Morris, M; Rogers, P; Kinghorn, G
Objectives: To determine whether the risk factors associated with bacterial vaginosis (BV) are consistent with it being a sexually transmitted infection (STI) by comparing the characteristics of women with BV with those of women with infections recognised as being sexually and non-sexually transmitted. Methods: A prospective cross sectional study was conducted among female patients presenting for diagnosis at a genitourinary medicine clinic in Sheffield between January 1996 and September 1998. Demographic and behavioural characteristics were reported from patient records and a standardised questionnaire was administered. Risk factor models for BV, two STIs, and two non-STIs were compiled using a multivariable logistic regression analysis. Results: Among the 8989 females under 45 years eligible for analysis, the prevalence of BV was 12.9%. Risk factors associated with BV included some in common with gonorrhoea and Chlamydia trachomatis and some that were not associated with these two STIs. Risk factors common to BV and the STIs included having had more than one sexual partner in the past 3 months, having a history of a bacterial STI, being of black Caribbean ethnicity, and living in a deprived area. However, BV had a contrasting age profile, being most prevalent among those over the age of 30. BV was also more common in those who were divorced. Conclusions: BV is associated with some factors related to the acquisition of gonorrhoea and Chlamydia trachomatis. However, infection is not only determined by those factors and therefore factors other than sexual activity may be important in the development of the condition. Key Words: bacterial vaginosis; sexually transmitted infections PMID:11158694
Sparling, P F; Elkins, C; Wyrick, P B; Cohen, M S
Bacterial infections of the genital tract (gonorrhea, chlamydia, chancroid, syphilis) are common and cause significant morbidity. Their importance is heightened by recent appreciation of their roles in facilitation of transmission of the human immunodeficiency virus (HIV). Each is capable of causing repeated infections, suggesting lack of permanent broadly effective immunity. An effective vaccine has yet to be developed for any of these diseases. Rapid progress in understanding the molecular basis for pathogenesis of infection, including mechanisms for escape from otherwise effective immune surveillance and mechanisms for causing injury to host cells, has stimulated renewed efforts to make vaccines for some of these infections. Progress has been greatest for Neisseria gonorrhoeae and Chlamydia trachomatis. Present emphasis is on the major or principal outer membrane proteins of N. gonorrhoeae and C. trachomatis, based on evidence for neutralizing antibodies directed against surface-exposed variable domains of each of these proteins. Other surface-exposed proteins, including the iron-repressible transferrin receptor in gonococci and certain heat-shock proteins in chlamydia, also may be targets for vaccines. Although much remains to be learned, cautious optimism is warranted. PMID:8146139
Sigle, Gavin W; Kim, Rebekah
There are many different sexually transmitted infections that can cause proctitis. Recognition of the common symptoms with anoscopic examination is crucial in accurate diagnosis of the pathogen. Clinicians should have a high index of suspicion of more than one inciting pathogen. Treatment should be prompt and extended to sexual partners who have been exposed to the disease. Effective treatment can alleviate the discomfort and potentially serious complications associated with sexually transmitted proctitides. This article illustrates and discusses the clinical presentations, diagnostic pearls, and treatments of sexually transmitted proctitides. PMID:26034402
Sexually transmitted diseases (STDs) are infections that you can get from having sex with someone who has the infection. The causes ... is no cure. Sometimes medicines can keep the disease under control. Correct usage of latex condoms greatly ...
A sexual history should be routinely obtained from all travellers. Those whose symptoms indicate a sexually transmitted disease may need to be investigated for unusual infections. Resistant strains of gonorrhea are becoming a major concern. Chancroid should be considered in the differential diagnosis of genital ulcer disease. The possiblility of human immunodeficiency virus infection should be discussed with all these patients. PMID:21233914
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...
Alice C. Thornton; Bojana Stevich; Janet N. Arno; Barbara Van Der Pol
\\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
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 ...
Bechtel, Mark A; Trout, Wayne
Sexually transmitted diseases (STDs) continue to be a global epidemic with significant risk of morbidity/mortality for the fetus. STDs with prominent cutaneous findings including condylomata acuminata, genital herpes infections, and syphilis are reviewed. Important clinical cutaneous findings help aid early diagnosis and facilitate treatment. Condylomata acuminata have the potential of causing cervical cancer, anogenital cancer, and oropharyngeal cancer. Significant advances have been made in human papilloma virus vaccinations and treatment. Genital herpes infection can produce significant physical and emotional distress to the patient and significant potential harm to the fetus. Early clinical recognition of STDs and their appropriate management is critical. PMID:25565081
Hammerschlag, Margaret R.
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…
Human viruses known to be spread by sexual contact include herpes simplex viruses (HSV), papillomaviruses (HPV), human immunodeficiency virus (HIV), hepatitis B virus, and cytomegalovirus. Infections with the first three (HSV, HPV, and HIV) have reached epidemic proportions and pose global health concerns. Most of what we know about these human pathogens has been learned only recently, owing to the advent of DNA technologies and advances in culture techniques. In fact, our awareness of one virally transmitted venereal disease, acquired immunodeficiency syndrome, dates to the early 1980s. This paper touches on various aspects of the biology, pathogenesis, clinical manifestations, and, where applicable, oncogenicity of these agents, as well as current treatments and vaccine initiatives. PMID:2549736
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
Patient Education Institute
This patient education program reviews the different types of STDs (viral, bacterial, and parasitic) and their symptoms, diagnosis, treatment, and prevention. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.
The link between different methods of contraception and the risk of acquiring sexually transmitted infections (STIs) raises several questions. Do the risks differ according to type of STI? Which methods reduce the risk of acquiring STIs and which, if any, increase the risk? How should people use such information when choosing a method of contraception? These questions have major public
This contribution considers links between different methods of contraception and the risk of acquiring sexually transmitted infections (STIs). This is a major public health issue, because STIs cause a huge disease burden that affects women disproportionately. Worldwide each year, there are 340 million new cases of curable STIs in 15–49-year-olds. In developing countries, STIs, even excluding HIV, are second only
Alberto Matteelli; Giampiero Carosi
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
Dhawan, Jyoti; Gupta, Somesh; Kumar, Bhushan
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
Van Kemseke, C
Sexually transmitted diseases (STD) are a major public health problem because their incidence is increasing worldwide despite prevention campaigns and because they raise the risk of HIV infection. Anorectal localisations of STD are common among men who have sex with men (MSM) but can also be seen among heterosexuals (men or women). Transmission of such infections is due to anal sex or to other sexual behaviours like "fisting". Although some pathogens (like Human Papillomavirus-HPV) are common in gastroenterologist/proctologist consultations, others are not so well-known. Furthermore during the last years, sexual risky behaviours have led to resurgence of old affections (like syphilis) or to emergence of unknown diseases (like lymphogranuloma venereum) in our countries. This presentation tends to focus on clinical manifestation, diagnosis and treatment of different STD: HPV, Herpes Simplex Virus, Neisseria gonorrhoeae, Chlamydia trachomatis (in particularly lymphogranuloma venereum) and Treponema pallidum. PMID:20163035
Ljubojevi?, Suzana; Lipozen?i?, Jasna
Sexually transmitted infections (STIs) remain a public health problem of major significance in most of the world. Adolescents make up about 20% of the world population, of whom 85% live in developing countries. They are at a greater risk of STIs because they frequently have unprotected intercourse, biologically may be more susceptible to infection, often are engaged in multiple monogamous relationships of limited duration, and face multiple obstacles in accessing confidential health care services. Young people who begin to have sexual intercourse in early or middle adolescence are more likely to develop an STI than those who postpone intercourse until later adolescence or adulthood. The most common STIs among adolescents are chlamydia, gonorrhea, human papillomavirus infection, and trichomoniasis. Unfortunately, lately the incidence of HIV/AIDS and syphilis among adolescents is growing. Comprehensive sex education programs in schools can increase STI knowledge and prevent risky sexual behaviors. Health care providers can promote STI prevention methods, including counseling about safe sex. PMID:21251451
Jenny, C; Hooton, T M; Bowers, A; Copass, M K; Krieger, J N; Hillier, S L; Kiviat, N; Corey, L; Stamm, W E; Holmes, K K
The risk of acquiring a sexually transmitted disease as a result of rape is not known, in part because it is difficult to ascertain whether infections were present before the assault or acquired during it. To investigate this question, we examined female victims of rape within 72 hours of the assault and again at least one week after the assault. Of the 204 girls and women initially examined within 72 hours of the rape, 88 (43 percent) were found to have at least one sexually transmitted disease. These diseases included infections caused by Neisseria gonorrhoeae (6 percent of those tested), cytomegalovirus (8 percent), Chlamydia trachomatis (10 percent), Trichomonas vaginalis (15 percent), herpes simplex virus (2 percent), Treponema pallidum (1 percent), and the human immunodeficiency virus type 1 (HIV-1; 1 percent) and bacterial vaginosis (34 percent). Among the 109 patients (53 percent) who returned for at least one follow-up visit (excluding those who were found to be infected at the first visit or who were treated prophylactically), the incidence of new disease was as follows: gonorrhea, 4 percent (3 of 71); chlamydial infection, 2 percent (1 of 65); trichomoniasis, 12 percent (10 of 81); and bacterial vaginosis, 19 percent (15 of 77). There were no new infections with herpes simplex virus, cytomegalovirus, Trep. pallidum, or HIV-1, but follow-up serologic testing was performed in only 26 percent of the patients. On the basis of our assumptions that most venereal infections present within 72 hours of a rape were preexisting and that new infections identified 1 to 20 weeks later were acquired during the assault, we conclude that the prevalence of preexisting sexually transmitted diseases is high in victims of rape and that they have a lower but substantial additional risk of acquiring such diseases as a result of the assault. PMID:2155389
Parents of preteens need to be aware of the rapidly increasing incidence of sexually transmitted diseases among teenagers and to begin talking to their preteens to help prevent or modify risky sexual experimentation during middle adolescence. (MT)
Brotman, Rebecca M.
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. PMID:22133886
Estreich, S; Forster, G E; Robinson, A
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. PMID:2265841
Sethi, Sunil; Singh, Gagandeep; Samanta, Palash; Sharma, Meera
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
SEXUALLY TRANSMITTED DISEASES AMONG AFRICAN AMERICANS IN ALLEGHENY COUNTY A BLACK PAPER County (hereafter referred to as "the County"). Although most sexually transmitted diseases characterized sexually transmitted diseases as "hidden epidemics." STDs are considered hidden because only
Amy Elizabeth Corman
This paper examines how teen sexual behavior responds to associated disease infection risks using the biannual 1993-99 waves of the Youth Risk Behavior Surveys. We estimate the effect of state level rates of AIDS and other sexually transmitted diseases on sexual behavior with probit regressions for the decision to have sex during the previous three months along with ordinary least
Sexually transmitted diseases (STDs) are caused by pathogens that are transmitted through sexual on worldwide public health and mortality. These include infectious diseases that are not sexually transmitted-health and financial burden on society worldwide. There are many types of sexually transmitted pathogens, and each
Adam Czelusta; Angela Yen-Moore; Melody Van der Straten; Daniel Carrasco; Stephen K. Tyring
The HIV epidemic has dramatically altered the field of sexually transmitted diseases (STDs). HIV infection is unique among sexually transmitted diseases because it can modify the clinical presentation and features of other STDs. Conversely, other STDs can affect the transmission of HIV. This review is the third part of a series that has provided a general overview of STDs. In
Introduction Oral sex (fellatio) is a very common sexual activity. H. pylori is mainly a gastric organism, but studies have reported that infected individuals may permanently or transiently carry H. pylori in their mouth and saliva. Material and methods A Pubmed search was conducted using the words infection, oral sex and urethritis. Results The existing studies support the hypothesis that H. pylori could be a causative agent of non–gonococcal urethritis. Conclusions It is possible that H. pylori may be transmitted via the act of fellatio in the urethra. Further research is required to explore the role of H. pylori in sexually transmitted urethritis. PMID:25667764
David E. Nelson; Barbara van der Pol; Qunfeng Dong; Kashi V. Revanna; Baochang Fan; Shraddha Easwaran; Erica Sodergren; George M. Weinstock; Lixia Diao; J. Dennis Fortenberry; Raphael H. Valdivia
BackgroundThe microbiome of the male urogenital tract is poorly described but it has been suggested that bacterial colonization of the male urethra might impact risk of sexually transmitted infection (STI). Previous cultivation-dependent studies showed that a variety of non-pathogenic bacteria colonize the urethra but did not thoroughly characterize these microbiomes or establish links between the compositions of urethral microbiomes and
Centers for Disease Control (DHHS/PHS), Atlanta, GA.
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…
Planned Parenthood Federation of America, Inc., New York, NY. Education Dept.
This document contains a reference sheet and an annotated bibliography concerned with sexually transmitted diseases (STD). The reference sheet provides a brief, accurate overview of STDs which includes both statistical and background information. The bibliography contains 83 entries, listed alphabetically, that deal with STDs. Books and articles…
G B Pham-Kanter; M H Steinberg; R C Ballard
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
Sexually transmitted diseases of insects: distribution, evolution, ecology and host behaviour) ABSTRACT Sexually transmitted diseases (STDs) of insects are known from the mites, nematodes, fungi on these subjects are lacking. Key words: sexually transmitted disease, STD, insect, host-pathogen, parasite
Measuring the transmission dynamics of a sexually transmitted disease Jonathan J. Ryder* , K. Mary, and approved August 28, 2005 (received for review June 18, 2005) Sexually transmitted diseases (STDs) occur individuals increase with population density. In con- trast, classic sexually transmitted disease (STD) models
Sexually transmitted diseases in polygynous mating systems: prevalence and impact on reproductive diseases; this is particularly evident with respect to sexually transmitted diseases (STDs). Here, we use). Conversely, the presence of a sexually transmitted disease (STD) can in£uence male and female reproductive
M. R. Hammerschlag
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
De Schryver, A.; Meheus, A.
Sexually transmitted diseases (STD) are now the commonest group of notifiable infectious diseases in most countries, particularly in the age group of 15 to 50 years and in infants. Their control is important considering the high incidence of acute infections, complications and sequelae, their socioeconomic impact, and their role in increasing transmission of the human immunodeficiency virus (HIV). The worldwide incidence of major bacterial and viral STD is estimated at over 125 million cases yearly. STD are hyperendemic in many developing countries. In industrialized countries, the bacterial STD (syphilis, gonorrhoea, chancroid) declined from the peak during the Second World War till up to the late fifties, then increased during the sixties and early seventies, and they have been decreasing again from the late seventies till the present. In the industrialized world, diseases due to Chlamydia trachomatis, genital herpes virus, human papillomaviruses and human immunodeficiency virus are now more important than the classical bacterial ones; both groups remain major health problems in most developing countries. Infection rates are similar in both women and men, but women and infants bear the major burden of complications and serious sequelae. Infertility and ectopic pregnancies are often a consequence of pelvic inflammatory disease, and are preventable. Sexually transmitted diseases in pregnant women can result in prematurity, stillbirth and neonatal infections. In many areas 1-5% of newborns are at risk of gonococcal ophthalmia neonatorum, a blinding disease; congenital syphilis causes up to 25% of perinatal mortality. Genital and anal cancers (especially cervical cancer) are associated with viral sexually transmitted diseases (genital human papillomavirus and herpes virus infections). Urethral stricture and infertility are frequent sequelae in men. PMID:2289300
Margaret J. Blythe
As adolescents progress through puberty, many biological changes occur and, for young women, this includes the onset of menses and the capability for reproduction. During this time, sexual identity is developed and expressions of sexuality become more frequent. Adolescent women engage in a variety of sexual behaviours, both non-coital and coital. As teens begin dating relationships, they are at risk
Anderson, D. Mark; Pörtner, Claus C.
People who drop out of high school fare worse in many aspects of life. We analyze the relationship between dropping out of high school and the probability of contracting a sexually transmitted infection (STI). Previous studies on the relationship between dropout status and sexual outcomes have not empirically addressed unobserved heterogeneity at the individual level. Using fixed effects estimators, we find evidence supporting a positive relationship between dropping out of high school and the risk of contracting an STI for females. Furthermore, we present evidence that illustrates differences between the romantic partners of dropouts versus enrolled students. These differences suggest that female dropouts may be more susceptible to contracting STIs because they partner with significantly different types of people than non-dropouts. Our results point to a previously undocumented benefit of encouraging those at risk of dropping out to stay in school longer. PMID:25705058
Lamb, Chris A; Lamb, Elizabeth Iris Mary; Mansfield, John C; Sankar, K Nathan
There is a rising incidence of several sexually transmitted infections (STIs), many of which can present with proctitis. Causative organisms include Neisseria gonorrhoeae, Chlamydia trachomatis, herpes simplex virus, Treponema pallidum (syphilis), Giardia lamblia (giardiasis) and Entamoeba histolytica (amoebiasis). This paper outlines important clinical discriminators and key investigations to distinguish these organisms from non-infective pathology that include inflammatory bowel disease, solitary rectal ulcer syndrome and Behçet's syndrome. Management of these infections is described and suggestions are made for successful gastroenterology clinical consultation when an STI is suspected. PMID:23914292
Workowski, Kimberly A; Bolan, Gail A
These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30-May 2, 2013. The information in this report updates the Sexually Transmitted Diseases Treatment Guidelines, 2010 (MMWR Recomm Rep 2010;59 [No. RR-12]). These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs. PMID:26042815
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J V Bailey; C Farquhar; C Owen; P Mangtani
Objectives: To describe the prevalence of sexually transmitted infection (STIs) in a sample of women who have sex with women (WSW) and to identify risk factors for the acquisition of STI.Method: Cross sectional survey. Questionnaire for demographic, sexual history, and sexual practice data linked with the results of genitourinary examination. 708 new patients attending two sexual health clinics for lesbians
Kelley, Colleen F; Vaughan, Adam S; Luisi, Nicole; Sanchez, Travis H; Salazar, Laura F; Frew, Paula M; Cooper, Hannah L F; Diclemente, Ralph; Del Rio, Carlos; Sullivan, Patrick S; Rosenberg, Eli S
Data reporting sexually transmitted infection (STI) incidence rates among HIV-negative U.S. men who have sex with men (MSM) are lacking. In addition, it is difficult to analyze the effect of STI on HIV acquisition given that sexual risk behaviors confound the relationship between bacterial STIs and incident HIV. The InvolveMENt study was a longitudinal cohort of black and white HIV-negative, sexually active MSM in Atlanta who underwent routine screening for STI and HIV and completed behavioral questionnaires. Age-adjusted incidence rates were calculated for urethral and rectal Chlamydia (CT), gonorrhea (GC), and syphilis, stratified by race. Propensity-score-weighted Cox proportional hazards models were used to estimate the effect of STI on HIV incidence and calculate the population attributable fraction (PAF) for STI. We included 562 HIV-negative MSM with 843 person-years of follow-up in this analysis. High incidence rates were documented for all STIs, particularly among black MSM. Having a rectal STI was significantly associated with subsequent HIV incidence in adjusted analyses (aHR 2.7; 95% CI 1.2, 6.4) that controlled for behavioral risk factors associated with STI and HIV using propensity score weights. The PAF for rectal STI was 14.6 (95% CI 6.8, 31.4). The high incidence of STIs among Atlanta MSM and the association of rectal STI with HIV acquisition after controlling for behavioral risk underscore the importance of routine screening and treatment for STIs among sexually active MSM. Our data support targeting intensive HIV prevention interventions, such as preexposure chemoprophylaxis (PrEP), for Atlanta MSM diagnosed with rectal STIs. PMID:25719950
Everett, Bethany G.
The terms MSM (men who have sex with men) and WSW (women who have sex with women) have been used with increasing frequency in the public health literature to examine sexual orientation disparities in sexual health. These categories, however, do not allow researchers to examine potential differences in sexually transmitted infection (STI) risk by sexual orientation identity. Using data from the National Longitudinal Survey of Adolescent Health, this study investigated the relationship between self-reported STIs and both sexual orientation identity and sexual behaviors. Additionally, this study examined the mediating role of victimization and STI risk behaviors on the relationship between sexual orientation and self-reported STIs. STI risk was found to be elevated among heterosexual-WSW and bisexual women, whether they report same-sex partners or not, whereas gay-identified WSW were less likely to report an STI compared to heterosexual women with opposite sex relationships only. Among males, heterosexual-identified MSM did not have a greater likelihood of reporting an STI diagnosis; rather, STI risk was concentrated among gay and bisexual identified men who reported both male and female sexual partners. STI risk behaviors mediated the STI disparities among both males and females, and victimization partially mediated STI disparities among female participants. These results suggest that relying solely on behavior-based categories, such as MSM and WSW, may mischaracterize STI disparities by sexual orientation. PMID:22350122
Bouzat, Sebastián; Zanette, Damián H.
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.
Wen, Luo-Sheng; Zhong, Jiang; Yang, Xiao-Fan
We study the susceptible-infected-susceptible (SIS) epidemic model on bipartite graph. According to the difference of sex conception in western and oriental nations, we construct the Barabási Albert-Barabási Albert (BA-BA) model and Barabási-Albert Homogeneity (BA-HO) model for sexually transmitted diseases (STDs). Applying the rate equation approach, the positive equilibria of both models are given analytically. We find that the ratio between infected females and infected males is distinctly different in both models and the infected density in the BA-HO model is much less than that in the BA-BA model. These results explain that the countries with small ratio have less infected density than those with large ratio. Our numerical simulations verify these theoretical results.
R N Thin; M Leighton; M J Dixon
We analysed data from a computer-based bank of clinical records of patients seen in a clinic for sexually transmitted diseases over a three-year period to investigate the association between genital yeast infections and sexually transmitted diseases (STDs). We classified STDs as primary and secondary syphilis; gonorrhoea; lymphogranuloma venereum; trichomoniasis; scabies; pediculosis; genital herpes; warts; and molluscum contagiosum. Of a total
Deborah Cohen; Clyde Dent; David Mackinnon
A condom skills educational program emphasizing how to use a condom was presented to groups of patients waiting to be seen in a public health sexually transmitted disease clinic. Compared to controls, patients exposed to the intervention were approximately half as likely to return within the subsequent 12 months with a new sexually transmitted disease. Other predictors of reinfection included
Singhal, P.; Naswa, S.; Marfatia, Y. S.
Viral infections in pregnancy are a major cause of morbidity and mortality for both mother and fetus. Viral STIs occur as surface infection and then gradually infect immunologically protected sites. Therefore, these are asymptomatic, hidden and hence underdiagnosed, persistent and difficult to treat. HSV, HPV, HBV, HIV and CMV (cytomegalovirus) are the common ones. Most of these are transmitted during intrapartum period. Proper screening, identification and treatment offered during prenatal period may help in preventing their complications. Twenty five percent of women with a history of genital herpes have an outbreak at some point during the last month of pregnancy. Acyclovir is the accepted efficacious and safe therapy for HSV in pregnancy. Globally, HPV infection is the most common sexually transmitted infection. Neonatal transmission can occur in the absence of clinically evident lesions. HPV 6 or 11 may lead to Juvenile Onset Recurrent Respiratory Papillomatosis (JORRP). TCA, liquid nitrogen, laser ablation or electrocautery can be used to treat external genital HPV lesions at any time during pregnancy. Cesarean section is recommended only if the lesions are obstructing the birth canal. Mother to child transmission (MTCT) in HIV accounts for 15–30% during pregnancy and delivery, and a further 5–20% of transmission occurs through breastfeeding. HBV infection during pregnancy does not alter the natural course of the disease. In women who are seropositive for both HBsAg and HBeAg, vertical transmission is approximately 90%. Pregnancy is not a contraindication for HBV vaccination. Cytomegalovirus (CMV) is the most common intrauterine infection. Cytomegalic inclusion disease (CID) is the most severe form of congenital CMV infection. Treatment is supportive. PMID:21938124
Shannon R. Galvin; Myron S. Cohen
More than 42 million people worldwide are now infected with HIV, in spite of sustained prevention activities. Although the spread of HIV has been primarily sexual, epidemiological studies have indicated that the efficiency of the spread of HIV is poor, perhaps as infrequently as 1 in every 1,000 episodes of sexual intercourse. However, sexually transmitted diseases (STDs) that cause ulcers
Jessica A. Turchik; Joanne Pavao; Deborah Nazarian; Samina Iqbal; Caitlin McLean; Rachel E. Kimerling
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
Williams, Corrine M.; Clear, Emily R.; Coker, Ann L.
Background Violence against women has been associated with subsequent risky sexual behaviors and sexually transmitted infections. We explored whether sexual coercion or violence at first intercourse was associated with self-reported sexually transmitted infections (STIs). Methods Using nationally representative data from the 2006–2010 National Survey of Family Growth, we analyzed female respondents ages 18–44 (n=9,466) who answered questions on coercion at first intercourse (wantedness, voluntariness and types of force used) and STIs using logistic regression analyses. We explored degrees of coercion, which we label as neither, sexual coercion (unwanted or nonphysical force), or sexual violence (involuntary or physical force). Results Eighteen percent of US women reported sexual coercion and 8.4% experienced sexual violence at first intercourse. Compared with women who experienced neither, the odds of reporting a STI was significantly greater for women who experienced sexual coercion (OR: 1.27, 95% CI: 1.01–1.60), after controlling for all variables. The association between sexual violence at first intercourse and STIs (OR: 1.20, 95% CI: 0.91–1.57) appeared to be attenuated by subsequent sexual violence. Conclusions Understanding that women who reported a variety of coercive sexual experiences are more likely to have contracted an STI may indicate a need to focus on the broader continuum of sexual violence to fully understand the impact of even subtle forms of violence on women’s health. In addition, focusing on subsequent sexual behaviors and other negative consequences remains important in order to improve the sexual health of women who have experienced coercive sexual intercourse. PMID:24275726
Ingram, David L.
This commentary on a paper (EC 619 276) about the transmissiblity of sexually transmitted diseases in sexually abused children discusses two issues: (1) determining if a child is infected with a sexually transmitted disease (STD) agent; and (2) determining if the child's STD was acquired from the mother before or during the birth process through…
Sawyer, Robin G.; Moss, Donald J.
This study examined sexual behavior, perceived risk of human immunodeficiency virus (HIV), and pathology of 66 males attending a college health center's sexually transmitted disease clinic. Data from patients' charts indicated a group of men who, despite high-risk behaviors, perceived their risk of contracting HIV as being extremely low. (SM)
... body fluids. Anyone who has sexual contact—vaginal, anal, or oral sex—with another person may get ... condom every time you have vaginal, oral, or anal sex decreases the chances of infection. Condoms lubricated ...
Seremet, Jasmina; Laginja, Stanislava; Radovi?, Endi; Muzi?, Vedrana; Janci?, Ervin
Sexually transmitted infections (STIs) are diseases transmitted by direct contact during sexual intercourse. Because of high incidence and possibility of development severe consequences on general and reproductive health, STIs are a major problem among young people in the world. Lack of information is one of the major risk factors for STI transmission. Most of young people (53.3%) had their first sexual intercourse at the age of 18 years, 67.7% of students have no knowledge about STI, 53.3% of students have already entered into sexual relations and 13% of them with more than 4partners. 31.1% of students who are sexually active was not examined by a gynecologist because of shame and fear. Most sexually active adolescents did not use contraceptives and they are not satisfied with the available information about STI. There is also continuing problem of teen pregnancy. The main goal of this research is to examine whether there is relationship between level of information and awareness of surveyed adolescents and their perception of sexually transmitted diseases. PMID:25842768
Senn, Theresa E.; Carey, Michael P.; Vanable, Peter A.; Coury-Doniger, Patricia; Urban, Marguerite A.
Childhood sexual abuse (CSA) is associated with a wide range of negative outcomes. The authors investigated the relation between CSA and sexual risk behavior in 827 patients recruited from a sexually transmitted disease (STD) clinic. Overall, CSA was reported by 53% of women and 49% of men and was associated with greater sexual risk behavior,…
White, Joël; Mirleau, Pascal; Danchin, Etienne; Mulard, Hervé; Hatch, Scott A; Heeb, Philipp; Wagner, Richard H
Ecology Letters (2010) 13: 1515-1524 ABSTRACT: Sexual transmission is an important mode of disease propagation, yet its mechanisms remain largely unknown in wild populations. Birds comprise an important model for studying sexually transmitted microbes because their cloaca provides a potential for both gastrointestinal pathogens and endosymbionts to become incorporated into ejaculates. We experimentally demonstrate in a wild population of kittiwakes (Rissa tridactyla) that bacteria are transmitted during copulation and affect the composition and diversity of female bacterial communities. We used an anti-insemination device attached to males in combination with a molecular technique (automated ribosomal intergenic spacer analysis) that describes bacterial communities. After inseminations were experimentally blocked, the cloacal communities of mates became increasingly dissimilar. Moreover, female cloacal diversity decreased and the extinction of mate-shared bacteria increased, indicating that female cloacal assemblages revert to their pre-copulatory state and that the cloaca comprises a resilient microbial ecosystem. PMID:20961376
White, Joël; Mirleau, Pascal; Danchin, Etienne; Mulard, Hervé; Hatch, Scott A.; Heeb, Philipp; Wagner, Richard H.
Sexual transmission is an important mode of disease propagation, yet its mechanisms remain largely unknown in wild populations. Birds comprise an important model for studying sexually transmitted microbes because their cloaca provides a potential for both gastrointestinal pathogens and endosymbionts to become incorporated into ejaculates. We experimentally demonstrate in a wild population of kittiwakes (Rissa tridactyla) that bacteria are transmitted during copulation and affect the composition and diversity of female bacterial communities. We used an anti-insemination device attached to males in combination with a molecular technique (ARISA) that describes bacterial communities. After inseminations were experimentally blocked, the cloacal communities of mates became increasingly dissimilar. Moreover, female cloacal diversity decreased and the extinction of mate-shared bacteria increased, indicating that female cloacal assemblages revert to their pre-copulatory state and that the cloaca comprises a resilient microbial ecosystem. PMID:20961376
Walcott, Christy M.; Meyers, Adena B.; Landau, Steven
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…
Edith Orion; Hagit Matz; Ronni Wolf
Scabies and pediculosis are diagnosed on an almost daily basis in many dermatology offices. Whether the patient seeks medical attention because of the often unbearable itch of scabies or because of the fear of lice infestations, the physician should be on the lookout for these ectoparasitic infestations. Secondary bacterial infection, resistance to medication, and the risk of spread of the
Brewis, A A
The potential health threat of AIDS to the native island-based populations in the Pacific is now widely appreciated by those working in the public-health sector throughout the region. Although several countries in the region are yet to identify any cases of AIDS or HIV seropositivity, there is reason to suspect that heterosexual contact may emerge as a predominant mode of spread of HIV infection into native Pacific island populations. Sexual networks and their relationship to potentially 'risky behaviours' are described for a single native Micronesian atoll community on the basis of ethnographic observation and interviewing. This description is combined with the investigation of historic-demographic dimensions of the epidemiology of sexually-transmitted diseases in the same population to draw some conclusions about the opportunities for HIV transmission and acquisition among the sexually-active portions of this community. Although sexually-transmitted diseases have not had an appreciable epidemiological or demographic impact on the population in the past, the sexual networks within the community and beyond provide ample opportunity for the introduction and spread of sexually transmitted diseases, including HIV and its sequel AIDS. PMID:10148657
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. PMID:8335310
Calhoun, Thomas; Pickerill, Brian
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.…
Mandell, David S.; Eleey, Catharine C.; Cederbaum, Julie A.; Noll, Elizabeth; Hutchinson, M. Katherine; Jemmott, Loretta S.; Blank, Michael B.
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…
East, Leah; Jackson, Debra; O'Brien, Louise; Peters, Kathleen
Sexually transmitted infections have long been associated with stigma and stereotypes due to their very nature. Throughout history sexually transmitted infections have been associated with female prostitution and deviant immoral behaviour making women who contract these infections particularly vulnerable to being stigmatised and stereotyped. Although the stigma attached to such infections has previously been documented in the literature, the aim of this research was to gain in depth insight into young Australian women's experiences of having a sexually transmitted infection from a feminist perspective. Findings from this study provide insight into the onerous effects stigma can have on women with these infections and sheds light on how these effects can influence self-perceptions, fear of rejection and feelings of unworthiness. These findings can provide nurses with greater understanding and insight into the effects of stigma on women's experiences of having a sexually transmitted infection. Having this understanding and insight has the potential to promote therapeutic care and minimise the stigma that may be felt among women who have contracted this type of infection. PMID:22482278
R N Thin; P Rendell; J Wadsworth
Although gonorrhoea is often regarded as the sexually transmitted disease against which others are measured, its infectivity is not clearly understood. Estimates of the infection rate have varied from 5--90%. In this study, 50 couples with gonorrhoea were matched with 50 couples with genital yeast infection. Gonorrhoea was diagnosed in both partners of 32 couples and genital yeast infection in
Christine Panchaud; Susheela Singh; Dina Feivelson; Jacqueline E. Darroch
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
Steven D. Wexner
During the past two decades, an explosive growth in both the prevalence and types of sexually transmitted diseases has occurred. Up to 55 percent of homosexual men with anorectal complaints have gonorrhea; 80 percent of the patients with syphilis are homosexuals. Chlamydia is found in 15 percent of asymptomatic homosexual men, and up to one third of homosexuals have active
Edward C. Green
Compared with both industrialized countries and other less developed parts of the world, most of sub-Saharan Africa suffers inordinately from sexually transmitted diseases (STDs). It has high prevalence rates of traditional STDs, such as gonorrhea and syphilis, and if accurate seroprevalence surveys were to be done it would probably prove to have the highest HIV serropositive incidence in the world.
S Day; H Ward
OBJECTIVES: To describe and assess measures to control sexually transmitted diseases (STDs) among sex workers and their partners. METHODS: A review of medical, historical and social literature, focusing on selected cases. RESULTS: Measures to control disease in sex workers today are often prompted by concerns about HIV transmission. However, the literature shows that prostitution varies from one place and time
Lorvick, Jennifer J.
vaginal swabs or urine to screen for Chlamydia trachomatis genital infections.vaginal sex, 28,138 multiple partners, 136,140 and STI infection.vaginal sex. ” The variable “sexually transmitted infection”
Andrade, Roumayne Fernandes Vieira; Araújo, Maria Alix Leite; Vieira, Luiza Jane Eyre de Souza; Reis, Cláudia Bastos Silveira; Miranda, Angélica Espinosa
OBJECTIVE To assess the prevalence and factors associated with intimate partner violence after the diagnosis of sexually transmitted diseases. METHODS This cross-sectional study was conducted in Fortaleza, CE, Northeastern Brazil, in 2012 and involved 221 individuals (40.3% male and 59.7% female) attended to at reference health care units for the treatment of sexually transmitted diseases. Data were collected using a questionnaire applied during interviews with each participant. A multivariate analysis with a logistic regression model was conducted using the stepwise technique. Only the variables with a p value < 0.05 were included in the adjusted analysis. The odds ratio (OR) with 95% confidence interval (CI) was used as the measure of effect. RESULTS A total of 30.3% of the participants reported experiencing some type of violence (27.6%, psychological; 5.9%, physical; and 7.2%, sexual) after the diagnosis of sexually transmitted disease. In the multivariate analysis adjusted to assess intimate partner violence after the revelation of the diagnosis of sexually transmitted diseases, the following variables remained statistically significant: extramarital relations (OR = 3.72; 95%CI 1.91;7.26; p = 0.000), alcohol consumption by the partner (OR = 2.16; 95%CI 1.08;4.33; p = 0.026), history of violence prior to diagnosis (OR = 2.87; 95%CI 1.44;5.69; p = 0.003), and fear of disclosing the diagnosis to the partner (OR = 2.66; 95%CI 1.32;5.32; p = 0.006). CONCLUSIONS Individuals who had extramarital relations, experienced violence prior to the diagnosis of sexually transmitted disease, feared disclosing the diagnosis to the partner, and those whose partner consumed alcohol had an increased likelihood of suffering violence. The high prevalence of intimate partner violence suggests that this population is vulnerable and therefore intervention efforts should be directed to them. Referral health care services for the treatment of sexually transmitted diseases can be strategic places to identify and prevent intimate partner violence. PMID:25741656
Willcox, R R
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 PMID:6894558
BETSY C. HEROLD; RISA KIRKPATRICK; DANIEL MARCELLINO; ANNA TRAVELSTEAD; VALENTINA PILIPENKO; HOLLY KRASA; JAMES BREMER; LI JIN DONG
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
Dever, Jennifer A.
to explain high rates of sexually transmitted disease among inner city African American and Puerto Rican. All rights reserved. Keywords: Syndemics; Sexually transmitted diseases; Young adults; African intertwined epidemics in Hartford (and elsewhere) of two sexually transmitted diseases (STDs) in the study
Barrow, Roxanne Y.; Berkel, Cady; Brooks, Lesley C.; Groseclose, Samuel L.; Johnson, David B.; Valentine, Jo A.
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. PMID:18955915
Atul Karkare; Anup R. Anvikar; Vikas G. Rao; Jyothi Bhat; Tapas Chakma; S. R. Qamra; V. Gadge; P. Dour; Mahendra Ukey; Canina Luke; Arvind Kavishwar
Patients having sexually transmitted diseases are at a higher risk of acquiring HIV infection. The present study attempts to analyze the trend of HIV infection and the risk factors among STD clinic attendees in central India. Of the 2264 patients tested, 36 were sero-positive for HIV, giving a prevalence rate of 1.6%. HIV sero-positivity was almost constant over the years
Duluc, Dorothee; Gannevat, Julien; Joo, HyeMee; Ni, Ling; Upchurch, Katherine; Boreham, Muriel; Carley, Michael; Stecher, Jack; Zurawski, Gerard; Oh, SangKon
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. PMID:23201532
bacteria, gastrointestinal microbiota, mating behaviour, sexual selection, sexually transmitted diseasesLETTER Sexually transmitted bacteria affect female cloacal assemblages in a wild bird Joe¨l White,1. Wagner4 Abstract Sexual transmission is an important mode of disease propagation, yet its mechanisms
Matthews, P; Fletcher, J
General practitioners and practice nurses require the clinical skills that will enable them to detect sexually transmitted infections in the context of a shift to having no, or insidious symptoms. They need to be able to confirm the diagnosis and have clear models for management and referral. Primary care and genitourinary medicine need to work more closely together to increase mutual understanding and clarify the issues which surround referral and attendance. Sexual health risk assessment through the investigation of sexual history is a helpful way forward in both differential diagnosis and in targeting sexual health promotion and care. Many aspects of these clinical skills are specific to the primary care context. There is a need for improved undergraduate, postgraduate, and in-service training. Multidisciplinary educational approaches are ideal for the subject of sexual health. Primary care groups offer a potential way forward to help develop quality in primary care and some are developing health improvement programmes that aim to address sexual health issues. PMID:11271875
Gonçalves, Sebastián; Kuperman, Marcelo; Ferreira da Costa Gomes, Marcelo
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.
Mendiratta, Vibhu; Agarwal, Soumya; Chander, Ram
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. PMID:24958982
1 Measures of sexual partnerships: lengths, gaps, overlaps and sexually transmitted infection Betsy system of sexually transmitted infections. We describe the distributions of gaps, lengths and overlaps language. We limited our analysis to the 1051 (88%) of participants who reported ever engaging in vaginal
SKALA, Stephanie L.; SECURA, Gina M.; PEIPERT, Jeffrey F.
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. PMID:22464074
Helsinki, University of
Mathematical Tools for Planning Effective Intervention Scenarios for Sexually Transmitted Diseases. MATHEMATICAL MODELS are being increasingly used for de- scription and control of sexually transmitted of the disease, and these in turn depend on differences in sexual behavior. An effective way to study
Mlynarczyk-Bonikowska, Beata; Majewska, Anna; Malejczyk, Magdalena; Mlynarczyk, Grazyna; Majewski, Slawomir
Sexually transmitted diseases (STD) are one of the most prevalent infectious diseases in the world and important cause of morbidity and mortality. Especially STDs of viral etiology are difficult to cure. In many cases the antiviral therapy can relieve the symptoms but not eliminate the virus. During the past decades, considerable progress has been made in the development of antiviral drugs. One of the oldest antiviral medications is acyclovir (ACV). It is approved to treat initial and recurrent genital herpes and as a suppressive therapy in severe recurrent genital infections as well. Drug resistance to ACV and related drugs is seen among immunocompromised hosts, including human immunodeficiency virus HIV-infected patients. Resistant infections can be managed by second-line drugs - foscarnet or cidofovir- but they are more toxic than ACV. In case of HPV there is not known specific target for the medication and that is why the substances used in human papilloma virus HPV infection therapy are either antimitotics or immunomodulators. The Part I review focuses on mechanisms of actions and mechanisms of resistance to antiviral agents used in a treatment of the genital herpes and genital HPV infection. In Part II we will show the therapeutic options in other sexually transmitted infections: hepatitis B, C and HIV. PMID:24032509
Gully, P. R.; Fisher, D. C.; Pless, R.; Herbert, C.
OBJECTIVE: To identify gaps in knowledge about sexually transmitted diseases (STDs) and evaluate practice. DESIGN: We compared how 49 family physicians managed 249 episodes of STDs with the recommendations of the 1988-1989 Canadian STD management guidelines. (The study took place before revised guidelines were distributed in late 1992.) SETTING: Family physicians' practices throughout Canada. PARTICIPANTS: Physicians recruited by the National Research System from among the members of the College of Family Physicians of Canada. These physicians had been in practice for a mean of 9 years; 43 were Certificants of the College. MAIN OUTCOME MEASURES: Family physicians' self-reported episodes of sexually transmitted disease evaluated in light of current Canadian guidelines. RESULTS: Of the 249 episodes studied, 215 (86.3%) were treated effectively, and 34 (13.7%) were judged to have been treated ineffectively. Of the 215 effective treatments, 67 (31.2%) were not completely in agreement with current guidelines. CONCLUSION: Experienced family physicians with postgraduate training usually manage STDs well. The number of ineffective treatments and effective treatments not following the 1988-1989 guidelines, especially for pelvic inflammatory disease, indicates that information on managing certain STDs and syndromes should be made available to all family physicians in a format that is easy to read and use. PMID:8563506
Peeling, R W; Holmes, K K; Mabey, D
In the developing world, laboratory services for sexually transmitted infections (STIs) are either not available, or where limited services are available, patients may not be able to pay for or physically access those services. Despite the existence of national policy for antenatal screening to prevent congenital syphilis and substantial evidence that antenatal screening is cost?effective, implementation of syphilis screening programmes remains unacceptably low because of lack of screening tools that can be used in primary health care settings. The World Health Organization Sexually Transmitted Diseases Diagnostics Initiative (SDI) has developed the ASSURED criteria as a benchmark to decide if tests address disease control needs: Affordable, Sensitive, Specific, User?friendly, Rapid and robust, Equipment?free and Deliverable to end?users. Rapid syphilis tests that can be used with whole blood approach the ASSURED criteria and can now be deployed in areas where no previous screening has been possible. Although rapid tests for chlamydia and gonorrhoea lack sensitivity, more tests are in development. The way forward for STI diagnostics requires a continuing quest for ASSURED tests, the development of a road map for test introduction, sustainable programmes for quality assurance, and the creation of a robust infrastructure linked to HIV prevention that ensures sustainability of STI control efforts that includes viral STIs. PMID:17151023
Mulaudzi, F M; Makhubela-Nkondo, O N
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
Steiner, Riley J; Swartzendruber, Andrea L; Rose, Eve; DiClemente, Ralph J
Among 284 African American girls aged 14 to 17 years, frequent family monitoring knowledge was associated with a reduced likelihood of sexually transmitted infections (STIs) and having a casual sex partner but was not associated with other partnership characteristics. Family monitoring may offer an additional STI prevention opportunity for this vulnerable population. PMID:25211255
Dembo, Richard; Belenko, Steven; Childs, Kristina; Greenbaum, Paul E.; Wareham, Jennifer
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…
Ronald H. Gray; Fred Wabwire-Mangen; Godfrey Kigozi; Nelson K. Sewankambo; David Serwadda; Lawrence H. Moulton; Thomas C. Quinn; Katherine L. O’Brien; Mary Meehan; Carlos Abramowsky; Merlin Robb; Maria J. Wawer
Objective: The purpose of this study was to assess presumptive sexually transmitted disease treatment on pregnancy outcome and HIV transmission. Study Design: In a randomized trial in Rakai District, Uganda, 2070 pregnant women received presumptive sexually transmitted disease treatment 1 time during pregnancy at varying gestations, and 1963 control mothers received iron\\/folate and referral for syphilis. Maternal-infant sexually transmitted disease\\/HIV
Breyer, Benjamin N.; Shindel, Alan W.
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. PMID:22221824
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. PMID:8244349
Hawkes, S; Santhya, K G
There are many features that make India a vulnerable country as far as a sexually transmitted infection (STI)/HIV epidemic is concerned. These include the lack of a strong evidence base on which to formulate decision making, a pluralistic and often unregulated health sector, and a highly vulnerable population. Nonetheless, India has shown strong commitment to other areas of a comprehensive reproductive health care programme, and may be able to do so in the field of STI/HIV control. Vast numbers of people in India are severely disadvantaged in terms of income, education, power structures, and gender. Addressing these basic issues of human rights lies at the core of achieving better health outcomes. PMID:12083445
The history of sexually transmitted diseases in Canada from 1800 to the present reflects the changing views and values of citizens, medical experts, politicians and bureaucrats. During the colonial period, the military devoted attention to the problem but strict moral codes and social conventions prevented public discussion. Although middle class reformers began to pressure the federal government for funding and direction after 1900, World War I was the catalyst for involvement. Health education through a voluntary group and federal-provincial cost-shared funding for treatment facilities across Canada were introduced to control STDs. Public perception of STD patients as marginalised or deviant limited the impact of these efforts. Social changes during the 1960s, new STDs appearing in the 1970s and the AIDS epidemic of the 1980s have redirected the STD campaign to focus on high risk groups and prevention rather than the moralistic curative efforts of the past. PMID:8300103
Todd, C S; Haase, C; Stoner, B P
OBJECTIVES: This study assessed the prevalence and correlates of asymptomatic genital tract infection with Neisseria gonorrhoeae and Chlamydia trachomatis among emergency department patients. METHODS: Individuals seeking emergency department evaluation for nongenitourinary complaints provided urine samples for N gonorrhoeae and C trachomatis testing by ligase chain reaction and completed a sociodemographic and behavioral questionnaire. RESULTS: Asymptomatic N gonorrhoeae or C trachomatis was found in 9.7% of persons tested. Correlates of C trachomatis infection included younger age, residence in high-morbidity zip code areas, previous history of N gonorrhoeae or C trachomatis, and number of sex partners in the past year. CONCLUSIONS: Urine-based screening of asymptomatic emergency department patients detected significant numbers of N gonorrhoeae and C trachomatis infections. Targeted screening programs may contribute to community-level prevention and control of sexually transmitted infections. PMID:11236416
Katon, Jodie G.; Williams, Emily C.; Nelson, Karin M.; Gardella, Carolyn M.; Reiber, Gayle E.; Simpson, Tracy L.
Abstract Background: Women veterans are a growing population with unique characteristics and documented health disparities. Few studies have examined their sexual behaviors and rates of sexually transmitted infections (STIs), and none have compared women veterans to nonveterans to identify potential sexual health disparities. Methods: We used data from the 1999–2010 National Health and Nutrition Examination Survey, a nationally representative U.S. survey. We compared lifetime sexual history (age at first intercourse, number of partners), sexual activity in the last year, and STIs between women veterans (n=151) and nonveterans (n=8738), adjusting for age, race/ethnicity, education, marital status, binge drinking, and survey year. Results: Compared to nonveterans, women veterans reported a younger age at first intercourse and a greater number of female and male lifetime sexual partners, and they were more likely to have ever had sex with a woman. They were also more likely than nonveterans to have genital herpes and genital warts. Conclusions: Women veterans reported higher rates of sexual activity and STIs than nonveterans. Future research is needed to assess high-risk behaviors and determine what factors may underlie these associations. Providers should ensure thorough screening and intervention services are provided for this growing population. PMID:24328438
Onorato, I M; McCray, E; Pappaioanou, M; Johnson, R; Aral, S; Hardy, A M; Dondero, T J
The Centers for Disease Control, in cooperation with State and local health departments, is conducting human immunodeficiency virus, type 1 (HIV), seroprevalence surveys, using standard protocols, in sexually transmitted disease (STD) clinics in selected metropolitan areas throughout the United States. The surveys are blinded (serologic test results not identified with a person) as well as nonblinded (clients voluntarily agreeing to participate). STD clinics are important sentinel sites for the surveillance of HIV infection because they serve persons who are at increased risk as a result of certain behaviors, such as unprotected sex, homosexual exposure, or intravenous drug use. HIV seroprevalence rates will be obtained in the sentinel clinics each year so that trends in infection can be assessed over an extended period of time. Behaviors that place clients at risk for infection, or protect against infection, are being evaluated in voluntary, nonblinded surveys to define groups for appropriate interventions and to detect changes in response to education and prevention programs. Although inferences drawn from the surveys are limited by the scope of the clinics and clients surveyed, HIV trends in STD clinic client populations should provide a sensitive monitor of the course of the acquired immunodeficiency syndrome (AIDS) epidemic among persons engaging in high-risk sexual behaviors. PMID:2108455
Howett, Mary K; Kuhl, Jeffrey P
In the last 50 years, changes in cultural and scientific realities and customs have resulted in a worldwide epidemic of sexually transmitted diseases (STD). This is a multi-factorial problem resulting in part from: 1) an increased permissiveness in sexual attitudes in the Western world that results in earlier onset of intercourse and increased numbers of partners and types of sex acts; 2) a global transportation network that facilitates contacts and interactions between urban and rural areas as well as between countries resulting in migration and spread of infections; 3) an emergence of new and mutated forms of pathogens with increased capabilities to cause infections and for which there are no available vaccines or therapies; and, 4) at risk populations in developing countries who are susceptible to these pathogens while having societal infrastructures that lack basic health education and proper access to healthcare. Overwhelming examples of increasing and emerging STD pathogens exist in the early twenty-first century. These include human immunodeficiency virus type 1 (HIV-1), the causative agent of acquired immunodeficiency syndrome (AIDS), with over 42 million current cases of infection, 20 million deaths to date, and an estimated 500,000 deaths per year; human papillomavirus (HPV) infections, the causative agents of genital warts and cervical cancer, with approximately 1 in 4 women harboring virus DNA in genital epithelium, 1-3 percent of women showing symptoms of infection and 250,000 deaths per year in women worldwide from cervical cancer; and numerous others. Topical microbicides have been proposed as agents to break the chain of transmission in these infections by providing chemical, biological, and/or physical barriers to infection by blocking and/or inactivating pathogens at the mucosal surface where infection can occur. For many sexually transmitted infections, vaccines do not exist, and therapeutic agents are only partially effective, expensive, and difficult to distribute. In addition, female partners in many relationships do not control pregnancy or STD risk and may benefit from discrete methods, other than condoms, that would provide protection. Thus, microbicides should be valuable additions to preventing these diseases if they can be shown effective. Currently, 62 microbicides are in development with 6 entering Phase III clinical trials, 11 entering Phase I clinical trials, and 44 in pre-clinical development. In this review, we will describe many of the principles of microbicide mechanisms and give examples of major types of microbicides and their actions. Space precludes a complete description of all of the agents and their mechanisms of action. We will also put forth the argument for alkyl sulfate microbicides, including sodium dodecyl sulfate (SDS), agents that are in active development in our laboratories. PMID:16305508
Silverman, Jay G; Decker, Michele R; Kapur, Nitin A; Gupta, Jhumka; Raj, Anita
Objective To assess the relationship between men's reported violence against wives and their sexual risk behaviours and sexual health. Design, setting and participants Cross?sectional analyses of a survey of a nationally representative household?based sample of married men in Bangladesh (n?=?3096). Main outcome measure(s) Physical and sexual violence against wives during the previous 12?months was assessed and examined for relations to men's extramarital sexual behaviours and sexually transmitted infection (STI) symptoms or diagnosis during this same period, as well as to men's disclosure of such infection to wives and condom use while infected. Results More than 1 in 3 (36.84%) married Bangladeshi men reported physically and/or sexually abusing their wives in the past year. Men perpetrating such violence were more likely to report both premarital and extramarital sex partners (ORadjs 1.80–3.45; 95% CI 1.20 to 8.23); those reporting physical violence were more likely to report STI symptoms or diagnosis in the past year (ORadjs 1.68–2.52; 95% CI 1.24 to 3.73). Men perpetrating physical violence and contracting an STI were somewhat more likely to fail to disclose infection status to wives (ORadj 1.58; 95% CI 0.93 to 2.70) than infected men not reporting such abuse. Conclusions Violence against wives is common among Bangladeshi men. Men who perpetrate such abuse represent increased risk regarding their wives' sexual health because they are more likely to both participate in extramarital sexual behaviour and contract an STI compared with non?abusive husbands. Given the growing epidemic of HIV infection among monogamous South Asian women based on intercourse with infected non?monogamous husbands, research and intervention regarding men's violence in marriage and implications of such behaviour for women's sexual health should be prioritised. PMID:17301104
Wiggins, R; Hicks, S; Soothill, P; Millar, M; Corfield, A
Background: Mucinases and sialidases contribute to the process of invasion and colonisation in many conditions and infections of the female reproductive tract by degrading the protective cervical mucus. The role of hydrolytic enzymes in the pathogenesis of sexually transmitted diseases and their effect on cervical mucus are discussed in this review. Methods: Articles were searched for using the keywords "sialidase," "mucinase," "protease," and "sexually transmitted infections." As well as review and other articles held by our group, searches were conducted using PubMed, Grateful Med, and the University of Bath search engine, BIDS. Results: Numerous publications were found describing the production of hydrolytic enzymes in sexually transmitted diseases. Because the number of publications exceeded the restrictions imposed on the size of the review, the authors selected and discussed those which they considered of the most relevance to sexually transmitted infections. Key Words: mucinase; sialidase; microbial protease Abbreviations: BSM (bovine submaxillary mucin), BV (bacterial vaginosis); Fuc (fucose); Gal (galactose); GalNAc (N-acetylgalactosamine); Glc (glucose); GlcNAc (N-acetylglucosamine); Man (mannose); PMN (polymorphonuclear neutrophils), human immunodeficiency virus 1 (HIV-1); sIgA (secretory immunoglobulin A). PMID:11714935
Hubach, Randolph D; Dodge, Brian; Davis, Alissa; Smith, Andrew D; Zimet, Gregory D; Van Der Pol, Barbara
Semistructured interviews were completed with a sample of 25 men residing in an urban area of the Midwestern United States to elicit preferred methods of sexually transmitted infection service delivery. Results highlight the influence of stigma, social support, and perceived risk on sexually transmitted infection screening uptake and preferred methods of screening. PMID:24413494
THURMAN, Andrea Ries; HOLDEN, Alan E C; SHAIN, Rochelle N; PERDUE, Sondra T.
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. PMID:19704393
Awang, Halimah; Wong, Li Ping; Jani, Rohana; Low, Wah Yun
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
Davoren, Martin P; Hayes, Kevin; Horgan, Mary; Shiely, Frances
Objective The burden of sexually transmitted infections (STIs) rests with young people, yet in Ireland there has been very little research into this population. The purpose of this study was to determine the incidence rate and establish risk factors that predict STI occurrence among adolescents in Ireland. Design Routine diagnostic, demographic and behavioural data from first-time visits to three screening centres in the southwest of Ireland were obtained. Univariate and multivariable logistic regression models were used to assess risk factors that predict STI occurrence among adolescents. Results A total of 2784 first-time patients, aged 13–19?years, received 3475 diagnoses between January 1999 and September 2009; 1168 (42%) of adolescents had notifiable STIs. The incidence rate of STIs is 225/100 000 person-years. Univariate analysis identified eligible risk factors (p<0.2) for inclusion in the multivariable model. Multivariable logistic regression showed the dominant risk factors for STI diagnosis to be: males who sometimes [odds ratio (OR) 2.02] or never (OR 1.83) use condoms; and females 18–19?years (OR 2.26) and 16–18?years (OR 1.8), with 2 (OR 1.33) or 3+ (OR 1.56) partners in the last 12?months, who are non-intravenous drug users (OR 0.72), are most likely to receive a positive STI diagnosis. Conclusions STI diagnosis has become increasingly common in Ireland. The proportion of notifications among those aged under 20?years is increasing. These data illustrate the significance of age, condom use and number of sexual partners as risk factors for STI diagnosis. Furthermore, providing data for the first time, we report on the high incidence rate of STIs among adolescents in Ireland. The high levels of risk-taking behaviour and STI acquisition are highlighted and suggest that there is a need for an integrated public health approach to combat this phenomenon in the adolescent population. PMID:24916479
Kyung-Hee Choi; Zheng Xiwen; Qu Shuquan; Kevin Yiee; Jeffrey Mandel
HIV and other sexually transmitted diseases (STDs) are spreading rapidly in China. However, little is known about HIV risk among STD patients. In October–November 1997, we recruited a consecutive sample of 1,371 STD clinic patients from 16 different provinces and municipalities across the country and examined their sexual practices and condom use. We found that the median age for sexual
Majewska, Anna; Mlynarczyk-Bonikowska, Beata; Malejczyk, Magdalena; Mlynarczyk, Grazyna; Majewski, Slawomir
This is a second part of a review under a main title Antiviral medication in sexually transmitted diseases. In the part we published in Mini Rev Med Chem. 2013,13(13):1837-45, we have described mechanisms of action and mechanism of resistance to antiviral agents used in genital herpes and genital HPV infection. The Part II review focuses on therapeutic options in HIV infection. In 1987, 6 years after the recognition of AIDS, the FDA approved the first drug against HIV--zidovudine. Since then a lot of antiretroviral drugs are available. The most effective treatment for HIV is highly active antiretroviral therapy--a combination of several antiretroviral medicines that cause a reduction of HIV blood concentration and often results in substantial recovery of impaired immunologic function. At present, there are over 20 drugs licensed and used for the treatment of HIV/AIDS, and these drugs are divided into one of six classes. Investigational agents include GS-7340, the prodrug of tenofovir and BMS-663068--the first in a novel class of drugs that blocks the binding of the HIV gp120 to the CD4 receptor. PMID:25751258
An ongoing resurgence of syphilis and continued transmission of other common sexually transmitted diseases (STDs) in HIV-infected patients is fueled by a number of factors, including "prevention burnout" resulting from fatigue with long-term, safer-sex behavior, use of recretional drugs (notably methamphetamine), and false sense of security associated with HIV serosorting and elevated CD4+ cell count. Annual screening for common STDs is recommended for HIV-infected patients. Issues in syphilis and herpes simplex virus-2 (HSV-2) diagnosis and treatment are discussed. New problems are briefly reviewed, which include the increased reporting of lymphogranuloma venereum and the increased frequency of fluoroquinolone-resistant gonorrhea. The recently revised Centers for Disease Control and Prevention guidelines for treatment of syphilis, HSV-2 infection, chlamydial infection, and gonorrhea are summarized. This article summarizes a presentation on syphilis and other STDs made by Jeanne Marrazzo, MD, MPH, at the International AIDS Society-USA Continuing Medical Education course in New York, in October 2006. The original presentation is available as a Webcast at www.iasusa.org. PMID:17406079
Coccipolipus hippodamiae Sexually transmitted disease Biological control a b s t r a c t The enemy releasePotential role of the sexually transmitted mite Coccipolipus hippodamiae in controlling populations of this species is the sexually transmitted mite Coccipolipus hip- podamiae (McDaniel & Morrill) (Acarina
Barry P. Katz; J. Dennis Fortenberry; Gregory D. Zimet; Margaret J. Blythe; Donald P. Orr
This study describes associations of partner?specific relationship characteristics with consistent condom use among 297 young people (ages 13–24) with sexually transmitted diseases (STD). Relationship?specific variables were relationship quality, reasons for sex, relationship duration, duration of sexual relationship, coital frequency, “established” versus “new” sexual partner, cohabitation, children, sexual coercion, and drug or alcohol use associated with coitus. Relationship characteristics associated with
Cross, A B; Harris, J R
A detailed appraisal of the British seafarer and his way of life is described and the prevailing management of sexually transmitted disease in the seafarer is outlined. It is shown that the available statistics on the incidence of sexually transmitted disease among seafarers are inadequate. Management at sea and ashore remains generally unsatisfactory. Suggestions are made to improve the management of venereal disease in foreign ports and a simple method is described of managing sexually transmitted disease at sea with trimethoprim/sulphamethoxazole. PMID:946784
Khan, L A; Chowdhury, M Z; Begum, R A
To collect information on epidemiological attributes in relation to hepatitis B virus (HBV), syphilis, and HIV-positive cases among persons seeking jobs abroad, a descriptive cross-sectional study was conducted in selected health checkup centers of Dhaka, Bangladesh. Data were gathered through a structured interview schedule and blood samples were collected from 206 persons going abroad for jobs. The majority of the workers belonged to the age group 21-30 years (71.36%), followed by the age group 31-40 years (15.53%). The distribution of respondents according to profession was the following: agriculture, 77 (37.37%); business, 60 (29.13%); private service, 26 (12.62%); unemployed, 18 (8.74%); students, 15 (7.28%); housewives, 6 (2.91%); government service holders, 3 (1.46%). Of the 206 workers, 18 (8.74%) were found to be positive for the HBV antigen (HBsAg), 5 (2.43%) were positive for syphilis, and none was found positive for HIV. Among these workers, 34 (16.50%) were abroad, and 7 (20.59%) of them engaged in sex. 51 (24.75%) indicated a history of premarital and 15 (14.29%) a history of postmarital sex. Only 2 (0.79%) received transfusions and none had undergone surgery within the last 6 months. 79 (38.35%) and 66 (32.04%) reported a history of regular and occasional saloon shaving, respectively. These findings indicate that while the prevalence of HIV in Bangladesh is still low, the prevalence of HBsAg and sexually transmitted diseases is increasing in the country. PMID:12179654
Cheslack-Postava, Keely; Brown, Alan S; Chudal, Roshan; Suominen, Auli; Huttunen, Jukka; Surcel, Helja-Marja; Sourander, Andre
Animal models and epidemiologic studies suggest that prenatal maternal infection, and sexually transmitted infection (STI) in particular, is associated with an increased risk of schizophrenia in the offspring. However, findings from prior research studies on common infections, including herpes simplex virus type 2 (HSV-2) and Chlamydia trachomatis (C. trachomatis) have been inconsistent. To investigate these associations, we conducted a case-control study nested in the population-based Finnish Prenatal Study of Schizophrenia. Using linked national registries, 963 cases with schizophrenia (ICD-10 F20) or schizoaffective disorder (ICD-10 F25), and 963 matched controls were identified from among all persons born between 1983 and 1998 in Finland. HSV-2 IgG antibody levels were quantified in archived maternal serum samples drawn during pregnancy. Mothers of 16.4% of cases versus 12.6% of controls were HSV-2 seropositive. Mean levels of maternal HSV-2 IgG were marginally higher among cases than controls (index values of 0.98 versus 0.86; p=0.06). The unadjusted odds ratio (OR) of maternal HSV-2 IgG seropositivity was 1.33 (95% confidence interval (CI)=1.03-1.72, p=0.03). Following adjustment for covariates, the relationship was attenuated (OR=1.22, CI=0.93-1.60; p=0.14). In an exploratory analysis of another STI, C. trachomatis antibodies were measured in a subsample of 207 case-control pairs drawn from the cohort. The proportions of subjects that were seropositive and the mean levels of C. trachomatis antibodies were similar for cases and controls. This study does not support a strong association of HSV-2 or C. trachomatis IgG antibodies in maternal serum during early to mid-gestation with the development of schizophrenia in the offspring. PMID:26022653
Caviness, Celeste M; Anderson, Bradley J; Stein, Michael D
Incarcerated women are at high risk for sexually transmitted infections. Left untreated, these infections can have severe adverse health effects. In this study the authors present prevalence rates of trichomonas, chlamydia, and gonorrhea, and factors related to having a sexually transmitted infection 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 34.0 (±8.8) 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 sexually transmitted infection, 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 sexually transmitted infectious women. Sexually transmitted infection 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 sexually transmitted infection prevention interventions. PMID:22458289
Donald, W H
The factors associated with the rising incidence of sexually transmitted diseases in adolescents in England and Wales are both social and medical. Among the social factors is the large part played by sex in periodicals, advertisements, the theater, radio, and television. Also playing their part are increased mobility of populations, particularly moves from rural to urban areas, increased affluence, increased alcohol comsumption and leisure time together with greater personal freedom. The medical factors include the prevalence of asymptomatic infection mainly in women but also in men, the high incidence in homosexual men who may be asymptomatic and very promiscuous, and the fact that modern treatment is simple and effective reduces the fear of infection. Furthermore, modern contraceptive techniques such as the IUD and oral contraceptives (OCs) offer no barriers to infection unlike the condom and diaphragm. Syphilis is no longer a problem in the UK, as the incidence has remained at a low level of 2-3 cases/100,000 population for the past 20 years. Gonorrhea has become a problem in its place reaching almost epidemic proportions by 1975, although the incidence is now showing some sign of leveling off. Nonspecific urethritis in men and nonspecific genital infection in women, and the virus condition of herpes genitalis and genital warts have all continued to increase in incidence. In most clinics 40-50% of female patients with gonorrhea are under the age of 20. Changing patterns of sexual behavior have altered the pattern of disease. Oral coitus, both fellatio and cunnilingus, have become more prevalent and can lead to pharyngeal gonorrhea which can be symptomless in both heterosexuals and homosexuals. Rectal gonorrhea occurs in women as well as in male homosexuals and can be a cause of failure of initial treatment. The diagnosis of gonorrhea is a bacteriological diagnosis, and smears and cultures must be taken from the urethra and cervix in the female. It is gradually becoming routine pratice in many clinics to swab the rectum and pharynx as well as the genital tract to exclude gonorrhea in those areas. Complications of gonorrhea have become common again. Salpingitis has increased in incidence. Gonococcal arthritis has reappeared. Nonspecific genital infection in both sexes is a considerable problem. In men, the incidence of nonspecific urethritis is greater than that of gonorrhea. In women, nonspecific vaginitis, cervicitis, and salpingitis increases in incidence year by year and can be difficult to treat. As many as 40% of all women suffering from gonorrhea also have an infection with Trichomonas vaginalis, which will cause symptoms. Virus infection continues to be on the increase. This is particularly the case with genital warts and herpes genitalis, which have doubled in incidence over the past 10 years. It is always important when dealing with these conditions to examine the sexual partner, or partners, for evidence of a similar infection. PMID:582209
Trenholm, Christopher; Devaney, Barbara; Fortson, Kenneth; Clark, Melissa; Bridgespan, Lisa Quay; Wheeler, Justin
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…
Christopher Trenholm; Barbara Devaney; Kenneth Fortson; Melissa Clark; Lisa Quay; Justin Wheeler
This paper examines the impacts of four abstinence-only education programs on adolescent sexual activity and risks of pregnancy and 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
R Zachariah; W Nkhoma; A D Harries; V Arendt; A Chantulo; M P Spielmann; M P Mbereko; L Buhendwa
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
Mellanby, A; Phelps, F; Lawrence, C; Tripp, J H
OBJECTIVE--Evaluation of teenagers' knowledge and understanding about sexually transmitted disease, conception and contraception. DESIGN--A questionnaire study. SETTING--Schools SUBJECTS--1025 teenagers aged 15/16 years (mean 16.00). MAIN OUTCOME MEASURES--Scores attained in response to questions about sexually transmitted disease related to the sources of information given as most helpful. RESULTS--Teenagers have an incorrect understanding of the risks of sexually transmitted diseases. CONCLUSIONS--Teenagers may substantially underestimate their personal risk of contracting sexually transmitted diseases following the promotion of information about HIV/AIDS. Apparently simple messages about HIV and AIDS given in mass media advertising programmes may have unwanted results and need to be balanced by appropriate professional interpretation to teenagers. PMID:1398659
Davidson, Anna E
ve Americans has the genital herpes virus; the United StatesHPV/genital warts 28 % T richomonas 5 % Syphilis 28 % Herpesherpes, hepatitis, chancroid, trichomoniasis, STD, sexually transmitted disease, cervical cancer, genital
... and Cost of Sexually Transmitted Infections in the United States FEBRUARY 2013 National Center for HIV/AIDS, Viral ... Reveal More than 110 Million STIs in the United States CDC’s analysis suggests that there are more than ...
Cherrie B Boyer; Mary-Ann Shafer; Charles J Wibbelsman; Donald Seeberg; Eileen Teitle; Nydia Lovell
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
Carolyn M. Black; Stephen A. Morse
Molecular diagnostic tests are more sensitive and, in many cases, more specific than conventional laboratory methods for the\\u000a detection of sexually transmitted infections. Here, we review recently developed molecular methods for the diagnosis and subtyping\\u000a of the most common sexually transmitted infections: infections caused by Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus, Trichomonas vaginalis, and the agents of genital ulcer disease
Johnson, L; Coetzee, D; Dorrington, R
Objectives: To review studies of sexually transmitted infection (STI) prevalence in South Africa between 1985 and 2003 in selected sentinel populations. To examine how STI prevalence varies between populations and to identify the limitations of the existing data. Methods: Studies of the prevalence of syphilis, chancroid, granuloma inguinale, lymphogranuloma venereum, gonorrhoea, chlamydia, trichomoniasis, bacterial vaginosis, candidiasis, and herpes simplex virus type 2 (HSV-2) were considered. Results were included if they related to women attending antenatal clinics or family planning clinics, commercial sex workers, individuals in the general population (household surveys), patients with STIs, patients with genital ulcer disease (GUD), or men with urethritis. Results: High STI prevalence rates have been measured, particularly in the case of HSV-2, trichomoniasis, bacterial vaginosis and candidiasis. The aetiological profile of GUD appears to be changing, with more GUD caused by HSV-2 and less caused by chancroid. The prevalence of gonorrhoea and syphilis is highest in "high risk" groups such as sex workers and attenders of STI clinics, but chlamydia and trichomoniasis prevalence levels are not significantly higher in these groups than in women attending antenatal clinics. Conclusions: The prevalence of STIs in South Africa is high, although there is extensive variability between regions. There is a need for STI prevalence data that are more nationally representative and that can be used to monitor prevalence trends more reliably. PMID:16061532
Fethers, K.; Marks, C.; Mindel, A.; Estcourt, C.
Objectives: To assess the prevalence of sexually transmitted infections (STIs) and blood borne viruses, risk behaviours, and demographics in women who have sex with women (WSW). Methods: Retrospective cross sectional study using a multivariate model. Demographic, behavioural, and morbidity data were analysed from standardised medical records of patients attending a public STI and HIV service in Sydney between March 1991 and December 1998. All women with any history of sex with a woman were compared with women who denied ever having sex with another woman (controls). Results: 1408 WSW and 1423 controls were included in the study. Bacterial vaginosis (BV) was significantly more common among WSW (OR 1.7, p<0.001). Abnormalities on cervical cytology were equally prevalent in both groups, except for the higher cytological BV detection rate in WSW (OR 5.3, p=0.003). Genital herpes and genital warts were common in both groups, although warts were significantly less common in WSW (OR 0.7, p=0.001). Prevalence of gonorrhoea and chlamydia were low and there were no differences between the groups. The prevalence of hepatitis C was significantly greater in WSW (OR 7.7, p<0.001), consistent with the more frequent history of injecting drug use in this group (OR 8.0, p<0.001). WSW were more likely to report previous sexual contact with a homo/bisexual man (OR 3.4, p<0.001), or with an injecting drug user (OR 4.2, p<0.001). Only 7% of the WSW reported never having had sexual contact with a male. Conclusion: We demonstrated a higher prevalence of BV, hepatitis C, and HIV risk behaviours in WSW compared with controls. A similar prevalence of cervical cytology abnormalities was found in both groups. Measures are required to improve our understanding of STI/HIV transmission dynamics in WSW, to facilitate better health service provision and targeted education initiatives. Key Words: sexually transmitted infections; lesbians; HIV PMID:11141849
Kathleen Ford; Anne E. Norris
Objectives. The objectives of this study were to assess: (1) ethnic and gender differences in reporting of diagnoses of sexually transmitted diseases (STDs), symptoms related to STDs and sexual behavior and (2) behavioral risk factors for STDs in a probability sample of low income African American and Hispanic youth.Methods. Data were analyzed from a household probability sample of youth. The
Newly single older women routinely have not been considered at risk for sexually transmitted infections (STIs). Divorce and separation have put many women back into the dating scene and into new sexual partner relationships. Recent studies have shown an increase in HPV, HSV, chlamydia, and gonorrhea infections in this population. Advanced practice nurses have a unique opportunity to anticipate needs
SHEANA S. BULL; CORNELIS A. RIETMEIJER
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 Inter- net. Methods: Study staff recruited participants in online chat rooms, bulletin boards, and other online venues. A total of 4507 participants responded to a 68-item, self- administered, online survey of Internet sex-seeking prac- tices.
Richard de Visser
The aims of this exploratory qualitative study were to increase our understanding of hetero- sexual 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 for STI prevention. Data came from
Jared M. Baeten; Patrick M. Nyange; Barbra A. Richardson; Ludo Lavreys; Bhavna Chohan; Harold L. Martin; Kishorchandra Mandaliya; Jeckoniah O. Ndinya-Achola; Job J. Bwayo; Joan K. Kreiss
Objectives: To examine the relationship between use of oral contraceptive pills or depot medroxyprogesterone acetate and sexually transmitted disease acquisition. Study Design: Prospective cohort included 948 Kenyan prostitutes. Multivariate Andersen-Gill proportional hazards models were constructed, adjusting for sexual behavioral and demographic variables. Results: When compared with women who were using no contraception, users of oral contraceptive pills were at increased
Abu Saleh M. Abdullah; Shahul H. Ebrahim; Richard Fielding; Donald E. Morisky
Sexually transmissible diseases (STDs), the most common notifiable infectious conditions, remain major threats to repro- ductive and public health worldwide. Travelers are particularly vulnerable to STDs, because of voluntary or involuntary sexual behavior while abroad, and are significant vectors who introduce new pathogens and resistant strains to unaffected parts of the world. This article outlines some key issues that travel
Serrano, J Artur; Wynn, Rolf; Lau, Annie YS
Background Online social media, such as the microblogging site Twitter, have become a space for speedy exchange of information regarding sexually transmitted diseases (STDs), presenting a potential risk environment for how STDs are portrayed. Examining the types of “tweeters” (users who post messages on Twitter) and the nature of “tweet” messages is important for identifying how information related to STDs is posted in online social media. Objective The intent of the study was to describe the types of message emitters on Twitter in relation to two different STDs—chlamydia and human immunodeficiency virus (HIV)—as well as the nature of content tweeted, including how seriously the topic was treated. Methods We used the Twitter search engine to look for tweets posted worldwide from August 1-7, 2013, and from September 1-7, 2013, containing the words “chlamydia” or “HIV”, and the hashtags “#chlamydia” or “#HIV”. Tweeters were classified by two independent reviewers according to the type of avatar of the user (human, logo, or fantasy), the identification of the emitter (identifiable, semi-identifiable, or non-identifiable), and the source (private company, general media, scientific media, non-governmental, individual account, academic institution, government department, or undefined). Tweet messages were also independently classified according to their nature (serious or jokes/funny), and whether their main message was factual or of a personal nature/experience. Results A total of 694 tweets were posted by 426 different users during the first 7 days of August and September, containing the hashtags and/or simple words “chlamydia” and/or “HIV”. Jokes or funny tweets were more frequently posted by individual users (89%, 66/74), with a human avatar (81%, 60/74), from a non-identifiable user (72%, 53/74), and they were most frequently related to chlamydia (76%, 56/74). Serious tweets were most frequently posted by the general media (20.6%, 128/620), using a logo avatar (66.9%, 415/620), and with identifiable accounts (85.2%, 528/620). No government departments, non-governmental organizations, scientific media, or academic institutions posted a joke on STDs. A total of 104 of these analyzed tweets were re-tweeted messages, belonging to 68 unique tweets. The content was serious (99%, 67/68), factual (90%, 52/58), and about HIV (85%, 58/68). Conclusions Social media such as Twitter may be an important source of information regarding STDs provided that the topic is presented appropriately. Reassuringly, the study showed that almost 9/10 of tweets on STDs (chlamydia and HIV) were of serious content, and many of the tweets that were re-tweeted were facts. The jokes that were tweeted were mainly about chlamydia, and posted by non-identifiable emitters. We believe social media should be used to an even larger extent to disseminate correct information about STDs. PMID:25289463
Victor, Elizabeth C; Chung, Richard; Thompson, Robert J
This study examined the association between survey responses to health behaviors, personality/psychosocial factors, and self-reported sexually transmitted infections (STIs) to create a brief survey to identify youth at risk for contracting STIs. Participants included 200 racially diverse 14- to 18-year-old patients from a pediatric primary care clinic. Two sexual behavior variables and one peer norm variable were used to differentiate subgroups of individuals at risk of contracting a STI based on reported history of STIs using probability (decision tree) analyses. These items, as well as sexual orientation and having ever had oral sex, were used to create a brief sexual health screening (BSHS) survey. Each point increase in total BSHS score was associated with exponential growth in the percentage of sexually active adolescents reporting STIs. Findings suggest that the BSHS could serve as a useful tool for clinicians to quickly and accurately detect sexual risk among adolescent patients. PMID:25527529
Kalichman, S.; Rompa, D.; Cage, M.
Objectives: To determine the prevalence of identified STIs and recognised symptoms of STIs and their association with health status, substance use, and sexual risk behaviour in a sample of HIV seropositive men and women. Methods: 223 men, 112 women, and five transsexual people living with HIV infection completed confidential surveys. Participants were recruited through community based services, community health clinics, and snowball (chain) recruitment techniques in Atlanta, GA, USA in December 1999. Results: We found that (263) 78% of participants had been sexually active in the previous 3 months. For the entire sample, 42 (12%) participants reported an STI in the past 3 months and 40 (11%) experienced symptoms of an STI without indicating a specific diagnosis in that time. Gonorrhoea, chlamydia, syphilis, and newly diagnosed herpes simplex virus (HSV) were identified at similar rates among men, whereas trichomonas, gonorrhoea, and newly diagnosed HSV occurred most often in women. STIs were associated with substance use in men and women, with "crack" cocaine users having the greatest likelihood of an STI relative to non-crack users. STIs were also associated with continued practice of sexual risk behaviours. Conclusions: This sample of people living with HIV-AIDS reported high rates of diagnoses and symptoms of STIs. There were significant associations between STIs, substance use, and continued high risk sexual practices in men and women. These findings support the need for studies that confirm prevalence of STIs using clinical laboratory tests. Key Words: HIV; sexual risk; HIV transmission PMID:11141850
Otten, M W; Zaidi, A A; Wroten, J E; Witte, J J; Peterman, T A
OBJECTIVES. The effects of posttest counseling on acquisition of sexually transmitted diseases in patients at a large urban sexually transmitted disease clinic were studied. METHODS. Comparisons were made of the percentage of patients who had a positive gonorrhea culture (or any sexually transmitted disease) in the 6 months before and after human immunodeficiency virus (HIV) counseling and testing. RESULTS. For 331 patients counseled about a positive HIV test, the percentage with gonorrhea was 6.3 before and 4.5 after posttest counseling (29% decrease). For 666 patients counseled about a negative test, the percentage with gonorrhea was 2.4 before and 5.0 after posttest counseling (106% increase). With any sexually transmitted disease as the outcome, patients who tested positive for HIV had a 12% decrease and patients who tested negative had a 103% increase after counseling. CONCLUSIONS. HIV counseling and testing was associated with a moderate decrease in sexually transmitted diseases among patients who tested positive for the virus, but risk increased for patients who tested negative. This suggests a need to improve posttest counseling in this clinic and to assess the effects of counseling and testing in other clinics. PMID:8460729
Rosenberg, M J; Gollub, E L
Although sexually transmitted diseases, including human immunodeficiency virus (HIV), are a major concern for women, few prevention messages are targeted specifically to women. Those that are generally stress abstaining, altering the number or selection of partners, and urging partners to use condoms. But these behaviors may be unrealistic for many women, particularly women who are at highest risk for sexually transmitted diseases, because they require significant changes in life-style or depend on male-controlled condom use. Recommendation of contraceptives for prevention of sexually transmitted diseases depends largely on how well specific methods perform under controlled conditions, either in the laboratory or in clinical trials. Observational studies, which better reflect day-to-day use, indicate that condoms, barriers, and spermicides, used properly and consistently, can provide substantial protection against various sexually transmitted diseases. Condoms can similarly help protect against HIV, but studies of barriers and spermicides are scant and currently inconclusive. Finally, those methods that are controlled by women are consistently more effective in preventing sexually transmitted diseases. Thus, although condoms used well are still the best choice, the imperative for female-controlled methods indicates that diaphragms and spermicides should receive greater emphasis in prevention messages. PMID:1443295
Nazrul Islam Mondal; Kamal Hossain; Rafiqul Islam; Abul Bashar Mian
We analyzed the sexual behavior and sexually transmitted diseases (STDs) of street-based female sex workers (SFSWs) of Rajshahi city and examined their socio-demographic profiles. Among the SFSWs attending three drop- in centers (DIC) named PIACT, PROVA, and Suraksha Madhumita in Rajshahi, 150 self-motivated and willing individuals were interviewed through a structured questionnaire to obtain obstetric histories and socio-demographic information. Among
Jennifer S. Hirsch; Jennifer Higgins; Margaret E. Bentley; Constance A. Nathanson
Objectives. This article explores the social context of the migration-related HIV epidemic in western Mexico. Methods. Data collection involved life histories and participant observation with mi- grant women in Atlanta and their sisters or sisters-in-law in Mexico. Results. Both younger and older women acknowledged that migrant men's sexual be- havior may expose them to HIV and other sexually transmitted diseases.Younger
Cook, Emily C.; Niccolai, Linda M.; Connell, Christian M.
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. PMID:23488501
Lee, Yeung Chung
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)
Hargreave, T B; Harvey, J; Elton, R A; McMillan, A
The tray slide agglutination test (TAT) and micro immobilisation test (MIT) to detect antisperm antibodies were carried out on serum samples from 217 men attending a clinic for sexually transmitted diseases (STD), 151 fertile men requesting vasectomy and 645 men with a marriage with primary infertility. There was no difference in results between the fertile men and the men attending the clinic for sexually transmitted diseases although both sets of results differ from those of the infertile men. These results make it unlikely that venereal disease will trigger antisperm antibody production. PMID:6547577
Eric G. Benotsch; Steven D. Pinkerton; Roman V. Dyatlov; Wayne DiFranceisco; Tatyana S. Smirnova; Valentina Y. Dudko; Andrei Kozlov
Russia is experiencing one of the fastest growing HIV epidemics in the world. Russian sexually transmitted disease (STD) clinic\\u000a patients are at elevated risk for infection with HIV and other STDs due to unsafe sexual behaviors. Future risk reduction\\u000a intervention efforts for this group must be grounded in a solid understanding of the factors associated with risky behaviors.\\u000a We collected
Abir Znazen; Olfa Frikha-Gargouri; Lamia Berrajah; Sihem Bellalouna; Hela Hakim; Nabiha Gueddana; Adnene Hammami
ObjectivesThe aim of this study was to determine the prevalence of Chlamydia trachomatis infection and other sexually transmitted infections (STI) in female sex workers (FSW) in Tunisia.Methods188 prostitutes from three Tunisian towns were enrolled at their weekly medical visit. Demographic and sexual behaviour data were collected. C trachomatis, Neisseria gonorrhoeae, herpes simplex virus 2 (HSV-2) and human papillomavirus (HPV) were
Susan Scheer; Priscilla Lee Chu; Jeffrey D Klausner; Mitchell H Katz; Sandra K Schwarcz
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
B G Evans; M A Catchpole; J Heptonstall; J Y Mortimer; C A McCarrigle; A G Nicoll; P Waight; O N Gill; A V Swan
OBJECTIVE--To examine surveillance data for evidence of changing sexual behaviour and continuing transmission of HIV-1 among men who have sex with men. DESIGN--Analytic study of surveillance data on sexually transmitted diseases. SETTING--England and Wales. MAIN OUTCOME MEASURES--Number of cases of rectal gonorrhoea and newly diagnosed HIV infection in homosexual men. RESULTS--New cases of gonorrhoea among men attending genitourinary medicine clinics
Lydia A. Shrier; Sion Kim Harris; William R. Beardslee
Objective: To examine the longitudinal associations between depressive symptoms and self-reported sexually transmitted disease (STD) diagnosis among adolescents. Setting and Participants: National Longitudinal Study of Adolescent Health data were analyzed for 7th through 12th graders who reported having sexual intercourse be- tween baseline (Wave 1) and 1-year follow-up (Wave 2) in-home interviews (N=4738 (2232 boys, 2506 girls)). The association between
Robert M. Brackbill; Maya R. Sternberg; Martin Fishbein
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
Henderson, Zsakeba; Tao, Guoyu; Irwin, Kathleen
Most STD cases in the United States are managed in health sectors dominated by commercial and Medicaid MCOs. To sustain the recent declines in bacterial STD incidence in the United States and to control expansion of the prevalent viral STD, MCOs will need to contribute substantially to control efforts. Applied researchers and quality improvement specialists must work with clinicians, patients, and health systems to develop and scale-up interventions to improve STD prevention and control. PMID:15963885
de Visser, Richard
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…
Richert, C A; Peterman, T A; Zaidi, A A; Ransom, R L; Wroten, J E; Witte, J J
OBJECTIVES. The purpose of this study was to develop a method to identify persons at high risk for acquiring new sexually transmitted infections. METHODS. Computerized medical records from sexually transmitted disease clinics in Dade County, Florida, were used to conduct a retrospective cohort study. For all patients who visited in 1987, risk factors were identified for returning to the clinics within a year with a new sexually transmitted infection. Predictor variables were derived from the index visit and any visits in the year prior to the index visit. Logistic regression was used to develop a model that was applied to all patients who attended in 1989. RESULTS. Of 24,439 patients attending in 1987, 18.5% returned within a year with a new infection. Return rates were highest for 15- to 19-year-old Black males (31.8%). The highest odds ratios for returning were a diagnosis or treatment for an infection in the previous year and a diagnosis or treatment for infection at the index visit. The patients predicted to be at highest risk had a 39% return rate. There were as many new infections among the 2893 patients at highest risk as there were among the 13,326 patients at lowest risk. CONCLUSIONS. We developed a model that identifies persons at very high risk for sexually transmitted infection. These persons should be targeted for intensive intervention to reduce their risk. PMID:8460727
Rachel Rosenheck; David Ngilangwa; Rachael Manongi; Saidi Kapiga
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
The sexually transmitted infection, genital herpes (herpes simplex virus 2, or HSV-2 genital herpes begin with the infection's primary location. Memory T cells circulate in the body to fight, and the entryway for HSV-2 the genital tract. Several years ago Akiko Iwasaki, PhD, Professor of Immunobiology
Fielder, Robyn L.; Carey, Kate B.; Carey, Michael P.
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…
S Moses; E N Ngugi; A Costigan; C Kariuki; I Maclean; R C Brunham; F A Plummer
Although it seems possible in a developing country context such as Kenya, given appropriate inputs and a sound approach, to shift a sexually transmitted disease (STI) epidemic from phase II to III, it is not entirely clear how to go beyond this stage, to low levels of endemicity or even elimination. Perhaps the most important challenge now is to expand
O'Connell, M L
Awareness of the effects that birth control methods have on the enhancement or protection against risk of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) is very important. Health care providers must be aware of these effects to advise clients about birth control. This article reviews the literature about the effects of birth control methods on STD/HIV risk. PMID:8835806
Kimberly A. Tyler; Les B. Whitbeck; Dan R. Hoyt; Kevin A. Yoder
Path analysis was used to investigate factors associated with self?reported sexually transmitted diseases among 569 homeless and runaway adolescents in four Midwestern states. Youth were interviewed by outreach workers directly on the streets, in shelters, and in drop?in centers. Results indicated that family abuse was positively related to substance use, affiliation with friends who sold sex, and time on own.
Artz, Lynn; Macaluso, Maurizio; Kelaghan, Joseph; Austin, Harland; Fleenor, Michael; Robey, Lawrence; Hook, III, Edward W.; Brill, Ilene
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…
Sevgi O. Aral; Janet S. St. Lawrence; Roman Dyatlov; Andrei Kozlov
The relationships between commercial sex work, drug use, and sexually transmitted infections (STI) in St. Petersburg, Russia were assessed using qualitative research methods and an examination of existing research, surveillance and epidemiology data. The rapid assessment methodology included in-depth qualitative interviews with key informants, naturalistic observations of commercial sex work and drug use sites, geo-mapping, and a critical review of
Smith, P. Davis; Roberts, Craig M.
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…
Williams, Jessica Roberts; Zenilman, Jonathan; Nanda, Joy P.; Mark, Hayley
Objective: The authors evaluated procedures for recruiting college students for sexually transmitted disease (STD) testing as part of a research study examining the impact of HSV serologic testing. Participants: A convenience sample of 100 students was drawn from students aged 18 to 35 years enrolled at one university in a mid-Atlantic state…
S. M. Bruisten; H. Fennema; A. Pijl; M. Buimer; P. G. H. Peerbooms; E. Van Dyck; A. Meijer; J. M. Ossewaarde; Doornum van G. J. J
The most common etiologic agents of genital ulcer disease (GUD) are herpes simplex virus type 1 (HSV-1), HSV-2, Treponema pallidum, and Haemophilus ducreyi. In an outpatient clinic for sexually transmitted diseases in Amsterdam, The Netherlands, specimens from 372 patients with GUD were collected from February to November 1996. Sera were collected at the time of the symptoms and, for most
Rosenberg, Michael J.; Gollub, Erica L.
Ten observational studies indicate that condoms help prevent human immunodeficiency virus (HIV) infection, but research on barriers and spermicides is lacking. Given the effectiveness of female-controlled methods in preventing other sexually transmitted diseases, more research into protection from HIV infection by use of diaphragms and spermicides…
Susan D. Hillis; Robert F. Anda; Vincent J. Felitti; Dale Nordenberg; Polly A. Marchbanks
Objective. Adverse childhood experi- ences (ACEs) may have long-term consequences on at- risk behaviors that lead to an increased risk of sexually transmitted diseases (STDs) during adulthood. There- fore, we examined the relationship between ACEs and subsequent STDs for both men and women. Methods. A total of 9323 (4263 men and 5060 women) adults >18 years of age participated in
Henry, David B.; Deptula, Daneen P.; Schoeny, Michael E.
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…
Cates, Joan R.
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,…
Khairun Nessa; Shama-A Waris; Zafar Sultan; Shirajum Monira; Maqsud Hossain; Shamsun Nahar; Habibur Rahman; Mahbub Alam; Pam Baatsen; Motiur Rahman
The prevalence of sexually transmitted infections (STIs) and reproductive tract infections (RTIs) among hotel-based sex workers (HBSWs) in Dhaka, Bangladesh, was studied. A total of 400 HBSWs were enrolled in the study during April to July 2002. Endocervical swabs, high vaginal swabs, and blood samples from 400 HBSWs were examined for Neisseria gonorrhoeae (by culture), Chlamydia trachomatis (by PCR), Trichomonas
Harrell W. Chesson; John M. Blandford; Thomas L. Gift; Guoyu Tao; Kathleen L. Irwin
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
Centers for Disease Control and Prevention, 2007
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…
Ken T. D. Eames; Matt J. Keeling
A wide range of communicable human diseases can be considered as spreading through a network of possible transmission routes. The implied network structure is vital in determining disease dynamics, especially when the average number of connections per individual is small as is the case for many sexually transmitted diseases (STDs). Here we develop an intuitive mathematical framework to deal with
Charles S Morrison; Christine Sekadde-Kigondu; William C Miller; Debra H Weiner; Samuel K Sinei
Sexually transmitted diseases (STD) are an important contraindication for intrauterine device (IUD) insertion. Nevertheless, laboratory testing for STD is not possible in many settings. The objective of this study is to evaluate the use of risk assessment algorithms to predict STD and subsequent IUD-related complications among IUD candidates. Among 615 IUD users in Kenya, the following algorithms were evaluated: 1)
de Vries, Henry J C
Homosexuality is a global human phenomenon. Although the American Psychiatric Association removed homosexuality from its list of disorders more than 35years ago, homophobia among physicians is still widely prevalent. Men who have sex with men (MSM) form a relatively new epidemiological risk group for STI. To perform correct management, clinicians evaluating men with male-male sex contacts for STI related complaints or STI screening must obtain a thorough sexual history. Emerging STI like lymphogranuloma venereum, hepatitis C, and multidrug resistant N. gonorrhea strains have been described first in MSM. STI related proctitis often occur in MSM. Within the MSM population, HIV positive patients form a special group affected by STI related diseases, such as anal carcinoma and neurosyphilis. The final part of this review concludes with recommendations to reduce the STI burden in MSM. PMID:24559552
Aral, Sevgi O; Ward, Helen
Recent trends in the behaviors of some groups with high sexual activity and of the general population in some countries suggest that sexual behavior profiles of high and low sexual activity categories may be converging and may call into question the assumptions around sexual mixing that are built into theoretical models of sexually transmitted infections (STIs)/human immunodeficiency virus (HIV) transmission dynamics. One category of high sexual activity, sex work, has been undergoing modification in many societies, becoming more acceptable, more dispersed, and larger in volume in some societies and shrinking in others. Concurrent with changes in the characteristics of sex work, the accumulating data on the sexual behaviors of the general population suggest a shift toward those of sex workers, including large numbers of sex partners and short-duration partnerships. The closing of the gap between behaviors associated with high and low sexual activity may have important implications for theories of sexual structure and models of transmission dynamics for STIs, including HIV infection. PMID:25381381
Aral, Sevgi O.; Ward, Helen
Recent trends in the behaviors of some groups with high sexual activity and of the general population in some countries suggest that sexual behavior profiles of high and low sexual activity categories may be converging and may call into question the assumptions around sexual mixing that are built into theoretical models of sexually transmitted infections (STIs)/human immunodeficiency virus (HIV) transmission dynamics. One category of high sexual activity, sex work, has been undergoing modification in many societies, becoming more acceptable, more dispersed, and larger in volume in some societies and shrinking in others. Concurrent with changes in the characteristics of sex work, the accumulating data on the sexual behaviors of the general population suggest a shift toward those of sex workers, including large numbers of sex partners and short-duration partnerships. The closing of the gap between behaviors associated with high and low sexual activity may have important implications for theories of sexual structure and models of transmission dynamics for STIs, including HIV infection. PMID:25381381
Chris Metzger McQuiston
Sexually transmitted disease (STD) is an area of increasing concern. Yet in spite of counseling regarding the numerous high risks involved, some women continue to engage in risk behaviors and are repeatedly exposed to and contract a variety of sexually transmitted diseases. Using Orem's Self-Care Deficit Nursing Theory, a predictive-correlational design was used to examine the impact of selected basic
Zhang, Juping; Jin, Zhen; Chen, Yuming
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
Downey, Robert F; Hammar, Donna; Jobe, Kathleen A; Schmidt, Terri A; Van Slyke, Lori; Yassemi, Yassi; Zive, Dana
The study attempts to determine the prevalence of organisms associated with urethritis in men in rural southwestern Haiti and to determine the association with demographic, clinical and laboratory variables. A standardised oral interview was conducted; genital examinations were done; urethral swabs were collected for nucleic acid amplification testing, and first void urine was obtained for urinalysis. The mean participant age was 54; 88.8% lived in a rural area. Swabs were positive for Trichomonas vaginalis in 13.7% (28/205), Mycoplasma genitalium in 6.3% (13/205), Chlamydia trachomatis in 4.4% (9/205) and Neisseria gonorrhoeae in 0% (0/205). Subjects who never reported using condoms were nearly 3.5 times more likely to have any positive swab result (OR: 3.46, 95% CI 1.31-9.14). Subjects who reported their partners had other sexual partners or were unsure were more than three times likely to have any positive swab result (OR: 3.44, 95% CI 1.33-8.92). Infections with Trichomonas vaginalis and Mycoplasma genitalium were the most common. PMID:25228665
Michael, R T; Wadsworth, J; Feinleib, J; Johnson, A M; Laumann, E O; Wellings, K
OBJECTIVES: The purpose of this study was to characterize sexual behavior and opinions about sex in the United States and Britain; implications are discussed for effective public health policy regarding sexually transmitted diseases (STDs) in the United States. METHODS: Large-scale national probability surveys conducted in the 2 countries detailed sexual behavior, opinions, and the prevalence of STDs. RESULTS: In comparison with that of Britain, the US population has greater variability in sexual behavior, less tolerant opinions about sexual behavior, and a higher STD prevalence and lower condom usage among men. CONCLUSIONS: The survey data show compelling evidence from both countries of a strong association between number of sex partners and STD risk. In the United States relative to Britain, there is both greater dispersion in sexual behavior and a greater incidence of unconditional opposition to certain sexual practices. The former implies a need for strong public health policy to address the risks of STDs, but the latter implies strong opposition to that policy. This disjuncture between public health need and feasibility may contribute to the high US rate of STDs. PMID:9585739
Epstein, Marina; Manhart, Lisa E.; Hill, Karl G.; Bailey, Jennifer A.; Hawkins, J. David; Haggerty, Kevin P.; Catalano, Richard F.
Purpose Age at sexual initiation is strongly associated with sexually transmitted infections (STI), yet prevention programs aiming to delay sexual initiation have shown mixed results in reducing STI. This study tested three explanatory mechanisms for the relationship between early sexual debut and STI: number of sexual partners, individual characteristics, and environmental antecedents. Methods A test-and-replicate strategy was employed using two longitudinal studies: the Seattle Social Development Project (SSDP) and Raising Healthy Children (RHC). Childhood measures included pubertal age, behavioral disinhibition, family, school, and peer influences. Alcohol use and age of sexual debut were measured during adolescence. Lifetime number of sexual partners and having sex under the influence were measured during young adulthood. STI diagnosis was self-reported at age 24. Early sex was defined as debut at <15 years. Path models were developed in SSDP evaluating relationships between measures and were then tested in RHC. Results The relationship between early sex and STI was fully mediated by lifetime sex partners in SSDP, but only partially in RHC, after accounting for co-occurring factors. Behavioral disinhibition predicted early sex, early alcohol use, number of sexual partners, and sex under the influence, but had no direct effect on STI. Family management protected against early sex and early alcohol use, while antisocial peers exacerbated the risk. Conclusions Early sexual initiation, a key mediator of STI, is driven by antecedents that influence multiple risk behaviors. Targeting co-occurring individual and environmental factors may be more effective than discouraging early sexual debut and concomitantly improve other risk behaviors. PMID:24280303
Ly, F; Guéye, N; Samb, N D; Sow, P S; Ndiaye, B; Mahé, A
The objectives of this study conducted from January to December 2001 at our reference centre for sexualy transmitted infections (STI) were to determine the epidemiological profile of men who consulted our facility for symptomatic STI, describe the clinical manifestations of STI, and propose recommendations for improving therapeutic management of STI in tropical areas. A total of 100 men consulting for symptomatic STI were included over the one-year study period. In addition to administering a standardized questionnaire to each patient, a thorough clinical examination especially of the urogenital tract was performed and blood and urethral discharge specimens were obtained for analysis at the Reference STI laboratory of Institut d'Hygiène Sociale (IHS). Analysis of study data demonstrated that the mean age of patients was 25 years, that 52% were single, and that level of education was generally low (primary school for 37% and secondary school for 27%). However it should be pointed out that 12% of patients had a university level education. Most patients were Wolof people living in or around Dakar and working in the trades sector (shopkeeper, artists, tailors, drivers, and seamen). Thirty-seven percent of patients reported previous STI involving urethral discharge in 34% and genital ulcer in 3%. Risk factors included sex with random partners in 51% including 31% with prostitutes, more than two partners at the time of the study in 34%, and regular alcohol use in 44%. Neisseria gonorrhoea was by far the most frequent infectious agent found in urethral discharge specimens (52%). Genital ulcer was found in only 13 cases. Eight of 13 patients with genital ulcers had positive syphilis serology suggesting that syphilis was the most frequent aetiology. The other aetiologies were uncommon STI, ie., condyloma (n=3), balanitis (n=2), venereal lymphogranuloma (n=1) and secondary syphilis (n=1). Serology was positive for HIV in 4% of patients. The epidemiologic profile of the patients in our study was similar to those previously reported in the literature. However it is interesting to note the non-negligible number of cases of STI transmission involving illegal prostitution, the high incidence of mismanagement of STI by the health care workers who provided initial treatment, the poor availability of drugs used for treatment of STI therapy in the centre's Banako Initiative (BI) pharmacy, and the frequency of condom non-use by patients with STI. PMID:16615618
Kershaw, Trace S.; Ethier, Kathleen A.; Milan, Stephanie; Lewis, Jessica B.; Niccolai, Linda M.; Meade, Christina; Ickovics, Jeannette R.
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…
Ghebremichael, Musie; Paintsil, Elijah; Larsen, Ulla
Background To assess the covariates of alcohol abuse and the association between alcohol abuse, high-risk sexual behaviors and sexually transmitted infections (STIs). Methods 2,019 women aged 20–44 were randomly selected in a two-stage sampling from the Moshi urban district of northern Tanzania. Participant’s demographic and socio-economic characteristics, alcohol use, sexual behaviors and STIs were assessed. Blood and urine samples were drawn for testing of human immunodeficiency virus, herpes simplex virus, syphilis, chlamydia, gonorrhea, trichomonas and mycoplasma genitalium infections. Results Adjusted analyses showed that a history of physical (OR=2.05; 95% CI: 1.06–3.98) and sexual violence (OR=1.63; 95% CI: 1.05–2.51) was associated with alcohol abuse. Moreover, alcohol abuse was associated with number of sexual partners (OR=1.66; 95% CI: 1.01–2.73). Women who abused alcohol were more likely to report STIs symptoms (OR=1.61; 95% CI: 1.08–2.40). Women who had multiple sexual partners were more likely to have an STI (OR=2.41; 95% CI: 1.46–4.00) compared to women with one sexual partner. There was no direct association between alcohol abuse and prevalence of STIs (OR=0.86; 95% CI: 0.55–1.34). However, alcohol abuse was indirectly associated with STIs through its association with multiple sexual partners. Conclusions The findings of alcohol abuse among physically and sexually violated women as well as the association between alcohol abuse and a history of symptoms of STIs and testing positive for STIs have significant public health implications. In sub-Saharan Africa, where women are disproportionately affected by the HIV epidemic screening for alcohol use should be part of comprehensive STIs and HIV prevention programs. PMID:19060779
Rubin, Susan E.; Alderman, Elizabeth M.; Fletcher, Jason; Campos, Giselle; O’Sullivan, Lucia F.; McKee, M. Diane
Objective Sexually active urban adolescents experience a high burden of sexually transmitted infections (STI). Adolescents often access medical care through general primary care providers; their time alone with a provider increases the likelihood that youth will disclose risky behavior, which may result in STI testing. Our goals were to assess the association (if any) between the provision of time alone and STI testing, and describe the rates of STI testing among sexually active adolescents in urban primary care. Methods Youth (aged 12–19 years) presenting for care at 4 urban health centers were invited to complete post-visit surveys of their experience. Sexually transmitted infection screening rates were obtained from the clinical information systems (CIS); CIS data were linked to survey responses. Results We received 101 surveys. Surveyed youth experienced time alone in 69% of all visits. Time alone varied by age (older teens experienced more time alone), and it occurred more frequently in preventive visits (71%) versus nonpreventive visits (33%). It did not vary by gender. Forty-two of the 46 sexually active youth experienced time alone. Screening rates for sexually active females, either at the index visit or within 6 months prior to the index visit, were 17.9% for human immunodeficiency virus and 32.1% for gonorrhea/Chlamydia. No sexually active surveyed males were tested. Overall screening rates varied widely across practices (human immunodeficiency virus 0%–29%; gonorrhea/Chlamydia 7%–29%). There was no difference in screening rates among youth with and without time alone. Conclusion STI testing for adolescents is being conducted in this primary care urban population, especially for sexually active females. However, clinicians in this setting are not screening females consistently enough and rarely screen males. We were unable to test our hypothesis that provision of time alone was associated with a higher rate of STI testing. Site differences suggest substantial variation in clinician practices that should be addressed in quality improvement interventions. PMID:23804803
Bello, C S; Elegba, O Y; Dada, J D
Between 1977 and 1981, 3089 patients attended the sexually transmitted diseases (STD) clinic in Zaria, northern Nigeria. The male-to-female ratio of attenders was 6:1. Postpubertal gonorrhoea accounted for 28.1% of cases, non-specific genital infections for 22.4%, and syphilis for 1.2%. Illiteracy, polygamy, the purdah system, widespread prostitution, and inadequate facilities are factors aiding the spread of these diseases in northern Nigeria. PMID:6687822
Yuan, Xin-Peng; Xue, Ya-Kui; Liu, Mao-Xing
In this paper, a sexually transmitted disease model is proposed on complex networks, where contacts between humans are treated as a scale-free social network. There are three groups in our model, which are dangerous male, non-dangerous male, and female. By mathematical analysis, we obtain the basic reproduction number for the existence of endemic equilibrium and study the effects of various immunization schemes about different groups. Furthermore, numerical simulations are undertaken to verify more conclusions.
Radcliffe, K W; Flew, S; Poder, A; Cusini, M
This guideline is intended to serve as a framework for those working in any location where sexually transmitted infections (STIs) are managed. It offers recommendations which will need to be adapted depending on local facilities and policies, and is not intended to be all encompassing. This guideline should be read in conjunction with other European guidelines on the management of specific infections (see http://www.iusti.org/). PMID:23033510
Ogunbanjo, B O
Available data show that sexually transmitted diseases constitute great medical, social and economic problems in Nigeria. Apart from the heavy affliction of urban dwellers, there is rapid excursion of these diseases to the rural areas as well. This situation is serious enough to attract government attention so that necessary control measures may be initiated in good time in order to avert the serious consequences. PMID:2486771
Cornelis A. Rietmeijer; Sara J. Shamos
Over the past decade, research and program efforts have sought to exploit the online presence of people at risk for sexually\\u000a transmitted infections (STIs) and HIV to develop Internet-based interventions to reduce STI and HIV transmission risk. This\\u000a study aimed to develop a typology of online STI and HIV interventions to guide implementation in public health practice. Online\\u000a interventions were
V D Ojeda; S A Strathdee; R Lozada; M L A Rusch; M Fraga; P Orozovich; C Magis-Rodriguez; A De La Torre; H Amaro; W Cornelius; T L Patterson
Objective:To examine associations between migration and sexually transmitted infection (STI) prevalence among Mexican female sex workers (FSW).Methods:FSW aged 18 years and older in Tijuana, Baja California (BC) underwent interviews and testing for HIV, syphilis, gonorrhoea and chlamydia. Multivariate logistic regressions identified correlates of STI.Results:Of 471 FSW, 79% were migrants to BC. Among migrant FSW, prevalence of HIV, syphilis, gonorrhoea, chlamydia
Mitike Molla; Maria Emmelin; Yemane Berhane; Bernt Lindtjørn
Studies pertaining to sexually transmitted infections (STIs) among rural young adults in Ethiopia are limited. This study provides information on knowledge about common STIs, and the perceptions, preferences and use of health services for STIs, among youths and healthcare providers in predominately rural Butajira, a town in south-central Ethiopia. We performed mixed-method research, using a cross-sectional survey among 3 743
Nnedu, Obinna N.; McCorvey, Staci; Campbell-Forrester, Sheila; Chang, Janice; Salihu, Hamisu M.; Jolly, Pauline E.
The use of condoms can reduce the risk of sexually transmitted infections (STIs) including the human immunodeficiency virus (HIV) infection. We conducted this study to determine factors that impact condom use among patients attending an STI clinic in Montego Bay, Jamaica. A questionnaire containing sections on socio-demographic characteristics, knowledge of STIs and HIV, preventive measures for STI/HIV transmission and sexual practices including condom use was administered to 212 participants. Using logistic regression, we determined the relationship between the different factors and condom use during the last sexual episode. Approximately 43% of study participants reported condom use during the last sexual episode. Employment (OR=2.2; 95%CI=1.1–4.1) and greater knowledge of STIs (OR=1.9, 95%CI=1.02–3.6) were associated with increased likelihood of condom use during the last sexual episode. Having multiple sexual partners was associated with decreased likelihood to report condom use (OR=0.3, 95%CI=0.1–0.9). Also, persons belonging to a religious organization were less likely to report condom use (OR=0.5, 95%CI=0.2–0.9). The results of this study can be used in formulating effective strategies to increase condom use in Montego Bay. This would decrease the transmission of STIs and HIV. PMID:20182645
Hammerschlag, Margaret R.; Guillén, Christina D.
Summary: 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 can have, in addition to medical implications, serious legal implications. The presence of an STI is often used to support the presence or allegations of sexual abuse, and conversely, the identification of an STI in a child will prompt an investigation of possible abuse. The purpose of this paper is to review the epidemiology of child sexual abuse, including the epidemiology of major STIs including Neisseria gonorrhoeae, Chlamydia trachomatis, syphilis, herpes simplex virus (HSV), Trichomonas vaginalis, and human papillomavirus, and the current recommendations for diagnostic testing in this population. PMID:20610820
Hughes, Gwenda; Field, Nigel
Sexually transmitted infections (STIs) are a major public health concern. The UK has some of the most advanced STI surveillance systems globally. This article uses national surveillance data to describe remarkable changes in STI epidemiology in the UK over the last century and explores the behavioral and demographic shifts that may explain these trends. The past 10 years have seen considerable improvements in STI service provision and the introduction of national public health interventions. However, sexual health inequalities persist and men who have sex with men, young adults and black ethnic minorities remain a priority for interventions. Technological advances in testing and a shift in sexual health service commissioning arrangements will present both opportunities and challenges in future. PMID:25598336
SAFER SEX INFORMATION There are many ways to reduce the risk of acquiring a Sexually Transmitted and consistently every time you have sex, can be a great safer sex strategy. The basic idea behind safer sex
Tobin, J M; Roy, R B
Out of 100 teenage girls attending a sexually transmitted disease clinic for the first time, 77 were found to be using a reliable method of contraception and had similar characteristics to teenage girls attending a family planning clinic. The 23 girls not using any reliable contraception exhibited a different pattern of sexual behaviour and were at high risk of unplanned pregnancy. Subsequently, another group of 23 girls not using contraception when seen at the sexually transmitted disease clinic were actively encouraged to attend a family planning clinic. Their risk of unplanned pregnancy was much reduced, although their pattern of sexual activity was unchanged. Ready availability of contraceptive advice for unprotected teenagers in sexually transmitted disease clinics would reduce their high risk of unplanned pregnancy. PMID:3917826
Cinta Folch; Jordi Casabona; M. Teresa Brugal; Xavier Majó; Anna Esteve; Mercè Meroño; Victoria Gonzalez
Background: The objectives of the study were to estimate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae and sexual risk practices, and to identify factors associated with infection by C. trachomatis\\/N. gonorrhoeae. Methods: Injecting drug users were interviewed at harm reduction centers and biological samples were collected to estimate the prevalence of C. trachomatis and N. gonorrhoeae. Results: The prevalence
Sonali Wayal; Carrie Llewellyn; Helen Smith; Martin Fisher
The increasing prevalence of sexually transmitted infection (STI) and delays in access to sexual health care among men who have sex with men are a major public health concern in the UK. This qualitative study, involving semi-structured interviews with 24 men recruited from a genitourinary medicine clinic in Brighton, UK, explored their views towards the introduction of home sampling kits
Raj, Anita; Decker, Michele R.; Murray, Jessica E.; Silverman, Jay G.
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 =…
Christopher Trenholm; Barbara Devaney; Kenneth Fortson; Melissa Clark; Lisa Quay; Justin Wheeler
This paper examines the impacts of four abstinence-only education programs on adolescent sexual activity and risks of pregnancy and 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
Bhattar, S; Bhalla, P; Rawat, D; Tripathi, R; Kaur, R; Sardana, K
This study aims to highlight the importance of screening all HIV positive women for various reproductive tract infections/sexually transmitted infections (RTIs/STIs) irrespective of symptoms and to determine its occurrence in asymptomatic HIV positive women. Relevant specimens were collected for diagnosis of various RTIs/STIs. STIs were diagnosed in nearly one-third of the HIV positive asymptomatic patients which is quite high. The national strategy for STIs/RTIs control misses out large number of asymptomatic RTIs/STIs in HIV positive women which is responsible for silently transmitting these infections in the community. So this strategy should be modified to include screening of all HIV positives women irrespective of symptoms of STIs/RTIs. PMID:26068345
Social historians of medicine and sexuality have focused in recent years upon various strands of public health policy towards sexually transmitted diseases. However, despite the fact that, from the 1930s, contact tracing became one of the primary weapons with which British government sought to contain the incidence of STDs, its history in twentieth-century Britain has been largely ignored. Based on a range of governmental and private archives, supplemented by interviews with former practitioners, this paper examines the development of contact tracing in Scotland from its origins in the interwar period, through its expansion under Defence Regulation 33B during the period 1942-7, to its postwar development within the National Health Service. Particular attention is paid to the discriminatory aspects of wartime controls and to the professional, resource, and legal constraints shaping contact tracing in postwar Scotland. PMID:11613447
Li, Shuping; Jin, Zhen
Considering homosexual contacts and heterosexual contacts in the course of sexual contacts, double degrees which describe the numbers of homosexual contacts and heterosexual contacts are introduced, correlation coefficients about degrees based on the joint probability distribution are given, and an SIS mean-field model about sexually transmitted diseases is presented when degrees are uncorrelated. The basic reproduction number of diseases is studied by the method of next generation matrix. Results show that, when homosexual contacts and heterosexual contacts all exist, once the disease is epidemic in the interior of male (female) population which is caused by male (female) homosexual transmissions, or the disease is epidemic between the two species which is caused by heterosexual transmissions, the disease must be epidemic in the whole population. Numerical simulations confirm the theoretical results.
Martini, Jussara Gue; Bandeira, Adriana da Silva
This study aims at evaluating the knowledge of adolescents regarding the prevention and transmission of DST's, HIV/AIDS. It was carried out in a school in the city of Canoas/RS. 121 students, with age between 12-19 participated in the study. According to the interviews 22.3% said that their sexual life starts at the age between 12 and 16. Student's knowledge regarding the transmission of DST's is evident, since 79% of the students pointed out that those diseases are transmitted through sexual contact if there is no use of condoms. However some myths and stereotypes related to these disease were also identified. 16.3% of the adolescents believe that contamination can occur in bathrooms, swimming pools and saunas. PMID:14692281
Liu, Mao-Xing; Ruan, Jiong
In this paper a new model for the spread of sexually transmitted diseases (STDs) is presented. The dynamic behaviors of the model on a heterogenous scale-free (SF) network are considered, where the absence of a threshold on the SF network is demonstrated, and the stability of the disease-free equilibrium is obtained. Three immunization strategies, uniform immunization, proportional immunization and targeted immunization, are applied in this model. Analytical and simulated results are given to show that the proportional immunization strategy in the model is effective on SF networks.
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
Sexually transmitted diseases (STD) are probably the most tabooed diseases we know. The many taboos and the related stigmata shape patients' lives and significantly influence health care policies, medical research, and current problems in medical ethics. To better understand these complex influences, the still powerful taboos and related metaphors associated with illness and disease are analyzed within their cultural and historical background and concerning the actual impact on patient care and research. It becomes obvious that research and health care policies cannot be satisfyingly successful in helping people affected by STDs as long as these "nonscientific" factors are not taken into account. PMID:24623036
Kaljee, Linda M; Green, Mackenzie; Riel, Rosemary; Lerdboon, Porntip; Tho, Le Huu; Thoa, Le Thi Kim; Minh, Truong Tan
As rates of HIV increase in Vietnam, there is a need for data on social relations and sexual risk and protective behaviors among Vietnamese adolescents in a context of rapid social and economic changes. The authors report results from qualitative interviews with 159 Vietnamese adolescents living in Hanoi, Nha Trang City, and Ninh Hoa District and a survey of 886 adolescents in these same three sites. In the qualitative interviews, youths report a strong adherence to ideals and values regarding abstinence outside of marriage. Youths reported low rates of engagement in vaginal, anal, and/or oral sex with a significant difference in reported behaviors between males (29/469, 6.2%) and females (7/416, 1.7%; p = .000). A total of 15 of 32 (46.9%) sexually active youths reported rarely or never using condoms. Females had significantly higher scores for perceived sexual stigma than males (t = -10.22 [95% confidence interval (CI); -3.72 to -2.52; p = .000) whereas males scored significantly lower than females on a scale of perceived self-efficacy for abstinence (t = 5.31 [95% CI; .27 to .59]; p = .000). The stigmatization of sexual relations outside of marriage particularly for young women reinforces abstinence; however, these same values decrease adolescents' ability to obtain accurate information about sexuality and HIV and sexually transmitted infections and engage in safer sex. PMID:17403496
Gaston, Jordan R; Roberts, Sally A; Humphreys, Tricia L
Haemophilus ducreyi, the etiologic agent of chancroid, has been previously reported to show genetic variance in several key virulence factors, placing strains of the bacterium into two genetically distinct classes. Recent studies done in yaws-endemic areas of the South Pacific have shown that H. ducreyi is also a major cause of cutaneous limb ulcers (CLU) that are not sexually transmitted. To genetically assess CLU strains relative to the previously described class I, class II phylogenetic hierarchy, we examined nucleotide sequence diversity at 11 H. ducreyi loci, including virulence and housekeeping genes, which encompass approximately 1% of the H. ducreyi genome. Sequences for all 11 loci indicated that strains collected from leg ulcers exhibit DNA sequences homologous to class I strains of H. ducreyi. However, sequences for 3 loci, including a hemoglobin receptor (hgbA), serum resistance protein (dsrA), and a collagen adhesin (ncaA) contained informative amounts of variation. Phylogenetic analyses suggest that these non-sexually transmitted strains of H. ducreyi comprise a sub-clonal population within class I strains of H. ducreyi. Molecular dating suggests that CLU strains are the most recently developed, having diverged approximately 0.355 million years ago, fourteen times more recently than the class I/class II divergence. The CLU strains' divergence falls after the divergence of humans from chimpanzees, making it the first known H. ducreyi divergence event directly influenced by the selective pressures accompanying human hosts. PMID:25774793
Gesink, Dionne C; Sullivan, Ashleigh B; Miller, William C; Bernstein, Kyle T
The authors' purpose was to expand sexually transmitted disease core theory by examining the roles of person, place, and time in differentiating geographic core areas from outbreak areas. The authors mapped yearly census-tract-level syphilis rates for San Francisco, California, based on new primary and secondary syphilis cases reported to the San Francisco City sexually transmitted disease surveillance program between January 1, 1985, and December 31, 2007. SaTScan software (Information Management Services, Inc., Silver Spring, Maryland) was used to identify geographic clusters of significantly elevated syphilis rates over space and time. The authors graphed epidemic curves for 1) core areas, 2) outbreak areas, 3) neither core nor outbreak areas, and 4) noncore areas, where noncore areas included outbreaks, and stratified these curves according to demographic characteristics. Five clusters of significantly elevated primary and secondary syphilis rates were identified. A 5-year threshold was useful for differentiating core clusters from outbreak clusters. Epidemic curves for core areas, outbreak areas, neither core nor outbreak areas, and noncore areas were perfectly synchronized in phase trends and wavelength over time, even when broken down by demographic characteristics. Between epidemics, the occurrence of syphilis affected all demographic groups equally. During an epidemic, a temporary disparity in syphilis occurrence arose and a homogeneous core group of cases could be defined. PMID:21540320
Colvin, M; Sharp, B
Objectives: To conduct a knowledge, attitude, and practice (KAP) study and to determine the prevalence of sexually transmitted diseases (STDs), including HIV, in a community residing in remote, rural Lesotho. Methods: In 1995 a cross sectional, community based epidemiological study was conducted on a population of 7500 people living in 89 villages. A total of 29 villages were randomly selected and a systematic sample of houses within villages was obtained. Questionnaires were administered to subjects after written consent was obtained. Determination of N gonococcus and C trachomatis infection was done on urine using ligase chain reaction (LCR) technology. Using blood specimens, syphilis was diagnosed by RPR and TPHA tests and HIV by a single ELISA and confirmed with a western blot. Results: Questionnaires were administered to 277 women, 100 men, and 149 youths (12–15 years). Chlamydia was diagnosed in 28.4% of adults, gonorrhoea in 5.9%, syphilis in 11.3%, and HIV infection in 6.3%. All cases of HIV occurred along the main road (p=0.001) and 72% of individuals with gonorrhoea were co-infected with chlamydia (p = 0.0001). 11.6% of women and 38.0% of men had had sex with a non-regular partner in the past 3 months and none had used condoms. Conclusion: A high prevalence of STDs and HIV infection was found in a population characterised by low levels of knowledge about STD/HIV, high risk sexual behaviour, and evidence of inappropriate health seeking behaviour for STDs. Key Words: HIV; sexually transmitted infections PMID:10817067
Dong, Yanyan; Zhang, Hongbo; Wang, Yongyang; Tao, Haidong; Xu, Song; Xia, Junrui; Huang, Wen; He, Huan; Zaller, Nickolas; Operario, Don
We conducted a survey of 358 young migrant women working in entertainment venues in China to explore the prevalence of and factors associated with two indicators of sexual and reproductive health: (1) multiple abortions and (2) the dual risk of sexually transmitted infections (STI) and abortion history. One quarter (25.4 percent) of the women in this sample had multiple abortions during their lifetime and, of those with any abortion history, 18.3 percent had had an abortion outside of a regulated health clinic. One-third (33.0 percent) of the sample had had an STI during the past year, and approximately one-fourth (23.7 percent) of those women did not receive STI treatment in a public hospital. Approximately one-fourth (23.5 percent) of the sample reported both a history of abortion and an STI during the past year. Women with a history of multiple abortions had significantly lower income levels, were more likely to have sex with clients and with husbands, and tended more to use alcohol before sex. Women who experienced both abortion and STI risks were more likely to report having had unprotected sex, genitourinary tract infections symptoms, anxiety, illicit drug use, and suicidal ideation. Enhanced efforts are needed to improve reproductive and sexual health for female migrants in urban China, particularly those working in entertainment venues. PMID:25902189
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
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
Stolte, I.; Dukers, N.; de Wit, J. B F; Fennema, J.; Coutinho, R.
Objectives: We investigated if a rise in rectal gonorrhoea and early syphilis among men who have sex with men (MSM) in Amsterdam coincided with the introduction of highly active antiretroviral therapies (HAART) in July 1996 and determined risk factors for these sexually transmitted infections (STI). Methods: Subjects were patients of the STI clinic of the municipal health service in Amsterdam. Surveillance data (1994–9) represented consultations (n=11 240) of MSM (n=6103). For analyses we used logistic regression. Results: Comparing the periods before and after the introduction of HAART, the infection rate for rectal gonorrhoea increased from 4% to 5.4% (p=.001) and for syphilis, from 0.5% to 0.8% (p = 0.050). Independent risk factors for rectal gonorrhoea (younger age, western nationality, and concurrent infection with another STI) and for early syphilis (non-western nationality and concurrent infection with rectal gonorrhoea) did not change after HAART became available. For rectal gonorrhoea, however, the infection rate increased only among men who had exclusively homosexual contacts (OR 1.38, p<0.01), compared with bisexual men. For early syphilis, the infection rate increased only among men of western nationality (OR 3.38, p<0.01) compared to men of non-western nationality. Conclusions: Infection rates of rectal gonorrhoea and early syphilis increased, indicating a change in sexual behaviour, possibly as a result of the introduction of HAART. For now, it is important to find out how sexual behaviour is changing and to keep monitoring trends in STIs (including HIV) among MSM in Amsterdam. Key Words: rectal gonorrhoea; syphilis; HAART; high risk sexual behaviour; MSM PMID:11402225
Rutherford, Grant; Friesen, Marcia R; McLeod, Robert D
This work uses agent-based modelling (ABM) to simulate sexually transmitted infection (STIs) spread within a population of 1000 agents over a 10-year period, as a preliminary investigation of the suitability of ABM methodology to simulate STI spread. The work contrasts compartmentalized mathematical models that fail to account for individual agents, and ABMs commonly applied to simulate the spread of respiratory infections. The model was developed in C++ using the Boost 1.47.0 libraries for the normal distribution and OpenGL for visualization. Sixteen agent parameters interact individually and in combination to govern agent profiles and behaviours relative to infection probabilities. The simulation results provide qualitative comparisons of STI mitigation strategies, including the impact of condom use, promiscuity, the form of the friend network, and mandatory STI testing. Individual and population-wide impacts were explored, with individual risk being impacted much more dramatically by population-level behaviour changes as compared to individual behaviour changes. PMID:23569641
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
The adult film industry nowadays represents a legal multi-billion dollar business. The main health risks of adult performers are well known. They mainly include the transmission of sexually transmitted diseases such as HIV, hepatitis, gonorrhoea, Chlamydia, herpes and papillomavirus. However, despite regular follow-up, the frequency of STD remains significant in this high-risk population since a large part of the industry continues to reject systematic use of condoms. Besides, performers are also exposed to other physical and mental health issues often not known to the public. This article provides a comprehensive review of what is known about STD and other risks among the community of performers in the adult film industry. PMID:24507206
Catchpole, M A
Surveillance and epidemiological studies are essential components of effective control programmes for sexually transmitted diseases. While other forms of basic biomedical research may add to our understanding of why an exposure or behaviour causes or prevents disease, only epidemiology allows the quantification of the magnitude of the exposure-disease relationship in humans. It is this measure of the association between risk and disease that is needed to inform rational policy on altering risk through intervention. Surveillance data are used both to determine the need for public health action and to assess the effectiveness of programmes: they are required for the setting of priorities, for planning and resource allocation, for the definition of population subgroups and risky behaviours for targeted interventions, for the development of disease prevention programmes, and for the evaluation of interventions. Data from surveillance systems and epidemiological studies can also inform diagnostic and therapeutic practice, and indicate areas for further research. Over the last 20 years chlamydia infections and viral agents have emerged as the major cause of STD in developed countries, and with this change in the aetiological mix of STD cases the focus of prevention and control of STDs has shifted from treatment and partner notification towards health education. In developing countries there is an urgent need for appropriate surveillance infrastructures, particularly now that there is evidence that STD control programmes, informed by surveillance data, can reduce HIV transmission at the population level. The importance of surveillance and epidemiology in the control of STDs is set to increase in the face of the changing pattern of sexually transmitted pathogens. The challenge to clinicians and epidemiologists is to work together in developing systems that will inform new approaches to control and prevention. PMID:8976846
Background Herpes simplex virus (HSV) infection is one of the commonest viral sexually transmitted infections (STIs). The aim of this study was to evaluate the prevalence of STIs among HSV positive patients at a tertiary hospital in Jeddah. Secondary objective of the study included the description of the demographic and clinical profile of patients with HSV and HIV co-infection. Methods A retrospective chart review of the medical records was performed for HSV positive women who presented to the emergency room and outpatient department of King Abdulaziz University Hospital, Jeddah, Saudi Arabia between January 1, 2003 and August 30, 2011. Data were collected from the medical records of all the patients and analyzed using the Statistical Package for the Social Sciences. Results Three hundred forty-three HSV positive patients were included in this study. Co-infection with HIV was documented in 45 patients (13.1%). Other STIs included chlamydia (n?=?43, 12.5%), gonorrhea (n?=?44, 12.8%), hepatitis B infection (n?=?8, 2.3%), and cytomegalovirus infection (n?=?37, 10.8%). Nineteen patients (5.5%) had a total of 47 term pregnancies and five abortions post HSV diagnosis. Genital ulcer disease was diagnosed in 11 (57.9%) of the cases during labor. One newborn developed neonatal herpes infection and subsequently showed delayed psychomotor development during follow up. Genital herpes was diagnosed in one patient’s partner; however, there was no documentation of screening for STIs in the partners of the other patients. Conclusions Sexually transmitted infections are relatively common among HSV positive patients at King Abdulaziz University Hospital. Amongst these, HIV is the most common, with a prevalence of 13.1%. Further studies are warranted to evaluate STIs in Saudi Arabia. Health policy makers should adopt a protocol to screen for STIs in the partners of persons who are positive for any STI as early detection and appropriate treatment can improve the outcome. PMID:23898826
Chen, Feng; Li, Chunguang
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.
Ghebremichael, Musie S; Finkelman, Matthew D
This research aimed to study the effect of premarital sex on sexually transmitted infections (STIs) and high risk behaviors among women in sub-Saharan Africa. It included 1393 women randomly selected from the Moshi urban district of northern Tanzania. Participants' demographic and socio-demographic characteristics, alcohol use, condom use, number of partners, symptoms of STIs and age at first sex and marriage were obtained. Moreover, blood and urine samples were tested for HIV-1, HSV-2, syphilis, chlamydia, gonorrhea, trichomonas and Mycoplasma genitalium infections. The average duration of premarital sex in the study participants was 1.66 years (SD of 2.61 years). Women with longer duration of premarital sex had higher odds of HIV-1, HSV-2 and other STIs. Moreover, women with longer duration of premarital sex were more likely to report multiple sexual partners. These findings highlight the importance of a lengthy period of premarital sex as a public health issue. STIs prevention programs in sub-Saharan Africa should address factors leading to a longer period of premarital sex in women. PMID:23626920
Zhong, Weihao; McClure, Colin D.; Evans, Cara R.; Mlynski, David T.; Immonen, Elina; Ritchie, Michael G.; Priest, Nicholas K.
Although it is well known that mating increases the risk of infection, we do not know how females mitigate the fitness costs of sexually transmitted infections (STIs). It has recently been shown that female fruitflies, Drosophila melanogaster, specifically upregulate two members of the Turandot family of immune and stress response genes, Turandot M and Turandot C (TotM and TotC), when they hear male courtship song. Here, we use the Gal4/UAS RNAi gene knockdown system to test whether the expression of these genes provides fitness benefits for females infected with the entomopathogenic fungus, Metarhizium robertsii under sexual transmission. As a control, we also examined the immunity conferred by Dorsal-related immunity factor (Dif), a central component of the Toll signalling pathway thought to provide immunity against fungal infections. We show that TotM, but not TotC or Dif, provides survival benefits to females following STIs, but not after direct topical infections. We also show that though the expression of TotM provides fecundity benefits for healthy females, it comes at a cost to their survival, which helps to explain why TotM is not constitutively expressed. Together, these results show that the anticipatory expression of TotM promotes specific immunity against fungal STIs and suggest that immune anticipation is more common than currently appreciated. PMID:24174107
Minichiello, Victor; Rahman, Saifur; Hussain, Rafat
Socioeconomic and health disadvantage is widespread within and across indigenous communities in the world, leading to differentials in morbidity and mortality between indigenous and non-indigenous populations. Sexually transmitted infections (STIs), including HIV/AIDS, among indigenous populations are an emerging public health concern. The focus of this paper is on examining the STI epidemiology in indigenous communities in various parts of the world utilizing a range of data sources. Most of the STI research on global indigenous communities has concentrated on developed countries, neglecting more than half the world's indigenous people in the developing countries. This has resulted in major gaps in data at global level for STIs and HIV/AIDS among indigenous populations. Available data show that the prevalence of STIs is increasing among the indigenous communities and in several instances, the rates of these infections are higher than among non-indigenous populations. However, HIV still remains low when compared with the rates of other STIs. The paper argues that there is an urgent need to collect more comprehensive and reliable data at the global level across various indigenous communities. There is also an opportunity to reverse current trends in STIs through innovative, evidence-based and culturally appropriate targeted sexual health programmes. PMID:24052012
Britton, Tom; Nordvik, Monica K; Liljeros, Fredrik
We model a sexually transmitted infection in a network population where individuals have different numbers of partners, separated into steady and casual partnerships, where the risk of transmission is higher in steady partnerships. An individual's number of partners of the two types defines its degree, and the degrees in the community specify the degree distribution. For this structured network population a simple model for disease transmission is defined and the basic reproduction number R0 is derived, R0 being a size-biased (i.e. biasing individuals with many partners) average number of new infections caused by individuals during the early stages of the epidemic. First a homosexual population is considered and then a heterosexual population. The heterosexual model is fitted to data from a census survey on sexual activity from the Swedish island of Gotland. The main empirical finding is that, for relevant transmission rates, the effect that so-called superspreaders have on R0 is over-estimated when not admitting for different types of partnerships. PMID:17707873
Ma, Qiaoqin; Pan, Xiaohong; Cai, Gaofeng; Yan, Jiezhe; Xu, Yun; Ono-Kihara, Masako; Kihara, Masahiro
This study is to determine the prevalence of unintended pregnancy and its risk factors among the female attendees of sexually transmitted disease (STD) clinics in Zhejiang Province, China. A self-administered questionnaire survey of a cross-sectional design was administered to attendees at four STD clinics in 2007. Of the 313 female STD clinic attendees, 42.5% reported that they had at least one unintended pregnancy; the induced abortion rate was 39.0%. Over their lifetime, 12.1% responded “use condoms always/often” and 5.4% “always/often used oral contraceptives.” The risk factors for the unintended pregnancy identified by the multivariate analysis were as follows: being married, experience of nonconsensual sex, and a history of STD, having two and over two sexual partners. Unintended pregnancies and induced abortion by female STD clinic attendees have reached an alarming prevalence. Doctors at STD clinics should attach importance not only to the STD problem of the female attendees, but also to the unintended pregnancy and the associated factors. Targeted contraceptive counseling and intervention should be promoted at STD clinics as a strategy to improve the efficiency and effectiveness of the reproductive health services in China. PMID:23841063
Hakre, Shilpa; Arteaga, Griselda B; Núñez, Aurelio E; Arambu, Nelson; Aumakhan, Bulbulgul; Liu, Michelle; Peel, Sheila A; Pascale, Juan M; Scott, Paul T
Respondent-driven sampling (RDS) was used to conduct a biobehavioral survey among men who have sex with men (MSM) in three cities in the Republic of Panama. We estimated the prevalence of HIV, syphilis, and other sexually transmitted infections (STIs), sociodemographic characteristics, and sexual risk behaviors. Among 603 MSM recruited, RDS-adjusted seroprevalences (95 % confidence intervals) were: HIV-David 6.6 % (2.2-11.4 %), Panama 29.4 % (19.7-39.7 %), and Colon 32.6 % (18.0-47.8 %); active syphilis-David 16.0 % (8.9-24.2 %), Panama 24.7 % (16.7-32.9 %), Colon 31.6 % (14.8-47.5 %); resolved HBV infection-David 10.0 % (4.8-16.8 %), Panama 29.4 % (20.0-38.3 %), and Colon 40.6 % (21.9-54.4 %); herpes simplex virus type 2-David 38.4 % (27.9-48.9 %), Panama 62.6 % (52.8-71.0 %), and Colon 72.9 % (57.4-85.8 %). At least a third of MSM in each city self-identified as heterosexual or bisexual. HIV prevalence is concentrated among MSM. Preventive interventions should focus on increasing HIV and syphilis testing, and increasing promotion of condom awareness and use. PMID:24927712
Adeyemi, Ezekiel Oluwagbemiga
Beyond the statistics of sex-based differences in infection rates, there are profound differences in the underlying causes and consequences of HIV infections in male and female which need to be examined. The study therefore examines; the gender differences in the STI knowledge and gender-related potential risks of HIV heterosexual transmission. Quantitative and qualitative data were collected. A multistage random sampling procedure was employed in administration of 1358 questionnaires. For qualitative data, four focus group discussions (FGD) were conducted to collect information from stakeholders within the study population, while In-depth interview was employed to collect information from 188 people living with HIV/AIDS through support groups in the State. The data collected were subjected to basic demographic analytical techniques. Combination of univariate, bivariate, and multivariate analysis were employed. Information from focus group discussions and in-depth interviews were transcribed and organized under broad headings that depict different aspects of the discussions. Majority of the respondents interviewed did not inform their partners about their infection in the study area. It was also discovered that stigmatization did not allow some women to disclose their status to their sexual partners. Some of the HIV-positive patients interviewed agreed that they did not attend the health facilities to treat the STI’s before they were finally confirmed positive. The study hypothesis revealed that communication between partners about STI’s was associated with an increase in risk reduction behaviour. The paper concluded that there is need for more information and education on communication about STI’s between the sexual partners; to reduce the spread of sexually transmitted diseases within the nation. PMID:24470905
SEXUALLY TRANSMITTED DISEASES/INFECTIONS (STD/STI) TESTS 2013-14 (Add venipuncture fee of $12) Serum $22.94 State IPP Chlamydia/GC Aptima Endocervical, Urethral, Vaginal or Urine $0.00 State Non-IPP Chlamydia/GC Aptima Endocervical, Urethral, Vaginal or Urine $40.55 Wet Mount Swab/Saline $28.15 #12;
Brandon DL Marshall; Thomas Kerr; Jean A Shoveller; Julio SG Montaner; Evan Wood
BACKGROUND: The prevalence of HIV and sexually transmitted infections (STIs) among street-involved youth greatly exceed that of the general adolescent population; however, little is known regarding the structural factors that influence disease transmission risk among this population. METHODS: Between September 2005 and October 2006, 529 street-involved youth were enroled in a prospective cohort known as the At Risk Youth Study
Merianos, Ashley L.; Rosen, Brittany L.; King, Keith A.; Vidourek, Rebecca A.; Fehr, Sara K.
The study purpose is to examine the impact of early substance use on lifetime and past year contraction of sexually transmitted diseases (STDs), including chlamydia, gonorrhea, herpes, and syphilis. A secondary analysis of the 2012 National Survey on Drug Use and Health (N = 52,529) was conducted to determine if lifetime or past year STD…
Wildsmith, Elizabeth; Schelar, Erin; Peterson, Kristen; Manlove, Jennifer
The incidence of sexually transmitted diseases (STDs) in the United States is among the highest in the western industrialized world. Nearly 19 million new STDs are diagnosed each year, and more than 65 million Americans live with an incurable STD, such as herpes and human papillomavirus (HPV). Young people, in particular, are at a heightened risk…
K. Limpakarnjanarat; T. D. Mastro; S. Saisorn; W. Uthaivoravit; J. Kaewkungwal; S. Korattana; N. L. Young; S. A. Morse; D. S. Schmid; B. G. Weniger; P. Nieburg
OBJECTIVES: To determine demographic and behavioural factors and sexually transmitted infections (STIs) associated with prevalent HIV-1 infection among brothel based and other female sex workers (FSWs) in Chiang Rai, northern Thailand. METHODS: Data were collected from questionnaires, physical examinations, and laboratory evaluations on Thai FSWs enrolled in a prospective cohort study in Chiang Rai, Thailand, from 1991 to the end
Andreas Gilsdorf; Alexandra Hofmann; Osamah Hamouda; Viviane Bremer
BACKGROUND: Sexual transmitted infections (STIs) have increased in Germany and other countries in Europe since the mid-nineties. To obtain a better picture of diagnostic methods used in STI testing institutions in Germany, we performed a nationwide survey amongst STI specialists in order to evaluate the quality of STI reports and provide recommendations to harmonize and possibly improve STI diagnostics in
Markowicz, Mateusz; Grilnberger, Evelyn; Huber, Florian; Leibl, Gabriele; Abrahamian, Heidemarie; Gartner, Manfred; Huber, Monika; Chott, Andreas; Reiter, Michael; Stanek, Gerold
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
Judith M. Vandepitte; Faustin Malele; Samuel Edidi; Said Abdellati; Joelle Kabamba; Catherine Van Overloop
Objective: The objective of this study was to determine the preva- lence and risk factors of HIV and other sexually transmitted infections (STIs) among female sex workers (FSWs) in Kinshasa, Democratic Republic of the Congo, in 2002. Study Design: A cross-sectional study was conducted among FSWs presenting for the first time at the STI clinic of Matonge, Kinshasa. The women
Barth, Karen R.; Cook, Robert L.; Downs, Julie S.; Switzer, Galen E.; Fischhoff, Baruch
Examined key factors that influenced college students to seek screening for sexually transmitted diseases. Data from student interviews indicated that social stigmas and negative consequences (particularly the negative consequences of testing and perceived vulnerability to infection) represented significant barriers to being tested. Many students…
Leston, Jessica D.; Jessen, Cornelia M.; Simons, Brenna C.
Background: The disparity in rates of sexually transmitted diseases (STDs), HIV/AIDS, and unplanned pregnancy between Alaska Native (AN) and non-AN populations, particularly among young adults and females, is significant and concerning. Focus groups were conducted to better understand the knowledge, attitudes, and beliefs of rural Alaska youth…
Using the Health Belief Model as a conceptual framework, this study examined university students who may seek access to healthcare through an on-campus student clinic for screening and treatment of sexually transmitted infections. A cross-sectional research design was used to collect data from students enrolled in a general health education…
Norton, Wynne E.; Fisher, Jeffrey D.; Amico, K. Rivet; Dovidio, John F.; Johnson, Blair T.
Objectives: Despite findings suggesting that young adults are more concerned about experiencing an unplanned pregnancy or contracting a sexually transmitted infection (STI) than becoming human immunodeficiency virus (HIV) infected, no empirical work has investigated whether the specific focus of an intervention may be more or less efficacious at…
N. Abdala; T. V. Krasnoselskikh; A. J. Durante; M. Y. Timofeeva; S. V. Verevochkin; A. P. Kozlov
Aims: This study investigates whether sexual transmitted behaviors and infections (STIs) among injection drug users (IDUs) may promote the spread of HIV among and beyond IDUs in Russia. Methods: We conducted a cross-sectional survey of behavior and tested for STIs in a convenience sample of 159 IDUs in St. Petersburg, Russia. Results: The median age was 27 and 57% were
Elkington, Katherine S.; Teplin, Linda A.; Mericle, Amy A.; Welty, Leah J.; Romero, Erin G.; Abram, Karen M.
Objectives To examine the prevalence and persistence of 20 HIV/sexually transmitted infection (STI) sexual and drug use risk behaviors and to predict their occurrence in 4 mutually exclusive diagnostic groups of delinquent youth: (1) major mental disorders (MMD); (2) substance use disorders (SUD); (3) comorbid MMD and SUD (MMD+SUD); and (4) neither disorder. Methods At the baseline interview, HIV/STI risk behaviors were assessed in 800 juvenile detainees, aged 10 to 18 years; youth were reinterviewed approximately 3 years later. The final sample (n = 689) includes 298 females and 391 males. Results The prevalence and persistence of HIV/STI risk behaviors was high in all diagnostic groups. Youth with SUD at baseline were over 10 times more likely to be sexually active and to have vaginal sex at follow-up than youth with MMD+SUD (AOR=10.86, 95% CI=1.43–82.32; AOR=11.63, 95% CI=1.49–90.89, respectively) and four times more likely to be sexually active and to have vaginal sex than youth with neither disorder (AOR=4.20, 95% CI=1.06–16.62; AOR=4.73, 95% CI=1.21–18.50, respectively). Youth with MMD at baseline were less likely to have engaged in unprotected vaginal and oral sex at follow-up compared with youth with neither disorder (AOR=0.11, 95% CI=0.02–0.50; AOR=0.07, 95% CI=0.01–0.34, respectively), and with youth with SUD (AOR=0.10, 95% CI=0.02–0.50; OR=0.10, 95% CI=0.02–0.47, respectively). Youth with MMD+SUD were less likely (AOR=0.28, 95% CI=0.09–0.92) to engage in unprotected oral sex compared with those with neither disorder. Conclusions Irrespective of diagnostic group, delinquent youth are at great risk for HIV/STIs as they age into adulthood. SUD increases risk. Because detained youth are released after approximately 2 weeks, their risk behaviors become a community health problem. Pediatricians and child psychiatrists must collaborate with corrections professionals to develop HIV/STI interventions and ensure that programs started in detention centers continue after youth are released. PMID:18645421
Wira, Charles R.; Fahey, John V.; Rodriguez-Garcia, Marta; Shen, Zheng; Patel, Mickey V.
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
Hiltabiddle, S J
A nurse practitioner at Women's and Children's Health Services in Philadelphia, Pennsylvania, has reviewed 26 documents on adolescent development, sexually transmitted disease (STDs), STD risk factors, and factors influencing condom use among heterosexual adolescents to develop recommendations for STD prevention programs. She uses the constructs of the Health Belief Model (HBM) to incorporate the findings of the literature review into the recommendations. Adolescents tend to use condoms infrequently and inconsistently. They also have a high rate of STDs. The perception that one can enjoy sex with condoms, condom use allows sex at the spur of the moment, condoms are clean and easy to use, condoms are popular with peers, and condoms require the male to be responsible has a positive association with intention to use condoms among adolescents. Among males, the perception of positive attitudes from their girlfriends toward condoms and an increased confidence in their ability to use condoms correctly is positively associated with condom use. Factors associated with nonuse include perceived barriers to condom use (inconvenience, reduced sexual pleasure, or embarrassing to use), increased use of nonbarrier contraceptives since they remove pregnancy prevention as a motivation for condom use, many lifetime partners, intercourse with strangers, multiple sex partners, and alcohol or illicit drug use. HBM focuses on the individual's perceptions, so health providers and educators should assess the individual's needs and how the adolescent's current behavior is meeting these needs. After identifying perceptions about condom use, the provider can intervene. Interventions include targeting misconceptions and perceptions of personal vulnerability and helping the adolescent do a more realistic risk assessment. Providers should focus on the social and physical benefits of condom use rather than just on the health benefits. They should also emphasize modes of STD transmission and effective means of protection, including a demonstration of condom use on a model. PMID:8627404
Hudson, C. P.
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. PMID:11217667
Li, Zhuokai; Liu, Hai; Tu, Wanzhu
Sexually transmitted infections (STIs) with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis are among the most common infectious diseases in the United States, disproportionately affecting young women. Because a significant portion of the infections present no symptoms, infection control relies primarily on disease screening. However, universal STI screening in a large population can be expensive. In this paper, we propose a semiparametric model-based screening algorithm. The model quantifies organism-specific infection risks in individual subjects and accounts for the within-subject interdependence of the infection outcomes of different organisms and the serial correlations among the repeated assessments of the same organism. Bivariate thin-plate regression spline surfaces are incorporated to depict the concurrent influences of age and sexual partners on infection acquisition. Model parameters are estimated by using a penalized likelihood method. For inference, we develop a likelihood-based resampling procedure to compare the bivariate effect surfaces across outcomes. Simulation studies are conducted to evaluate the model fitting performance. A screening algorithm is developed using data collected from an epidemiological study of young women at increased risk of STIs. We present evidence that the three organisms have distinct age and partner effect patterns; for C. trachomatis, the partner effect is more pronounced in younger adolescents. Predictive performance of the proposed screening algorithm is assessed through a receiver operating characteristic analysis. We show that the model-based screening algorithm has excellent accuracy in identifying individuals at increased risk, and thus can be used to assist STI screening in clinical practice. Copyright © 2015 John Wiley & Sons, Ltd. PMID:25900920
Wang, Bo; Li, Xiaoming; Stanton, Bonita; Zhang, Lei; Fang, Xiaoyi
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. PMID:20601927
Do, Khoi; Minichiello, Victor; Hussain, Rafat; Khan, Asaduzzaman
Sexually transmitted infections (STIs) in Vietnam have been increasing. Control of STIs among female sex workers (FSWs) is important in controlling the epidemic. Effective STI control requires that physicians are skilful in taking sexual history for FSW patients. Three hundred and seventy-one physicians responded to a survey conducted in three provinces in Vietnam. The respondents were asked whether they asked FSW patients about their sexual history and information asked during sexual history taking. The respondents were also asked about their barriers for taking sexual history. Over one-fourth (27%) respondents always, over half (54%) respondents sometimes and 19% respondents never obtained a sexual history from FSW patients. Multivariable analysis revealed that factors associated with always taking a sexual history were being doctor, training in STIs and working at provincial level facilities. Physician's discomfort was found to be inversely associated with training on communication with patients, seeing 15 or fewer patients a week, working at provincial level facilities. Issues in sexual history taking among FSW patients in general practice in Vietnam were identified. These issues can help STI control for FSW patients and need due attention in order to improve STI management in Vietnam. PMID:24676130
Meyer, L; Goulet, V; Massari, V; Lepoutre-Toulemon, A
OBJECTIVE--To present recent trends in sexually transmitted diseases (STDs) in France and to estimate the gonorrhoea incidence in 1990. METHODS--Trends were analysed from data of three surveillance systems: (1) STD clinics: number of diagnoses, (2) a sentinel voluntary General Practitioner (GP) network: mean number of acute male urethritis/week/GP, characteristics of the notified urethritis (age, presence of discharge, sexual orientation), (3) a sentinel voluntary laboratory network: mean number of gonorrhoea isolates/month/laboratory, characteristics of patients with positive isolates (sex, age, site of sampling) and of strains (PPNG and TRNG rates). To estimate the gonorrhoea incidence in France in 1990, results of a study held among a national sample of laboratories were used, combined with data from surveillance systems and specific studies. RESULTS--Decreasing trends in gonorrhoea in STD clinics and in the laboratory network as well as in acute male urethritis in the GP network have been observed since implementation of the networks in 1985. The rate of PPNG strains has regularly increased in the laboratory network to reach 14% in 1991. Data suggest that the incidence in some acute non recurrent STDs could have increased among homo/bisexual men since 1988. Chlamydia trachomatis is now the most frequent diagnosis in STD clinics. Estimation of male gonorrhoea incidence rate in France in 1990 of 74/100,000 inhabitants (15-59 years) is consistent with figures observed in England and Wales, where the age distribution is very similar. On the other hand, the estimated female gonorrhoea incidence rate of 14/100,000, which concerns only microbiologically ascertained cases, is one third in France than that observed in England and Wales. CONCLUSION--The consistency of the decreasing trends in gonorrhoea and acute male urethritis observed from the different networks reduces the possibility of a bias due to any change in notification or in prescription. Trends in Chlamydia trachomatis will be better appraised in the near future with the recent implementation of new systems. The French STD surveillance appears quite satisfactory for male infections and has been able to show a marked decrease in the incidence of some STDs in the last years. Surveillance of female STDs is to be improved, in terms of monitored diagnoses and selected health care facilities. Differences between the female gonorrhoea incidence rate observed in England and Wales and the one computed for France could be attributed to differences in contact tracing policies between the two countries or to differences in sexual lifestyles. PMID:8300093
Wallace, Amanda R; Blood, Emily A; Crosby, Richard A; Shrier, Lydia A
Despite developmental differences between young adults and adults, studies of condom use have not typically considered young adults as a distinct age group. This study sought to examine how condom use and its correlates differed between high-risk young adults and adults. Sexually transmitted infection (STI) clinic patients (n?=?763) reported STI history, contraception, negative condom attitudes, fear of partner reaction to condom use and risky behaviours. Past 3-month condom use was examined as unprotected vaginal sex (UVS) acts, proportional condom use and consistent condom use. Regression models tested associations of age group and potential correlates with each condom use outcome. Interaction models tested whether associations differed by age group. Proportional condom use was greater in young adults than adults (mean 0.55 vs. 0.47); UVS and consistent condom use were similar between age groups. Young adults with a recent STI reported less condom use, whereas for older adults, a distant STI was associated with less condom use, compared to others in their age groups. Negative condom attitudes were more strongly linked to UVS acts for younger versus older adults. STI prevention efforts for younger adults may be improved by intensifying counselling about condom use immediately following STI diagnosis and targeting negative condom attitudes. PMID:25070945
Chico, R Matthew; Chandramohan, Daniel
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. PMID:21736423
WANG, BO; LI, XIAOMING; STANTON, BONITA; YANG, HONGMEI; FANG, XIAOYI; ZHAO, RAN; DONG, BAIQING; ZHOU, YUEJIAO; LIU, WEI; LIANG, SHAOLING
Background and Objective Vaginal douching has been hypothesized to increase a woman’s risk for human immunodeficiency virus (HIV) infection. However, data on the prevalence of this practice and its association with condom use and sexually transmitted infections (STIs) are limited. Study A cross-sectional survey among 454 female sex workers (FSWs) in a Chinese county. Results Vaginal douching was reported by 64.7% of the women. The prevalence of self-reported history of STI and that of current STI was 19.4% and 41.5%, respectively. Fifteen percent of the women reported consistent use of condoms with their clients and 8.4% with their regular partners. Vaginal douching was significantly associated with decreased use of condoms (with clients: OR = 0.31; with regular partner(s): OR = 0.22) and increased rate of self-reported STI history (OR = 1.95). However, there was no direct relation between douching and current STI. Over one third of the women believed that douching can prevent STI/HIV. Conclusion Vaginal douching exposes FSWs to a high risk of STI/HIV. Medical professional and public health workers should correct women’s misconception about the effectiveness of douching and discourage women from douching through educational activities. PMID:16254545
Ding, Honglei; Gong, Siqi; Tian, Yingxin; Yang, Zhangsheng; Brunham, Robert; Zhong, Guangming
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. PMID:24303023
Giles, Barbara E; Pettersson, Tor Mikael; Carlsson-Granér, Ulla; Ingvarsson, Pär K
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
Sexually transmitted infections (STIs) are highly prevalent in sub-Saharan Africa, where there is a severe HIV epidemic. Thus, accurate recognition and diagnosis of STIs are essential for successful HIV prevention programs in the region. Due to lack of trained personnel and adequate laboratory infrastructure in the region, information regarding the profile of STIs relies essentially on self-reported or physician-diagnosed symptoms. The main objective of the study was to assess the effectiveness of the syndromic diagnosis of STIs, which is often used as a proxy for laboratory diagnosis of STIs in sub-Saharan Africa and other resource-limited settings. The study builds on previously collected data from a community-based survey in Northern Tanzania. We found no significant agreements between patient-reported STIs symptoms and laboratory-confirmed STIs tests. The reported STIs symptoms had high specificity (range?=?85–99%) and poor sensitivity (range?=?2–17%). Knowledge gained from our study will have significant public health implications, and can help improve the syndromic diagnosis of STIs. PMID:24729919
Choy, Youyin; Apuzzio, Joseph; Skurnick, Joan; Zollicoffer, Carl; McGovern, Peter G.
Objective: To test the hypothesis that our inner city obstetric patients who have been infected with sexually transmitted diseases (STDs) will have a higher prevalence of hepatitis C virus infection than the general population and to identify specific risk factors and high-risk groups. Methods: All patients in our prenatal clinic (July 1997–April 1999) who tested positive for one or more STDs were asked to return for hepatitis C antibody testing. Medical charts of all patients who returned for hepatitis C testing were reviewed. Results: A total of 106 patients with STDs were tested for hepatitis C. Positive screening tests for anti-hepatitis C antibody were found in 6.6% (7/106) of the patients (95% CI = 2.7–13.1%). This frequency is significantly higher than the hepatitis C prevalence (1.8%) in the general United States population (p = 0.006). Multiple logistic regression analysis confirmed only older age (p = 0.016) and positive HIV status (p = 0.023) to be significant predictors of hepatitis C infection. Conclusions: Inner city STD-infected obstetric patients are at high risk for hepatitis C infection compared with the general population. Increasing age and HIV-positive status are risk factors which are significantly associated with hepatitis C infection. PMID:15108864
Behets, F M; Génécé, E; Narcisse, M; Liautaud, B; Cohen, M; Dallabetta, G A
Despite major obstacles, activities to control sexually transmitted diseases (STDs) were initiated in Haiti in 1992 in collaboration with local nongovernmental organizations. The approaches included review of available local data, assessment of STD case management practices and constraints, and development of specific STD control activities at the primary health care level, such as systematic screening of all pregnant women for syphilis and improved comprehensive syndrome-based STD case management. The activities included conduct of local studies, presentation and dissemination of results to key audiences, training of health care providers, improvement of local capacities, and consensus-building on implementation of STD control approaches. STD awareness and case management improved considerably; for example, 69% of the clinicians interviewed reported correct STD treatments in the north-eastern primary health care centres in 1995, compared with < 10% in 1992. At the end of the project, national STD case management guidelines were developed by consensus between the various organizations and the Ministry of Health. Lessons learned included the importance of local data generation and of communication and collaboration with various institutions for consensus-building, the need for continued training, and field supervision to ensure behaviour change among STD care providers. A national STD control programme should be implemented as soon as possible in both the public and private sector. External funding will remain critical to control this important public health problem in Haiti. PMID:9648360
Green, M; Hoffman, I F; Brathwaite, A; Wedderburn, M; Figueroa, P; Behets, F; Dallabetta, G; Hoyo, C; Cohen, M S
The Jamaican Ministry of Health has estimated that over 60% of all sexually transmitted diseases (STDs) are managed within the private sector, where 800 (66%) of the country's 1200 registered physicians practice. To improve the quality of STD case management provided by these practitioners, the Medical Association of Jamaica organized a series of 6 half-day seminars repeated at 3-4 month intervals in three geographic locations between December 1993 and July 1995. Topics addressed included urethritis, genital ulcer disease, HIV/AIDS, vaginal discharge, pelvic inflammatory disease, and STDs in children and adolescents. A total of 628 private practitioners attended at least one seminar and almost half the physicians attended two or more. Comparisons of scores on a written pretest completed before the seminar and those from a post-test conducted by telephone after the seminar revealed significant improvements in all four general STD management categories: counseling/education, diagnostics/screening, treatment, and knowledge. The proportion of practitioners who obtained syphilis serologies during pregnancy rose from 38.3% to 83.8% and those providing effective treatment for gonorrhea increased from 57.8% to 81.1%. Overall, 96% of practitioners were providing some level of risk-reduction counseling at the time of the post-test and 74% were prescribing correct treatment regimens. Ongoing education and motivation by the national STD control program or the Medical Association are recommended to improve STD case management even further. PMID:9792363
Francis, Andrew M; Mialon, Hugo M; Peng, Handie
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
Gouveia-Oliveira, Rodrigo; Pedersen, Anders Gorm
By examining published, empirical data we show that men and women consistently differ in the shape of the distribution of the number of sexual partners. The female distribution is always relatively narrow-variance is low-with a big majority of women having a number of partners close to the average. The male distribution is much wider-variance is high-with many men having few sex partners and many others having more partners than most females. Using stochastic modelling we demonstrate that this difference in variance is, in principle, sufficient to cause a difference in the gender prevalence of sexually transmitted diseases: compared to the situation where the genders have identical sex partner distributions, men will reach a lower equilibrium value, while women will stay at the same level (meaning that female prevalence becomes higher than male). We carefully analyse model behaviour and derive approximate expressions for equilibrium prevalences in the two different scenarios. We find that the size of the difference in gender prevalence depends on the variance ratio (the ratio between the variances of the male and female sex partner distributions), on the expected number of life-time partners, and on the probability of disease transmission. We note that in addition to humans, the variance phenomenon described here is likely to play a role for sexually transmitted diseases in other species also. We also show, again by examining published, empirical data, that the female to male prevalence ratio increases with the overall prevalence of a sexually transmitted disease (i.e., the more widespread the disease, the more women are affected). We suggest that this pattern may be caused by the effect described above in highly prevalent sexually transmitted diseases, while its impact in low-prevalence epidemics is surpassed by the action of high-risk individuals (mostly males). PMID:19627993
Fagundes, Luiz Jorge; Vieira Junior, Elso Elias; Moysés, Ana Carolina Marteline Cavalcante; de Lima, Fernão Dias; de Morais, Fátima Regina Borges; Vizinho, Natalina Lima
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. PMID:24068122
Genrich, Gillian L; Brathwaite, Brader A
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
Hammerschlag, Margaret R.; Gaydos, Charlotte A.
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. PMID:22782828
Julie Mooney-Somers; Anna Olsen; Wani Erick; Robert Scott; Angie Akee; John Kaldor; Lisa Maher
The Indigenous Resilience Project is an Australian community-based participatory research project using qualitative methods to explore young Aboriginal and Torres Strait Islander people's views of blood-borne viral and sexually transmitted infections (BBV\\/STI) affecting their communities. In this paper we present an analysis of narratives from young people who had a previous BBV\\/STI diagnosis to explore how they actively negotiate the
Pawlaczyk, M; Grys, E
The age-related increase in the prevalence of bacterial vaginosis was determined in adolescent virginal and sexually active girls aged 13 to 18 years. Higher rates were recorded for girls with two or more sexual partners. Considering the potential spectrum of consequences of bacterial vaginosis, preventive strategies are required in this age group, not only for bacterial vaginosis but also for other sexually transmitted diseases. PMID:11879583
Background The lack of information on the care for sexually transmitted infections (STI) associated syndromes may contribute for its non-inclusion as prevention and control strategy for STI in Brazil. This study aims to analyze the cases of STI – Associated Syndromes assisted in primary health care center in a city in Northeast Brazil associating them with socio-demographic and behavioral variables. Methods This is a retrospective study that analyzed 5148 consultation forms and medical records of patients assisted in a primary health care center who presented at least one genital syndrome from 1999 to 2008. Was considered as dependent variables the genital syndromes and serologies for syphilis and HIV and as independent variables the socio-demographic and behavioral aspects. It was used Pearson’s chi-square test to analyze the differences between the categorical variables, with a significance level of 5%. It was performed a multivariate analysis through the multivariate logistic regression model with the variables with p <0.05. We used odds ratio with a confidence interval of 95%. Results The most frequent syndromes were vaginal discharge and/or cervicitis (44%) and genital wart (42.2%). Most people were between 20 and 39 years old (70%) and women (74.2%). Genital ulcer was most prevalent among men (OR?=?2.67; CI 95% 1.99-3.58) and people who studied more than eight years (OR?=?1.33; CI 95% 1.00-1.75) and wart prevailed among men (OR?=?3.92; IC 95% 3.36-4.57), people under 29 years old (OR?=?1.81; CI 95% 1.59-2.07) and who studied more than eight years (OR?=?1.75; CI 95% 1.54-1.99). The Venereal Disease Research Laboratory (VDRL) was positive in 7.3% of men and in 7.1% of women and the Anti-HIV in 3.1% of men and 0.7% of women. Conclusion Vaginal discharge was the most frequent syndrome assisted in primary health care, followed by genital wart. The high prevalence of genital wart justifies the greater effort for the proper follow-up of these cases. Men presented more genital wart and ulcer and reported having more sexual partners, showing their need for a greater access and inclusion in health activities developed in primary health care in Brazil. PMID:22853173
Carter, M; Gallo, M; Anderson, C; Snead, MC; Wiener, J; Bailey, A; Costenbader, E; Legardy-Williams, J; Hylton-Kong, T
Objectives Although common worldwide, intravaginal cleansing is associated with poor health outcomes. We sought to describe intravaginal cleansing among women attending a sexually transmitted infection (STI) clinic in Jamaica. Methods We examined intravaginal cleansing (“washing up inside the vagina”, douching, and products or materials used) among 293 participants in a randomized trial of counselling messages at an STI clinic in Kingston. We focussed on information on intravaginal cleansing performed in the 30 days and three days preceding their baseline study visit. We describe reported cleansing behaviours and used logistic regression to identify correlates of intravaginal cleansing. Results Fifty-eight per cent of participants reported intravaginal cleansing in the previous 30 days, and 46% did so in the three days before baseline. Among those who cleansed in the previous 30 days, 88% reported doing so for hygiene unrelated to sex, and three-fourths reported generally doing so more than once per day. Soap (usually with water) and water alone were the most common products used for washing; commercial douches or detergents were reported infrequently. Intravaginal cleansing in the three days before the baseline visit was positively associated with having more than one sex partner in the previous three months (adjusted odds ratio [AOR], 1.9; 95% CI, 1.1, 3.2), and negatively associated with experiencing itching in the genital area at baseline (AOR, 0.6; 95% CI, 0.4, 1.0). Conclusions A large proportion of women attending STI clinics in Jamaica engage in frequent intravaginal cleansing, indicating a need for clinicians to discuss this topic with them accordingly. PMID:24171329
Cook, Robert L; Østergaard, Lars; Hillier, Sharon L; Murray, Pamela J; Chang, Chung?Chou H; Comer, Diane M; Ness, Roberta B
Objective Home screening tests could eliminate several barriers to testing sexually transmitted diseases (STDs). Aim To determine whether offering repeated home screening tests would increase the rate of testing for chlamydia and gonorrhoea in a high?risk sample of young women. Methods In this randomised controlled trial, 403 young women (mean age 18.9?years, 70% black) with a recent STD or with STD?related risk factors were enrolled. Participants were recruited from clinics and high?prevalence neighbourhoods and then randomly assigned to receive either a home testing kit or an invitation to attend a medical clinic for testing at 6, 12 and 18?months after enrollment. Over 80% of women were followed for 2?years. The trial is registered with ClinicalTrials.gov, number NCT 00177437. Results Of 197 women in the intervention group, 140 (71%) returned at least one home test and 25 of 249 (10%) home tests were positive. Women who received home screening tests completed significantly more STD tests overall (1.94 vs 1.41 tests per woman?year, p<0.001) and more STD tests in the absence of symptoms (1.18 vs 0.75 tests per woman?year, p<0.001). More women in the intervention group completed at least one test when asymptomatic (162 (82.2%) vs 117 (61.3%), p<0.001). The intervention was most effective among women recruited outside medical clinics. There was no significant difference in the overall rate of STDs detected. Conclusions Home screening significantly increased the utilisation of chlamydia and gonorrhoea testing in this sample of high?risk young women, and thus represents a feasible strategy to facilitate STD testing in young women. PMID:17301105
Gorbach, Pamina M.; Weiss, Robert E.; Fuchs, Edward; Jeffries, Robin A.; Hezerah, Marjan; Brown, Stephen; Voskanian, Alen; Robbie, Edward; Anton, Peter; Cranston, Ross D.
Background Use of lubricant products is extremely common during receptive anal intercourse (RAI) yet has not been assessed as a risk for acquisition of sexually transmitted infections (STIs). Methods From 2006–2008 a rectal health and behavior study was conducted in Baltimore and Los Angeles as part of the UCLA Microbicide Development Program (NIAID IPCP# #0606414). Participants completed questionnaires and rectal swabs were tested for Neisseria gonorrhoeae and Chlamydia trachomatis with the Aptima Combo 2 assay and blood was tested for syphilis (for RPR and TPHA with titer) and HIV. Of those reporting lubricant use and RAI, STI results were available for 380 participants. Univariate and multivariate regressions assessed associations of lubricant use in the past month during RAI with prevalent STIs. Results Consistent lubricant use during RAI in the past month was reported by 36% (137/380) of participants. Consistent past month lubricant users had a higher prevalence of STI than inconsistent users (9.5% vs. 2.9%; p=0.006). In a multivariable logistic regression model testing positive for STI was associated with consistent use of lubricant during RAI in the past month (adjusted Odds Ratio (AOR) 2.98 (95%CI 1.09, 8.15) after controlling for age, gender, study location, HIV status, and numbers of RAI partners in the past month. Conclusions Findings suggest some lubricant products may increase vulnerability to STIs. Because of wide use of lubricants and their potential as carrier vehicles for microbicides, further research is essential to clarify if lubricant use poses a public health risk. PMID:22183849
Choi, K H; Zheng, X; Zhou, H; Chen, W; Mandel, J
We examined health-care seeking practices among patients with sexually transmitted diseases (STDs) in south China. In 1995, we recruited a consecutive sample of 939 STD patients attending the STD clinics of the Municipal STD Control Centers of Guangzhou and Shenzhen, 'special economic zones' near Hong Kong. Attending physicians interviewed patients face-to-face using a standard survey questionnaire. Twenty-seven per cent of all subjects had sought treatment elsewhere for their presenting complaints, before visiting a study clinic. The main sources of prior treatment were private physicians followed by public clinics and drugstores. Women were more likely than men to delay in presenting their current symptoms to a study clinic (32% vs 25%, P=0.046). Factors associated with treatment delay differed by gender. Among men, seeking prior treatment from private physicians (OR=3.31; 95% CI=1.70, 6.43), having no urethral discharge (OR=4.00; 95% CI=2.33, 6.85), having engaged in sex trade (OR=1.64; 95% CI=1.03, 2.63), or being a resident in Shenzhen (OR=1.80; 95% CI=1.12, 2.89) were more likely to delay seeking treatment. Among women, only living in Shenzhen (OR=2.86; 95% CI=1.56, 5.25) was associated with treatment delay. Promotion of appropriate health-seeking behaviours and better management of STDs must be a top priority to slow a rapid spread of STD/HIV in China. Health education, improvement of STD care in the public and private sectors, and regulations of unauthorized private physicians, may help with STD control and HIV prevention. PMID:10361920
Graseck, Anna S.; Secura, Gina M.; Allsworth, Jenifer E.; Madden, Tessa; Peipert, Jeffrey F.
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. PMID:20308834
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. PMID:21099596
Rusch, Melanie LA; Shoveller, Jean A; Burgess, Susan; Stancer, Karen; Patrick, David M; Tyndall, Mark W
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. PMID:19021915
Mutha, Sonali A; Baghel, Paritosh J; Patil, Ramanand J; Bhagat, Sagar B; Patel, Sadiq B; Watsa, Mahinder C
Introduction: One in four Indians is a juvenile. Sexual crimes, pre marital sex, sexually transmitted diseases and unwanted pregnancies are on the rise. It has been shown that lack of sexuality education can significantly contribute to the above. Aim: We conducted this study to determine the knowledge and awareness of college students regarding sex and related matters and the factors affecting the prevalent outlook and practices of youth towards the same. Methodology: A prospective cross-sectional survey was conducted amongst 500 students of the K.P.B. Hinduja College of Commerce from December 2012 to March 2013 as per the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Main Outcome Measures: 1. Sex knowledge scores of males and females regarding contraception, sexually transmitted diseases and HIV/AIDS. 2. Percentage response of males and females to questions depicting attitudes and perceptions regarding premarital sex and promiscuity, sexual fantasy and masturbation, unwanted pregnancies and contraception. 3. Responses depicting participant’s premarital and high risk sexual activities. Results: The mean age was 18.6 ±1.6 years, 46% of participants were female. The total sex related knowledge scores of males and females were 8.2±1.2 and 6.2±2.4 (p<0.0001), respectively. 84% males and 72% females disagree that virginity should be preserved till marriage. Premarital sex was reported by 48% males and 18% females. Out of those who had premarital sex, 68% males and none of the females had more than one sex partner and 21% males and 12% females had used a contraceptive during their sexual encounter. 87% males and 82% females disagree that sex education in secondary schools will cause a rise in premarital intercourse. 40% males and 13% females are of the view that birth control is primarily a female’s responsibility. 14% of males and 21% of females (p = 0.2) reported being forced to have sex. Conclusion: Participants, especially females, lacked basic information about sexuality and related concepts. Male participants had a very casual attitude towards having sex with multiple partners. Premarital sex is more common than once believed. In the light of our finds and the current scenario, sexuality education is indispensable in order to guide the youth to develop and adopt healthy and appropriate sexual practices. PMID:25302214
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. PMID:23110684
Senior, Kate; Helmer, Janet; Chenhall, Richard; Burbank, Victoria
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
Nguyen, Hoa Ngan; Liamputtong, Pranee; Murphy, Gregory
In this article, we examine knowledge of contraceptives and sexually transmitted diseases (STDs) and contraceptive practices amongst young Vietnamese people. We conducted a qualitative study on sexuality and abortion with young people in Ho Chi Minh City, Vietnam. Twelve female and 4 male young people were individually interviewed using an in-depth interview technique. We found that condoms and pills were contraceptives known by almost all young people, but their knowledge of condoms and pills was still inadequate. Fears of side effects of taking pills and rumors and beliefs regarding condoms were quite common among young people. The limitations in young people's knowledge of contraceptives and STDs were a reflection of limited sources of their knowledge. Sexual education provided by educational institutions and within families was very basic. It did not provide clear knowledge on the sensitive topics such as contraceptive methods, and other issues related to sexuality for unmarried people. From a gender perspective, there are two points to note here: While sex issues were discussed openly among unmarried men, most unmarried women felt uncomfortable or expressed difficulty when talking about these issues; and the passiveness of unmarried women in making the decision of using condoms as well as contraceptives was marked. Amongst young people, the use of contraceptives was based mainly on ineffective methods including withdrawal and periodic abstinence. Further, young people's understanding of these methods was neither clear nor adequate. For the young people who did not use any contraceptives, sexual relations occurred unexpectedly. We conclude that creating a climate in which sexual issues can be discussed openly is an important step for the improvement of sexual health for young people. This will inevitably improve knowledge and understanding of contraceptives and STDs and may lead to a safer sexual life among this group of young people. PMID:16877291
Jemmott, Loretta S.; O’Leary, Ann; Ngwane, Zolani; Icard, Larry D.; Heeren, G. Anita; Mtose, Xoliswa; Carty, Craig
Objectives. We tested the efficacy of a sexual risk-reduction intervention for men in South Africa, where heterosexual exposure is the main mode of HIV transmission. Methods. Matched-pairs of neighborhoods in Eastern Cape Province, South Africa, were randomly selected and within pairs randomized to 1 of 2 interventions based on social cognitive theory and qualitative research: HIV/sexually transmitted infection (STI) risk-reduction, targeting condom use, or attention-matched control, targeting health issues unrelated to sexual risks. Sexually active men aged 18 to 45 years were eligible. The primary outcome was consistent condom use in the past 3 months. Results. Of 1181 participants, 1106 (93.6%) completed the 12-month follow-up. HIV and STI risk-reduction participants had higher odds of reporting consistent condom use (odds ratio [OR]?=?1.32; 95% confidence interval [CI]?=?1.03, 1.71) and condom use at last vaginal intercourse (OR?=?1.40; 95% CI?=?1.08, 1.82) than did attention-control participants, adjusting for baseline prevalence. No differences were observed on unprotected intercourse or multiple partnerships. Findings did not differ for sex with steady as opposed to casual partners. Conclusions. Behavioral interventions specifically targeting men can contribute to efforts to reduce sexual risk behaviors in South Africa. PMID:24432923
Cingolani, Antonella; Zona, Stefano; Girardi, Enrico; Cozzi Lepri, Alessandro; Monno, Laura; Quiros Roldan, Eugenia; Guaraldi, Giovanni; Antinori, Andrea; d'Arminio Monforte, Antonella; Marcotullio, Simone
Introduction Sexually transmitted diseases (STDs) data collected in HIV+ patients could be used as indicator of risky sexual behaviour possibly linked to HIV transmission. We described the STDs incidence over time and identified higher incidence factors. Methodology All patients in the ICONA Foundation Study enrolled after 1998 were included. STDs considered: any-stage syphilis, human papilloma virus (HPV) diseases, gonococcal and non-gonococcal urethritis, herpes simplex virus (HSV) genital ulcers, vaginitis and acute hepatitis B virus (HBV), hepatitis A virus (HAV), and hepatitis C virus (HCV) infections (only for non-IVDU (intravenous drug user) patients). STDs incidence rate (IR): number of STDs divided by person years of follow-up (PYFU). Calendar periods: 1998–2002, 2003–2007 and 2008–2012. Predictors of STDs occurrence were identified using Poisson regression and sandwich estimates for the standard errors were used for multiple STD events. Results Data of 9,168 patients were analyzed (median age 37.3 (SD=9.3), 74% male, 30% MSM). Over 46,736 PYFU, 996 episodes of STDs were observed (crude IR 17.3/1,000 PYFU). Median (IQR) CD4/mmc and HIV-RNA/mL at STD: 433 (251–600) and 10,900 (200–63,000). Highest crude IRs were observed for any-stage syphilis (3.95, 95% CI 3.59–4.35), HPV diseases (1.96, 1.71–2.24) and acute hepatitis (1.72, 1.49–1.99). At multivariable analysis (variables of adjustment shown in Figure 1), age (IRR 0.82 per 10 years younger, 95% CI 0.77–0.89), MSM contacts (IRR 3.03, 95% CI 2.52–3.64 vs heterosexual) and calendar period (IRR 1.67, 95% CI 1.42–1.96, comparing 2008–2012 with 1998–2002) significantly increased the risk of acquiring STDs. Moreover, having a HIV-RNA >50 c/mL (IRR 1.44, 95% CI 1.19–1.74 vs HIV-RNA <50 c/mL) and current CD4+ cell count <100/mmc (IRR 4.66, 95% CI 3.69–5.89, p<0.001 vs CD4+ cell count >500) showed an increased risk of STDs. Being on ARV treatment significantly reduced the risk of developing an STD (IRR 0.37, 95% CI 0.32–0.43) compared to ART-naïve people, even in the situation of temporary interruption of treatment (IRR 0.51, 95% CI 0.39–0.43) (see Figure 1). Conclusions The overall incidence of STDs has been increasing in the recent years. Interventions to prevent STDs and potential further spread of HIV infection should target the recently HIV diagnosed, the young population and MSM. Being on ARV treatment (potentially an indicator of whether a person is regularly seen for care) seems to reduce the risk of acquiring STDs independently of its viro-immunological effect. PMID:25394157
WANG, BO; LI, XIAOMING; STANTON, BONITA; FANG, XIAOYI; LIN, DANHUA; MAO, RONG
Background and Objective Men who pay for sexual services are at increased risk for HIV/sexually transmitted disease. Data on the sociodemographic and behavioral characteristics of such men in China are limited. Study Design Two cross-sectional surveys, using similar instruments, were completed among Chinese migrants in Beijing, Shanghai, and Nanjing in 2002. A total of 1304 rural-to-urban migrant men from community settings (“community sample”) and 465 migrant men attending sexually transmitted disease clinics (“STD clinic sample”) were included in the current study. Results Ten percent of men in the community sample and 32.7% of men in the STD clinic sample reported having ever paid for sex. Nearly 20% of clients from the community sample and 60% of clients from the STD clinic sample reported a history of STDs. For both the community and STD clinic samples, working at industrial or construction sectors, multiple sexual partners, regular sex partner having sex with others, and a history of drug use were associated with being a male client. In addition, perceived peer sexual risk and perceived vulnerability to STD were associated with being a male client in the community sample, and a history of STD and being tested for STD/HIV were associated with being a male client in the STD sample. Conclusion Male migrants who paid for sex in China were vulnerable to HIV/STDs. HIV prevention efforts should target young migrant men who work at factory and construction sectors. STD clinics may be important sites for outreach and intervention efforts among male clients. PMID:16755272
Paudyal, Priyamvada; Llewellyn, Carrie; Lau, Jason; Mahmud, Mohammad; Smith, Helen
Background Routine screening is key to sexually transmitted infection (STI) prevention and control. Previous studies suggest that clinic-based screening programmes capture only a small proportion of people with STIs. Self-sampling using non- or minimally invasive techniques may be beneficial for those reluctant to actively engage with conventional sampling methods. We systematically reviewed studies of patients’ experiences of obtaining self-samples to diagnose curable STIs. Methods We conducted an electronic search of MEDLINE, EMBASE, CINAHL, PsychINFO, BNI, and Cochrane Database of Systematic Reviews to identify relevant articles published in English between January 1980 and March 2014. Studies were included if participants self-sampled for the diagnosis of a curable STI and had specifically sought participants’ opinions of their experience, acceptability, preferences, or willingness to self-sample. Results The initial search yielded 558 references. Of these, 45 studies met the inclusion criteria. Thirty-six studies assessed patients’ acceptability and experiences of self-sampling. Pooled results from these studies shows that self-sampling is a highly acceptable method with 85% of patients reporting the method to be well received and acceptable. Twenty-eight studies reported on ease of self-sampling; the majority of patients (88%) in these studies found self-sampling an “easy” procedure. Self-sampling was favoured compared to clinician sampling, and home sampling was preferred to clinic-based sampling. Females and older participants were more accepting of self-sampling. Only a small minority of participants (13%) reported pain during self-sampling. Participants were willing to undergo self-sampling and recommend others. Privacy and safety were the most common concerns. Conclusion Self-sampling for diagnostic testing is well accepted with the majority having a positive experience and willingness to use again. Standardization of self-sampling procedures and rigorous validation of outcome measurement will lead to better comparability across studies. Future studies need to conduct rigorous economic evaluations of self-sampling to inform policy development for the management of STI. PMID:25909508
Zetola, Nicola M.; Bernstein, Kyle T.; Wong, Ernest; Louie, Brian; Klausner, Jeffrey D.
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. PMID:19367993
Kao, Tsui-Sui Annie; Manczak, Melissa
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…
Mittal, Mona; Senn, Theresa E.; Carey, Michael P.
Background Intimate partner violence (IPV) is associated with a wide range of negative outcomes, including sexual risk behavior. This cross-sectional study explored mediators of the relationship between IPV and risky sexual behavior in 717 women recruited from an STD clinic. Methods Participants were recruited from a public STD clinic in upstate New York as part of a randomized control trial (RCT) that was designed to evaluate several sexual risk reduction interventions. They completed an Audio Computer-Assisted Self-Interview in a private room. Results Among these women, 18% reported IPV in the past 3 months and 57% reported lifetime experience of IPV. Recent IPV was associated with greater sexual risk as measured by more episodes of unprotected sex (overall and with a steady partner). Although IPV was associated with depressive symptoms and drug use before sex, these variables did not mediate the relationship between IPV and sexual risk behavior. Conclusions The results indicate that IPV is common among women who attend an STD clinic and warrants increased attention. Research is needed to better understand the pathways linking IPV and HIV risk in women to optimize the design of effective interventions. PMID:21258269
Fogel, Catherine I; Gelaude, Deborah J; Carry, Monique; Herbst, Jeffrey H; Parker, Sharon; Scheyette, Anna; Neevel, A
Incarcerated women are disproportionately affected by HIV and sexually transmitted infections (STIs) due to risk factors before, during, and after imprisonment. This study assessed the behavioral, social, and contextual conditions that contribute to continuing sexual risk behaviors among incarcerated women to inform the adaptation of an evidenced-based behavioral intervention for this population. Individual, in-depth interviews were conducted with 25 current and 28 former women prisoners to assess HIV/STI knowledge, perceptions of risk, intimate relationships, and life circumstances. Interviews were independently coded using an iterative process and analyzed using established qualitative analytic methods. Major themes identified in the interviews involved three focal points: individual risk (substance abuse, emotional need, self-worth, perceptions of risk, and safer sex practices); interpersonal risk (partner pressure, betrayal, and violence); and risk environment (economic self-sufficiency and preparation for reentry). These findings highlight the critical components of HIV/STI prevention interventions for incarcerated women. PMID:25204565
Castro, Jose G.; Jones, Deborah L.; López, Maria R.; Weiss, Stephen M.
The objectives of this study were assessment of the prevalence of male circumcision (MC) among patients attending the Miami-Dade County (MDC) sexually transmitted diseases (STDs) clinic and exploration of attitudes of MC among Hispanic STD clinic attendees. Prevalence of MC was assessed by a review of 500 clinic records. Attitudes toward MC were explored during focus group sessions. The overall rate of MC was 27%. Men associated acceptability of MC with sexual performance, their partner’s anticipated responses to MC, and scientific proof of STD protection; whereas women focused on experiences with previous partners and hygiene. We found a low rate of circumcision in males attending the MDC STD clinic. Approximately half of the Hispanic men and women in focus groups also found MC acceptable or desirable. PMID:25152700
The impact of sexual experiences of young minority group members in the United States, and the associated risks of sexually transmitted infection (STI) transmission among adults in the United States and China
Garcia, Ginny Elizabeth
This thesis explores incidence rates of sexually transmitted infections (STIs) among minority group teenagers in the United States and among adults aged 20-34 in the U.S. and in China. The focus is on trends and patterns ...
Baker, Joanne R; Arnold-Reed, Diane E; Brett, Tom; Hince, Dana A; O'Ferrall, Ilse; Bulsara, Max K
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 (GP) and their level of comfort would be enhanced if they knew their GP had a special interest or qualification in sexual health. Willingness to discuss issues increased or remained unchanged if the GP took time to explain it to them or was a good listener. Patients were willing to discuss STIs if they were a new patient and irrespective of the GP's gender and age. Fewer patients were willing to discuss STIs if they knew the GP socially. Patients who had sex with a new partner were willing to request a STI test from their GP. Patients were not embarrassed if discussion was initiated in a consultation unrelated to sexual health and did not mind discussing the topic in the presence of a partner or parent, though this depended on circumstances. Waiting room STI test advertising did not affect patient comfort level. Patients would involve their GP when seeking information about STIs. Patients have fewer barriers to discussing sexual health matters than perceived by GPs. PMID:22950952
Remis, R S; Dufour, A; Alary, M; Vincelette, J; Otis, J; Mâsse, B; Turmel, B; LeClerc, R; Parent, R; Lavoie, R
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. PMID:11029990
Werny, David M; Saraiya, Mona; Chen, Xiao; Platz, Elizabeth A
Background Sexually transmitted infections (STIs) are hypothesized to play a role in the development of prostate cancer, perhaps due to inflammation-induced oncogenesis. We assessed in a nationally representative population of middle-aged men whether sexual behavior indicators for an increased risk of genital infection were associated with serum prostate-specific antigen (PSA) concentration, a marker of prostatic disease and inflammation. Results The percentage of men between the ages of 40 and 59 with a PSA ? 4.0 ng/ml was 2.6% (95% confidence interval [CI], 1.8% – 3.8%). The percentage of men between the ages of 40 and 59 self-reporting a past diagnosis of genital warts or genital herpes, or a recent diagnosis of gonorrhea or chlamydia is estimated to be 7.3% (95% CI, 6.2% – 8.6%). Men self-reporting that they had had sex without using a condom in the past month had a lower PSA concentration and higher %fPSA than those who did not. There were no associations between any of the other sexual activity or laboratory measures and PSA or %fPSA. Conclusion In this nationally representative sample of middle-aged American men, we did not find consistent evidence for an association between sexual behavior or a history of STIs and PSA levels. Therefore, sexual factors are unlikely to lead to falsely elevated PSA tests in this population. We cannot rule out the role of these factors in causing false positive PSA tests in subgroups of the population that have a higher prevalence of high-risk sexual behavior, and more protracted or recent exposures to these agents. PMID:17958890
Cavazos-Rehg, Patricia A; Spitznagel, Edward L; Schootman, Mario; Strickland, Jaime R; Afful, Stephanie E; Cottler, Linda B; Bierut, Laura Jean
Cocaine users routinely engage in high-risk sexual behaviors that place them at an elevated risk of contracting HIV and other blood-borne infections. The purpose of the present study was to compare trading sex for drugs and/or money, having 10 or more sexual partners in 1 year, and sexually transmitted diseases (STDs) of cocaine-dependent individuals in treatment for their dependence across race and gender and against participants who live in their community. Cocaine-dependent individuals (n = 459) were identified through nine publicly and privately funded inpatient and outpatient chemical dependency treatment centers in the St. Louis area during 2001-2006. Community-based participants (n = 459) were matched to cocaine-dependent participants on age, ethnicity, gender, and zip code of residence. Mean age of the sample was 36 years old, 50% were Caucasians, 50% were African American, and 47% were male. Nearly half of cocaine-dependent participants in treatment had traded sex for drugs and/or money and over one-third had more than 10 sexual partners in 1 year with a risk concentrated among African Americans even after controlling for income and educational attainment. Participants recruited from the community with some exposure to cocaine reported similar rates of high risk sexual behaviors as the cocaine dependent subjects from treatment settings. It is important for clinicians to recognize that once released from treatment, cocaine-dependent individuals may be returning to high-risk environments where sexual risk behaviors are occurring in the context of cocaine use. PMID:19645618
N O’Farrell; L Morison; P Moodley; K Pillay; T Vanmali; M Quigley; A W Sturm
Objectives: A study of men with genital ulcer disease (GUD) in Durban, South Africa, at the start of the local HIV epidemic in 1988\\/1989 found that 36% of men with GUD continued with sexual intercourse despite symptoms. The aim of this study was to determine whether this high-risk behaviour was still prevalent and to enquire about similar risk behaviours with
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Tingey, Lauren; Strom, Rachel; Hastings, Ranelda; Parker, Anthony; Barlow, Allison; Rompalo, Anne; Gaydos, Charlotte
American Indians suffer a disproportionate burden of sexually transmitted infection, particularly adolescents. Screening access barriers in rural and reservation-based communities necessitate alternatives to clinic-based options. Self-administered screening for three sexually transmitted infections was piloted among 32 American Indian adolescents aged 18 to 19. Participants self-collected in a private location; specimens were processed by trained, American Indian paraprofessionals and analysis was conducted by an outside laboratory. Participants testing positive were treated by a Public Health Nurse from the Indian Health Service. Results suggest high overall acceptability: 69% preferred a self-administered method over clinic-based screening, 75% would encourage their friends to use this method and 100% would use it again. A self-administered screening method has the ability to reach this and other high-risk populations that might not otherwise access screening, with added potential within the Indian Health Services system for uptake and dissemination in rural, reservation communities facing significant screening barriers. PMID:25228666
Malipatil, Vijayakumari; Madagi, Shivkumar; Bhattacharjee, Biplab
Objective: Sexually transmitted diseases (STD) are the serious public health problems and also impose a financial burden on the economy. Sexually transmitted infections are cured with single or multiple antibiotics. However, in many cases the organism showed persistence even after treatment. In the current study, the set of druggable targets in STD pathogens have been identified by comparative genomics. Materials and Methods: The subtractive genomics scheme exploits the properties of non-homology, essentiality, membrane localization and metabolic pathway uniqueness in identifying the drug targets. To achieve the effective use of data and to understand properties of drug target under single canopy, an integrated knowledge database of drug targets in STD bacteria was created. Data for each drug targets include biochemical pathway, function, cellular localization, essentiality score and structural details. Results: The proteome of STD pathogens yielded 44 membrane associated proteins possessing unique metabolic pathways when subjected to the algorithm. The database can be accessed at http://biomedresearchasia.org/index.html. Conclusion: Diverse data merged in the common framework of this database is expected to be valuable not only for basic studies in clinical bioinformatics, but also for basic studies in immunological, biotechnological and clinical fields. PMID:24130375
Landripet, Ivan; Štulhofer, Aleksandar; Ba?ak, Valerio
Aim To determine changes in sexual behaviors and other relevant characteristics related to human immunodeficiency virus (HIV) and sexually transmitted infection (STI) risks among young Croatian adults. Method We surveyed adults aged 18-24 in 2005 (n?=?1092) and 18-25 in 2010 (n?=?1005). Both samples were probabilistic and stratified by county, settlement size, age, and gender. The samples were non-matched. Trained interviewers conducted structured face-to-face interviews in participants’ households. The part of the questionnaire assessing sensitive information was self-administered. Results A majority of participants at both survey points (85.2%-86.2%) were sexually active. Median age at sexual debut (17 years) remained unchanged. Lifetime number of sexual partners was also stable. More women than men reported only one lifetime sexual partner. The prevalence of condom use at first intercourse increased (from 62.6 to 70%, P?=?0.002), while the prevalence of condom use at most recent sexual intercourse remained stable (54% in 2005 and 54.7% in 2010). Consistent condom use also remained unchanged. About one fifth of participants (19.2% in 2005 and 20% in 2010) reported consistent condom use in the past year. At both survey points for both genders, consistent condom use was associated with age (odds ratio [OR] Women2005?=?0.74, P?=?0.004; ORWomen2010?=?0.72, P?0.001; ORMen2005?=?0.73, P?0.001; ORMen2010?=?0.80, P?=?0.006), negative attitudes toward condom use (ORWomen2005?=?0.84, P?=?0.001; ORWomen2010?=?0.90, P?=?0.026; ORMen2005?=?0.92, P?=?0.032; ORMen2010?=?0.90, P?=?0.011)), and condom use at first intercourse (ORWomen2005?=?3.87, P?0.001; ORWomen2010?=?4.64, P?0.001; ORMen2005?=?5.85, P?0.001; ORMen2010?=?4.03, P?0.001). In the observed period, HIV/AIDS knowledge was stable. Conclusion Risky sexual practices remain common among young Croatian adults. Given the recently reported STI prevalence rates in this age cohort, introduction of school-based sex education that would focus on protective behavioral and communication skills seems to be of crucial epidemiological importance. PMID:21853540
Muñoz-Laboy, Miguel; Dodge, Brian
Objectives. We sought to determine whether there were differences in sexual risk among behaviorally and self-identified bisexual men, men who reported having sex with both men and women without reporting a bisexual identity and men who self-identified as bisexual but reported only recent homosexual behavior over the past 6 months. Methods.secondary data analysis, we conducted stepwise linear regression equation modeling to determine which factors were significant predictors of sexual risk among various subgroups of bisexual Latino men. Results. Having sex with women, regardless of sexual identity, increased the likelihood of insertive unprotected anal intercourse with men. Bisexual identity was not statistically associated with unprotected anal intercourse with men. Conclusions. Future studies should begin to examine differences within groups rather than focusing on group comparisons that yield limited insights into sexual risk predictors for homosexually and bisexually active men. Further research that explores risk and protective factors in the sexual lives of Latino bisexual men is also needed. PMID:17463376
Field, Stuart G; Michiels, Nico K
The precise transmission mode(s) of acephaline gregarines in their earthworm hosts has long been questioned, yet a rigorous experimental evaluation of sexual transmission is currently lacking. That Monocystis sp., a common gregarine parasite of the earthworm Lumbricus terrestris, infects the sexual organs of its host is suggestive of sexual transmission. Considering the divergent evolutionary consequences of various modes of transmission, excluding or proving sexual transmission in this host-parasite system is critical to fully understanding it. We cultured uninfected earthworms from cocoons and subsequently mated them to either an infected or uninfected partner (from the wild). We then compared these individuals with an orally infected group, which were infected using a newly developed gavage (oral injection) method. Our data have unambiguously established that (1) horizontal sexual transmission does not play a significant role in the transmission of Monocystis sp., and (2) oral transmission through the soil is likely the principal mode of transmission between earthworms. This finding is important to models of mate-choice because infection avoidance does not appear to drive mating decisions. Finally, we further report a successful and relatively simple method to obtain infection-free individuals, which can subsequently be infected via oral gavage and used in empirical studies. PMID:16729685
Jonathan G. Tubman; Marilyn J. Montgomery; Andrés G. Gil; Eric F. Wagner
This study documents significant associations among lifetime abuse experiences, psychiatric diagnoses, and sexual risk behaviors in a multiethnic community sample of young men and women (N = 1803) in South Florida. Self-report data were collected via structured interviews as part of a longitudinal follow-up of a larger school-based study. Participants were grouped according to extent of lifetime abuse experiences. Cumulative
Brown, Monique J; Pugsley, River; Cohen, Steven A
The Internet has now become a popular venue to meet sex partners. People who use the Internet to meet sex partners may be at a higher risk for contracting HIV and STIs. This study examined the association between meeting sex partners from the Internet, and HIV testing, STI history, and risky sexual behavior. Data were obtained from the Virginia Department of Health STD Surveillance Network. Logistic regression models were used to obtain crude and adjusted odds ratios, and 95 % confidence intervals for the associations between meeting sex partners through the Internet and ever tested for HIV, HIV testing in the past 12 months, STI history, and risky sexual behavior. Logistic regression was also used to determine if gender and men who have sex with men interaction terms significantly improved the model. Women who met a sex partner from the Internet were more likely to have had an HIV test in the past 12 months than women who did not meet a partner in this way. On the other hand, men who met a sex partner through the Internet were more likely to have ever had an HIV test than other men, but this was only seen for heterosexual men. All populations who met a sex partner from the Internet were more likely to take part in risky sexual behavior. HIV prevention strategies should emphasize annual testing for all populations. PMID:25567074
Meda, N; Sangaré, L; Lankoandé, S; Sanou, P T; Compaoré, P I; Catraye, J; Cartoux, M; Soudré, R B
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. PMID:9306899
Jin, Fengyi; Prestage, Garrett P; Zablotska, Iryna; Rawstorne, Patrick; Kippax, Susan C; Donovan, Basil; Cunningham, Philip H; Templeton, David J; Kaldor, John M; Grulich, Andrew E
Background/objectives Higher levels of sexual risk behaviours have been reported in HIV positive than in HIV negative homosexual men. In clinic based studies, higher rates of sexually transmitted infections (STIs) have also been reported. We compared rates of common STIs between HIV positive and HIV negative homosexual men from two ongoing community based cohort studies in Sydney, Australia. Methods Participants in the two cohorts were recruited using similar community based strategies. They were interviewed face to face annually after enrolment. Comprehensive sexual health screening, including hepatitis A and B, syphilis, gonorrhoea, and chlamydia (in urethra and anus) was offered to participants in both cohorts. Results In participants in the HIV positive cohort, 75% were hepatitis A seropositive, 56% had serological evidence of previous or current hepatitis B infection, and 24% had evidence of vaccination against hepatitis B infection. 19% of men tested positive for syphilis and 4% had evidence of recent infections. Compared with men in the HIV negative cohort, after adjustment for age, HIV positive participants had significantly higher prevalence of previous or current hepatitis B infection, syphilis, and anal gonorrhoea. Conclusion This finding supports the need for frequent STI testing in HIV positive men to prevent morbidity and to decrease the risk of ongoing HIV transmission. PMID:17556503
Spiwak, Rae; Afifi, Tracie O; Halli, Shiva; Garcia-Moreno, Claudia; Sareen, Jitender
To investigate the association between physical intimate partner violence (IPV) and sexually transmitted infection (STI) in two national samples. Data came from the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (n=34,653) and the National Family Health Survey-3 (n=124 385). Ever-married women between the ages of 20 and 49 were asked if they had experienced physical violence by their partner in the past year. Outcomes were presence of doctor confirmed HIV and self-reported STI. Age at first intercourse was examined as a mediator of the relationship between IPV and STI. Logistic regression examined associations between IPV, age at first intercourse and STI. Compared to individuals with no physical IPV, risk for STI was higher for individuals who experienced past year IPV living in the United States and India, however once controlling for age at first intercourse, age, education, household wealth/income and past year sexual violence, the relationship between IPV, and STI was significant in the American sample [(AOR)=1.65, 95% (CI)=1.21-2.26], however not for individuals living in India [(AOR)=1.75, 95% (CI)=0.84-3.65]. Individuals with exposure to physical IPV are at increased odds for STI. Age at first intercourse although a marker of risk, may not be an accurate marker of risky sexual behavior in both samples. PMID:23778315
Occhionero, Marcelo; Paniccia, Laura; Pedersen, Dina; Rossi, Gabriela; Mazzucchini, Héctor; Entrocassi, Andrea; Gallo Vaulet, Lucia; Gualtieri, Valeria; Rodríguez Fermepin, Marcelo
Chlamydia trachomatis genital infection is nowadays considered one of the most frequent causes of sexually transmitted infections (STI) in the world, mainly affecting the group of young people under 25 years old. The aim of this study was to determine the prevalence of C. trachomatis infection in newly admitted students to Universidad Nacional del Sur, Bahía Blanca, Argentina, and to evaluate the risk factors to acquire STI. For that purpose, 204 young college students with a mean age of 19 were involved in this study. Each participant delivered a sample of first-void urine and completed a questionnaire which was then submitted anonymously. The research for C. trachomatis was done on 114 valid samples through a technique of DNA amplification, whose molecular target was the gene ompA. Four cases of infection by C. trachomatis were detected with a prevalence of 3.5%. The risks factors associated to the infection were a history of 7 or more partners since the start of sexual activity and contact with a new sexual partner in the last 4 months. The prevalence of such infection reflects a moderate circulation of this microorganism in the studied population. This fact, along with some aspects shown by the questionnaire results, would characterize a population having a low risk profile for acquiring STIs. However, some other information obtained from the questionnaires gave some opposite evidence, which would alert us on the need of keeping watch, raising awareness and implementing preventive actions in this population. PMID:25683522
Jonathan Klick; T. 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; Thomas Stratmann
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
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…
Wright, Pam; Vaughan, David
Students for Safer Sexuality is a peer education program designed to train 11th and 12th graders to be key agents in the delivery of sexuality education, HIV prevention, and communication skills programs. There were 15 students involved in the first year and 20 students currently involved. Participants are trained to lead discussion groups,…
D R Tomlinson; R J Hillman; J R Harris; D Taylor-Robinson
OBJECTIVE--To provide a screening service for sexually transmissible infections to male prostitutes working in the London area. DESIGN--An open access service recruiting by a diverse range of methods to avoid over-representation of the more visible elements of this group. SETTING--Department of genitourinary medicine in a London teaching hospital and a community-based clinic at a safe address. RESULTS--During the 10 months
Mooney-Somers, Julie; Olsen, Anna; Erick, Wani; Scott, Robert; Akee, Angie; Kaldor, John; Maher, Lisa
The Indigenous Resilience Project is an Australian community-based participatory research project using qualitative methods to explore young Aboriginal and Torres Strait Islander people's views of blood-borne viral and sexually transmitted infections (BBV/STI) affecting their communities. In this paper we present an analysis of narratives from young people who had a previous BBV/STI diagnosis to explore how they actively negotiate the experience of BBV/STI infection to construct a classic resilience narrative. We examine two overarching themes: first, the context of infection and diagnosis, including ignorance of STI/BBV prior to infection/diagnosis and, second, turning points and transformations in the form of insights, behaviours, roles and agency. Responding to critical writing on resilience theory, we argue that providing situated accounts of adversity from the perspectives of young Indigenous people prioritises their subjective understandings and challenges normative definitions of resilience. PMID:20972915
Lye, M S; Archibald, C; Ghazali, A A; Low, B T; Teoh, B H; Sinniah, M; Rus, S C; Singh, J; Nair, R C
A study was conducted to determine the feasibility of establishing a sentinel human immunodeficiency virus (HIV) surveillance system involving patients with sexually transmitted diseases attending private clinics and a government sexually transmitted disease clinic in Kuala Lumpur, Malaysia. Information on risk behaviours for HIV infection were also collected. A total of 84 female and 91 male patients were interviewed and tested for HIV infection; 41.7% of the women reported working as prostitutes, other occupations included masseuses, hairdressers, waitresses, salesgirls, receptionists, factory workers, and others. The most common diagnosis was gonorrhoea. Other diagnoses included non-specific genital infection, pelvic inflammatory disease, genital herpes and syphilis. 58.3% of the women had a hundred or more sex partners during the previous month; 99% had 6 or more sex partners. Only 4.8% of female patients had their male partners using condoms most of the time, 11.9% hardly used condoms at all. Of the males, 93.3% were heterosexual, while 6.7% were bisexuals, 41.1% had between 6-20 different partners in the previous year. 78.0% of them had prostitutes as their sex partners most of the time. 41.8% had experiences in Thailand and the Philippines. 73.6% never used condoms, while 19.8% only used condoms rarely. Although all patients were tested negative for HIV antibodies, lot quality assurance sampling methods indicate that the upper limits of prevalences for females and males were 3.5% and 3.3% respectively, at a 5% type I error. The study has shown that it is feasible to carry out a sentinel surveillance programme among STD patients and provided useful baseline data for future comparisons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8031914
Kwena, Z A; Bukusi, E A; Gorbach, P; Sharma, A; Sang, N M; Holmes, K K
Research on hygiene has been relatively limited in the current era of rigorous observational studies and clinical trials. We set out to investigate the perception and practices of genital hygiene among fishermen working on the beaches along Lake Victoria, targeted for a topical male microbicide hygiene intervention. We conducted 12 focus group discussions involving fishermen (n = 130), recording the discussions in Dholuo (the local language) and transcribing them verbatim before translating into English. Transcripts were double-coded and analysed using constant comparative analysis. Despite easy access to lake water and recognition of a link that may exist between poor genital hygiene and the risk of penile infection and poor sexual relationships, few fishermen regularly washed their genitalia due to fear/embarrassment from cleaning their genitalia in public, traditional Luo beliefs such as that washing with soap would reduce the fish catch, lack of time because of their busy schedules, laziness and lack of responsibility, and excessive consumption of alcohol and illicit drugs. Hygiene practices of the fishermen were poor and could contribute to genital infections including sexually transmitted infections. Given the fishermen's poor genital hygiene practices, they may benefit from hygiene intervention, including that provided by penile microbicides, which can be applied in the privacy of their bedrooms. PMID:20606226
Cates, Joan R; Coyne-Beasley, Tamera
A significant barrier to the delivery of HPV vaccine is reluctance by both healthcare providers and parents to vaccinate at age 11 or 12, which may be considered a young age. This barrier has been called "vaccine hesitancy" in recent research. In this commentary, we suggest using social marketing strategies to promote HPV vaccination at the recommended preteen ages. We emphasize a critical public health message of a sexually transmitted infection (STI) as preventable and vaccination against HPV as a way to protect against its consequences. The message tackles the issue of vaccine hesitancy head on, by saying that most people are at risk for HPV and there is a way to prevent HPV's serious consequences of cancer. Our approach to this conversation in the clinical setting is also to engage the preteen in a dialog with the parent and provider. We expect our emphasis on the risk of STI infection will not only lead to increased HPV vaccination at preteen ages but also lay important groundwork for clinical adoption of other STI vaccines in development (HIV, HSV, Chlamydia, and Gonorrhea) as well as begin conversations to promote sexual health. PMID:25692313
Plamondon, Mireille; Labbé, Annie-Claude; Frost, Eric; Deslandes, Sylvie; Alves, Alfredo Claudino; Bastien, Nathalie; Pepin, Jacques
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. PMID:17440608
Vallely, Andrew; Page, Andrew; Dias, Shannon; Siba, Peter; Lupiwa, Tony; Law, Greg; Millan, John; Wilson, David P.; Murray, John M.; Toole, Michael; Kaldor, John M.
Background The potential for an expanded HIV epidemic in Papua New Guinea (PNG) demands an effective, evidence-based and locally-appropriate national response. As sexually transmitted infections (STIs) may be important co-factors in HIV transmission nationally, it is timely to conduct a systematic review of STI prevalences to inform national policy on sexual health and HIV/STI prevention. Methodology/Principal Findings We undertook a systematic review and meta-analysis of HIV and STI prevalences in PNG, reported in peer-reviewed and non-peer-reviewed publications for the period 1950–2010. Prevalence estimates were stratified by study site (community or clinic-based), geographic area and socio-demographic characteristics. The search strategy identified 105 reports, of which 25 studies (10 community-based; 10 clinic-based; and 5 among self-identified female sex workers) reported STI prevalences and were included in the systematic review. High prevalences of chlamydia, gonorrhoea, syphilis and trichomonas were reported in all settings, particularly among female sex workers, where pooled estimates of 26.1%, 33.6%, 33.1% and 39.3% respectively were observed. Pooled HIV prevalence in community-based studies was 1.8% (95% CI:1.2–2.4) in men; 2.6% (95% CI:1.7–3.5) in women; and 11.8% (95% CI:5.8–17.7) among female sex workers. Conclusions/Significance The epidemiology of STIs and HIV in PNG shows considerable heterogeneity by geographical setting and sexual risk group. Prevalences from community-based studies in PNG were higher than in many other countries in the Asia-Pacific. A renewed focus on national STI/HIV surveillance priorities and systems for routine and periodic data collection will be essential to building effective culturally-relevant behavioural and biomedical STI/HIV prevention programs in PNG. PMID:21203468
Corey M. Long; Jeffrey D. Klausner; Segundo Leon; Franca R. Jones; Maziel Giron; Julio Cuadros; Jose Pajuelo; Carlos Caceres; Thomas J. Coates
Objectives: The objective of this study was to characterize syphilis epidemiology and the relationship of HIV status and initial rapid plasma reagin (RPR) titer to syphilis treatment in Lima, Peru. Study Design: We screened 1,261 individuals at high risk for sexually transmitted diseases for syphilis and HIV infection. Syphilis was treated with penicillin injection or doxycycline; treatment was repeated in
Donata Medaglini; Catherine M. Rush; Piersante Sestini; Gianni Pozzi
There is a need to develop vaccines to control the spread of sexually transmitted diseases (STDs). Novel immunization strategies that elicit a mucosal immune response in the genital tract, may show improved protection by preventing or at least limiting entry of the pathogenic micro-organism. However, it has proven difficult to obtain a local immune response in the vaginal mucosa. Our
Diane M. Grimley; Gabrielle E. Riley; Jeffrey M. Bellis; James O. Prochaska
A synergistic approach was taken to examine contraceptive use adoption for two related behaviors: pregnancy prevention and the prevention of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV)\\/acquired immunodeficiency syndrome (AIDS). One hundred twenty-three young adults responded to questionnaire items based on two constructs from the Transtheoretical Model of Change, the Stages of Change and Decisional Balance, as well
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. PMID:24884734
Singh, Susheela; Bankole, Akinrinola; Woog, Vanessa
Young people's need for sex education is evidenced by their typically early initiation of sexual activity, the often involuntary context within which they have sexual intercourse, high-risk sexual behaviours and the inadequate levels of knowledge of means of protecting their sexual health. The earliness of initiation of sexual intercourse has…
Pike, Emily C; LeGrand, Sara; Hightow-Weidman, Lisa B
Background Mobile phone applications (apps) provide a new platform for delivering tailored human immunodeficiency virus (HIV) and sexually transmitted disease (STD) prevention and care. Objective To identify and evaluate currently available mobile phone apps related to the prevention and care of HIV and other STDs. Methods We searched the Apple iTunes and Android Google Play stores for HIV/STD-related apps, excluding apps that exclusively targeted industry, providers, and researchers. Each eligible app was downloaded, tested, and assessed for user ratings and functionality as well as 6 broad content areas of HIV prevention and care: HIV/STD disease knowledge, risk reduction/safer sex, condom promotion, HIV/STD testing information, resources for HIV-positive persons, and focus on key populations. Results Search queries up to May 2012 identified 1937 apps. Of these, 55 unique apps met the inclusion criteria (12 for Android, 29 for iPhone, and 14 for both platforms). Among these apps, 71% provided disease information about HIV/STDs, 36% provided HIV/STD testing information or resources, 29% included information about condom use or assistance locating condoms, and 24% promoted safer sex. Only 6 apps (11%) covered all 4 of these prevention areas. Eight apps (15%) provided tools or resources specifically for HIV/STD positive persons. Ten apps included information for a range of sexual orientations, 9 apps appeared to be designed for racially/ethnically diverse audiences, and 15 apps featured interactive components. Apps were infrequently downloaded (median 100-500 downloads) and not highly rated (average customer rating 3.7 out of 5 stars). Conclusions Most available HIV/STD apps have failed to attract user attention and positive reviews. Public health practitioners should work with app developers to incorporate elements of evidence-based interventions for risk reduction and improve app inclusiveness and interactivity. PMID:23291245
Morris, Jessica L; Lippman, Sheri A; Philip, Susan; Bernstein, Kyle; Neilands, Torsten B; Lightfoot, Marguerita
A self-administered, street intercept survey was conducted in order to examine the relation of stigma and shame associated with sexually transmitted infections (STI) to STI testing practices, partner notification, and partner-delivered treatment among young African American men (n=108) in a low-income, urban community in San Francisco with high STI burden. Multivariate logistic regression revealed that increasing STI-related stigma was significantly associated with a decreased odds of STI testing, such that every standard deviation increase in stigma score was associated with 0.62 decreased odds of having been tested (aOR: 0.62, 95% CI: 0.38-1.00), controlling for age. STI stigma was also significantly associated with a decreased willingness to notify non-main partners of an STI (aOR: 0.64 95% CI: 0.41-0.99). Participants with higher levels of stigma and shame were also significantly less likely to be willing to deliver STI medication to a partner (stigma aOR: 0.57, 95% CI: 0.37-0.88; shame aOR 0.53 95% CI: 0.34-0.83). Findings suggest that STI-related stigma and shame, common in this population, could undermine STI testing, treatment, and partner notification programs. The medical establishment, one of the institutional factors to have reinforced this culture of stigma, must aid efforts to reduce its effects through providing integrated services, reframing sexual health in campaigns, educating clients, and providing wider options to aid disclosure and partner notification practices. PMID:25133501
Background and objectives Sexually transmitted infections (STIs) contribute largely to the burden of health in South Africa and are recognized as major contributors to the human immunodeficiency virus (HIV) epidemic. Young women are particularly vulnerable to STIs. The purpose of this secondary analysis was to examine the risk factors associated with prevalent and incident STIs among women who had participated in three clinical trials. Methods A total of 5,748 women were screened and 2293 sexually active, HIV negative, non-pregnant women were enrolled in three clinical trials in Kwazulu-Natal, South Africa. The prevalence of individual STIs Chlamydia trachomatis (CT), Neisseria gonorrhea (NG), syphilis, and Trichomonas vaginalis (TV) was assessed at screening; and incident infections were evaluated over a 24 month period. Results Overall, the combined study population of all three trials had a median age of 28 years (inter-quartile range (IQR):22–37), and a median duration of follow-up of 12 months. Prevalence of STIs (CT, NG, TV, or syphilis) was 13% at screening. The STI incidence was estimated to be 20/100 women years. Younger women (<25 years, p?0.001), women who were unmarried (p?0.001) and non-cohabiting women (p?0.001) were shown to be at highest risk for incident STIs. Conclusions These results confirm the extremely high prevalence and incidence of STIs among women living in rural and urban communities of KwaZulu-Natal, South Africa, where the HIV epidemic is also particularly severe. These findings strongly suggest an urgent need to allocate resources for STI and HIV prevention that mainly target younger women. Trial registration Clinical Trials.gov, NCT00121459. PMID:25243015
Coma Auli, Núria; Mejía-Lancheros, Cília; Berenguera, Anna; Pujol-Ribera, Enriqueta
Objective This study aimed to determine in detail the risk perception of sexually transmitted infections (STIs) and HIV, and the contextual circumstances, in Nigerian commercial sex workers (CSWs) in Barcelona. Design A qualitative study with a phenomenological approach. Setting Raval area in Barcelona. Participants 8 CSWs working in Barcelona. Methods A phenomenological study was carried out with Nigerian CSWs in Barcelona. Sampling was theoretical, taking into account: different age ranges; women with and without a partner; women with and without children; and women participating or not in STI/HIV-prevention workshops. Information was obtained by means of eight semistructured individual interviews. An interpretative content analysis was conducted by four analysts. Results Illegal immigrant status, educational level, financial situation and work, and cultural context had mixed effects on CSW knowledge of, exposure to, and prevention and treatment of STI and HIV. CSWs were aware of the higher risk of STI associated with their occupation. They identified condoms as the best preventive method and used them during intercourse with clients. They also implemented other preventive behaviours such as personal hygiene after intercourse. Control of sexual services provided, health education and healthcare services had a positive effect on decreasing exposure and better management of STI/HIV. Conclusions Nigerian CSWs are a vulnerable group because of their poor socioeconomic status. The perception of risk in this group and their preventive behaviours are based on personal determinants, beliefs and experiences from their home country and influences from the host country. Interventions aimed at CSWs must address knowledge gaps, risk behaviours and structural elements. PMID:26078307
Background Globally, the incidence of sexually transmitted infections (STI) is rising, posing a challenge to its control and appropriate management. Text messaging has become the most common mode of communication among almost six billion mobile phone users worldwide. Text messaging can be used to remind patients about clinic appointments, to notify patients that it is time for STI re-testing, and to facilitate patient communication with their health professionals with any questions and concerns they may have about their sexual health. While there are a handful of systematic reviews published on short message service (SMS) interventions in a variety of health settings and issues, none are related to sexual health. We plan to conduct a systematic review to examine the impact text messaging might have on interventions for the prevention and care of patients with STIs. Methods/Design Eligible studies will include both quantitative and qualitative studies published after 1995 that discuss the efficacy and effectiveness of SMS interventions for STI prevention and management using text messaging. Data will be abstracted independently by two reviewers using a standardized pre-tested data abstraction form. Inter-rater reliability scores will be obtained to ensure consistency in the inclusion and data extraction of studies. Heterogeneity will be assessed using the I2 test and subgroup analyses. A nonhypothesis driven inductive reasoning approach as well as a coding framework will be applied to analyze qualitative studies. A meta-analysis may be conducted if sufficient quantitative studies are found using similar outcomes. Discussion For this protocol, we identified ten related systematic reviews. The reviews were limited to a particular disease or setting, were not exclusive to SMS interventions, or were out of date. This systematic review will be the first comprehensive examination of studies that discuss the effectiveness of SMS on multiple outcomes that relate to STI prevention and management, covering diverse settings and populations. Findings of the systematic review and any additional meta-analyses will be published and presented to our key knowledge users. This information will provide the evidence that is required to appropriately adopt text messaging into standard practice in STI care. PMID:24433348
NGUYEN, THUONG VU; VAN KHUU, NGHIA; LE, TRUC THANH THI; NGUYEN, ANH PHUONG; CAO, VAN; THAM, DUNG CHI; DETELS, ROGER
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. PMID:18685547
Binswanger, Ingrid A.; Mueller, Shane; Beaty, Brenda L.; Min, Sung-joon; Corsi, Karen F.
Women in prison have a higher prevalence of HIV than men. After release from prison, former inmates have the opportunity to engage in risk behaviors for HIV and other sexually transmitted infections (STI). We sought to assess change in risk behaviors over time and the association of gender with risk behavior in the post-release period. In this prospective cohort study, we interviewed 200 former inmates (51 women) approximately 2 weeks (baseline) and 3 months (follow-up) after release and tested them for HIV infection at follow-up. We examined the association of gender with unprotected vaginal or anal sex in the last seven days using chi-square and Fisher’s exact tests and multivariable logistic regression. At baseline, 22% of men and 41% of women reported unprotected vaginal sex (p<0.01) and 5% of men and 8% of women reported unprotected anal sex (p=0.51). Being younger (OR for each decade increase 0.48, 95% CI 0.29-0.80), being gay/lesbian or being bisexual (compared with being heterosexual, OR=4.74 95% CI 1.01–22.17, OR=3.98, 95% CI 1.41–11.26, respectively), or reporting a drug of choice of heroin/speedballs or cocaine/crack (compared with marijuana/no drug of choice, OR=24.00, 95% CI 5.15–111.81 and OR=3.49, 95% CI 1.20–10.18, respectively) were associated with unprotected vaginal or anal sex after adjusting for race, homelessness, and hazardous drinking. At follow-up, 21% of men and 44% of women reported unprotected sex (p=0.005), and female gender (OR=4.42, 95% CI 1.79–10.94) and hazardous drinking (compared with not meeting criteria for hazardous drinking, OR=3.64, 95% CI 1.34–9.86) were associated with unprotected sex, adjusting for race and homelessness. In this population with a high prevalence of HIV, we demonstrated persistent engagement in sexual risk behavior during the post-release period. Enhanced efforts to promote sexual health and reduced risk behavior among both male and female current and former prison inmates are needed, including improved access to preventive care and HIV and STI screening, testing and treatment. PMID:24266415
Jones, H E; Holloway, I W; Pressman, E; Meier, J; Westhoff, C L
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
Ford, Chandra L.; Daniel, Mark; Miller, William C.
PURPOSE: In the current diagnosis-based, human immunodeficiency virus (HIV) prevention climate, previous testing among persons at elevated HIV risk has cost and efficacy implications, as it signals continued behavioral risk, limited HIV knowledge or overuse of services. This study sought to determine the proportion of African Americans newly seeking sexually transmitted disease (STD) diagnosis who previously had obtained HIV counseling and testing. METHODS: This was a clinic-based, cross-sectional survey of African-American adults (N=408) seeking STO diagnosis at a public STD clinic located in a high-HIV and STD prevalence city in the U.S. south. MAIN FINDINGS: Eighty-four percent of respondents had previously obtained HIV counseling and testing: 68% had previously obtained care at the clinic. Sixty-five percent of respondents perceived themselves as having low or no HIV risk. Seventy-two percent correctly answered > or = 3 of 4 HIV knowledge items. CONCLUSIONS: Although diagnosis-based HIV prevention initiatives promote HIV counseling and testing for both primary and secondary HIV prevention, these findings suggest that many African-American STD patients remain at risk following testing. Future research should explore how the counseling portion of standard HIV counseling and testing influences subsequent knowledge, attitudes, risk perceptions and behaviors. PMID:16775904
Wong, M L; Chan, R K; Chua, W L; Wee, S
This study compares the prevalence of sexually transmitted diseases (STDs), condom use, and health-screening behavior between freelance and brothel-based sex workers in Singapore. A total of 111 female freelance sex workers arrested from November 1996 to March 1997 for illicit prostitution were interviewed; 333 brothel-based sex workers served as the comparison group for the analysis. STD test results revealed that freelance sex workers (34.8%) have higher STD rates than brothel-based sex workers (24%). The two most common STDs in both groups were chlamydial cervicitis and syphilis. Moreover, condom use was significantly lower among freelance sex workers than brothel-based sex workers and was associated with younger age (25 years old), decreasing number of clients, and perception of non-condom use among peers. In addition, freelance workers were more educated and had equally high knowledge on STDs and AIDS. Since most of these freelance workers practice high-risk behaviors and poor health screening behaviors such as not going for regular medical check-ups, STD services and education programs should target this group. PMID:10560725
Jeong, Heon-Jae; Jo, Heui-Sug; Oh, Moo-Kyung; Oh, Hyung-Won
Clinical practice guidelines (CPG) are one of the most effective ways to translate evidence of medical improvement into everyday practice. This study evaluated the dissemination and implementation of the Sexually Transmitted Infections-Korean Guidelines (STIKG) by applying the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. A survey questionnaire was administered to clinicians via the internet. Among the 332 respondents, 190 (57.2%) stated that they were aware of STIKG and 107 (33.2%) implemented STIKG in their practice. The odds that a physician was exposed to STIKG (dissemination) were 2.61 times greater among physicians with previous training or education for any CPG than those who did not. Clinicians who indicated that STIKG were easy to understand were 4.88 times more likely to implement STIKG in their practice than those who found them not so easy. When a clinician's workplace had a supporting system for CPG use, the odds of implementation was 3.76 times higher. Perceived level of effectiveness of STIKG did not significantly influence their implementation. The findings of this study suggest that, ultimately, knowing how to engage clinicians in CPG implementation is as important as how to disseminate such guidelines; moreover, easy-to-use guidelines and institutional support are key factors. PMID:26130944
Obisesan, Oluranti J.; Olowe, Olugbenga A.; Taiwo, Samuel S.
The management of genitourinary candidiasis (GC) is fraught with challenges, especially, in an era of increasing antifungal resistance. This descriptive cross-sectional study conducted between May 2013 and January 2014 determined the prevalence and characteristics of GC and the species of Candida among 369 attendees of a Sexually Transmitted Disease (STD) clinic of Ladoke Akintola University Teaching Hospital, Osogbo, Nigeria. Appropriate urogenital specimen collected from each attendee was examined by microscopy and culture for Candida, with preliminary species identification by CHROMAgar Candida and confirmation by Analytical Profile Index (API) 20C AUX. The age range of attendees was 1-80 years, mean age was 36.32 ± 11.34 years, and male to female ratio was 1 to 3. The prevalence of genitourinary candidiasis was 47.4%, with 4.9% in males and 42.5% in females (p < 0.0001). The age groups 31–45 and 16–30 have the highest prevalence of 23.3% and 16.8%, respectively. The species of Candida recovered include Candida glabrata 46.9%, Candida albicans 33.7%, Candida dubliniensis 9.7%, Candida tropicalis 5.7%, Candida krusei 1.7%, Candida lusitaniae 1.7%, and Candida utilis 0.6%. This study reported non-C. albicans Candida, especially C. glabrata, as the most frequently isolated species in GC, contrary to previous studies in this environment and elsewhere.
Libby Topp; Katherine M. Conigrave; Paul S. Haber; Carolyn A. Day
OBJECTIVE: Drug users are at elevated risk of HIV and other sexually transmitted infections (STIs). This study examines prevalence of STIs and perceived barriers to safe sex among drug users accessing low-threshold primary healthcare in inner-city Sydney. METHODS: Data were extracted manually from clients' medical records and analysed using STATA. RESULTS: Prevalence of HIV, syphilis, chlamydia and gonorrhoea were low
Bilardi, Jade E.; Walker, Sandra; Temple-Smith, Meredith; McNair, Ruth; Mooney-Somers, Julie; Bellhouse, Clare; Fairley, Christopher K.; Chen, Marcus Y.; Bradshaw, Catriona
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. PMID:24040236
Brooks, B; Patel, R
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
Truong, Hong-Ha M; Pipkin, Sharon; O?Keefe, Kara J; Louie, Brian; Liegler, Teri; McFarland, Willi; Grant, Robert M; Bernstein, Kyle; Scheer, Susan
There were 1311 newly diagnosed HIV cases in San Francisco between 2005 and 2011 that were linked to care at publicly funded facilities and had viral sequences available for analysis. Of the 214 cases characterized as recently infected with HIV at the time of diagnosis, 25% had a recent sexually transmitted infection diagnosis (vs. 10% among longer-standing HIV infections, P < 0.001) and 57% were part of a phylogenetic transmission cluster (vs. 42% among longer-standing HIV infection, P < 0.001). The association observed between recent HIV infection and having a sexually transmitted infection diagnosis during the interval overlapping likely HIV acquisition points to potential opportunities to interrupt HIV transmission. PMID:25967271
Ludo Lavreys; Kishorchandra Mandaliya
To determine the effect of circumcision status on acquisition of human immunodeficiency virus (HIV) type 1 and other sexually transmitted diseases, a prospective cohort study of 746 HIV-1-seronegative trucking company employees was conducted in Mombasa, Kenya. During the course of follow-up, 43 men acquired HIV-1 antibodies, yielding an annual incidence of 3.0%. The annual incidences of genital ulcers and urethritis
Seth C Kalichman; Jennifer Pellowski; Christina Turner
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
Irena Jakopanec; Barbara Schimmer; Andrej M Grjibovski; Elise Klouman; Preben Aavitsland
BACKGROUND: The incidences of reportable sexually transmitted infections (STI) among men who have sex with men (MSM) have increased since the late 1990 s in Norway. The objectives of our study were to assess factors, associated with recent selected STI among MSM, living in Norway in order to guide prevention measures. METHODS: We conducted a cross-sectional Internet-based survey during 1-19
B M Ramesh; Tara S H Beattie; Isac Shajy; Reynold Washington; Latta Jagannathan; Sushena Reza-Paul; James F Blanchard; Stephen Moses
ObjectivesTo examine the impact of a large-scale HIV prevention programme for female sex workers (FSW) in Karnataka state, south India, on the prevalence of HIV\\/sexually transmitted infections (STI), condom use and programme coverage.MethodsBaseline and follow-up integrated biological and behavioural surveys were conducted on random samples of FSW in five districts in Karnataka between 2004 and 2009.Results4712 FSW participated in the
Wand, Handan; Ramjee, Gita
Introduction Understanding the impact of curable sexually transmitted infections (STIs) on HIV transmissibility is essential for effective HIV prevention programs. Investigating the impact of longitudinally measured recurrent STIs on HIV seroconversion is the interest of the current paper. Methods In this prospective study, data from a total of 1456 HIV-negative women who enrolled in a HIV biomedical trial were used. It was hypothesized that women who had recurrent STI diagnoses during the study share a common biological heterogeneity which cannot be quantified. To incorporate this “unobserved” correlation in the analysis, times to HIV seroconversion were jointly modelled with repeated STI diagnoses using Cox regression with random effects. Results and discussion A total of 110 HIV seroconversions were observed (incidence rate of 6.00 per 100 person-years). In a multivariable model, women who were diagnosed at least once were more likely to seroconvert compared to those who had no STI diagnosis [hazard ratio (HR): 1.63, 95% confidence interval (CI): 1.04, 2.57]; women who had recurrent STI diagnoses during the study were 2.5 times more likely to be at increased risk of HIV infection (95% CI: 1.35, 4.01) with an estimated frailty variance of 1.52, with p<0.001, indicating strong evidence that there is a significant correlation (heterogeneity) among women who had recurrent STIs. In addition to this, factors associated with incidence of STIs, namely not being married and having a new sexual partner during the study follow-up, were all significantly associated with increased risk for HIV seroconversion (HR: 2.92, 95% CI: 1.76, 5.01 and HR: 2.25, 95% CI: 1.63, 3.83 respectively). Conclusions The results indicated that women who were at risk for STIs were also at risk of HIV infection. In fact, they share the similar risk factors. In addition to this, repeated STI diagnoses also increased women’s susceptibility for HIV infection significantly. Decreasing STIs by increasing uptake of testing and treatment and reducing partner change plays a significant role in the trajectory of the epidemic. PMID:25912181
Trienekens, Suzan C M; van den Broek, Ingrid V F; Donker, Gé A; van Bergen, Jan E A M; van der Sande, Marianne A B
Objectives In the Netherlands, sexually transmitted infection (STI) care is provided by general practitioners (GPs) as well as by specialised STI centres. Consultations at the STI centres are monitored extensively, but data from the general practice are limited. This study aimed to examine STI consultations in the general practice. Design Prospective observational patient survey. Setting General practices within the nationally representative Dutch Sentinel GP network (n=125?000 patient population), 2008–2011. Outcome measures GPs were asked to fill out a questionnaire at each STI consultation addressing demographics, sexual behaviour and laboratory test results. Patient population, testing practices and test positivity are reported. Participants Patients attending a consultation concerning an STI/HIV-related issue. Results Overall, 1 in 250 patients/year consulted their GP for STI/HIV-related problems. Consultations were concentrated among young heterosexuals of Dutch origin. Laboratory testing was requested for 83.3% of consultations. Overall consult positivity was 33.4%, highest for chlamydia (14.7%), condylomata (8.7%) and herpes (6.4%). 32 of 706 positive patients (4.5%) were diagnosed with multiple infections. Main high-risk groups were patients who were <25?years old (for chlamydia), >25?years old (syphilis), men who have sex with men (MSM; for gonorrhoea/syphilis/HIV) or having symptoms (for any STI). Adherence to guideline-recommendations to test for multiple STI among high-risk groups varied from 15% to 75%. Conclusions This study found that characteristics of patients who consulted a GP for STIs were comparable to those of patients attending STI centres regarding age and ethnicity; however, consultations of high-risk groups like MSM and (clients of) commercial sex workers were reported less by the general practice. Where the STI centres routinely test all patients for chlamydia/syphilis/HIV/gonorrhoea, GPs tested more selectively, even more restricted than advised by GP guidelines. Test positivity was, therefore, higher in general practice, although it is unknown how many STIs are missed (particularly among high-risk groups). Opportunities for a more proactive role in STI/HIV testing at general practices in line with current guidelines should be explored. PMID:24381253
Luchters, Stanley; Chersich, Matthew F; Rinyiru, Agnes; Barasa, Mary-Stella; King'ola, Nzioki; Mandaliya, Kishorchandra; Bosire, Wilkister; Wambugu, Sam; Mwarogo, Peter; Temmerman, Marleen
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. Methods A pre-intervention survey in 2000, recruited 503 FSW using snowball sampling. Thereafter, peer educators provided STI/HIV education, condoms, and facilitated HIV testing, treatment and care services. In 2005, data were collected using identical survey methods, allowing comparison with historical controls, and between FSW who had or had not received peer interventions. Results Over five years, sex work became predominately a full-time activity, with increased mean sexual partners (2.8 versus 4.9/week; P < 0.001). Consistent condom use with clients increased from 28.8% (145/503) to 70.4% (356/506; P < 0.001) as well as the likelihood of refusing clients who were unwilling to use condoms (OR = 4.9, 95%CI = 3.7–6.6). In 2005, FSW who received peer interventions (28.7%, 145/506), had more consistent condom use with clients compared with unexposed FSW (86.2% versus 64.0%; AOR = 3.6, 95%CI = 2.1–6.1). These differences were larger among FSW with greater peer-intervention exposure. HIV prevalence was 25% (17/69) in FSW attending ? 4 peer-education sessions, compared with 34% (25/73) in those attending 1–3 sessions (P = 0.21). Overall HIV prevalence was 30.6 (151/493) in 2000 and 33.3% (166/498) in 2005 (P = 0.36). Conclusion Peer-mediated interventions were associated with an increase in protected sex. Though peer-mediated interventions remain important, higher coverage is needed and more efficacious interventions to reduce overall vulnerability and risk. PMID:18445258
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
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. PMID:23355766
Background Men having sex with men (MSM) remain the largest high-risk group involved in on-going transmission of sexually transmitted infections (STI), including HIV, in the Netherlands. As risk behaviour may change with age, it is important to explore potential heterogeneity in risks by age. To improve our understanding of this epidemic, we analysed the prevalence of and risk factors for selected STI in MSM attending STI clinics in the Netherlands by age group. Methods Analysis of data from the national STI surveillance system for the period 2006–2012. Selected STI were chlamydia, gonorrhoea, infectious syphilis and/or a new HIV infection. Logistic regression was used to identify factors associated with these selected STI and with overall STI positivity. Analyses were done separately for MSM aged younger than 25 years and MSM aged 25 years and older. Results In young MSM a significant increase in positivity rate was seen over time (p?0.01), mainly driven by increasing gonorrhoea diagnoses, while in MSM aged 25 and older a significant decrease was observed (p?0.01). In multivariate analyses for young MSM, those who were involved in commercial sex were at higher risk (OR: 1.5, 95% CI: 1.2-1.9). For MSM aged 25 years and older this was not the case. Having a previous negative HIV test was protective among older MSM compared to those not tested for HIV before (OR: 0.8, 95% CI: 0.8-0.8), but not among younger MSM. Conclusions MSM visiting STI clinics remain a high-risk group for STI infections and transmission, but are not a homogenous group. While in MSM aged older than 25 years, STI positivity rate is decreasing, positivity rate in young MSM increased over time. Therefore specific attention needs to be paid towards targeted counselling and reaching particular MSM sub-groups, taken into account different behavioural profiles. PMID:25170341
Yadav, Diwakar; Ramanathan, Shreena; Goswami, Prabuddhagopal; Ramakrishnan, Lakshmi; Saggurti, Niranjan; Sen, Shrabanti; George, Bitra; Paranjape, Ramesh
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. PMID:24205210
Wenten, David; Phipps, Paula; Gremminger, Roger; Schuknecht, Mary Kay; Napierala, Maureen; Hamer, Deb; Olson, Robin; Schell, Ronald F.; Hryciuk, Jeanne E.
Transcription-mediated amplification (TMA) enhances detection of Neisseria gonorrhoeae and Chlamydia trachomatis from rectal and pharyngeal sources. The utility of TMA for detection of Trichomonas vaginalis has recently been described. We report on the performance of TMA for detection of sexually transmitted infection (STI) agents from extraurogenital sources, with a focus on T. vaginalis. Within a 21-month interval, 1,314 consecutive male patient encounters at an STI clinic resulted in collection of 2,408 specimens for C. trachomatis, N. gonorrhoeae, and T. vaginalis TMA screening. A total of 471 encounters were managed with a single specimen collection (94.9% urine), with 12.7% positive for at least one STI agent. This detection percentage increased to 14.4% with collection of specimens from two sources and to 20.3% with collection from three sources (P = 0.03 versus single-source sampling). A total of 44.4% of encounters were managed by collection of urine and pharyngeal specimens and 19.1% by the addition of a third (rectal) collection. While procurement of urine and rectal specimens resulted in greater detection of C. trachomatis (6.1% and 11.3% rates, respectively) than of other STI agents, 858 pharyngeal specimens yielded a 2.9% T. vaginalis detection rate compared with 2.1% for N. gonorrhoeae and 1.6% for C. trachomatis. All T. vaginalis pharyngeal detections were confirmed by TMA-based alternative target testing. A total of 38.1% of T. vaginalis-positive pharyngeal specimens were derived from symptomatic patient encounters. A total of 85.7% of males with T. vaginalis-positive pharyngeal collections indicated strictly heterosexual preference. Additional specimen source sampling is necessary to make STI screening comprehensive. Incorporation of extraurogenital sources into assessment for T. vaginalis detection may identify additional symptomatic and asymptomatic male STI carriers. PMID:23554208
Kokku, Suresh Babu; Mahapatra, Bidhubhusan; Tucker, Saroj; Saggurti, Niranjan; Prabhakar, Parimi
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. PMID:24718405
Tomas, Myreen E; Getman, Damon; Donskey, Curtis J; Hecker, Michelle T
Urinary tract infections (UTIs) and sexually transmitted infections (STIs) are commonly diagnosed in emergency departments (EDs). Distinguishing between these syndromes can be challenging because of overlapping symptomatology and because both are associated with abnormalities on urinalysis (UA). We conducted a 2-month observational cohort study to determine the accuracy of clinical diagnoses of UTI and STI in adult women presenting with genitourinary (GU) symptoms or diagnosed with GU infections at an urban academic ED. For all urine specimens, UA, culture, and nucleic acid amplification testing for Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis were performed. Of 264 women studied, providers diagnosed 175 (66%) with UTIs, 100 (57%) of whom were treated without performing a urine culture during routine care. Combining routine care and study-performed urine cultures, only 84 (48%) of these women had a positive urine culture. Sixty (23%) of the 264 women studied had one or more positive STI tests, 22 (37%) of whom did not receive treatment for an STI within 7 days of the ED visit. Fourteen (64%) of these 22 women were diagnosed with a UTI instead of an STI. Ninety-two percent of the women studied had an abnormal UA finding (greater-than-trace leukocyte esterase level, positive nitrite test result, or pyuria). The positive and negative predictive values of an abnormal UA finding were 41 and 76%, respectively. In this population, empirical therapy for UTI without urine culture testing and overdiagnosis of UTI were common and associated with unnecessary antibiotic exposure and missed STI diagnoses. Abnormal UA findings were common and not predictive of positive urine cultures. PMID:26063863
Fialho, Margaret; Messias, Márcia; Page-Shafer, Kimberly; Farre, Lourdes; Schmalb, Márcia; Pedral-Sampaio, Diana; Ramos, Mauro; Brites, Carlos
To determine the prevalence of sexually transmitted and blood-borne infections among incarcerated adolescents in Salvador, Brazil, we interviewed 300 incarcerated youth aged 11-18 years to participate in a physical examination and to provide a blood sample to test for HIV-1, hepatitis B and C viruses exposure, human T-cells lymphotrophic virus, and syphilis. Overall prevalence was anti-HIV, 0.34%; anti-HBc, 11.1%; HBsAg, 2.4%; anti-HCV, 6.4%; HTLV, 1.09%; and syphilis, 3.4%. The majority (86.3%) reported a history of sexual activity; 27% had never used condoms. Girls also reported previous pregnancy (35%), abortion (26%) and sexual abuse (74%). Many youth reported a family history of alcohol abuse (56%), illicit drug use (24.7%), or legal problems (38%). Serological results show that youth in Salvador are at high risk for blood-borne and sexually transmitted infections. Policies to reduce the risk and impact of these infections should be a requisite part of health care for incarcerated youth. PMID:18500658
Jones, Krista; Eathington, Patricia; Baldwin, Kathleen; Sipsma, Heather
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
CHIAO, CHI; MORISKY, DONALD E.
Objective The main objective of this study is to understand the association between living with a regular sex partner, risk-taking behaviors, and one’s history of sexually transmitted infections (STIs). Methods Data on sexual behavior and STI histories were obtained from 876 Filipina entertainment establishment workers (FEEWs) through a large-scale participatory research survey. Results About one-third of FEEWs live with a regular sex partner. Single FEEWs are significantly more likely than partnered FEEWs to engage in commercial sex. Being single, engaging in commercial sex, and using condoms inconsistently, in turn, are significantly associated with a positive STI history. Conclusion These results suggest that living with a regular sex partner is an independent and protective factor against having an initial STI and subsequent reinfection. Programmatic strategies aimed at reducing STIs among entertainment establishment workers through promoting safer sex behaviors could potentially benefit by including a component that addresses sexual networks. PMID:17710751
... as the baby passes through the birth canal. HIV can cross the placenta during pregnancy and infect the baby during the birth process. ... infection to the newborn. For women who are HIV positive, taking antiviral medicines during pregnancy can lower the risk of giving HIV to ...
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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. PMID:24238493
Inácio, Ângela S.; Ramalho-Santos, João; Vaz, Winchil L. C.; Vieira, Otília V.
Background The need for woman-controlled, cheap, safe, effective, easy-to-use and easy-to-store topical applications for prophylaxis against sexually transmitted infections (STIs) makes surfactant-containing formulations an interesting option that requires a more fundamental knowledge concerning surfactant toxicology and structure-activity relationships. Methodology/Principal Findings We report in vitro effects of surfactant concentration, exposure time and structure on the viability of mammalian cell types typically encountered in the vagina, namely, fully polarized and confluent epithelial cells, confluent but non-polarized epithelial-like cells, dendritic cells, and human sperm. Representatives of the different families of commercially available surfactants – nonionic (Triton X-100 and monolaurin), zwitterionic (DDPS), anionic (SDS), and cationic (CnTAB (n?=?10 to 16), C12PB, and C12BZK) – were examined. Triton X-100, monolaurin, DDPS and SDS were toxic to all cell types at concentrations around their critical micelle concentration (CMC) suggesting a non-selective mode of action involving cell membrane destabilization and/or destruction. All cationic surfactants were toxic at concentrations far below their CMC and showed significant differences in their toxicity toward polarized as compared with non-polarized cells. Their toxicity was also dependent on the chemical nature of the polar head group. Our results suggest an intracellular locus of action for cationic surfactants and show that their structure-activity relationships could be profitably exploited for STI prophylaxis in vaginal gel formulations. The therapeutic indices comparing polarized epithelial cell toxicity to sperm toxicity for all surfactants examined, except C12PB and C12BZK, does not justify their use as contraceptive agents. C12PB and C12BZK are shown to have a narrow therapeutic index recommending caution in their use in contraceptive formulations. Conclusions/Significance Our results contribute to understanding the mechanisms involved in surfactant toxicity, have a predictive value with regard to their safety, and may be used to design more effective and less harmful surfactants for use in topical applications for STI prophylaxis. PMID:21603626
Cachay, Edward R.; Sitapati, Amy; Caperna, Joseph; Freeborn, Kellie; Lonergan, Joseph T.; Jocson, Edward; Mathews, William C.
Background The Centers for Disease Control recommend screening for asymptomatic sexually transmitted infection (STI) among HIV-infected men when there is self-report of unprotected anal-receptive exposure. The study goals were: (1) to estimate the validity and usefulness for screening policies of self-reported unprotected anal-receptive exposure as a risk indicator for asymptomatic anorectal infection with Neisseria gonorrhoeae (GC) and/or Chlamydia trachomatis (CT). (2) to estimate the number of infections that would be missed if anal diagnostic assays were not performed among patients who denied unprotected anorectal exposure in the preceding month. Methods and Findings Retrospective analysis in HIV primary care and high resolution anoscopy (HRA) clinics. HIV-infected adult men were screened for self-reported exposure during the previous month at all primary care and HRA appointments. Four sub-cohorts were defined based on microbiology methodology (GC culture and CT direct fluorescent antibody vs. GC/CT nucleic acid amplification test) and clinical setting (primary care vs. HRA). Screening question operating characteristics were estimated using contingency table methods and then pooled across subcohorts. Among 803 patients, the prevalence of anorectal GC/CT varied from 3.5–20.1% in the 4 sub-cohorts. The sensitivity of the screening question for self-reported exposure to predict anorectal STI was higher in the primary care than in the HRA clinic, 86–100% vs. 12–35%, respectively. The negative predictive value of the screening question to predict asymptomatic anorectal STI was ?90% in all sub-cohorts. In sensitivity analyses, the probability of being an unidentified case among those denying exposure increased from 0.4–8.1% in the primary care setting, and from 0.9–18.8% in the HRA setting as the prevalence varied from 1–20%. Conclusion As STI prevalence increases, denial of unprotected anal-receptive exposure leads to an increasingly unacceptable proportion of unidentified asymptomatic anorectal STI if used as a criterion not to obtain microbiologic assays. PMID:20041143
Kaushic, Charu; Nazli, Aisha; Ferreira, Victor H; Kafka, Jessica K
Evidence from clinical and epidemiological studies indicates that women are disproportionately susceptible to sexually transmitted viral infections. To understand the underlying biological basis for this increased susceptibility, more studies are needed to examine the acute events in the female reproductive tract following exposure to viruses during sexual transmission. The epithelial lining of the female reproductive tract is the primary barrier that sexually transmitted viruses, such as HIV-1 and HSV-2 need to infect or traverse, in order to initiate and establish productive infection. We have established an ex-vivo primary culture system to grow genital epithelial cells from upper reproductive tract tissues of women. Using these cultures, we have extensively examined the interactions between epithelial cells of the female genital tract and HSV-2 and HIV-1. In this review, we describe in detail the experimental protocol to grow these cultures, monitor their differentiation and inoculate with HSV-2 and HIV-1. Prospective use of these cultures to re-create the microenvironment in the reproductive tract is discussed. PMID:21996033
Andersson, Neil; Shea, Bev; Archibald, Chris; Wong, Tom; Barlow, Kevin; Sioui, Georges
There is evidence that Aboriginal people may be at increased risk of HIV infection; they also experience higher rates of other blood-borne viral (BBV) and sexually transmitted infections (STI). This project will provide insights into the role of resilience and its impact on the health and well-being of Aboriginal youth, especially as it relates to sexual and injecting behaviour. The primary recipients of this information will be agencies that provide risk education related to BBVs and STIs. The project involves several phases. First, the framework for the research will be established, with Aboriginal leadership and involvement at every level. Next, both qualitative and quantitative methodologies will be used to identify factors that protect Aboriginal youth against blood-borne viral and sexually transmitted infections and their transmission within local communities. Finally, results from this project will be used to develop interventions and appropriate frameworks for their evaluation in Aboriginal communities. An important component of this project will involve the building of capacity within participating communities, with the goal of identifying strategies related to resilience that can be incorporated into public health and clinical practice. The project will run for five years. PMID:20862231
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.
Mesenburg, Marilia Arndt; Muniz, Ludmila Correa; Silveira, Mariângela Freitas
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
Carolyn Tucker Halpern; Denise Hallfors; Daniel J. Bauer; Bonita Iritani; Martha W. Waller; Hyunsan Cho
RESULTS: Among 16 clusters, the two defined by the lowest risk behaviors (sexual abstinence and little or no substance use) comprised 47% of adolescents; fewer than 1% in these groups reported ever having received an STD diagnosis. The next largest cluster—characterized by sexual activity (on average, with one lifetime partner) and infrequent sub- stance use—contained 15% of participants but nearly
... such as not using condoms regularly and having anal sex - increase STD risk. Homophobia, stigma, and discrimination ... who has an STD. Sexual contact includes oral, anal, and vaginal sex, as well as genital skin- ...
Temu, M M; Changalucha, J M; Mosha, F F; Mwanga, J R; Siza, J E; Balira, R
The study was conducted to determine knowledge, attitude and practice towards Sexually Transmitted Diseases and HIV infections among communities in Biharamulo and Muleba districts, Kagera Tanzania. A total of 915 study participants were recruited and most of them (96.3%) knew that there are diseases which could be transmitted through sexual contact. Seventy one percent of participants thought STDs could be acquired through sharing a towel while fifty percent thought HIV could be transmitted through insect bites. Eighty five percent of school pupils who participated in the study reported to have been taught about AIDS and less than 30% on sex and pregnancy. Sixty three percent of study participants were of the opinion that a girl or woman should not refuse to have sex after being given a gift, and having sex with an elder partner was thought to be acceptable by almost fifty percent of participants. Over 50% percent of interviewees thought a girl or woman should not refuse to have sex with their friends. Although 99% of interviewees reported to have ever heard about condoms, only 28% reported to have ever used them irrespective of been affordable. Most schoolboys and about 50% of schoolgirls reported to have experienced sex by the time of the study. Thirty eight percent of girls reported to have first sex at the age of 14 years. Nine percent of the participants who reported to have experienced sex were forced to do so. Knowledge regarding STDs and HIV/AIDS was high among participants, but a sizeable proportion report misconception on transmission of STDs/HIV such as through sharing a towel and insect bites. Therefore it is recommended that S&RH intervention programme should address these misconceptions in order to match knowledge and practice, and achieve the intended objectives. PMID:19402582
Gindi, Renee M.; Erbelding, Emily J.; Page, Kathleen R.
Background Many studies have evaluated factors influencing STD/HIV disparities between African-American and white populations, but fewer have explicitly included Latinos for comparison. Methods We analyzed demographic and behavioral data captured in electronic medical records of patients first seen by a clinician in one of two Baltimore City public STD clinics between 2004 and 2007. Records from white, African-American, and Latino patients were included in the analysis. Results There were significant differences between Latinos and other racial/ethnic groups for several behavioral risk factors studied, with Latino patients reporting fewer behavioral risk factors than other patients. Latinos were more likely to have syphilis, but less likely to have gonorrhea than other racial/ethnic groups. English-proficient Latina (female) patients reported higher rates of infection and behavioral risk factors than Spanish-speaking Latina patients. After adjustment for gender and behavioral risk factors, Spanish-speaking Latinas also had significantly less risk of sexually transmitted infections than did English-speaking Latinas. Conclusions These results are consistent with other studies showing that acculturation (as measured by language proficiency) is associated with increases in reported sexual risk behaviors among Latinos. Future studies on sexual risk behavior among specific Latino populations characterized by country of origin, level of acculturation, and years in the U.S. may identify further risk factors and protective factors to guide development of culturally appropriate STD/HIV interventions. PMID:19910863
Hamlyn, E; McAllister, J; Winston, A; Sinclair, B; Amin, J; Carr, A; Cooper, D A
Background/aims Non?occupational HIV post?exposure prophylaxis (NPEP) is routinely prescribed after high risk sexual exposure. This provides an opportunity to screen and treat individuals at risk of concurrent sexually transmitted infections (STI). The aim of this study was to assess the efficacy of an STI screening programme in individuals receiving NPEP. Methods STI screens were offered to all individuals receiving NPEP from March 2001 to May 2004. Screen results were compared to type of sexual exposure and baseline patient characteristics. Results A total of 253 subjects were screened, representing 85% of the target population. All were men who have sex with men (MSM). Common exposure risks were receptive anal intercourse (RAI) in 61% and insertive anal intercourse (IAI) in 33%. 32 (13%) individuals had one or more STI. The most common STIs were rectal infections with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in 11 (4.5%) and six (2.5%) individuals, respectively. Subjects with rectal CT were significantly more likely to be co?infected with rectal NG (p<0.001). There was no association between the presence of a rectal STI and age or exposure risk. Only six (19%) individuals with an STI were symptomatic at screening. Conclusion In this cohort of MSM receiving NPEP, high rates of concomitant STIs are observed highlighting the importance of STI screening in this setting. PMID:16461596
Keaveney, S; Sadlier, C; O'Dea, S; Delamere, S; Bergin, C
In Ireland the incidence of sexually transmitted infections (STIs) is steadily increasing while the number of new HIV-diagnoses in men who have sex with men has more than doubled in the past decade. This study investigated the prevalence of STIs in asymptomatic HIV-infected men who have sex with men (MSM) attending a clinic for routine HIV care in the largest HIV-centre in Ireland. Fifty HIV-infected MSM were included in the study (mean age [SD] 38years , 66% Irish). Sixteen per cent of HIV-infected MSM screened were diagnosed with a STI. Thirty-eight per cent reported always using condoms while 4% reported never using condoms, 46% used condoms inconsistently and 10% reported no sexual contacts in the preceding 12 months. Recognising the need to optimise STI screening, a pilot self-screening programme was subsequently introduced to our HIV clinic as a quality improvement initiative. Asymptomatic MSM attending for routine HIV care were invited to have an opportunistic STI screen either provider performed or by self-screening. Seventy-one patients were included in the pilot. Sixty-five (92%) opted for self-collected rectal swabs. Ten STIs were detected in eight patients. This study supports guidelines recommending routine screening for STIs in the care of HIV-infected patients and highlights opportunities to provide relevant screening and education interventions targeting unsafe sexual behaviours. PMID:24480850
Angela D. Bryan; Leona S. Aiken; Stephen G. West
A multicomponent intervention to increase condom use in sexually active young women was designed, implemented, and evaluated in a randomized experiment. Participants were 198 unmarried female college students (mean age = 18.6 years) who received a 1-session condom promotion intervention or a control (stress management) intervention. The condom promotion intervention led to increased self-reported condom use up to 6 months
Nonoxynol-9 spermicide for prevention of vaginally acquired HIV and other sexually transmitted infections: systematic review and meta-analysis of randomised controlled trials including more than 5000 women.
Wilkinson, David; Tholandi, Maya; Ramjee, Gita; Rutherford, George W
We aimed to determine the effectiveness of the vaginally administered spermicide nonoxynol-9 (N-9) among women for the prevention of HIV and other sexually transmitted infections (STIs). We did a systematic review of randomised controlled trials. Nine such trials including 5096 women, predominantly sex workers, comparing N-9 with placebo or no treatment, were included. Primary outcomes were new HIV infection, new episodes of various STIs, and genital lesions. Five trials included HIV and nine included STI outcomes, and all but one (2% of the data) contributed to the meta-analysis. Overall, relative risks of HIV infection (1.12, 95% confidence interval 0.88-1.42), gonorrhoea (0.91, 0.67-1.24), chlamydia (0.88, 0.77-1.01), cervical infection (1.01, 0.84-1.22), trichomoniasis (0.84, 0.69-1.02), bacterial vaginosis (0.88, 0.74-1.04) and candidiasis (0.97, 0.84-1.12) were not significantly different in the N-9 and placebo or no treatment groups. Genital lesions were more common in the N-9 group (1.18, 1.02-1.36). Our review has found no statistically significant reduction in risk of HIV and STIs, and the confidence intervals indicate that any protection that may exist is likely to be very small. There is some evidence of harm through genital lesions. N-9 cannot be recommended for HIV and STI prevention. PMID:12383611
... 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 ...
CHIAO, CHI; MORISKY, DONALD E.; ROSENBERG, RHONDA; KSOBIECH, KATE; MALOW, ROBERT
The HIV/Sexually Transmitted Infection (STI) risk associated with alcohol use between female commercial sex workers (FCSWs) and their customers has been understudied. We examined this relationship for 1,114 FCSWs aged 15–54 with data collected during the baseline study period (1994 to 1998) in four southern provinces of the Philippines. Two alcohol-related risk situations during commercial sex episodes were examined: prior alcohol use by an FCSW and perceived intoxication in a customer. The influence of sociodemographic variables on sexual risk behaviors was also studied. Multiple sexual risk behaviors were observed with more frequency for FCSWs if alcohol was used before commercial sex or if the episode involved a customer perceived to be intoxicated. Forty-two percent of FCSWs who had sex with an intoxicated customer were STI positive, significantly more than FCSWs who did not have sex with an intoxicated customer (28%, p < .01). Similar significant differences were found for FCSWs who did not consume alcohol before having sex and were STI positive (29%) versus FCSW who did consume alcohol before sex and were STI positive (33%, p < .01). Our analyses reinforce accumulating evidence in the field that sexual risk reduction interventions need to go beyond the behaviors of individual FCSWs to meet the layering of risks such as observed in this study. Multilevel strategies targeting customer substance use and other situational and structural factors have proven to be pivotal mediators in our other research with this population. These experiences and the limitations of this study are discussed. PMID:17002991
Sullivan, John T; Belloir, Joseph A
Injection of crude lipopolysaccharide (LPS) from Escherichia coli into the hemocoel of Biomphalaria glabrata stimulates cell proliferation in the amebocyte-producing organ (APO). However, it is not known if mitogenic activity resides in the lipid A or O-polysaccharide component of LPS. Moreover, the possible role of substances that commonly contaminate crude LPS and that are known to stimulate innate immune responses in mammals, e.g., peptidoglycan (PGN), protein, or bacterial DNA, is unclear. Therefore, we tested the effects of the following injected substances on the snail APO: crude LPS, ultrapurified LPS (lacking lipoprotein contamination), two forms of lipid A, (diphosphoryl lipid A and Kdo2-lipid A), O-polysaccharide, Gram negative PGN, both crude and ultrapurified (with and without endotoxin activity, respectively), Gram positive PGN, PGN components Tri-DAP and muramyl dipeptide, and bacterial DNA. Whereas crude LPS, ultrapurified LPS, and crude PGN were mitogenic, ultrapurified PGN was not. Moreover, LPS components, PGN components, and bacterial DNA were inactive. These results suggest that it is the intact LPS molecule which stimulates cell division in the APO. PMID:24113288
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
Mary McFarlane; Sheana S Bull; Cornelis A Rietmeijer
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 information
Morisky, Donald E.; Stein, Judith A.; Chiao, Chi; Ksobiech, Kate; Malow, Robert
The authors assessed the relative impact of structural and social influence interventions on reducing sexually transmitted infections (STIs) and HIV risk behavior among female sex workers in the Philippines (N = 897). Four conditions included manager influence, peer influence, combined manager–peer influence, and control. Intervention effects were assessed at the establishment level in multilevel models because of statistical dependencies among women employed within the same establishments. Control group membership predicted greater perceived risk, less condom use, less HIV/AIDS knowledge, and more negative condom attitudes. Combination participants reported more positive condom attitudes, more establishment policies favoring condom use, and fewer STIs. Manager-only participants reported fewer STIs, lower condom attitudes, less knowledge, and higher perceived risk than peer-only participants. Because interventions were implemented at the city level, baseline and follow-up city differences were analyzed to rule out intervention effects due to preexisting differences. PMID:17014277
Characteristics of substance abuse treatment programs providing services for HIV/AIDS, hepatitis C virus infection, and sexually transmitted infections: The National Drug Abuse Treatment Clinical Trials Network
Brown, Lawrence S.; Kritz, Steven Allan; Goldsmith, R. Jeffrey; Bini, Edmund J.; Rotrosen, John; Baker, Sherryl; Robinson, Jim; McAuliffe, Patrick
Illicit drug users sustain the epidemics of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), hepatitis C (HCV), and sexually transmitted infections (STIs). Substance abuse treatment programs present a major intervention point in stemming these epidemics. As a part of the “Infections and Substance Abuse” study, established by the National Drug Abuse Treatment Clinical Trials Network, sponsored by National Institute on Drug Abuse, three surveys were developed; for treatment program administrators, for clinicians, and for state and District of Columbia health and substance abuse department administrators, capturing service availability, government mandates, funding, and other key elements related to the three infection groups. Treatment programs varied in corporate structure, source of revenue, patient census, and medical and non-medical staffing; medical services, counseling services, and staff education targeted HIV/AIDS more often than HCV or STIs. The results from this study have the potential to generate hypotheses for further health services research to inform public policy. PMID:16716846
Yavorsky, Risa L.; Hollman, Dominic; Steever, John; Soghomonian, Christine; Diaz, Angela; Strickler, Howard; Schlecht, Nicolas; Burk, Robert D.; Ochner, Christopher N.
Background Sexually transmitted infections (STIs) are common among adolescents, and multiple STIs over one’s lifetime can increase health risks. Few studies have assessed lifetime STI prevalence. This study evaluates minority, underserved adolescents’ self-reported lifetime STI history and objective STI rates. Methods Lifetime STI rates of female patients at an urban adolescent health center were obtained from self-administered questionnaires. Additionally, STI test results were retrieved from electronic medical records. Results Patients reported a high lifetime prevalence of STIs. By comparing self-report and objective data, underreporting was identified for chlamydia, gonorrhea, and herpes. Conclusions STI rates in at-risk adolescent females are higher than in the general population and remain elevated over time. Lifetime STI reports could expand our understanding of sexual health and should be further studied. Underreporting, which may increase health risks and hinder health care delivery, requires further investigation. Improvements in STI screening and prevention targeting at-risk populations are warranted. PMID:24807980
Chow, Eric P. F.; Fehler, Glenda; Chen, Marcus Y.; Bradshaw, Catriona S.; Denham, Ian; Law, Matthew G.; Fairley, Christopher K.
Background The frequency of testing sex workers for sexually transmitted infections (STIs) in Victoria, Australia, was changed from monthly to quarterly on 6 October 2012. Our aim was to determine the impact of this change to the clients seen at the Melbourne Sexual Health Centre (MHSC). Methods Computerised medical records of all clients attending at MHSC from 7 October 2011 to 7 October 2013 were analysed. Results Comparing between the monthly and quarterly testing periods, the number of consultations at MSHC with female sex workers (FSW) halved from 6146 to 3453 (p<0.001) and the consultation time spent on FSW reduced by 40.6% (1942 h to 1153 h). More heterosexual men (p<0.001), and women (p<0.001) were seen in the quarterly testing period. The number of STIs diagnosed in the clinic increased from 2243 to 2589 from the monthly to quarterly period, respectively [15.4% increase (p<0.001)]. Up to AU$247,000 was saved on FSW testing after the shift to quarterly testing. Conclusions The change to STIs screening frequency for sex workers from monthly to quarterly resulted in a 15% increase in STI diagnoses in the clinic and approximate a quarter of a million dollars was diverted from FSW testing to other clients. Overall the change in frequency is likely to have had a beneficial effect on STI control in Victoria. PMID:25048817
Zhu, Bang-Yong; Bu, Jin; Huang, Pei-Yong; Zhou, Zhi-Guang; Yin, Yue-Ping; Chen, Xiang-Sheng; Wei, Wan-Hui; Zhong, Ming-Ying; Wang, Hong-Chu; Wang, Hong; Gan, Quan
This study assessed the epidemiology of sexually transmitted infections (STIs), HIV, and associated risk factors among female sex workers (FSWs) in Guangxi autonomous region, China. A cross-sectional study of 488 FSWs was conducted using a structured questionnaire to collect sociodemographic and behavioral information. Biological specimens from subjects were sampled to detect various STIs and HIV infection. Among FSWs, the prevalence rates of syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, genital herpes, condyloma acuminate, and HIV were 7.2%, 1.8%, 18.2%, 0.4%, 2.3%, and 0.8%, respectively. The prevalence rates of single, double, and triple infections were 22.3%, 3.9%, and 0.20%, respectively. Multivariate analysis indicated that STIs and HIV infection was independently related to low education level (OR = 7.244; 95% CI = 3.031-17.213; P < 0.001), low knowledge of STIs/HIV (OR = 0.191; 95% CI = 0.108-0.337; P < 0.001), low-grade working place (OR = 1.64; 95%CI = 1.016-2.648; P = 0.046), and no condom use during the last sexual intercourse (OR = 0.199; 95% CI = 0.113-0.350; P < 0.001). The prevalence of STIs is high among FSWs in Guangxi, is accompanied by a 0.8% HIV-positive rate, and may be largely related to high-risk sexual behaviors. Future interventions should be focused on the reduction of risk factors, including promotion of condom use and improvement of knowledge of STIs and HIV among FSWs. PMID:22274163
Effectiveness of interventions for the prevention of HIV and other sexually transmitted infections in female sex workers in resource poor setting: a systematic review: Systematic review: effectiveness of HIV interventions
Maryam Shahmanesh; Vikram Patel; David Mabey; Frances Cowan
Summary objective To systematically review the evidence for effectiveness of HIV and sexually transmitted infection (STI) prevention interventions in female sex workers in resource poor settings. method Published and unpublished studies were identified through electronic databases (Cochrane database, Medline, Embase, and Web of Science), hand searching and contacting experts. Randomized- controlled-trials and quasi-experimental studies were included if they were conducted
Richard Crosby; Jami S Leichliter; Robert Brackbill
Background: Although adolescent use of condoms has been increasing, incidence of sexually transmitted diseases (STDs) among young people remains high. To identify adolescent behavioral risk factors for acquiring STDs, this study assessed adolescent self-reports of acquired chlamydia, gonorrhea, syphilis, and trichomoniasis within 1 year after a baseline interview.Methods: We used data from the National Longitudinal Survey of Adolescent Health for
Hemalatha, R.; Kumar, R. Hari; Venkaiah, K.; Srinivasan, K.; Brahmam, G.N.V.
Background & objectives: As part of the baseline survey carried out during 2005-06, biological and behavioural data were generated on about 3200 female sex workers (FSWs), from eight districts of Andhra Pradesh (AP), India. This study describes the relationship between socio-demographic and behavioural factors with consistent condom use (CCU) and HIV among FSWs in AP. Methods: A cross-sectional community-based study was conducted among female sex workers (FSW) in eight districts of Andhra Pradesh, India, using conventional cluster sampling and time-location cluster sampling. Key risk behaviours and STIs related to the spread of HIV were assessed. Blood samples were collected to detect syphilis, Herpes simplex virus type 2 (HSV-2) Chlamydia trachomatis (CT), Neiserria gonorrhoeae (NG) and HIV serology. Results: About 70 per cent of the FSWs were illiterates, nearly 50 per cent were currently married and 41 per cent of the FSWs had sex work as the sole source of income. More than 95 per cent of the FSWs heard of HIV, but about 99 per cent believed that HIV/AIDS cannot be prevented. Logistic regression analysis showed significantly lesser CCU with high client volume, not carrying condom and could not use condom in past 1 month due to various reasons such as non co-operation by the clients. Similarly, CCU was significantly (P<0.001) lesser (only 8.9%) with regular non-commercial partners. Overall there was 16.3 per cent prevalence of HIV amongst FSWs. C. trachomatis and N. gonorrheae were prevalent in 3.4 and 2 per cent of the FSWs, respectively and about 70 per cent of the FSWs were positive for HSV2 serology. HIV was significantly associated with STIs. Interpretation & conclusions: Misconception that HIV/AIDS cannot be prevented is very high. Most of the subjects in the present study had first sexual debut at a very young age. HIV was associated with STIs, emphasizing aggressive STI diagnosis and treatment. CCU must be emphasized right from first sexual debut with all clients and non-commercial partners as well. PMID:22089609
Jennings, Jacky M.; Woods, Stacy E.; Curriero, Frank C.
This study examined temporal and spatial relationships between neighborhood drug markets and gonorrhea among census block groups from 2002 to 2005. This was a spatial, longitudinal ecologic study. Poisson regression was used with adjustment in final models for socioeconomic status, residential stability and vacant housing. Increased drug market arrests were significantly associated with a 11% increase gonorrhea (Adjusted Relative Risk (ARR) 1.11; 95% CI 1.05, 1.16). Increased drug market arrests in adjacent neighborhoods were significantly associated with a 27% increase in gonorrhea (ARR 1.27; 95% CI 1.16, 1.36), independent of focal neighborhood drug markets. Increased drug market arrests in the previous year in focal neighborhoods were not associated with gonorrhea (ARR 1.04; 95% CI 0.98, 1.10), adjusting for focal and adjacent drug markets. While the temporal was not supported, our findings support an associative link between drug markets and gonorrhea. The findings suggest that drug markets and their associated sexual networks may extend beyond local neighborhood boundaries indicating the importance of including spatial lags in regression models investigating these associations. PMID:23872251
Abu-Rajab, K; Scoular, A; Church, S; Connell, J; Winter, A; Hart, G
We applied the principles of Hazard Analysis and Critical Control Points (HACCP) to systematically analyse the care pathway of patients diagnosed with gonorrhoea to identify potential intervention opportunities for preventive action. Data were collected on individuals with culture-positive gonococcal infection during 27 February 2003 to 08 January 2004. Qualitative data were gathered within individual semi-structured interviews. Two hundred and twenty-three gonorrhoea patient episodes were evaluated. The median interval between presentation and treatment was significantly longer in females and men having sex with men (MSM), compared with heterosexual men (P = 0.002). Females were significantly more likely to be in regular relationships at the timepoint of perceived infection acquisition than heterosexuals or MSM (P < 0.0001). Four major themes emerged from the interviews: life-stage and infection risk, determinants of risk perception around sexual encounters, attitudes to preventing re-infection and condom use. These informed three potential 'critical control points': health-related attitudes/behaviours preceding infection; access to appropriate care and optimizing health promotion to prevent further infection. PMID:19255264
In England, a comparison of the number of newly reported cases of sexually transmitted diseases for the years ending June 30, 1977 and 1978 indicated that during the latter year there was an increase in the incidence of early and late syphilis, genital candidosis, genital herpes, simplex, and nonspecific genital infection and a slight decline in the incidence of gonorrhea. During the year ending June 30, 1978, early syphilis increased 5.4% among men and 11.8% among women, and the number of cases/100,000 population was 10.18 for men and 1.91 for women. The reported number of new cases of late syphilis increased 15.8% during that same year, and the number of new cases/100,000 was 4.32 for men 1.90 for women. Gonorrhea cases decreased by 2.5% among men and by 3.3% among women, and the number of new cases/100,000 was 160.55 for men and 89.23 for women. The number of new cases of chancroid increased slightly, and there were 0.11 cases /100,000 population. Nonspecific genital infections increased for the total population by 2.2%; however, the rate among women declined by 2.1% and among men increased by 3.4%. The number of new cases of herpes simplex/100,000 population was 22.50 for men and 12.25 for women. 4 tables provided information on 1) the number of new reported cases for the years ending in June 30, 1977 and 1978 and the incidence rates for 1974-78 for syphilis, gonorrhea, and chancroid and 2) incidence rates for the years ending on June 1974-78 for other sexually transmitted diseases. During the year ending June 30, 1978, a total of 518,839 persons, representing a 2% increase over the previous year, presented at hospital clinics for venereal disease checkups. 5% of these individuals were noninfected. During 1978, progress was made in training more workers and expanding facilities for tracing individuals who had contact with persons known to have venereal disease. In addition, the genitourinary medical staff at facilities in England and Wales increased from 203-211 between 1977-78. 101 of these staff members were consultants. Consultants, according to the Special Advisory Committee in Genitourinary Medicine of the Royal College of Physicians should be members of the Royal College of Physicians and have 4 years of training at the senior registrar level. This requirement has been relaxed somewhat, however, due to recruitment difficulties. Requirement of male nurses is still inadedquate. In regard to progress in education and training personnel to work in the venereal disease area, a Department of Genitourinary Medicine is being established at the Middlesex Hospital Medical School of London University. British physicians played an active role in several international conferences on sexually transmitted diseases in 1978, and the Department of Health and Social Security continued to provide funds for health professionals to visit veneral disease centers in other countries in order to learn about new techniques for diagnosing and treating veneral disease. PMID:6893565
Oyekale, Abayomi Samuel
Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), are among the major public health challenges in Cameroon. This paper determined the effect of men’s sex-related behaviors and HIV knowledge on reported STIs. The data came from the 2012 Cameroon’s Demographic and Health Survey (DHS) that were collected from 7191 respondents in 2012. Descriptive and logistic regression methods were used for data analysis. Results showed that majority of the respondents were aware of STIs and Acquired Immune Deficiency Syndrome (AIDS), while 3.96% reported STIs. Also, 49.45% of the men had no wife, while 75.58% and 84.58% noted that condoms and keeping of one partner could be used to prevent HIV transmission, respectively. Wrong impressions that mosquito bites and sharing of food could lead to HIV infection were held by 31.94% and 12.44% of the men, respectively. Among those that reported STIs, 33.33%, 30.18% and 13.33% respectively used condom during sex with most recent partner, second to most recent partner and third to most recent partner, compared to 24.69%, 15.04% and 4.17% among those that did not report STIs. Logistic regression results showed that probability of STI increased significantly (p < 0.05) with condom use with third most recent partners, being married, wrong knowledge that mosquito bites cause HIV and being away for more than one month, while it significantly reduced (p < 0.05) with number of children, knowledge that having one partner prevents STIs. It was concluded that policy initiatives and programmes to enhance right sexual knowledge and behavior among men would go a long way in reducing STI incidence in Cameroon. PMID:25500999
Robertson, Angela M; Syvertsen, Jennifer L; Ulibarri, Monica D; Rangel, M Gudelia; Martinez, Gustavo; Strathdee, Steffanie A
Female sex workers (FSWs) acquire HIV and other sexually transmitted infections (STIs) through unprotected sex with commercial and non-commercial (intimate) male partners. Little research has focused on FSWs' intimate relationships, within which condom use is rare. We sought to determine the prevalence and correlates of HIV/STIs within FSWs' intimate relationships in Northern Mexico. From 2010 to 2011, we conducted a cross-sectional survey of FSWs and their non-commercial male partners in Tijuana and Ciudad Juárez, Mexico. Eligible FSWs and their verified male partners were aged ?18 years; FSWs reported lifetime use of heroin, cocaine, crack, or methamphetamine and recently exchanged sex (past month). Participants completed baseline questionnaires and testing for HIV, chlamydia, gonorrhea, and syphilis. We determined the prevalence and correlates of individuals' HIV/STI positivity using bivariate probit regression. Among 212 couples (n?=?424), prevalence of HIV was 2.6 % (n?=?11). Forty-two (9.9 %) tested positive for any HIV/STIs, which was more prevalent among women than men (12.7 % vs. 7.1 %, p?0.05). FSWs with regular sex work clients were less likely to test positive for HIV/STIs than those without regular clients. Similarly, male partners of FSWs who had regular clients were 9 % less likely to have HIV/STIs. Higher sexual decision-making power was protective against HIV/STIs for women. Men who recently used methamphetamine or reported perpetrating any conflict within steady relationships were more likely to test positive for HIV/STIs. Within FSWs' intimate relationships in two Mexican-US border cities, nearly one in ten partners tested positive for HIV/STIs. Couple-based prevention interventions should recognize how intimate relationship factors and social contexts influence HIV/STI vulnerability. PMID:24488651
Liu, Xiao-Yan; Hao, Chao; Jiang, Hui; Sun, Lin; Zhou, Jian-Bo; Yin, Yue-Ping; Tang, Weiming; Jiang, Ning; Mahapatra, Tanmay; Mahapatra, Sanchita; Chen, Xiang-Sheng; Yang, Hai-Tao; Fu, Geng-Feng; Huan, Xi-Ping
Objectives To estimate the prevalence of HIV and syphilis, incidence of syphilis and to identify the correlates of syphilis infection among heterosexual male attendees of sexually transmitted infection (STI) clinics (MSC). Methods A cohort study of one-year duration was conducted in Yangzhou and Changzhou cities in Jiangsu province of China. The baseline survey commenced in June 2009, recruited 1225 consenting adult MSCs (609 in Yangzhou and 617 in Changzhou) through STI-clinic based convenience sampling. Results Baseline HIV and syphilis prevalence were 0.49% and 17.29% respectively. Syphilis incidence rate was 7.22 per 100 person-years (6.53 in Yangzhou and 7.76 in Changzhou) during the 6-month follow-up with retention fractions of 27.38% and 35.15% for Yangzhou and Changzhou respectively. Majority of the participants were middle-aged, high school educated, married, living with partners and non-migrants. Very few subjects reported recent and consistent condom-use with regular partners. Although considerable number of MSCs reported recent sexual exposure with female sex workers (FSW) and non-FSW casual partners, the proportion of reported condom use was very low during those exposures. In multivariate analyses higher age, having recent sex with FSWs and being HIV-positive were associated with higher syphilis sero-positivity while higher education was protective. In bivariate analyses, being married, divorced/widowed, official residency of the study cities and non-use of condom with regular partners predicted higher risk. Conclusions Considering the potential bridging role of MSCs between high and low-risk populations, effective intervention strategies among them targeting the correlates of syphilis infection are urgently called for in Jiangsu province of China. PMID:24743839
Background Papua New Guinea (PNG) has a high burden of sexually transmitted infections (STIs) and the highest adult HIV prevalence in the Pacific region. Despite this burden of disease, heterosexual anal intercourse (HAI) has rarely been considered. Given the increasing number of, and interest in, behavioural surveys in PNG and the changing nature of PNG’s HIV epidemic, it is timely to conduct a systematic review of HAI in PNG order to improve sexual health. Methods We performed a systematic review of HAI in PNG as reported in peer-reviewed and non-peer-reviewed publications for the period 1950–May 2012. The search strategy identified 475 publications. After screening by geographical location, topic and methodology, we identified 23 publications for full text review, following which 13 publications were included in the final review. Using data from the review, we performed a risk equation analysis to demonstrate the potential impact of HAI on HIV acquisition and incidence in PNG. Results There is a paucity of well-informed behavioural research on HAI in PNG. Inconsistency in key questions on HAI made it impossible to conduct a meta-analysis. The data available on HAI shows that it is practiced in all geographical areas and among all populations. Of those who reported HAI, rates varied from as low as 8% to as high as 77% depending on the recall period and partner type. Condom use during HAI was consistently low. Our risk equation analysis indicates that even if only 20% of females engage in HAI, and only 10% of sex acts involve HAI, the total number of new HIV infections among females would be 40% greater than if vaginal intercourse only occurred. Conclusions Our findings of indicate that HAI may be an important driver of the HIV epidemic in PNG. In order to improve the sexual health of Papua New Guineans, efforts are required to improve behavioural surveillance of HAI as well as develop national HIV/STI programing and policy to better address the risks associated with unprotected HAI. PMID:24289271
Wen, Yi; Guan, Jihui; Wu, Zunyou; Li, Li; Rotheram-Borus, Mary Jane; Lin, Chunqing; Detels, Roger
Background Pharmacies play a special role in providing treatment services for patients with sexually transmitted diseases (STDs) in China. There is a need to study the STD/human immunodeficiency virus (HIV) knowledge among pharmacy workers in retail pharmacies. Method A total of 200 pharmacy workers were recruited from 120 randomly selected retail pharmacies in Fuzhou, China. A self-administrated questionnaire was used to collect information of demographics, working experience, pharmacy structure and clientele profile, and pharmacy workers’ attitudes toward traditional Chinese folk remedies and their STD/HIV knowledge. Results Work-related training during the past 6 months, holding pharmacist license, and years of being a pharmacy worker showed significant association with STD/HIV knowledge. Work-related training also significantly associated with provision of consultation. Years of education and medical training, however, failed to show significant association with STD/HIV knowledge. Conclusions In order to improve service quality and avoid misdiagnosis and inappropriate treatment of STD/HIV, on-the-job training or continuous education for pharmacy workers should be required, implemented, and monitored as part of the national effort for STD control and treatment. PMID:19265742
Roth, A M; Rosenberger, J G; Reece, M; Van Der Pol, B
Routine screening is a key component of sexually transmitted infection (STI) prevention and control; however, traditional programmes often fail to effectively reach men and women in hidden communities. To reduce prevalence, we must understand the programmatic features that would encourage utilization of services among asymptomatic individuals. Using incentivized snowball sampling, 44 women and men recently engaging in transactional sex were recruited (24 women, 20 men); median age 37 years. Respondents were offered the opportunity to collect genital, oropharyngeal and rectal samples for STI testing and completed a face-to-face interview about their experience with self-obtained sampling. Interviews were analysed using qualitative methods. Participants were unaware of potential risk for STI, but found self-sampling in non-clinical settings to be acceptable and preferable to clinic-based testing. All participants collected genital specimens; 96% and 4% collected oropharyngeal and rectal specimens, respectively. The burden of disease in this population was high: 38% tested positive for at least one STI. We detected multiple concomitant infections. Incorporating field collection of self-obtained samples into STI control programmes may increase utilization among high-risk populations unlikely to access clinic-based services. High infection rates indicate that individuals engaging in transactional sex would benefit from, and be responsive to, community-based self-sampling for STI screening. PMID:23970665
Muessig, Kathryn E; Smith, M Kumi; Maman, Suzanne; Huang, Yingying; Chen, Xiang-Sheng
Despite widespread biomedical advances in treatment and prevention, HIV and other sexually transmitted infections (STI) continue to affect a large portion of the world's population. The profoundly social nature of behaviorally driven epidemics and disparities across socioeconomic divides in the distribution of HIV/STI and care outcomes emphasize the need for innovative, multilevel interventions. Interdisciplinary approaches to HIV/STI control are needed to combine insights from the social and biological sciences and public health fields. In this concluding essay to a Special Issue on HIV/STI in south China, we describe the evolution of the region's HIV/STI epidemics and the government response, then synthesize findings from the 11 studies presented in this issue to extend seven recommendations for future HIV/STI prevention and care research in China. We discuss lessons learned from forging international collaborations between the social and biological sciences and public health to inform a shared research agenda to better meet the needs of those most affected by HIV and other STI. PMID:24443101
Phrasisombath, Ketkesone; Thomsen, Sarah; Hagberg, Jan; Sychareun, Vanphanom; Faxelid, Elisabeth
This study aimed to assess the knowledge and attitudes among health care providers (HCPs) providing sexually transmitted infection (STI) service to female sex workers (FSWs). A cross-sectional survey was performed in 6 districts along Road 9, traversing Savannakhet province from Thailand to Vietnam. In total, 244 HCPs providing STI services were interviewed. In all, 54% of respondents had no STI training despite providing STI treatment. Misperceptions of STI causes, transmission routes, and symptoms were common among respondents. Attitudes differed neither between male and female respondents nor between those who had or had not received STI training. A higher proportion of pharmacists/drug sellers (68%) had negative attitudes followed by medical doctors (59%) and nurse/midwives (55%). The proportion of herbalists with negative attitudes (53%) was less in comparison with the other professionals. To improve the quality of STI services and to enhance FSWs' access to health care services, educational improvements of HCPs' knowledge about STIs and their attitudes are needed. PMID:21807620
Dehne, K. L.; Snow, R.; O'Reilly, K. R.
It has been widely believed that, by combining the services for preventing and treating sexually transmitted infections (STI) with those for family planning (FP), STI coverage would increase and the combined service would be of higher quality and more responsive to the needs of women. So far, there is little concrete evidence that integration has had such an impact. Besides the absence of documentation, a clear definition of integration is lacking. We therefore carried out a comprehensive review of concrete experiences with integrated services, and present a summary of our findings in this article. The results indicate that the tasks of STI prevention, such as education for risk reduction and counselling, have been integrated into family planning services much more frequently than the tasks of STI diagnosis and treatment. Some STI/FP integration efforts appear to have been beneficial, for instance when the integration of STI/HIV prevention had a positive impact on client satisfaction, and on the acceptance of family planning. Less clear is whether STI prevention, when concentrated among traditional FP clients, is having a positive impact on STI risk behaviours or condom use. A few projects have reported increases in STI caseloads following integration. In some projects, FP providers were trained in STI case management, but few clients were subsequently treated. PMID:10859857
Roth, A M; Rosenberger, J G; Reece, M; Van Der Pol, B
Summary Routine screening is a key component of sexually transmitted infection (STI) prevention and control; however, traditional programmes often fail to effectively reach men and women in hidden communities. To reduce prevalence, we must understand the programmatic features that would encourage utilization of services among asymptomatic individuals. Using incentivized snowball sampling, 44 women and men recently engaging in transactional sex were recruited (24 women, 20 men); median age 37 years. Respondents were offered the opportunity to collect genital, oropharyngeal and rectal samples for STI testing and completed a face-to-face interview about their experience with self-obtained sampling. Interviews were analysed using qualitative methods. Participants were unaware of potential risk for STI, but found self-sampling in non-clinical settings to be acceptable and preferable to clinic-based testing. All participants collected genital specimens; 96% and 4% collected oropharyngeal and rectal specimens, respectively. The burden of disease in this population was high: 38% tested positive for at least one STI. We detected multiple concomitant infections. Incorporating field collection of self-obtained samples into STI control programmes may increase utilization among high-risk populations unlikely to access clinic-based services. High infection rates indicate that individuals engaging in transactional sex would benefit from, and be responsive to, community-based self-sampling for STI screening. PMID:23970665
Bacterial vaginosis is a common cause of malodorous vaginal discharge. It is also associated with sexually transmitted infections and adverse pregnancy outcomes. The magnitude of the gynecological and obstetrical consequences has stimulated therapeutic research and led to the testing of several therapies. The objective of this work is to present the currently available therapeutic strategies for the treatment of bacterial vaginosis and associated recommendations, and discuss the emerging therapies. PMID:21976983
Moreno-García, Miguel; Vargas, Valeria; Ramírez-Bello, Inci; Hernández-Martínez, Guadalupe; Lanz-Mendoza, Humberto
Gender differences in the immune response of insects are driven by natural selection for females and sexual selection for males. These natural forces entail a multitude of extrinsic and intrinsic factors involved in a genotype-environment interaction that results in sex-biased expression of the genes shared by males and females. However, little is known about how an infection at a particular ontogenetic stage may influence later stages, or how it may impact sexual immune dimorphism. Using Aedes aegypti mosquitoes, the aim of the present study was to analyze the effect of a bacterial exposure at the larval stage on adult immunity in males and females. The parameters measured were phenoloxidase activity, nitric oxide production, antimicrobial activity, and the antimicrobial peptide transcript response. As a measure of the immune response success, the persistence of injected bacteria was also evaluated. The results show that males, as well as females, were able to enhance survival in the adult stage as a result of being exposed at the larval stage, which indicates a priming effect. Moreover, there was a differential gender immune response, evidenced by higher PO activity in males as well as higher NO production and greater antimicrobial activity in females. The greater bacterial persistence in females suggests a gender-specific strategy for protection after a previous experience with an elicitor. Hence, this study provides a primary characterization of the complex and gender-specific immune response of male and female adults against a bacterial challenge in mosquitoes primed at an early ontogenetic stage. PMID:26181517
Vide?nik Zorman, Jerneja; Mati?i?, Mojca; Jeverica, Samo; Smrkolj, Tomaž
Prostate inflammation is a common syndrome, especially in men under 50. It usually presents with voiding symptoms and pain in the genitourinary area, and sometimes as sexual dysfunction. Based on clinical and laboratory characteristics, prostatitis is classified as acute bacterial prostatitis, chronic bacterial prostatitis, chronic inflammatory and non-inflammatory prostatitis or chronic pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Bacterial prostatitis is most often caused by infection with uropathogens, mainly Gram-negative bacilli, but Gram-positive and atypical microorganisms have also been identified as causative organisms of chronic prostatitis. According to reports by several authors, Chlamydia trachomatis and Trichomonas vaginalis are some of the most common pathogens, making chronic prostatitis a sexually transmitted disease. Diagnosis and treatment of acute and chronic bacterial prostatitis in particular can be challenging. PMID:26086164
Background The incidences of reportable sexually transmitted infections (STI) among men who have sex with men (MSM) have increased since the late 1990 s in Norway. The objectives of our study were to assess factors, associated with recent selected STI among MSM, living in Norway in order to guide prevention measures. Methods We conducted a cross-sectional Internet-based survey during 1-19 October 2007 among members of a MSM-oriented Norwegian website using an anonymous questionnaire on demographics, sexual behaviour, drug and alcohol use, and STI. The studied outcomes were gonorrhoea, syphilis, HIV or Chlamydia infection in the previous 12 months. Associations between self-reported selected STI and their correlates were analysed by multivariable Poisson regression. P value for trend (p-trend), adjusted prevalence ratios (PR) with 95% confidence intervals  were calculated. Results Among 2430 eligible 16-74 years old respondents, 184 (8%) reported having had one of the following: syphilis (n = 17), gonorrhoea (n = 35), HIV (n = 42) or Chlamydia (n = 126) diagnosed in the past 12 months. Reporting Chlamydia was associated with non-western background (PR 2.8 [1.4-5.7]), number of lifetime male partners (p-trend < 0.001), unsafe sex under the influence of alcohol (PR 1.8 [1.1-2.9]) and with younger age (p-trend = 0.002). Reporting gonorrhoea was associated with unrevealed background (PR 5.9 [1.3-26.3]), having more than 50 lifetime male partners (PR 4.5 [1.3-15.6]) and more than 5 partners in the past 6 months (PR 3.1 [1.1-8.8]), while mid-range income was protective (PR 0.1 [0.0-0.6]). Reporting HIV was associated with residing in Oslo or Akershus county (PR 2.3 [1.2-4.6]), non-western background (PR 5.4 [1.9-15.3]), unrevealed income (PR 10.4 [1.5-71.4]), number of lifetime male partners (p-trend < 0.001) and being under the influence of selected drugs during sex in the past 12 months (PR 5.2 [2.7-11.4]). In addition, the frequency of feeling drunk was reversibly associated with HIV. Conclusions Our study demonstrates different associations of demographic and behavioural factors with different STI outcomes in the study population. Number of lifetime male partners was the most important potential predictor for Chlamydia and HIV. The STI prevention efforts among MSM should focus on Oslo and Akershus, promote safe sex practices and tackle sex-related drug and alcohol use. PMID:20815931
Background Prompt, correct diagnosis and treatment with health information are essential components of reproductive tract infection (RTI) and sexually transmitted infection (STI) services. This study aims to describe care seeking behaviour and barriers to accessing RTI/STI services among female sex workers (FSWs) in Laos. Methods A cross-sectional survey using closed and open-ended questions was performed in six districts along Road 9, traversing Savannakhet province from Thailand to Vietnam. In total, 407 FSWs were interviewed. The data were analyzed and presented descriptively. Multiple logistic regression analysis was applied to assess associations between respondents' background characteristics and care seeking behaviour. Results About half of the respondents (49%) were less than or equal to 19 years of age, and 50% had started or completed secondary school. Fifty-eight percent had been engaged in sex work for less than 1 year. Eighty-six percent of the respondents reported RTI/STI signs or symptoms currently or in the last 3 months but only two-thirds of those with symptoms sought treatment. Source of treatment for the last RTI/STI episode was the drop-in centre (53%) followed by a public hospital (23%), private clinic (12%), private pharmacy (9%), and herbalist (2%). The main barriers to service use were long waiting time, inconvenient location of the clinic, not knowing where to get the services needed, and negative attitudes among healthcare providers. Care seeking behaviour was associated with longer duration of sex work (OR = 2.6, 95%CI 1.52-5.36). Forty-four percent received health information from peer educators, 34% from fellow friends, 26% from a pimp, and 26% had received information from a healthcare provider during the visit. Conclusion There were several barriers to accessing RTI/STI services and they were related to both structural and individual factors. Innovative STI service strategies to inform FSWs about the importance of early diagnosis and treatment should be established. Continuous training for STI service providers focusing on counseling skills and awareness of the sexual health care needs for FSWs is recommended in order to minimize the barriers experienced by FSWs in this particular setting. PMID:22333560
Musyoki, Helgar; Kellogg, Timothy A; Geibel, Scott; Muraguri, Nicholas; Okal, Jerry; Tun, Waimar; Fisher Raymond, H; Dadabhai, Sufia; Sheehy, Meredith; Kim, Andrea A
We conducted a respondent driven sampling survey to estimate HIV prevalence and risk behavior among female sex workers (FSWs) in Nairobi, Kenya. Women aged 18 years and older who reported selling sex to a man at least once in the past 3 months were eligible to participate. Consenting FSWs completed a behavioral questionnaire and were tested for HIV and sexually transmitted infections (STIs). Adjusted population-based prevalence and 95 % confidence intervals (CI) were estimated using RDS analysis tool. Factors significantly associated with HIV infection were assessed using log-binomial regression analysis. A total of 596 eligible participants were included in the analysis. Overall HIV prevalence was 29.5 % (95 % CI 24.7-34.9). Median age was 30 years (IQR 25-38 years); median duration of sex work was 12 years (IQR 8-17 years). The most frequent client-seeking venues were bars (76.6 %) and roadsides (29.3 %). The median number of clients per week was seven (IQR 4-18 clients). HIV testing was high with 86.6 % reported ever been tested for HIV and, of these, 63.1 % testing within the past 12 months. Of all women, 59.7 % perceived themselves at 'great risk' for HIV infection. Of HIV-positive women, 51.0 % were aware of their infection. In multivariable analysis, increasing age, inconsistent condom use with paying clients, and use of a male condom as a method of contraception were independently associated with unrecognized HIV infection. Prevalence among STIs was low, ranging from 0.9 % for syphilis, 1.1 % for gonorrhea, and 3.1 % for Chlamydia. The data suggest high prevalence of HIV among FSWs in Nairobi. Targeted and routine HIV and STI combination prevention strategies need to be scaled up or established to meet the needs of this population. PMID:25428282
Mohan, Harnalli L.; Bhattacharjee, Parinita; Chandrashekar, Sudha; Isac, Shajy; Wheeler, Tisha; Prakash, Ravi; Ramesh, Banadakoppa M.; Blanchard, James F.; Heise, Lori; Vickerman, Peter; Moses, Stephen; Watts, Charlotte
Objectives. We examined the impact of community mobilization (CM) on the empowerment, risk behaviors, and prevalence of HIV and sexually transmitted infection in female sex workers (FSWs) in Karnataka, India. Methods. We conducted behavioral–biological surveys in 2008 and 2011 in 4 districts of Karnataka, India. We defined exposure to CM as low, medium (attended nongovernmental organization meeting or drop-in centre), or high (member of collective or peer group). We used regression analyses to explore whether exposure to CM was associated with the preceding outcomes. Pathway analyses explored the degree to which effects could be attributable to CM. Results. By the final survey, FSWs with high CM exposure were more likely to have been tested for HIV (adjusted odd ratio [AOR]?=?25.13; 95% confidence interval [CI]?=?13.07, 48.34) and to have used a condom at last sex with occasional clients (AOR?=?4.74; 95% CI?=? 2.17, 10.37), repeat clients (AOR?=?4.29; 95% CI?=?2.24, 8.20), and regular partners (AOR?=?2.80; 95% CI?=?1.43, 5.45) than FSWs with low CM exposure. They were also less likely to be infected with gonorrhea or chlamydia (AOR?=?0.53; 95% CI?=?0.31, 0.87). Pathway analyses suggested CM acted above and beyond peer education; reduction in gonorrhea or chlamydia was attributable to CM. Conclusions. CM is a central part of HIV prevention programming among FSWs, empowering them to better negotiate condom use and access services, as well as address other concerns in their lives. PMID:24922143
Munson, Kimber L.; Napierala, Maureen; Schell, Ronald F.; Kramme, Timothy; Miller, Cheryl; Hryciuk, Jeanne E.
Trichomonas vaginalis infection in males has been largely uncharacterized. Past reports indicated increased susceptibility to other sexually transmitted infection (STI) agents such as human immunodeficiency virus and Neisseria gonorrhoeae with concurrent T. vaginalis infection. This warrants a more thorough review of male T. vaginalis incidence. A retrospective 3-year investigation of transcription-mediated amplification (TMA)-based urethral swab and first-void urine screening for T. vaginalis within a regional health care system was performed to address T. vaginalis prevalence in males. Of 622 total samples tested, 6.6% were positive for T. vaginalis. Delineation of all specimens by ZIP code of patient residence revealed 11 predominant ZIP codes with respect to testing volume and detection rates. Within these 11 ZIP codes, representing 78.3% of total testing volume, urine was the preferred specimen source compared to urethral swabs. Seven of these 11 ZIP codes contained majority African American populations. The aggregate T. vaginalis detection rate trended higher than that of the remaining four ZIP codes, which were comprised primarily of Caucasian populations (8.9% versus 5.0%, respectively; P = 0.15). The average age of a T. vaginalis-infected male (39.9 years) was significantly greater than those for Chlamydia trachomatis or N. gonorrhoeae (27.6 and 25.9 years, respectively; P < 0.001). Given the significant rate of T. vaginalis detection, with age distribution analogous to that reported in females, TMA-based detection of T. vaginalis can be a routine constituent within a comprehensive STI screening panel for males in high-prevalence STI communities. PMID:23100348
Semde, Gisèle; Sika, Lazare; Crucitti, Tania; Ettiegne Traore, Virginie; Buve, Anne; Laga, Marie
Objectives To assess condom use and prevalence of sexually transmitted infections (STI) and HIV among male sex workers (MSW) in Abidjan, Côte d'Ivoire. Methods A cross-sectional survey was conducted between October 2007 and January 2008 among MSW attending a sex worker clinic in Abidjan. A short questionnaire was administered in a face-to-face interview, and the participants were asked to provide a urine sample for STI testing and to self-collect transudate of the gingival mucosa for anonymous HIV testing, using a rapid test. A rectal swab for STI testing was taken by a physician. Molecular amplification assays were performed for the detection of Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis. Results 96 MSW participated in the survey, their median age was 27?years and the median duration of sex work was 5?years. Consistent condom use with clients during the last working day was 86.0%, and consistent condom use with the regular partner during the last week was 81.6%. HIV infection was detected in 50.0% of the participants. The prevalence of N gonorrhoeae was 12.8%, chlamydia infection was present in 3.2% and T vaginalis in 2.1% of the study participants. Conclusions HIV and STI rates found in this study confirm the high risk and vulnerability status of MSW in Côte d'Ivoire. There is a definite need for studies exploring risk and risk perceptions among MSW in more depth and for services tailored to their needs, including developing and validating simple algorithms for the diagnosis of STI in MSW and men who have sex with men. PMID:22328644
Chai, Shua Joshua; Aumakhan, Bulbulgul; Barnes, Mathilda; Jett-Goheen, Mary; Quinn, Nicole; Agreda, Patricia; Whittle, Pamela; Hogan, Terry; Jenkins, Wiley D.; Rietmeijer, Cornelis A.; Gaydos, Charlotte A.
Background Internet-based screening for sexually-transmitted infections (STIs) has been acceptable to women, and can reach high-risk populations. No prior literature describes internet-based screening for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in men. We studied whether internet-based screening was acceptable and reached a high-risk population, and what risk factors were associated with STI positivity. Methods The website, www.iwantthekit.org, encouraged men ? 14 years of age to request a home self-sampling kit and a questionnaire on risk factors and acceptability of internet-based screening. Penile swabs and urine samples were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis using a nucleic acid amplification test. Risk factors and acceptability were examined using chi-squared tests and logistic regression. Results Of 501 samples received for testing, 106 (21%) were positive for at least one STI, 64 (13%) for chlamydia, 4 (1%) for gonorrhea, and 49 (10%) for trichomonas. In multivariable analyses, age, race, household income, and frequency of condom use were independently associated with infection with at least one STI. Of respondents, 34% had a prior STI; 29% reported having a partner with an STI, but only 13% reported always using a condom. Seventy-seven percent of men preferred a self-administered specimen versus attending a clinic, 89% reported swab use was easy, and 89% would use internet-based screening again. Conclusions Men who access internet-based screening had known risk factors for STIs and had a high prevalence of infection. Internet-based screening was acceptable and could access these high-risk men, who might not otherwise be reached through traditional means. PMID:20644498
Guedj, M; Sastre, M T Muñoz; Mullet, E; Sorum, P C
Objective To determine under what conditions lay people and health professionals find it acceptable for a physician to breach confidentiality to protect the wife of a patient with a sexually transmitted disease (STD). Methods In a study in France, breaching confidentiality in 48 scenarios were accepted by 144 lay people, 10 psychologists and 7 physicians. The scenarios were all possible combinations of five factors: severity of the disease (severe, lethal); time taken to discuss this with (little time, much time); intent to inform the spouse about the disease (none, one of these days, immediately); intent to adopt protective behaviours (no intent, intent); and decision to consult an expert in STDs (yes, no), 2×2×3×2×2. The importance and interactions of each factor were determined, at the group level, by performing analyses of variance and constructing graphs. Results The concept of breaching confidentiality to protect a wife from her husband's STD was favoured much more by lay people and psychologists than by physicians (mean ratings 11.76, 9.28 and 2.90, respectively, on a scale of 0–22). The patient's stated intentions to protect his wife and to inform her of the disease had the greatest impact on acceptability. A cluster analysis showed groups of lay participants who found breaching confidentiality “always acceptable” (n?=?14), “depending on the many circumstances” (n?=?87), requiring “consultation with an expert” (n?=?30) and “never acceptable (n?=?13)”. Conclusions Most people in France are influenced by situational factors when deciding if a physician should breach confidentiality to protect the spouse of a patient infected with STD. PMID:16816043
Barriers and facilitators of sexually transmissible infection testing in remote Australian Aboriginal communities: results from the Sexually Transmitted Infections in Remote Communities, Improved and Enhanced Primary Health Care (STRIVE) Study.
Hengel, Belinda; Guy, Rebecca; Garton, Linda; Ward, James; Rumbold, Alice; Taylor-Thomson, Debbie; Silver, Bronwyn; McGregor, Skye; Dyda, Amalie; Knox, Janet; Kaldor, John; Maher, Lisa
Background Remote Australian Aboriginal communities experience high rates of bacterial sexually transmissible infections (STI). A key strategy to reduce STIs is to increase testing in primary health care centres. The current study aimed to explore barriers to offering and conducting STI testing in this setting. Methods: A qualitative study was undertaken as part of the STI in Remote communities, Improved and Enhanced Primary Health Care (STRIVE) project; a large cluster randomised controlled trial of a sexual health quality improvement program. We conducted 36 in-depth interviews in 22 participating health centres across four regions in northern and central Australia. Results: Participants identified barriers including Aboriginal cultural norms that require the separation of genders and traditional kinship systems that prevent some staff and patients from interacting, both of which were exacerbated by a lack of male staff. Other common barriers were concerns about client confidentiality (lack of private consulting space and living in small communities), staff capacity to offer testing impacted by the competing demands for staff time, and high staff turnover resulting in poor understanding of clinic systems. Many participants also expressed concerns about managing positive test results. To address some of these barriers, participants revealed informal strategies, such as team work, testing outside the clinic and using adult health checks. Conclusions: Results identify cultural, structural and health system issues as barriers to offering STI testing in remote communities, some of which were overcome through the creativity and enthusiasm of individuals rather than formal systems. Many of these barriers can be readily addressed through strengthening existing systems of cultural and clinical orientation and educating staff to view STI in a population health framework. However others, particularly issues in relation to culture, kinship ties and living in small communities, may require testing modalities that do not rely on direct contact with health staff or the clinic environment. PMID:25426563
Spiegel, C A
Bacterial vaginosis (BV) is the most common of the vaginitides affecting women of reproductive age. It appears to be due to an alteration in the vaginal ecology by which Lactobacillus spp., the predominant organisms in the healthy vagina, are replaced by a mixed flora including Prevotella bivia, Prevotella disiens, Porphyromonas spp., Mobiluncus spp., and Peptostreptococcus spp. All of these organisms except Mobiluncus spp. are also members of the endogenous vaginal flora. While evidence from treatment trials does not support the notion that BV is sexually transmitted, recent studies have shown an increased risk associated with multiple sexual partners. It has also been suggested that the pathogenesis of BV may be similar to that of urinary tract infections, with the rectum serving as a reservoir for some BV-associated flora. The organisms associated with BV have also been recognized as agents of female upper genital tract infection, including pelvic inflammatory disease, and the syndrome BV has been associated with adverse outcome of pregnancy, including premature rupture of membranes, chorioamnionitis, and fetal loss; postpartum endometritis; cuff cellulitis; and urinary tract infections. The mechanisms by which the BV-associated flora causes the signs of BV are not well understood, but a role for H2O2-producing Lactobacillus spp. in protecting against colonization by catalase-negative anaerobic bacteria has been recognized. These and other aspects of BV are reviewed. PMID:1747864
Hottes, Travis Salway; Kerr, Thomas; Taylor, Darlene; Fairley, Christopher K; Lester, Richard; Wong, Tom; Trussler, Terry; Marchand, Rick; Shoveller, Jean; Ogilvie, Gina
Background Internet-based testing programs are being increasingly used to reduce testing barriers for individuals at higher risk of infection, yet the population impact and potential for exacerbation of existing health inequities of these programs are not well understood. Objective We used a large online sample of men who have sex with men (MSM) in Canada to measure acceptability of Internet-based testing and perceived advantages and disadvantages of this testing approach. Methods We asked participants of the 2011/2012 Sex Now Survey (a serial online survey of gay and bisexual men in Canada) whether they intended to use Internet-based testing and their perceived benefits and disadvantages of use. We examined whether intention to use was associated with explanatory variables spanning (A) sociodemographics, (B) Internet and technology usage, (C) sexually transmitted infections (STI)/ human immunodeficiency virus (HIV) and risk, and (D) health care access and testing, using multivariable logistic regression (variable selection using Bayesian information criterion). Results Overall, intention to use was high (5678/7938, 71.53%) among participants with little variation by participant characteristics. In our final model, we retained the variables related to (B) Internet and technology usage: use of Internet to cruise for sex partners (adjusted odds ratio [AOR] 1.46, 95% CI 1.25-1.70), use of Internet to search for sexual health information (AOR 1.36, 95% CI 1.23-1.51), and mobile phone usage (AOR 1.19, 95% 1.13-1.24). We also retained the variables for (D) health care access and testing: not “out” to primary care provider (AOR 1.24, 95% CI 1.10-1.41), delayed/avoided testing due to privacy concerns (AOR 1.77, 95% CI 1.49-2.11), and delayed/avoided testing due to access issues (AOR 1.65, 95% CI 1.40-1.95). Finally, we retained the variable being HIV positive (AOR 0.56, 95% CI 0.46-0.68) or HIV status unknown (AOR 0.89, 95% CI 0.77-1.01), age <30 years (AOR 1.41, 95% CI 1.22-1.62), and identifying as bisexual (AOR 1.18, 95% CI 1.04-1.34) or straight/other (AOR 0.67, 95% CI 0.50-0.90). The greatest perceived benefits of Internet-based testing were privacy (2249/8388, 26.81%), general convenience (1701/8388, 20.28%), and being able to test at any time (1048/8388, 12.49%). The greatest perceived drawbacks were the inability to see a doctor or nurse (1507/8388, 17.97%), wanting to talk to someone about results (1430/8388, 17.97%), not wanting online results (1084/8388, 12.92%), and low trust (973/8388, 11.60%). Conclusions The high and wide-ranging intention to use that we observed suggests Internet-based testing has the potential to reach into all subgroups of MSM and may be particularly appealing to those facing current barriers to accessing STI/HIV testing and who are more comfortable with technology. These findings will be used to inform the promotion and further evaluation of an Internet-based testing program currently under development in British Columbia, Canada. PMID:24240644
Jones, F R; Miller, G; Gadea, N; Meza, R; Leon, S; Perez, J; Lescano, A G; Pajuelo, J; Caceres, C F; Klausner, J D; Coates, T J
The goal of this study was to determine the prevalence of bacterial vaginosis (BV) in Peruvian women from socioeconomically deprived populations and to determine the association between BV and risk factors for sexually transmitted diseases (STDs). Women were administered an epidemiologic survey to determine sexual risk behaviour and they provided biological samples to test for BV and STDs. The prevalence of BV was high (27%) and was significantly associated with having a bacterial STD or trichomoniasis. Age, marital status, and a history of sex work, but not of sexual experience, frequency of intercourse, and unprotected intercourse, were associated with BV. As BV may be a marker for STDs, screening for STDs should be performed in individuals with BV to promote early detection and treatment of co-infecting sexually transmitted pathogens. PMID:17362553
B M Jones; L M Willcox
OBJECTIVES--Bacterial vaginosis (BV) is a prevalent vaginal infection that is now regarded as a risk factor in more serious pelvic and obstetric complications. Spermicides are known to have antimicrobial activity against other sexually transmitted diseases and the aim of this study was to test whether the causative organisms of BV were also susceptible to spermicides, in vitro. DESIGN--Minimal Inhibitory Concentrations
Zongxin Ling; Jianming Kong; Fang Liu; Haibin Zhu; Xiaoyi Chen; Yuezhu Wang; Lanjuan Li; Karen E Nelson; Yaxian Xia; Charlie Xiang
BACKGROUND: Bacterial vaginosis (BV) is an ecological disorder of the vaginal microbiota that affects millions of women annually, and is associated with numerous adverse health outcomes including pre-term birth and the acquisition of sexually transmitted infections. However, little is known about the overall structure and composition of vaginal microbial communities; most of the earlier studies focused on predominant vaginal bacteria
Immediate needs after sexual assault include safety and privacy in the first instance, followed by treatment of injuries and prevention of unwanted pregnancy and sexually transmitted infections, including human immunodeficiency virus. Management should include risk identification of self-harm and suicide, as well as safeguarding children and vulnerable adults. Pregnancy prevention can be achieved through oral or mechanical methods of emergency contraception. Availability of emergency contraception may vary between districts and countries, depending on local laws and cultural or religious beliefs. Sexually transmitted infections, including gonorrhoea, chlamydia, hepatitis B and human immunodeficiency virus, represent an important part of management of victims of sexual assault. They can be prevented immediately by offering bacterial and viral prophylaxis followed by sexual health screening 2 weeks later unless symptomatic. In deciding what antibiotics to use as prophylaxis, local prevalence of infections and resistance to antibiotics should be considered. Prophylaxis against human immunodeficiency virus infection after sexual exposure should be discussed and offered in high-risk cases for up to 72 h after exposure. This should be accompanied by baseline human immunodeficiency virus test and referral for follow up. In high prevalence areas, prophylaxis against human immunodeficiency virus infection after sexual exposure should be offered as a routine. Psychosocial support and risk assessment of vulnerabilities, including self-harm or domestic violence and practical support should be addressed and acted on depending on identified needs. PMID:23200638
Effect of an educational intervention on knowledge, attitudes and preventive behaviours related to HIV and sexually transmitted infections in female sex workers in southern Iran: a quasi-experimental study.
Sakha, Minoo Alipour; Kazerooni, Parvin Afsar; Lari, Mahmood Amini; Sayadi, Mehrab; Azar, Farbod Ebadi Fara; Motazedian, Nasrin
This quasi-experimental, before-after study was designed to assess the effect of an educational intervention on knowledge and attitudes about sexually transmitted infections, HIV and preventive behaviours among female sex workers in Shiraz, Iran. A single-group pre-post test design was used and the study was done between August and December 2009. The participants were 80 female sex workers recruited from three drop-in centers in Shiraz, with stratified random sampling. Pre-intervention knowledge was assessed by interview with a standard questionnaire. The educational intervention consisted of a lecture, face-to-face education, printed information, an educational movie, role playing and a contest. After 2 months, the effect of the intervention was evaluated (post-test). The average age of the participants was 32.6 ± 9.1 years. After the intervention, the mean score for general knowledge about HIV and sexually transmitted infections increased from 13.7 ± 0.95 (pre-test) to 19.47 ± 11.62 (post-test, p<0.001). There were significant improvements in attitude and the number of participants who self-reported preventive behaviours such as using a condom consistently (from 45 to 63) (p<0.001). The results show that the educational programme was successful in increasing the participants' HIV- and AIDS-related knowledge and attitudes, and in decreasing their risk behaviours. PMID:23970587
ELEC3030 (EL336) Computer Networks S Chen ALOHA Class of Multiple Access Protocols . ALOHA, also called pure ALOHA: Whenever a user has a frame to send, it simply transmits the frame. If collision t ALOHA: f f 71 ELEC3030 (EL336) Computer Networks S Chen ALOHA Class (continue) . Slotted ALOHA: time
Keane, F E; Thomas, B J; Whitaker, L; Renton, A; Taylor-Robinson, D
OBJECTIVES: The aetiology of non-gonococcal urethritis (NGU) in a considerable proportion of men remains unaccounted for. We wished to investigate the possible aetiological role of bacterial vaginosis (BV), the commonest cause of abnormal discharge in women, in this condition. METHODS: We carried out two studies. In the first, case-control, study, we recruited men with and without NGU and examined their female partners for evidence of BV. The second, cohort design, study which ran concurrently with the first study involved recruiting women with and without BV and examining their male partners for evidence of NGU. The diagnoses of both NGU and BV were made microscopically to include symptomatic and asymptomatic individuals in both disease categories. RESULTS: In the case-control study 51 couples were recruited. Of these 39 men had NGU and 12 (31%) of their female contacts had BV. In contrast, of 12 men without NGU, only one (8%) of the female partners had BV (odds ratio 4.89, 95% CI: 0.51-42.27). When only Chlamydia trachomatis negative patients were considered, the odds ratio for an association between BV and NGU was increased to 6.77, 95% CI: 0.73-62.68). Thirty eight couples were recruited to the cohort design study. Of 17 women with BV, 12 (71%) of their male partners had NGU. In contrast, of 21 women without BV, seven (33%) of their male partners had NGU (p = 0.049, odds ratio 4.8). When only C trachomatis negative patients were considered, the significance of the association was increased (p = 0.037; odds ratio 5.42). CONCLUSIONS: An association exists between NGU and BV, and vice versa. If BV arises de novo the findings could help to explain the development of urethritis in stable sexual relationships. PMID:9534747
Magri, Vittorio; Montanari, Emanuele; Škerk, Višnja; Markoti?, Alemka; Marras, Emanuela; Restelli, Antonella; Naber, Kurt G; Perletti, Gianpaolo
We previously demonstrated the safety and efficacy of fluoroquinolone–macrolide combination therapy in category II chronic bacterial prostatitis (CBP). The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin (500 mg, thrice-weekly) with a once-daily 500- or 750-mg dose of ciprofloxacin (Cipro-500 or Cipro-750 cohort, respectively). Combined administration of azithromycin (1500 mg week?1) with ciprofloxacin at the rate of 750 mg day?1 for 4 weeks rather than at 500 mg day?1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen (PSA) were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction (ED) at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone–macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation. PMID:21765442
Guffey, M. Bradford; Richardson, Barbra; Husnik, Marla; Makanani, Bonus; Chilongozi, David; Yu, Elmer; Ramjee, Gita; Mgodi, Nyaradzo; Gomez, Kailazarid; Hillier, Sharon L.; Karim, Salim Abdool
Objectives To estimate the effectiveness of candidate microbicides BufferGel and 0.5% PRO 2000 Gel (P) (PRO 2000) for prevention of non-ulcerative sexually transmitted infections (STIs). Methods Between 2005 and 2007, 3099 women were enrolled in HIV Prevention Trials Network (HPTN) protocol 035, a phase II/IIb evaluation of the safety and effectiveness of BufferGel and PRO 2000 for prevention of sexually transmitted infections, including Neisseria gonorrhoeae (GC), Chlamydia trachomatis (CT), and Trichomonas vaginalis (TV). Incidences of STIs were determined by study arm, and hazard ratios (HRs) of BufferGel and PRO 2000 versus placebo gel or no gel control groups were computed using discrete time Andersen-Gill proportional hazards model. Results The overall incidence rates were 1.6/100 person-years at risk (PYAR) for GC, 3.9/100 PYAR for CT, and 15.3/100 PYAR for TV. For BufferGel versus placebo gel, HRs were 0.99 (95% CI 0.49–2.00), 1.00 (95% CI 0.64–1.57), and 0.95 (95% CI 0.71–1.25) for prevention of GC, CT, and TV respectively. For PRO 2000, HRs were 1.66 (95% CI 0.90–3.06), 1.16 (95% CI 0.76–1.79), and 1.18 (95% CI 0.90–1.53) for prevention of GC, CT, and TV respectively. Conclusions The incidence of STIs was high during HPTN 035 despite provision of free condoms and comprehensive risk-reduction counselling, highlighting the need for effective STI prevention programmes in this population. Unfortunately, candidate microbicides BufferGel and PRO2000 had no protective effect against gonorrhoea, Chlamydia, or trichomoniasis. PMID:24898857
Franco, Sandra; Tural, Cristina; Nevot, Maria; Moltó, José; Rockstroh, Jürgen Kurt; Clotet, Bonaventura; Martinez, Miguel Angel
There is an international epidemic of hepatitis C virus (HCV) infection among human immunodeficiency virus-infected men who have sex with men. Transmission of HCV variants that are resistant to recently approved direct-acting antivirals (DAAs) could be an important clinical and public health problem. We document a case of transmission of a DAA-resistant variant of HCV from a patient who was treated with telaprevir to his sexual partner. The transmission of HCV DAA-resistant variants could impair therapeutic regimens that include DAAs. PMID:24859204
Severe, Linda; Fitzgerald, Daniel W.; Deschamps, Marie M.; Reif, Lindsey; Post, Kendall; Johnson, Warren D.; Pape, Jean W.; Boutin-Foster, Carla
Haitian women are twice as likely as men to have HIV/AIDs. Factors underlying the feminization of HIV are complex. Self-esteem is an important correlate of sexual behavior. However, its meaning and impact on health behaviors may be influenced by cultural factors. This qualitative study took place in Haiti 4 months after the 2010 earthquake and examines the meaning of self-esteem among young Haitian women seeking treatment for a recurrent sexually transmitted infection (STI). The meaning of self-esteem was derived from a sense of gratitude and was rooted in their ability to provide for family. This may have led to behaviors such as not using condoms or having sex with partners in concurrent relationships. This article highlights the resilience and resourcefulness of Haitian women, provides insight into how women with apparent positive self-images were led to make choices that placed them at high risk for contracting HIV, and concludes with recommendations for future interventions. PMID:24694329
Jeanne M Marrazzo; Katherine K Thomas; Kathleen Ringwood
ObjectivesBacterial vaginosis (BV) is common in lesbians, and treatment fails in up to 28%. Risks include sexual behaviours that transmit vaginal fluid. The authors measured efficacy of a behavioural intervention to reduce sexual transfer of vaginal fluid between female sex partners in reducing BV persistence.MethodsWomen aged 16–35 years with BV who reported sex with women (prior year) were eligible. Participants
Goettsch, Stephen L.
Reviews eight current human sexuality textbooks for both their general organization and substantive content. Addresses specifically the content areas of sexual response cycle; sexual disfunction; acquaintance rape; AIDS and sexually transmitted diseases; extramarital sex; abortion; homosexuality; and pornography. Identifies as a recurring fault…
Wei, Shanbo; Chen, Xinguang; Li, Gang; Zhou, Wang; Shi, Weidong; Wang, Xia
The growing HIV/AIDS epidemic in China appears to be related to the vast rural-to-urban migration, with rural migrants serving as a “living bridge” for the spread of HIV. The purpose of this study is to examine whether migrants' wives remaining in rural homes play a role in spreading the virus. Participants were recruited from 12 rural villages. Social and demographic factors, sexual behaviour, and HIV/AIDS knowledge were assessed using survey questionnaire. Reproductive tract infection (RTI; syphilis, chlamydia, gonorrhea, vaginalis trichomonas, and candidiasis) were assessed using blood and vaginal specimens. Among the total 63 participants, 28 (44.4%) were wives remaining behind while their husbands migrated to a city (“remaining”) and 35 were women whose spouses remained in the rural setting (“comparison”). The reported median duration (inter-quarter range (IQR)) since the last episode of sex with husband was nine months (IQR: 7–15) for the remaining women and three months (IQR: 2–7) for the comparison women (Z?=?3.95, p?0.01). RTI was 32.1% for remaining women and 17.1% for the comparison women (Odds ratio?=?2.28, 95%CI: 0.70–7.48, p?=?0.165). The high rate of RTI suggests that remaining women in rural areas may be at increased risk for acquiring HIV infection compared to women whose husbands remained in rural homes. PMID:25750769
Reproductive-aged victims of sexual assault are at risk of unintended pregnancy, sexually transmitted infections, and mental health conditions, including posttraumatic stress disorder. Health care providers should screen routinely for a history of sexual assault and offer victims both emergency contraception and sexually transmitted infection prophylaxis. The health care provider who examines victims of sexual assault has a responsibility to comply with state and local statutory or policy requirements for the use of evidence-gathering kits. PMID:24785635
... sex and how sex affects your health. Besides pregnancy, having sex puts you at risk of getting a sexually transmitted disease, such as herpes or genital warts, or HIV, the virus that causes AIDS. The only way ...
This activity provides questions and Web sites to guide student investigation of birth control methods, fetal development, risks of alcohol and smoking during pregnancy, changes during puberty, and HIV/AIDS and other sexually transmitted diseases.
... population were located in the South. Gonorrhea by Sex Gonorrhea rates among women have been slightly higher ... the Special Focus Profiles. Gonorrhea by Region and Sex During 2011â€“2012, gonorrhea rates among women and ...
... HIV/AIDS Physical examination,, and thorough medical history, plus one or more of the following blood tests ... exam in young women, and thorough medical history, plus laboratory analysis of cervical secretions or urine, to ...
... and Sex Behavior The male-to-female rate ratio for P&S syphilis rates rose steeply during 2000â€“ ... men than women ( Figure 31 ). In 2012, this ratio was almost double the ratio of 2003, and ...
Jalal, Hamid; Delaney, Andrew; Bentley, Neil; Sonnex, Christopher; Carne, Christopher A
Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), Trichomonas vaginalis (TV) and Mycoplasma genitalium (MG) are established pathogens for human genital tract. However, the role of Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in genital pathology is poorly unerstood. A prospective study to investigate the prevalence of above infections was performed on a cohort of 1,718 consecutive patients attending a Genitourinary Medicine (GUM) clinic. A previously published in-house real-time PCR assay, for the detection of CT DNA in genital swabs, was modified for this study. Two amplification reactions detected the DNAs of TV, NG, MG, CT, UU and UP in genital swabs from 4 (0.2%), 11 (0.6%), 17 (1%), 129 (8%), 282 (16%) and 636 (37%) patients, respectively. 594 (70%) of 848 women and 333 (38%) of 870 men were infected with at least one type of microorganism. Among 594 infected females, 485 (82%) had a single infection, 97 (16%) had a double infection, and 12 (2%) had a triple infection. Of the 333 infected men, 304 (91%) had a single infection, 27 (8%) had a double infection, and 2 (1%) had a triple infection. The prevalence of infection in both genders decreased with increasing age. The prevalence proportion of UP was significantly higher in women (54%) compared with men (18%). The high prevalence of UU and UP suggests that these bacteria are commensals of genital tract. PMID:24046809
Risk assessment can be an effective pedagogical strategy for sexuality education. Objectives: After learning about the modes of transmission and prevention strategies of sexually transmitted infections (STIs), students engaged in this teaching technique will define sexual intercourse and sexual activity, assess the level of STI risk associated…
Since the sexual revolution of the 1960s there has been an openness regarding sexual exploration that has resulted in an increase of sexually transmitted diseases and teenage pregnancies. Clinicians can mitigate the unhealthy results of such exploration through a therapeutic relationship with their patients. This article provides practical ways to approach and educate the pediatric patient and parent regarding normal sexual growth and development and the promotion of healthy, responsible sexual behavior. Using developmental theories as a foundation, sexuality is examined from birth through the adolescent years. PMID:8233152
Kenyon, Chris Richard; Osbak, Kara; Buyze, Jozefien; Chico, R Matthew
Prevalence estimates of various bacterial sexually transmitted infections in South Africa have declined considerably since the mid-1990s. Syphilis among pregnant women, for example, declined from 10.8% in 1998 to 2.8% in 2001. We used Pearson's correlation coefficients to estimate the association between the prevalence of syphilis/male urethral discharge/male genital ulcers and the peak HIV prevalence at a district and provincial level in the early and late phases of the HIV epidemic in South Africa. Prevalence estimates of syphilis, male urethral discharge and male genital ulcers during the period preceding the peak HIV prevalence were all positively correlated with the peak HIV prevalence at a provincial level (Pearson's correlation coefficient [r]?=?0.83, p?=?0.006; r?=?0.66, p?=?0.052; r?=?0.79, 0.011, respectively). These relationships all switched to a negative association later in the HIV epidemic at a provincial level (r?=?-0.53, p?=?0.14; r?=?-0.73, p?=?0.130; r?=?-0.54, p?=?0.027, respectively). AIDS mortality may have played an important role in the decline of bacterial sexually transmitted infections such as syphilis in this region. Consequently, the relatively recent scale-up of antiretroviral therapy may result in a resurgence of syphilis and other sexually transmitted infections as observed in high-income countries. PMID:25122576
Rushworth, Jo V.; Hirst, Natalie A.; Millner, Paul A.
SUMMARY Bacterial pathogens are important targets for detection and identification in medicine, food safety, public health, and security. Bacterial infection is a common cause of morbidity and mortality worldwide. In spite of the availability of antibiotics, these infections are often misdiagnosed or there is an unacceptable delay in diagnosis. Current methods of bacterial detection rely upon laboratory-based techniques such as cell culture, microscopic analysis, and biochemical assays. These procedures are time-consuming and costly and require specialist equipment and trained users. Portable stand-alone biosensors can facilitate rapid detection and diagnosis at the point of care. Biosensors will be particularly useful where a clear diagnosis informs treatment, in critical illness (e.g., meningitis) or to prevent further disease spread (e.g., in case of food-borne pathogens or sexually transmitted diseases). Detection of bacteria is also becoming increasingly important in antibioterrorism measures (e.g., anthrax detection). In this review, we discuss recent progress in the use of biosensors for the detection of whole bacterial cells for sensitive and earlier identification of bacteria without the need for sample processing. There is a particular focus on electrochemical biosensors, especially impedance-based systems, as these present key advantages in terms of ease of miniaturization, lack of reagents, sensitivity, and low cost. PMID:24982325
Jessica A. Turchik; John P. Garske; Danielle R. Probst; Clinton R. Irvin
Sexual risk taking among college students is common and can lead to serious consequences, such as unintended pregnancies and sexually transmitted infections. This study utilized responses from 310 undergraduate psychology students aged 18 to 23 to examine personality, sexuality, and substance use predictors of sexual risk behaviors over a six-month period. Data were collected from 2005 to 2006 at a
... assault fact sheet Sexual assault fact sheet ePublications Sexual assault fact sheet Print this fact sheet Sexual assault ... assaulted? More information on sexual assault What is sexual assault? Sexual assault and abuse is any type of ...
A STOCHASTIC MODEL FOR THE SPREAD OF A SEXUALLY TRANSMITTED DISEASE WHICH RESULTS IN A SCALE power-law behaviour. The implications of this for the spread of a sexually transmitted disease (STD transmitted disease (STD) is presented. To reflect varying degrees of promiscuity among individuals
Milner, Fabio Augusto
and phrases. sexually transmitted diseases, isolation, population models. 1 #12;2 D. MAXIN AND F. A. MILNER-lasting sexually transmitted disease (without recovery and additional mortality). The main question that we address affect two important aspects of a real population with a sexually transmitted disease: its growth
David P Wilson
Background Exposures to sexually transmitted infections are discrete identifiable events. Interventions to prevent sexually transmitted infections have a certain probability of effectiveness in reducing risk in any given event.Purpose Randomized control trials for sexually transmitted infections interventions are designed to estimate the effectiveness in preventing acquisition of infection. Typically, randomized control trials are run over a specific period of time
O'Hara, Ross E; Gibbons, Frederick X; Gerrard, Meg; Li, Zhigang; Sargent, James D
Early sexual debut is associated with risky sexual behavior and an increased risk of unplanned pregnancy and sexually transmitted infections later in life. The relations among early movie sexual exposure (MSE), sexual debut, and risky sexual behavior in adulthood (i.e., multiple sexual partners and inconsistent condom use) were examined in a longitudinal study of U.S. adolescents. MSE was measured using the Beach method, a comprehensive procedure for media content coding. Controlling for characteristics of adolescents and their families, analyses showed that MSE predicted age of sexual debut, both directly and indirectly through changes in sensation seeking. MSE also predicted engagement in risky sexual behaviors both directly and indirectly via early sexual debut. These results suggest that MSE may promote sexual risk taking both by modifying sexual behavior and by accelerating the normal rise in sensation seeking during adolescence. PMID:22810165
Receive Transmit Telescope Telescope Acquisition, Tracking, and Pointing Technology Development technologies. BRMS utilizes two optically coupled telescopes to relay a laser source from the ground telescope is attached to the spacecraft bus with navigation and attitude control subsystems. The BRMS
Quincy, Michael L.
The purpose of this review paper, "Adolescent Sexual Education: Designing Curriculum That Works", is to present some basic curriculum necessities for developing an in-school sexual education program that results in decreasing the number of teenagers initiating sex, thus reducing the number of teen pregnancies and cases of sexually transmitted…
sexual Assault sexual Assault if You Are a Victim of a sexual Assault 1. Get to a safe place. 2. Call out for help. 3. DiAl 6111 or ask someone to ring for you and state "sEXUAl AssAUlT" giving exact. if You Witness a sexual Assault 1. Everyone is asked to assist in making the campus a safe place by being
Bruce, Janine Suzanne
abortions and adoptions for youth young women and men in foster care.abortions, and sexually transmitted infections among young women and men in foster care.abortions, and sexually transmitted infections among young women and men in foster care.
... Sexual Assault Share This Page: Sexual Assault Resources Sexual Assault Sexual assault is a significant problem affecting American ... National Network at 1-800-656-HOPE (4673). Sexual Assault Examinations It is important to know that a ...
Barr, Elissa M.; Goldfarb, Eva S.; Russell, Susan; Seabert, Denise; Wallen, Michele; Wilson, Kelly L.
Background: Teaching sexuality education to support young people's sexual development and overall sexual health is both needed and supported. Data continue to highlight the high rates of teen pregnancy, sexually transmitted disease, including human immunodeficiency virus (HIV) infections, among young people in the United States as well as the…
Floyd, Leah J.; Latimer, William
Combining substance use and sex compounds the risk of contracting sexually transmitted diseases, including HIV. However, the association between substance use and sexual behaviors may vary by substance and sexual behavior. The current study sought to examine the relationship between alcohol and marijuana use frequency and specific sexual…
Marcell, Arik V; Wibbelsman, Charles; Seigel, Warren M
Male adolescents' sexual and reproductive health needs often go unmet in the primary care setting. This report discusses specific issues related to male adolescents' sexual and reproductive health care in the context of primary care, including pubertal and sexual development, sexual behavior, consequences of sexual behavior, and methods of preventing sexually transmitted infections (including HIV) and pregnancy. Pediatricians are encouraged to address male adolescent sexual and reproductive health on a regular basis, including taking a sexual history, performing an appropriate examination, providing patient-centered and age-appropriate anticipatory guidance, and delivering appropriate vaccinations. Pediatricians should provide these services to male adolescent patients in a confidential and culturally appropriate manner, promote healthy sexual relationships and responsibility, and involve parents in age-appropriate discussions about sexual health with their sons. PMID:22123881
Sustaining and strengthening the ability of the elderly to continue their sexual needs can be realized as part of improving their quality of life, health and well-being. There is no age at which ends the expression of sexuality and intimacy. Through education, quality of life and advances in medicine, the average life expectancy is still increasing. Sexual activity of older people society usually describe using pejorative terms as an inappropriate, bizarre or obscene, but these labels are different than reality. Hormonal changes and other physiological changes associated with aging affect sexual interest. Erectile dysfunction is a problem in men increasing with age. There is no evidence that premature ejaculation is more common in older age. Cross-sectional studies showed no difference in sexual dysfunction between older and younger women. Age is not a barrier to sexually transmitted diseases. The most common pathogenetic factors for male erectile dysfunction are vascular diseases. In women, the most important symptoms of sexual dysfunction are lack of emotional wellbeing and a sense of intimacy during sexual intercourse. PMID:25815611
... The Most Common Types of Sexual Problems in Older Adults For women, age-related changes due to menopause ... sexual intercourse. How Common are Sexual Problems in Older Adults? Researchers have found that about half of sexually ...
Bacteria exchange genes rarely but are promiscuous in the choice of their genetic partners. Inter-specific recombination has the advantage of increasing genetic diversity and promoting dissemination of novel adaptations, but suffers from the negative effect of importing potentially harmful alleles from incompatible genomes. Bacterial species experience a degree of 'sexual isolation' from genetically divergent organisms ^ recombination occurs more frequently
Creatsas, G K
Adolescent sexual activity is increasing. Premature sexual intercourse results in high figures of adolescent pregnancy and abortion, as well as in increased risk of sexually transmitted diseases (STDs). Lack of information on the prevention of STDs and poor hygiene in both boys and girls are also main reasons for increased morbidity because of STDs during adolescence. Contraceptive behaviour during adolescence varies between countries and communities. It seems, however, that the condom and oral contraceptives (OC) are popular contraceptive methods. Ineffective methods such as periodic abstinence, coitus interruptus, and withdrawal before ejaculation are in use. On the other hand, compliance of adolescents on contraception is poor. The above are additional causes for increasing rates of adolescent pregnancies. Countries providing sexual education programs in schools present lower rates of pregnancy and abortion. Adolescent pregnancy is safe if a careful follow up is accepted by the teenager. A significant number of homeless youth are homosexuals or lesbian adolescents. Most of them are at high risk for HIV infection, AIDS, and STDs. It is concluded that sexual education programs are absolutely necessary to offer adolescents the knowledge on the complications of premature sexual activity, as well as prevention of the undesired pregnancy and STDs. PMID:8286689
A E Biddlecom
Objectives: To describe trends over time in sexual behaviour, condom use, and sexually transmitted infections among female and male adolescents in the United States.Methods: A review was carried out of published studies using data from six surveys since the 1970s on sexual behaviour and surveillance data on sexually transmitted infections.Results: The proportion of adolescents who have ever had sexual intercourse
... Harassment and Sexual Bullying Print A A A Text Size What's in this article? What Are Sexual ... technology to harass someone sexually (like sending inappropriate text messages, pictures, or videos). Sometimes sexual harassment can ...
... consultations 2014 Fact sheets Features Commentaries Multimedia Contacts Soil-transmitted helminth infections Fact sheet N°366 Updated May 2015 Key facts Soil-transmitted helminth infections are caused by different species ...
Kosmahl, H. G. (inventor)
An RF transmitting tube for the 20 GHz to 500 GHz range comprises a gyrotron and a multistage depressed collector. A winding provides a magnetic field which acts on spent, spinning or orbiting electrons changing their motion to substantially forward linear motion in a downstream direction. The spent electrons then pass through a focusser into the collector. Nearly all of the electrons injected into the collector will remain within an imaginary envelope as they travel forward toward the end collector plate. The apertures in the collector plates are at least as large in diameter as the envelope at any particular axial position.
are shared between many sexually transmitted infections, the prevalence of these diseases across differentThe dynamics of sexual contact networks: effects on disease spread and control Katy Robinson1, Ted Sexually transmitted pathogens persist in populations despite the availability of biomedical interven tions
Rowe, Melissah; Czirják, Gábor Árpád; McGraw, Kevin J; Giraudeau, Mathieu
Bacteria present in ejaculates can impair sperm function and reduce male reproductive success. Thus, selection should favour the evolution of antimicrobial defences to limit the detrimental effects of sperm-associated bacteria. Additionally, current hypotheses suggest that ornamental traits may signal information about the infection status of an individual or the ability of an individual to resist bacterial-induced sperm damage. However, despite the evolutionary implications of ejaculate antimicrobials, and the putative importance of pathogens for the evolution of male ornamentation, tests of these hypotheses are lacking. We examined the antibacterial activity of semen from mallard ducks (Anas platyrhynchos) and tested whether the bactericidal capacity of semen was associated with bill coloration, a sexually selected trait. We show that mallard semen exhibits significant antibacterial activity, as measured by the in vitro capacity to kill Escherichia coli and Staphylococcus aureus. Furthermore, we demonstrate that males with more colourful bills have semen with superior bacterial-killing ability. These results suggest that females could use male phenotypic traits to avoid sexually transmitted pathogens and acquire partners whose sperm suffer less bacteria-induced damage. PMID:21490006
Christine Markham; Melissa Peskin; Belinda F Hernandez; Kimberly Johnson; Robert C. Addy; Paula Cuccaro; Ross Shegog; Susan Tortolero
Background: The US has higher rates of teen births and sexually transmitted infections (STI) than other developed countries. Texas youth are disproportionately impacted. Purpose: To review local, state, and national data on teens’ engagement in sexual risk behaviors to inform policy and practice related to teen sexual health. Methods: 2009 middle school and high school Youth Risk Behavior Survey (YRBS)
Morales-Campos, Daisy Y.; Markham, Christine; Peskin, Melissa Fleschler; Fernandez, Maria E.
Background: Hispanic youths have high rates of sexually transmitted infections and pregnancies, yet little research has targeted multiple protective/risk factors for early sexual initiation in this group. This study examined two main factors--parenting practices and acculturation--on early sexual initiation among Hispanic middle school students in…
Rebecca L. Collins; Marc N. Elliott; Sandra H. Berry; David E. Kanouse; Dale Kunkel; Sarah B. Hunter; Angela Miu
Background. Early sexual initiation is an important social and health issue. A recent survey sug- gested that most sexually experienced teens wish they had waited longer to have intercourse; other data indicate that unplanned pregnancies and sexually transmitted diseases are more common among those who begin sex- ual activity earlier. The American Academy of Pediatrics has suggested that portrayals of
S D Cunningham; J Tschann; J E Gurvey; J D Fortenberry; J M Ellen
Objectives: To determine the association between stigma and shame about having a sexually transmitted disease and adolescents’ past STD related care seeking; between stigma, shame, and perceptions about disclosure of sexual behaviours to a doctor or nurse; and whether the association of stigma, shame, and care seeking was moderated by perceptions about disclosure.Methods: A household sample of 142 sexually active
Comprehensive sexuality education (CSE) has been recognised globally as key to helping young people assert their sexual and reproductive rights. In India too, there is growing awareness of the importance of providing CSE not only to reduce sexually transmitted infections, unintended pregnancies and abortions but also to teach important life…
Roy F. Oman; Sara K. Vesely; Cheryl B. Aspy; Eleni Tolma; Sharon Rodine; LaDonna Marshall; Janene Fluhr
Compared with youth of other races\\/ethnicities, Native American youth (ages 15-19 years) are more likely to have participated in sexual intercourse, thus placing them at greater risk for sexually transmitted diseases (STDs) and unintended pregnancies. This study's purpose was to investigate relationships among protective factors (assets) and sexual intercourse in a Native American youth population. Data were collected from Native
Debra Esernio-Jenssen; Marilyn Barnes
The American Academy of Pediatrics recommends that site-specific cultures be obtained, when indicated, for sexually victimized children. Nucleic acid amplification testing is a highly sensitive and specific methodology for identifying sexually transmitted infections. Nucleic acid amplification tests are also less invasive than culture, and this may provide an efficacious alternative for children suspected of being sexually abused.
Sexual assault is any sexual activity to which you haven't freely given your consent. This includes completed ... trust, a friend, an acquaintance, or a stranger. Sexual assault can affect your health in many ways. It ...
King, Bruce M.
Considerable progress has been made in the last three decades in contraceptive technology and the treatment of sexually transmitted infections. However, education of the nation's youth about sexual health issues has been less successful. Most parents remain silent on the topic of sexuality while states argue over the curriculum. As a result, a…
Sexually transmitted diseases are extremely prevalent among youth, and it is only by understanding the processes involved in negotiating sexual relationships that effective prevention and intervention programs can be designed. This study explores sexual communication among young adults, how gender and sexual orientation influence negotiation for safer sex, the strategies employed for risk reduction, and the barrier to safer sex.
Silver, Ellen Johnson; Bauman, Laurie J.
We examined whether sexual attitudes of adolescents were related to their self-reported sexual risk behavior by analyzing survey data from 1,052 boys and girls aged 14 to 17 years from a low income, urban community. Sexual behavior norms that may increase sexually transmitted infection/HIV risks in youth were sanctioned more by males and by…
Steven C. Martino; Rebecca L. Collins; Marc N. Elliott; Amy Strachman; David E. Kanouse; Sandra H. Berry
BACKGROUND.Early sexual activity is a significant problem in the United States. A recent survey suggested that most sexually experienced teens wish they had waited longer to have intercourse; other data indicate that unplanned pregnancy and sexually transmitted diseases are more common among those who begin sexual activity earlier. Popular music may contribute to early sex. Music is an integral part
Najam Muhammad Amin; Michael Weber
In modern mobile communication systems higher bandwidths are required by users. But higher bandwidths mean, that in Frequency Division Duplex (FDD) standard where uplink and downlink is separated, the receive band has to be protected against the transmit band. Violation of the receiver is caused by distortion coming from the transmitter, which is insufficiently suppressed by Transmit (TX) duplex filter
A study was conducted to determine what physical sexual activities lesbians engage in and what attitudes lesbians have toward various aspects of their sexuality. The sample consisted of 286 homosexual women. This article reports results in the following areas: first orgasm, first sexual experience with another women, sexual fantasies, number of sex partners, faking orgasm, sex toys, initiating sex, techniques
Novilla, M. Lelinneth B.; Dearden, Kirk A.; Crookston, Benjamin T.; De La Cruz, Natalie; Hill, Susan; Torres, Scott B.
This study describes the prevalence of risky sexual activities among Bolivian adolescents within the context of other behavioral factors that contribute to compromised health outcomes, unintended pregnancies, and sexually transmitted infections including HIV/AIDS. Data was collected from 576 adolescents, 13-18 years of age, from six schools in La…
\\u000a The term “internet sexuality” (or OSA, online sexual activities) refers to sexual-related content and activities observable\\u000a on the internet (cf. Adams, Oye, & Parker, 2003; Cooper, McLoughlin, & Campbell, 2000; Leiblum & Döring, 2002). It designates\\u000a a variety of sexual phenomena (e.g., pornography, sex education, sexual contacts) related to a wide spectrum of online services\\u000a and applications (e.g., websites, online
Allison L. Diamant; Mark A. Schuster; Kimberly McGuigan; Janet Lever
Results: Of respondents, 77.3% had 1 or more lifetime male sexual partners, 70.5% had a lifetime history of vagi- nal intercourse, 17.2% had a lifetime history of anal in- tercourse, and 17.2% had a lifetime history of a sexually transmitted disease. Exactly 5.7% reported having had a male sexual partner during the past year. Conclusion: These findings reinforce the need
Allison L. Diamant; Mark A. Schuster; Kimberly McGuigan; Janet Lever
Results: Of respondents, 77.3% had 1 or more lifetime male sexual partners, 70.5% had a lifetime history of vagi- nal intercourse, 17.2% had a lifetime history of anal in- tercourse, and 17.2% had a lifetime history of a sexually transmitted disease. Exactly 5.7% reported having had a male sexual partner during the past year. Conclusion: These findings reinforce the need
Gerber, Daniel L
Simultaneous transmit and receive (STAR) is an important problem in the field of communications. Engineers have researched many different models and strategies that attempt to solve this problem. One such strategy is to ...
Moore, S; Rosenthal, D
This study was an examination of the sexual worlds of 153 adolescents aged 15 to 18 years through the content analysis of interviews on the topics of love, romance, relationships between the sexes, sexual values and sexual behaviors. The aim was to develop more detailed descriptions of the dimension of adolescent sexuality and relate these dimensions to sexual risk, that is, the tendency to engage in unprotected intercourse, an activity which increases vulnerability to AIDS and other sexually transmitted diseases. To this end, seven themes were isolated from the interview scripts, these being permissiveness, double standards, belief about sexual control (the Id Factor), romance, regrets about permissiveness, sexual aggression, and questioning. Measures of four of these themes were constructed, and sex and sub-group differences explored, as were the relationships between themes and sexual risk. The implications of different "pathways" to sexual risk-taking were discussed. PMID:1487577
Gaspari, V; D'Antuono, A; Bellavista, S; Trimarco, R; Patrizi, A
Prostitution involves the exchange of sexual services for economic compensation. As sexual behaviour is an important determinant in transmitting HIV and sexually transmitted diseases (STDs), sex workers (SWs), transgenders and clients are often labeled as a "high risk group" in the context of HIV and STDs. It has been documented that female sex workers in particular have an increased prevalence of untreated STDs and have been hypothesized to affect the health and HIV incidence of the general population. People involved in prostitution are a cause for concern from both public health and economic perspectives. However, little is known about why they remain in this type of activity given the risks prostitution presents, and even less is known about how to intervene and interrupt the complex cycle of prostitution. The aim of this paper is to provide a clinical and epidemiological analysis of the relationship between prostitution, sexual behavior and outbreaks of STDs; to assess the role that migrants, transgenders and clients of SWs have in prostitution and in the outbreaks of STDs. In addition, we also want to highlight how new sexual networks, like the Internet, have become an increasingly important vehicle to sharing information about prostitution, sexual behavior and STDs. Finally we present what may be the prevention strategies and the goals in order to stem the spread of STDs among these hard-to-access groups. PMID:23007210
Lestrade, Katherine N.; Talbot, Nancy L.; Ward, Erin A.; Cort, Natalie A.
Objective National estimates of childhood sexual abuse histories among black women range from 34% to 40%. Poor outcomes in adulthood, including impaired psychiatric functioning (e.g., depression), high-risk sexual behaviors (e.g., unprotected sex, exchange of sex for money or drugs), and lifetime sexually transmitted infections are robustly associated with sexual abuse histories. In the current study, we examined the relationships of intrafamilial and extrafamilial perpetration of childhood sexual abuse to high-risk sexual behaviors and sexually transmitted infections among black women. Methods We conducted a secondary analysis of data from 60 black women who participated in a depression treatment trial in a community mental health center. Results Our results demonstrated that intrafamilial perpetration of childhood sexual abuse, as compared to extrafamilial perpetration, was more strongly associated with high-risk sexual behaviors in a clinical sample of depressed black women. There were no significant associations between intrafamilial or extrafamilial perpetration of childhood sexual abuse and sexually transmitted infections. Conclusions These findings suggest that characteristics of childhood sexual abuse among depressed black women may be important factors for health professionals to consider when conducting clinical assessments and providing treatment. PMID:23499057
Schick, Vanessa R.; Calabrese, Sarah K.; Rima, Brandi N.; Zucker, Alyssa N.
Findings regarding the link between body image and sexuality have been equivocal, possibly because of the insensitivity of many of body image measures to potential variability across sensory aspects of the body (e.g., appearance versus odor), individual body parts (e.g., genitalia versus thighs), and social settings (e.g., public versus intimate). The current study refined existing methods of evaluating women’s body image in the context of sexuality by focusing upon two highly specified dimensions: satisfaction with the visual appearance of the genitalia and self-consciousness about the genitalia during a sexual encounter. Genital appearance dissatisfaction, genital image self-consciousness, and multiple facets of sexuality were examined with a sample of 217 undergraduate women using an online survey. Path analysis revealed that greater dissatisfaction with genital appearance was associated with higher genital image self-consciousness during physical intimacy, which, in turn, was associated with lower sexual esteem, sexual satisfaction, and motivation to avoid risky sexual behavior. These findings underscore the detrimental impact of negative genital perceptions on young women’s sexual wellbeing, which is of particular concern given their vulnerability at this stage of sexual development as well as the high rates of sexually transmitted infections within this age group. Interventions that enhance satisfaction with the natural appearance of their genitalia could facilitate the development of a healthy sexual self-concept and provide long-term benefits in terms of sexual safety and satisfaction. PMID:20824180
Miguel Angel Sánchez-Alemán; Felipe Javier Uribe-Salas; Eduardo Cesar Lazcano-Ponce; Santa García-Cisneros; Sergio Eguiza-Fano; Carlos Jesús Conde-Glez
ObjectivesEarly sexual debut is a behaviour that has been associated with acquiring sexually transmitted infections. Higher schooling may delay sexual debut, thus the university population is categorised with low-risk sexual behaviours. The rate ratio of herpes simplex virus type 2 (HSV-2) seroincidence according to demographic characteristics and sexual behaviour was estimated for a cohort of university students.MethodsA dynamic cohort of
The term “internet sexuality” (or OSA, online sexual activities) refers to sexual-related content and activities observable on the internet (cf. Adams, Oye, & Parker, 2003; Cooper, McLoughlin, & Campbell, 2000; Leiblum & Döring, 2002). It designates a variety of sexual phenomena (e.g., pornography, sex education, sexual contacts) related to a wide spectrum of online services and applications (e.g., websites, online chat rooms, peer-to-peer networks). If an even broader range of computer networks - such as the Usenet or bulletin board systems - is included in this extensional definition, one speaks of “online sexuality” or “cybersexuality.”
... Department of Health and Human Services: Office of Public Health and Science — Office of Population Affairs Teen Talk # ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of Public Health and Science Office of Population Affairs
... or Unintentional Injuries All Injuries Assault or Homicide Suicide and Self-Inflicted Injury Life Stages and Populations Age Groups Adolescent Health Child Health Infant Health Older Persons' Health ...
Ronald H. Gray; Maria J. Wawer; Chelsea B. Polis; Godfrey Kigozi; David Serwadda
Three randomized trials in Africa have shown that adult male circumcision reduces HIV acquisition in men by approximately\\u000a 60%. It is biologically plausible that circumcision reduces HIV risk in men because the inner mucosa of the foreskin is lightly\\u000a keratinized and has a high density of dendritic cells and other HIV target cells, making it vulnerable to HIV infection. Also,
Vatano?lu, Emine Elif; Ataman, Ahmet Do?an
AIDS has become the new plague; a disease that is not only physically and psychologically debilitating, but culturally and socially devastating as well. Like the plague, AIDS has caused fear, prejudice and even panic in society. Although there are remarkable improvements in the diagnosis and treatment of the disease, AIDS continues its grim passage around the globe. After a slight downturn in the early 1990’s, it then returned with a vengeance. By the end of the 20th century, AIDS was reliably estimated to have caused over 20 million deaths throughout the world. At the same time, 40 million people were estimated to be HIV positive. This paper provides an overview of the history of AIDS, including the discovery and its progress in the world through philately. Philately is the study of stamps and postal history and other related items. Philately involves more than just stamp collecting, it contains the study of the design and educational impact of a philatelic material. We have presented AIDS stamps produced world-wide to emphasize the history of AIDS. PMID:24591992
... for Kids for Teens Teens Home Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Q&A School & ... to Defensive Driving Volunteering Learn the facts about sexual health with articles about puberty, menstruation, infections, and just ...
Sharpe, Thomasina H.
This article offers a medical and psychosocial perspective of adolescent sexual development. Sub-types of sexual development are discussed as well as treatment implications for allied health providers. (Contains 38 references.) (Author)
Sexual Intimacy After Sexual Assault or Sexual Abuse1 Many survivors find that their sexual attitudes and reactions are impacted after a sexual assault or sexual abuse. While these effects are not permanent, they can be very frustrating as they can decrease the enjoyment of one's sexual life and intimacy
Alexander C. Tsai; Kristin J. Hung; Sheri D. Weiser
Alexander Tsai and colleagues show that in sexually active women in Brazil severe food insecurity with hunger was positively associated with symptoms potentially indicative of sexually transmitted infection and with reduced odds of condom use.
Tracey Chapman; Göran Arnqvist; Jenny Bangham; Locke Rowe
Sexual conflict occurs when the genetic interests of males and females diverge. Recent evidence supporting the view that male and female genomes are in conflict has now revolutionized the way in which we interpret interactions between the sexes, and suggests that sexual conflict is a potent force in male–female coevolution. Here, we consider the nature of sexual conflict and what
Angela D. Bryan; Sarah J. Schmiege; Renee E. Magnan
Adolescents involved with the juvenile justice system have a high incidence of risky sexual behaviors resulting in unintended pregnancy and sexually transmitted infections. Substance use may be particularly important as a risk factor for unsafe sexual behavior for this group, and recent evidence suggests a possible association between marijuana use and risky sexual behavior. Adolescents (n = 728; 33% female)
Data shows that elevated sialidase in bacterial vaginosis patients correlates to premature births in women. Bacterial sialidase also plays a significant role in the unusual colonization of Pseudomonas aeruginosa in cystic fibrosis patients. Crystals of Salmonella sialidase have been reproduced and are used for studying the inhibitor-enzyme complexes. These inhibitors may also be used to inhibit a trans-sialidase of Trypanosome cruzi, a very similar enzyme to bacterial sialidase, therefore preventing T. cruzi infection, the causitive agent of Chagas' disease. The Center for Macromolecular Crystallography suggests that inhibitors of bacterial sialidases can be used as prophylactic drugs to prevent bacterial infections in these critical cases.
Testa, Maria; VanZile-Tamsen, Carol; Livingston, Jennifer A.
Childhood sexual abuse (CSA) has been proposed to influence both women’s adult sexual risk behaviors and the quality of their intimate relationships. Among a household sample of women (n = 732), good fit was obtained for a model in which CSA predicted Wave 1 male partner sexual risk and aggression characteristics, resulting in lower relationship satisfaction, and ultimately in higher numbers of Wave 2 sexual partners. The model was generally replicated among women who entered new relationships at Waves 2 and 3. Partner sexual risk characteristics also were associated with women’s risk of sexually transmitted infection from current partner. Elevated sexual risk behaviors among CSA survivors reflect difficulty in establishing stable and safe relationships and may be reduced by interventions aimed at improving intimate relationships. PMID:16392972
Mosack, Katie E.; Randolph, Mary E.; Dickson-Gomez, Julia; Abbott, Maryann; Smith, Ellen; Weeks, Margaret R.
This study investigated the mechanisms of risk for urban women at high risk for HIV with and without childhood sexual abuse histories. Childhood sexual abuse survivors reported more unprotected intercourse and sexually transmitted infections (STIs). The association of STI locus of control with frequency of unprotected sex was fully mediated by…
Buzi, Ruth S; Tortolero, Susan R; Roberts, Robert E; Ross, Michael W; Addy, Robert C; Markham, Christine M
The goal of this study was to explore whether a history of sexual abuse is associated with high-risk sexual behaviors among female adolescents attending alternative schools in a large urban city in the southwestern United States, and to examine the role of depression and substance abuse in explaining this association. One hundred eighty-four sexually active female adolescents constituted the sample for this analysis. Forty-nine (26.6%) reported that they were forced to have sex. Having a history of sexual abuse substantially increased sexual risk behaviors. Adolescents reporting a history of sexual abuse, compared to those who did not report such a history, were significantly more likely to have initiated sexual activity (intercourse) before age 14, to have had three or more sexual partners in the last 3 months, and to have had a history of sexually transmitted diseases. These associations remained significant after controlling for age, ethnicity, and family income. Depression and substance abuse did not explain the association between sexual abuse and high-risk sexual behaviors. It seems reasonable to conclude that adolescents with a history of sexual abuse have greater difficulty practicing safe sexual behaviors than do those who have not been sexually abused. Given the prevalence of child sexual abuse and the extent of its impact, it is critical that intervention strategies for adolescent females address the issue of abuse and help them adopt self-protective sexual behaviors. The findings also highlight the importance of targeting adolescents who attend alternative schools. PMID:15053488
Hansen, Lisa; Mann, Janice; McMahon, Sharon; Wong, Thomas
Health Issue Much attention is devoted to women's reproductive health, but the formative and mature stages of women's sexual lives are often overlooked. We have analyzed cross-sectional data from the Sexual Behaviour module of the 2000/2001 Canadian Community Health Survey (CCHS), and reviewed the literature and available indicators of the sexual health of Canadian women. Key Findings Contemporary Canadian adolescents are becoming sexually active at younger ages than in previous generations. The gender gap between young males and females in age at first intercourse has virtually disappeared. The mean age at first intercourse for CCHS respondents aged 15–24 years was between 16 and 17. Canadian-born respondents are significantly younger at first intercourse than those who were born outside of Canada. Few adolescents recognize important risks to their sexual health. Older Canadians are sexually active, and continue to find emotional and physical satisfaction in their sexual relationships. Data Gaps and Recommendations Both health surveys and targeted research must employ a broader understanding of sexuality to measure changes in and determinants of the sexual health of Canadians. There is reluctance to direct questions about sexual issues to younger Canadians, even though increased knowledge of sexual health topics is associated with delayed onset of sexual intercourse. Among adults, sex-positive resources are needed to address aspects of aging, rather than medicalizing age-related sexual dysfunction. Age and gender-appropriate sexual health care, education, and knowledge are important not only for women of reproductive age, but for Canadians at all stages of life. PMID:15345087
SEXUAL ASSAULT AND SEXUAL HARASSMENT QUICK REFERENCE Sexual Assault Definition any form of sexual contact without both parties' voluntary consent. Contrary to what most people think, sexual assault. Zvulony & Company The Law of Sexual Assault in Canada. Sexual Harassment Definition is comment
Schulien, Mary Beth; Zajackowski, Mark
A pilot study was performed to obtain preliminary data regarding the need for targeted therapy of bacterial vaginosis (BV) when it accompanies clinically defined cervicitis. Specifically, women attending a sexually transmitted disease (STD) clinic with clinically defined BV and cervicitis were treated in the first phase of the study with doxycycline alone. In phase II, the patients received doxycycline and concomitant intravaginal metronidazole gel. All patients were reexamined 3–4 weeks after therapy. Persistence of BV occurred in 18/19 (95%) of women in phase I vs. 1/7 (14%) of women in phase II (P < 0.001). We concluded that, in women with coexistent clinically defined cervicitis and BV, the treatment of cervicitis does not result in a normalization of the vaginal flora. PMID:18476033