interval = 1.5, 8.8). among women, number of partners was associated with any sexually transmitted infection antibody, while intercourse before 18 years of age was associated with C trachomatis antibody. At every level of perceived risk, sexually transmitted infection antibody was more frequent among women. CONCLUSIONS. Men having unprotected sex with female sex workers had the greatest risk of acquiring infections and (by inference) of transmitting them to women.
Sanchez, J; Gotuzzo, E; Escamilla, J; Carrillo, C; Phillips, I A; Barrios, C; Stamm, W E; Ashley, R L; Kreiss, J K; Holmes, K K
This study examined relationship power as a possible mediator of the relationship between dating violence and sexually transmitted 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' sexually transmitted 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 sexually transmitted 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.
Gonçalves, Sebastián; Kuperman, Marcelo
OBJECTIVE To determine whether men who perform recreational sounding are at increased risk of engaging in unsafe sexual behaviours, developing sexually transmitted 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.
Breyer, Benjamin N.; Shindel, Alan W.
Background.?Among human immunodeficiency virus (HIV)–infected men who have sex with men (MSM) taking combination antiretroviral therapy (cART), the impact of rectal sexually transmitted infections (STIs) on rectal HIV-1 shedding is unknown. Methods.?Human immunodeficiency virus type 1 (HIV-1) RNA was quantified from rectal swabs collected for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) screening of HIV-1-infected MSM. Correlations of STIs with rectal viral load were explored using multinomial regression modeling. HIV-1 coreceptor tropism was predicted from sequencing in a subset of men. Results.?Thirty-one (39%) of 80 men (59 prescribed combination antiretroviral therapy [cART]) had HIV detected in 38 (42%) of 91 rectal swabs. Rectal HIV detection was associated with plasma virus loads above 3.15 log10 copies/mL (95% confidence limit [CL] 2.73, 3.55) and paired rectal viral loads and plasma viral loads were correlated (Kendall’s tau [?] 0.68, Spearman rho [P] = .77). Rectal STIs and abnormal anal cytology were not associated with rectal viral load. HIV coreceptor distribution was very similar between the plasma and rectum in 3 of 4 men. Conclusions.?Plasma and rectal viral load were correlated, and rectal STIs did not increase the likelihood of detecting HIV in the rectal secretions in MSM, including those with low or undetectable plasma viral load. Suppressing plasma viral load is likely to reduce risk of HIV transmission to insertive partners.
Haaland, Richard E.; Patel, Pragna; Evans-Strickfaden, Tammy; Farshy, Carol; Hanson, Debra; Mayer, Kenneth; Lennox, Jeffrey L.; Brooks, John T.; Hart, Clyde E.
Cutaneous signs and skin conditions associated with sexually transmitted infections (STIs) are discussed. Syphilis, condyloma acuminata, and scabies are well-known STIs with cutaneous manifestations. Chlamydia and gonorrhea can also cause specific muco-cutaneous signs and symptoms. HIV often manifests itself through skin conditions. Dermatologists are pivotal in the timely diagnosis of HIV infection and play an important role in the disease prognosis and ongoing transmission. Anal intra-epithelial neoplasia (AIN), an HPV related precursor of anal carcinoma affecting HIV positive men, is a relatively new condition that many dermatologists will face in the future. STIs should be involved in the differential diagnosis when dermatologists are confronted with anogenital dermatoses, especially in patients with an increased risk for STIs. PMID:24559554
de Vries, Henry J C
The rationale for providing in-reach services for sexually transmitted 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 ample evidence worldwide that STI and BBV infection are more highly prevalent in prison populations than in the outside community. STI diagnosis and treatment services are therefore an essential component of any STI control programme. Services should be commissioned with characteristics of the prison setting in mind and link in with the local health strategy and action plan. Approval of funding is strongly supported by the quick win from the diagnosis and treatment of highly prevalent STI. The quality of services must be assured by a monitoring and governance framework grounded on national standards. PMID:21422046
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 sexually transmitted 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.
This paper points to the congruence between political and social variables and the epidemiology of sexually transmitted diseases (STDs) in modern China. STDs became a major health problem after the fall of the empire in 1911 and were only reluctantly addressed by a weak nationalist government during the 1930s. During the 1950s and 60s, the communist regime brought STDs under control, but problems have reappeared since reforms were implemented during the 1980s. Cultural values and social attitudes have also structured medical responses to venereal disease. From the reform movements between the two World Wars to the more recent communist health campaigns, medical theory has often been confused with moral prescription.
A cross sectional anonymously administered questionnaire was used amongst 1689 secondary school girls and boys to determine their knowledge of AIDS and other sexually transmitted diseases (STDs). Their knowledge was found to be very low. While 80% could name an STD in an open question, only 16% could recognise the important symptoms of the common and treatable diseases such as gonorrhoea and syphilis. This finding is worrying in view of the fact that these common STDs facilitate transmission of HIV/AIDS. The awareness of AIDs was high but when it came to the mode of transmission of AIDS the large majority were not aware of the risk of intercourse with an infected person. Furthermore, despite an intensive AIDS awareness campaign programme mounted by the government of Zimbabwe a large number of students thought that one can contract HIV/AIDS by shaking hands, sharing a toilet and witchcraft. Misconceptions on transmission abound. The data show that there is a need to review strategies of disseminating information to teenagers regarding STD, including AIDS, reproductive biology, sexuality and contraception. The best strategy may be the introduction of a reproductive health education curriculum in all schools starting at an early age. PMID:9185389
Kasule, J; Mbizvo, M T; Gupta, V; Fusakaniko, S; Mwateba, R; Mpanju-Shumbusho, W; Kinoti, S H; Padachy, J
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-transmitted bacterial 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.
Sexually transmitted diseases (STDs) are an increasing public health problem in Zambia. About 200 000 cases of STDs are treated annually in the formal health sector. Young people are the most affected by STDs. High-risk sexual behaviour has been identified as the major risk factor for STDs among young people. We conducted interviews and focus group discussions with a purposely selected sample of 126 young men aged between 16 and 26 in Chiawa, rural Zambia. The aim of the interviews and focus group discussions was to explore views about sexual practices and attitudes towards STD. Fifty-eight (59%) young men reported having had pre-marital or extra-marital sexual partners during the past year. The maximum number was five partners for six individuals. Forty-two (43%) had pre-marital or extra-marital sexual partners at the time of the interviews. Focus group discussions revealed that perceptions of manhood encouraged multiple sexual relationships. Twenty-two (23%) reported having suffered from an STD in the past. Seventy-nine (81%) said they were likely to inform their sexual partners if they had an STD. Although condoms were believed to give protection against STDs by the majority (94%), only 6% said they always used condoms. The data suggest that condoms were perceived to affect male potency. These results show that STDs, multiple sexual relationships and unprotected sex are common among the young men of Chiawa. Perceptions that emphasize manhood are widespread and these may negatively affect efforts for positive behavioural change. Health messages that target the young men should take into account the local perceptions and values that seem to sustain risky sexual behaviour. PMID:11238437
Ndubani, P; Höjer, B
OBJECTIVE: To examine the effect of patient defined non-regular sexual relationships and other risk behaviours on the incidence of sexually transmitted infections in heterosexual men and the role of condom use in the prevention of their spread. DESIGN: A prospective cross sectional study of sexual behaviour reported by a standardised self administered questionnaire in new patients who presented for screening
B A Evans; R A Bond; K D MacRae
Objectives We compared the male sexual partners of teen girls, age 15 - 19 years-old, currently infected with a sexually transmitted infection (STI) versus the male partners of adult women, age 20 - 41 years-old, with an STI to determine risk factors in these high-risk sexual dyads related to the male partner. Study Design Interview of 514 men who were partnered with 152 teen girls and 362 adult women, enrolled in Project Sexual Awareness for Everyone (SAFE), a randomized controlled trial of behavioral intervention to reduce recurrent STIs. Results Compared to the male partners of adult women, male partners of teen girls were significantly more likely (p < 0.05) to be infected with any STI at intake. Men partnered with teens were younger and had significantly more sexual partners per year sexually active, shorter relationship length, and shorter length of monogamy with the index girls. They were more likely to report that it was “really important” for the teen to have their baby (p = 0.04) and were slightly more likely to be the father of her children (p = 0.17). Young age independently predicted STI infection in men. Conclusions Although all women had an STI at intake, important differences were noted among the male partners of teens versus adults. Clinicians with similar populations may use this data to understand the characteristics of male partners of teens with STIs, in order to more effectively counsel adult and teen women on partner notification, treatment and STI prevention.
THURMAN, Andrea Ries; HOLDEN, Alan E C; SHAIN, Rochelle N; PERDUE, Sondra T.
This study examines the knowledge of sexually transmitted 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
Context: The prevalence of sexually transmitted diseases and associated risk behaviors among California farmworkers is not well described. Purpose: To estimate the prevalence of sexually transmitted 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: Sexually transmitted infections (STIs) are public health problems, which significantly increase the risk of HIV transmission. A proper understanding of the pattern of STIs in different geographical regions is important for proper planning of STI control. Aims: To determine the pattern of sexually transmitted diseases in a tertiary care hospital in Eastern India. Subjects and Methods: This is a hospital-based, cross-sectional study done in a tertiary care hospital of Eastern India. All the consecutive patients attending the STI clinic of a tertiary care hospital from January 2011 to December 2011 were included in the study, irrespective of age and sex. Thorough history was taken; proper clinical examination and relevant laboratory investigations were done. STIs were categorized in different syndromes as depicted by National AIDS Control Organization(NACO) in the syndromic management of STIs. The STIs, which were not included in the syndromic management, were also identified by clinical features and investigations. Partner notification and condom promotion was done. The statistical analysis used was Chi-square test using MedcalcR statistical software Version 9.3 (Belgium). Results: The commonest STI was genital herpes. Viral STIs like genital herpes, condyloma acuminata, molluscum contagiosum were more prevalent than the non-viral ones like genital ulcer disease non-herpetic, syphilis. STIs which were not included in the syndromic management like molluscum contagiosum, condyloma acuminata, genital scabies were common. HIV seropositivity in the study population (4.2%) was more than the NACO estimate. Condom promotion, partner notification, and partner management was not adequate. Occurrence of venereophobia was found to be significantly higher in male than in female attendees of STI clinic. Conclusions: The trend for viral STIs is increasing while that for bacterial STIs is decreasing. Proper training of the health care providers regarding minor STIs, condom promotion, partner notification and partner management, counseling regarding venereophobia should be undertaken to make STI control programs successful.
Sarkar, S; Shrimal, A; Das, J; Choudhury, SR
The human immunodeficiency virus (HIV-1) pandemic has been driven primarily by the sexual transmission of the virus, and facilitated by prior infections with other sexually transmitted disease (STD) pathogens. Although treatment of these STDs has been proposed as a means to decrease the rate of HIV-1 sexual transmission, preventive measures effective against both HIV-1 and other STD pathogens are expected
A. Robert Neurath; Nathan Strick; Yun-Yao Li; Kang Lin; Shibo Jiang
BACKGROUND AND METHODS--The absence of any official statistics on the prevalence of STD in homosexual men in Spain induced us to carry out a prospective study of new homosexual patients who consulted the STD Clinic of the School of Medicine in Seville, between January 1988 and December 1989. The aim of the study was to determine the prevalence of symptomatic and asymptomatic infections in this group of patients. RESULTS--1805 patients were seen during the study period; 318 patients were homosexual of whom 309 agreed to participate in the study. Of the 309 homosexual men, 108 (35%) had symptoms and the remaining 201 (65%) were asymptomatic. In the symptomatic group the diagnoses were: syphilis 28 (25.9%); urethritis 40 (37%) (of these 40, 11 had Neisseria gonorrhoeae, five had Chlamydia trachomatis, five had Ureaplasma urealyticum, one had Herpes simplex virus and in 18 no pathogen was detected); genital herpes seven (6.4%). Eleven (10%) had concomitant infections. The following infections were found in the asymptomatic group: syphilis 23 (11.4%), N gonorrhoeae six (3%), C trachomatis two (1%), Herpes simplex virus one (0.5%). Antibodies against HIV were detected in 30 (9.6%) of the total group. CONCLUSIONS--Sexually transmitted diseases are common amongst homosexual men in Seville and many of these are asymptomatic.
Rodriguez-Pichardo, A; Aznar, J; Camacho, F; Borobio, M V; Perea, E J
Cell surface heparan sulfate (HS), a polysaccharide composed of alternating uronic acid and glucosamine residues, represents a common link that many sexually transmitted 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.
Tiwari, Vaibhav; Maus, Erika; Sigar, Ira M; Ramsey, Kyle H; Shukla, Deepak
Two rapid assessment studies of the magnitude of sexually transmitted disease (STD) were performed in Senegal and Uganda in 1989 and 1990. The study objectives were: to develop and validate STD indicators for the "rapid" assessment of the frequency of STD in populations; and to develop a standardized survey methodology to assess STD prevalence using these indicators. The World Bank, World Health Organization (WHO), and Senegal and Ugandan government officials desired a product similar to the WHO/UNICEF immunization coverage survey instrument, which is an accepted and proven methodology, implemented by national programs and donors worldwide. Three indicators were used: 1) past or present signs of selected STD; 2) symptoms as noted by a clinician; and 3) simple laboratory tests performed and results obtained at examination. Each indicator was validated against a confirmatory laboratory test considered the gold standard in indicating the presence or absence of an STD. Male military members, women seeking prenatal care, and female prostitutes were the three population groups chosen. With the exception of the rapid plasma reagin (RPR) test for syphilis, symptoms, signs, and simple laboratory tests failed to accurately predict STD in individuals in all three of these population groups. Indicators for the major STD other than syphilis among populations not seeking STD care will have to be the "gold standard laboratory tests" until easy-to-perform and low-cost alternatives are found. PMID:8042125
Roseberry, W L; Heymann, D L; Ndoye, I; Nsubuga, P S
The aim of the study was to determine the differences in sexual behaviour and condom use as a protection against sexually transmitted 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
Dijani?, Tomislav; Kozul, Karlo; Miskulin, Maja; Medi?, Alan; Jurcev-Savicevi?, Anamarija; Burazin, Jelena
Accurate and inexpensive point-of-care (POC) tests are urgently needed to control sexually transmitted 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.
Gaydos, Charlotte; Hardick, Justin
Background Data on sexually transmitted infections (STI) prevalence among HIV-infected women in Thailand are limited. We studied, among HIV-infected women, prevalence of STI symptoms and signs; prevalence and correlates of having any STI; prevalence and correlates of Chlamydia trachomatis (CT) or Neisseria gonorrhoeae (GC) among women without CT and/or GC symptoms or signs; and number of women without CT and/or GC symptoms or signs needed to screen (NNS) to detect one woman with CT and/or GC overall, among pregnant women, and among women ?25 years. Methods During October 2004–September 2006, HIV-infected women at 3 obstetrics and gynecology clinics were asked about sexual behaviors and STI symptoms, physically examined, and screened for chlamydia, gonorrhea, trichomoniasis, and syphilis. Multivariate logistic regression was used to identify correlates of infections. NNS was calculated using standard methods. Results Among 1,124 women, 526 (47.0%) had STI symptoms or signs, 469 (41.7%) had CT and/or GC symptoms or signs, and 133 (11.8%) had an STI. Correlates of having an STI included pregnancy and having STI signs. Among 469 women and 655 women with vs. without CT and/or GC symptoms or signs, respectively, 43 (9.2%) vs. 31 (4.7%), 2 (0.4%) vs. 9 (1.4%), and 45 (9.6%) vs. 38 (5.8%) had CT, GC, or “CT or GC”, respectively; correlates included receiving care at university hospitals and having sex with a casual partner within 3 months. NNS for women overall and women ?25 years old were 18 (95% CI, 13-25) and 11 (95% CI, 6-23), respectively; and for pregnant and non-pregnant women, 8 (95% CI, 4-24) and 19 (95% CI, 14-27), respectively. Conclusions STI prevalence among HIV-infected women, including CT and GC among those without symptoms or signs, was substantial. Screening for CT and GC, particularly for pregnant women, should be considered.
Objectives: To describe health seeking and sexual behaviour including condom use among patients presenting with sexually transmitted infections (STIs) and, to identify sociodemographic and behavioural risk factors associated with “no condom use” during the symptomatic period.Methods: A cross sectional study of consecutive new STI cases presenting at the district STI clinic in Thyolo, Malawi. They were interviewed by STI counsellors
R Zachariah; W Nkhoma; A D Harries; V Arendt; A Chantulo; M P Spielmann; M P Mbereko; L Buhendwa
Purpose: To examine the influence of sociodemographic characteristics, sexually transmitted 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
Sexual violence is associated with women's risks for HIV infection. The current study investigated factors related to risks for sexually transmitted 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 assault, HIV risk behaviours, substance use and non-sexual relationship abuse. Surveys were completed by 90% of women approached. Forty-four per cent (N = 119) of women reported a history of sexual assault. Multiple logistic regressions, controlling for participant age, education, marital status and survey venue, showed that women who had been sexually assaulted were significantly more likely to have shared injection drug equipment, exchanged sex to meet survival needs, and used alcohol compared to women who had not been sexually assaulted. Women with a history of sexual assault were also significantly more likely to have multiple male sex partners, greater rates of unprotected vaginal intercourse, lower rates of condom protected anal intercourse, more sexual contacts involving blood, more STIs and genital ulcers. Finally, women who had been sexually assaulted were more likely to have been non-sexually abused by relationship partners and were more likely to fear asking partners to use condoms. There is a close connection between sexual assault and women's risks for STIs and HIV. Structural and behavioural interventions are needed to simultaneously reduce the prevalence of sexual assault against women and prevent the transmission of HIV. PMID:15370057
Kalichman, S C; Simbayi, L C
A survey was conducted in four major urban centres in Somalia in 1983 to determine the etiology and distribution of sexually transmitted diseases (STDs). Results a serosurvey oof 1923 STD clinic patients and 553 healthy controls revealed positive serologi...
J. K. Podgore M. A. Omar
ObjectivesTo estimate the lifetime prevalence of four sexually transmitted infections (STIs) and to identify correlates of these infections among patients seeking care for a substance use disorder at a specialized DeAddictions Unit in southern India.
Michael P. Carey; V. Ravi; Prabha S. Chandra; Anita Desai; Dan J. Neal
Sexually transmitted 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 sexually transmitted 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
White, Joël; Richard, Murielle; Massot, Manuel; Meylan, Sandrine
The claim that circumcision reduces the risk of sexually transmitted 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 sexually transmitted 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 sexually transmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections. Consequently, the prevention of sexually transmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexually transmitted infections is not supported by the evidence in the medical literature.
Van Howe, Robert S.
Objectives. I estimated the sexually transmitted disease-related mortality among US reproductive-aged women from 1999 to 2010. Methods. I estimated mortality from National Center for Health Statistics' Multiple Cause of Death data. I defined reproductive age as 15 to 44 years. For diseases partially caused by sexual transmission, I estimated the proportion attributable to sexual transmission from the literature. To calculate mortality rates, I estimated number of deaths from each disease and Census Bureau population for reproductive-aged women for 1999 to 2010. Results. From 1999 to 2010, the cumulative sexually transmitted disease-related mortality rate decreased by 49%, from 5.3 to 2.7 deaths per 100?000. The primary contributors were HIV and human papilloma virus infections. Mortality from sexually transmitted HIV infection decreased by 62%, from 3.4 to 1.3 deaths per 100?000. Mortality from human papilloma virus-associated gynecologic cancers decreased by 19%, from 1.6 deaths per 100?000 in 1999 to 1.3 deaths per 100?000 in 2010. Conclusions. Screening and treatment for sexually transmitted diseases may reduce mortality. Research is needed to determine whether sexually transmitted disease-related morbidity among reproductive-aged women has decreased over the past decade. PMID:24922169
McElligott, Kara A
Introduction Violence against women perpetrated by their intimate partners is a social problem with adverse health consequences. Intimate partner violence has acute and chronic as well as direct and indirect health consequences related to physical, psychological, and reproductive health. Studies exploring relationships of intimate partner violence and health consequences are rare in Nepal. Hence, this study aimed to examine the relationships between intimate partner violence and sexually transmitted infections. Method This study used data from the nationally representative Nepal Demographic Health Survey 2011, which collected data through a two-stage complex sampling technique. Women 15–49 years were asked about domestic violence including intimate partner violence. For this analysis, 3,084 currently married women were included. Questions about domestic violence were adapted from the Conflict Tactic Scale. Relationships between different forms of physical and sexual intimate partner violence and reported signs and symptoms of sexually transmitted infections were examined using multiple logistic regression analysis. Results Approximately 15% of currently young and middle-aged married women experienced some form of violence in the last 12 months. About one in four women who were exposed to physical and sexual intimate partner violence reported sexually transmitted infection in the last 12 months. The odds of getting sexually transmitted infection were 1.88 [95% CI:1.29, 2.73] times higher among women exposed to any form of intimate partner violence in the last 12 months compared to women not exposed to any form of intimate partner violence. Conclusion Intimate partner violence was common among currently married women in Nepal. Being exposed to intimate partner violence and getting signs and symptoms of sexually transmitted disease were found to be associated. Integration of intimate partner violence prevention and reproductive health programs is needed to reduce the burden of sexually transmitted disease among currently married women.
Dhakal, Liladhar; Berg-Beckhoff, Gabriele; Aro, Arja R
Most primary prevention research has attempted to explain sexual health outcomes, such as sexually transmitted 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…
Shoveller, Jean A.; Johnson, Joy L.; Savoy, Daphne M.; Pietersma, W. A. Wia
In a pioneering study undertaken in Pakistan, urban men's sexual behaviors, perceptions and knowledge regarding sexually transmitted infections including HIV/AIDS were determined by employing both qualitative and quantitative research methods. Focus group discussions were carried out initially and followed by a structured cross sectional survey…
Mohammad Mir, Ali; Reichenbach, Laura; Wajid, Abdul
Changes in sexually transmitted disease (STD) rates among adolescents and young adults may depend on changes in sexual activity, accessibility of referral and treatment services, and education. To assess the knowledge and attitudes of college students toward various aspects of STD's, a 45-item Likert inventory focusing on symptoms, prevalence,…
Frazer, Gregory H.; Klein, Daniel
Examined risk factors associated with acquisition of sexually transmitted 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
Background: African American female adolescents liv- ing in low-income urban areas are at increased risk for sexually transmitted diseases. Objective: To determine if high levels of perceived pa- rental supervision and communication were associated with reduced gonorrhea (GC) and chlamydia (CT) in- cidence in low-income, African American, sexually ex- perienced female adolescents, aged 14 to 19 years, at- tending urban
Julie A. Bettinger; David D. Celentano; Frank C. Curriero; Nancy E. Adler; Susan G. Millstein; Jonathan M. Ellen
A literature review that addressed the possible reasons sexually transmitted infection (STI) rates are increasing indicated that self-directed STI testing for gonorrhea and chlamydia should be trialed. As such, a self-directed STI testing kit was developed and piloted for 6 months, during which 182 bathhouse patrons accessed services from both an on-site nurse and through the self-directed kits. In total, 127 of these individuals presented for testing from the nurse, with the remaining using the self-directed testing kits. Community/Participant feedback indicated that this testing method was a welcome adjunct to traditional services, thus suggesting that self-directed testing should be further explored. PMID:20974060
The aim of the study was to test for relationships between state-level sex educational policies and sexually transmitted disease (STD) rates. We analysed US case reports of gonorrhoea and chlamydial infection for 2001-2005 against state policies for abstinence coverage in sexuality education, using the proportion of the population per state who identified as black (aged 15-24 years) as a covariate. We also tested for effects on 15-19 year olds versus 35-39 year olds and tuberculosis rates (the latter to ensure findings applied only to STD). States with no mandates for abstinence had the lowest mean rates of infection among the overall population and among adolescents. States with mandates emphasizing abstinence had the highest rates; states with mandates to cover (but not emphasize) abstinence fell in between. Rates in some states covering abstinence changed faster than in others, as reflected in sharper declines (gonorrhoea) or slower increases (chlamydial infection). These effects were not shown for tuberculosis or 35-39 year olds. Having no abstinence education policy has no apparent effect on STD rates for adolescents. For states with elevated rates, policies mandating coverage may be useful, although policies emphasizing abstinence show no benefit. PMID:20378905
Hogben, M; Chesson, H; Aral, S O
Objective To measure associations among depression, sexual risk behaviors, and sexually transmitted 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.
Khan, Maria R; Kaufman, Jay S; Pence, Brian Wells; Gaynes, Bradley N; Adimora, Adaora A; Weir, Sharon S; Miller, William C
Lambeth, Southwark, and Lewisham are three London boroughs that probably have the worst set of indicators of sexual health in the United Kingdom. This area is used to illustrate an urban epidemic of bacterial sexually transmitted infections in an industrialised country with well developed public health infrastructure, and the generalisability of the phase specific model for prevention and control of sexually trasmitted infections. The results show that national strategies for preventing and controlling sexually transmitted infections comprise a limited repertoire of activities that fit with those suggested by the phase specific model. Specific strategies for men and for young black heterosexuals in the most heavily affected areas should be developed. There is, however, insufficient empirical evidence about whether particular interventions introduced at different epidemic stages are effective. PMID:12083432
Objectives We examined patterns of sexual behavior and risk for sexually transmitted 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.
Pflieger, Jacqueline C.; Cook, Emily C.; Niccolai, Linda M.; Connell, Christian M.
exually transmitted diseases (STDs) present a formidable social, health, and economic problem for our nation. More than 65 million U.S. citizens are currently living with STDs, and an additional 15 million become infected with one or more STDs each year, including 3.5 million teenagers (CDC, 2000). Health risks associated with STDs include pain, increased susceptibility to other diseases, blindness, and
Danielle T. Jones; Brenda Parker; Scott Scrivner
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
Objectives: To determine the prevalence of sexually transmitted infections (STIs) and the mental health needs of female child and adolescent survivors of rape and sexual assault who were referred to a specialist genitourinary medicine (GUM) clinic. Method: Retrospective case notes review of 98 females aged 16 or less, who attended over a 5 year period (1996–2000). Results: The overall prevalence of STIs was 26%. Among the girls who were aged 0–12 years (n = 16), one had gonorrhoea and another had Trichomonas vaginalis infection. Prevalence of STIs in those aged 13–16 years, who were not sexually active before the index assault, was 24% and in those who gave a history of previous consensual sexual activity it was 39% (p = 0.17). Chlamydial infection was more common among the girls who disclosed previous consensual sexual activity than in those did not disclose previous sexual activity (p = 0.012). The overall prevalence of vaginal candidiasis was 17% and bacterial vaginosis 13%. More than one third of the study population gave a history of previous sexual, physical, or other abuse. 81% reported having current psychological difficulties. Mood changes and sleep disturbances were reported more frequently than other psychological symptoms; 15% attempted self harm. All types of psychological difficulties, except mood changes, were not affected by the time interval between index assault and first presentation to the clinic and the type of assailant. 29% had no involvement with social and mental health services before their attendance at the clinic Conclusions: The prevalence of STIs among female child and adolescent survivors of rape and sexual assault attending a specialist clinic was high. The range of mental health and social difficulties was wide and multiple. The importance of an early assessment for the presence of STIs and mental health difficulties was demonstrated.
Kawsar, M; Anfield, A; Walters, E; McCabe, S; Forster, G
This paper examines the impacts of four abstinence-only education programs on adolescent sexual activity and risks of pregnancy and sexually transmitted 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 in one of the four programs or a control group that was not. The findings show no significant impact on teen sexual activity, no differences in rates of unprotected sex, and some impacts on knowledge of STDs and perceived effectiveness of condoms and birth control pills PMID:18401923
Trenholm, Christopher; Devaney, Barbara; Fortson, Kenneth; Clark, Melissa; Bridgespan, Lisa Quay; Wheeler, Justin
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 sexually transmitted diseases. (Author/YDS)
Lee, Yeung Chung
BACKGROUND: As stigma is a socially constructed concept, it would follow that stigma related to sexual behaviours and sexually transmitted 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
Sexually transmitted infections constitute economic burden for developing countries, exposure to causative agents is an occupational hazard for female sex workers. Targeted interventions for this population can reduce the incidence and prevalence of sexually transmitted infections including human immunodeficiency virus, but barriers exists which can hinder effective implementation of such programs. This descriptive cross sectional study sought to assess the prevalence, knowledge and treatment practices of sexually transmitted infections among brothel based female sex workers. Three hundred and twenty three consenting female sex workers were surveyed using pre tested, interviewer administered questionnaires. More than half of the respondents (54.2%) had poor knowledge of symptoms of sexually transmitted infections. Only 13.9% were aware that sexually transmitted infections could be asymptomatic. The self reported prevalence of symptomatic sexually transmitted infections was 36.5%. About half of those with sexually transmitted infectionss sought treatment in a hospital or health centre while 32.5% from a patent medicine vendor. Most respondents (53.8%) mentioned the perceived quality of care as the main reason for seeking treatment in their chosen place. More of the respondents with good knowledge of sexually transmitted infections reported symptoms compared to those with fair and poor knowledge. The knowledge of sexually transmitted infections among these female sex workers is poor and the prevalence is relatively high. Efforts to improve knowledge promote and encourage preventive as well as effective treatment practices must be made for this population. PMID:24069738
Sekoni, Adekemi O; Odukoya, Oluwakemi O; Onajole, Adebayo T; Odeyemi, Kofoworola A
Researchers conducted a survey of 199 students enrolled 2 public high schools in Alberta in Canada to learn of their knowledge about sexually transmitted 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 Harvard University Asia Center hosted a symposium in October 2010 focused on sex work and sexually transmitted infections in Asia, engaging a biosocial approach to promote sexual health in this region. Asia has an estimated 151 million cases of curable sexually transmitted infections (STIs; eg, syphilis, gonorrhea, chlamydia) each year, with commercial sex interactions playing a large role in ongoing transmission. Substantial human movement and migration, gender inequalities, and incipient medical and legal systems in many states stymie effective STI control in Asia. The articles in this supplement provide theoretical and empirical pathways to improving the sexual health of those who sell and purchase commercial sex in Asia. The unintended health consequences of various forms of regulating commercial sex are also reviewed, emphasizing the need to carefully consider the medical and public health consequences of new and existing policies and laws.
Kaufman, Joan; Bhabha, Jacqueline; Kleinman, Arthur
Historically, the diagnosis of sexually transmitted diseases (STDs) has been difficult. The introduction of molecular biology techniques in microbiological diagnosis and their application to non-invasive samples has produced significant advances in the diagnosis of these diseases. Overall, detection of Neisseria gonorrhoeae by molecular biology techniques provides a presumptive diagnosis and requires confirmation by culture in areas with a low prevalence. For Chlamydia trachomatis infections, these techniques are considered to be the most sensitive and specific procedures for mass screening studies, as well as for the diagnosis of symptomatic patients. Diagnosis of Mycoplasma genitalium infection by culture is very slow and consequently molecular techniques are the only procedures that can provide relevant diagnostic information. For Treponema pallidum, molecular techniques can provide direct benefits in the diagnosis of infection. Molecular techniques are not established for the routine diagnosis of donovanosis, but can be recommended when performed by experts. Molecular methods are advisable in Haemophilus ducreyi, because of the difficulties of culture and its low sensitivity. In genital herpes, molecular techniques have begun to be recommended for routine diagnosis and could soon become the technique of choice. For other genital infections, bacterial vaginosis, vulvovaginal candidosis and trichomoniasis, diagnosis by molecular methods is poorly established. With genital warts, techniques available for screening and genotyping of endocervical samples could be used for certain populations, but are not validated for this purpose. PMID:19195446
Otero Guerra, Luis; Lepe Jiménez, José Antonio; Blanco Galán, María Antonia; Aznar Martín, Javier; Vázquez Valdés, Fernando
Purpose of review Sexually transmitted 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.
Tucker, Joseph D.; Bien, Cedric H.; Peeling, Rosanna W.
Summary Background There has been an increase in high-risk sexual behaviour and sexually transmitted 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
The aim of this study was to evaluate transmission of Brucella abortus biotype 1 via sexual intercourse in rats. Male and female virgin Sprague-Dawley (SD) rats were experimentally infected intraperitoneally with 1×10(9)colony forming units (CFU) of B. abortus biotype 1, a Korean bovine isolate. At 14 days after infection, infected male rats (n=10) were housed with uninfected female rats (n=10) and infected female rats (n=10) were housed with uninfected male rats (n=10) for a period of one month. During this period all uninfected female rats became pregnant and 6 of 10 infected female rats became pregnant. Serum from two out of 10 female uninfected rats had positive reactions in the Rose Bengal Plate Agglutination Test (RBPAT), Tube Agglutination Test (TAT) or the Enzyme-Linked Immunosorbent Assay (ELISA); whereas none of the uninfected male rat had positive reactions in these tests. Using bacteriological culture and AMOS-PCR assay, B. abortus biotype 1 was isolated and identified from two uninfected female rats and all of the uninfected male rats were found negative for B. abortus biotype 1. It was concluded that transmission of B. abortus biotype 1 from infected male to uninfected female rats resulted from sexual intercourse. PMID:23664185
Islam, Md Ariful; Khatun, Mst Minara; Baek, Byeong-Kirl
Bacterial contamination of tissue allografts obtained from cadaveric donors has been a serious cause of morbidity and mortality\\u000a in recipients. Recent cases of fatal and nonfatal bacterial infections in recipients of contaminated articular cartilage (distal\\u000a femur) and tendon allografts have called attention to the importance of avoiding tissue donors suspected of carrying infectious\\u000a disease, of not processing donated tissue carrying
Abstract Adolescents and young adults are at high risk of human immunodeficiency virus (HIV) infection in sub-Saharan Africa. Previous reports have found that university students in Africa comprise a sexually active population, although the prevalence of HIV or sexually transmitted infections (STI) has not been measured. We conducted a cross-sectional survey of students from five large universities in Kampala, Uganda, using respondent-driven sampling. We asked students to complete behavioral questionnaires and provide biological samples to test for HIV, Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, Trichomonas vaginalis, and bacterial vaginosis. We enrolled 649 students and obtained interpretable data from 640. Around 50% of the respondents were male, and the mean age was 22 years. An estimated 0.8% (95% CI 0.0-2.0) of male students had Chlamydia infection, approximately 4.3% (95% CI 2.0-7.0) had syphilis, 0.4% (95% CI 0.0-0.9) had HIV, and none had gonorrhea. An estimated 32.6% (95% CI 22.4-40.8) of women had bacterial vaginosis, 2.5% (95% CI 0.7-6.3) had Chlamydia infection, 1.7% (95% CI 0.5-3.6) had syphilis, 1.0% (95% CI 0.0-2.4) had gonorrhea, 0.9% (95% CI 0.0-4.2) had trichomoniasis, and 0.9% (95% CI 0.0-1.8) had HIV. We found no significant risk factors for HIV or other STI among males. We also found that not using a condom during the latest sexual intercourse was significantly associated with HIV infection, other STI, or bacterial vaginosis (OR 2.16; 95% 1.26-3.78) among females. We conclude that while university students are sexually active and there is substantial risk for syphilis, there is little evidence of substantially increased HIV risk among them. PMID:24762640
Rutherford, George W; Anglemyer, Andrew; Bagenda, Danstan; Muyonga, Michael; Lindan, Christina P; Barker, Joseph L; Johnston, Lisa; Hladik, Wolfgang
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 sexually transmitted infections (STIs) in the industrialized world. Four constituencies with important roles in communicating about STIs are youth, parents,…
Cates, Joan R.
The aims of this exploratory qualitative study were to increase our understanding of heterosexual young adults knowledge and beliefs about sexually transmitted 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…
de Visser, Richard
Objective: To assess the acceptability of sexually transmitted infection (STI) testing using self-collected vaginal swabs (SCVS) among college women. Participants: First-year female students ("N" = 483). Methods: Participants were offered free testing for 3 STIs using SCVS in April 2010 and later completed a survey regarding their…
Fielder, Robyn L.; Carey, Kate B.; Carey, Michael P.
This curriculum guide provides school districts that already have VD education programs with up-to-date information about research and epidemiology relating to sexually transmitted diseases. For districts wishing to implement a program for the first time, it offers both a structured framework and the resources and materials needed for a complete…
California State Dept. of Education, Sacramento.
CONTEXT: Each year, millions of U.S. youth acquire sexually transmitted 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
Sexually transmitted infections (STIs) are a major public health problem, and controlling their spread is a priority. According to the World Health Organization (WHO), there are 340 million new cases of treatable STIs among 15–49 year olds that occur yearly around the world (1). Infection with STIs can lead to several complications such as pelvic inflammatory disorder (PID), cervical cancer,
Betiel K Fesseha
EveryBody is a curriculum that emphasizes prevention of human immunodeficiency virus (HIV) and other sexually transmitted 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…
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 sexually transmitted infection. The interviews allowed youth to talk about their experiences with paternity, their sex lives and their views on sex education.…
Manseau, Helene; Blais, Martin; Engler, Kim; Bosse, Marie-Andre
The study analysed the patterns of Sexually Transmitted 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…
Omobude-Idiado, S. N.; Bazuaye, G. N.
Objective : To determine the prevalence of sexually transmitted diseases in female athletes. Methods : An observational, cross-sectional study was conducted including 50 female athletes with mean age of 20±3 years. Colposcopy, pap smear, and polymerase chain reaction for Chlamydia trachomatis, human papillomavirus and Neisseria gonorrhoeae were performed. Blood samples were collected to test for the human immunodeficiency virus, syphilis, hepatitis B and C. The athletes presenting clinical diseases or conditions identifiable by laboratory tests were treated and followed up in the unit. Results : Forty-six percent of the participants were unaware of sexually transmitted diseases. The prevalence of sexually transmitted diseases among athletes was 48% (24 cases). Human papillomavirus was the most frequent agent (44%). Considering the human papillomavirus genotypes, subtype 16 was the most prevalent (53%), followed by 11-6 (22%) and 18 (13%). Two athletes tested positive for C. trachomatis. There were no cases diagnosed of infection by N. gonorrhoeae, syphilis, hepatitis B, hepatitis C and human immunodeficiency virus. However, only 26 athletes had been vaccinated for hepatitis B. Conclusion : The prevalence of sexually transmitted diseases in female athletes was high. Primary prevention measures (hepatitis B and human papillomavirus vaccination) and secondary (serology, pap smears) must be offered to this specific group of women. The matter should be further approached in sports. PMID:24728243
Araujo, Maíta Poli de; Kleine, Henrique Truffa; Parmigiano, Tathiana Rebizzi; Gomes, Natalia Tavares; Caparroz, Graziela Pascom; Silva, Ismael Dale Cotrim Guerreiro da; Girão, Manoel João Batista Castello; Sartori, Marair Gracio Ferreira
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 sexually transmitted disease (STD) prevention, covering the following topics (1) Health Education; and…
Centers for Disease Control and Prevention, 2007
Consists of two articles on the topics of (1) sexually transmitted diseases and (2) acquired immune deficiency syndrome (AIDS). Yarber discusses how these topics should be taught to young people, with emphasis on health education as opposed to morality. Newschwander states the facts related to AIDS, including risks of enrolling infected students.…
Yarber, William L.; Newschwander, Gregg E.
Objectives: The goal of this study was to assess the baseline prev- alence of and risk factors for HIV and other sexually transmitted infections (STIs) among beer girls enrolled in a behavioral interven- tion in Battambang, Cambodia. Methods: Ninety-two of 114 women participated in baseline inter- viewing, HIV\\/STI testing, and STI treatment. Blood specimens were tested for syphilis and HIV
Andrea A. Kim; Ly Penh Sun; Chhea Chhorvann; Christina Lindan; Frits Van Griensven; Peter H. Kilmarx; Pachara SirivongrangsoN; Janice K. Louie; Hor Bun Leng; Kimberly Page-Shafer
Objective: The authors describe the cervical cytology and sexually transmitted 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…
Smith, P. Davis; Roberts, Craig M.
Background: Delays in receipt of positive HIV test results and in entry into HIV care are common problems in clinics; in public venues, up to 33% of patients with negative results and 25% of those with positive results never learn their results. Methods: Patients aged 18 years or older at an urban sexually transmitted disease (STD) clinic were offered rapid
Sabrina R. Kendrick; Karen A. Kroc; David Withum; Robert J. Rydman; Bernard M. Branson; Robert A. Weinstein
BACKGROUND: Control of sexually transmitted infections (STIs) is an important part of the effort to reduce the risk of HIV\\/AIDS. STI clinics in the government hospitals in India provide services predominantly to the poor. Data on the cost and efficiency of providing STI services in India are not available to help guide efficient use of public resources for these services.
Lalit Dandona; Pratap Sisodia; TLN Prasad; Elliot Marseille; M Chalapathi Rao; A Anod Kumar; SG Prem Kumar; YK Ramesh; Mead Over; M Someshwar; James G Kahn
Google Trends was used to determine the relationship between sexually transmitted infection (STI)-related search engine trends and STI rates. Trends seem to be similar to the relative rates of STIs and to regional differences in rates. Search engine trends are an innovative tool to integrate into STI surveillance. PMID:24326584
Johnson, Amy K; Mehta, Supriya D
Objectives: Sexually transmitted infection (STI) screening in correctional facilities provides access to people at high risk for STIs who might not be screened elsewhere. These screening programmes are becoming more widespread, but with decreasing funding for STI control, maximising screening impact has become increasingly important. We aimed to make recommendations about the impact of age and sex targeted screening in
Pennan M Barry; Charlotte K Kent; Katherine C Scott; Ameera Snell; Joseph Goldenson; Jeffrey D Klausner
OBJECTIVE--To determine the prevalence of infection with the human immunodeficiency virus (HIV) in all patients attending a London sexually transmitted disease clinic over four weeks at the end of 1987 and to see how it varied from that in similar samples studied between 1982 and 1986. DESIGN--Anonymous testing of serum samples from consecutive heterosexual and homosexual patients having routine serological
C. Loveday; L. Pomeroy; I. V. Weller; J. Quirk; A. Hawkins; H. Williams; A. Smith; P. Williams; R. S. Tedder; M. W. Adler
This article describes a 1-hour behavioral intervention designed to promote female condoms and safer sex to women at a high risk for sexually transmitted 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
The problems and risks of unprotected sex, unintended pregnancy and sexually transmitted infections are inextricably linked. In this context, the critical yet overlooked problem of infertility also needs to be addressed. Dual protection means concurrent protection against unintended pregnancy and STI\\/HIV. This paper argues for a more comprehensive notion of “triple protection” to include the safeguarding of fertility. This is
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 sexually transmitted infections (STI) and unintended pregnancies. Friends' attitudes and behavior were assessed with…
Henry, David B.; Deptula, Daneen P.; Schoeny, Michael E.
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 sexually transmitted illnesses (STIs) among male clients. They were also asked about their perceptions
Phillimon Ndubani; Bengt Höjer
The US Centers for Disease Control and Prevention recently updated its recommendations for treating sexually transmitted 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.
Lee, Maria Veneranda C; Wasserman, Glenn M
Sexually transmitted diseases can pose major health problems so scientists and health agencies are very concerned about the spread of these diseases. Sexually transmitted diseases spread through a network of contacts created by the formation of sexual partnerships. In the paper, the spreading of sexually transmitted diseases on bipartite scale-free graphs, representing heterosexual and homosexual contact networks, is considered. We propose an SIS model on sexual contact networks. We analytically derive the expression for the epidemic threshold and its dependence with the ratio of female and male in finite populations. It is shown that if the basic reproduction number R0 is less than 1 then the disease-free equilibrium is globally asymptotically stable; if R0>1 then the disease-free equilibrium is unstable and there is a unique endemic equilibrium, which asymptotically attracts all nontrivial solutions. These theoretical results are supported by numerical simulations. We also carry out some sensitivity analysis of the basic reproduction number R0 in terms of various model parameters. PMID:23403371
Zhang, Juping; Jin, Zhen; Chen, Yuming
Cephalosporins have a role in the treatment of gonorrhoea, and especially infections caused by strains that are penicillin-resistant, either because they produce plasmid-mediated beta-lactamase or they have chromosomally mediated diminished permeability or modified penicillin-binding proteins. Although none of the oral or Group I agents are useful, most of the Group II, III and IV agents are, and especially cefuroxime, cefotaxime, ceftriaxone and cefoxitin. In addition to uncomplicated urethral, cervical or rectal infections, appropriate regimens are also effective for the treatment of pharyngeal infections, disseminated infections and gonococcal ophthalmia. The cephalosporins have no clear role in the treatment of syphilis, granuloma inguinale, Mycoplasma or chlamydial infections or bacterial vaginosis, but ceftriaxone may be effective in chancroid, and cefoxitin in combination with an antichlamydial agent (such as a tetracycline) might be used for the treatment of pelvic inflammatory disease. PMID:3319500
Individuals often stop reproducing some time before they die. In this paper we compose and analyze a logistic two-sex population model in which individuals form pairs just to mate (i.e. pair bonds are ephemeral) and later move on to sexually abstaining groups. Using this model, we study the impact of sexually abstaining groups on persistence of a benign sexually transmitted infection (STI) in populations with such ephemeral pair bonds. We observe that the presence of sexually abstaining groups cannot prevent an STI from invasion or eliminate it when already present if the transition rates to the sexually abstaining groups are independent of the infection status of individuals (susceptible or infected). On the other hand, if they depend on that status, the presence of sexually abstaining groups can prevent an STI from invasion or eliminate it when present. Specifically, in the simple case of sex-independent vital parameters, this happens if the transition rate of the infected individuals to the sexually abstaining group is higher than the transition rate of the susceptible ones. These results contrast the earlier results based on assuming long-term, stable pair bonds, in which case one is capable of preventing or eliminating the disease with the same isolation rate for the susceptible and infected individuals. PMID:21978737
Maxin, D; Berec, L; Covello, M; Jessee, J; Zimmer, M
Risky sexual behavior can lead to pregnancy, sexually transmitted 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.
A lack of investigation in specific regions has impeded the understanding of epidemiological trends in the prevalence of sexually transmitted 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
Kim, Jae Kyung
Objective To investigate the sexual and treatment?seeking behaviour for sexually transmitted infection (STI) in long?distance transport workers of East Africa. Methods A health?seeking behaviour survey was carried out at four sites on the Mombasa–Kampala trans?Africa highway (n?=?381). The questionnaires probed details of STI knowledge, symptoms and care?seeking behaviour. In one site at the Kenya–Uganda border, a sexual patterning matrix was used (n?=?202) to measure sexual behaviour in truck drivers and their assistants over the 12?month period before the interview. Results Over half of the sexual acts of long?distance transport workers over 12?months were with female sex workers, with an annual average of 2.8 sexual partners. Condom use was reported at 70% for liaisons with casual partners. 15% of truckers had had a self?reported STI and one?third exhibited high?risk sexual behaviour in the previous year. Of those with an STI, 85% had symptoms when on the road and 77.2% sought treatment within 1?week of onset of symptoms. 94% of drivers and 56% of assistants sought treatment for STI in a private health facility or pharmacy. The cost of private facilities and pharmacies was not significantly higher than in the public sector. Waiting times were three times longer in the public sector. Only 28.9% of patients completed their medication courses as prescribed. Conclusions Truck drivers and their assistants in East Africa have high rates of reported STIs and many continue to exhibit high?risk sexual behaviour. The transport workers studied here favoured private health facilities because of convenience and shorter waiting times.
Morris, Chester N; Ferguson, Alan G
Objectives. We examined disparities in risk determinants and risk behaviors for sexually transmitted infections (STIs) between gay-identified, bisexual-identified, and heterosexual-identified young men who have sex with men (YMSM) and heterosexual-identified young men who have sex with women (YMSW) using a school-based sample of US sexually active adolescent males. Methods. We analyzed a pooled data set of Youth Risk Behavior Surveys from 2005 and 2007 that included information on sexual orientation identity, sexual behaviors, and multiple STI risk factors. Results. Bisexual-identified adolescents were more likely to report multiple STI risk behaviors (number of sex partners, concurrent sex partners, and age of sexual debut) compared with heterosexual YMSW as well as heterosexual YMSM and gay-identified respondents. Gay, bisexual, and heterosexual YMSM were significantly more likely to report forced sex compared with heterosexual YMSW. Conclusions. Our results provide evidence that sexual health disparities emerge early in the life course and vary by both sexual orientation identity and sexual behaviors. In particular, they show that bisexual-identified adolescent males exhibit a unique risk profile that warrants targeted sexual health interventions. PMID:24825214
Everett, Bethany G; Schnarrs, Phillip W; Rosario, Margaret; Garofalo, Robert; Mustanski, Brian
Health-care seeking behaviour for sexually transmitted infection (STI)-related symptoms is not well known in the Netherlands. Within the framework of a large representative study, the second National Survey of General Practice (NIVEL 2001), 9687 persons aged 18 years and older were interviewed about their STI and STI-related health-care seeking behaviour. In total, 1.2% of the interviewees reported STI-related symptoms in the past year (18-24 years: 5%). A (lifetime) history of STI was reported by 2.7% (18-44 years: 4%). In all, 63% of interviewees visited their general practitioner (GP) for these complaints; 20% went to an STI-clinic and/or municipal public health services and 8% to a different care-provider. A total of 9% did not undertake any action. The majority of persons with STI-related symptoms in the Netherlands visit the GP. Reported history of STI-related symptoms was twice lower in the Netherlands compared with the UK National Sexual Health Survey. Appropriate attention for sexual health in primary care is needed. PMID:17609024
van Bergen, Jan Eam; Kerssens, Jan J; Schellevis, Francois G; Sandfort, Theo G; Coenen, Ton T; Bindels, Patrick J
A moment closure model of sexually transmitted disease spread through a concurrent partnership network is developed. The model employs pair approximations of higher-order correlations to derive equations of motion in terms of numbers of pairs and singletons. The model is derived from an underlying stochastic process of partnership network formation and disease transmission. The model is analysed numerically; and the final size and time evolution are considered for various levels of concurrency, as measured by the concurrency index kappa3 of Kretzschmar and Morris. Additionally, a new way of calculating R0 for spatial network models is developed. It is found that concurrency significantly increases R0 and the final size of a sexually transmitted disease, with some interesting exceptions.
Bauch, C; Rand, D A
ObjectivesTo propose a Bayesian approach to uncertainty analysis of sexually transmitted 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
The in-vitro activity of cefpirome was compared with other antibiotics against organisms causing sexually transmitted diseases (STD). The excellent activity of cefpirome against Neisseria gonorrhoeae (MIC90 1.0 mg/L), Haemophilus ducreyi (MIC90 0.5 mg/L), and Gardnerella vaginalis (MIC90 1.0 mg/L) suggests that this agent might be useful in the empirical treatment of a variety of venereal diseases. PMID:1318294
Limbert, M; Seibert, G; Winkler, I; Isert, D; Klesel, N; Markus, A; Schrinner, E
Objectives: In January 2007, opt-out HIV testing replaced provider-initiated testing at the sexually transmitted infections (STI) outpatient clinic in Amsterdam, The Netherlands. The effect of the opt-out strategy on the uptake of HIV testing was studied and factors associated with refusal of HIV testing were identified. Study Design: Data routinely collected at the STI clinic were analysed separately for men
R. L. J. Heijman; I. G. Stolte; H. F. J. Thiesbrummel; Leent van E; R. A. Coutinho; J. S. A. Fennema; M. Prins
A study was conducted to determine the prevalence rate and risk factors for sexually transmitted diseases (STDs) in Haiti's rural Artibonite Valley. Women attending antenatal services at Hospital Albert Schweitzer from October to December 1996 were tested for gonorrhea, chlamydia, trichomonas, syphilis, and human immunodeficiency virus (HIV). Of the 476 women tested, 121 (25.4%) had trichomonas, 11\\/475 (2.3%) had gonorrhea,
DANIEL W. FITZGERALD; FRIEDA BEHETS; ANGELA CALIENDO; DOMINIQUE ROBERFROID; CATHERINE LUCET; JENNIFER W. FITZGERALD; LUC KUYKENS
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 sexually transmitted 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
C. M Holland-Hall; H. C Wiesenfeld; P. J Murray
Objective To examine whether emergency contraceptive use predicts future sex at risk for pregnancy, pregnancy, or sexually transmitted infection among young women. Study Design A secondary analysis of control group participants (n=718) from a recent trial of advanced provision of emergency contraception. Results We found no association between use of emergency contraception and either pregnancy or infection. Recent use predicted decreased occurrence of subsequent sex at risk for pregnancy among women with a history of sexually transmitted infection (Relative Risk [RR], 0.39; 95% Confidence Interval [CI], 0.15, 0.97), while ever having used predicted increased occurrence among women who either were highly effective method users (RR, 1.45; 95% CI, 1.05, 2.01) or had no history of sexually transmitted infection (RR, 1.31; 95% CI, 1.04-1.65). Conclusions Information about prior emergency contraceptive use was not a useful predictor of subsequent pregnancy, infection, or sex at risk for pregnancy among these young women.
Sander, Petra M.; Raymond, Elizabeth G.; Weaver, Mark A.
The development of new, safe, topical microbicides for intravaginal use for the prevention of sexually transmitted diseases is imperative. Previous studies have suggested that bile salts may inhibit human immunodeficiency virus infection; however, their activities against other sexually transmitted pathogens have not been reported. To further explore the potential role of bile salts in preventing sexually transmitted diseases, we examined the in vitro activities and cytotoxicities of select bile salts against Chlamydia trachomatis, herpes simplex virus (types 1 and 2), Neisseria gonorrhoeae, and human immunodeficiency virus in comparison to those of nonoxynol-9 and benzalkonium chloride using both primary cells and cell lines derived from the human female genital tract. We found that taurolithocholic acid 3-sulfate and a combination of glycocholic acid and taurolithocholic acid 3-sulfate showed excellent activity against all of the pathogens assayed. Moreover, taurolithocholic acid 3-sulfate alone or in combination was less cytotoxic than nonoxynol-9 and benzalkonium chloride. Thus, taurolithocholic acid 3-sulfate alone or in combination warrants further evaluation as a candidate topical microbicidal agent.
Herold, Betsy C.; Kirkpatrick, Risa; Marcellino, Daniel; Travelstead, Anna; Pilipenko, Valentina; Krasa, Holly; Bremer, James; Dong, Li Jin; Cooper, Morris D.
Heteronormative assumptions can negatively influence the lives of young gay and bisexual men, and recent sociological analyses have identified the negative impacts of heteronormativity on heterosexual men (e.g. 'fag discourse' targeted at heterosexual adolescents). However, insights into how heteronormative discourses may be (re)produced in clinical settings and how they contribute to health outcomes for gay, bisexual and heterosexual men are poorly understood. This analysis draws on in-depth interviews with 45 men (15-25 years old) and 25 clinicians in British Columbia, Canada, to examine how heteronormative discourses affect sexually transmitted infection testing. The sexually transmitted infection/HIV testing experience emerged as a unique situation, whereby men's (hetero)sexuality was explicitly 'interrogated'. Risk assessments discursively linked sexual identity to risk in ways that reinforced gay men as the risky 'other' and heterosexual men as the (hetero)normal and, therefore, relatively low-risk patient. This, in turn, alleviated concern for sexually transmitted infection/HIV exposure in heterosexual men by virtue of their sexual identity (rather than their sexual practices), which muted discussions around their sexual health. The clinicians also positioned sexual identities and practices as important 'clues' for determining their patients' social contexts and supports while concurrently informing particular tailored clinical communication strategies. These findings highlight how men's experiences with sexually transmitted infection/HIV testing can (re)produce heteronormative assumptions and expectations or create opportunities for more equitable gendered relations and discourses. PMID:23117592
Knight, Rod; Shoveller, Jean A; Oliffe, John L; Gilbert, Mark; Goldenberg, Shira
The objective of this paper was to discusses historical developments of sexually transmitted disease (STD)/HIV sexual health policies in Britain, principally from the 19th to the 21st century. Repeating trends were identified and a consideration of how history addresses today's urgent need for better management of sexual health is discussed. In January 1747, the first venereal disease (VD) treatment was established at Lock Hospital, London. As the 19th century passed, sexuality emerged from a conspiracy of silence and became part of social consciousness. In Victorian times, prostitution was regarded with revulsion. Renewed medical interest in VD was brought about by improvements in medical knowledge from 1900-10. In the period 1913-17, there was a significant change in sexual health policy. From 1918, treatment centres increasingly recognized the difficulties in persuading attendees to return for a complete course of treatment. AIDS in Britain wrecked havoc in the period 1981-86 with incidences of infection in several widely differing groups and public alarm fuelled by the media. In conclusion, education, advertising and public health counselling need to be moulded effectively so that the public recognize the real risks associated with unprotected sexual intercourse. PMID:17945042
Cooper, R G; Reid, P D
The last few decades have provided new perspectives on the increasingly complex interrelationships between the evolutionary epidemiology of STDs and their agents, human sexuality, and economic, social, cultural, and technological developments. Rapidly emerging HIV/AIDS, globalization, migration, and information technology are some factors that stress the importance of focusing on how old and new sexually transmitted infections (STIs) are spread, both in and between networks and populations. This review of determinants of STI transmission emphasizes their impact on disease prevalence and transmission, as well as their potential for affecting the agents themselves--directly or indirectly. Interventions aiming to control the spread of STIs and HIV on the different levels of society need to be adapted to the specific environment and need to integrate social structures, such as economic and gender inequality and mobility, as well as the great variability and complexity of sexual behavior. PMID:21824166
Nahmias, Susa Beckman; Nahmias, Daniella
Background Sexually transmitted infections (STIs) and Reproductive tract infections (RTIs) are responsible for high morbidity among women. We aim to quantify the magnitude of the burden and risk factors of STI/RTI s among pregnant women in Zimbabwe. Methods A cross sectional study of pregnant women enrolled at 36 weeks of gestation from the national PMTCT program. Study was conducted from three peri-urban clinics around Harare Zimbabwe offering maternal and child health services. Results A total of 691 pregnant women were enrolled. Prevalence of HSV was (51.1%), HIV (25.6%) syphilis (1.2%), Trichomonas vaginalis (11.8%), bacterial vaginosis (32.6%) and Candidiasis (39.9%). Seven percent of the women had genital warts, 3% had genital ulcers and 28% had an abnormal vaginal discharge. Prevalence of serological STIs and vaginal infections were 51% and 64% respectively. Risk factors for a positive serologic STI were increasing age above 30 years, polygamy and multigravid; adjusted OR (95% CI) 2.61(1.49-4.59), 2.16(1.06-4.39), 3.89(1.27-11.98) respectively, partner taking alcohol and number of lifetime sexual partners. For vaginal infections it was age at sexual debut; OR (95% CI) 1.60(1.06-2.42). More than 25% of the women reported previous STI treatment. Fifty two percent reported ever use of condoms and 65% were on oral contraceptives. Mean age gap for sexual partners was 6.3 years older. Conclusions There is a high morbidity of STI/RTIs in this cohort. There is need to continuously screen, counsel, treat and monitor trends of STI/RTIs to assess if behaviour changes lead to reduction in infections and their sustainability.
Sexually Transmitted Diseases (STDs) among men not only jeopardize their own health but also increase sexual morbidities among their spouses. STDs are primarily attributed to high-risk sexual behavior. The study was carried out among male patients attending the OPD of a Government dispensary. Risk taking behavior was assessed using a structured, pre-tested questionnaire and STDs were diagnosed using syndromic approach supported by laboratory investigations. Three hundred two men were selected by systemic random sampling for inclusion in the study. 39% had pre-marital sexual relationship, 20% had sex with Commercial Sex Workers. 12% of the married men had extramarital sex mostly with CSWs. 27% had more than one sex partner ever. Only 3.6% used condoms consistently. Thirteen per cent respondents had history of symptoms suggestive of STDs. Prevalence of syphilis, gonorrhea and other STDs among study subjects were 3.6%, 0.7% and 0.7% respectively. High risk sexual behavior is widely prevalent and STDs are also common. Behavior change communication and early diagnosis and prompt treatment of STDs will reduce the burden significantly. PMID:16637401
Gupta, Pushpa; Sharma, Arun Kr; Ramachandran, V G
Objectives: To estimate the lifetime prevalence of four sexually transmitted infections (STIs) and to identify correlates of these infections among patients seeking care for a substance use disorder at a specialized DeAddictions unit in southern India. Methods: Consecutive inpatients (n = 361; 97% male; M age = 36.7 years) admitted to DeAddictions Unit of the National Institute of Mental Health and Neuro Sciences in Bangalore, India, participated in a structured interview to obtain demographic, psychiatric, sexual behavior, and substance use data; and provided a blood sample for serologic testing for HIV, chlamydia, syphilis, and Hepatitis B. Results: One-quarter of all patients tested positive for at least one STI. Lifetime seroprevalence rates were 12.9% for syphilis, 10.3% for chlamydia, 3.1% for Hepatitis B, and 1.1% for HIV. Analyses did not reveal any consistent pattern of associations between STI status and sociodemographic, psychiatric, and sexual behavioral characteristics. Conclusions: All patients should receive a comprehensive sexual assessment during standard care; for those patients who report risky sexual practices, we recommend voluntary counseling and serologic testing for STIs. Although we do not recommend universal testing for STIs at this time, this should be revisited based upon national epidemiologic surveillance data.
Carey, Michael P.; Ravi, V.; Chandra, Prabha S.; Desai, Anita; Neal, Dan J.
In female sexually transmitted infection clinic attendees, Mycoplasma genitalium was more frequently detected using vaginal (53/73) versus endocervical (43/73) specimens. In women without other sexually transmitted infections, M. genitalium detection (N = 44) was associated with age ?22 years (odds ratio, 2.53; P = 0.006) and clinical evidence of cervicitis (odds ratio, 2.11; P = 0.03). PMID:22902666
Mobley, Victoria L; Hobbs, Marcia M; Lau, Karen; Weinbaum, Barbara S; Getman, Damon K; Seña, Arlene C
This paper examines the impacts of four abstinence-only education programs on adolescent sexual activity and risks of pregnancy and sexually transmitted 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
OBJECTIVES: To review the scientific data on the role of sexually transmitted diseases (STDs) in sexual transmission of HIV infection and discuss the implications of these findings for HIV and STD prevention policy and practice. METHODS: Articles were selected from a review of Medline, accessed with the OVID search engine. The search covered articles from January 1987 to September 1998
D. T. Fleming; J. N. Wasserheit
This study aimed to assess associations between school HIV education and protective sexual behaviors and sexually transmitted 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.
INTRODUCTION--Patients attending a clinic for sexually transmitted diseases (STD) in general have engaged in at risk sexual behaviour. Therefore they are at increased risk of acquiring HIV through sexual contact. OBJECTIVE--To determine the HIV prevalence among patients attending a STD clinic in Amsterdam. METHODS--An anonymous cross sectional study was conducted in two 5-week periods in Spring and Autumn 1991. RESULTS--Of
J S Fennema; E J van Ameijden; R A Coutinho; G J van Doornum; C J Henquet; J A van den Hoek
OBJECTIVE: To investigate the in vitro microbicidal and cytocidal potency of monocaprin dissolved in pharmaceutical hydrogel formulations and to evaluate their potential use as vaginal microbicides against sexually transmitted pathogens such as herpes simplex virus type 2 (HSV-2), human immunodeficiency virus type 1 (HIV-1), Chlamydia trachomatis, and Neisseria gonorrhoeae. METHODS: Gel formulations were mixed with equal volumes of virus/bacteria suspensions in culture medium and incubated for 1 and 5 minutes. The reduction in virus/bacteria titre was used as a measure of microbicidal activity. Similarly, gels were mixed with human semen to study their effect on leucocytes. The toxicity of the gels was tested in rabbits by the standard vaginal irritation test. RESULTS: Gels containing 20 mM of monocaprin caused a greater than 100,000-fold inactivation of HSV-2 and Neisseria in 1 minute and of Chlamydia in 5 minutes. Similarly, the gels caused a greater than 10,000-fold inactivation of HIV-1 in semen in 1 minute. They caused more than a 10,000-fold reduction in the number of viable leucocytes in semen in 1 minute. No toxic effect on the vaginal mucosa of rabbits was observed after daily exposure for 10 days. CONCLUSIONS: Hydrogels containing monocaprin are potent inactivators of sexually transmitted viruses and bacteria in vitro. This simple lipid seems to be a feasible choice as a mucosal microbicide for prevention of sexually transmitted infections. It is a natural compound found in certain foodstuffs such as milk and is therefore unlikely to cause harmful side effects in the concentrations used. ???
Thormar, H.; Bergsson, G.; Gunnarsson, E.; Georgsson, G.; Witvrouw, M.; Steingrimsson, O.; De Clercq, E.; Kristmundsdottir, T.
Prevalence rates of many sexually transmitted infections (STIs) are highest among adolescents. If nonviral STIs are detected early, they can be treated, transmission to others can be eliminated, and sequelae can be averted. The US Preventive Services Task Force and the Centers for Disease Control and Prevention have published chlamydia, gonorrhea, and syphilis screening guidelines that recommend screening those at risk on the basis of epidemiologic and clinical outcomes data. This policy statement specifically focuses on these curable, nonviral STIs and reviews the evidence for nonviral STI screening in adolescents, communicates the value of screening, and outlines recommendations for routine nonviral STI screening of adolescents. PMID:24982099
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 sexually transmitted 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.
We explored STD (sexually transmitted disease) service preferences among 108 African-American adolescent males recruited from a high-morbidity neighborhood. Participants largely preferred to seek care at traditional STD testing venues (86.5%) rather than nontraditional venues. Additionally, most males preferred receiving STD test results from a clinician (61.1%) rather than online (11.1%) or through email or text message (12.0%). These results highlight the need for continued strengthening of traditional public health clinics to ensure capacity to meet young men's health needs and to improve outreach and access to traditional STD services for young men. PMID:22592826
Saadatmand, Heva Jasmine; Bernstein, Kyle T; McCright, Jacqueline; Gallaread, Alonzo; Philip, Susan S; Lippman, Sheri A
Intracellular reorganization of secretory epitheliocytes in the main, intermediate, and periurethral prostatic glands was studied in chronic prostatitis under conditions of sexually-transmitted infections. The destructive and autophagic processes in the secretory epitheliocytes were stimulated by persistence of microorganisms, Mycoplasmataceae (mainly mycoplasmas and ureaplasmas) and Chlamydia trachomatis, in the prostatic terminal compartments, epithelial layer, and epitheliocytes. Significant intracellular reorganization of smooth-muscle cells was found: focal destruction of ultrastructures (mainly in the perinuclear zone) and lythic changes in the myofilaments (focal and diffuse). PMID:22816103
Lushnikova, E L; Nepomnyashchikh, L M; Abdullaev, N A; Klepikova, I I; Molodykh, O P; Neimark, A I
Data are presented from an investigation designed to study market of medical services delivered to patients with sexually transmitted 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
Martynenko, A V
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 migrant women in Atlanta and their sisters or sisters-in-law in Mexico. Results. Both younger and older women acknowledged that migrant men’s sexual behavior may expose them to HIV and other sexually transmitted diseases.Younger Mexican women in both communities expressed a marital ideal characterized by mutual intimacy, communication, joint decisionmaking, and sexual pleasure, but not by willingness to use condoms as an HIV prevention strategy. Conclusions. Migrant Mexican women’s commitment to an illusion of fidelity will hinder HIV prevention initiatives targeted toward them. Furthermore, the changing meanings of marital sex may make it harder to convince young couples to use condoms as an HIV prevention strategy. If the chain of heterosexual marital HIV transmission is to be interrupted in this community, prevention programs must target men. (Am J Public Health. 2002;92:1227–1237)
Hirsch, Jennifer S.; Higgins, Jennifer; Bentley, Margaret E.; Nathanson, Constance A.
Although recent data have supported the role of heterosexual activity in the transmission of hepatitis B virus infection in women, studies generating these data have enrolled few black women. We therefore examined black female participants attending our local health department's sexually transmitted disease clinic for the treatment of presumed uncomplicated gonorrhea in serologic and risk-factor surveys of hepatitis B virus infection. Twenty-four (17.6%) of 136 subjects tested had evidence of prior hepatitis B infection. Serologic evidence of hepatitis B infection was significantly associated with three different barometers of sexual activity that included: (1) years of sexual activity (P less than 0.005); (2) history of sexually transmitted disease (P less than 0.02); and (3) number of lifetime heterosexual partners (P less than 0.001). These data provide further support that the quantity of sexual exposure seems to be an important risk factor for hepatitis B infection in heterosexually active females. PMID:3227474
Baddour, L M; Bucak, V A; Somes, G; Hudson, R
Introduction and background At the time of incarceration, women have a high prevalence of sexually transmitted infections (STI). In the months following community release, women remain at high risk for new infections. This study assessed the rates and predictors of incident Chlamydia, Gonorrhea, and Trichomoniasis in a sample of hazardously-drinking women following incarceration. Methods Self-reported behavioral data were collected from 245 incarcerated women. Vaginal swabs were collected at baseline, 3-, and 6-month time-points and tested for Chlamydia, Gonorrhea, and Trichomoniasis. Treatment was provided for all positive tests. Results Participants’ mean age was 34.1 years of age, 175 (71.4%) (n=175) were Caucasian, 47 (19.2%) were African-American, 17 (6.9%) were Hispanic and 6 (2.4%) were of other ethnic origins. The STI incidence rate was estimated to be 30.5 (95%CI 21.3 – 43.5) new infections per 100 person-years. Number of male sex partners reported during follow-up was a significant (z = 2.16, p = .03) predictor of STI; each additional male sex partner increased the estimated hazard of STI by 1.26. Conclusions and discussion Incarcerated women who are hazardous drinkers are at high risk for sexually transmitted infection in the months following their return to the community. In addition to testing and treatment during incarceration, post-release rescreening, education, partner treatment, and follow-up are recommended.
Stein, Michael D.; Caviness, Celeste M.; Anderson, Bradley J.
Background.?A genetic bottleneck is known to exist for human immunodeficiency virus (HIV) at the point of sexual transmission. However, the nature of this bottleneck and its effect on viral diversity over time is unclear. Methods.?Interhost and intrahost HIV diversity was analyzed in a stable population in Rakai, Uganda, from 1994 to 2002. HIV-1 envelope sequences from both individuals in initially HIV-discordant relationships in which transmission occurred later were examined using Sanger sequencing of bulk polymerase chain reaction (PCR) products (for 22 couples), clonal analysis (for 3), and next-generation deep sequencing (for 9). Results.?Intrahost viral diversity was significantly higher than changes in interhost diversity (P < .01). The majority of HIV-1–discordant couples examined via bulk PCR (16 of 22 couples), clonal analysis (3 of 3), and next-generation deep sequencing (6 of 9) demonstrated that the viral populations present in the newly infected recipient were more closely related to the donor partner's HIV-1 variants found earlier during infection as compared to those circulating near the estimated time of transmission (P = .03). Conclusions.?These findings suggest that sexual transmission constrains viral diversity at the population level, partially because of the preferential transmission of ancestral as opposed to contemporary strains circulating in the transmitting partner. Future successful vaccine strategies may need to target these transmitted ancestral strains.
Redd, Andrew D.; Collinson-Streng, Aleisha N.; Chatziandreou, Nikolaos; Mullis, Caroline E.; Laeyendecker, Oliver; Martens, Craig; Ricklefs, Stacy; Kiwanuka, Noah; Nyein, Phyu Hninn; Lutalo, Tom; Grabowski, Mary K.; Kong, Xiangrong; Manucci, Jordyn; Sewankambo, Nelson; Wawer, Maria J.; Gray, Ronald H.; Porcella, Stephen F.; Fauci, Anthony S.; Sagar, Manish; Serwadda, David; Quinn, Thomas C.
Seminal plasma is not just a spermatozoa carrier. It induces the expression of inflammatory cytokines and chemokines and a massive infiltration of neutrophils, monocytes and dendritic cells in the female genital mucosa after coitus, enabling the innate immune system to fight against sexually transmitted pathogens. However, exposure to seminal plasma not only turns on an inflammatory response but also induces regulatory mechanisms that allow the fetus (a semiallograft) to grow and develop in the uterus. In mouse models it has been shown that seminal plasma induces the expansion of regulatory T cells specific to seminal Ags in the receptive partner, thus promoting tolerance to paternal alloantigens and avoiding allogeneic fetal rejection. These mechanisms appear to be mainly induced by prostaglandins of the E series (PGE) and TGF-?, which are present at huge concentrations in the seminal plasma. Moreover, we have recently shown that exposure to seminal plasma induces the differentiation of dendritic cells into a tolerogenic profile through a mechanism dependent on the activation of the prostanoid receptors EP2 and EP4 by seminal PGE. Our hypothesis proposes that this tolerogenic response induced by seminal PGE, while promoting fertility by inducing tolerance toward paternal alloantigens, might also compromise the development of the adaptive immune response against sexually transmitted pathogens in the receptive partner. PMID:24837236
Remes Lenicov, F; Varese, A; Merlotti, A; Geffner, J; Ceballos, A
In the United States statistics on sexually transmitted diseases (STDs), other than gonorrhoea and syphilis, are meagre. In this study the relative and seasonal incidences of most STDs in an American clinic where 34,938 patient visits were recorded over a two-year period (1975-76) are assessed. Gonorrhoea was the most common STD in male and female patients combined (18%), while nongonococcal urethritis (NGU) was most common in men (23%), and vaginitis (trichomonal 7.5%, yeast 7.1%, and non-specific 7.1%) was the most common in women. A significantly higher incidence of NGU occurred in Caucasian (63%) than in black (42%) men (P less than 0.005). No other STD was diagnosed in more than 5% of patients, and 31% had normal findings on clinical examination and investigation, and could be described as the 'worried well'. Two or more STDs co-existed in 4.2% of patients. In 1976 the incidence of genital herpes and scabies decreased in contrast to other STDs and total patient visits, which increased. A seasonal peak in late summer and early autumn was observed for most STDs. These observations indicate the importance of a comprehensive approach when attempting to compile accurate statistics on selected epidemiological aspects of sexually transmitted diseases.
Wright, R A; Judson, F N
Introduction Practice protocols that mandate prescreening for sexually transmitted infection prior to insertion of an intrauterine device for contraception can pose obstacles for women seeking this highly effective method of birth control. Some practices screen for presumed risk factors for sexually transmitted infection in order to identify those who may be infected or those in whom laboratory testing should be obtained. The value of such criterion-based screening is unclear. Methods Data from a prospective observational trial of offering the copper intrauterine device for emergency contraception were used to assess the value of several screening questions in predicting the presence of sexually transmitted infection. Criteria evaluated were age under 25 years, history of a sexually transmitted infection, and having 2 or more sexual partners in the previous 3 months. The sensitivity, specificity, and likelihood ratio of both positive and negative test results and positive and negative predictive values were calculated for 3 separate questions as well as for combinations of these 3 questions. Results There were 197 women who received a copper intrauterine device for emergency contraception at the same time they were tested for sexually transmitted infection. In this sample, there were 8 cases of Chlamydia trachomatis identified and no cases of Neisseria gonorrhoeae. The sensitivity of individual and combined questions in identifying those who were infected ranged from 0% to 88%; specificity ranged from 37% to 97%. The positive predictive values for single or combined screening questions were in the range of 4% to 6%. Likelihood ratios for both positive and negative test results did not change posttest likelihood of disease in any appreciable way. Discussion Standard screening questions used to identify sexually transmitted infection risk could presume infection in large numbers of uninfected women and are of little value in identifying the women who are truly infected.
Murphy, Patricia; Jacobson, Janet; Turok, David K.
Using population-based and family structural data from a high HIV-prevalence district of Southern India, this paper considers four suggested social scenarios used to explain the positive correlation between HIV prevalence and previously married status among Indian women: (1) infection from and then bereavement of an infected husband; (2) abandonment after husbands learn of their wives' HIV status; (3) economic instability after becoming previously married, leading women to seek financial support through male partners; and (4) the social status of being previously married exposing women to sexual harassment and predation. By also considering seroprevalence of two other common sexually transmitted infections (STIs), herpes and syphilis, in a combined variable with HIV, we limit the likelihood of the first two scenarios accounting for the greater part of this correlation. Through a nuanced analysis of household residences patterns (family structure), standard of living, and education, we also limit the probability that scenario three explains a greater portion of the correlation. Scenario four emerges as the most likely explanation for this correlation, recognizing that other scenarios are also possible. Further, the interdisciplinary literature on the social position of previously married women in India strongly supports the suggestion that, as a population, previously married women are sexually vulnerable in India. Previously married status as an STI risk factor requires further biosocial research and warrants concentrated public health attention. PMID:22519844
Walters, Kimberly; Dandona, Rakhi; Walters, Lawrence C; Lakshmi, Vemu; Dandona, Lalit; Schneider, John A
Using population-based and family structural data from a high HIV-prevalence district of southern India, this paper considers four suggested social scenarios used to explain the positive correlation between HIV prevalence and previously married status among Indian women: I) infection from and then bereavement of an infected husband; II) abandonment after husbands learn of their wives’ HIV status; III) economic instability after becoming previously married, leading women to seek financial support through male partners; IV) the social status of being previously married exposing women to sexual harassment and predation. By also considering seroprevalence of two other common sexually transmitted infections (STI), herpes and syphilis, in a combined variable with HIV, we limit the likelihood of the first two scenarios accounting for the greater part of this correlation. Through a nuanced analysis of household residences patterns (family structure), standard of living and education, we also limit the probability that scenario three explains a greater portion of the correlation. Scenario four emerges as the most likely explanation for this correlation, recognizing that other scenarios are also possible. Further, the interdisciplinary literature on the social position of previously married women in India strongly supports the suggestion that, as a population, previously married women are sexually vulnerable in India. Previously married status as an STI risk factor requires further biosocial research and warrants concentrated public health attention.
Walters, Kimberly; Dandona, Rakhi; Walters, Lawrence C.; Dandona, Lalit; Lakshmi, Vemu; Schneider, John A.
A cross-sectional study was conducted among youth clients of hotel-based female sex workers (YCHBFSWs) in nine randomly selected hotels in Bangladesh to examine sexual-risk behaviour, condom use and determinants of condom use in last sex, knowledge of HIV, sexually transmitted infection (STI) prevalence and STI care-seeking behaviour. A prestructured questionnaire was used to collect sociodemographic, behavioural, clinical information; urine specimens (before sex) and blood were collected for diagnosis of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and herpes simplex virus 2 (HSV2) infection. One thousand and thirteen participants were enroled in the study. Approximately half of them reported visiting female sex workers (FSWs) at least once a month and 25% visited FSWs at least once a week. Only 12% of participants reported regular condom use. The prevalence of N. gonorrhoeae, C. trachomatis, T. vaginalis, syphilis and HSV2 was 2.2%, 3.9%, 7.2%, 2.6% and 12.9%, respectively. Only 15.3% of the YCHBFSW sought STI care in the past year. Negotiation of condom use with FSWs was the main determinant (odds ratio = 17.95) for condom use at last sex. Male clients of FSWs, including YCHBFSW, are an important bridge population for HIV transmission in Bangladesh and HIV interventions should be designed and implemented for them. PMID:22930291
Haseen, F; Chawdhury, F A H; Hossain, M E; Huq, M; Bhuiyan, M U; Imam, H; Rahman, D M M; Gazi, R; Khan, S I; Kelly, R; Ahmed, J; Rahman, M
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 sexually transmitted 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.
Tanton, Clare; Mercer, Catherine H; Nicholson, Soazig; Soldan, Kate; Beddows, Simon; Ison, Catherine; Johnson, Anne M; Sonnenberg, Pam
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 sexually transmitted 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
This paper examines the reporting of sexual and other risk behaviors within a randomized experiment using a computerized versus face-to-face interview mode. Biomarkers for sexually transmitted infection (STI) were used to validate self-reported behavior by interview mode. As part of a parent study evaluating home versus clinic screening and diagnosis for STIs, 818 women aged 18?40 years were recruited in 2004 at or near a primary care clinic in São Paulo, Brazil, and were randomized to a face-to-face interview or audio computer-assisted self-interviewing. Ninety-six percent of participants were tested for chlamydia, gonorrhea, and trichomoniasis. Reporting of STI risk behavior was consistently higher with the computerized mode of interview. Stronger associations between risk behaviors and STI were found with the computerized interview after controlling for sociodemographic factors. These results were obtained by using logistic regression approaches, as well as statistical methods that address potential residual confounding and covariate endogeneity. Furthermore, STI-positive participants were more likely than STI-negative participants to underreport risk behavior in the face-to-face interview. Results strongly suggest that computerized interviewing provides more accurate and reliable behavioral data. The analyses also confirm the benefits of using data on prevalent STIs for externally validating behavioral reporting.
Mensch, Barbara S.; de A. Ribeiro, Manoel Carlos S.; Jones, Heidi E.; Lippman, Sheri A.; Montgomery, Mark R.; van de Wijgert, Janneke H. H. M.
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 sexually transmitted 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
Thrall, P H; Antonovics, J; Dobson, A P
More than 340 million cases of bacterial and protozoal sexually transmitted infections (STIs) occur annually. Approximately 70,000 refugees arrive in the United States on a yearly basis. Refugees are a particularly disenfranchised and vulnerable population. The prevalence of Chlamydia and gonorrhea in refugee populations has not been described, and the utility of routine screening is unknown. We performed a descriptive evaluation of 25,779 refugees who completed a screening medical examination in Minnesota during 2003–2010. A total of 18,516 (72%) refugees were tested for at least one STI: 183 (1.1%) of 17,235 were seropositive for syphilis, 15 (0.6%) of 2,512 were positive for Chlamydia, 5 (0.2%) of 2,403 were positive for gonorrhea, 136 (2.0%) of 6,765 were positive for human immunodeficiency virus, and 6 (0.1%) of 5,873 were positive for multiple STIs. Overall prevalence of Chlamydia (0.6%) and gonorrhea (0.2%) infection was low, which indicated that routine screening may not be indicated. However, further research on this subject is encouraged.
Stauffer, William M.; Painter, John; Mamo, Blain; Kaiser, Robyn; Weinberg, Michelle; Berman, Stuart
At present very little information is available on the prevalence and pattern of sexually transmitted diseases (STDs) in many countries of tropical Africa. The available evidence does, however, suggest that these diseases are highly prevalent and that a considerable reservoir of infection exists among the female population. Gonorrhoea is probably the most commonly recognised STD in tropical Africa, frequently causing epididymitis and urethral stricture in men and salpingitis and pelvic inflammatory disease in women. The prevalence of a infectious syphilis is still high, particularly the late manifestations of the disease. The prevalence of the other STDs is also high. Thus, the problem is clearly very serious and the need for improving facilities for diagnosis and treatment urgent; some attempt also must be made to initiate control measures.
Osoba, A O
This report summarizes incidence rates of the five most commonly diagnosed sexually transmitted infections (STIs) among active component service members of the U.S. Armed Forces during 2000 to 2012. Human papillomavirus (HPV) infections were the most common, followed in decreasing order of frequency by infections associated with chlamydia, herpes simplex virus, gonorrhea, and syphilis. Compared to their counterparts, women, younger service members, soldiers, and enlisted members had higher incidence rates of each STI. Rates tended to be lower among married personnel. Rates of chlamydia, HPV, and gonorrhea diagnoses were notably higher among women during 2006 to 2008 but rates of the latter two infections have since declined sharply. The relatively recent introduction of STI screening among young service women and the HPV vaccine are discussed. PMID:23461303
This paper employs syndemics theory to explain high rates of sexually transmitted 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 paper argues that respondents employed a cultural logic of risk assessment which put them at high risk for STD infection. This cultural logic was shaped by their experiences of growing up in the inner city which included: coming of age in an impoverished family, living in a broken home, experiencing domestic violence, limited expectations of the future, limited exposure to positive role models, lack of expectation of the dependency of others, and fear of intimacy. PMID:16782250
Singer, Merrill C; Erickson, Pamela I; Badiane, Louise; Diaz, Rosemary; Ortiz, Dugeidy; Abraham, Traci; Nicolaysen, Anna Marie
This paper provides a brief history of sexually transmitted diseases (STDs) in Thailand. The presentation is divided into three main sections: the period up to the 1930s; the period from the 1930s until the end of the early 1980s; and the period from the early 1980s until the present, the so-called 'AIDS Era'. The discussion in each of these sections focuses, as far as sources permit, on the epidemiological picture, as well as describing public and official responses to these diseases. In the final part of the paper consideration is given to these findings in relation to the present situation in Thailand regarding the HIV/AIDS epidemic.
Bamber, S D; Hewison, K J; Underwood, P J
China has experienced an increasing epidemic of sexually transmitted 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.
The relationship between sexually transmitted infections (STIs) and prostate cancer (PC) remains inconclusive. Moreover, all such studies to date have been conducted in Western populations. This study aimed to investigate the risk of PC following STI using a population-based matched-cohort design in Taiwan. The study cohort comprised 1055 patients with STIs, and 10 550 randomly selected subjects were used as a comparison cohort. Cox proportional hazards regression analysis revealed that the hazard ratio for PC during the 5-year follow-up period for patients with a STI was 1.95 (95% confidence interval 1.18-3.23), that of comparison subjects after adjusting for urbanization level, geographical region, monthly income, hypertension, diabetes, hyperlipidaemia, obesity, chronic prostatitis, history of vasectomy, tobacco use disorder, and alcohol abuse. We concluded that the risk of PC was higher for men who were diagnosed with a STI in an Asian population. PMID:23461984
Chung, S D; Lin, Y K; Huang, C C; Lin, H C
Beginning in 1946, the United States government immorally and unethically-and, arguably, illegally-engaged in research experiments in which more than 5000 uninformed and unconsenting Guatemalan people were intentionally infected with bacteria that cause sexually transmitted diseases. Many have been left untreated to the present day. Although US President Barack Obama apologized in 2010, and although the US Presidential Commission for the Study of Bioethical Issues found the Guatemalan experiments morally wrong, little if anything has been done to compensate the victims and their families. We explore the backdrop for this unethical medical research and violation of human rights and call for steps the United States should take to provide relief and compensation to Guatemala and its people. PMID:24134370
Rodriguez, Michael A; García, Robert
Beginning in 1946, the United States government immorally and unethically—and, arguably, illegally—engaged in research experiments in which more than 5000 uninformed and unconsenting Guatemalan people were intentionally infected with bacteria that cause sexually transmitted diseases. Many have been left untreated to the present day. Although US President Barack Obama apologized in 2010, and although the US Presidential Commission for the Study of Bioethical Issues found the Guatemalan experiments morally wrong, little if anything has been done to compensate the victims and their families. We explore the backdrop for this unethical medical research and violation of human rights and call for steps the United States should take to provide relief and compensation to Guatemala and its people.
Rodriguez, Michael A.; Garcia, Robert
Sera from 500 (496 male and 4 female) consecutive patients with sexually transmitted diseases (STD) were examined for the presence of HIV1 antibodies. The serological tests were done using the ELISA (Wellcozyme) and confirmed by the western blot (Biorad). Sixty (12%) of the 500 patients were HIV-1 antibody positive. Seropositivity varied with the type of STD. A positivity rate of 16% seen with genital ulcer disease is significantly higher than the 7% prevalence rate seen in STD patients with urethral discharge. Infection with more than one kind of STD increases seropositivity significantly. Of the potential risk factors identified during the interview it seems that only shaving at barbers' shop is positively associated with seroprevalence. This study suggests that the presence of STDs is associated with an increased HIV-1 seroprevalence. Therefore, any effort to reduce HIV-1 infection should aim at the control of STDs. PMID:2060508
Kefenie, H; Desta, B; Mengesha, S; Zewide, D; Kebede, T
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 sexually transmitted 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.
Frange, Pierre; Meyer, Laurence; Jung, Matthieu; Goujard, Cecile; Zucman, David; Abel, Sylvie; Hochedez, Patrick; Gousset, Marine; Gascuel, Olivier; Rouzioux, Christine; Chaix, Marie-Laure
We develop a moment closure approximation (MCA) to a network model of sexually transmitted disease (STD) spread through a steady/casual partnership network. MCA has been used previously to approximate static, regular lattices, whereas application to dynamic, irregular networks is a new endeavour, and application to sociologically-motivated network models has not been attempted. Our goals are 1). to investigate issues relating to the application of moment closure approximations to dynamic and irregular networks, and 2). to understand the impact of concurrent casual partnerships on STD transmission through a population of predominantly steady monogamous partnerships. We are able to derive a moment closure approximation for a dynamic irregular network representing sexual partnership dynamics, however, we are forced to use a triple approximation due to the large error of the standard pair approximation. This example underscores the importance of doing error analysis for moment closure approximations. We also find that a small number of casual partnerships drastically increases the prevalence and rate of spread of the epidemic. Finally, although the approximation is derived for a specific network model, we can recover approximations to a broad range of network models simply by varying model parameters which control the structure of the dynamic network. Thus our moment closure approximation is very flexible in the kinds of network models it can approximate. PMID:12424529
Bauch, C T
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 sexually transmitted 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.
Chen, Feng; Li, Chunguang
Incarcerated women are at high risk for sexually transmitted 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 the self-report baseline assessment. Participants averaged 34.1 (± 8.9) years of age; 174 (71.3%) were non-Hispanic Caucasian, 47 (19.3%) were African-American, 17 (7.0%) were Hispanic, and 6 (2.5%) were of other racial or ethnic origins. Twenty-three percent of participants tested positive for Chlamydia, Trichomonas, or Gonorrhea. Being African-American, more frequent sex with a casual partner, and reporting more than one male partner were significantly positively related to STI, while more frequent sex with a main partner was inversely related. Due to the high rates of infection in this population, jail admission provides a public health opportunity to access a concentrated group of STI-infected women. STI testing targeted at specific demographic factors, for instance younger age, will miss infected women. Risky sexual partnerships, as well as the benefit of maintaining stable main partnerships may be important topics during STI prevention interventions.
Caviness, Celeste M.; Anderson, Bradley J.; Stein, Michael D.
Objectives To identify partner attributes associated with sexually transmitted 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.
Swartzendruber, Andrea; Zenilman, Jonathan M.; Niccolai, Linda M.; Kershaw, Trace S.; Brown, Jennifer L.; DiClemente, Ralph J.; Sales, Jessica M.
In Los Angeles County, the GIG intervention offers education to adolescents about pregnancy and sexually transmitted 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…
de Anda, Diane
Proctitis caused by Chlamydia trachomatis L2b can manifest with very mild, nonspecific symptoms, and appropriate diagnostic evaluation is crucial. The case report demonstrates that rapid screening test, detection of specific antibodies in serum, and direct pathogen identification by PCR performed on tissue sample or rectal swab allow successful diagnosis of the still emerging sexually transmitted disease among homosexual patients. PMID:23806660
Markowicz, Mateusz; Grilnberger, Evelyn; Huber, Florian; Leibl, Gabriele; Abrahamian, Heidemarie; Gartner, Manfred; Huber, Monika; Chott, Andreas; Reiter, Michael; Stanek, Gerold
BACKGROUND: Sexually transmitted infections (STIs) and Reproductive tract infections (RTIs) are responsible for high morbidity among women. We aim to quantify the magnitude of the burden and risk factors of STI\\/RTI s among pregnant women in Zimbabwe. METHODS: A cross sectional study of pregnant women enrolled at 36 weeks of gestation from the national PMTCT program. Study was conducted from
Nyaradzai E Kurewa; Munyaradzi P Mapingure; Marshal W Munjoma; Mike Z Chirenje; Simbarashe Rusakaniko; Babill Stray-Pedersen
This paper proposes that international sexually transmitted disease (STD)/HIV prevention efforts might be enhanced by the application of social marketing principles. It first outlines the conceptual basis of social marketing approaches to health behaviour change generally and then explores key issues and opportunities for using these principles to improve current STD/HIV prevention efforts. PMID:9792356
Lamptey, P R; Price, J E
We aimed to identify patient perceptions of barriers to discussing sexually transmitted infections (STIs) at the primary care level. An anonymous questionnaire was available to patients (16–70 years) in the waiting room of four metropolitan Perth general practices. Results are based on 370 participant views (9.5% of the potential target population). Patients felt comfortable discussing STIs with their general practitioner
Joanne R Baker; Diane E Arnold-Reed; Tom Brett; Dana A Hince; Ilse OFerrall; Max K Bulsara
Our study focused on two topics, Sexually Transmitted Infections (STIs) and their control using condoms. For this, we analysed and compared 42 school textbooks from 16 countries on the general topic "Human Reproduction and Sex Education" using a specific grid designed by the BIOHEAD-Citizen project. Acquired Immune Deficiency Syndrome (AIDS) was a…
Bernard, Sandie; Clement, Pierre; Carvalho, Graca; Gilda, Alves; Berger, Dominique; Thiaw, Seyni Mame; Sabah, Selmaoui; Salaheddine, Khzami; Skujiene, Grita; Abdelli, Sami; Mondher, Abrougui; Calado, Florbela; Bogner, Franz; Assaad, Yammine
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 sexually transmitted 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
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 sexually transmitted 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.
Hoffman, Susie; Higgins, Jenny A.; Beckford-Jarrett, Sharlene T.; Augenbraun, Michael; Bylander, Kimberly E.; Mantell, Joanne E.; Wilson, Tracey E.
Sexually transmitted 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
Arya, O P; Lawson, J B
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 sexually transmitted 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
Adamo, Shelley A
This paper reviews the scientific basis for trials exploring the relation between sexually transmitted 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.
Hudson, C. P.
Background Reproductive tract infections (RTI) and sexually transmitted infections (STI) are often subclinical and remain undetected. The current study aimed to estimate the burden of RTI/STI, associated symptoms, risk factors and the impact of the condition on quality of life (QOL). Methods A community based, cross sectional study was conducted. Married women aged 18 to 49 years were selected through systematic random sampling in a rural area. A semi-structured questionnaire was used to evaluate socio-demographic characteristics, symptoms, risk factors and knowledge regarding RTI/STI. A standardized instrument from the World Health Organization (WHO-BREF) was used to measure QOL. The chi square (?2) and unpaired t tests were used for statistic evaluation of results. Results In a sample of 464 women, 60 (13%) women were symptomatic and the commonest symptom was abnormal vaginal discharge (n = 54). 24 of the women had sought treatment. Age (p = 0.0006) and socio-economic status (p = 0.0004) were significant for an outcome of RTI/STI. Significant risk factors included lack of use of barrier contraceptives (p < 0.001), past history of infection (p < 0.001), use of reusable cloth during menstruation (p < 0.001) and presence of spousal symptoms (p < 0.001). QOL scores were impacted on all domains with significant differences. The largest mean difference was in the social relations and sexual activity domain. Conclusion In the current study, the obtained data was a 13% prevalence of RTI/ STI symptoms with a significant lack of awareness regarding occurrence and prevention among women and significant impairment on all QOL domains.
Valsangkar, Sameer; Selvaraju, Dhamodharan; Rameswarapu, Rohin; Kamutapu, Shivaprasad
Background and Objective Alcohol use has been suggested to interfere with condom use and to increase sexual risk behaviors. However, data on the prevalence of this practice among female sex workers and its association with condom use and sexually transmitted infections (STIs) are limited. Methods Data were collected through the baseline survey of an HIV prevention project among 454 establishment-based female sex workers in Guangxi, China, in 2004. Both global association and situational analysis were performed using 2 measures of alcohol use (alcohol intoxication and drinking alcohol before having sex with a client). Multiple logistic regression analyses were performed to examine the association of alcohol use with women's condom use and STIs. Results One-third of women reported being intoxicated with alcohol at least once a month during the previous 6 months, and about 30% reported using alcohol before having sex with clients. In comparison with women who did not use alcohol before engaging in sex with clients, women who did so reported significantly less consistent condom use and higher rates of both current STIs and a history of STI. However, alcohol intoxication was not associated with condom use and STIs. These findings indicate event-specific rather than global associations of alcohol use with inconsistent condom use and STIs. Conclusion Alcohol use before commercial sex is associated with unprotected sex and increased risk for STIs. Interventions that address both alcohol use and HIV risk behaviors in the context of commercial sex may have a great impact in preventing the spread of HIV in China.
Wang, Bo; Li, Xiaoming; Stanton, Bonita; Zhang, Lei; Fang, Xiaoyi
Criminal justice involvement (CJI) disrupts social and sexual networks, and sexually transmitted 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
The World Health Organization estimates that 340 million new cases of curable sexually transmitted 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 affect the health and HIV incidence of the general population. This paper aims to investigate why some female sex workers who experience symptoms of vaginal discharge or genital ulcers seek treatment while others do not. Data were collected from a cohort study conducted between 2002 and 2005 among female bar and hotel workers in Moshi, Tanzania. Study subjects were recruited from 7 out of 15 administrative wards in Moshi as part of the Moshi's Women's Health Project. Data were restricted to women self-reporting symptoms of vaginal discharge or genital ulcers (n=459) within the past year. Logistic regression was performed with SAS 9.1. Qualitative analysis was performed using in-depth interviews and focus group discussions among a convenience sample (n=42) of women already enrolled in the study. All interviews and focus group discussions were tape-recorded and transcribed, and data were analyzed thematically. Sixty-four percent of the sample sought treatment for either ailment. Multivariate analysis identified relationship to man of last sexual intercourse, ever experiencing a pregnancy, and age as significant predictors to seeking treatment. Four salient themes of threats to fertility, stigma correlated with prostitution, discomfort with the physical exam, and perceived views of clients were revealed as predictors to why women seek or intentionally ignore symptoms. Understanding the motivations and barriers for seeking treatment of STIs has far ranging public health implications that could help curtail the unnecessary associated morbidity and mortality and curtail the transmission of HIV. PMID:20635239
Rosenheck, Rachel; Ngilangwa, David; Manongi, Rachael; Kapiga, Saidi
The population of Sikkim is a unique blend of multi-tribal and metropolitan culture. However, till date, no data regarding prevalence of sexually transmitted diseases (henceforth abbreviated as STDs) among this population is available and hence requires attention. Hence the objective is to determine the prevalence of STDs in Sikkim and to describe associated risk factors. A cross-sectional study involving 'Questionnaire-based anonymous feedback system' was followed to collect data from 2,000 individuals across the society. The four most common STDs, gonorrhea, syphilis, chlamydia and HIV, were considered for the study. Total 69 (3.6%) cases of STDs were found in 1,918 individuals was affected by at least one of the STDs, out of which 43 were males and 26 were females. Cases of gonorrhea, syphilis, chlamydiasis and HIV were 25, 22, 4 and 18 respectively. Out of total 69 cases of STDs, 20 individuals were also suffering from some kind of hepatitis. Addictions like alcoholism, smoking and drugs were also found in significant number, with 1,019 (>50%) individuals with at least one of these addictions. Relative risk analysis indicates that gender-wise females are more vulnerable to STDs than males. The number of partners, addictions, especially alcohol and drug abuse, also contribute to STD cases. STDs act as a significant risk factor in transmitting some of the types of hepatitis. In such cases, females are more vulnerable than males. The results suggest that new community health programs are essential for both, HIV and non-HIV STDs in Sikkim. PMID:22811073
Rajapure, Vikram; Tirwa, Ranjan; Poudyal, Hemant; Thakur, Nagendra
The immune system in the female reproductive tract (FRT) does not mount an attack against human immunodeficiency virus (HIV) or other sexually transmitted 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 FRT. Working together, these antimicrobials along with mucosal antibodies attack viral, bacterial, and fungal targets. Within the FRT, the unique challenges of protection against sexually transmitted pathogens coupled with the need to sustain the development of an allogeneic fetus, has 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 (E2 ) and progesterone secreted during the menstrual cycle act both directly and indirectly on epithelial cells, fibroblasts and 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 and adaptive immune systems are under hormonal control, that protection varies with the stage of the menstrual cycle and as such, is dampened during the secretory stage of the cycle to optimize conditions for 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:24734774
Wira, Charles R; Fahey, John V; Rodriguez-Garcia, Marta; Shen, Zheng; Patel, Mickey V
Gender and racial differences in infection rates for chlamydia and gonorrhea have been reported within community-based populations, but little is known of such differences within juvenile offending populations. Moreover, while research has demonstrated that certain individual-level and community-level factors affect risky behaviors associated with sexually transmitted disease (STD), less is known about how multi-level factors affect STD infection, particularly among delinquent populations. The present study investigated gender and racial differences in STD infection among a sample of 924 juvenile offenders. Generalized linear model regression analyses were conducted to examine the influence of individual-level factors such as age, offense history, and substance use and community-level factors such as concentrated disadvantage, ethnic heterogeneity, and family disruption on STD status. Results revealed significant racial and STD status differences across gender, as well as interaction effects for race and STD status for males only. Gender differences in individual-level and community-level predictors were also found. Implications of these findings for future research and public health policy are discussed.
Dembo, Richard; Childs, Kristina; Belenko, Steven; Schmeidler, James; Wareham, Jennifer
The problem of sexually transmitted diseases (STDs) in the United States has been growing, in both scope and complexity, at an alarming rate. As evidence of the emergence of these diseases as a primary national concern, the Surgeon General has designated them as 1 of 15 priority areas in which further actions are required to improve the health of the American people. The key targets for the 1990 objectives for the nation in the STD area include reducing the incidence of gonorrhea; gonococcal pelvic inflammatory disease; and primary, secondary, and congenital syphilis. This report updates progress toward these objectives. There is good news with respect to the continuing success of proven methods in preventing and controlling both gonorrhea and syphilis. However, the picture is less bright with respect to control of other STDs that have gained new prominence--Chlamydia, herpesvirus, human papillomavirus, and human T-cell lymphotropic virus type III infections. Escalating interest in STDs reflects more recent appreciation of their relation to reproductive outcomes. STD organisms clearly have a far-reaching effect on the nation's population, including the capacity to reproduce, the rate of perinatal infection, the incidence of genital cancers, and the occurrence of acquired immune deficiency syndrome (AIDS).(ABSTRACT TRUNCATED AT 250 WORDS)
Parra, W C; Cates, W
Plasmid-free Chlamydia trachomatis serovar L2 organisms have been transformed with chlamydial plasmid-based shuttle vectors pGFP::SW2 and pBRCT using ?-lactamase as a selectable marker. However, the recommendation of amoxicillin, a ?-lactam antibiotics, as one of the choices for treating pregnant women with cervicitis due to C. trachomatis infection has made the existing shuttle vectors unsuitable for transforming sexually transmitted infection (STI)-causing serovars of C. trachomatis. Thus, in the current study, we modified the pGFP::SW2 plasmid by fusing a blasticidin S deaminase gene to the GFP gene to establish blasticidin resistance as a selectable marker and replacing the ?-lactamase gene with the Sh ble gene to eliminate the penicillin resistance. The new vector termed pGFPBSD/Z::SW2 was used for transforming plasmid-free C. trachomatis serovar D organisms. Using blasticidin for selection, stable transformants were obtained. The GFP-BSD fusion protein was detected in cultures infected with the pGFPBSD/Z::SW2-trasnformed serovar D organisms. The transformation restored the plasmid property to the plasmid-free serovar D organisms. Thus, we have successfully modified the pGFP::SW2 transformation system for studying the biology and pathogenesis of other STI-causing serovars of C. trachomatis.
Ding, Honglei; Gong, Siqi; Tian, Yingxin; Yang, Zhangsheng; Brunham, Robert; Zhong, Guangming
Background The feasibility and acceptability of partner notification (PN) for sexually transmitted infections (STIs) in developing countries was assessed through a comprehensive literature review, to help identify future intervention needs. Methods The Medline, Embase, and Google Scholar databases were searched to identify studies published between January 1995 and December 2007 on STI PN in developing countries. A systematic review of the research extracted information on: (1) willingness of index patients to notify partners; (2) the proportion of partners notified or referred; (3) client-reported barriers in notifying partners; (4) infrastructure barriers in notifying partners; and (5) PN approaches that were evaluated in developing countries. Results Out of 609 screened articles, 39 met our criteria. PN outcome varied widely and was implemented more often for spousal partners than for casual or commercial partners. Reported barriers included sociocultural factors such as stigma, fear of abuse for having an STI, and infrastructural factors related to the limited number of STD clinics, and trained providers and reliable diagnostic methods. Client-oriented counselling was found to be effective in improving partner referral outcomes. Conclusions STD clinics can improve PN with client-oriented counselling, which should help clients to overcome perceived barriers. The authors speculate that well-designed PN interventions to evaluate the impact on STI prevalence and incidence along with cost-effectiveness components will motivate policy makers in developing countries to allocate more resources towards STI management.
This paper analyzes the relationship between same-sex marriage laws and sexually transmitted 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
Francis, Andrew M; Mialon, Hugo M; Peng, Handie
Introduction: The first-line therapy for the intermittent preventive treatment of malaria in pregnancy (IPTp) is sulphadoxine-pyrimethamine (SP). There is an urgent need to identify safe, well-tolerated and efficacious alternatives to SP due to widespread Plasmodium falciparum resistance. Combination therapy using azithromycin and chloroquine is one possibility that has demonstrated adequate parasitological response > 95% in clinical trials of non-pregnant adults in sub-Saharan Africa and where IPTp is a government policy in 33 countries. Areas covered: Key safety, tolerability and efficacy data are presented for azithromycin and chloroquine, alone and/or in combination, when used to prevent and/or treat P. falciparum, P. vivax, and several curable sexually transmitted and reproductive tract infections (STI/RTI). Pharmacokinetic evidence from pregnant women is also summarized for both compounds. Expert opinion: The azithromycin-chloroquine regimen that has demonstrated consistent efficacy in non-pregnant adults has been a 3-day course containing daily doses of 1 g of azithromycin and 600 mg base of chloroquine. The pharmacokinetic evidence of these compounds individually suggests that dose adjustments may not be necessary when used in combination for treatment efficacy against P. falciparum, P. vivax, as well as several curable STI/ RTI among pregnant women, although clinical confirmation will be necessary. Mass trachoma-treatment campaigns have shown that azithromycin selects for macrolide resistance in the pneumococcus, which reverses following the completion of therapy. Most importantly, no evidence to date suggests that azithromycin induces pneumococcal resistance to penicillin.
Chico, R Matthew; Chandramohan, Daniel
This article reports on the prevalence of AIDS and sexually transmitted diseases (STDs) in Southeast Asia. The spread of HIV infection in this region has been predicted to be worse than that of Africa. The high-prevalence countries are Thailand, Cambodia, and Myanmar, where prevalence rates in the population at risk (15-49 year olds) are up to 2%; while low prevalence countries with rates of 0.1% include the Philippines, Indonesia, Laos, Brunei, and Singapore. Heterosexual transmission in Southeast Asia is the main mode of spread of HIV. Another route is through migration, rural-to-urban or international migration of people seeking jobs; with concurrent loneliness and anonymity, they become vulnerable to STDs and HIV infection. Intravenous drug use poses an increasing risk of transmission. The unavailability of data in some countries makes it difficult to evaluate the extent of the epidemic or if there's an impending epidemic. There are a number of caveats to the data compilation from various countries. These include the following: under-reporting of cases; underdiagnosis; missed diagnosis; and differences in the time of data collection. It is clear that poverty, illiteracy, and poor access to educational information in most countries in this region facilitate the rapid spread of HIV. These coupled with lack of primary health care services, and in most instances, enormously high cost of drugs make the pain and suffering due to the HIV/AIDS epidemic a human disaster far worse than the ravages of war. PMID:10330595
Floral traits endowing high reproductive fitness can also affect the probability of plants contracting sexually transmitted 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
Mycoplasma genitalium is an emerging sexually transmitted 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. Over 27,000 women from 48 published reports have been screened for M. genitalium urogenital infection in high- or low-risk populations worldwide with an overall prevalence of 7.3% and 2.0%, respectively. M. genitalium was present in the general population at rates between those of Chlamydia trachomatis and Neisseria gonorrhoeae. Considering more than 20 studies of lower tract inflammation, M. genitalium has been positively associated with urethritis, vaginal discharge, and microscopic signs of cervicitis and/or mucopurulent cervical discharge in seven of 14 studies. A consistent case definition of cervicitis is lacking and will be required for comprehensive understanding of these associations. Importantly, evidence for M. genitalium PID and infertility are quite convincing and indicate that a significant proportion of upper tract inflammation may be attributed to this elusive pathogen. Collectively, M. genitalium is highly prevalent in high- and low-risk populations, and should be considered an etiologic agent of select reproductive tract disease syndromes in women.
McGowin, Chris L.; Anderson-Smits, Colin
Limited literature exists on the quality and availability of treatment and care of sexually transmitted infections (STIs) in Pakistan. This article aims to document existing services for the care and treatment of STIs available in Pakistan's public and private sectors to high risk groups (HRG), particularly the transgendered population. We conducted a cross-sectional survey to document STI services in Lahore, Karachi, Rawalpindi, Peshawar, and Quetta. Seventy-three interviews were administered with health service providers at the 3 largest public sector hospitals in each city, as well as with general physicians and traditional healers in the private sector. Twenty-five nongovernmental organizations (NGO) providing STI services were also interviewed. Fewer than 45% of private and public sector general practitioners had been trained in STI treatment after the completion of their medical curriculum, and none of the traditional healers had received any formal training or information on STIs. The World Health Organization (WHO) syndromic management guidelines were followed for STI management by 29% of public and private sector doctors and 5% of traditional healers. STI drugs were available at no cost at 44% of NGOs and at some public sector hospitals. Our findings show that although providers do treat HRGs for STIs, there are significant limitations in their ability to provide these services. These deterrents include, but are not limited to, a lack of STI training of service providers, privacy and adherence to recommended WHO syndromic management guidelines, and costly diagnostic and consultation fees. PMID:19856743
Rahimtoola, Minal; Hussain, Hamidah; Khowaja, Saira N; Khan, Aamir J
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 sexually transmitted 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.
Sexually transmitted diseases (STDs) represent a major public health problem in the country, cause patients enormous suffering, and cost the nation billions of dollars annually. Demographic, sociological, and behavioral changes in our society during the past decade are important contributors to the growing complexity and scope of the STD problem. Several agencies in the Public Health Service are engaged in the Federal effort against STDs. The Centers for Disease Control, as the lead agency, assists State and local health departments in their STD control efforts. In fiscal year 1981, federally supported syphilis and gonorrhea control efforts--based on prevention of an estimated 209,400 new cases--saved the taxpayers approximately $150 million. To meet the 1990 objectives, both the public and private medical sectors must recognize the STD problem of the 1980s. Without the support of the professional community and involvement of the private sector, the incidence of STDs will continue to increase at alarming proportions during this decade. The opportunity for promoting health, preventing human suffering, and reducing costs to society is great. Making the best of this opportunity is our challenge during this decade.
Wiesner, P J; Parra, W C
This study aimed to evaluate the prevalence of sexually transmitted infections (STIs) and associated risk factors in HIV-infected pregnant women followed for prenatal care in Salvador, Bahia. This was a cross-sectional study of 63 women seeking prenatal care at a reference center. Participants were interviewed regarding socio-epidemiological and clinical history, and were tested for HBsAg, anti-HCV, anti HTLV I/II, VDRL, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Ureaplasma urealyticum, CD4 count, and HIV plasma viral load. The main outcome variable was the presence of any STI. The mean age of patients was 28.2 years (16-40 years). 23 (36.5%) were diagnosed with at least one STI. The frequency of diagnoses was: HBV, 3.2%; HCV, 8.1%; HTLV I/II, 3.4%; syphilis, 9.5%; Chlamydia trachomatis, 11.1%; HPV, 15.0%; Mycoplasma hominis, 2.1%, and Ureaplasma urealyticum, 2.1%. No case of Neisseria gonorrhoeae was identified. No association was found between socio-epidemiological variables and the presence of an STI. CD4 T lymphocyte < 500 cells/?L (p=0.047) and plasma viral load >1,000 copies (p = 0.027) were associated with the presence of STI. STIs are frequent in pregnant women infected with HIV, and all HIV-infected pregnant women should be screened to decrease transmission of these pathogens and to protect their own health. PMID:23168304
Travassos, Ana Gabriela Álvares; Brites, Carlos; Netto, Eduardo M; Fernandes, Sheyla de Almeida; Rutherford, George W; Queiroz, Conceição Maria
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 sexually transmitted 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 sexually transmitted 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
Genrich, Gillian L; Brathwaite, Brader A
BACKGROUND Sexually Transmitted Diseases are still considered a serious public health problem in Brazil and worldwide. OBJECTIVE To examine Sexually Transmitted Diseases prevalence and the sickness impact profile of STDs in a reference health center specializing in the treatment of Sexually Transmitted Diseases. METHOD We collected epidemiological, demographic, clinical and laboratory data from the medical records and interviews of 4,128 patients who had attended the center from January 1999 to December 2009. RESULTS Male patients outnumbered (76%) females (24%), Caucasians outnumbered (74.3%) those of mixed race (14.8%), blacks (10.8%) and Asians (0.1%). STD occurrence was higher in the 20-29 age group (46.2%) This population included 34.7% high school graduates, 8.7% college graduates and 0.8% illiterates. As for affective-sexual orientation, 86.5% were heterosexual, 7.8% homosexual and 5.5% bisexual. Regarding patients' sexual practices over the previous 30 days, 67.7% reported sexual intercourse with one person, 8.6% had had sex with two persons and 3.9%, with three or more people. The highest incidence of STD was condyloma acuminata, affecting 29.4% of all the patients, genital candidiasis 14.2%, and genital herpes 10.6%. Of the 44.3% who submitted to serologic testing for HIV detection 5% were positive, with a ratio of 6.8 males to 1 female. CONCLUSIONS STD prevalence remains high in Brazil and it is necessary to invest in early detection, prevention and treatment.
Fagundes, Luiz Jorge; Vieira Junior, Elso Elias; Moyses, Ana Carolina Marteline Cavalcante; de Lima, Fernao Dias; de Morais, Fatima Regina Borges; Vizinho, Natalina Lima
Testing for sexually transmitted 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, in addition to medical implications, can have 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 significance of the identification of a sexually transmitted agent in such children as evidence of possible child sexual abuse varies by pathogen. While culture has historically been used for the detection of STIs in cases of suspected abuse in children, the increasing use of nucleic acid amplification tests (NAATs) in adults and the increasing proliferation of second-generation tests with better sensitivity and specificity has made inroads into the use of such tests in children, especially for diagnostic and treatment purposes. Acceptance by the medicolegal system for sexual abuse cases is still controversial and more test cases will be necessary before definitive use becomes standard practice. In addition, if these assays ever become legally admissible in court, there will be recommendations that more than one NAAT assay be used in order to assure confirmation of the diagnostic result.
Hammerschlag, Margaret R.; Gaydos, Charlotte A.
SummaryA randomised trial was done to evaluate the impact of improved sexually transmitted 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
BackgroundTrichomonas vaginalis is the causative agent of human trichomoniasis, the most common non-viral sexually transmitted 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
The pharmaceutical industry is not supplying the penicillin preparations that are required for the treatment of syphilis. For those in whom penicillin hypersensitivity is suspected there is a need for a safe injectable alternative that is effective if given once daily or, preferably, at two- or three-day intervals. Existing treatments for chancroid, lymphogranuloma venereum, and granuloma inguinale are described, but even collectively there are few cases and treatments for other sexually transmitted diseases merit priority. Treatments for scabies and pediculosis pubis, although not perfect, are reasonable. There is a need for better local treatment for condylomata acuminata and systemic immunological methods, including those that increase cell-mediated immunity, deserve attention. The same is true for molluscum contagiosum. There is an urgent need for an effective, safe treatment of herpes genitalis that is able to eradicate the virus from the host. If it is proved that the herpes virus is responsible for carcinoma of the cervix this could then be the most serious sexually transmitted disease as in many countries such carcinomas are responsible for approximate seven times more deaths in women than is syphilis in men and women together. The limitations of prophylactic methods in preventing all possibility of infection with one or more of the sexually transmitted diseases are discussed.
Willcox, R. R.
Sex workers and their clients as core groups of high frequency transmitters play a dominant role in the transmission of HIV and other sexually transmitted diseases (STDs). In Surabaya, Indonesia, little is known about the prevalence of STDs in various sex establishments. We conducted an STD prevalence survey of 1873 female sex workers in Surabaya, Indonesia. We did not find any sex workers with HIV infection. Prevalence rates of other STDs (chlamydia, gonorrhoea, serological test for syphilis positive, and/or trichomoniasis) in female sex workers were 48% in brothels (n = 696), 42% on the streets (n = 192), 16% in massage parlours (n = 344), 25% in barber shops (n = 150), 17% at call-girl houses (n = 73), and 10% in nightclubs (n = 418). Sex workers from the brothels had the highest prevalence rates of gonorrhoea (24%) and trichomoniasis (8%), while sex workers from the streets and the barber shop had the highest rates of serological test for syphilis (STS) positive (30%) and chlamydia (18%). STD rates decreased with an increase in age (except for STS positive), an increase in education, a decrease in the number of sex partners, and condom use in the previous week. Condom use in the previous week was universally low among sex workers, especially among sex workers from the brothels (14%). Sex workers from the brothels had STD rates about 4 times higher than sex workers from the nightclubs (adjusted odds ratio of 4.4). Although the HIV seroprevalence rate is currently low, widespread prostitution and high rates of STDs in sex workers warrant programmes to avert a potential explosion of HIV transmission. Because sex workers from the brothels in Surabaya have high rates of STDs and low use of condoms but good cooperation with local authorities, STD preventive measures should focus on this group. PMID:9292347
Joesoef, M R; Linnan, M; Barakbah, Y; Idajadi, A; Kambodji, A; Schulz, K
Objective To estimate completion rate and acceptability of home screening for sexually transmitted 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.
Graseck, Anna S.; Secura, Gina M.; Allsworth, Jenifer E.; Madden, Tessa; Peipert, Jeffrey F.
Objective To determine whether home-based screening for sexually transmitted infections (STIs) results in a higher STI screening rate compared to clinic-based screening in participants using long-acting reversible contraception. Methods We performed a randomized clinical trial of women using long-acting reversible contraception methods in the Contraceptive CHOICE Project (n = 558). Participants were randomly assigned to home-based testing (swabs mailed to the participant's home or clinic-based testing. Self-collected vaginal swabs were tested for Chlamydia trachomatis and Neisseria gonorrhoeae using strand displacement analysis. We estimated the relative risk of screening by group using Poisson regression with robust error variance. Results The randomization groups were similar at baseline, except for marital status; the clinic group had more never-married women (62.0% vs. 51.6%), and the home group had more divorced women (12.1% vs. 5.6%, p = 0.007). Women in the home group were more likely to self-report screening compared to women in the clinic group in the multivariable analysis (56.3% vs. 32.9%, RR 1.7, 95% CI 1.4 – 2.0). When analyzed by tests received or documented in medical records, similar results were obtained (56.3% vs. 25.0%, RR 2.2, 95% CI 1.7 – 2.7). Women who completed screening had higher levels of education and were more likely to receive public assistance compared to those who did not complete screening. Conclusion Long-acting reversible contraception users randomized to STI screening at home were more likely to complete screening than those randomized to traditional clinic-based screening. Home-based screening may be useful in women using LARC methods who may not present for regular screening.
Graseck, Anna S.; Secura, Gina M.; Allsworth, Jenifer E.; Madden, Tessa; Peipert, Jeffrey F.
BACKGROUND AND OBJECTIVE: Inadequate follow-up of positive sexually transmitted infection (STI) test results is a gap in health care quality that contributes to the epidemic of STIs in adolescent women. The goal of this study was to improve our ability to contact adolescent women with positive STI test results after an emergency department visit. METHODS: We conducted an interventional quality improvement project at a pediatric emergency department. Phase 1 included plan-do-study-act cycles to test interventions such as provider education and system changes. Phase 2 was a planned experiment studying 2 interventions (study cell phone and patient activation card), using a 2 × 2 factorial design with 1 background variable and 2 replications. Outcomes were: (1) the proportion of women aged 14 to 21 years with STI testing whose confidential telephone number was documented in the electronic medical record; (2) the proportion of STI positive women successfully contacted within 7 days. RESULTS: Phase 1 interventions increased the proportion of records with a confidential number from 24% to 58% and the proportion contacted from 45% to 65%, and decreased loss to follow-up from 40% to 24%. In phase 2, the proportion contacted decreased after the electronic medical record system changed and recording of the confidential number decreased. Study interventions (patient activation card and study cell phone) had a synergistic effect on successful contact, especially when confidential numbers were less reliably documented. CONCLUSIONS: Feasible and sustainable interventions such as improved documentation of a confidential number worked synergistically to increase our ability to successfully contact adolescent women with their STI test results.
Reed, Jennifer L.; Munafo, Jennifer Knopf; Ekstrand, Rachel; Gillespie, Gordon; Holland, Carolyn; Britto, Maria T.
Objectives To determine the etiology and factors associated with genital ulcer disease (GUD) among patients presenting to a sexually transmitted 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.
Gomes Naveca, Felipe; Sabido, Meritxell; Amaral Pires de Almeida, Tatiana; Araujo Veras, Elaine; Contreras Mejia, Matilde del Carmen; Galban, Enrique; Benzaken, Adele Schwartz
Background As stigma is a socially constructed concept, it would follow that stigma related to sexual behaviours and sexually transmitted 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 sexually transmitted 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.
Rusch, Melanie LA; Shoveller, Jean A; Burgess, Susan; Stancer, Karen; Patrick, David M; Tyndall, Mark W
This paper examines young people's perceived vulnerability to sexually transmitted 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
An intense social and political debate continues in the United States regarding sexuality education. Included in the debate are those who favor comprehensive approaches, those who favor abstinence-only approaches, and those who favor no sexuality education. In this study, we showed that men who received school-based condom education were less likely to have been diagnosed with sexually transmitted infections (STIs) and were more likely to ever have been tested for sexually transmitted infections than were men without such education. School-based condom education is associated with less, rather than more, STI risk. PMID:19833985
Dodge, Brian; Reece, Michael; Herbenick, Debby
In order to investigate the overall impact of the British Association for Sexual Health and HIV (BASHH) Sexually Transmitted Infections Foundation (STIF) course taught in Ireland since 2007, attendees were sent two questionnaires to investigate the overall impact of the course, its effect on clinical practice and the need for further education. Response rate was 19.4%. The majority found the course beneficial and that it did cover their practice needs (96.4%), with 83.6% saying that their confidence and technique in sexual history taking had improved. There was a 3.7% increase in the provision of HIV testing from precourse levels, although only 80% did so routinely; a 12.7% increase in syphilis testing; a 5.4% increase in testing for Chlamydia and a 12.7% increase for gonorrhoea. Some confusion seems to persist in relation to sexually transmitted infection (STI) risk factors. The second questionnaire tested STI knowledge. Most respondents scored well (average 81% correct answers); however, respondents who attended four years previously scored, on average, 7% worse than the others, suggesting the need for a periodic update in the area of STI education. PMID:23562968
Calamai, A; Howard, R; Kelly, R; Lambert, J
Objectives: To determine the proportion of sexually experienced African American adolescents who report having been screened for sexually transmitted diseased (STDs), and to determine the proportion who report having been screened for STDs among those adolescents who have had a preventive primary healthcare visit in the past 2 years. Methods: A telephone survey of a population based sample of African American 12–17 year old adolescents residing in a low income San Francisco neighbourhood with a high prevalence of STDs. Results: Of the 302 adolescents surveyed, 118 (39%) reported a history of sexual intercourse. Of these, 26% of the males and 59% of the females had been screened for an STD in the previous 12 months. 31% of the males and 63% of the females had been screened for an STD in the previous 24 months. Of the 93 participants who had had a preventive primary care visit since their first episode of sexual intercourse, 26% of the males and 60% of the females had been screened for an STD in the previous 24 months. Conclusions: Sexually experienced African American adolescents in San Francisco are being screened for STDs at rates well below that recommended by current clinical guidelines. A low rate of screening was found even in those adolescents who had been seen for a preventive primary care visit since they first had sex. This suggests that the preventive primary care visit is not being used to its full potential as an opportunity to screen and treat adolescents for STDs. Capitalising on this opportunity to screen may increase the number of STDs diagnosed and, thus, decrease rates of STDs in this population. Key Words: sexually transmitted diseases; adolescents; screening; San Francisco
Ellen, J; Lane, M; McCright, J
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 Chlamydia infection is the most common notifiable sexually transmitted infection (STI) in Australia and mostly affects young people (15 – 25 years). This paper presents baseline data from a randomised controlled trial that aimed to increase chlamydia testing among sexually active young people. The objectives were to identify associations between sexual behaviour, substance use and STI history and explore attitudes to chlamydia testing. Methods This study was conducted in cyberspace. Study recruitment, allocation, delivery of interventions and baseline and follow up data collection all took place online. Participants were 16 – 25 years old and resided in Australia. Substance use correlates of sexual activity; predictors of history of STIs; barriers to and facilitators of chlamydia testing were analysed. Results Of 856 participants (79.1% female), 704 had experienced penetrative intercourse. Sexually active participants were more likely to smoke regularly or daily, to drink alcohol, or to have binge drunk or used marijuana or other illicit substances recently. Risk factors for having a history of any STI were 3 or more sexual partners ever, 6 or more partners in the past 12 months, condom non-use and being 20 years or older. Almost all sexually active participants said that they would have a chlamydia test if their doctor recommended it. Conclusions Sexually active young people are at risk of STIs and may engage in substance use risk behaviours. Where one health risk behaviour is identified, it is important to seek information about others. Chlamydia testing can be facilitated by doctors and nurses recommending it. Primary care providers have a useful role in chlamydia control. Trial Registration Australian and New Zealand Trials Registry ACTRN12607000582459
Abstract Background: Adolescents are at high risk of acquiring sexually transmitted diseases (STDs). However, little is known about differences in knowledge and risk behaviors across nationalities. The objective of this study was to assess and compare the knowledge and perceptions of STDs and the sexual risk behaviors in Latino adolescents in the United States (US) and the Dominican Republic (DR). Methods: A survey was administered to 364 high school students after obtaining parental consent. The questionnaire asked about demographics, sources of STD information, risk behaviors, and knowledge of syphilis, gonorrhea, and human immunodeficiency virus (HIV). Mean percentage scores were calculated to compare correct responses by nationality, gender, and sexual activity. Predictors of self-reported high risk sexual behavior were identified by multivariable logistic regression analysis. Results: In all, 242 (66%) US and 122 (34%) DR students were interviewed. Of these, 52% were males. Median age was 15 years (range, 13-18). Sexual activity was reported by 40% of the participants and did not differ by gender (p=0.43) or national origin (p=0.53), although it was greater for adolescents older than 15 years of age (60% vs. 35%, p<0.001). US students identified abstinence as an effective STD prevention method more often than their counterparts (p=<0.001). Knowledge of specific STDs was higher in girls (p=0.002) and Dominicans (p=0.003). Predictors of high risk behavior were male gender (OR
Brito, Maximo O; Davis, Melinda; Chakrabarti, Anindita
Background Sexually transmitted 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 Sexually Transmitted 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.
Randomized Controlled Trial on the Effectiveness of Counseling Messages for Avoiding Unprotected Sexual Intercourse During Sexually Transmitted Infection and Reproductive Tract Infection Treatment Among Female Sexually Transmitted Infection Clinic Patients
Background The effectiveness of counseling messages to avoid unprotected sex during short-term treatment for curable sexually transmitted infections is unknown. Methods We randomized 300 female STI clinic patients 18 years or older with cervicitis and/or vaginal discharge in Kingston, Jamaica, in 2010 to 2011, to 1 of 2 counseling messages for their course of syndromic treatment: abstinence only or abstinence backed up by condom use. At a follow-up visit 6 days afterward, we collected vaginal swabs to test for prostate-specific antigen (PSA), a biological marker of recent semen exposure, and administered a questionnaire assessing sexual behavior. Results No differences were found in the proportions of women testing positive for PSA at follow-up in the abstinence-plus-condom group (11.9%) and abstinence-only group (8.4%) (risk difference, 3.5; 95% confidence interval, ?3.5 to 10.5). There also was no significant difference in reporting of unprotected sex between groups. Reporting a history of condom use before enrollment significantly modified the effect of counseling arm on PSA positivity (P = 0.03). Among those reporting recent condom use, 10.3% in the abstinence-only arm and 4.8% in the abstinence-plus-condom arm tested positive for PSA. Conversely, among those not reporting recent condom use, 6.5% in the abstinence-only arm and 17.3% in the abstinence-plus-condom arm had PSA detected. Conclusions We found no evidence to support the superiority of either counseling message. Post hoc analyses suggest that women with recent condom experience may benefit significantly more from abstinence-plus-condom messages, whereas women without such experience may benefit significantly more from abstinence-only messages. Providers should weigh individual condom use history when determining the most appropriate counseling message.
Anderson, Clive; Gallo, Maria F.; Hylton-Kong, Tina; Steiner, Markus J.; Hobbs, Marcia M.; Macaluso, Maurizio; Figueroa, J. Peter; Jamieson, Denise J.; Legardy-Williams, Jennifer; Wiener, Jeffrey; Warner, Lee
Background The incidence and prevalence of sexually transmitted 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 first time attendees of 6 public STI clinics in Hong Kong were interviewed before clinical consultation using a standard questionnaire to assess their demographic, clinical and behavioural characteristics. A GIS (geographic information system)-based approach was adopted with mapping performed. The cases attending the clinics in different locations were profiled. A comparison was made between neighbourhood cases (patients living near a clinic) and distant cases (those farther off), by calculating the odds ratio for demographic, behavioural and geographic characteristics. Results Of the 1142 STI patients evaluated, the residence locations of 1029 (90.1%) could be geocoded, of which 95.6% were ethnic Chinese and 63.4% male. Geographically only about a quarter lived in the same district as the clinic. STI patients aged 55 or above were more likely to be living in the vicinity of the clinic, located in the same or adjacent tertiary planning unit (a small geographic unit below district level). A majority of patients came from locations a few kilometers from the clinic, the distance of which varies between clinics. Overall, more syphilis cases were reported in patients residing in the same or adjacent tertiary planning unit, while distant cases tended to give a higher risk of inconsistent condom use. There were otherwise no significant clinical and epidemiologic differences between neighbourhood and distant STI cases. Conclusions There was no specific relationship between STI and the residence location of patients as regards their clinical and epidemiologic characteristics in the territory of Hong Kong. Older STI patients were however more inclined to attend the nearby STI clinics. Most patients have travelled a variable distance to access the STI service. The relationship between STI clinic cases and distance could be a complex issue intertwined between psychosocial characteristics and STI service coverage.
Background It is hypothesized that sexually transmitted diseases (STDs) increase the risk of HIV acquisition. Yet, difficulties establishing an accurate temporal relation and controlling confounders have obscured this relationship. In an attempt to overcome prior methodologic shortcomings, we explored the use of different study designs to examine the relationship between STDs and HIV acquisition. Methods Acutely HIV-infected patients were included as cases and compared to 1) HIV-uninfected patients (matched case-control), 2) newly diagnosed, chronically HIV-infected patients (infected analysis), and 3) themselves at prior clinic visits when they tested HIV-negative (case-crossover). We used t-tests to compare the average number of STDs and logistic regression to determine independent correlates and the odds of acute HIV infection. Results Between October 2003 and March 2007, 13,662 male patients who had sex with men were tested for HIV infection at San Francisco's municipal STD clinic and 350 (2.56%) HIV infections were diagnosed. Among the HIV-infected patients, 36 (10.3%) cases were identified as acute. We found consistently higher odds of having had an STD within the 12 months (matched case-control, OR 5.2 [2.2-12.6]; infected analysis, OR 1.4 [1.0-2.0]; case-crossover, OR 1.3 [0.5-3.1]) and 3 months (matched case-control, OR 34.5 [4.1-291.3]; infected analysis, OR 2.3 [1.1-4.8]; case-crossover OR 1.8 [0.6-5.6]) prior to HIV testing among acutely HIV-infected patients. We found higher odds of acute HIV infection among patients with concurrent rectal gonorrhea (17.0 [2.6 - 111.4], p<0.01) or syphilis (5.8 [1.1 - 32.3], p=0.04) when compared to those HIV-uninfected. Conclusions Acute HIV infection was associated with a recent or concurrent STD, particularly rectal gonorrhea, among men at San Francisco's municipal STD clinic. Given the complex relationship between STDs and HIV infection, no single design will appropriately control for all the possible confounders; studies using complementary designs are required.
Zetola, Nicola M.; Bernstein, Kyle T.; Wong, Ernest; Louie, Brian; Klausner, Jeffrey D.
This ethnographic research among rural South African men and women seeking care for STDs explores constraints to communication among partners and defines predominant patterns of sexual networking. A series of fifteen open-ended interviews explored topics related to sexual networking and partner communication. Patterns of sexual networking showed clear gender variation, with men more likely to discuss multiple partners. Both men and women believed they should tell one partner about their STD, most often a steady partner. Strong distinctions were made between regular and casual partners, with an emphasis on the role of trust in a steady relationship. Men and women expressed anxiety about telling their partners of their illness, but women more often expressed fear whereas men felt embarrassed. Multi-partnered sexuality is common and is widely accepted for men. While the importance of regular partnerships is clear for both men and women, sexual relationships appear to be highly unstable. Communication among partners could be facilitated by stronger health promotion messages, such as the importance of telling a partner about an STD. Prevailing patterns of communication and sexual networking have profound implications for the STD epidemic. PMID:10175971
Harrison, A; Lurie, M; Wilkinson, N
Sexual debut for boys in Kenya occurs mostly by mid-adolescence. This study looks at the perspectives of adolescent boys aged 15-19 attending schools in rural, eastern Kenya on the dual risks of unwanted pregnancy, STDs and HIV, based on qualitative data from eight focus group discussions with 90 boys. Despite a high knowledge of sexual risks, fear of HIV and awareness of the protective value of condoms, the young men exhibit high risk behaviour. They feel the need to conform to social prescriptions of male prowess, early sexual experience, and having more than one partner, yet their feelings about this behaviour are ambiguous and contradictory. They consider getting girls pregnant and having had a treatable STD as marks of masculinity, blame girls for not protecting themselves (and girls' parents), and want to boast about their sexual conquests to their peers. Yet they feel embarrassed and reticent about discussing sexual issues with adults, and are unwilling to get condoms from places where anonymity is not assured as they know their sexual activity is not sanctioned. There is a clear need for educational programmes that confront male sexual norms, address issues of gender power relations, promote communication skills, informed choice and sexual responsibility among boys as well as girls, and provide a consistent supply of good quality condoms free or at affordable prices. PMID:11468825
Sexual debut for boys in Kenya occurs mostly by mid-adolescence. This study looks at the perspectives of adolescent boys aged 15–19 attending schools in rural, eastern Kenya on the dual risks of unwanted pregnancy, STDs and HIV, based on qualitative data from eight focus group discussions with 90 boys. Despite a high knowledge of sexual risks, fear of HIV and
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…
Kao, Tsui-Sui Annie; Manczak, Melissa
Background: This study examined the acceptability and feasibility of using a biological outcome measure to evaluate a school-based sexuality education program. Confidential field-delivered sexually transmitted infection (STI) testing by nonmedical field staff and STI treatment by medically trained field staff was assessed in off-campus and…
Chacko, Mariam R.; Markham, Christine; Thiel, Melanie; Crandall, Stacy M.; Peskin, Melissa F.; Shegog, Ross; Tortolero, Susan
BACKGROUND: We evaluated the cost-effectiveness of the WINGS project, an intervention to prevent HIV and other sexually transmitted diseases among urban women at high risk for sexual acquisition of HIV. METHODS: We used standard methods of cost-effectiveness analysis. We conducted a retrospective analysis of the intervention's cost and we used a simplified model of HIV transmission to estimate the number
Harrell W Chesson; Judith B Greenberg; Michael Hennessy
Abstract Background This study examined racial differences in the prevalence of sexual risk behaviors and their associations with sexually transmitted diseases (STDs) among recent heroin-using and cocaine-using women. Methods Participants were 214 women (59% black, 41% white) who were recruited during 2002–2010 using targeted sampling to participate in a study in Baltimore, Maryland, and reported using heroin, cocaine, or crack during the previous 6 months. Participants completed self-report questionnaires about their drug use, sexual risk behaviors, and lifetime history of one of six STDs, including gonorrhea, syphilis, chlamydia, genital herpes, genital warts, or trichomoniasis. Results More black women (50%) than white women (28%) reported a lifetime STD. Although there were no racial differences in the lifetime prevalence of sexual risk behaviors assessed, there were racial differences in the sexual behaviors associated with ever having a lifetime STD. Simple logistic regressions revealed that ever having a casual sex partner or anal sex were correlates of having a lifetime STD among black women but not among white women. Multiple logistic regression analyses revealed that ever having a casual sex partner was significantly associated with having a lifetime STD among black women, and ever trading sex for money was significantly associated with having a lifetime STD among white women. Conclusions Findings are consistent with national studies and elucidate racial disparities in STDs and associated sexual behaviors among recent heroin-using and cocaine-using women. Findings underscore the need to tailor STD prevention interventions differently for black and white recent heroin-using and cocaine-using women.
Floyd, Leah J.; Penniman, Typhanye V.; Hulbert, Alicia; Gaydos, Charlotte; Latimer, William W.
In 2010, Senate Bill 1309 included language to repeal an existing Arizona law that enables minors younger than 18 years of age to seek diagnosis and treatment of sexually transmitted diseases (STDs) without parental consent. Numerous implications were identified that would have stemmed from parental consent provisions originally proffered in Senate Bill 1309. These implications included diminished access to essential health services among minors, exacerbated existing health disparities, increased health-care spending costs, and thwarted efforts to curb the spread of STDs. Lastly, minors would have been deprived of existing privacy protections concerning their STD-related medical information. This case study describes how collaborative advocacy efforts resulted in the successful amendment of Senate Bill 1309 to avert the negative sexual and reproductive health outcomes among adolescents stemming from the potential repeal of their existing legal right to seek STD treatment without parental consent. PMID:22547855
Goodwin, Kimberly D; Taylor, Melanie M; Brown, Erin C Fuse; Winscott, Michelle; Scanlon, Megan; Hodge, James G; Mickey, Tom; England, Bob
Data from 1087 adolescent participants in three waves of the National Longitudinal Study of Adolescent Health was used to examine the effects of peer selection and socialization processes in adolescence on later reports of sexually-transmitted infections (STI) and unintended pregnancies. Friends’ attitudes and behavior were assessed with friends’ reports. Among males, there was evidence for selection effects on STI diagnoses and socialization effects on reports of unintended pregnancy, both involving friends’ attitudes. Among females, there was evidence for long-term effects of both socialization and selection processes involving same-sex friends’ attitudes. Discussion focuses on the importance of peer and individual attitudes as potential intervention targets.
Henry, David B.; Deptula, Daneen P.; Schoeny, Michael E.
OBJECTIVES: This study determined the prevalence and factors associated with hepatitis B virus (HBV) infection among men who have sex with men. METHODS: At the baseline visit of an HIV study among men who have sex with men, we asked about HBV vaccination status and tested for HBV markers. RESULTS: Of 625 subjects, 48% had received at least 1 dose of HBV vaccine. Of 328 unvaccinated men, 41% had 1 or more HBV markers. HBV prevalence increased markedly with age and was associated with many sexual and drug-related behaviors. In a multivariate model, 7 variables were independently associated with HBV infection: ulcerative sexually transmitted diseases (odds ratio [OR] = 10.1; 95% confidence interval [CI] = 2.6, 54); injection drug use (OR = 5.2; 95% CI = 1.2, 26); gonorrhea or chlamydia (OR = 4.0; 95% CI = 1.9, 8.9); sexual partner with HIV/AIDS (OR = 3.6; 95% CI = 1.8, 7.1); 50 or more casual partners (OR = 3.4; 95% CI = 1.6, 7.1); received money for sex (OR = 3.0; 95% CI = 1.2, 7.8); and 20 or more regular partners (OR = 2.5; 95% CI = 1.1, 6.1). CONCLUSIONS: In Montreal, men who have sex with men are at risk for HBV infection, but a substantial proportion remain unvaccinated; new strategies are required to improve coverage. Men who have sex with men and who have a sexually transmitted infection, especially a genito-ulcerative infection, appear to be at particularly high risk for HBV infection.
Remis, R S; Dufour, A; Alary, M; Vincelette, J; Otis, J; Masse, B; Turmel, B; LeClerc, R; Parent, R; Lavoie, R
This article discusses how process indicators can complement outcomes as part of a comprehensive explanatory evaluation framework, using the example of skills-based behavioural interventions to prevent sexually transmitted infections and promote sexual health among young people in schools. A systematic review was conducted, yielding 12 eligible outcome evaluations, 9 of which included a process evaluation. There were few statistically significant effects in terms of changes in sexual behaviour outcomes, but statistically significant effects were more common for knowledge and self-efficacy. Synthesis of the findings of the process evaluations identified a range of factors that might explain outcomes, and these were organized into two overarching categories: the implementation of interventions, and student engagement and intervention acceptability. Factors which supported implementation and engagement and acceptability included good quality teacher training, involvement and motivation of key school stakeholders and relevance and appeal to young people. Factors which had a negative impact included teachers' failure to comprehend the theoretical basis for behaviour change, school logistical problems and omission of topics that young people considered important. It is recommended that process indicators such as these be assessed in future evaluations of school-based sexual health behavioural interventions, as part of a logic model. PMID:24488650
Shepherd, J; Harden, A; Barnett-Page, E; Kavanagh, J; Picot, J; Frampton, G K; Cooper, K; Hartwell, D; Clegg, A
Although it is known that most HIV-1 infections worldwide result from exposure to virus in semen, it has not yet been established whether transmitted strains originate as RNA virions in seminal plasma or as integrated proviral DNA in infected seminal leukocytes. We present phylogenetic evidence that among six transmitting pairs of men who have sex with men, blood plasma virus in the recipient is consistently more closely related to the seminal plasma virus in the source. All sequences were subtype B, and the env C2V3 of transmitted variants tended to have higher mean isoelectric points, contain potential N-linked glycosylation sites, and favor CCR5 co-receptor usage. A statistically robust phylogenetically corrected analysis did not detect genetic signatures reliably associated with transmission, but further investigation of larger samples of transmitting pairs holds promise for determining which structural and genetic features of viral genomes are associated with transmission.
Butler, David M.; Delport, Wayne; Kosakovsky Pond, Sergei L.; Lakdawala, Malcolm K.; Cheng, Pok Man; Little, Susan J.; Richman, Douglas D.; Smith, Davey M.
website extra Extended tables can be found on the STI website www.sextransinf.com Objective: To identify risk factors for incident sexually transmitted infections (STI) in a remote Aboriginal community in Australia. Design: A population based cohort study. Setting: An Aboriginal community in central Australia. Participants: 1034 Aboriginal people aged 12–40 years, resident in the study region, seen during the period 1 January 1996 to 30 June 1998 for STI diagnosis. Main outcome measures: Incident rate of gonorrhoea, chlamydia, and syphilis per 100 person years. Results: There were 313 episodes of incident gonorrhoea, 240 of incident chlamydial infection, and 17 of incident syphilis. For gonorrhoea, risk factors were age, substance abuse, and previous prevalent chlamydial infection with a rate ratio (RR) of 3.2 in people aged 15–19 years, 1.6 in people who abused alcohol, and 3.2 in women who had sniffed petrol on a regular basis. For chlamydia, risk factors were sex, age, and a previous history of STI with a RR of 2.7 in people aged 15–19 years. Similar factors were associated with an increased risk of syphilis but the associations were not statistically significant. Conclusion: This study identified objective predictors of incident STI which can be used to target interventions and maximise their impact. The results of this study may well have relevance to indigenous communities in other countries that are faced with high levels of STI and substance abuse. Key Words: Aborigines; sexually transmitted infections; risk factors; Australia
Miller, P; Law, M; Torzillo, P; Kaldor, J
The global impact of sexually transmitted infections (STIs) is significant. The sexual transmission of viruses such as herpes simplex virus type-2 (HSV-2) and the human immunodeficiency virus type-1 (HIV-1), has been especially difficult to control. To date, no effective vaccines have been developed to prevent the transmission of these STIs. Although antiretroviral drugs have been remarkably successful in treating the symptoms associated with these viral infections, the feasibility of their widespread use for prevention purposes may be more limited. Microbicides might provide an attractive alternative option to reduce their spread. In particular, topically applied small inhibitory RNAs (siRNAs) have been shown to not only block transmission of viral STIs to mucosal tissues both in vitro and in vivo, but also confer durable knockdown of target gene expression, thereby circumventing the need to apply a microbicide around the time of sexual encounter, when compliance is mostly difficult. Despite numerous clinical trials currently testing the efficacy of siRNA-based therapeutics, they have yet to be approved for use in the treatment of viral STIs. While several obstacles to their successful implementation in the clinic still exist, promising preclinical studies suggest that siRNAs are a viable modality for the future prevention and treatment of HSV and HIV. PMID:24526828
Wheeler, Lee Adam
Few studies have examined whether and how receiving an sexually transmitted disease (STD) diagnosis while in a romantic relationship relates to condom use and psychosocial sexual outcomes. Using dyadic data, we examined associations of a personal or a partner’s STD diagnosis during a relationship with condom use, monogamy intentions, condom intentions and attitudes, and STD susceptibility and communication. Because beliefs about how the STD was acquired may shape associations with behavior and cognitions, gender and suspecting that one’s partner had other sexual partners (i.e., partner concurrency) were examined as moderators. Participants were 592 individuals in 296 couples expecting a baby; 108 individuals had been diagnosed with an STD during the relationship. Personal STD diagnosis was unrelated to outcomes or was associated with increased risk. A partner’s diagnosis related to more positive condom intentions and attitudes. Among men who suspected concurrency, both a personal and a partner’s STD diagnosis were associated with less condom use. Receiving the STD diagnosis during pregnancy was associated with greater susceptibility and marginally greater condom use. Results suggest potential benefits of enhancing communication and encouraging joint risk reduction counseling among couples, engaging men more fully in preventive efforts, and capitalizing on the short window during which risk reduction occurs.
Magriples, Urania; Niccolai, Linda M.; Gordon, Derrick M.; Divney, Anna A.; Kershaw, Trace S.
The global impact of sexually transmitted infections (STIs) is significant. The sexual transmission of viruses such as herpes simplex virus type-2 (HSV-2) and the human immunodeficiency virus type-1 (HIV-1), has been especially difficult to control. To date, no effective vaccines have been developed to prevent the transmission of these STIs. Although antiretroviral drugs have been remarkably successful in treating the symptoms associated with these viral infections, the feasibility of their widespread use for prevention purposes may be more limited. Microbicides might provide an attractive alternative option to reduce their spread. In particular, topically applied small inhibitory RNAs (siRNAs) have been shown to not only block transmission of viral STIs to mucosal tissues both in vitro and in vivo, but also confer durable knockdown of target gene expression, thereby circumventing the need to apply a microbicide around the time of sexual encounter, when compliance is mostly difficult. Despite numerous clinical trials currently testing the efficacy of siRNA-based therapeutics, they have yet to be approved for use in the treatment of viral STIs. While several obstacles to their successful implementation in the clinic still exist, promising preclinical studies suggest that siRNAs are a viable modality for the future prevention and treatment of HSV and HIV.
Wheeler, Lee Adam
Objective To identify whether school enrolment is protective against laboratory?confirmed diagnosis of sexually transmitted diseases (STDs) and against a spectrum of sexual risk factors. Methods A cross?sectional study of 715 African?American adolescent females (15–21?years old) was conducted. Data collection included an audio?computer?assisted self?interview lasting about 60?min and a self?collected vaginal swab for nucleic acid amplification testing of Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae. Results In total, 65% were enrolled in school. After adjusting for age and whether adolescents resided with a family member, those not enrolled were twice as likely to test positive for one of the three STDs compared with those enrolled (adjusted OR2; 95% CI 1.38 to 2.91). Similarly, school enrolment was protective against risk factors contributing to STD acquisition. The measures of sexual risk behaviour of 8 of 10, retained significance after adjusting for the covariates, and 2 of the 3 psychosocial mediators retained significance. Conclusion This study provides initial evidence suggesting that keeping high?risk African?American adolescent females in school (including forms of school that occur after high?school graduation) may be important from a public health standpoint.
Crosby, Richard A; DiClemente, Ralph J; Wingood, Gina M; Salazar, Laura F; Rose, Eve; Sales, Jessica M
Rational choice models of teenage sexual behaviour lead to radically different predictions than do models that assume such behaviour is random. Existing empirical evidence has not been able to distinguish conclusively between these competing models. I use regional data from England between 1998 and 2001 to examine the impact of recent increases in…
Abstract: Laws requiring minors to seek parental consent or to notify a parent prior to obtaining an abortion raise the cost of risky sex for teenagers. Assuming choices to engage,in risky sex are made rationally, parental involvement laws should lead to less risky sex among teens, either because of a reduction of sexual activity altogether or because teens will be
Jonathan Klick; Thomas Stratmann
Laws requiring minors to seek parental consent or to notify a parent prior to obtaining an abortion raise the cost of risky sex for teenagers. Assuming choices to engage in risky sex are made rationally, parental involvement laws should lead to less risky sex among teens, either because of a reduction of sexual activity altogether or because teens will be
Jonathan Klick; T. Stratmann
INTRODUCTION--Patients attending a clinic for sexually transmitted diseases (STD) in general have engaged in at risk sexual behaviour. Therefore they are at increased risk of acquiring HIV through sexual contact. OBJECTIVE--To determine the HIV prevalence among patients attending a STD clinic in Amsterdam. METHODS--An anonymous cross sectional study was conducted in two 5-week periods in Spring and Autumn 1991. RESULTS--Of the 2362 patients attending the clinic during the study period, 2292 (97%) consented to participate; of these, 2138 (93%) were interviewed and anonymously tested, while 154 (7%) consented to be interviewed but refused HIV antibody testing. The HIV prevalence was 4.2% (90/2138); 93% of seropositive participants reported homosexual contacts and/or intravenous use of drugs (IVDU). HIV prevalence among heterosexual non-IVDU men was 0.5% and among non-IVDU women 0.1%. Among all heterosexually active participants, including IVDU and bisexual men, the HIV prevalence was 1.5%. The 28 of 90 HIV infected participants that were heterosexually active reported together approximately 135 heterosexual partners in the six months preceding the study; 13 of these 28 heterosexually active participants had a STD diagnosed at their present clinic visit, while four (30%) of them already knew they were HIV infected. CONCLUSIONS--From these data we conclude that there is a substantial risk of further transmission of HIV through heterosexual contact. In order to try to reduce this potential for further sexual transmission of HIV, services offered by the STD clinic should not only include voluntary confidential counselling and HIV testing, but also notification of partners of HIV infected clinic-attendants. Finally, we conclude that anonymous HIV prevalence studies that link HIV test results to risk behaviour for HIV infection can be performed with a high rate of participation. Repeating such prevalence studies in time can help in monitoring the HIV incidence in the heterosexually active population.
Fennema, J S; van Ameijden, E J; Coutinho, R A; van Doornum, G J; Henquet, C J; van den Hoek, J A
The objective of this study was to determine the prevalence of urethral Mycoplasma genitalium infections among male patients attending a sexually transmitted disease (STD) clinic in China and identify risk factors associated with this disease. A total of 423 patients were recruited in Hezhou City, Guangxi Province, China, and each was requested to complete a questionnaire regarding sociological and sexual behaviors. First-void urine samples were collected for M. genitalium analysis by polymerase chain reaction. Of the 406 urine samples collected, 114 were M. genitalium-positive, giving a prevalence rate of 28.1%. Univariate logistic regression analysis showed that M. genitalium infection was associated with younger age, having received at least senior high school education, and single marital status. In both univariate and multivariate logistic regression analyses, M. genitalium infection was found to be associated with lack of symptoms for STD in the past year (adjusted odds ratio [AOR] = 2.839; 95% CI = 1.495-5.392; P = 0.001), no use of condoms with steady partners in the past year (AOR = 2.830; 95% CI = 1.468-5.455; P = 0.002), and having sexual encounters with female sexual workers within the past 3 months (AOR = 2.955; 95% CI = 1.637-5.336; P < 0.0003). The observed high rate of M. genitalium infection among male STD patients in Hezhou City indicates an M. genitalium epidemic in the study population; thus, the national surveillance program and clinical health providers in China should more closely monitor this disease. PMID:24451096
Zheng, Bing-jie; Yin, Yue-ping; Xiang, Zhi; Han, Yan; Shi, Mei-qin; Jiang, Ning; Yu, Rui-xing; Chen, Xiang-sheng
Objectives. We evaluated risk for hepatitis C virus (HCV) infection in women residing in low-income neighborhoods of northern California. Methods. A population-based sample of 1707 women, aged 18 to 29, were surveyed and screened for sexually transmitted infections and HCV. Results. Women infected with HCV (2.5%) were more likely to have a history of injection and noninjection drug use, to exchange sex for money or drugs, and to have sexually transmitted infections. HCV was independently associated with history of injection drug use, herpes simplex virus type 2 (HSV-2) infection, and heroin and cocaine use. Conclusions. Injection drug use is the highest risk exposure for HCV, but HSV-2 and noninjection drug use contribute significantly to increased risk. HCV prevention programs in impoverished areas should integrate drug treatment and sexually transmitted infection control.
Page-Shafer, Kimberly A.; Cahoon-Young, Barbara; Klausner, Jeffrey D.; Morrow, Scott; Molitor, Fred; Ruiz, Juan; McFarland, Willi
OBJECTIVES: (1) To determine the prevalence of sexually transmitted diseases (STDs) in pregnant women in Burkina Faso. (2) To evaluate the potential of clinical management of STDs based on screening with clinical data and urine leucocyte esterase test (LET). METHODS: Cross sectional study among antenatal clinic attendees was conducted in 1994 in Ouagadougou and Bobo-Dioulasso, the two largest urban centres in Burkina Faso, where more than 94% of the pregnant women benefit from antenatal care at least twice during their pregnancy. Each woman selected underwent an interview, general and gynaecological examination. Genital samples were collected to confirm the presence of STD pathogens. Logistic regression analysis was done to identify models that predict (a) gonorrhoea and/or chlamydia, (b) trichomoniasis and/or bacterial vaginosis, (c) candidiasis. Sensitivity, specificity and positive and negative predictive values of these models were assessed using standard methods. RESULTS: All 645 consecutive pregnant women were enrolled in the two sites. Among these women 32.4% presented at least one STD. The major STDs were: trichomoniasis (14%), bacterial vaginosis (13%), recent syphilis (3.6%), chlamydial infection (3.1%), genital warts (3%), gonococcal infection (1.6%) and genital ulcer (0.8%). Prevalence of vaginal candidiasis was 14%. The use of a risk marker (length of relationship with regular sexual partner < 3 years), and the positivity +3 of the urine LET provided a sensitivity of 80% and a positive predictive value of 7% for the screening of gonococcal and/or chlamydial infection. If clinical signs and positivity of the urine LET were taken into account sensitivity and positive predictive value of trichomoniasis and/or bacterial vaginosis screening were 77% and 37%, respectively. Clinical signs and positivity of the urine LET showed a low sensitivity (23%) for screening vaginal candidiasis. CONCLUSIONS: The prevalence of STDs in pregnant women is high in urban Burkina Faso. Systematic screening combined with effective treatment should be included in antenatal care in the future. Urine LET, if associated with interview and clinical examination offers a simple, rapid and affordable tool for systematic screening of STDs in pregnant women. However, the proportion of overtreatments with proposed strategies will be high. Further studies are needed to develop and validate better algorithms with probably cheap laboratory tests.
Meda, N; Sangare, L; Lankoande, S; Sanou, P T; Compaore, P I; Catraye, J; Cartoux, M; Soudre, R B
OBJECTIVE: To devise a flowchart suitable for assessing risk of trichomoniasis, chlamydia and gonorrhoea in an adolescent population, not all of whom will be sexually experienced or currently in a relationship. METHODS: The data used to derive the flowchart were generated from cross-sectional microbiological surveys of girls aged 14-19 years in Port Harcourt, Nigeria. The flowchart screened on the basis of: (i) sexual experience; (ii) recent sexual activity; (iii) a positive urine leukocyte esterase (LE) test; and (iv) among LE negatives, a history of malodorous/pruritic discharge. FINDINGS: Using this flowchart, we found that 26.2% of all adolescents screened would receive treatment for cervicitis and vaginitis. Chlamydial, gonococcal, and trichomonal infections were correctly diagnosed in 37.5%, 66.7%, and 50% of the cases, respectively. CONCLUSION: Although the flowchart is more suitable for an adolescent population than the vaginal discharge algorithm used in syndromic management protocols, it still lacks precision and needs adapting to local settings.
Obunge, O. K.; Brabin, L.; Dollimore, N.; Kemp, J.; Ikokwu-Wonodi, C.; Babatunde, S.; White, S.; Briggs, N. D.; Hart, C. A.
Objectives. We sought to determine the prevalence of and risk factors associated with Mycoplasma genitalium infection in a nationally representative sample of young adults in the United States. Methods. Urine specimens from 1714 women and 1218 men who participated in Wave III of the National Longitudinal Study of Adolescent Health (N=14322) were tested for M genitalium. Poststratification sampling weights were used to generate nationally representative estimates. Results. The prevalence of M genitalium was 1.0% compared with 0.4%, 4.2%, and 2.3% for gonococcal, chlamydial, and trichomonal infections, respectively. No M genitalium–positive individuals reported symptoms of discharge. M genitalium prevalence among those who reported vaginal intercourse was 1.1% compared with 0.05% among those who did not. In multivariate analyses, M genitalium prevalence was 11 times higher among respondents who reported living with a sexual partner, 7 times higher among Blacks, and 4 times higher among those who used condoms during their last vaginal intercourse. Prevalence of M genitalium increased by 10% for each additional sexual partner. Conclusions. M genitalium was more prevalent than Neisseria gonorrhoeae but less prevalent than Chlamydia trachomatis, and it was strongly associated with sexual activity.
Manhart, Lisa E.; Holmes, King K.; Hughes, James P.; Houston, Laura S.; Totten, Patricia A.
African-American female adolescents who engaged in vaginal sex only (N = 272) were compared to adolescents who engaged in two types (vaginal plus oral or anal; N = 295) and three types (vaginal, oral and anal; N = 144) on a constellation of other sexual risk behaviors (SRBs) and on sexually transmitted infections (STIs). Adjusted contrasts\\u000a among groups revealed that adolescents who engaged in two and
Laura F. Salazar; Richard A. Crosby; Ralph J. DiClemente; Gina M. Wingood; Eve Rose; Jessica McDermott-Sales; Angela M. Caliendo
During the last 20 years, both the United Kingdom and the Russian Federation have seen changes to clinical services for sexually transmitted diseases (STDs) health systems and other mechanisms through which STDs are controlled. In the UK these changes followed the description of the acquired immunodeficiency syndrome (AIDS) and the human immunodeficiency virus (HIV); its causal agent. In Russia, the breakdown of the Soviet Union following glasnost and perestroika, and its associated political, social and economic changes generated substantial developments to the ideological and legislative framework within which STD control is achieved as well as a revolution in the financial base upon which clinical STD services operate. The purpose of this paper is to sketch these developments in STD services within the 2 countries to provide a context for the series of papers presented in this edition. PMID:10582633
Renton, A M; Borisenko, K K; Tichonova, L I; Akovbian, V A
Prevention research in the past decade has proved the efficacy of risk reduction counselling in reducing the risks for sexually transmitted infections (STIs). The question currently facing STI service providers is therefore not so much whether counselling should be part of the standard of STI care but rather how this intervention can be implemented given the logistical and resource constraints of a busy practice setting. After a brief introduction of the history and an overview of the models for risk reduction counselling and their theoretical and scientific underpinnings, the focus of this paper will be on the extent to which individual prevention models have been adopted in different clinical settings, the impediments to implementation and suggestions for improvement.
Rietmeijer, C A
The reactivity of a non-specific reagin (RPR) test and a specific treponemal (FTA-ABS) test were determined in 21 patients with primary syphilis, 430 patients with proven non-treponemal genital ulcerations and 719 patients with acute urethritis presenting at a clinic for sexually transmitted diseases in southern Africa. Excluding those 21 cases of primary syphilis, 358 of 1149 tests performed (31%) were found to be reactive by at least one test. The rate of false positive RPR tests was very low (0.02%). Significantly higher rates of seropositivity were detected in patients with genital ulcerations than in patients with acute urethritis. The highest rates were detected among patients with proven lymphogranuloma venereum (34% RPR positive, FTA-ABS positive; 19% RPR negative, FTA-ABS positive). The geometric mean titres (GMT) of positive RPR tests in non-treponemal infections were found to be lower than in darkfield positive cases of genital ulcer disease.
Sischy, A; da L'Exposto, F; Dangor, Y; Fehler, H G; Radebe, F; Walkden, D D; Miller, S D; Ballard, R C
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 sexually transmitted infection clinic. The 60-minute risk reduction counselling intervention was grounded in the Information-Motivation-Behavioural Skills (IMB) model of HIV preventive behaviour change, adapted through a series of interdisciplinary collaborative workshops. This paper reports the process of developing and culturally adapting the brief risk reduction counselling intervention. The processes used for adapting the HIV risk reduction counselling for South Africa provides a potential model for conducting technology transfer activities with other HIV prevention interventions. Several lessons learned from this process may help guide future efforts to transfer HIV prevention technologies. PMID:17601009
Mathiti, V; Simbayi, L C; Jooste, S; Kekana, Q; Nibe, X P; Shasha, L; Bidla, P; Magubane, P; Cain, D; Cherry, C; Kalichman, S C
Little is known about Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) rates in community-supervised juvenile justice-involved (CSJJI) females, or how to best provide screening for sexually transmitted infections in this population. A pilot intervention allowed case managers to offer optional CT/GC screening to CSJJI females during mandated visits. Anonymous satisfaction surveys and discussion groups assessed intervention acceptability. Case managers met with 514 CSJJI females; 102 (20%) agreed to screening and 117 tests were completed. Among those screened, 21 (18%) had CT and 3 (3%) had GC. Intervention feedback from case managers and clients was positive, but there were barriers to recruitment. Lessons learned from this case manager-facilitated intervention may increase the acceptability and effectiveness of future screening methods in this setting.
Donaldson, Abigail A.; Burns, Jessica; Bradshaw, Catherine P.; Ellen, Jonathan M.; Maehr, Jennifer
We determined the prevalence of seven clinically important pathogens that cause sexually transmitted infections (STIs) (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, herpes simplex virus 1 [HSV-1], HSV-2, and Treponema pallidum), by using a multiplex polymerase chain reaction (M-PCR) in samples from Brazilian woman infected with human immunodeficiency virus 1 (HIV-1) and uninfected Brazilian women (controls). The M-PCR assay identified all STIs tested for and surprisingly, occurred association between the control and STIs. This association was probably caused by excellent HIV infection control and regular monitoring in these women established by public health strategies in Brazil to combat HIV/acquired immunodeficiency syndrome. Studies using this M-PCR in different populations may help to better elucidate the roles of STIs in several conditions. PMID:24080632
Souza, Raquel P; de Abreu, André L P; Ferreira, Érika C; Rocha-Brischiliari, Sheila C; de B Carvalho, Maria D; Pelloso, Sandra M; Bonini, Marcelo G; Gimenes, Fabrícia; Consolaro, Marcia E L
Background and Objective The Sonagachi Project in Calcutta, India, organized sex workers to improve working conditions. Goal To compare rates of sexually transmitted diseases between the Sonagachi Project and other areas in which only the National AIDS Control Organization (NACO) interventions were implemented. Study A cross-sectional survey of randomly selected female sex workers. Results There was no difference in the prevalence of all STDs between the 2 areas; both were lower than reported in other surveys in 1992. Analysis using propensity scores also failed to demonstrate any difference. The number of preventive activities was similar in the Sonagachi and NACO-only areas but was more prevalent than in 1992. Sex workers in the Sonagachi area had better treatment-seeking behavior and attitudes. Both the Sonagachi and NACO strategies have resulted in lower STD rates, but the Sonagachi Project also increased the proportion who had an optimistic attitude and increased prevention and treatment-seeking behavior.
GANGOPADHYAY, DWIJENDRA NATH; CHANDA, MITRA; SARKAR, KAMALESH; NIYOGI, SWAPAN KUMAR; CHAKRABORTY, SEKHAR; SAHA, MALAY KUMAR; MANNA, BYOMKESH; JANA, SMARAJIT; RAY, PRATIM; BHATTACHARYA, SUJIT KUMAR; DETELS, ROGER
Little is known about Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) rates in community-supervised juvenile justice-involved (CSJJI) females, or how to best provide screening for sexually transmitted infections in this population. A pilot intervention allowed case managers to offer optional CT/GC screening to CSJJI females during mandated visits. Anonymous satisfaction surveys and discussion groups assessed intervention acceptability. Case managers met with 514 CSJJI females; 102 (20%) agreed to screening and 117 tests were completed. Among those screened, 21 (18%) had CT and 3 (3%) had GC. Intervention feedback from case managers and clients was positive, but there were barriers to recruitment. Lessons learned from this case manager-facilitated intervention may increase the acceptability and effectiveness of future screening methods in this setting. PMID:23983235
Donaldson, Abigail A; Burns, Jessica; Bradshaw, Catherine P; Ellen, Jonathan M; Maehr, Jennifer
The global control of sexually transmitted diseases (STDs) represents a daunting task, and there have been very few examples of success. The scope of the STD problem in China before the formation of the People's Republic and the effects of a governmental STD control program were reviewed. In major cities, 10% of the population had syphilis, reaching 50% prevalence in some rural minorities. By 1964, STDs in China were virtually eliminated through a program that destigmatized STDs, provided an infrastructure for case finding and therapy, and eliminated prostitution. The People's Republic of China demonstrated the possibility of eliminating STDs, at least for some period of time. Although the Chinese approach may not be ideal for Western democracies, understanding some features of the Chinese program may help in designing a strategy for the eradication of human immunodeficiency virus when or if treatment becomes available. PMID:8843252
Cohen, M S; Henderson, G E; Aiello, P; Zheng, H
Nongonococcal urethritis (NGU), an inflammation of the urethra not caused by gonorrhea, is the most common urethritis syndrome seen in men in the United States. It is a sexually transmitted infection commonly caused by Chlamydia trachomatis, a pathogen which occurs more frequently in African-American men compared to white men. The purpose of this study was to investigate factors related to retention of study participants in a randomized, double-blinded clinical trial that evaluated four treatment regimens for the treatment of NGU. After the one-week treatment period, follow-up visits were scheduled during days 15–19 and days 35–45. Participants were phoned prior to scheduled appointments to encourage attendance, and contacted after missed appointments to reschedule their clinic visits. Of the 305 male study participants, 298 (98%) were African-American, 164 (54%) were 25 years of age or younger, and 80 (31%) had a post-secondary school education. The overall retention rate was 75%. Factors associated with study completion were educational level attained and clinical center. Participants with higher levels of education were more likely to complete the study. Clinical centers with the highest retention rates also provided the highest monetary incentives for participation. The retention rate for this study suggests that strategies are needed for improving the proportion of study participants that complete a clinical trial among young men with a sexually transmitted disease. These strategies may include increasing contacts with study participants to remind them of scheduled study visits using text messaging or social media and the use of financial incentives.
Lee, Jeannette Y.; Lensing, Shelly Y.; Schwebke, Jane R.
Nongonococcal urethritis (NGU), an inflammation of the urethra not caused by gonorrhea, is the most common urethritis syndrome seen in men in the United States. It is a sexually transmitted infection commonly caused by Chlamydia trachomatis, a pathogen which occurs more frequently in African-American men compared to white men. The purpose of this study was to investigate factors related to retention of study participants in a randomized, double-blinded clinical trial that evaluated four treatment regimens for the treatment of NGU. After the one-week treatment period, follow-up visits were scheduled during days 15-19 and days 35-45. Participants were phoned prior to scheduled appointments to encourage attendance, and contacted after missed appointments to reschedule their clinic visits. Of the 305 male study participants, 298 (98%) were African-American, 164 (54%) were 25 years of age or younger, and 80 (31%) had a post-secondary school education. The overall retention rate was 75%. Factors associated with study completion were educational level attained and clinical center. Participants with higher levels of education were more likely to complete the study. Clinical centers with the highest retention rates also provided the highest monetary incentives for participation. The retention rate for this study suggests that strategies are needed for improving the proportion of study participants that complete a clinical trial among young men with a sexually transmitted disease. These strategies may include increasing contacts with study participants to remind them of scheduled study visits using text messaging or social media and the use of financial incentives. PMID:22261236
Lee, Jeannette Y; Lensing, Shelly Y; Schwebke, Jane R
Background Sub-Saharan Africa is the continent with the highest prevalence of Hepatitis C virus (HCV) infection. Genotype 2 HCV is thought to have originated from West Africa several hundred years ago. Mechanisms of transmission remain poorly understood. Methodology/Principal Findings To delineate mechanisms for HCV transmission in West Africa, we conducted a cross-sectional survey of individuals aged ?50 years in Bissau, Guinea-Bissau. Dried blood spots were obtained for HCV serology and PCR amplification. Prevalence of HCV was 4.4% (47/1066) among women and 5.0% (27/544) among men. In multivariate analysis, the independent risk factors for HCV infection were age (baseline: 50–59 y; 60–69 y, adjusted odds ratio [AOR]: 1.67, 95% CI: 0.91–3.06; ?70 y, AOR: 3.47, 95% CI: 1.89–6.39), belonging to the Papel, Mancanha, Balanta or Mandjako ethnic groups (AOR: 2.45, 95% CI:1.32–4.53), originating from the Biombo, Cacheu or Oio regions north of Bissau (AOR: 4.16, 95% CI: 1.18–14.73) and having bought or sold sexual services (AOR: 3.60, 95% CI: 1.88–6.89). Of 57 isolates that could be genotyped, 56 were genotype 2. Conclusions Our results suggest that transmission of HCV genotype 2 in West Africa occurs through sexual intercourse. In specific locations and subpopulations, medical interventions may have amplified transmission parenterally.
Plamondon, Mireille; Labbe, Annie-Claude; Frost, Eric; Deslandes, Sylvie; Alves, Alfredo Claudino; Bastien, Nathalie; Pepin, Jacques
Molluscum contagiosum is a viral disease of the skin characterized by discrete, multiple, flesh-colored papules. It is caused by a highly infectious, enveloped deoxyribonucleic acid virus, called molluscum contagiosum virus (MCV). Molluscum contagiosum is very common in children, sexually active adults and immunocompromised patients, especially those who are infected with the human immunodeficiency virus. MCV transmission usually takes place through direct skin-to-skin contact. Infections in childhood are often linked to swimming-pool attendance. Adults are infected usually through sexual contact. An intimate skin-to-skin contact is sufficient for transmission of the virus. In immunocompetent adults, the warts remain in the genital area and adjacent regions of the skin. In children and patients with immunocompromised conditions, however, various regions of the body are usually affected. Therapy of molluscum contagiosum should be undertaken in an individualized manner, a specific treatment does not exist. For the treatment, physical methods such as curettage and cryotherapy, topic acids (e. g., acetic acid) and alkalis (e. g., potassium hydroxide), some other topical agents such as cantharidin and imiquimod, as well as several systemic agents the pharmacological treatments is, however, sparse. Effective prevention is problematic due to the high infectivity of the virus. A vaccine is not available. PMID:23977728
Objective: To determine the aetiology of genital ulcers and discharges in rural south western Uganda and to assess response to syndromic treatment. Method: A longitudinal, prospective study using laboratory testing and questionnaires to evaluate 561 adult men and women presenting with clinically verified genital ulcers, urethral, or vaginal discharge at a general outpatient clinic and two health centres between December 1999 and July 2001. Results: One third of patients had genital ulcers and two thirds discharges. There was good response to treatment in 461/508 patients (90.7%). Herpes simplex virus type 2 was found in 95/217 (43.8%) genital ulcers. In 24.1% of ulcer cases there was also a genital discharge. HIV seropositivity was high in ulcer cases (63.2%), with significantly more HSV2 and secondary bacterial infection than in seronegative cases. Neisseria gonorrhoeae was found in 135/204 (66.2%) male genital discharges. Female genital discharges were mostly associated with bacterial vaginosis (36.1%), Trichomonas vaginalis (18.9%), and candidiasis (18.6%). Conclusions: The aetiological pattern of STI syndromes reported will help inform revision of national STI guidelines. The importance of herpes simplex virus type 2, the variation in causes of genital ulcers according to HIV serostatus, the high frequency of multiple infections and secondary bacterial contamination of genital ulcers are notable. These results help explain the lack of effect of an STI intervention on HIV incidence in a recent trial in this area.
Pickering, J; Whitworth, J; Hughes, P; Kasse, M; Morgan, D; Mayanja, B; Van der Paal, L; Mayaud, P
Background: In Sri Lanka little is known about the prevalence of Chlamydia trachomatis (CT) infection. Objective was to determine the prevalence of CT in female patients attending sexually transmitted disease (STD) clinics in the Colombo district. Materials and Methods: A descriptive cross-sectional study was carried out for the prevalence of CT in all female patients (n = 168) more than 18 years of age, attending two STD clinics in the Colombo district from January to May 2012. Endocervical swabs were collected and tested for CT using the Amplicor CT/NG polymerase chain reaction assay. Results: Prevalence of CT in females attending the STD clinics in the Colombo district was 8.3%. Mean age of those infected with CT was 32.9 years (SD ± 8.2). Majority of females with CT infections were Sinhalese and married. There was no significant association with age, ethnicity or being married or not. Females who did not attend school, or had their education only up to Grade 5 were significantly found to have six times the risk of having CT infection (95% CI = 1.8-22.6). A significant association was found with number of sexual partners but not with commercial sex work or past history of STD. Conclusions: Prevalence of CT was moderately high in this population. PMID:24739832
Mangalika, Gunasekera Henadira Appuhamilage Kamani; Cankanamge, Silva Koththigoda; Priyadarshana, Dhammike; Shamini, Prathapan; Sujatha, Mananwatte; Geeganage, Weerasinghe; Nalaka, Abeygunasekera
The objective of the study is to investigate products used by women self-treating symptoms of reproductive tract infections (RTIs), including sexually transmitted infections (STIs), and their methods of administration. A household survey using a multi-stage cluster sample design was undertaken in KwaZulu-Natal, South Africa. Women aged 18-60 years were interviewed (n = 867) and information was collected on demographics, reproductive health and sexual behaviours. A fifth of women reported having RTI/STI symptoms (20.5%), of whom 41.9% were treating these symptoms (mostly discharge [79.1%], ulcers [6.8%] and itching [7.7%]). Only three women were using medication prescribed by a health provider, while the remainder were self-treating using traditional medicines and modern products, including antiseptics, soaps, petroleum jelly, menthol creams and alum. Products were administered in various ways. Although RTI/STI treatment is widely available and free in public health facilities, many women are still self-treating. Potential harm of products for self-treatment requires further investigation and efforts should be made to improve STI service uptake. PMID:21297085
Beksinska, M E; Smit, J; Scorgie, F; Dube, S; Kunene, B; Martin-Hilber, A; Chersich, M
Few studies have assessed the effect of educational level on sexually transmitted infections (STIs) and risk-taking behaviours among commercial sex workers (CSWs). This study analysed this association among female CSWs in Quito, Ecuador. Eighty-five CSWs were given a Spanish-language questionnaire on behaviours, socioeconomics and demographics. The correlation between years of education and number of prior STIs was calculated. Three groups of varying education level were formed and risk factors were analysed by Chi-square tests and analysis of variances. Lower educational level was associated with more STIs (r= -0.36; F=4.2; P=0.04), poorer knowledge of HIV/AIDS (P=0.03), earlier first prostitution (P=0.05) and first sex (P=0.00), willingness to engage in group sex (P=0.05) and work on the street (P=0.02), and presence of non-paying sexual partners (P=0.05). CSWs with lower educational levels were disproportionately afflicted with STIs and participated in more high-risk behaviours. Low educational level may predispose CSWs to STIs and associated risk factors. PMID:18482947
Solomon, M M; Smith, M J; del Rio, C
Data on viral hepatitis B (HBV) testing and vaccination in primary care settings among persons at sexual risk for HBV infection have been sparse. We examined rates and factors associated with HBV serologic testing and vaccination rates in adults infected with sexually transmitted infections. We conducted a retrospective cohort study of adults diagnosed with chlamydia, gonorrhea, or syphilis in Kaiser Permanente Southern California in 2008-2011. The vaccine series initiation was examined in subjects who were tested susceptible. The 90-day hepatitis B surface antigen (HBsAg) testing rate was 28.1% in 15 357 adults. Testing rates increased through the study period. Only 8.8% of patients received both HBsAg and hepatitis B surface antibody tests to determine prior exposure and susceptibility to HBV. Among those who were tested susceptible, 116 (10.6%) subjects initiated the vaccine series. In multivariable logistic regression analysis, the odds of receiving testing was inversely associated with female sex, black race, other/unknown race, or having prespecified chronic comorbidities. In survival analysis, adults aged 25-34 years and ?55 years were more likely to initiate hepatitis B vaccine series compared with those aged 18-24 years. There are missed opportunities in HBV testing and vaccination in primary care. Implementation of provider decision-making support tools in the electronic medical record system may potentially improve hepatitis B testing and vaccination rates. PMID:24571863
Hechter, Rulin C; Jacobsen, Steven J; Luo, Yi; Nomura, Jim H; Towner, William J; Tartof, Sara Y; Tseng, Hung Fu
Targeted intervention research (TIR) studies were performed in five African countries (Senegal, Ethiopia, Benin, Morocco, and Swaziland) to improve the utilization of a community perspective in sexually transmitted disease (STD) programs. TIR, conducted by program managers with the aid of a multidisciplinary technical advisory group, examines factors at five levels of analysis (individual, social network, organization, community, and policy) through a variety of qualitative methods. The TIR studies indicated that patients' conceptions of normal versus abnormal health are fundamental to the process of interpreting symptoms and subsequently seeking care. The interpretation of STD symptoms varied across settings (e.g., vaginal lesions and discharge were considered signs of healing in Morocco and Benin), but increasing pain and discomfort were key triggers to seeking treatment. The concept of sexual transmission was blended with other causes such as violation of religious or moral codes, consumption of certain foods, and supernatural forces. Care-seeking tended to reflect an ordered yet loosely constructed process of elimination in pursuit of symptom relief, beginning with alternative regimens. Barriers to biomedical STD care included the need for husband's permission, costs, confidentiality concerns, long waits in public clinics, and fear of judgmental health provider attitudes. Overall, the findings highlight the importance of location-specific strategies aimed at increasing prompt care-seeking at qualified biomedical facilities. PMID:9792369
Field, M L; Price, J; Niang, C; N'tcha, J; Zwane, I T; Lurie, M; Nxumalo, M; Dialmy, A; Manhart, L; Gebre, A; Saidel, T; Dallabetta, G
Background Female sex workers have been the target of numerous sexually transmitted infection (STI) prevention strategies in China, but their male clients have attracted considerably less public health attention and resources. We sought to systematically assess the prevalence of HIV, syphilis, gonorrhea, and chlamydia among heterosexual male clients of female sex workers in China. Methods/Principal Findings Original research manuscripts were identified by searching Chinese and English language databases, and 37 studies analyzing 26,552 male clients were included in the review. Client STI prevalence across studies was heterogeneous. Pooled prevalence estimates and 95% confidence intervals were 0.68% (0.36–1.28%) for HIV, 2.91% (2.17–3.89%) for syphilis, 2.16% (1.46–3.17%) for gonorrhea, and 8.01% (4.94–12.72%) for chlamydia. Conclusions/Significance The pooled prevalence estimates of HIV, syphilis, gonorrhea, and chlamydia among clients in this review exceed the prevalences previously reported among population-representative samples and low-risk groups in China. However, heterogeneity across studies and sampling limitations prevent definitive conclusions about how the prevalence of STIs in this population compares to the general population. These findings suggest a need for greater attention to clients’ sexual risk and disease prevalence in China’s STI research agenda in order to inform effective prevention policies.
McLaughlin, Megan M.; Chow, Eric P. F.; Wang, Cheng; Yang, Li-Gang; Yang, Bin; Huang, Jennifer Z.; Wang, Yanjie; Zhang, Lei; Tucker, Joseph D.
... experiences, free of coercion, discrimination and violence.  Sexual Health News & Information HHS Statement on LGBT Health Awareness ... infectious diseases, reproductive health and sexual violence prevention. Sexual Health Topics Sexually Transmitted Diseases Up-to-date information ...
Background Both periodontal disease and bacterial vaginosis may cause adverse pregnancy outcomes. This study evaluated the association between periodontal disease and bacterial vaginosis. Methods Data from 3569 women enrolled in the Longitudinal Study of Vaginal Flora was used. Periodontal disease, defined as >3 sites with ?4mm attachment loss, was assessed by specially-calibrated hygienists at baseline. Positive bacterial vaginosis status was based on a Nugent Gram stain score ?7. Pairs of independent variables were compared with Pearson's chi-square and risk ratios were calculated through log-binomial regression. Results 28% of women with bacterial vaginosis had periodontal disease compared to 22% without, corresponding to 1.29 (95% CI: 1.13, 1.47) times greater risk of periodontal disease among women with bacterial vaginosis. In adjusted analysis the risk ratio dropped to 1.23 (95% CI: 1.08, 1.40). Receptive oral sex with an uncircumcised partner was associated with 1.28 times (95% CI: 0.97, 1.69) the risk for periodontal disease compared to receptive oral sex with a circumcised partner, though the association is not statistically significant. Conclusions In this population, there is a small but significant association between periodontal disease and bacterial vaginosis and a possible trend between receptive oral sex with an uncircumcised partner and periodontal disease.
Zabor, Emily Craig; Klebanoff, Mark; Yu, Kai; Zhang, Jun; Nansel, Tonja; Andrews, William; Schwebke, Jane; Jeffcoat, Marjorie
Objective To determine the effects of a behavioural intervention for prevention of HIV and sexually transmitted diseases that identified, trained, and engaged leaders of Roma (Gypsy) men's social networks to counsel their own network members. Design A two arm randomised controlled trial. Setting A disadvantaged, impoverished Roma settlement in Bulgaria. Participants 286 Roma men from 52 social networks recruited in
Jeffrey A Kelly; Yuri A Amirkhanian; Elena Kabakchieva; Sylvia Vassileva; Boyan Vassilev; Timothy L McAuliffe; Wayne J DiFranceisco; Radostina Antonova; Elena Petrova; Roman A Khoursine; Borislav Dimitrov
The high sensitivity of nucleic acid amplification tests such as ligase chain reaction (LCR) has the potential to simplify specimen collection for the microbiologic diagnosis of gonorrhea. We screened first-void urine specimens from 283 women attending a Birmingham, Ala., sexually transmitted disease (STD) clinic by using LCR and compared the results to those of cervical and urethral cultures for gonorrhea
KIM R. SMITH; SHANFUN CHING; HELEN LEE; YOSHIHIRO OHHASHI; HSIANG-YUN HU; HENRY C. FISHER; ANDEDWARD W. HOOK
Objective: To examine the practices of anal intercourse and dry sex within a cohort of female sex workers (FSWs) in Kenya, focusing on the prevalence and perceived risk of the practices, demographic and behavioural correlates, and association with sexually transmitted infections (STI).Methods: A survey was conducted among FSWs in Meru, Kenya, with 147 participants randomly sampled from an existing cohort
M Schwandt; C Morris; A Ferguson; E Ngugi; S Moses
Asian women who work at massage parlors in San Francisco have high levels of riskfor sexually transmitted infections (STIs), including HIV, and being victims of violence, which jeopardizes their health and wellbeing. On the basis of mapping, the targeted districts in San Francisco where massage parlors were located, 23 massage parlors were identified where commercial sex activity took place. Using
Tooru Nemoto; Mariko Iwamoto; Serena Wong; Mai Nhung Le; Don Operario
Objective: The objective of this study was to estimate the cost- effectiveness of syndromic management, with and without periodic presumptive treatment (PPT), in averting sexually transmitted infec- tions (STIs) and HIV in female sex workers (FSWs) participating in a hotel-based intervention in Johannesburg. Study Design: Financial and economic providers' costs were esti- mated. A mathematical model, fitted to epidemiologic data,
Peter Vickerman; Fern Terris-Prestholt; Sinead Delany; Lilani Kumaranayake; Helen Rees; Charlotte Watts
The goals of the current study were to: (1) estimate the prevalence of forced sex among women accessing services at a women's health clinic in rural Haiti; and (2) examine factors associated with forced sex in this population. Based on data from a case-control study of risk factors for sexually transmitted diseases (STDs), a cross-sectional analysis to examine factors associated
M. C. Smith Fawzi; W. Lambert; J. M. Singler; Y. Tanagho; F. Léandre; P. Nevil; D. Bertrand; M. S. Claude; J. Bertrand; M. Louissaint; L. Jeannis; J. S. Mukherjee; S. Goldie; J. J. Salazar; P. E. Farmer
Background To reduce the incidence of HIV and sexually transmitted infections (STIs), it is necessary to target high-risk populations such as prison inmates. This study aims to explore the range of knowledge on HIV and STIs, sexual behaviors, and adoption of preventive measures among women inmates. Methods This was a survey conducted between July 1, 2012 and July 29, 2012 among women inmates at Briman Prison, Jeddah, Saudi Arabia. The author gave an educational lecture on STIs in a conference room at the prison. Educational material was distributed to the attendees after the lecture, and the survey was conducted one week later. All the participants were asked to complete an anonymous 40-item self-administered questionnaire in the presence of a professional health assistant and a translator, for non-Arabic speakers. Data collected included the personal data of the respondent, her alleged criminal background, penal status, accumulative time in prison, history of smoking, alcohol or drug addiction, knowledge about the seven most common STIs, symptoms, modes of transmission, prevention, sexual activity, addiction, and means of protection. Descriptive analysis was performed using Microsoft Excel. Results We interviewed 204 women aged 16-60 years (mean, 33.3 years). Most of the respondents (n?=?170; 83?·?0%) were not aware of STIs; 117 respondents (57?·?4%) did not undergo screening for STIs before marriage or intercourse, while only 59 (28?·?9%) did. Over half of the respondents (n?=?107; 52.5%) thought they knew how to protect themselves from STIs. Nevertheless, 87 (42.6%) were uncertain about the role of condoms in protection from STIs and (n?=?41; 20.1%) thought condoms provide 100% protection against STIs, while 72 respondents (35.3%) thought condoms did not confer 100% protection against STIs. Only 10 respondents (4.9%) used condoms to protect themselves from STIs. Saudi women (P?=?0.033) and those with a higher level of education (P?0.01) were significantly more likely to have better knowledge. Conclusion Women inmates at Briman Prison have poor knowledge of STIs as well as risky sexual behaviors. Campaigns aimed at increasing awareness of STIs should also target prison inmates, who in general constitute high-risk populations.
Men who have sex with men (MSM) are at particular risk for HIV/sexually transmitted infections (STI). To investigate the European guidance used for MSM STI and HIV screening, risk level profiling and how this translated to practice, we conducted a questionnaire survey of leading physicians in the European branch of the International Union against Sexually Transmitted Infections (IUSTI). We identified that most European countries have limited guidance on screening intervals for MSM. Where risk profiling is advised, it is often left to clinicians to weight different behaviours and decide on screening frequency. Our results suggest that European MSM STI and HIV testing guidelines be developed with clear and specific recommendations around screening intervals and risk profiling. These guidelines will be particularly helpful due to rapidly evolving models of sexual healthcare, and the emergence of new providers who may benefit from guidelines that require less interpretation. PMID:24216033
Patel, Rupali R; Patel, Sonali; Clarke, Emily; Khan, Ahmed W; Doshi, Bhavin; Radcliffe, Keith W
The correlation between sexually transmitted infections and cervicovaginal dysplasia has been evaluated in a cohort of 135 women who tested positive for human immunodeficiency virus type I (HIV-1) and were admitted to Amedeo di Savoia Hospital of Turin during the years 1997 and 1998 (stages B2 and B3 or C2 and C3). Of these women. 31 presented with sexually transmitted diseases (STDs; mean age, 33.5 +/- 5.9 years). Among them, 14 were affected by cervicovaginal dysplasia of differing severity; human papillomavirus (HPV) infection was found in 13 subjects (10 with cervicovaginal dysplasia). Herpes simplex virus type 2 (HSV-2) infection was detected in six women. Finally, Trichomonas vaginalis and Candida albicans were found in 10 and in 6 patients, respectively. Immunologic and hematologic evaluations were performed in the patients affected by STDs; in 28 patients of our case report unaffected by STDs but of similar ages (34.1 +/- 5.6 years) and stage of infection; and in 20 HIV-negative women unaffected by STDs. A significant reduction among the patients affected by STDs, as compared to those unaffected, was found in the case of white cells, CD4+ T cells, and ratio values (CD4 +/ and CD8 + T cells). Moreover, red cell count and hemoglobin concentration were lower in those women in the STD group. A lack of correlation was found between HIV RNA loads and CD4 + T cell counts and between HIV RNA and hemoglobin concentration in the patients with cervicovaginal dysplasia and in those affected by HSV-2 infection, which differed from the findings in subjects affected only by trichomoniasis or candidiasis. This suggests that the two former pathologic conditions (cervico-vaginal dysplasia and HSV-2 infection), other than HIV- I infection, may contribute to the impairment of these values. Moreover in our case report, T vaginalis and HSV-2 infections, which are suspected to have an oncogenic potential, do not seem to be relevant in the induction or facilitation of genital neoplastic diseases. Noteworthy is that the patients affected by HSV-2 infection, such as those affected by genital neoplastic diseases, showed the most compromised values of total white cells, CD4+ T cells, ratio index, red cells, and hemoglobin concentration. PMID:11270419
Pugliese, A; Saini, A; Andronico, L; Pagliano, G; Gallo, G
The Israeli Ministry of Health inaugurated two walk-in community sexually transmitted disease (STD) clinics in 2002. This review focuses on the Levinsky Clinic in Tel Aviv. The clinics were established as a response to the increase in N. gonorrhea morbidity during the late 1990's, especially in the Tel Aviv district and following the rise in trafficking of women into Israel. The target populations were later extended to include other individuals at risk of developing STD, such as prostitutes, drug addicts, men who have sex with men, persons who have multiple sex partners or individuals considering themselves to be at high-risk. The clinic is operated by a multi-professional team, including physicians, nurses, social and community workers, and volunteers. Each patient is interviewed by a nurse or social-worker to stratify her/his risk of acquiring STD. Laboratory tests and physical examinations are performed as indicated. The services are free of charge and the clients have the option to remain anonymous in order to hamper possible barriers in accessing the clinic. The medical and psycho-social services of the Levinsky Clinic are tailored for the target populations. Therefore, some of the services are provided by a mobile unit outreaching the streets, brothels, shelters for trafficked women and refugees, correctional facilities, gay venues and drug trade locations. The staff employs the harm reduction strategy, is sensitive to the status of the individual in the community, and attentive to the influence of the environment over the clients' ability to control their risks of acquiring STD. The staff encourages an open and direct conversation with the clients about sex and sexuality, in a non-judgmental and respectful fashion. Many of those interventions are provided by community workers, who are familiar with the unique social behaviors, language, values and life style of the vulnerable populations, and aware of the limitations in adopting safe sex practices. PMID:21341428
Mor, Zohar; Goor, Yael; de Musquita, Sarah Bueno; Shohat, Tamy
There are reports of increased sexual risk behaviors in the HIV-positive population since the introduction of highly active antiretroviral therapy (HAART). Little is known about the effects of the case management (CM) program and HAART on sexually transmitted diseases (STDs) in Taiwan. HIV-positive subjects, who visited the outpatient clinics of Taoyuan General Hospital between 2007 and 2010, were enrolled. A total of 574 subjects and 14,462 person-months were reviewed. Incident STDs occurred in 104 (18.1%) subjects, and the incidence rate was 8.6 (95% confidence interval [CI], 7.1-10.5) per 100 person-years (PY). For men who have sex with men (MSM), heterosexual men and women, and injection drug users (IDU), 19.4 per 100 PY(95% CI, 15.7-24.0), 3.5 per 100 PY (95% CI, 1.4-7.3), and 1.1 per 100 PY (95% CI, 0.4-2.4) of STDs were noted, respectively; (MSM versus IDU and MSM versus heterosexual subjects, p<0.000001; heterosexual subjects versus IDU, p=0.061). Syphilis (59.6%) was the most common STD. Regular CM and no HAART (hazard ratio, 2.58; 95% CI, 1.14-5.84; p=0.02) was significantly associated with STDs in MSM. Though this retrospective study might underestimate the incidence of STDs and not draw the conclusion of causality, we concluded that the CM program and HAART are associated with lower acquisition of STDs in the Taiwanese HIV-positive population. PMID:23442028
Cheng, Shu-Hsing; Yang, Chin-Hui; Hsueh, Yu-Mei
Objective: The prevalence of hepatitis B and hepatitis C in a sexually transmitted disease (STD) clinic population was studied, along with the prevalence of various STD agents, in an attempt to identify possible STD markers for the hepatitis C virus and help delineate the role of hepatitis C as an STD. The hepatitis C antibody rates found in the STD clinic were also compared with those found among patients attending a local OB/GYN clinic and those enrolled in a blood donor program, all from the same geographical area. Methods: A total of 150 women attending an STD clinc were examined for each of the following agents: Chlamyadia trachomatis, Neisseria gonorrhoeae, syphilis, hepatitis B surface antigen, hepatitis B core antibody, hepatitis B surface antibody, and hepatitis C virus antibody. Additionally, several patients who signed informed consent to be evaluated for human immunodeficiency virus (HIV) antibody were tested by an enzyme immunoassay (EIA) screen method. The prevalence of each agent was then compared with the other agents. Results: The overall prevalence rates detected were as follows: hepatitis B 16%, hepatitis C 4%, chlamydia 18.7%, gonorrhea 7.4%, syphilis 0.7%, and HIV 0%. Hepatitis C antibody was detected in 4% of patients in the STD clinic, 0.76% of volunteer blood donors from central Pennsylvania, and 0% of patiants studied from the Harrisburg Hospital (Harrisburg, PA) prentatal population. Conclusions: This screening study reveals an association between attending a Harrisburg, PA, area STD clinic and having an increased prevalence of hepatitis C antibody, but larger matched control studies will be needed to help clarify sexual transmission as a mode of transmission for the hepatitis C virus.
Jones, Sharon; Weber, Daniel I.; LeBar, William D.; Heitjan, Daniel F.; Kopreski, Mary Magdalene C.; Curcio, Frederick D.
Objectives Biological and behavioural surveillance of HIV and sexually transmitted infections (STIs) among populations at highest risk have been used to monitor trends in prevalence and in risk behaviours. Sex work in Panama is regulated through registration with the Social Hygiene Programme, Ministry of Health. We estimated prevalence of HIV and STIs, and factors associated with active syphilis among female sex workers (FSWs). Methods A cross-sectional study using venue-based, time-space sampling was conducted among FSWs in Panama from 2009 to 2010. FSWs were interviewed about sociodemographic characteristics, sexual risk behaviour, health history and drug use using an anonymous structured questionnaire. Blood was collected for serological testing of HIV and other STIs. Factors associated with active syphilis were studied using logistic regression analysis. Results The overall HIV-1 prevalence of 0.7% varied by FSW category; 1.6% in 379 unregistered, and 0.2% in 620 registered FSWs. Overall prevalence (and 95% CI) of STIs were: syphilis antibody, 3.8% (2.7% to 5.2%); herpes simplex virus type 2 antibody (anti-HSV-2), 74.2% (71.4% to 76.9%); hepatitis B surface antigen, 0.6% (0.2% to 1.3%); hepatitis B core antibody, 8.7% (7.0% to 10.6%); and hepatitis C antibody, 0.2% (0.0% to 0.7%). In multivariate analysis, registration (adjusted OR (AOR)=0.35; 95% CI 0.16 to 0.74), having a history of STI (AOR=2.37; 95% CI 1.01 to 5.58), forced sex (AOR=2.47; 95% CI 1.11 to 5.48), and anti-HSV-2 (AOR=10.05; 95% CI 1.36 to 74.38) were associated with active syphilis. Conclusions Although HIV prevalence is low among FSWs in Panama, unregistered FSWs bear a higher burden of HIV and STIs than registered FSWs. Programmes aimed at overcoming obstacles to registration, and HIV, STI and harm reduction among unregistered FSWs is warranted to prevent HIV transmission, and to improve their sexual and reproductive health.
Hakre, Shilpa; Arteaga, Griselda; Nunez, Aurelio E; Bautista, Christian T; Bolen, Aimee; Villarroel, Maria; Peel, Sheila A; Paz-Bailey, Gabriela; Scott, Paul T; Pascale, Juan M
Goal To determine the prevalence of selected STIs and correlates of chlamydia (CT) and gonorrhea (GC) infection among (FSWs) in Soc Trang province, Vietnam. Study Design Four hundred and six FSWs in Soc Trang province participated in a cross-sectional study between May and August, 2003. The study subjects were interviewed to obtain information about socio-demographic and behavioral characteristics and gynecologic and STI history, using a standardized interview. They underwent a physical examination during which cervical swabs were collected for GC and CT testing by polymerase chain reaction (PCR). Vaginal wet mount microscopy was performed to detect candidiasis and trichomoniasis (TV), and blood was drawn for testing for syphilis using rapid plasma reagin (RPR)+ Treponema pallidum hemagglutination assay (TPHA). Univariate and multivariate analyses were used to assess the associations of GC, CT, and GC/CT with selected variables. Results Prevalences were 14.9% for GC, 48.4% for CT, 54.9% for GC/CT, 3.8% for syphilis, 8.9% for trichomoniasis, and 12.2% for candidiasis. Increased risk for CT was associated with sex work for more than 6 months (aOR = 2.40, 95% CI: 0.99–5.82), receiving $4 US or less per sexual transaction (aOR = 1.91, 95% CI 1.13–3.23), and ever having terminated a pregnancy (aOR = 1.68, 95% CI 1.00–2.82). Reduced likelihood of CT was associated with older age (aOR = 0.96, 95% CI: 0.93–1.00) and ever having douched in the past month (aOR = 0.60, 95% CI 0.36–1.00). Only ever douching in the past month was associated with decreased risk for GC (aOR = 0.47, 95% CI 0.25–0.87). Higher likelihood of GC/CT was associated with having more than 4 clients per month (OR = 2.35, 95% CI 1.02–5.41) and receiving $4 US or less per sexual transaction (aOR = 1.74, 95% CI 1.04–2.93). Conclusions The prevalence of GC/CT is high amongst FSWs in Soc Trang. Therefore, periodic presumptive treatment (PPT) for cervicitis, together with World Health Organization-recommended periodic syndromic sexually transmitted disease management, for FSWs and further interventions should be considered, and a 100% condom use program should be promptly implemented. The existing STI health education program for FSWs should be strengthened, with special consideration of the correlates observed in this study.
NGUYEN, THUONG VU; VAN KHUU, NGHIA; LE, TRUC THANH THI; NGUYEN, ANH PHUONG; CAO, VAN; THAM, DUNG CHI; DETELS, ROGER
Female reproductive tract (FRT) epithelial cells protect against potential pathogens and sexually transmitted infections. The purpose of this study was to determine if epithelial cells from the upper FRT secrete antimicrobials that inhibit reproductive tract pathogens which threaten women's health. Apical secretions from primary cultures of Fallopian tube, uterine, cervical and ectocervical epithelial cells were incubated with Neisseria gonorrhoeae, Candida albicans (yeast and hyphal forms), HIV-1, and Lactobacillus crispatus, prior to being tested for their ability to grow and/or infect target cells. Epithelial cell secretions from the upper FRT inhibit N. gonorrhoeae and both forms of Candida, as well as reduce HIV-1 (R5) infection of target cells. In contrast, none had an inhibitory effect on L. crispatus. Cytokines and chemokines analysis in uterine secretions revealed several molecules that could account for pathogen inhibition. These findings provide definitive evidence for the critical role of epithelial cells in protecting the FRT from infections, without comprising the beneficial presence of L. crispatus, which is part of the normal vaginal microflora of humans.
Wira, CR; Ghosh, M; Smith, JM; Shen, L; Connor, RI; Sundstrom, P; Frechette, Gregory M.; Hill, EM; Fahey, JV
The prevalence of asymptomatic chlamydial and gonococcal infections in male and female military populations was determined using urine-based ligase chain reaction DNA amplification assays (DAAs). Cross-sectional surveys in four military settings revealed an overall prevalence of asymptomatic chlamydial infection of 4.2% (56/1338). This included 3.4% (21/618) of Western Pacific shipboard US Marine Corps enlisted men; 5.2% (21/406) of male marines shore-based in Okinawa, Japan; 2.7% (5/183) of female enlisted US Navy subtender personnel in dry dock; and 6.9% (9/131) of shore-based female naval personnel in San Diego. No gonococcal infections were detected. All subjects were treated within 2 weeks of screening; none of them had progressed to symptomatic disease. General population-based screening for asymptomatic sexually transmitted diseases, and in particular chlamydial infection, can be successfully implemented using urine-based DAA tests. Benefits are maximized in a population in which compliance for follow-up therapy is high. PMID:9806061
Brodine, S K; Shafer, M A; Shaffer, R A; Boyer, C B; Putnam, S D; Wignall, F S; Thomas, R J; Bales, B; Schachter, J
Sexually transmitted diseases (STDs) may impair sperm parameters and functions thereby promoting male infertility. To date limited molecular studies were conducted to evaluate the frequency and type of such infections in semen Thus, we aimed at conceiving and validating a multiplex PCR (M-PCR) assay for the simultaneous detection of the following STD pathogens in semen: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Herpes virus simplex (HSV) -1 and -2, and Treponema pallidum; We also investigated the potential usefulness of this M-PCR assay in screening programs for semen pathogens. In addition, we aimed: to detect human Papillomavirus (HPV) and genotypes by single PCR (sPCR) in the same semen samples; to determine the prevalence of the seven STDs, HPV and co-infections; to assess the possibility that these infections affect semen parameters and thus fertility. The overall validation parameters of M-PCR were extremely high including agreement (99.2%), sensitivity (100.00%), specificity (99.70%), positive (96.40%) and negative predictive values (100.00%) and accuracy (99.80%). The prevalence of STDs was very high (55.3%). Furthermore, associations were observed between STDs and changes in semen parameters, highlighting the importance of STD detection in semen. Thus, this M-PCR assay has great potential for application in semen screening programs for pathogens in infertility and STD clinics and in sperm banks. PMID:24921247
Gimenes, Fabrícia; Medina, Fabiana Soares; Abreu, André Luelsdorf Pimenta de; Irie, Mary Mayumi Taguti; Esquiçati, Isis Baroni; Malagutti, Natália; Vasconcellos, Vinícius Rodrigo Bulla; Discacciati, Michele Garcia; Bonini, Marcelo Gialluisi; Maria-Engler, Silvya Stuchi; Consolaro, Marcia Edilaine Lopes
Professional organizations recommend rescreening chlamydia-infected women. The iwantthekit Internet-screening program offered rescreening opportunities by using iwantthekit. Mailed, home-collected vaginal swabs were tested for chlamydia, gonorrhea, and trichomonas by nucleic acid amplification tests. Demographics and risk behaviors of repeat users were determined from questionnaires. Predictors of repeat users were measured in a matched case–control study. Of 1747 women, 304 (17%), who used iwantthekit, indicated they had used the kit previously. Mean age was 24.7 ± 5.7 year and 69% were African American. Repeat iwantthekit users were more likely to be ?20 years (OR = 2.10); were more likely to have been treated for a sexually transmitted infection (OR = 2.32); less likely to drink alcohol before sex (OR = 0.63); and to never use condoms (OR = 0.43). Of repeaters, 84.2% had a negative prior test and 15.8% had a positive. At current test, 13.2% were infected. Previous trichomonas was associated with current trichomonas (p < 0.05). The iwantthekit may offer rescreening opportunities for previously infected women.
Gaydos, Charlotte A; Barnes, Mathilda; Jett-Goheen, Mary; Quinn, Nicole; Whittle, Pamela; Hogan, Terry; Hsieh, Yu-Hsiang
Objectives The purpose of this study was to investigate the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium, in women attending a sexually transmitted disease (STD) clinic, as well as the frequency of coinfections, and relationship of each organism to cervicitis. Methods In this cross-sectional study of 324 women attending Baltimore City STD Clinics, C. trachomatis, N. gonorrhoeae, T. vaginalis, and M. genitalium were detected using nucleic acid amplification tests. Demographic characteristics and risk factors were ascertained. Results Overall prevalence of infection with C. trachomatis, N. gonorrhoeae, T. vaginalis, and M. genitalium was found to be 11.1%, 4.6%, 15.3%, and 19.2%, respectively. Prevalence in women with cervicitis was 15.8%, 6%, 18.9%, and 28.6% for C. trachomatis, N. gonorrhoeae, T. vaginalis, and M. genitalium, respectively. Percentages of coinfections were high. C. trachomatis and M. genitalium were significantly associated with cervicitis in univariate analysis, but only M. genitalium was significantly associated with cervicitis (AOR: 2.5) in multiple logistic regression models. Conclusion Knowledge of the statistical association of M. genitalium with cervicitis in this study increases the need for further confirmation of the etiologic significance of this organism with cervicitis in more diverse populations. The high prevalence merits more study and may have implications for diagnosis and treatment of cervicitis.
Gaydos, Charlotte; Maldeis, Nancy E.; Hardick, Andrew; Hardick, Justin; Quinn, Thomas C.
Sexually transmitted diseases (STDs) may impair sperm parameters and functions thereby promoting male infertility. To date limited molecular studies were conducted to evaluate the frequency and type of such infections in semen Thus, we aimed at conceiving and validating a multiplex PCR (M-PCR) assay for the simultaneous detection of the following STD pathogens in semen: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Herpes virus simplex (HSV) ?1 and ?2, and Treponema pallidum; We also investigated the potential usefulness of this M-PCR assay in screening programs for semen pathogens. In addition, we aimed: to detect human Papillomavirus (HPV) and genotypes by single PCR (sPCR) in the same semen samples; to determine the prevalence of the seven STDs, HPV and co-infections; to assess the possibility that these infections affect semen parameters and thus fertility. The overall validation parameters of M-PCR were extremely high including agreement (99.2%), sensitivity (100.00%), specificity (99.70%), positive (96.40%) and negative predictive values (100.00%) and accuracy (99.80%). The prevalence of STDs was very high (55.3%). Furthermore, associations were observed between STDs and changes in semen parameters, highlighting the importance of STD detection in semen. Thus, this M-PCR assay has great potential for application in semen screening programs for pathogens in infertility and STD clinics and in sperm banks.
de Abreu, Andre Luelsdorf Pimenta; Irie, Mary Mayumi Taguti; Esquicati, Isis Baroni; Malagutti, Natalia; Vasconcellos, Vinicius Rodrigo Bulla; Discacciati, Michele Garcia; Bonini, Marcelo Gialluisi; Maria-Engler, Silvya Stuchi; Consolaro, Marcia Edilaine Lopes
We critically evaluate a recent article by Van Howe involving 12 meta-analyses that concludes, contrary to current evidence, that male circumcision increases the risk of various common sexually transmitted infections (STIs). Our detailed scrutiny reveals that these meta-analyses (1) failed to include results of all relevant studies, especially data from randomized controlled trials, (2) introduced bias through use of inappropriate control groups, (3) altered original data, in the case of human papillomavirus (HPV), by questionable adjustments for “sampling bias,” (4) failed to control for confounders through use of crude odds ratios, and (5) used unnecessarily complicated methods without adequate explanation, so impeding replication by others. Interventions that can reduce the prevalence of STIs are important to international health. Of major concern is the global epidemic of oncogenic types of HPV that contribute to the burden of genital cancers. Meta-analyses, when well conducted, can better inform public health policy and medical practice, but when seriously flawed can have detrimental consequences. Our critical evaluation leads us to reject the findings and conclusions of Van Howe on multiple grounds. Our timely analysis thus reaffirms the medical evidence supporting male circumcision as a desirable intervention for STI prevention.
Morris, Brian J.; Hankins, Catherine A.; Tobian, Aaron A. R.; Krieger, John N.; Klausner, Jeffrey D.
High prevalence of chlamydia in the USA persists despite efforts to annually screen women under the age of 26. Tailoring sexually transmitted infection (STI) services to client preferences may strengthen existing programmes. We report women's preferences for STI services from a family planning clinic in New York City serving low-income women. Seventy-eight percent (995/1275) of eligible women participated, with a mean age of 26 (SD±7). Ninety-one percent self-identified as Latina. Nineteen percent reported a past STI. Women preferred self-collection (65%) for testing to a speculum exam (20%); 15% had no preference. Women with a previous STI were more likely to prefer a pelvic exam to women with no previous STI (50% versus 32%, P < 0.01). Nearly all women (94%) preferred informing a sex partner about a positive STI test themselves, but 88% were willing to bring expedited partner therapy to a partner. Women were more likely to prefer third party partner notification if their last partner was casual rather than a main partner (14% versus 3%, respectively, P < 0.01). Forty-four percent of participants worried about physical violence after partner notification. Self-collecting specimens for screening was widely acceptable. Partner notification strategies should be based on understanding partnership status, including fears of violence. PMID:23970748
Jones, H E; Holloway, I W; Pressman, E; Meier, J; Westhoff, C L
Professional organizations recommend rescreening chlamydia-infected women. The iwantthekit Internet-screening programme offered rescreening opportunities by using iwantthekit. Mailed, home-collected vaginal swabs were tested for chlamydia, gonorrhoea, and trichomoniasis by nucleic acid amplification tests. Demographics and risk behaviours of repeat users were determined from questionnaires. Predictors of repeat users were measured in a matched case-control study. Of 1747 women, 304 (17%), who used iwantthekit, indicated they had used the kit previously. Mean age was 24.7 ± 5.7 years and 69% were African-American. Repeat iwantthekit users were more likely to be aged ? 20 years (OR=2.10); were more likely to have been treated for a sexually transmitted infection (OR=2.32); less likely to drink alcohol before sex (OR=0.63); and to never use condoms (OR=0.43). Of repeat users, 84.2% had a negative prior test and 15.8% had a positive. At current test, 13.2% were infected. Previous trichomoniasis was associated with current trichomoniasis (p<0.05). The iwantthekit may offer rescreening opportunities for previously infected women. PMID:23970594
Gaydos, Charlotte A; Barnes, Mathilda; Jett-Goheen, Mary; Quinn, Nicole; Whittle, Pamela; Hogan, Terry; Hsieh, Yu-Hsiang
Background.?Diagnosis and treatment of sexually transmitted infections (STIs) is a public health priority, particularly in regions where the incidence of human immunodeficiency virus (HIV) infection is high. In most developing countries, STIs are managed syndromically. We assessed the adequacy of syndromic diagnosis of STIs, compared with laboratory diagnosis of STIs, and evaluated the association between STI diagnosis and the risk of HIV acquisition in a cohort of high-risk women. Methods.?HIV-uninfected high-risk women (n = 242) were followed for 24 months. Symptoms of STIs were recorded, and laboratory diagnosis of common STI pathogens was conducted every 6 months. Forty-two cytokines were measured by Luminex in cervicovaginal lavage specimens at enrollment. Human immunodeficiency virus type 1 (HIV-1) infection was evaluated monthly. Results.?Only 12.3% of women (25 of 204) who had a laboratory-diagnosed, discharge-causing STI had clinically evident discharge. Vaginal discharge was thus a poor predictor of laboratory-diagnosed STIs (sensitivity, 12.3%; specificity, 93.8%). Cervicovaginal cytokine concentrations did not differ between women with asymptomatic STIs and those with symptomatic STIs and were elevated in women with asymptomatic STIs, compared with women with no STIs or bacterial vaginosis. Although laboratory-diagnosed STIs were associated with increased risk of HIV infection (hazard ratio, 3.3 [95% confidence interval, 1.5–7.2)], clinical symptoms were not. Conclusions.?Syndromic STI diagnosis dependent on vaginal discharge was poorly predictive of laboratory-diagnosed STI. Laboratory-diagnosed STIs were associated with increased susceptibility to HIV acquisition, while vaginal discharge was not.
Mlisana, Koleka; Naicker, Nivashnee; Werner, Lise; Roberts, Lindi; van Loggerenberg, Francois; Baxter, Cheryl; Passmore, Jo-Ann S.; Grobler, Anneke C.; Sturm, A. Willem; Williamson, Carolyn; Ronacher, Katharina; Walzl, Gerhard; Abdool Karim, Salim S.
Objectives. We examined race differences in the longitudinal associations between adolescent alcohol use and adulthood sexually transmitted infection (STI) risk in the United States. Methods. We estimated multivariable logistic regression models using Waves I (1994–1995: adolescence) and III (2001–2002: young adulthood) of the National Longitudinal Study of Adolescent Health (n?=?10?783) to estimate associations and assess differences between Whites and African Americans. Results. In adjusted analyses, adolescent alcohol indicators predicted adulthood inconsistent condom use for both races but were significantly stronger, more consistent predictors of elevated partnership levels for African Americans than Whites. Among African Americans but not Whites, self-reported STI was predicted by adolescent report of any prior use (adjusted odds ratio [AOR]?=?1.47; 95% confidence interval [CI]?=?1.00, 2.17) and past-year history of getting drunk (AOR?=?1.53; 95% CI?=?1.01, 2.32). Among Whites but not African Americans, biologically confirmed STI was predicted by adolescent report of past-year history of getting drunk (AOR?=?1.68; 95% CI?=?1.07, 2.63) and consistent drinking (AOR?=?1.65; 95% CI?=?1.03, 2.65). Conclusions. African American and White adolescent drinkers are priority populations for STI prevention. Prevention of adolescent alcohol use may contribute to reductions in adulthood STI risk.
Berger, Amanda T.; Wells, Brooke E.; Cleland, Charles M.
The European Collaborative Clinical Group (ECCG) was inaugurated at the 26th International Union against Sexually Transmitted Infections (IUSTI) Congress in Riga, Latvia 2011. The ECCG is a network of over 100 sexually transmitted infection specialists who have come together to conduct questionnaire-based research across the European region. It is expected that this work will focus and direct guideline development. A central core group of the ECCG has also been established who are responsible for identifying suitable survey questions that will be carried out but only after approval by the full ECCG Board. The ECCG aims to conduct a maximum of two projects per year which will be presented at the annual regional congresses and published as appropriate. PMID:23970741
Brooks, B; Patel, R
A randomized controlled trial was carried out to assess the effectiveness of azithromycin versus a standard regimen with doxycycline/ciprofloxacin in the treatment of sexually transmitted infections in a resource-poor environment. Infection with Chlamydia trachomatis was cured in 23/24 (95.8%) of women in the azithromycin arm versus 19/21 (90.5%) in the doxycycline arm (P = 0.6), resulting in three treatment failures. Gonorrhoea was cured in 55/56 (98.2%) women, with one treatment failure in a patient with concomitant C. trachomatis infection. These results indicate that a single oral dose of azithromycin may prove to be a more effective and convenient treatment for sexually transmitted infections in women in a resource-poor environment PMID:12003988
Rustomjee, Roxana; Kharsany, A B M; Connolly, C A; Karim, S S Abdool
Background Curable, non-viral pathogens account for a significant burden of sexually transmitted infections (STIs), and there is established evidence that STIs increase both HIV acquisition and transmission. We investigated the prevalence, trends, and factors associated with Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Treponema pallidum, and the performance of syndromic management, among a cohort of women working in bars, hotels, and other food and recreational facilities near large-scale mines in northwestern Tanzania. Methods HIV-negative women aged 18–44 years (N?=?966) were enrolled and followed for 12 months in a microbicides feasibility study. We collected sociodemographic and behavioural data, performed clinical examinations, and tested for STIs, at enrolment and 3-monthly. Risk factors for STIs were investigated using logistic regression models with random effects. Sensitivity, specificity and predictive values of syndromic management were calculated. Results At enrolment, the prevalences of C. trachomatis, N. gonorrhoeae, T. vaginalis, and high-titre active syphilis were 111/956 (12%), 42/955 (4%), 184/945 (19%) and 46/965 (5%), respectively. There were significant decreases over time for C. trachomatis and T. vaginalis (OR trend per month: 0.94 [95% CI 0.91, 0.97]; and 0.95 [0.93, 0.98], respectively; both p<0.001). The majority of these infections were not diagnosed by the corresponding syndrome; therefore, most participants were not treated at the diagnosis visit. Syndromic management was poorly predictive of laboratory-diagnosed infections. We identified a number of risk factors for STIs, including low educational level, some sexual behaviours, and ever having been pregnant. Conclusions This analysis demonstrates that the prevalences of curable STIs are high among women who work in food and recreational facilities in northwestern Tanzania. Most of these infections are missed by syndromic management. Accurate and affordable rapid-point-of-care tests and innovative interventions are needed to reduce the burden of STIs in this population which is at increased risk for HIV.
Francis, Suzanna C.; Ao, Trong T.; Vanobberghen, Fiona M.; Chilongani, Joseph; Hashim, Ramadhan; Andreasen, Aura; Watson-Jones, Deborah; Changalucha, John; Kapiga, Saidi; Hayes, Richard J.
Summary Background We assessed prevalences of seven sexually transmitted infections (STIs) in Peru, stratified by risk behaviours, to help to define care and prevention priorities. Methods In a 2002 household-based survey of the general population, we enrolled randomly selected 18–29-year-old residents of 24 cities with populations greater than 50?000 people. We then surveyed female sex workers (FSWs) in these cities. We gathered data for sexual behaviour; vaginal specimens or urine for nucleic acid amplification tests for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis; and blood for serological tests for syphilis, HIV, and (in subsamples) herpes simplex virus 2 (HSV2) and human T-lymphotropic virus. This study is a registered component of the PREVEN trial, number ISRCTN43722548. Findings 15?261 individuals from the general population and 4485 FSWs agreed to participate in our survey. Overall prevalence of infection with HSV2, weighted for city size, was 13·5% in men, 13·6% in women, and 60·6% in FSWs (all values in FSWs standardised to age composition of women in the general population). The prevalence of C trachomatis infection was 4·2% in men, 6·5% in women, and 16·4% in FSWs; of T vaginalis infection was 0·3% in men, 4·9% in women, and 7·9% in FSWs; and of syphilis was 0·5% in men, 0·4% in women, and 0·8% in FSWs. N gonorrhoeae infection had a prevalence of 0·1% in men and women, and of 1·6% in FSWs. Prevalence of HIV infection was 0·5% in men and FSWs, and 0·1% in women. Four (0·3%) of 1535 specimens were positive for human T-lymphotropic virus 1. In men, 65·0% of infections with HIV, 71·5% of N gonorrhoeae, and 41·4% of HSV2 and 60·9% of cases of syphilis were in the 13·3% who had sex with men or unprotected sex with FSWs in the past year. In women from the general population, 66·7% of infections with HIV and 16·7% of cases of syphilis were accounted for by the 4·4% who had been paid for sex by any of their past three partners. Interpretation Defining of high-risk groups could guide targeting of interventions for communicable diseases—including STIs—in the general Peruvian population. Funding Wellcome Trust-Burroughs Wellcome Fund Infectious Disease Initiative and US National Institutes of Health.
Carcamo, Cesar P; Campos, Pablo E; Garcia, Patricia J; Hughes, James P; Garnett, Geoff P; Holmes, King K
UK national audit against the key performance indicators in the British Association for Sexual Health and HIV Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.
A national audit of practice performance against the key performance indicators in the British Association for Sexual Health and HIV (BASHH) and HIV Medical Foundation for AIDS Sexual Health Standards for the Management of Sexually Transmitted Infections (STIs) was conducted in 2011. Approximately 60% and 8% of level 3 and level 2 services, respectively, participated. Excluding partner notification performance, the five lowest areas of performance for level 3 clinics were the STI/HIV risk assessment, care pathways linking care in level 2 clinics to local level 3 services, HIV test offer to patients with concern about STIs, information governance and receipt of chlamydial test results by clinicians within seven working days (the worst area of performance). The five lowest areas of performance for level 2 clinics were participating in audit, having an audit plan for the management of STIs for 2009-2010, the STI/HIV risk assessment, HIV test offer to patients with concern about STIs and information governance. The results are discussed with regard to the importance of adoption of the standards by commissioners of services because of their relevance to other national quality assurance drivers, and the need for development of a national system of STI management quality assurance measurement and reporting. PMID:23104750
McClean, H; Sullivan, A K; Carne, C A; Warwick, Z; Menon-Johansson, A; Clutterbuck, D
Chlamydial partner notification in the British Association for Sexual Health and HIV (BASHH) 2011 UK national audit against the BASHH Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.
This paper reports on chlamydial partner notification (PN) performance in the 2011 BASHH national audit against the British Association for Sexual Health and HIV (BASHH) Medical Foundation for AIDS Sexual Health (MedFASH) Sexually Transmitted Infection Management Standards (STIMS). There was wide regional variation in level 3 clinic PN performance against the current standard of index case-reported chlamydial PN, with 43% (regional range 0-80%) of clinics outside London meeting the ?0.6 contacts seen per index standard, and 85% of clinics (regional range 82-88%) in London meeting the ?0.4 standard. For level 2 clinics, 39% (regional range 0-100%) of clinics outside London met the ?0.6 standard, and 43% (regional range 40-50%) of clinics in London met the ?0.4 standard. Performance for health-care worker (HCW)-verified contact attendance is also reported. New standards for each of these performance measures are proposed for all level 3 clinics: ?0.6 contacts seen per index case based on index case report, and ?0.4 contacts seen per index case based on HCW verification, both within four weeks of the first partner notification interview. The results are discussed with regard to the importance of adoption of standards by commissioners of services, relevance to national quality agendas, and the need for development of a national system of PN quality assurance measurement and reporting. PMID:23104751
McClean, H; Carne, C A; Sullivan, A K; Radcliffe, K W; Ahmed-Jushuf, I
Sexually transmitted co-infections increase HIV infectiousness through local inflammatory processes. The prevalence of STI among people living with HIV\\/AIDS has implications for containing the spread of HIV in general and the effectiveness of HIV treatments for prevention in particular. Here we report a systematic review of STI co-infections in people living with HIV\\/AIDS. We focus on STI contracted after becoming
Seth C Kalichman; Jennifer Pellowski; Christina Turner
Background The feasibility and acceptability of Internet-based sexually transmitted infection (STI) testing have been demonstrated; however, few programs have included testing for human immunodeficiency virus (HIV). In British Columbia, Canada, a new initiative will offer online access to chlamydia, gonorrhea, syphilis, and HIV testing, integrated with existing clinic-based services. We presented the model to gay men and other men who have sex with men (MSM) and existing clinic clients through a series of focus groups. Objective To identify perceived benefits, concerns, and expectations of a new model for Internet-based STI and HIV testing among potential end users. Methods Participants were recruited through email invitations, online classifieds, and flyers in STI clinics. A structured interview guide was used. Focus groups were audio recorded, and an observer took detailed field notes. Analysts then listened to audio recordings to validate field notes. Data were coded and analyzed using a scissor-and-sort technique. Results In total, 39 people participated in six focus groups. Most were MSM, and all were active Internet users and experienced with STI/HIV testing. Perceived benefits of Internet-based STI testing included anonymity, convenience, and client-centered control. Salient concerns were reluctance to provide personal information online, distrust of security of data provided online, and the need for comprehensive pretest information and support for those receiving positive results, particularly for HIV. Suggestions emerged for mitigation of these concerns: provide up-front and detailed information about the model, ask only the minimal information required for testing, give positive results only by phone or in person, and ensure that those testing positive are referred for counseling and support. End users expected Internet testing to offer continuous online service delivery, from booking appointments, to transmitting information to the laboratory, to getting prescriptions. Most participants said they would use the service or recommend it to others. Those who indicated they would be unlikely to use it generally either lived near an STI clinic or routinely saw a family doctor with whom they were comfortable testing. Participants expected that the service would provide the greatest benefit to individuals who do not already have access to sensitive sexual health services, are reluctant to test due to stigma, or want to take immediate action (eg, because of a recent potential STI/HIV exposure). Conclusions Internet-based STI/HIV testing has the potential to reduce barriers to testing, as a complement to existing clinic-based services. Trust in the new online service, however, is a prerequisite to client uptake and may be engendered by transparency of information about the model, and by accounting for concerns related to confidentiality, data usage, and provision of positive (especially HIV) results. Ongoing evaluation of this new model will be essential to its success and to the confidence of its users.
Hottes, Travis Salway; Farrell, Janine; Bondyra, Mark; Haag, Devon; Shoveller, Jean
The clinical features of sexually transmitted disease (STD) infection in female sex workers found in a community based study in different red light areas of Kolkata are discussed in this paper. Out of 867 sex workers clinically examined in the clinics in their respective areas, 80.16% were having different signs and symptoms of sexually transmitted diseases. The vaginal discharge was the commonest feature present in 49.6% sex workers. The chronic vaginal discharge of more than a month was found in 47.44%, while 37.90% sex workers had vaginal discharge of less than one month. The genital ulcer was present in 25.03% (217) sex workers. The other sexually transmitted infection that was found includes genital warts 13.73%, scabies 12.11 and Inguinal bubo in 1.73% sex workers. The sex workers were also having other symptoms e.g. chronic weight loss, prolonged fever and chronic diarrhoea in 13.73% (119), 10.03% (87) and in 1.96% (17) sex workers respectively. PMID:15909751
Raut, D K; Pal, D; Das, A
Background and objective: Nowadays sexually transmitted diseases (STDs) are a priority health problem. Therefore, they were included in the Framework Document for the Development of the Health Plan for Catalonia for the year 2000.Several health objectives were fixed: 30% reduction of siphylis incidence, 25% reduction of gonorhea incidence, 50% reduction of infections caused by -lactamase producer strains of N. gonorrheae, the oftalmia neonatorum and congenital siphylis eradication and 20% reduction of other STDs. We have analyzed whether this aims have been accomplished or not.Subjects and method: In order to evaluate the objectives, we have use these indicators: gonorhea, siphylis, oftalmia neonatorum, congenital siphylis and other STDs incidence rates and the percentage of gonorhea caused by -lactamase producer strains of N. gonorrheae ocurred during the 1989-2000 period.Results: Siphylis incidence rate decreased from 7.1 to 1.5 (78%) and gonorhea incidence rate sunk from 78.9 to 3.6 (95%) in 12 months. Furthermore, these objectives were successful in the early stages of the study period. In addition, the percentage of gonorhea caused by -lactamase producer strains of N. gonorrheae fell from 20.4% in 1989 to 6.1% in 2000 (70% reduction). Oftalmia neonatorum have not been eradicated yet but its incidence showed a marked downward trend. Congenital siphylis eradication was achieved in 1995 and this objective remains unchanged. Other STDs incidence rates showed a 42% reduction.Conclusions: All the predicted objectives were achieved except the neoftalmia neonatorum eradication. Several new preventive strategies have been developed during the study period and this may play a role in the actual situation of these indicators. PMID:15274832
Calmet, Montserrat; Domínguez, Angela; Barrabeig, Irene; Sanz, Benicio; Armengol, Pere; Boronat, Josep
In the current era of effective anti-retroviral therapy, immuno-compromised patients with HIV-1 infection do live long enough to suffer diseases caused by many opportunistic infections, such as herpes simplex virus type 1 and/or type 2 (HSV-1/2). An estimated two-third of the 40 million individuals that have contracted HIV-1 worldwide are co-infected with HSV-1/2 viruses, the causative agents of ocular oro-facial and genital herpes. The highest prevalence of HIV and HSV-1/2 infections are confined to the same regions of Sub-Saharan Africa. HSV-1/2 infections affect HIV-1 immunity, and vice versa. While important research gains have been made in understanding herpes and HIV immunity, the cellular and molecular mechanisms underlying the crosstalk between HSV-1/2 and HIV co-infection remain to be fully elucidated. Understanding the mechanisms behind the apparent HSV/HIV negative immuno-synergy maybe the key to successful HSV and HIV vaccines; both are currently unavailable. An effective herpes immunotherapeutic vaccine would in turn - indirectly - contribute in reducing HIV epidemic. The purpose of this review is: (i) to summarize the current trends in understanding the negative immuno-crosstalk between HIV and HSV-1/2 infections; and (ii) to discuss the possibility of developing a novel mucosal herpes immunotherapeutic strategy or even a combined or chimeric immunotherapeutic vaccine that simultaneously targets HIV and HSV-1/2 infections. These new trends in immunology of HSV-1/2 and HIV co-infections should become part of current efforts in preventing sexually transmitted infections. The alternative is needed to balance the ethical and financial concerns associated with the rising number of unsuccessful mono-valent clinical vaccine trials.
Chentoufi, Aziz Alami; Dervillez, Xavier; Rubbo, Pierre-Alain; Kuo, Tiffany; Zhang, Xiuli; Nagot, Nicolas; Tuaillon, Edouard; Van De Perre, Philippe; Nesburn, Anthony B.; BenMohamed, Lbachir
Background Individuals with a self-reported history of sexually transmitted infection (STI) are at high risk for depression. However, little is known about how social support affects the association between STI and depression among young women in Canada. Methods Data were drawn from the Canadian Community Health Survey (CCHS), conducted in 2005. A total of 2636 women aged 15–24 years who provided information on STI history were included in the analysis. Depression was measured by a depression scale based on the Composite International Diagnostic Interview Short-Form (CIDI-SF). The 19-item Medical Outcomes Study (MOS) Social Support Survey assessed functional social support. A log-binomial model was used to estimate the prevalence ratio (PR) for self-reported STI history associated with depression and to assess the impact of social support on the association. Results The adjusted PR for self-reported STI history associated with depression was 1.61 (95% CI, 1.03 to 2.37), before social support was included in the model. The association between STI history and depression was no longer significant when social support was included in the model (adjusted PR, 1.28; 95% CI, 0.83 to 1.84). The adjusted PRs for depression among those with low and intermediate levels of social support versus those with a high level of social support were 5.62 (95% CI, 3.50 to 9.56) and 2.19 (1.38 to 3.68), respectively. Conclusions Social support is an important determinant of depression and reduces the impact of self-reported STI on depression among young women in Canada.
Gao, Yanhui; MacDonald, Don; Collins, Kayla D.; Alaghehbandan, Reza; Chen, Yue
The relative prevalence of sexually transmitted diseases and the agents available for the treatment of these diseases commonly presenting as genital discharges—namely, gonorrhoea, candidosis, trichomoniasis, and non-specific genital infection—are reviewed. The many agents that are active against gonorrhoea are listed, but none is ideal. Penicillin, in spite of its allergic side effects, has remained the drug of choice for 25 years because it is cheap, easily obtained, lacks toxicity even in pregnancy, and is effective. Its use is now threatened by the emergence of some strains that are able to produce penicillinase. At present the policy is to obtain the best results from penicillin while these are acceptable, but the clinician in some countries is badly served by the availability of procaine penicillin in aqueous suspension. There is a need for an effective penicillin or cephalosporin that is penicillinase resistant and cheap. Cefuroxime offers considerable hope but it is likely to be expensive in the immediate future. There are many preparations for the local treatment of candidosis. The confidence expressed by the manufacturers in recommending a three-day treatment is, it is hoped, based on a superior product. Nevertheless there is a need for a safe systemically absorbed fungicide which could be used orally, or some substance that could render the vagina an inhospitable environment for the organism. In the treatment of trichomoniasis the pharmaceutical industry in providing substances more than 90% effective in a single dose has done all that can be expected. Any further advances lie in the field of human behaviour rather than pharmaceutical research. In the treatment of non-specific genital infection the needs are more of research than of therapy. More knowledge is required of the cause of the condition and the relative role of contending pathogens, and of the results of treatment of patients and contacts in which Chlamydia or other suspect pathogens have been isolated.
Willcox, R. R.
This study was designed to determine the prevalence and distribution of Chlamydia trachomatis genotypes from clinical specimens in Guangzhou, China, obtained in the period 2005-2008. One hundred and ninety-four urogenital C. trachomatis samples were collected from sexually transmitted disease clinic patients, and the VS1-VS2 of OmpA gene was amplified by nested PCR and sequenced using an ABI-prism 3730 sequencer. Clinical C. trachomatis strains were genotyped and analyzed for a mutation with respect to the reference VS1-VS2 sequence. VS1-VS2 fragments with 453 bp were amplified from 194 clinical samples. Upon alignment with the sequences of the reference strains, 189 strains with discernible sequences were typed into 9 genotypes, while 5 with ambiguous sequences were considered to be mixed-serovar samples. The most prevalent genotypes were E (50, 26%), F (46, 24%), J (35, 19%), and D (24, 13%). There was no significant difference in the distribution of any of the genotypes detected during the study period, except for genotype K (P<0.01). A total of 16 (8%, 16/189) genetic variants of the OmpA VS1-VS2 of the reference strains were identified. Mutations occurred frequently for genotypes D (2/24, 8%), E (6/50, 12%), F (2/46, 4%), G (1/8, 13%), H (1/12, 8%), and K (4/11, 36%), with most of these being sense mutations that may result in amino acid substitution. Sequencing the OmpA VS1-VS2 enabled the genotype and sequence variations within each genotype to be analyzed. Genotypes E, F, J, and D continued to dominate among urogenital C. trachomatis, whereas genotype K increased significantly in Guangzhou between 2005 and 2008. PMID:20859001
Yang, Bin; Zheng, He-Ping; Feng, Zhan-Qin; Xue, Yao-Hua; Wu, Xing-Zhong; Huang, Jin-Mei; Xue, Xiu-Juan; Jiang, Han-Ning
Background & objectives: Providing sexually transmitted infection (STI) services to female sex workers (FSWs) in rural and resource constrained settings is a challenge. This paper describes an approach to address this challenge through a partnership with government health facilities, and examines the effect of this partnership on the utilization of STI services by FSWs in Andhra Pradesh, India. Methods: Partnerships were formed with 46 government clinics located in rural areas for providing STI treatment to FSWs in 2007. Government health facilities were supported by local and State level non-government organizations (NGOs) through provision of medicines, training of medical staff, outreach in the communities, and other coordination activities. Data from programme monitoring and behaviour tracking survey were used to examine the accessibility and acceptability in utilization of STI services from partnership clinics. Results: The number of FSWs accessing services at the partnership clinics increased from 1627 in 2007 to over 15,000 in 2010. The average number of annual visits by FSWs to these clinics in 2010 was 3.4. In opinion surveys, the majority of FSWs accessing services at the partnership clinics expressed confidence that they would continue to receive effective services from the government facilities even if the programme terminates. The overall attitude of FSWs to visit government clinics was more positive among FSWs from partnership clinic areas compared to those from non-partnership clinic areas. Interpretation & conclusions: The partnership mechanism between the NGO-supported HIV prevention programme and government clinic facilities appeared to be a promising opportunity to provide timely and accessible STI services for FSWs living in rural and remote areas.
Kokku, Suresh Babu; Mahapatra, Bidhubhusan; Tucker, Saroj; Saggurti, Niranjan; Prabhakar, Parimi
In this study, we investigated the prevalence of sexually transmitted infections (STIs) using multiplex real-time PCR assay in healthy Korean women. We also evaluated the risk factors of STIs, and compared the various factors between the STI-positive and the STI-negative groups. A total of 799 endocervical swab samples from healthy Korean women who visited our hospital for general medical check-ups during January 2012 to October 2012 were included. Eight STIs including Human papillomavirus (HPV), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), Ureaplasma parvum (UP), and Trichomonas vaginalis (TV) were detected using Anyplex II STI-7 Detection assay Detection (Seegene, Seoul, Korea) and Hybrid Capture 2 High-Risk HPV DNA test (Digene Corporation, Gaithersburg, MD, USA) according manufacture's protocols. Ninety-seven (12.1%) subjects were positive for HPV. Of 393 (49.2%) subjects were infected with at least one microorganism and a total of 499 STIs were identified. Among the 393 STI-positive subjects, the proportion of single, double and triple infection was 76.3%, 20.4% and 3.3%, respectively. The median age of the STI-positive group (47 years, range 42-52) was younger than the STI-negative group (49 years, range 43-56; P < 0.001). The infection rate of HPV was significantly higher in the STI-positive group (15.8%, 62/393) than the STI-negative group (8.6%, 35/406) (P = 0.002). PMID:24462432
Kim, Yoonjung; Kim, Juwon; Lee, Kyung-A
Background Empowering female sex workers (FSWs) to address structural barriers and forming community groups (CGs) through community mobilization are seen as essential components of HIV prevention programs in India. Taking the membership of a CG as an exposure intervention, we hypothesized whether participation in a CG lead to reduced sexually transmitted infections (STIs) and increased treatment-seeking behavior among FSWs in three selected states of India — Andhra Pradesh, Maharashtra and Tamil Nadu. Methods and Findings The propensity score matching (PSM) approach examined the effect of CG membership, as against no membership, on STI-related risk, described as selected outcome measures — presence of any STI, self-reported STI symptoms, and treatment-seeking behavior among FSWs. A cross sectional bio-behavioral survey was administered in 2009–2010 and covered 7,806 FSWs through two-stage probability-based conventional and time location cluster sampling in 23 administrative districts of Andhra Pradesh, Maharashtra and Tamil Nadu. Only 2,939 FSWs were reported to be members of a CG and among them 4.5% had any STIs. A majority of FSWs were aged above 24 years (86.4%), had ever been married (73%), operated from a public place for solicitation (81.5%), and had ever received HIV test results (75.6%). The average effect of CG exposure was reduction in STI prevalence by 4%, while self-reported STI symptom treatment-seeking behavior increased by 13.7%. Conclusion FSWs who were exposed to a CG were at a substantially lower risk of STIs than those who were unexposed. The FSWs exposed to a CG had a higher chance of seeking STI treatment from public and private health facilities. Collectivization related challenges must be overcome to provide access to tailored STI prevention and care services.
Yadav, Diwakar; Ramanathan, Shreena; Goswami, Prabuddhagopal; Ramakrishnan, Lakshmi; Saggurti, Niranjan; Sen, Shrabanti; George, Bitra; Paranjape, Ramesh
Despite the increased use of social media and text messaging among adolescents, it is unclear how effective education transmitted via these mechanisms is for reducing sexual risk behavior. Accordingly, we conducted a systematic review of the literature to examine the effectiveness of social media and text messaging interventions designed to increase sexually transmitted disease (STD) knowledge, increase screening/testing, decrease risky sexual behaviors, and reduce the incidence of STDs among young adults aged 15 through 24 years. Eleven studies met our inclusion criteria. Most of the included studies used a control group to explore intervention effects and included both young men and women. Sample sizes ranged from 32 to 7606 participants, and follow-up periods ranged between 4 weeks and 12 months. These studies provide preliminary evidence indicating that social media and text messaging can increase knowledge regarding the prevention of STDs. These interventions may also affect behavior, such as screening/testing for STDs, sexual risk behaviors, and STD acquisition, but the evidence for effect is weak. Many of these studies had several limitations that future research should address, including a reliance on self-reported data, small sample sizes, poor retention, low generalizability, and low analytic rigor. Additional research is needed to determine the most effective and engaging approaches for young men and women. PMID:24922099
Jones, Krista; Eathington, Patricia; Baldwin, Kathleen; Sipsma, Heather
Objectives Sexually transmitted infections (STIs) are an important cause of morbidity among incarcerated women and female sex workers (FSW). Little is known about FSW incarcerated in New York City (NYC) jails. We reviewed jail health records to identify the STI and HIV prevalence among newly incarcerated FSW in NYC jails. We also examined the relationship of demographics and self-reported clinical and risk behaviour history with FSW status and compared FSW with non-FSW incarcerated women to identify FSW predictors and, guide NYC jail programme planning and policy. Methods We retrospectively reviewed routinely collected jail health record data to identify the prevalence of chlamydia (Ct), gonorrhoea (Ng) and HIV infection among women newly incarcerated in NYC jails in 2009–2010 (study period) and studied the relationship of STIs, demographics and self-reported clinical and risk behaviour history with FSW status. Results During the study period, 10?828 women were newly incarcerated in NYC jails. Of these, 10?115 (93%) women were tested for Ct and Ng; positivity was 6.2% (95% CI 5.7% to 6.7%) and 1.7% (95% CI 1.4% to 1.9%), respectively. Nine percent had HIV infection. Seven hundred (6.5%) were defined as FSW. FSW were more likely to have Ct (adjusted OR (AOR): 1.55; 95% CI 1.17 to 2.05; p<0.0001) but not Ng or HIV. FSW were more likely to report age 20–24?years, reside in boroughs other than Manhattan, ?6 prior incarcerations, ?2 incarcerations during the study period, condom use with current sex partners, multiple sex partners and current drug use. Conclusions Women incarcerated in NYC jails had high rates of Ct, Ng, and HIV infection. FSW were at higher risk for Ct than non-FSW incarcerated women. These findings are being used to design targeted interventions to identify FSW, provide clinical and preventive services in jail and coordinate care with community partners.
Parvez, Farah; Katyal, Monica; Alper, Howard; Leibowitz, Ruth; Venters, Homer
In sub-Saharan Africa where sexually transmitted diseases (STDs) are prevalent but health resources are scarce, algorithms that act as STD/HIV risk assessment (RA) tools for family planning (FP) and maternal/child health (MCH) clinic attenders may be useful. These RA algorithms generally comprise questions about a person's social, economic, demographic, behavioural and clinical background. The answers can be scored or scaled to indicate a higher probability of current STD/HIV infection and thus the need for testing or treatment. RA can be done alone, or can be combined with clinical examination where laboratory diagnosis is not feasible. But how accurate are RA tools? We reviewed six studies at African sites that examined the use of RA combined with a clinical algorithm for STD screening of clinic attendees. Researchers reported the standard measures of test accuracy: sensitivity (per cent of infected women found positive by the tool); specificity (per cent of uninfected women found negative by the tool), and positive predictive value (per cent of women found positive by the tool who are truly infected). Most algorithms had low sensitivity (< 50%) and low positive predictive value (< 20%). The addition of clinical examination, and of leucocyte esterase (LE) testing, improved accuracy. But algorithms that performed well in one site were less accurate at other sites. For illustrative purposes, we considered a hypothetical population of 1,000 women attending a FP clinic. With a prevalence of cervical gonorrhoea of five per cent, algorithm sensitivity of 40%, and algorithm specificity of 75%, the positive predictive value of the RA tool would be 7.7%. In other words, 20 (7.7%) women diagnosed as infected would actually have gonorrhoea, and 237 false positive women would be treated needlessly, with the attendant costs and risks. However, with a disease prevalence above 50%, as might prevail for vaginal infections, and the same sensitivity and specificity figures, the positive predictive value may reach 70-80%. Risk assessment appears to be a relatively easy way to integrate STD management into family planning and MCH practice. However, there is no evidence to show its effectiveness for screening low-risk populations. We urge improvement of these tools, including information on the behaviour of male partners, and addition of simple screening tests such as leucocyte esterase dipsticks. PMID:9557419
Welsh, M; Feldblum, P; Chen, S
Background HIV disproportionately affects African-Caribbean women in Canada but the frequency and distribution of sexually transmitted infections in this community have not been previously studied. Methods We recruited women based on HIV status through a Toronto community health centre. Participants completed a socio-behavioural questionnaire using Audio Computer Assisted Self-Interview (ACASI) and provided blood for syphilis, HIV, hepatitis B and C, herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), and human cytomegalovirus (CMV) serology, urine for chlamydia and gonorrhea molecular testing and vaginal secretions for bacterial vaginosis (BV) and human papillomavirus (HPV). Differences in prevalence were assessed for statistical significance using chi-square. Results We recruited 126 HIV-positive and 291 HIV-negative women, with a median age of 40 and 31 years, respectively (p?0.001). Active HBV infection and lifetime exposure to HBV infection were more common in HIV-positive women (4.8% vs. 0.34%, p?=?0.004; and 47.6% vs. 21.2%, p?0.0001), as was a self-reported history of HBV vaccination (66.1% vs. 44.0%, p?=?0.0001). Classical STIs were rare in both groups; BV prevalence was low and did not vary by HIV status. HSV-2 infection was markedly more frequent in HIV-positive (86.3%) than HIV-negative (46.6%) women (p?0.0001). Vaginal HPV infection was also more common in HIV-positive than in HIV-negative women (50.8% vs. 22.6%, p?0.0001) as was infection with high-risk oncogenic HPV types (48.4% vs. 17.3%, p?0.0001). Conclusions Classical STIs were infrequent in this clinic-based population of African-Caribbean women in Toronto. However, HSV-2 prevalence was higher than that reported in previous studies in the general Canadian population and was strongly associated with HIV infection, as was infection with hepatitis B and HPV.
Assessment of sexual risk behaviors and perception of vulnerability to sexually transmitted diseases/acquired immunodeficiency syndrome in women, 1999-2012: a population based survey in a medium-sized Brazilian city.
Sexual behavior is a key factor for susceptibility to sexually transmitted diseases. An evaluation of the sexual behavior of women at reproductive age was conducted in 1999. A replication of this study aims to evaluate the current situation and identify changes in sexual behavior, 13 years later. This is a population-based cross-sectional study, conducted with 1071 women in Pelotas, Brazil. Compared to the 1999 study, a 14% increase in early sexual debut and an 8% decrease in the non-use of condoms were observed in 2012. The proportion of women who reported anal sex doubled between these periods. There was no trend of increase or decrease in the prevalence of behaviors with distinct patterns being observed for each of them. Reduction of non-use of condoms may be an indicator of the effectiveness of campaigns to promote safe sex. However, the increased prevalence of early sexual debut and anal sex indicates the need for campaigns to continue and to expand their focus, especially among vulnerable groups. PMID:24780361
Mesenburg, Marilia Arndt; Muniz, Ludmila Correa; Silveira, Mariângela Freitas
Background Bacterial vaginosis is a common vaginal infection, causing an abnormal vaginal discharge and/or odour in up to 50% of sufferers. Recurrence is common following recommended treatment. There are limited data on women’s experience of bacterial vaginosis, and the impact on their self-esteem, sexual relationships and quality of life. The aim of this study was to explore the experiences and impact of recurrent bacterial vaginosis on women. Methods A social constructionist approach was chosen as the framework for the study. Thirty five women with male and/or female partners participated in semi-structured interviews face-to-face or by telephone about their experience of recurrent bacterial vaginosis. Results Recurrent bacterial vaginosis impacted on women to varying degrees, with some women reporting it had little impact on their lives but most reporting it had a moderate to severe impact. The degree to which it impacted on women physically, emotionally, sexually and socially often depended on the frequency of episodes and severity of symptoms. Women commonly reported that symptoms of bacterial vaginosis made them feel embarrassed, ashamed, ‘dirty’ and very concerned others may detect their malodour and abnormal discharge. The biggest impact of recurrent bacterial vaginosis was on women’s self-esteem and sex lives, with women regularly avoiding sexual activity, in particular oral sex, as they were too embarrassed and self-conscious of their symptoms to engage in these activities. Women often felt confused about why they were experiencing recurrent bacterial vaginosis and frustrated at their lack of control over recurrence. Conclusion Women’s experience of recurrent bacterial vaginosis varied broadly and significantly in this study. Some women reported little impact on their lives but most reported a moderate to severe impact, mainly on their self-esteem and sex life. Further support and acknowledgement of these impacts are required when managing women with recurrent bacterial vaginosis.
Bilardi, Jade E.; Walker, Sandra; Temple-Smith, Meredith; McNair, Ruth; Mooney-Somers, Julie; Bellhouse, Clare; Fairley, Christopher K.; Chen, Marcus Y.; Bradshaw, Catriona
Abstract The goals of the current study were to: (1) estimate the prevalence of forced sex among,women,accessing services at a women’s,health clinic in rural Haiti; and,(2) examine,factors associated with forced sex in this population. Based on data from a case-control study of risk factors for sexually transmitted diseases (STDs), a cross-sectional analysis to examine,factors associated,with,forced,sex was,performed.,A number,of factors related to
M. c. Smith Fawzi; W. Lambert; J. m. Singler; Y. Tanagho; F. Le Andre; P. Nevil; D. Bertrand; M. s. Claude; J. Bertrand; M. Louissaint; L. Jeannis; J. s. Mukherjee; S. Goldie; J. j. Salazar; P. e. Farmer
Background Social networks directly and indirectly influence STI risk. The objective was to explore associations between sex with a male recently released from incarceration and sexual risk and intimate partner violence (IPV) among African-American adolescent females. Methods Sociodemographic, psychosocial and sexual behavior data were collected at baseline, 6- and 12-months from African-American females, 15–21 years, participating in an HIV/STI prevention trial. Among 653 participants with ?1 follow-up assessments, generalized estimating equations tested associations during follow-up between having a recently released partner and STI acquisition, sexual risk behaviors and IPV, adjusting for age, treatment assignment and corresponding baseline measure. Results Eighty-three (13.6%) participants had a recently released partner at 6-months and 56 (9.3%) at 12-months. Participants with a recently released partner were more likely to: have vaginal (AOR: 5.48), anal (AOR: 2.43) and oral (AOR: 1.51) sex, a casual partner (AOR: 1.66), sex while high/drunk (AOR: 1.57) or with a high/drunk partner (AOR: 2.27); use condoms inconsistently (AOR: 0.58); acquire Chlamydia (AOR: 1.80) and experience emotional (AOR: 4.09), physical (AOR: 2.59) or sexual abuse (AOR: 4.10) by a boyfriend. They had a greater number of sex partners, lower partner communication- and refusal-self-efficacy, were high/drunk during sex more frequently and used condoms during oral sex less frequently. Conclusions A recently released sex partner is associated with sexual risk and IPV among African-American adolescent females. Prevention programs should inform adolescents about potential risks associated with recently released partners as well as provide adolescents with skills to establish and maintain healthy sexual relationships.
Brown, Jennifer L.; Sales, Jessica M.; Murray, Colleen C.; DiClemente, Ralph J.
Objective To determine the effects of a behavioural intervention for prevention of HIV and sexually transmitted diseases that identified, trained, and engaged leaders of Roma (Gypsy) men's social networks to counsel their own network members. Design A two arm randomised controlled trial. Setting A disadvantaged, impoverished Roma settlement in Bulgaria. Participants 286 Roma men from 52 social networks recruited in the community. Intervention At baseline all participants were assessed for HIV risk behaviour, tested and treated for sexually transmitted diseases, counselled in risk reduction, and randomised to intervention or control groups. Network leaders learnt how to counsel their social network members on risk prevention. Networks were followed up three and 12 months after the intervention to determine evidence of risk reduction. Main outcome measure Occurrence of unprotected intercourse during the three months before each assessment. Results Reported prevalence of unprotected intercourse in the intervention group fell more than in control group (from 81% and 80%, respectively, at baseline to 65% and 75% at three months and 71% and 86% at 12 months). Changes were more pronounced among men with casual partners. Effects remained strong at long term follow-up, consistent with changes in risk reduction norms in the social network. Other measures of risk reduction corroborated the intervention's effects. Conclusions Endorsement and advice on HIV prevention from the leader of a social network produces well maintained change in the reported sexual practices in members of that network. This model has particular relevance for health interventions in populations such as Roma who may be distrustful of outsiders. Trial registration Clinical Trials NCT00310973.
Amirkhanian, Yuri A; Kabakchieva, Elena; Vassileva, Sylvia; Vassilev, Boyan; McAuliffe, Timothy L; DiFranceisco, Wayne J; Antonova, Radostina; Petrova, Elena; Khoursine, Roman A; Dimitrov, Borislav
Recent research has incorporated situational factors into assessment of risk. Working from a rational appraisal framework, however, these studies have not emphasized contextual features that might introduce motivated risk assessment. In the current study, participants (N = 40 male undergraduates) lowered their risk perceptions for STDs following the induction of a sexual motivation. In an initial baseline condition, participants estimated
Hart Blanton; Meg Gerrard
... Healthy Aging This information in Spanish ( en español ) Sexual health More information on sexual health Many older women ... Protecting yourself Return to top More information on Sexual health Read more from womenshealth.gov Sexually Transmitted Infections ...
IMPORTANCE To increase HIV testing rates, many institutions and jurisdictions have revised policies to make the testing process rapid, simple, and routine. A major issue for testing scale-up efforts is the effectiveness of HIV risk-reduction counseling, which has historically been an integral part of the HIV testing process. OBJECTIVE To assess the effect of brief patient-centered risk-reduction counseling at the time of a rapid HIV test on the subsequent acquisition of sexually transmitted infections (STIs). DESIGN, SETTING, AND PARTICIPANTS From April to December 2010, Project AWARE randomized 5012 patients of 9 sexually transmitted disease (STD) clinics in the US to either receive brief patient-centered HIV risk-reduction counseling with a rapid HIV test or the rapid HIV test with information only. Participants were assessed for multiple sexually transmitted infections (STIs) at both baseline and at 6-month follow-up. INTERVENTION Participants randomized to counseling received individual patient-centered risk-reduction counseling based on an evidence-based model. The core elements included a focus on the patient’s specific HIV/STI risk behavior and negotiation of realistic and achievable risk-reduction steps. All participants received a rapid HIV test. MAIN OUTCOMES AND MEASURES The prespecified outcome was a composite endpoint of cumulative incidence of any of the measured STIs over 6 months. All participants were tested for Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum (syphilis), Herpes Simplex Virus 2, and HIV. Women were also tested for Trichomonas vaginalis. RESULTS There was no significant difference in 6-month composite STI incidence by study group (aRR = 1.12, 95% CI (0.94–1.33). There were 250/2039 (12.3%) incident cases in the counseling group and 226/2032 (11.1%) in the information-only group. CONCLUSION AND RELEVANCE Risk-reduction counseling in conjunction with a rapid HIV test did not significantly affect STI acquisition among STD clinic patients, suggesting no added benefit from brief patient-centered risk-reduction counseling. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01154296
Metsch, Lisa R.; Feaster, Daniel J.; Gooden, Lauren; Schackman, Bruce R.; Matheson, Tim; Das, Moupali; Golden, Matthew R.; Huffaker, Shannon; Haynes, Louise F.; Tross, Susan; Malotte, C. Kevin; Douaihy, Antoine; Korthuis, P. Todd; Duffus, Wayne A.; Henn, Sarah; Bolan, Robert; Philip, Susan S.; Castro, Jose G.; Castellon, Pedro C.; McLaughlin, Gayle; Mandler, Raul N.; Branson, Bernard; Colfax, Grant N.
Purpose of review The purpose of this review is to summarize the latest research regarding HIV/STI risk among female sex workers (FSWs) along the Mexico-U.S. border. Although Mexico has a low prevalence of HIV overall, HIV prevalence among FSWs in Tijuana is quite high, and even higher among FSWs who inject drugs (FSW-IDUs). Efforts to better understand and curtail the HIV epidemic among FSWs in this region are greatly needed. Recent findings A brief HIV/STI risk reduction intervention for FSWs was successful in decreasing HIV/STI sexual risk behavior with clients among FSWs in Tijuana and Ciudad Juarez, Mexico. However, the intervention was less effective among FSW-IDUs, and had no effect on FSWs' condom use with their non-commercial partners. While the majority of research thus far has focused on FSWs' individual-level risk factors, comparatively less is known about their clients and non-commercial sexual partners who may heavily influence their behavior, and engage in high risk behaviors themselves. Summary Further studies including FSWs' intimate partners and clients are needed as well as interventions specific to FSW-IDUs. Targeting the most at risk populations and reducing both sexual and injection risk behaviors simultaneously may curb the growing HIV epidemic in the Mexico-U.S. border region.
Ulibarri, Monica D.; Strathdee, Steffanie A.; Patterson, Thomas L.
‹ki Uçlu Duygudurum Bozukluu Olan Hastalarda Cinsel Yolla Bulaflan Hastal›klar Hakk›ndaki Bilgi Düzeyi ve Riskli Cinsel Davran›fllar: Sal›kl› Kontrol Grubu ile Karfl›laflt›rmal› Bir Çal›flma Awareness of Sexually-Transmitted Diseases and Risky Sexual Behavior in Bipolar Patients: A Comparative Study with Healthy Controls
Objective: It is known that patients with bipolar mood disorder have a high risk of acquiring sexually-transmitted diseases (STD). The objective of this study was to evaluate bipolar outpatients regarding their knowledge on STD and possible high risk sexual behaviors, and to compare both sexes in patient group and patients with healthy controls. Method: A total of 129 outpatients with
Aytül Gürsu HAR; Figen KARADA; Peykan GÖKALP; Umut Mert AKSOY
Young adults on the Internet: risk behaviors for sexually transmitted diseases and HIV 1 1 The full text of this article is available via JAH Online at http:\\/\\/www.elsevier.com\\/locate\\/jahonline
Purpose: To examine the sexual behaviors and related risk factors for sexually transmitted diseases and HIV among young adults who seek sex partners on the Internet.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 practices. The survey solicited inf