Sexually transmitted diseases (STDs) are the most common infectious diseases worldwide, with over 350 million new cases occurring each year, and have far-reaching health, social, and economic consequences. Failure to diagnose and treat STDs at an early stage may result in serious complications and sequelae. STDs are passed from person to person primarily by sexual contact and are classified into varied groups. Some cause mild, acute symptoms and some are life-threatening. They are caused by many different infectious organisms and are treated in different ways. Syphilis and gonorrhea are ancient afflictions. Now, however, Chlamydia is prevalent and has become the most common bacterial STD. Antimicrobial resistance of several sexually transmitted pathogens is increasing, rendering some regimens ineffective, adding to therapeutic problems. A standardized treatment protocol for STDs is recommended to ensure that all patients receive adequate treatment. Appropriate treatment of STDs is an important public health measure. PMID:22025952
The three direct determinants of the rate of spread of sexually transmitted diseases (STDs) are sexual behaviors, the mean duration of infectiousness, and the mean efficiency of sexual transmission of each STD. Underlying ecological and behavioral factors that operate through one or more of these direct determinants lie on a continuum, ranging from those most proximate back to those more remote (in time or mechanism) from the direct determinants. Most remote and least modifiable are the historical stages of economic development that even today conspicuously influence patterns of sexual behavior. Next are the distribution and changing patterns of climate, hygiene, and population density; the global population explosion and stages of the demographic transition; and ongoing changes in human physiology (e.g., menarche at younger age) and culture (e.g., later marriage). More proximate on the continuum are war, migration, and travel; and current policies for economic development and social welfare. Most recent or modifiable are technologic and commercial product development (e.g., oral contraceptives); circumcision, condom, spermicide, and contraception practices; patterns of illicit drug use that influence sexual behaviors; and the accessibility, quality, and use of STD health care. These underlying factors help explain why the curable bacterial STDs are epidemic in developing countries and why the United States is the only industrialized country that has failed to control bacterial STDs during the AIDS era. Images PMID:8146138
Holmes, K K
Diphtheria is caused by diphtheria toxin-producing Corynebacterium species. While classical respiratory diphtheria is transmitted by droplets, cutaneous diphtheria often results from minor trauma. This report concerns the first case of sexually transmitted diphtheria in a patient with non-gonococcal urethritis after orogenital contact. PMID:22628666
Berger, Anja; Lensing, Carmen; Konrad, Regina; Huber, Ingrid; Hogardt, Michael; Sing, Andreas
This review discusses current trends in sexually transmitted diseases. Topics include treatment and prevention of syphilis and gonorrhea, as well as the association of sexually transmitted diseases with sexual assault. Also discussed are the various organisms that cause vulvitis, including Trichomonas, Candida, and Gardnerella species, along with a discussion of vulvar lesions that are especially difficult to diagnose and treat. Diagnosis, sampling, pathogenesis, and treatment of Chlamydia trachomatis are also covered. A discussion of the various degrees of protection offered by different forms of contraception encourages use of barrier methods and oral contraceptives for teenagers as well as postponement of sexual activity. Detection, treatment, and vaccination against genital herpes are covered, along with diagnosing anogenital warts in children as either skin or genital wart virus types, and the relationship between human papillomavirus and cancer. PMID:1958806
Sexually transmitted diseases (STDs) constitute a major health burden in the United States, causing pelvic inflammatory disease, ectopic pregnancy, infertility, chronic pelvic pain, genital lesions, genital neoplasms, adverse pregnancy outcomes, immune system dysfunction, liver disease, and even death. STDs disproportionately affect adolescents and young adults. Of the estimated 15 million STDs that occur annually each year in the United States, 4 million are among adolescents and 6 million among young adults. The current epidemic is complicated by the high asymptomatic carrier state associated with most STDs and the inadequate protection of condoms in preventing transmission. Sexually active individuals, particularly adolescents, must be educated on the ramifications of early onset of sexual activity and the health consequences of multiple sexual partners. PMID:14724772
Sulak, Patricia J
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 ...
\\u000a Sexually transmitted diseases (STDs) affect an estimated 19 million people a year in the United States. Clinicians who may\\u000a encounter patients with STDs need to be aware of treatment guidelines and recent changes in treatment recommendations. For\\u000a example, due to increased resistance, fluoroquinolones are no longer recommended for the treatment of infections due to Neisseria gonorrhoeae. Recent new approaches also
Alice C. Thornton; Bojana Stevich; Janet N. Arno; Barbara Van Der Pol
Sexually transmitted diseases (STDs) are infections and resulting clinical syndromes caused by more than 25 infectious organisms transmitted through sexual activity. International travellers are at great risk of contracting any of these STDs, including HIV, if they have been sexually exposed to persons with any of these diseases. Population movement has been shown to be a major contributing factor in
Ziad A Memish; Abimbola O Osoba
This study explored the relationship between the social organization of neighborhoods including informal social control and social cohesion and a current bacterial sexually transmitted infection (STI) among adolescents and young adults in one U.S. urban setting. Data for the current study were collected from April 2004 to April 2007 in a cross-sectional household study. The target population included English-speaking, sexually-active persons between the ages of 15 and 24 years who resided in 486 neighborhoods. The study sample included 599 participants from 63 neighborhoods. A current bacterial STI was defined as diagnosis of a chlamydia and/or gonorrhea infection at the time of study participation. Participants reported on informal social control (i.e. scale comprised of 9 items) and social cohesion (i.e. scale comprised of 5 items) in their neighborhood. In a series of weighted multilevel logistic regression models stratified by gender, greater informal social control was significantly associated with a decreased odds of a current bacterial STI among females (AOR 0.53, 95% CI 0.34, 0.84) after controlling for individual social support and other factors. The association, while in a similar direction, was not significant for males (AOR 0.73, 95% CI 0.48, 1.12). Social cohesion was not significantly associated with a current bacterial STI among females (OR 0.85, 95% CI 0.61, 1.19) and separately, males (OR 0.98, 95% CI 0.67, 1.44). Greater individual social support was associated with an almost seven-fold increase in the odds of a bacterial STI among males (AOR 6.85, 95% CI 1.99, 23.53), a finding which is in contrast to our hypotheses. The findings suggest that neighborhood social organizational factors such as informal social control have an independent relationship with sexual health among U.S. urban youth. The causality of the relationship remains to be determined. PMID:25089964
Jennings, Jacky M; Hensel, Devon J; Tanner, Amanda E; Reilly, Meredith L; Ellen, Jonathan M
This paper summarizes what is known about, and research needs on, the transmissibility to sexually abused children of the following sexually transmitted diseases: gonorrhea, chlamydia trachomatis, human papillomavirus genital warts, condylomata acuminata, syphilis, bacterial vaginosis, trichomonas vaginalis, herpes simplex, and human…
Hammerschlag, Margaret R.
Coinfections of sexually transmitted infections are frequent due to the same transmission routes which may facilitate the transmission of other sexually transmitted infections. Sexually transmitted coinfections are associated with atypical and generally more severe clinical features, more complications, resistency to treatment, unfavourable outcome, and worse prognosis. Sexually transmitted infections may increase the likelihood of acquiring and transmission of HIV infection. The authors summarize the most important characteristics of sexually transmitted infections (such as HIV and hepatitis B virus, HIV and hepatitis C virus, HIV and syphilis, HIV and gonorrhoeae, HIV and chlamydia coinfections). These infections are more frequent in HIV infected patients than in the normal population. The shared transmission routes, impairment of the immune response, elevated cytokine levels and the associated inflammatory milieu produce local tissue damage, breaches in mucosal epithelium, which increases the risk of human immunodeficiency virus infection. Regular screening for sexually transmitted infections, use of more sensitive diagnostic methods, improved reporting and avoidance of unsafe sexual behaviour among certain subpopulations as well as education are essential in the prevention of sexually transmitted coinfections. Orv. Hetil., 2015, 156(1), 4-9. PMID:25544048
Marschalkó, Márta; Pónyai, Katinka; Kárpáti, Sarolta
Prevention of sexually transmitted diseases (STDs) is a low priority among travel clinic services, despite increasing evidence that travelers have an increased risk of acquiring such infections. A proportion of 5%-50% of short-term travelers engage in casual sex while abroad, and this rate is even higher among long-term travelers. Few publications are available on STD preventive interventions among travelers. Education
Alberto Matteelli; Giampiero Carosi
During the last 10 years the health care needs of homosexuals have been receiving increasing attention. However, in their attempts to provide health care to this group, physicians must be familiar with the various lifestyles of homosexuals and the types of infection to which they are susceptible. This paper summarizes the results of recent studies and proposes guidelines for the prevention and treatment of sexually transmitted disease among homosexuals. PMID:6546356
Landis, S. J.
Sexually transmitted diseases (STDs) in children are not uncommon in India, though systematic epidemiological studies to determine the exact prevalence are not available. STDs in children can be acquired via sexual route or, uncommonly, via non-sexual route such as accidental inoculation by a diseased individual. Neonatal infections are almost always acquired intrauterine or during delivery. Voluntary indulgence in sexual activity is also an important factor in acquisition of STDs in childhood. Sexual abuse and sex trafficking remain the important problems in India. Surveys indicate that nearly half of the children are sexually abused. Most at risk children are street-based, homeless or those living in or near brothels. Last two decades have shown an increase in the prevalence of STDs in children, though most of the data is from northern part of the country and from major hospitals. However, due to better availability of antenatal care to majority of women, cases of congenital syphilis have declined consistently over the past two-three decades. Other bacterial STDs are also on decline. On the other hand, viral STDs such as genital herpes and anogenital warts are increasing. This reflects trends of STDs in the adult population. Concomitant HIV infection is uncommon in children. Comprehensive sex education, stringent laws to prevent sex trafficking and child sexual abuse, and antenatal screening of all the women can reduce the prevalence of STDs in children. PMID:20826987
Dhawan, Jyoti; Gupta, Somesh; Kumar, Bhushan
These guidelines for treatment of sexually transmitted diseases (STD) were established after careful deliberation by a group of experts and staff of the Centers for Disease Control (CDC). Commentary received after dissemination of preliminary documents to a large group of physicians was also considered. Certain aspects of these guidelines represent the best judgment of experts. The guidelines should not be construed as rules, but rather as a source of guidance within the United States. This is particularly true for topics that are controversial or based on limited data. PMID:6688083
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)
Sexually transmitted infections (STIs) are highly prevalent and cause a wide spectrum of disease. However, the majority of these infections may be unrecognized due to lack of overt signs or symptoms of infection. Asymptomatic infections remain significant as a result of the potential for long-term sequelae, predominately in women, and the risks of complications during pregnancy as well as mother-to-child transmission. Laboratory diagnostics play an important role in identifying infection and in public health efforts to reduce the prevalence of these diseases. Serologic diagnosis is appropriate for syphilis and, in some settings, for herpes infections. However, the organisms that cause discharge such as Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium are best diagnosed using molecular assays. Currently available molecular assays are suitable for use with non-invasively collected sample types, most notably vaginal swabs for women thus expanding the potential reach of STI control programs to include non-clinic based screening. PMID:25083897
Van Der Pol, Barbara
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
Brotman, Rebecca M.
Diseases of the anus and rectum are frequently the outcome of proctogenital and oral-anal sexual activities. These sexually transmitted diseases are more common among homosexual and bisexual men than among heterosexuals. A variety of infectious agents are responsible including viruses, bacteria, spirochetes, helminths, and protozoa. Anal warts, herpetic ulcers, and syphilitic chancres are common anal STDs. Gonorrhea, herpes, and chlamydial organisms are common causes of venereal acute proctitis. Enteric infections such as shigellosis, amebiasis, giardiasis and pinworms can be transmitted by oral-anal contact. Aggressive sexual attempts at auto-eroticism using rectally inserted foreign bodies may cause traumatic proctitis complicated by bacterial peritonitis or perirectal abscesses. PMID:21263807
Warren, Ralph E.
The management of 63 patients diagnosed by surgeons as having sexually transmitted disease (STD) was audited. A diagnosis of STD was made in 51 (81%) of patients without taking a sexual history. Only 2 (3%) patients were referred to genitourinary medicine (GUM). Appropriate microbiological specimens were obtained from only two of 52 (4%) patients diagnosed with either pelvic inflammatory disease (PID) or epididymo-orchitis. Reliance was placed on inappropriate specimens in 22 (42%). There was widespread use of inappropriate antibiotics. The management of sexually transmitted disease by surgeons was very poor. These patients should all be referred to genito-urinary medicine. Images Figure 1 PMID:9849339
Hunt, L. M.; Nash, J. R.; Dilke-Wing, G. M.
Sexually transmitted infections (STIs) are often associated with chronic diseases and can have severe impacts on host reproductive success. For airborne or socially transmitted pathogens, patterns of contact by which the infection spreads tend to be dispersed and each contact may be of very short duration. By contrast, the transmission pathways for STIs are usually characterized by repeated contacts with a small subset of the population. Here we review how heterogeneity in sexual contact patterns can influence epidemiological dynamics, and present a simple model of polygyny/polyandry to illustrate the impact of biased mating systems on disease incidence and pathogen virulence. PMID:23339239
Ashby, Ben; Gupta, Sunetra
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.
The very great increase in the tourist industry during the past 20 years is described. This has occurred at a time when there has been an unprecedented rise in the incidence of sexually transmitted diseases. Evidence is presented that there is a relationship between the number of tourists and other travellers and the prevalence of sexually transmitted diseases. Case histories from three different categories of tourist are described and the impact of tourism on the spread of disease is stressed. It is suggested that health authorities throughout the world should give further consideration to plans to meet the challenge of the mobility explosion. PMID:1243165
Catterall, R. D.
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
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
Despite concerted efforts to control sexually transmitted diseases (STDs) worldwide, they still remain a major public health problem. Out of the 25 organisms known to be transmitted sexually, travelers are at greater risk of acquiring HIV and other STDs in developing countries in view of the high prevalence rates in these countries, particularly after sexual exposure to local commercial sex workers (CSWs). Some of the STDs acquired during international travel are more likely to be resistant to standard antimicrobial regimens for the STDs. HIV, gonorrhoea, syphilis, non-specific urethritis, hepatitis B, hepatitis C, and other STDs are a significant risk for travelers who engage in unprotected sex, especially with overseas CSWs. It is recognized that barrier contraceptives provide considerable protection against STDs, but they are not regarded as 100% protective. Sexual abstinence and sexual monogamy with a 'known' partner carry a much lower risk than the safest of 'safer sex' practices. However, in the event of a sexual exposure to a new partner in the country being visited, prior hepatitis B immunization and the consistent and proper use of a latex condom are strongly advised, followed by proper medical investigations and physical examination on returning home, before sexual activity is resumed. PMID:16887730
Memish, Ziad A; Osoba, Abimbola O
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…
Planned Parenthood Federation of America, Inc., New York, NY. Education Dept.
This survey covers periodical literature published in the field of research on sexually transmitted diseases during 1985. The articles cover the following diseases: (1) genital chlamydial infection; (2) gonorrhea; (3) genital herpes infection; (4) human papillomavirus infection; (5) acquired immunodeficiency syndrome (AIDS); (6) genital…
Centers for Disease Control (DHHS/PHS), Atlanta, GA.
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
Lamb, Chris A; Lamb, Elizabeth Iris Mary; Mansfield, John C; Sankar, K Nathan
Sexually transmitted infections (STIs) are common and costly, in part because they are asymptomatic and result in serious complications. Primary care clinicians can easily diagnose and effectively treat most STIs. Clinicians should screen patients for STIs based on high-risk behaviors, and consult with local public health officials to adapt national screening guidelines to local epidemiology. Clinical encounters involving STI screening are opportunities to counsel patients on risk behaviors, and vaccinate against human papillomavirus and hepatitis B. Electronic health records and mobile phone apps show promise for improving the clinical care of STIs. PMID:24830606
Hunter, Paul; Dalby, Jessica; Marks, Jaime; Swain, Geoffrey R; Schrager, Sarina
CONTEXT Sexually transmitted diseases (STDs) can be spread between female sex partners, probably through the exchange of cervicovaginal fluid and direct mucosal contact. Additionally, lesbians have a high prevalence of bacterial vaginosis, which may represent an STD in this population. However, few data on sexual practices or perceived STD risk among lesbians are available to guide development of interventions aimed at reducing the risk. METHODS To inform the development of a safer-sex intervention for women who have sex with women, focus group discussions were conducted with 23 lesbian and bisexual women aged 18–29. Topics included sexual practices, STD transmission and prevention, and knowledge about bacterial vaginosis. RESULTS Although six participants had had bacterial vaginosis and three an STD, women reported little use of preventive measures with female partners (washing hands, using rubber gloves and cleaning sex toys). Participants said that vaginal penetrative practices using sex toys and fingers or hands are common, and that partners frequently share sex toys during a sexual encounter, generally without condoms. Knowledge of potential for STD transmission between women, and of bacterial vaginosis, was limited. Participants viewed use of barrier methods (gloves or condoms) as acceptable, provided that there is a reason (usually STD-focused) to use them and that they are promoted in the context of sexual health and pleasure. CONCLUSIONS Safer-sex messages aimed at lesbian and bisexual women should emphasize the plausibility of STD transmission between women, personal responsibility and care for partners’well-being; should target common sexual practices; and should promote healthy sexuality. PMID:15888397
Marrazzo, Jeanne M.; Coffey, Patricia; Bingham, Allison
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 have been reported. Whereas nearly all vertebrate STDs are viruses or bacteria, the majority of insect
Trichomoniasis is the most common, sexually transmitted infection. It is caused by the flagellated protozoan parasite Trichomonas vaginalis. Symptoms include vaginitis and infections have been associated with preterm delivery, low birth weight and increased infant mortality, as well as predisposing to HIV\\/AIDS and cervical cancer. Trichomoniasis has the highest prevalence and incidence of any sexually transmitted infection. The 5-nitroimidazole drugs,
Rebecca L DUNNE; Linda A DUNN; Peter UPCROFT; Peter J O'DONOGHUE; Jacqueline A UPCROFT
The prevalence of sexually transmitted disease (STD), pelvic inflammatory disease (PID), and cervical cancer, and the relation between these conditions were studied in 2111 Ethiopian women. Early sexual activity was associated with an increase in prevalence rates of STD and PID; possible aetiological factors include physical and immunological immaturity of the female genital tract and the number of sexual partners. PMID:1967779
Duncan, M E; Tibaux, G; Pelzer, A; Reimann, K; Peutherer, J F; Simmonds, P; Young, H; Jamil, Y; Daroughar, S
Sexually transmitted diseases (STDs) have shown a considerable resurgence in recent years both in number of cases and in spread of new infectious agents. The spread of STDs is favored by numerous factors including the liberalization of sexual behavior made possible by reliable contraception. Information on STDs has not been widely diffused. Changes in the status of women and the development of means of communication and transportation have encouraged less rigid control of sexual behavior. STDs themselves have often escaped diagnosis or not been cured despite treatment, increasing the risk of spread. Numerous organisms cause STDs, from external parasites to life-threatening viruses. 60% of upper genital tract infections that can lead to sterility, tubal alterations, ectopic pregnancy and pain result from STDs. Chlamydia infections are insidious and chronic, and cause greater damage with each recurrence. The risk of STDs should be considered in contraceptive choice along with other indications and contraindications. Combined oral contraceptives provide protection against acute upper genital tract infections. The protective role has been explained by scanty and highly viscous cervical mucus forming a barrier against germs and by reductions of menstrual flow, myometrial activity, and inflammation. It is actually uncertain whether combined oral contraceptives protect against latent chlamydia infections, since higher rates of cervicitis caused by chlamydia have been found in pill users. In situations carrying risk of STDs, pill users should be protected by a supplementary barrier method. IUDs have been implicated in numerous studies in acute pelvic infections. Possible explanations are the local trauma and inflammations due to the physical presence of the IUD, more abundant bleeding, absence of a cervical barrier to motile sperm that could be a vector for germs, and possible ascent of the infectious agent on the string. Other risk factors are involved. Epidemiologic studies indicate that the spermicides benzalkonium chloride and nonoxynol 9 have a protective effect against gonococcus, trichomonas, and chlamydia as well as cervical cancer. The protection is not absolute and is associated with the use of barrier methods. Condoms provide an excellent barrier against gonorrhea, chlamydia, cytomegalovirus, herpes, hepatitis B, and HIV infection. Use of spermicides may increase protection even more. PMID:12342583
Erny, R; Porte, H
The bacterial sexually transmitted infections (STIs) syphilis, gonorrhoea and chlamydia can all be cured with a single dose of antibiotic. Unfortunately, however, these infections often remain undiagnosed as many infected individuals have few if any symptoms. Diagnostic tests with high sensitivity and specificity are available for all three infections but, owing to their expense and the lack of laboratory capacity,
Rosanna W. Peeling; David Mabey; Alan Herring; Edward W. Hook
Adolescent sexual activity and the resulting pregnancy and transmission of sexually transmitted diseases have been on the rise during the past several decades. This chapter addresses each of the three objectives regarding sexual behavior outlined in the Healthy People 2000 initiative. Background data and trends in adolescent sexual behavior are…
Sagrestano, Lynda M.; Paikoff, Roberta L.
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, including more sexual partners, unprotected
Theresa E. Senn; Michael P. Carey; Peter A. Vanable; Patricia Coury-Doniger; Marguerite A. Urban
This article assesses the relationship between low marriage rates and racial disparities in sexually transmitted infection (STI) rates. Data from the 2002 National Survey of Family Growth was used to examine the prevalence of sexual risk behaviors by marital status. Logistic regression was used to examine whether racial differences in marriage…
Taylor, Eboni M.; Adimora, Adaora A.; Schoenbach, Victor J.
Sexually transmitted diseases (STDs) are the first 10 causes of unpleased diseases in young adult women in the world. The concept of STDs includes a series of syndromes caused by pathogens that can be acquired by sexual intercourse or sexual activity.Adolescents and young adults are responsible for only 25% of the sexually active population and they represent almost 50% of all newly acquired STDs.In this way, we evaluated the epidemiological and clinical aspects of most relevant pathogens as Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum, Haemophilus Ducreyi, Trichomonas vaginalis, herpes simplex virus, human papilloma virus (HPV) with the exception of hepatitis, and HIV infections for which we suggest specific guidelines.To attain this objective, we analyzed the results of epidemiological and clinical aspects of STDs through a review of the literature using MEDLINE and PubMed database for original articles published using the terms "sexual transmitted disease, epidemiology, diagnosis and therapy" from 2005 to 2014. PMID:25532465
Siracusano, Salvatore; Silvestri, Tommaso; Casotto, Daniela
Many adolescents are susceptible to negative outcomes associated with sexual behavior. This is particularly true for those who initiate sexual intercourse at an early age, have many sex partners, or engage in unprotected sex because these behaviors put one at risk for sexually transmitted infections (STIs), including HIV. This article reviews the…
Walcott, Christy M.; Meyers, Adena B.; Landau, Steven
Background: Victimization by intimate partner violence (IPV) may play an important role in sexual decision-making, increasing the risk for sexually transmitted diseases (STDs) and HIV. Goal: To explore the relationship between IPV and high- risk sexual behaviors, substance abuse, partners who had sex outside the relationship, and history of STD among women attending an STD clinic. Study Design: A self-administered
HEIDI M. BAUER; PAUL GIBSON; MARIA HERNANDEZ; CHARLOTTE KENT; JEFFREY KLAUSNER; GAIL BOLAN
Disease spreading is a topical issue in a variety of fields ranging from computer viruses in the Internet to air-borne (e.g. influenza) diseases in societies. In particular, the description of the spread of sexually transmitted diseases (Chlamydia, Syphilis, Gonorrhea, AIDS) across population constitutes a major concern for scientists and health agencies. In this context, both data collection on sexual contact networks and the modeling of disease spreading are intensively contributing to the search for effective immunization policies. Here, the spread of sexually transmitted diseases on bipartite scale-free graphs, representing heterosexual contact networks, is considered. We analytically derive the expression for the epidemic threshold and its dependence with the system size in finite populations. The results indicate that in finite bipartite populations with degree distribution as those found in national surveys of sexual attitudes, the onset of the epidemic outbreak takes place for larger spreading rates t...
Gómez-Gardenes, J; Moreno, Y; Profumo, E V
Between November 1992 and April 1993, interviews were conducted with 400 patients (169 men, 231 women) aged 14-52 years at the sexually transmitted disease (STD) clinic of the Institut d'Hygiene Sociale in Antananarivo, Madagascar, to determine the pattern of STDs and to improve treatment of the leading STDs. The 400 patients presented with 434 syndromes. 124 men had urethral discharge. 210 women had cervicovaginal discharge. 43 men and 18 women had genital ulcers. Clinicians could not establish a diagnosis in 33 patients. 171 patients had more than one infection. Chlamydia infection was the most common infection associated with another STD (gonorrhea in 22% of men and 11% of women with discharge, trichomoniasis in 2.4% of men and 13% of women, candidiasis in 1.6% of men and 9% of women, and bacterial vaginosis in 15% of women with discharge). Gonorrhea was the most common etiology for male discharge (69%) while chlamydia infection was for female discharge (52%). Women with discharge were more likely than men with discharge to have chlamydia infection (52% vs. 42%), trichomoniasis (30% vs. 9%; p 0.00001), and candidiasis (32% vs. 12%; p 0.00001). 37% of women with discharge had bacterial vaginosis. Chlamydia infection was the most common STD in this population (45%). 32% of male and 71% of female gonorrhea cases also had chlamydia infection. 70 patients had syphilis. 36 of them had secondary stage syphilis. No one had HIV-1 or HIV-2 infection. The most efficacious antibiotics for gonorrhea were ampicillin, ciprofloxacin, and spectinomycin (100% susceptibility). 31% and 26% of isolates were susceptible to tetracycline and cotrimoxazole, respectively. Public facilities in Madagascar do not have the capabilities to diagnosis chlamydia, resulting in many untreated chlamydia cases. These findings stress the need to improve combined treatment of gonorrhea and chlamydia infection and for educational efforts to increase awareness of genital ulcer disease. PMID:7871444
Harms, G; Matull, R; Randrianasolo, D; Andriamiadana, J; Rasamindrakotroka, A; Kirsch, T; Hof, U; Rarivoharilala, E; Korte, R
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
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 (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.
White, Joël; Mirleau, Pascal; Danchin, Etienne; Mulard, Hervé; Hatch, Scott A.; Heeb, Phillipp; Wagner, Richard H.
Concerns have been voiced in the national press that the surge in migrant construction workers leading up to the 2012 Olympics Games would increase the levels of sexual ill health in East London. Between 2009 and 2011, we sent a sexual health outreach team to the Olympic Park and Village. A total of 614 clients were tested, of whom 91% were men and 46% reported English/Scottish/Welsh ethnicity. The age range was 17-73 years and median age 30 years. Reported sexual risk factors were low, including use of commercial sex workers. Prevalence of sexually transmitted infections was low, with Chlamydia trachomatis found in 20 clients (3%), and hepatitis B diagnosed in one client. This study, although small, did not support the image of construction workers presenting a higher than average sexual health risk. PMID:23033522
Shanmugaratnam, S; Horne, P; Coyne, K M
Conducted unstructured interviews with 18 male street prostitutes between the ages of 13 and 22 to determine the extent of accurate knowledge they possessed concerning four common sexually transmitted diseases. Found that subjects possessed more factual information on gonorrhea and syphilis than on herpes and Acquired Immune Deficiency Syndrome.…
Calhoun, Thomas; Pickerill, Brian
The authors' objectives in this study were to describe the proportion of schools providing and the percentage of students with access to HIV and sexually transmitted disease (STD) education, treatment, and prevention services at 2-year and 4-year US colleges and universities. The authors mailed self-administered questionnaires to a stratified…
Koumans, Emilia H.; Sternberg, Maya R.; Motamed, Cathy; Kohl, Katrin; Schillinger, Julia A.; Markowitz, Lauri E.
Fertility regulation and prevention of sexually transmitted diseases (STDs) are recognized pillars in fertility health work. The HIV epidemic has made it clear that there are people at risk for STDs all over the world. Both STDs and unwanted pregnancies are negative consequences of the same behavior, i.e., unprotected intercourse. From the perspective of the individual the risks with unprotected
The spread of sexually transmitted diseases (e.g., chlamydia, syphilis, gonorrhea, HIV, etc.) across populations is a major concern for scientists and health agencies. In this context, both the data collection on sexual contact networks and the modeling of disease spreading are intensive contributions to the search for effective immunization policies. Here, the spreading of sexually transmitted diseases on bipartite scale-free graphs, representing heterosexual contact networks, is considered. We analytically derive the expression for the epidemic threshold and its dependence with the system size in finite populations. We show that the epidemic outbreak in bipartite populations, with number of sexual partners distributed as in empirical observations from national sex surveys, takes place for larger spreading rates than for the case in which the bipartite nature of the network is not taken into account. Numerical simulations confirm the validity of the theoretical results. Our findings indicate that the restriction to crossed infections between the two classes of individuals (males and females) has to be taken into account in the design of efficient immunization strategies for sexually transmitted diseases. PMID:18212127
Gómez-Gardeñes, Jesús; Latora, Vito; Moreno, Yamir; Profumo, Elio
Sexually transmitted infections (STIs) have occupied a central place in public health agendas for at least the past 500 years, but have been the subject of opinions, decrees and “moral positions” for much longer. Societies have long tried to control the sexual behaviors of their populations, not only for reasons of social control, but also with the objective of controlling
Mycoplasma genitalium is an emerging pathogen that has been detected in the male and female reproductive tracts. It is an established cause of\\u000a nongonococcal urethritis and evidence linking it to cervicitis, endometritis, and tubal factor infertility is accumulating.\\u000a Whether a pathogen is sexually transmitted has important implications for clinical management because partner management strategies\\u000a are an essential part of the
Lisa E. Manhart; Noa Kay
IntroductionMore new HIV-1 infections occur within stable HIV-1-discordant couples than in any other group in Africa, and sexually transmitted infections (STIs) may increase transmission risk among discordant couples, accounting for a large proportion of new HIV-1 infections. Understanding correlates of STIs among discordant couples will aid in optimizing interventions to prevent HIV-1 transmission in these couples.MethodsHIV-1-discordant couples in which HIV-1-infected
Brandon L. Guthrie; James N. Kiarie; Susan Morrison; Grace C. John-Stewart; John Kinuthia; William L. H. Whittington; Carey Farquhar; Etienne Joly
The Centers for Disease Control and Prevention (CDC) Sexually Transmitted Disease (STD) Treatment Guidelines were last updated in 2006. To update the “Clinical Guide to Prevention Services” section of the 2010 CDC STD Treatment Guidelines, we reviewed the recent science with reference to interventions designed to prevent acquisition of STDs, including human immunodeficiency virus (HIV) infection. Major interval developments include (1) licensure and uptake of immunization against genital human papillomavirus, (2) validation of male circumcision as a potent prevention tool against acquisition of HIV and some other sexually transmitted infections (STIs), (3) failure of a promising HIV vaccine candidate to afford protection against HIV acquisition, (4) encouragement about the use of antiretroviral agents as preexposure prophylaxis to reduce risk of HIV and herpes simplex virus acquisition, (5) enhanced emphasis on expedited partner management and rescreening for persons infected with Chlamydia trachomatis and Neisseria gonorrhoeae, (6) recognition that behavioral interventions will be needed to address a new trend of sexually transmitted hepatitis C among men who have sex with men, and (7) the availability of a modified female condom. A range of preventive interventions is needed to reduce the risks of acquiring STI, including HIV infection, among sexually active people, and a flexible approach targeted to specific populations should integrate combinations of biomedical, behavioral, and structural interventions. These would ideally involve an array of prevention contexts, including (1) communications and practices among sexual partners, (2) transactions between individual clients and their healthcare providers, and (3) comprehensive population-level strategies for prioritizing prevention research, ensuring accurate outcome assessment, and formulating health policy. PMID:22080271
Sexually transmitted infections (STI) comprise a variety of infections transmissible through sexual contact. Mutually consenting sexual relationships have become commonplace in adolescence and sexual abuse or exploitation awareness has risen, resulting in increased presentations of children with sexual health concerns. Difficulties persist in diagnosing and managing STIs in children. With increased emphasis on paediatrician's involvement in transitional care, competence in sexual history taking and clinical presentation recognition remains essential. Additionally, an awareness of strengths and limitations of diagnostic modalities needs to be present. Furthermore, specific additional issues in this age group such as independent consent for diagnosis and treatment, fear of pregnancy and privacy and confidentiality concerns should be addressed carefully. Failure to address these issues may lead to disengagement with health services resulting in potentially adverse short- and long-term health and social consequences in young persons. This review aims to provide an overview of an approach to diagnosing and managing a pubertal child with an STI and the consideration of the unique issues surrounding children's care. PMID:22036714
Manikam, Logan; Rogstad, Karen; Singh, Gurdeep; Lakhanpaul, Monica
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
Mendiratta, Vibhu; Agarwal, Soumya; Chander, Ram
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 to another, together with the risk of sexually transmitted disease. A broad social definition of prostitution rather than a narrow reference to levels of sexual activity is important for effective disease control, as an understanding of the relation between social disadvantage and sexual activity enables the provision of occupational services that sex workers actually want and use. Social prejudice and legal sanctions cause some sex workers and their partners to avoid even the most appropriate and accessible specialist services. Therefore targeted programmes can only complement, and not replace, general measures to control STDs, which are developed for other social groups or the local population as a whole. CONCLUSIONS: Sex workers and sex work differ from one place to another and so a single model for STD control is inappropriate. None the less, occupational health risks suggest a general need for specialist services. Where these do not compound the disadvantages that sex workers already suffer, medical services are likely to offer significant benefits in prevention, early diagnosis, and treatment of STDs. As the stigma of prostitution leads many people to remain invisible to services, a general health infrastructure and anti-discriminatory measures will be equally important to effective disease control. PMID:9306894
Day, S; Ward, H
The populations of developing countries have younger age structures than the populations of more developed, Western countries. That is, children, adolescents, and youth constitute a far greater proportion of the populations of developing countries than in developed countries. These young people experiment with sex and sexual intercourse or have coitus on a regular basis depending upon their individual personalities and circumstances. The prevalence of sexually transmitted diseases (STD) among younger age groups in developing countries is not well documented. It may, however, be inferred on the basis of reported experience of STD in surveys of adolescents and young adults that many children are infected with STDs. Some young people have sex consensually, some are coaxed into it, and others are coerced. On the one hand, young children have been thought to contract STD by sitting on the laps of infected, scantily-clad adults where such limited attire is the norm. Close contact between youngsters such as communal sleeping, for example, could then facilitate the spread of the STD among children. Sex, consensual or otherwise, is not involved in such infection and transmission beyond the index adult. On the other hand, however, many children and adolescents are forced to have sexual relations and/or intercourse either directly against their will or as a result of the primal need to ensure their individual survival. For example, there are an estimated 100-200 million street children worldwide; many have little alternative but to sell sex to survive. When having sex, they may not use condoms because they are unaware of the STD risk they face, they have no access to free condoms, clients/employers/peers prevent them from using condoms, or due to a myriad of other reasons. Struggling to survive, many such kids place condom use very low on their list of priorities. Children and adolescents can also become infected and transmit STDs to others by engaging in sexual intercourse under more narrowly-defined cultural norms. For example, the belief exists that a male with urethritis can be cured by sexual intercourse with a virgin or prepubertal girl. Elsewhere, it is normal practice for an adult male, typically a boy's uncle, to have anal insertive sexual intercourse with the boy on a regular basis over the period of a couple years to facilitate his transition into manhood. People in young age groups around the world have sex for a range of reasons under a variety of conditions. Measures are needed to ensure that they have the means to prevent infection with STDs and control that infection, if possible, once acquired. Sections discuss vulvovaginitis, donovanosis, chancroid, and venereal and nonvenereal treponematosis, as well as prevention and future research. PMID:7959715
Data was collected on arrested youths processed at a centralized intake facility, including youths released back to the community and those placed in secure detention. This article reports the results of a test of a structural model involving newly arrested male and female youths' sexually transmitted diseases (STD) test results, urine analysis…
Dembo, Richard; Belenko, Steven; Childs, Kristina; Greenbaum, Paul E.; Wareham, Jennifer
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
Peeling, R W; Holmes, K K; Mabey, D
Sexually transmitted diseases (STDs) have been shown to increase the costs of multiple mating and therefore favor relatively monogamous mating strategies. We examine another way in which STDs can influence mating systems in species in which female choice is important. Because more popular males are more likely to become infected, STDs can counteract any selective pressure that generates strong mating skews. We build two models to investigate female mate choice when the sexual behavior of females determines the prevalence of infection in the population. The first model has no explicit social structure. The second model considers the spatial distribution of matings under social monogamy, when females mated to unattractive males seek extrapair fertilizations from attractive males. In both cases, the STD has the potential to drastically reduce the mating skew. However, this reduction does not always happen. If the per contact transmission probability is low, the disease dies out and is of no consequence. In contrast, if the transmission probability is very high, males are likely to be infected regardless of their attractiveness, and mating with the most attractive males imposes again no extra cost for the female. We also show that optimal female responses to the risk of STDs can buffer the prevalence of infection to remain constant, or even decrease, with increasing per contact transmission probabilities. In all cases considered, the feedback between mate choice strategies and STD prevalence creates frequency-dependent fitness benefits for the two alternative female phenotypes considered (choosy vs. randomly mating females or faithful vs. unfaithful females). This maintains mixed evolutionarily stable strategies or polymorphisms in female behavior. In this way, a sexually transmitted disease can stabilize the populationwide proportion of females that mate with the most attractive males or that seek extrapair copulations. PMID:12144011
Kokko, Hanna; Ranta, Esa; Ruxton, Graeme; Lundberg, Per
Background.?Among human immunodeficiency virus (HIV)–infected men who have sex with men (MSM) taking combination antiretroviral therapy (cART), the impact of rectal sexually transmitted infections (STIs) on rectal HIV-1 shedding is unknown. Methods.?Human immunodeficiency virus type 1 (HIV-1) RNA was quantified from rectal swabs collected for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) screening of HIV-1-infected MSM. Correlations of STIs with rectal viral load were explored using multinomial regression modeling. HIV-1 coreceptor tropism was predicted from sequencing in a subset of men. Results.?Thirty-one (39%) of 80 men (59 prescribed combination antiretroviral therapy [cART]) had HIV detected in 38 (42%) of 91 rectal swabs. Rectal HIV detection was associated with plasma virus loads above 3.15 log10 copies/mL (95% confidence limit [CL] 2.73, 3.55) and paired rectal viral loads and plasma viral loads were correlated (Kendall’s tau [?] 0.68, Spearman rho [P] = .77). Rectal STIs and abnormal anal cytology were not associated with rectal viral load. HIV coreceptor distribution was very similar between the plasma and rectum in 3 of 4 men. Conclusions.?Plasma and rectal viral load were correlated, and rectal STIs did not increase the likelihood of detecting HIV in the rectal secretions in MSM, including those with low or undetectable plasma viral load. Suppressing plasma viral load is likely to reduce risk of HIV transmission to insertive partners. PMID:21844302
Haaland, Richard E.; Patel, Pragna; Evans-Strickfaden, Tammy; Farshy, Carol; Hanson, Debra; Mayer, Kenneth; Lennox, Jeffrey L.; Brooks, John T.; Hart, Clyde E.
Objective: To assess the association between vaginal douching and sexually transmitted infections (STI) among a group of female sex workers (FSWs) in Nairobi, Kenya. Methods: This study was part of a randomised, placebo controlled trial of monthly prophylaxis with 1 g of azithromycin to prevent STIs and HIV infection in a cohort of Nairobi FSWs. Consenting women were administered a questionnaire and screened for STIs. Results: The seroprevalence of HIV-1 among 543 FSWs screened was 30%. HIV infection was significantly associated with bacterial vaginosis (BV), trichomoniasis, gonorrhoea, and the presence of a genital ulcer. Regular douching was reported by 72% of the women, of whom the majority inserted fluids in the vagina, generally after each sexual intercourse. Water with soap was the fluid most often used (81%), followed by salty water (18%), water alone (9%), and a commercial antiseptic (5%). Douching in general and douching with soap and water were significantly associated with bacterial vaginosis (p = 0.05 and p = 0.04 respectively). There was a significant trend for increased frequency of douching and higher prevalence of BV. There was no direct relation observed between douching and risk for HIV infection or other STIs. Conclusion: The widespread habit of douching among African female sex workers was confirmed. The association between vaginal douching and BV is of concern, given the increased risk of HIV infection with BV, which has now been shown in several studies. It is unclear why we could not demonstrate a direct association between douching and HIV infection. Further research is required to better understand the complex relation between douching, risk for bacterial vaginosis, and risk for HIV and other STIs. Key Words: vaginal douching; sexually transmitted infections; female sex workers PMID:11463927
Fonck, K; Kaul, R; Keli, F; Bwayo, J; Ngugi, E; Moses, S; Temmerman, M
Sexually transmitted infections (STI) in HIV-infected people are of increasing concern. We estimated STI prevalence and sexual healthcare seeking behaviour in 224 sexually active HIV-infected people, including men who have sex with men (MSM, n = 112), heterosexual men (n = 65) and women (n = 47). Laboratory-diagnosed bacterial STI were more common in MSM (Chlamydia trachomatis 10.7%; 95% CI 6.2, 18.0%, lymphogranuloma venereum 0.9%; 95% CI 0.1, 6.2%, Neisseria gonorrhoeae 2.7%; 95% CI 0.9, 8.0%, syphilis seroconversion 5.4%; 95% CI 2.0, 11.3%) than heterosexual men (gonorrhoea 1.5%; 95% CI 0.2, 10.3%) or women (no acute infections). Combined rates of laboratory-diagnosed and self-reported bacterial STI in the year before the study were: MSM (27.7%; 95% CI 21.1, 36.7%); heterosexual men (1.5%; 95% CI 0.2, 10.3%); and women (6.4%; 95% CI 2.1, 21.0%). Antibodies to hepatitis C virus were least common in MSM. Antibodies to herpes simplex type 2 virus were least common in heterosexual men. Most MSM, but not heterosexual men or women, agreed that STI testing should be offered every year. In this study, combined rates of bacterial STI in MSM were high; a regular assessment of sexual health would allow those at risk of STI to be offered testing, treatment and partner management. PMID:25237598
Sprenger, Katharina; Evison, John Marc; Zwahlen, Marcel; Vogt, Cedric M.; Elzi, Maria Verena; Hauser, Christoph
The Division of STD Prevention of the US Centers for Disease Control has recently released this update (MMWR 1998;47(No. RR-1)) to the 1993 set of guidelines with the same title. The guidelines were developed by CDC staff after consultation with a "group of invited experts" in early 1997. Included are sections on various sexually transmitted diseases, including HIV, Genital Ulcers, Epididymitis, Human Papillomavirus Infection, and vaccine preventable STDs, among others. Guideline evidence is briefly discussed in each section of the report, and the CDC is committed to providing "more comprehensive, annotated discussions of such evidence...in background papers that will be published in 1998." Note that in the HTML version of the report, some of the interior links within chapters are inaccurate. In those cases, it is prudent to click on the section headings to find the relevant information.
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
Surveillance of sexually transmitted infections (STIs) in England and Wales has, in the past, relied principally on aggregated statistical data submitted by all genitourinary medicine clinics to the Communicable Disease Surveillance Centre, supplemented by various laboratory reporting systems. Although these systems provide comparatively robust surveillance data, they do not provide sufficient information on risk factors to target STI control and prevention programmes appropriately. Over recent years, substantial rises in STIs, the emergence of numerous outbreaks of STIs, and changes in gonococcal resistance patterns have necessitated the introduction of more sophisticated surveillance mechanisms. This article describes current STI surveillance systems in England and Wales, including new systems that have recently been introduced or are currently being developed to meet the need for enhanced STI surveillance data. PMID:11679688
Hughes, G; Paine, T; Thomas, D
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
Background Sexually-transmitted pathogens often have severe reproductive health implications if treatment is delayed or absent, especially in females. The complex processes of disease progression, namely replication and ascension of the infection through the genital tract, span both extracellular and intracellular physiological scales, and in females can vary over the distinct phases of the menstrual cycle. The complexity of these processes, coupled with the common impossibility of obtaining comprehensive and sequential clinical data from individual human patients, makes mathematical and computational modelling valuable tools in developing our understanding of the infection, with a view to identifying new interventions. While many within-host models of sexually-transmitted infections (STIs) are available in existing literature, these models are difficult to deploy in clinical/experimental settings since simulations often require complex computational approaches. Results We present STI-GMaS (Sexually-Transmitted Infections – Graphical Modelling and Simulation), an environment for simulation of STI models, with a view to stimulating the uptake of these models within the laboratory or clinic. The software currently focuses upon the representative case-study of Chlamydia trachomatis, the most common sexually-transmitted bacterial pathogen of humans. Here, we demonstrate the use of a hybrid PDE–cellular automata model for simulation of a hypothetical Chlamydia vaccination, demonstrating the effect of a vaccine-induced antibody in preventing the infection from ascending to above the cervix. This example illustrates the ease with which existing models can be adapted to describe new studies, and its careful parameterisation within STI-GMaS facilitates future tuning to experimental data as they arise. Conclusions STI-GMaS represents the first software designed explicitly for in-silico simulation of STI models by non-theoreticians, thus presenting a novel route to bridging the gap between computational and clinical/experimental disciplines. With the propensity for model reuse and extension, there is much scope within STI-GMaS to allow clinical and experimental studies to inform model inputs and drive future model development. Many of the modelling paradigms and software design principles deployed to date transfer readily to other STIs, both bacterial and viral; forthcoming releases of STI-GMaS will extend the software to incorporate a more diverse range of infections. PMID:24923486
Trichomoniasis is the most common, sexually transmitted infection. It is caused by the flagellated protozoan parasite Trichomonas vaginalis. Symptoms include vaginitis and infections have been associated with preterm delivery, low birth weight and increased infant mortality, as well as predisposing to HIV/AIDS and cervical cancer. Trichomoniasis has the highest prevalence and incidence of any sexually transmitted infection. The 5-nitroimidazole drugs, of which metronidazole is the most prescribed, are the only approved, effective drugs to treat trichomoniasis. Resistance against metronidazole is frequently reported and cross-resistance among the family of 5-nitroimidazole drugs is common, leaving no alternative for treatment, with some cases remaining unresolved. The mechanism of metronidazole resistance in T. vaginalis from treatment failures is not well understood, unlike resistance which is developed in the laboratory under increasing metronidazole pressure. In the latter situation, hydrogenosomal function which is involved in activation of the prodrug, metronidazole, is down-regulated. Reversion to sensitivity is incomplete after removal of drug pressure in the highly resistant parasites while clinically resistant strains, so far analysed, maintain their resistance levels in the absence of drug pressure. Although anaerobic resistance has been regarded as a laboratory induced phenomenon, it clearly has been demonstrated in clinical isolates. Pursuit of both approaches will allow dissection of the underlying mechanisms. Many alternative drugs and treatments have been tested in vivo in cases of refractory trichomoniasis, as well as in vitro with some successes including the broad spectrum anti-parasitic drug nitazoxanide. Drug resistance incidence in T. vaginalis appears to be on the increase and improved surveillance of treatment failures is urged. PMID:12974614
Dunne, Rebecca L; Dunn, Linda A; Upcroft, Peter; O'Donoghue, Peter J; Upcroft, Jacqueline A
Background: Binge drinking is associated with risky sexual behaviors and sexually transmitted diseases (STDs). Few studies have investigated this by gender or in an STD clinic. This cross- sectional study examined the association between binge drinking and risky sexual behaviors ? STDs among patients attending an urban STD clinic. Method: A total of 671 STD clinic patients were tested for
Heidi E. Hutton; Mary E. McCaul; Patricia B. Santora; Emily J. Erbelding
Background: Sexually transmitted infections (STIs) are public health problems, which significantly increase the risk of HIV transmission. A proper understanding of the pattern of STIs in different geographical regions is important for proper planning of STI control. Aims: To determine the pattern of sexually transmitted diseases in a tertiary care hospital in Eastern India. Subjects and Methods: This is a hospital-based, cross-sectional study done in a tertiary care hospital of Eastern India. All the consecutive patients attending the STI clinic of a tertiary care hospital from January 2011 to December 2011 were included in the study, irrespective of age and sex. Thorough history was taken; proper clinical examination and relevant laboratory investigations were done. STIs were categorized in different syndromes as depicted by National AIDS Control Organization(NACO) in the syndromic management of STIs. The STIs, which were not included in the syndromic management, were also identified by clinical features and investigations. Partner notification and condom promotion was done. The statistical analysis used was Chi-square test using MedcalcR statistical software Version 9.3 (Belgium). Results: The commonest STI was genital herpes. Viral STIs like genital herpes, condyloma acuminata, molluscum contagiosum were more prevalent than the non-viral ones like genital ulcer disease non-herpetic, syphilis. STIs which were not included in the syndromic management like molluscum contagiosum, condyloma acuminata, genital scabies were common. HIV seropositivity in the study population (4.2%) was more than the NACO estimate. Condom promotion, partner notification, and partner management was not adequate. Occurrence of venereophobia was found to be significantly higher in male than in female attendees of STI clinic. Conclusions: The trend for viral STIs is increasing while that for bacterial STIs is decreasing. Proper training of the health care providers regarding minor STIs, condom promotion, partner notification and partner management, counseling regarding venereophobia should be undertaken to make STI control programs successful. PMID:23919191
Sarkar, S; Shrimal, A; Das, J; Choudhury, SR
Before condoms can be considered as a prophylaxis for sexually transmitted human immunodeficiency virus (HIV), their efficacy must be considered. This paper reviews evidence on condom effectiveness in reducing the risk of heterosexually transmitted human HIV. A meta-analysis conducted on data from in vivo studies of HIV discordant sexual partners is used to estimate the protective effect of condoms. Although
Susan C. Weller
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
Davoren, Martin P; Hayes, Kevin; Horgan, Mary; Shiely, Frances
Purpose of review To review recent findings on immunity and vaccine development to Chlamydia trachomatis. Recent findings There is increasing knowledge on the interactions between Chlamydia trachomatis and infected host cells. During genital infection the organism avoids generating protective immunity but immune responses to a number of chlamydial proteins have been associated with reproductive tract pathology. Various vaccine and adjuvant preparations have been tried experimentally. Information generated by proteomics and complex studies of serological and T-lymphocyte immune responses points to novel vaccine candidates. Summary Chlamydia trachomatis, an obligate intracellular bacterium, is the commonest sexually transmitted infection worldwide and is associated with reproductive pathology. To develop rational vaccines it is necessary to understand the complex life-cycle of the organism, the host immune response to infection and how these relate to disease. Infection does not prevent reinfection and antibiotic treatment prevents antibody production at a population level. It remains unclear what type of immune response would be sufficient to prevent infection and/or reinfection. Although the prevalence and demographics of infection and the severity of disease associations suggest it would be desirable, there is no vaccine currently available. A number of studies have identified novel vaccine candidates. PMID:21124214
Howie, Sarah E. M.; Horner, Patrick J.; Horne, Andrew W.; Entrican, Gary
Cell surface heparan sulfate (HS), a polysaccharide composed of alternating uronic acid and glucosamine residues, represents a common link that many sexually transmitted infections (STIs) require for infection. Variable modifications within the monomeric units of HS chains together with their unique structural conformations generate heterogeneity, which expands the ability of HS to bind a diverse array of host and microbial proteins. Recent advances made in the field of glycobiology have critically enhanced our understanding of HS and its interactions with microbes and their significance in important human diseases. The role of HS has been elaborated for several STIs to include those caused by herpes simplex virus, human immunodeficiency virus, human papillomavirus, and Chlamydia. In addition, gonorrhea, syphilis, and yeast infections are also dependent on the presence of HS on human target cells. Critical steps such as pathogen adhesion or binding to host cells followed by internalization to enhance intracellular survival and possible spread to other cells are mediated by HS. In addition, HS guided cell signaling plays a role in the development of angiogenesis and inflammation associated with many STIs. Past and ongoing investigations are providing new push for the development of HS-mimetics and analogs as novel prevention strategies against many different STIs. This review article summarizes the significance of HS in STIs and describes how emerging new products that target HS can be used to control the spread of STIs. PMID:22773448
Tiwari, Vaibhav; Maus, Erika; Sigar, Ira M; Ramsey, Kyle H; Shukla, Deepak
Accurate and inexpensive point-of-care (POC) tests are urgently needed to control sexually transmitted infection (STI) epidemics, so that patients can receive immediate diagnoses and treatment. Current POC assays for Chlamydia trachomatis and Neisseria gonorrhoeae perform inadequately and require better assays. Diagnostics for Trichomonas vaginalis rely on wet preparation, with some notable advances. Serological POC assays for syphilis can impact resource-poor settings, with many assays available, but only one available in the U.S. HIV POC diagnostics demonstrate the best performance, with excellent assays available. There is a rapid assay for HSV lesion detection; but no POC serological assays are available. Despite the inadequacy of POC assays for treatable bacterial infections, application of technological advances offers the promise of advancing POC diagnostics for all STIs. PMID:24484215
Gaydos, Charlotte; Hardick, Justin
The aim of the study was to determine the differences in sexual behaviour and condom use as a protection against sexually transmitted infections (STI) between the first-year and the last-year students. Data were collected by filling anonymous and consented questionnaire in June of 2011 at University of Josip Juraj Strossmayer in Osijek, Croatia. Out of 857 students in the planned sample, 462 (53.9%) filled out the questionnaire, and 353/462 (76.4%) were sexually active. Data from sexually active students were processed and statistically significant results between first-year and the last-year students were presented. Studied sample consisted of 192/353 (54.4%) first-year students and 161/353 (45.6%) last-year students. Average age of sexual initiation for the first-year students was 17.28 +/- 1.29 years, a for the last-year students 18.45 +/- 2.14 years, and the difference is significant (Man-Whitney test = 10335.00, p < 0.01). First-year students have lower number of sexual partners (chi2 = 28.005, p < 0.01), during relationship they had lower number of intercourses with the third person (2 = 17.947, p < 0.01), and feel that lower number of their friends were already sexually active at the time of their own sexual initiation (chi2 = 18.350, p < 0.01). First-year students more often inform their partners about existing or previous STI (chi2 = 14.476, p < 0.01) and curiosity significantly influenced their decision regarding sexual initiation (chi2 = 8.689, p < 0.05). First-year students more often used condom at their first sexual intercourse (chi2 = 7.275, p < 0.01), and more rarely used withdrawal (chi2 = 6.380, p < 0.05). At their last sexual intercourse, first-year students more often used any kind of protection (chi2 = 3.853, p < 0.05),more often used condom (chi2 = 11.110, p < 0.01) and withdrawal (chi2 = 5.156, p < 0.05), and more rarely used contraceptive pills (chi2 = 4.405, p < 0.05). First-year students more often use condom in a permanent relationship (chi2 = 13.384, p < 0.05), and also plan to use it during following intercourse in the permanent relationship (chi2 = 17.575, p < 0.01). Growing condom use and decreasing risky sexual behaviour among students, as well as other adolescents and young adults needs to be maintained. Youth should learn before sexual initiation that only correct condom use at every sexual intercourse protects them against STI and human immunodeficiency virus (HIV). Sexual education and STI/HIV prevention programmes, positive role of media (television) and civil organisations that communicate with the youth can help that. Such changes among adolescents and young adults should have to be seen in student population as well. PMID:24851594
Dijani?, Tomislav; Kozul, Karlo; Miskulin, Maja; Medi?, Alan; Jurcev-Savicevi?, Anamarija; Burazin, Jelena
Regional estimates prepared by the World Health Organization of the prevalence of HIV infections and curable sexually transmitted diseases (STDs) reveal that the HIV epidemic parallels STD incidence and is likely to undergo explosive growth in areas such as Asia where the ratio of HIV to STDs is currently low. HIV has had an especially severe impact on young women, and quickly moves into a general population through the gateway presented by sexually active youth. The impact of HIV has been severe in Africa where it has negated advances in child survival in some countries and created hundreds of thousands of orphans in others. The impact of curable STDs is also severe and is greatest among women who suffer from infertility and in children who develop ocular infection. The sex behavior that places individuals at risk of HIV or STDs is better understood today than ever before as are biological factors such as the increased risk of acquiring HIV for individuals infected with a genital ulcer. The biological and behavioral link between HIV and STDs is so close that the same strategies are important for prevention of both. The adoption of safe sex practices, especially promotion of condom use, is an important goal, and development of a female-controlled method of prevention (especially one that could not be detected by the male partner) would be a valuable alternative to the male condom. The second major prevention strategy is early diagnosis and treatment of STDs through a syndromic approach to diagnosis. Syndromic management will improve with advances in sensitivity and specificity, health-seeking behavior, and partner notification, but the approach still faces major problems caused by the overuse of antibiotics and the asymptomatic nature of many infections in women. While STD incidence is dropping in many countries, the mixture of HIV subtypes is increasing as is the resistance of STDs to antibiotics. With a significant worldwide decline in STDs within reach, complacency must be avoided and additional tools for STD/HIV prevention and control must be developed to avoid a backslide. Research and development of vaginal microbicides, STD diagnostic tests for use in resource-limited settings, HIV vaccines, and new antibiotics must continue. PMID:12291196
Heymann, D L
Background Patient-initiated notification is a commonly used practice for notifying sex partners of possible exposure to a sexually transmitted infection (STI), yet 46% to 75% of partners are never treated. The Contraceptive CHOICE Project (CHOICE) is a longitudinal cohort study of women that provides no-cost contraception, STI testing, treatment to participants, and free partner treatment. Our objective was to evaluate characteristics of women who tested positive for chlamydia, gonorrhea, or trichomoniasis, and their association with successful partner treatment. Methods We analyzed baseline survey and STI testing, notification, and treatment data from the first 5,087 participants enrolled in CHOICE. We considered “treated partners” to be men who received antibiotic treatment at the study clinic or by a prescription through the study. Independent predictors of successful partner treatment were identified using univariate analysis and multivariable analysis using Poisson regression with robust error variance. Results Forty-four percent of male partners were successfully treated. Women whose partners were less likely to obtain treatment were black (RRadj=0.6; 95% CI: 0.5–0.8) or reported some concern about future STI with the partner (RRadj=0.6; 95% CI: 0.4, 0.8). Women whose partners were more likely to receive treatment were living with their partner (RRadj=1.4; 95% CI: 1.1–1.8) or reported recent inconsistent condom use (RRadj=1.5; 95% CI: 1.1–2.1). Conclusions The male partner treatment rate resulting from female patient-initiated partner notification in our study was low. Our findings highlight the need to develop novel notification interventions that yield higher partner treatment rates and consider patient-specific factors, such as race and relationship status. PMID:23001263
Secura, Gina M.; Desir, Fidel A.; Mullersman, Jennifer L.; Madden, Tessa; Allsworth, Jenifer E.; Peipert, Jeffrey F.
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…
Trenholm, Christopher; Devaney, Barbara; Fortson, Kenneth; Clark, Melissa; Bridgespan, Lisa Quay; Wheeler, Justin
Purpose: To examine the influence of sociodemographic characteristics, sexually transmitted disease (STD)\\/human immunodeficiency virus knowledge, and psychosocial and behavioral risk factors on sexual risk and STDs in adolescents using constructs from the Information, Motivation, and Behavioral Skills model (IMB).Methods: A convenience sample of 303 sexually experienced, racially diverse adolescents (mean age 16.7 years, 57.9% female) who were seeking health care
Cherrie B Boyer; Mary-Ann Shafer; Charles J Wibbelsman; Donald Seeberg; Eileen Teitle; Nydia Lovell
... Information Clinical Trials Resources and Publications How can men reduce the risk of getting a sexually transmitted ... on social media links Share this: Page Content Men can take the following measures to avoid STDs: ...
The actual field diameter of 24 microscopes used in clinics for sexually transmitted diseases has been measured by means of a stage micrometer. The variation in findings is given, and the difficulties in producing accurate measurements are discussed. PMID:361169
Aumonier, F J
Sexual violence is associated with women's risks for HIV infection. The current study investigated factors related to risks for sexually transmitted infections (STIs), including HIV, among South African women with a history of sexual assault. An anonymous street intercept survey of women (N = 272) living in an African township in the Western Cape, South Africa assessed demographic characteristics, history of sexual assault, HIV risk behaviours, substance use and non-sexual relationship abuse. Surveys were completed by 90% of women approached. Forty-four per cent (N = 119) of women reported a history of sexual assault. Multiple logistic regressions, controlling for participant age, education, marital status and survey venue, showed that women who had been sexually assaulted were significantly more likely to have shared injection drug equipment, exchanged sex to meet survival needs, and used alcohol compared to women who had not been sexually assaulted. Women with a history of sexual assault were also significantly more likely to have multiple male sex partners, greater rates of unprotected vaginal intercourse, lower rates of condom protected anal intercourse, more sexual contacts involving blood, more STIs and genital ulcers. Finally, women who had been sexually assaulted were more likely to have been non-sexually abused by relationship partners and were more likely to fear asking partners to use condoms. There is a close connection between sexual assault and women's risks for STIs and HIV. Structural and behavioural interventions are needed to simultaneously reduce the prevalence of sexual assault against women and prevent the transmission of HIV. PMID:15370057
Kalichman, S C; Simbayi, L C
In January 1989, the Center for Sexually Transmitted Diseases (STD) of Galliera Hospital-Genoa was equipped with a network of 5 Personal Computers connected by a Token Ring to another Personal Computer which is the "server" unit. The Authors report their experiences in the use of the computer system and examine the advantages of networking in the management of a Center for Sexually Transmitted Disease. PMID:2279749
Massone, L; Solari, G; Pestarino, A; Priano, L; Anonide, A; Piccini, R; Borghi, S
OBJECTIVE--To determine the association of sexually transmitted pathogens in women with cervical intra-epithelial neoplasia (CIN). SETTING--An urban tertiary referral hospital serving a large indigent developing community. PARTICIPANTS--48 women attending a colposcopy clinic and 49 women attending a family planning clinic. METHODS--Vaginal, endocervical, rectal swab specimens and sera were collected for the detection of sexually transmitted pathogens. Cervical cytology was performed
A B Kharsany; A A Hoosen; J Moodley; J Bagaratee; E Gouws
The claim that circumcision reduces the risk of sexually transmitted infections has been repeated so frequently that many believe it is true. A systematic review and meta-analyses were performed on studies of genital discharge syndrome versus genital ulcerative disease, genital discharge syndrome, nonspecific urethritis, gonorrhea, chlamydia, genital ulcerative disease, chancroid, syphilis, herpes simplex virus, human papillomavirus, and contracting a sexually transmitted infection of any type. Chlamydia, gonorrhea, genital herpes, and human papillomavirus are not significantly impacted by circumcision. Syphilis showed mixed results with studies of prevalence suggesting intact men were at great risk and studies of incidence suggesting the opposite. Intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexually transmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections. Consequently, the prevention of sexually transmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexually transmitted infections is not supported by the evidence in the medical literature. PMID:23710368
Van Howe, Robert S.
The effect of psychiatric disorders on human immunodeficiency virus/sexually transmitted infection (HIV/STI) risk behaviors in juvenile justice youths is examined. Prevalence, persistence and prediction are addressed among four mutually exclusive diagnostic groups and results show a high prevalence rate of many HIV/STI sexual risk behaviors that…
Elkington, Katherine; Teplin, Linda A.; Mericle, Amy A.; Welty, Leah J.; Romero, Erin G.; Abram, Karen M.
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.
SHEANA S. BULL; CORNELIS A. RIETMEIJER
CONTEXT: Most research on heterosexual transmission of HIV and other sexually transmitted diseases (STDs) has fo- cused on women. However, heterosexual transmission of STDs cannot be prevented without a better understanding of men's, as well as women's, sexual beliefs and behaviors. METHODS: Heterosexually active men's beliefs about four methods of STD prevention—abstinence, mutual monogamy, use of male condoms and use
Mary Rogers Gillmore; Sorrel Stielstra; Bu Huang; Sharon A. Baker; Blair Beadnell; Diane M. Morrison
Changes in sexually transmitted disease (STD) rates among adolescents and young adults may depend on changes in sexual activity, accessibility of referral and treatment services, and education. To assess the knowledge and attitudes of college students toward various aspects of STD's, a 45-item Likert inventory focusing on symptoms, prevalence,…
Frazer, Gregory H.; Klein, Daniel
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
Serrano, J Artur; Wynn, Rolf; Lau, Annie YS
This study examined the prevalence and correlates of sexual risk behaviors and sexually transmitted infections (STIs) in two samples of outpatients with borderline personality disorder (BPD), including suicidal BPD women (n = 99) and opiate-dependent BPD men and women (n = 125). High rates of sexual risk behaviors and STIs were found, particularly in the opiate-dependent BPD sample. Compared with suicidal BPD outpatients, opiate-dependent BPD outpatients reported higher rates of past-year sexual activity, commercial sex work, and lifetime hepatitis, as well as a greater number of lifetime sex partners. Substance use and demographic characteristics (age, sex, and marital status) were associated with higher rates of sexual risk behaviors and/or STIs, whereas cognitive-behavioral factors and indicators of psychiatric impairment were not. These findings point to a clear need for interventions aimed at decreasing sexual risk behaviors among individuals with BPD. PMID:22048134
Harned, Melanie S; Pantalone, David W; Ward-Ciesielski, Erin F; Lynch, Thomas R; Linehan, Marsha 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
Kalichman, S.; Rompa, D.; Cage, M.
Note added at proof stage An updated search of the literature was made in August 2000. Objectives: To postulate that Helicobacter pylori infection may be transmitted sexually, using the human female vagina as a reservoir for transmission. Methods: A literature search was performed using Medline, Embase, Biological Abstracts, and Currents Contents (January 1983 to August 2000). Relevant keywords were used and additional manual searches were made using the reference lists from the selected articles to retrieve other papers relevant to the topic. Conclusions: Helicobacter pylori infection could be transmitted sexually with the vagina acting as a potential temporary/permanent reservoir given the right environmental conditions. Key Words: sexually transmitted infections; Helicobacter pylori; vagina; oral-genital contact PMID:11221134
The American Academy of Pediatrics (AAP) male circumcision policy states that while there are potential medical benefits of newborn male circumcision, the data are insufficient to recommend routine neonatal circumcision. Since 2005, however, 3 randomized trials have evaluated male circumcision for prevention of sexually transmitted infections. The trials found that circumcision decreases human immunodeficiency virus acquisition by 53% to 60%, herpes simplex virus type 2 acquisition by 28% to 34%, and human papillomavirus prevalence by 32% to 35% in men. Among female partners of circumcised men, bacterial vaginosis was reduced by 40%, and Trichomonas vaginalis infection was reduced by 48%. Genital ulcer disease was also reduced among males and their female partners. These findings are also supported by observational studies conducted in the United States. The AAP policy has a major impact on neonatal circumcision in the United States. This review evaluates the recent data that support revision of the AAP policy to fully reflect the evidence of long-term health benefits of male circumcision. PMID:20048246
Tobian, Aaron A. R.; Gray, Ronald H.; Quinn, Thomas C.
The Harvard University Asia Center hosted a symposium in October 2010 focused on sex work and sexually transmitted infections in Asia, engaging a biosocial approach to promote sexual health in this region. Asia has an estimated 151 million cases of curable sexually transmitted infections (STIs; eg, syphilis, gonorrhea, chlamydia) each year, with commercial sex interactions playing a large role in ongoing transmission. Substantial human movement and migration, gender inequalities, and incipient medical and legal systems in many states stymie effective STI control in Asia. The articles in this supplement provide theoretical and empirical pathways to improving the sexual health of those who sell and purchase commercial sex in Asia. The unintended health consequences of various forms of regulating commercial sex are also reviewed, emphasizing the need to carefully consider the medical and public health consequences of new and existing policies and laws. PMID:22043032
Tucker, Joseph D; Kaufman, Joan; Bhabha, Jacqueline; Kleinman, Arthur
BackgroundThe trafficking of women and girls for sexual exploitation is an internationally recognised form of gender-based violence, and is thought to confer unique sexual and reproductive health vulnerabilities. To date, little research has compared sexual risk or health outcomes among female sex workers (FSWs) on the basis of experiences of sex trafficking.AimTo compare experiences of sexual risk and sexual and
Michele R Decker; Heather L McCauley; Dusita Phuengsamran; Surang Janyam; Jay G Silverman
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
Aral, Sevgi O; Ward, Helen
CONTEXT: Each year, millions of U.S. youth acquire sexually transmitted diseases (STDs). Estimates of the economic burden of STDs can help to quantify the impact of STDs on the nation's youth and on the payers of the cost of their medical care. METHODS: We synthesized the existing literature on STD costs to estimate the lifetime medical cost per case of
Harrell W. Chesson; John M. Blandford; Thomas L. Gift; Guoyu Tao; Kathleen L. Irwin
Data from 1,087 adolescent participants in three waves of the National Longitudinal Study of Adolescent Health were used to examine the effects of peer selection and socialization processes in adolescence on later reports of sexually transmitted infections (STI) and unintended pregnancies. Friends' attitudes and behavior were assessed with…
Henry, David B.; Deptula, Daneen P.; Schoeny, Michael E.
Objective: The authors describe the cervical cytology and sexually transmitted infection (STI) testing patterns of US college health centers. Participants and Methods: A total of 128 self-selected US college health centers--representing more than 2 million college students--completed an online survey during February and March 2007. Results: Almost…
Smith, P. Davis; Roberts, Craig M.
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…
Williams, Jessica Roberts; Zenilman, Jonathan; Nanda, Joy P.; Mark, Hayley
This article describes a 1-hour behavioral intervention designed to promote female condoms and safer sex to women at a high risk for sexually transmitted diseases (STDs). The intervention includes a promotional videotape; a skills-oriented counseling session with a nurse clinician; assorted take-home items, including a videotape for men; and free…
Artz, Lynn; Macaluso, Maurizio; Kelaghan, Joseph; Austin, Harland; Fleenor, Michael; Robey, Lawrence; Hook, III, Edward W.; Brill, Ilene
Outcomes from sex education are shaped not only by the knowledge and attitudes of youth but also by groups influential in young people's lives. American youth bear one of the highest rates of sexually transmitted infections (STIs) in the industrialized world. Four constituencies with important roles in communicating about STIs are youth, parents,…
Cates, Joan R.
The 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
Sevgi O. Aral; Janet S. St. Lawrence; Roman Dyatlov; Andrei Kozlov
The study analysed the patterns of Sexually Transmitted Infections (STIs) among students in a Nigerian University. It is a retrospective study of 38,933 students who attended the University Health Centre from 2001 to 2005. The results showed that 1.8% of all the students who attended the clinic had STIs. The study also revealed that 85.26% of the…
Omobude-Idiado, S. N.; Bazuaye, G. N.
This curriculum guide provides school districts that already have VD education programs with up-to-date information about research and epidemiology relating to sexually transmitted diseases. For districts wishing to implement a program for the first time, it offers both a structured framework and the resources and materials needed for a complete…
California State Dept. of Education, Sacramento.
Sexually transmitted infections (STIs) are a major public health problem, and controlling their spread is a priority. According to the World Health Organization (WHO), there are 340 million new cases of treatable STIs among 15–49 year olds that occur yearly around the world (1). Infection with STIs can lead to several complications such as pelvic inflammatory disorder (PID), cervical cancer,
Betiel K Fesseha
BACKGROUND: The feasibility and acceptability of partner notification (PN) for sexually transmitted infections (STIs) in developing countries was assessed through a comprehensive literature review, to help identify future intervention needs. METHODS: The Medline, Embase, and Google Scholar databases were searched to identify studies published between January 1995 and December 2007 on STI PN in developing countries. A systematic review of
Nazmul Alam; Eric Chamot; Sten H Vermund; Kim Streatfield; Sibylle Kristensen
Objective: To assess the acceptability of sexually transmitted infection (STI) testing using self-collected vaginal swabs (SCVS) among college women. Participants: First-year female students ("N" = 483). Methods: Participants were offered free testing for 3 STIs using SCVS in April 2010 and later completed a survey regarding their…
Fielder, Robyn L.; Carey, Kate B.; Carey, Michael P.
Objective: To determine the event-level associations between perceived risk of sexually transmitted disease (STD) acquisition/transmission and condom use during penile-vaginal intercourse (PVI) among STD clinic attendees. Method: A convenience sample (N = 622) completed daily electronic assessments. Two questions were proxies of perceived risk:…
Crosby, Richard A.; Milhausen, Robin R.; Graham, Cynthia A.; Yarber, William L.; Sanders, Stephanie A.; Charnigo, Richard; Shrier, Lydia A.
In order to determine the prevalence of sexually transmitted infections (STI) in recluse women of Chorrillos Penitentiary I in the city of Lima, Peru, a cross-sectional study was performed, including a simple random sample of women between ages 18 and 54, from whom 180 serum samples and 168 samples of cervical and vaginal discharge were analyzed. The most prevalent etiologic agents identified from cervical and vaginal discharge samples were Chlamydia trachomatis in 42.3%, Gardnerella vaginalis in 24.4% and Trichomonas vaginalis in 10.1% and for serum samples the most prevalent were syphilis and HIV, both in 2.2%. We conclude that there is a high prevalence of sexually transmitted infections in recluse women of Chorrillos Penitentiary I in the city of Lima, Peru. There should be routine screenings established for diagnosis and treatment of STIs within the prison system and this population should be included in the sexual and reproductive health programs. PMID:24100816
Garaycochea, María del Carmen; Pino, Raquel; Chávez, Imelda; Portilla, José L; Miraval, María L; Arguedas, Evelyn; Linares, Pamela; Cabezudo, Edwin; Romero, Soledad; Espinoza, Manuel
OBJECTIVE--To investigate the risk factors for HIV infection in patients attending clinics for sexually transmitted diseases in India. DESIGN--Descriptive study of HIV serology, risk behaviour, and findings on physical examination. SUBJECTS--2800 patients presenting to outpatient clinics between 13 May 1993 and 15 July 1994. SETTING--Two clinics and the National AIDS Research Institute, in Pune, Maharashtra State, India. MAIN OUTCOME MEASURE--HIV status, presence of sexually transmitted diseases, and sexual behaviour. RESULTS--The overall proportion of patients infected with HIV was 23.4% (655/2800); 34% (184) of the women and 21% (459) of the men were positive for HIV infection. Of the 560 women screened, 338 (60%) had a reported history of sex working, of whom 153 (45%) were infected with HIV-1. The prevalence of HIV-1 infection in the 222 women who were not sex workers was 14%. The significant independent characteristics associated with HIV infection based on a logistic regression analysis included being a female sex worker, sexual contact with a sex worker, lack of formal education, receptive anal sex in the previous three months, lack of condom use in the previous three months, current or previous genital ulcer or genital discharge, and a positive result of a Venereal Disease Research Laboratory test. CONCLUSIONS--In India the prevalence of HIV infection is alarmingly high among female sex workers and men attending clinics for sexually transmitted diseases, particularly in those who had recently had contact with sex workers. A high prevalence of HIV infection was also found in monogamous, married women presenting to the clinics who denied any history of sex working. The HIV epidemic in India is primarily due to heterosexual transmission of HIV-1 and, as in other countries, HIV infection is associated with ulcerative and non-ulcerative sexually transmitted diseases. PMID:7633230
Rodrigues, J. J.; Mehendale, S. M.; Shepherd, M. E.; Divekar, A. D.; Gangakhedkar, R. R.; Quinn, T. C.; Paranjape, R. S.; Risbud, A. R.; Brookmeyer, R. S.; Gadkari, D. A.
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
Downey, Robert F; Hammar, Donna; Jobe, Kathleen A; Schmidt, Terri A; Van Slyke, Lori; Yassemi, Yassi; Zive, Dana
The notification of sexually transmitted diseases (STD) is a prime component of well-designed public health policy. However, peculiar aspects of STD must be taken into account for the correct management of surveillance activities. Here, we describe the distribution of the most common sexually transmitted diseases among patients attended by the gynecological clinics of the principal public hospitals of Brasilia and the Federal District, Brazilian capital, during six years. A total of 142,158 patients had their cervicovaginal samples collected for Papanicolaou preparations and eventual biopsies. Diagnosis was made according to cytological and histological alterations, distinguishing among vaginal infections, and pre-cancerous and cancerous cervical lesions. We also looked at the annual prevalence of the various types of infections and alterations. There was a high prevalence of bacterial vaginosis, trichomoniasis and candidiasis, with suggestive changes over the years. Pre-cancerous and cancerous lesions increased 2.2 fold during the six years. A large proportion of the cases involved late stages of cervical cancer, indicating the necessity of prompt attendance of the population in a routine gynecological prevention program. PMID:12144746
Simões-Barbosa, Augusto; Coutinho Feijó, Gilvânia; da Silva, Joaquim Xavier; Rama Leal, Isabel Irene; Wanderley Paes Barbosa, Tânia
Little has changed in sexually transmitted infection (STI) epidemiology in Ireland since 2000. Three STIs comprise approximately 90% of notifications; ano-genital warts, Chlamydia trachomatis and non-specific urethritis. Our objective was to compare the risk factors for prevalent STIs in attendees at two genitourinary medicine clinics and examine the incidence of coinfection. Diagnostic, demographic and behavioural information on attendees at two clinics in southwest Ireland were collected from January 1999 to July 2009. Risk factors associated with first episodes of ano-genital warts, genital herpes simplex viral infection, non-specific urethritis and C. trachomatis were investigated. In all, 22,705 STI patients (mean age 27 years) received 26,824 diagnoses; 1628 had more than one infection. Ano-genital warts was most likely to be diagnosed with a coinfection. Having multiple partners was positively associated with a diagnosis of bacterial infection but not viral infection. Our large cohort outlines those at risk in the region, showing age and gender influences the risk and type of infection. Smoking, alcohol and drug use is also common, all regarded as markers of risk-taking behaviour. The younger the age, the higher the risk of acquiring infection, regardless of infection type. Prevention strategies that target youth, bacterial STIs and high-risk behaviour, including sexual, alcohol and drugs, may be effective in reducing STI incidence in Ireland. PMID:23970627
Shiely, Frances; Hayes, Kevin; Horgan, Mary
Risky sexual behavior can lead to pregnancy, sexually transmitted diseases (STDs), and human immunodeficiency virus (HIV). Our study of 300 adolescent females takes an integrative approach by incorporating these multiple outcomes to assess the influence of risk perceptions on sexual behavior by (1) identifying subgroups of perceived susceptibility…
Kershaw, Trace S.; Ethier, Kathleen A.; Milan, Stephanie; Lewis, Jessica B.; Niccolai, Linda M.; Meade, Christina; Ickovics, Jeannette R.
Introduction: Little information is available regarding the specific sexual practices of lesbians, and whether these activities may carry an associated health risk. Methods: Self-identified lesbians from all U.S. states (N = 6935) responded to a questionnaire that was printed in a national biweekly gay, lesbian and bisexual news magazine. Items included sexual practices engaged in with women during the past
Allison L. Diamant; Janet Lever; Mark A. Schuster
We assessed the association between risk behaviors and sexually transmitted infections (STIs) among men. We interviewed 794 men randomly selected from Moshi district of Tanzania. Blood and urine samples were tested for STIs. About 46% of the men tested positive for at least one STI including human immunodeficiency virus (HIV-1), herpes simplex virus (HSV-2), syphilis, chlamydia, trichomonas, and mycoplasma infection. Multiple sexual partners, casual sex, alcohol abuse, and older age were associated with higher odds of having an STI. Effective STI prevention programs in sub-Saharan Africa should have components aimed at addressing modifiable risk behaviors in men. PMID:19636698
Ghebremichael, Musie; Paintsil, Elijah
A study was conducted to determine the prevalence rate and risk factors for sexually transmitted diseases (STDs) in Haiti's rural Artibonite Valley. Women attending antenatal services at Hospital Albert Schweitzer from October to December 1996 were tested for gonorrhea, chlamydia, trichomonas, syphilis, and human immunodeficiency virus (HIV). Of the 476 women tested, 121 (25.4%) had trichomonas, 11\\/475 (2.3%) had gonorrhea,
DANIEL W. FITZGERALD; FRIEDA BEHETS; ANGELA CALIENDO; DOMINIQUE ROBERFROID; CATHERINE LUCET; JENNIFER W. FITZGERALD; LUC KUYKENS
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.
Yuan, Xin-Peng; Xue, Ya-Kui; Liu, Mao-Xing
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
Gillian L Genrich; Brader A Brathwaite
Heteronormative assumptions can negatively influence the lives of young gay and bisexual men, and recent sociological analyses have identified the negative impacts of heteronormativity on heterosexual men (e.g. 'fag discourse' targeted at heterosexual adolescents). However, insights into how heteronormative discourses may be (re)produced in clinical settings and how they contribute to health outcomes for gay, bisexual and heterosexual men are poorly understood. This analysis draws on in-depth interviews with 45 men (15-25 years old) and 25 clinicians in British Columbia, Canada, to examine how heteronormative discourses affect sexually transmitted infection testing. The sexually transmitted infection/HIV testing experience emerged as a unique situation, whereby men's (hetero)sexuality was explicitly 'interrogated'. Risk assessments discursively linked sexual identity to risk in ways that reinforced gay men as the risky 'other' and heterosexual men as the (hetero)normal and, therefore, relatively low-risk patient. This, in turn, alleviated concern for sexually transmitted infection/HIV exposure in heterosexual men by virtue of their sexual identity (rather than their sexual practices), which muted discussions around their sexual health. The clinicians also positioned sexual identities and practices as important 'clues' for determining their patients' social contexts and supports while concurrently informing particular tailored clinical communication strategies. These findings highlight how men's experiences with sexually transmitted infection/HIV testing can (re)produce heteronormative assumptions and expectations or create opportunities for more equitable gendered relations and discourses. PMID:23117592
Knight, Rod; Shoveller, Jean A; Oliffe, John L; Gilbert, Mark; Goldenberg, Shira
The development of new, safe, topical microbicides for intravaginal use for the prevention of sexually transmitted diseases is imperative. Previous studies have suggested that bile salts may inhibit human immunodeficiency virus infection; however, their activities against other sexually transmitted pathogens have not been reported. To further explore the potential role of bile salts in preventing sexually transmitted diseases, we examined the in vitro activities and cytotoxicities of select bile salts against Chlamydia trachomatis, herpes simplex virus (types 1 and 2), Neisseria gonorrhoeae, and human immunodeficiency virus in comparison to those of nonoxynol-9 and benzalkonium chloride using both primary cells and cell lines derived from the human female genital tract. We found that taurolithocholic acid 3-sulfate and a combination of glycocholic acid and taurolithocholic acid 3-sulfate showed excellent activity against all of the pathogens assayed. Moreover, taurolithocholic acid 3-sulfate alone or in combination was less cytotoxic than nonoxynol-9 and benzalkonium chloride. Thus, taurolithocholic acid 3-sulfate alone or in combination warrants further evaluation as a candidate topical microbicidal agent. PMID:10103175
Herold, Betsy C.; Kirkpatrick, Risa; Marcellino, Daniel; Travelstead, Anna; Pilipenko, Valentina; Krasa, Holly; Bremer, James; Dong, Li Jin; Cooper, Morris D.
ABSTRACT? 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
Hughes, Gwenda; Field, Nigel
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
Objective To examine the effectiveness of methods to improve partner notification by patient referral (index patient has responsibility for informing sex partners of their exposure to a sexually transmitted infection). Design Systematic review of randomised trials of any intervention to supplement simple patient referral. Data sources Seven electronic databases searched (January 1990 to December 2005) without language restriction, and reference lists of retrieved articles. Review methods Selection of trials, data extraction, and quality assessment were done by two independent reviewers. The primary outcome was a reduction of incidence or prevalence of sexually transmitted infections in index patients. If this was not reported data were extracted according to a hierarchy of secondary outcomes: number of partners treated; number of partners tested or testing positive; and number of partners notified, located, or elicited. Random effects meta-analysis was carried out when appropriate. Results 14 trials were included with 12?389 women and men diagnosed as having gonorrhoea, chlamydia, non-gonococcal urethritis, trichomoniasis, or a sexually transmitted infection syndrome. All studies had methodological weaknesses that could have biased their results. Three strategies were used. Six trials examined patient delivered partner therapy. Meta-analysis of five of these showed a reduced risk of persistent or recurrent infection in patients with chlamydia or gonorrhoea (summary risk ratio 0.73, 95% confidence interval 0.57 to 0.93). Supplementing patient referral with information for partners was as effective as patient delivered partner therapy. Neither strategy was effective in women with trichomoniasis. Two trials found that providing index patients with chlamydia with sampling kits for their partners increased the number of partners who got treated. Conclusions Involving index patients in shared responsibility for the management of sexual partners improves outcomes. Health professionals should consider the following strategies for the management of individual patients: patient delivered partner therapy, home sampling for partners, and providing additional information for partners. PMID:17237298
Trelle, Sven; Shang, Aijing; Nartey, Linda; Cassell, Jackie A
This article discusses how process indicators can complement outcomes as part of a comprehensive explanatory evaluation framework, using the example of skills-based behavioural interventions to prevent sexually transmitted infections and promote sexual health among young people in schools. A systematic review was conducted, yielding 12 eligible…
Shepherd, J.; Harden, A.; Barnett-Page, E.; Kavanagh, J.; Picot, J.; Frampton, G. K.; Cooper, K.; Hartwell, D.; Clegg, A.
This study aimed to assess associations between school HIV education and protective sexual behaviors and sexually transmitted disease (STD)/HIV diagnosis with a representative sample of male and female high school students. Data from male and female adolescent participants in the 1999, 2001 and 2003 Massachusetts Youth Risk Behavior Survey (n =…
Raj, Anita; Decker, Michele R.; Murray, Jessica E.; Silverman, Jay G.
OBJECTIVES: To review the scientific data on the role of sexually transmitted diseases (STDs) in sexual transmission of HIV infection and discuss the implications of these findings for HIV and STD prevention policy and practice. METHODS: Articles were selected from a review of Medline, accessed with the OVID search engine. The search covered articles from January 1987 to September 1998
D. T. Fleming; J. N. Wasserheit
Several recent publications have used, without demonstrating its derivation, a mathematical model that describes the risk of being infected by a sexually transmitted agent as a function of four parameters: the number of partners, the number of contacts with each partner, the per-contact probability of transmission, and the probability of a partner being infected. The model is derived both from elementary probability concepts and, more formally, by using the binomial expansion and conditional probabilities. The assumptions involved in these derivations are brought out, as are the limitations they impose on the uses of the model. The model equations used so far in published studies are shown to be special cases of a general form that allows for more variability of the sexual behavior modeled. The different uses to which the model has been put are categorized, and some further ones are suggested. PMID:2081234
Sexually transmitted diseases in developing countries are causing concern to those responsible for their control and eradication. To gain a better understanding of the problems involved in a country struggling with development, the economic and psychosocial factors influencing the spread of STD in Ethiopia have been studied. Increased migration and urbanisation and the changing role of women have led to a rise in prostitution. Thus changes in the social structure--particularly in relation to the education and employment of women--and improved medical services are essential for the long-term control of STD. PMID:6895708
Plorde, D S
Conducted by the Henry J. Kaiser Family Foundation (see the February 9, 1999 Scout Report for Social Sciences), this new national survey of 15- to 17-year-olds examines their knowledge, awareness, attitudes, and behavior in relation to sexually transmitted diseases (STDs). Despite national estimates claiming that about one in four teenagers contracts an STD every year, most teens underestimate their personal risk and underrate the overall incidence of STDs. Moreover, many teens are mis- or uninformed about treatment and health consequences. The report provides survey highlights and methodology, a summary of findings, detailed results, and the survey questionnaire. A supplementary chart pack clearly presents key findings.
Aim This study examined the association between functional social support and sexually transmitted infection (STI) based on data\\u000a from a cross-sectional survey in three Canadian provinces.\\u000a \\u000a \\u000a \\u000a \\u000a Subject and Methods We analyzed data from the Canadian Community Health Survey (CCHS), conducted in 2005. A total of 24,045 participants (12,581\\u000a women and 11,464 men) aged 15–49 years who answered questions about STI and completed the
Yanhui Gao; Yue Chen
Perception of risk has been suggested as an important element of sexual behaviour change among people who engage in behaviours which place them at risk of HIV infection. A study of the relationship between perception of risk of HIV infection and risk-related sexual behaviours was conducted in a genitourinary medicine clinic. The sample comprised 767 patients attending over a 3-month period; data collection was by self-completed questionnaire. A total of 574 questionnaires were suitable for analysis, representing a response rate of 75%. The majority of people in the sample reported behaviours which increased their risk of HIV infection, but only 19% (n = 112) of the sample perceived themselves to be personally 'at risk', despite adequate knowledge of HIV transmission and methods of risk reduction. Significant differences between social class groups were found for knowledge scores, with highest scores among professionals and lowest among unemployed subjects (Kruskal Wallis test chi 2 = 24.6, P less than or equal to 0.001). Increasing age was significantly associated with better knowledge; significantly more young people aged 16-20 years who did not perceive themselves 'at risk' (64%), had lower knowledge scores than older people who did not perceive themselves 'at risk' (41%). Among heterosexuals who reported having sex with other people in addition to their regular partner, 79% did not perceive themselves as 'at risk' of HIV infection, and of these, 64% reported only infrequent condom use with casual sexual partners. Significantly more heterosexual men (67%) than women (44%) reported multiple sex partners.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1911959
James, N J; Gillies, P A; Bignell, C J
Although recent data have supported the role of heterosexual activity in the transmission of hepatitis B virus infection in women, studies generating these data have enrolled few black women. We therefore examined black female participants attending our local health department's sexually transmitted disease clinic for the treatment of presumed uncomplicated gonorrhea in serologic and risk-factor surveys of hepatitis B virus infection. Twenty-four (17.6%) of 136 subjects tested had evidence of prior hepatitis B infection. Serologic evidence of hepatitis B infection was significantly associated with three different barometers of sexual activity that included: (1) years of sexual activity (P less than 0.005); (2) history of sexually transmitted disease (P less than 0.02); and (3) number of lifetime heterosexual partners (P less than 0.001). These data provide further support that the quantity of sexual exposure seems to be an important risk factor for hepatitis B infection in heterosexually active females. PMID:3227474
Baddour, L M; Bucak, V A; Somes, G; Hudson, R
Knowledge of the rates and correlates of juvenile offenders’ sexually transmitted diseases (STD) has been limited to samples of incarcerated youths comprised mostly of males. Data collected on 442 female and 506 male youths processed at a centralized intake facility enabled us to study this important public health problem among a sample of juvenile offenders at the front end of the justice system. Female-male, multi-group latent class analyses identified two subgroups, High Risk and Lower Risk, of youths described by a latent construct of risk based on drug test results, STD test results, and a classification for the seriousness of arrest charge. The results found: (1) a similar classification distinguished High Risk and Lower Risk male and female youths, and (2) important gender group differences in sexual risk related factors (e.g., substance use during sexual encounters). Among the youths in this sample who tested positive for an STD, 66% of the girls and 57% of the boys were released back into the community after arrest. Overall, our findings raise serious public health and social welfare concerns, for both the youths and the community. Prevention and intervention implications of these findings are also discussed. PMID:18979194
Dembo, Richard; Belenko, Steven; Childs, Kristina; Wareham, Jennifer
Using population-based and family structural data from a high HIV-prevalence district of southern India, this paper considers four suggested social scenarios used to explain the positive correlation between HIV prevalence and previously married status among Indian women: I) infection from and then bereavement of an infected husband; II) abandonment after husbands learn of their wives’ HIV status; III) economic instability after becoming previously married, leading women to seek financial support through male partners; IV) the social status of being previously married exposing women to sexual harassment and predation. By also considering seroprevalence of two other common sexually transmitted infections (STI), herpes and syphilis, in a combined variable with HIV, we limit the likelihood of the first two scenarios accounting for the greater part of this correlation. Through a nuanced analysis of household residences patterns (family structure), standard of living and education, we also limit the probability that scenario three explains a greater portion of the correlation. Scenario four emerges as the most likely explanation for this correlation, recognizing that other scenarios are also possible. Further, the interdisciplinary literature on the social position of previously married women in India strongly supports the suggestion that, as a population, previously married women are sexually vulnerable in India. Previously married status as an STI risk factor requires further biosocial research and warrants concentrated public health attention. PMID:22519844
Walters, Kimberly; Dandona, Rakhi; Walters, Lawrence C.; Dandona, Lalit; Lakshmi, Vemu; Schneider, John A.
Sexually transmitted diseases (STDs), with special emphasis to HIV infection, involve legal and ethical issues regarding informed consent to submit to a diagnostic, observance of professional secrecy in regard to partner(s) and community; legal troubles of particular difficulties are related to STD involving minors; lastly, physicians must be able to recognize the state of so called medical necessity. Knowledge and awareness of these related obligations are crucial to STD in medical practice; it is also important to allow for proper protection of victims of suspected sexual abuse under observation of healthcare. With regard to this aspect should be emphasized that violence against women and minors is a worldwide problem that has not yet been sufficiently acknowledged. Italian legislation (Law n. 96/1996) against rapes finally gave significant relevance to sex crimes. When sexual abusers have to be evaluated some obstacles may arise for lack of appropriate interdisciplinary approach, with insurance of the collection of biological samples, also related to STD diagnosis and alerts of legal authorities. Personal preconceptions may interfere with investigation if the biological evidences in children are few. In this regard, rules of document "Carta di Noto" drafted in 1996 and reviewed in July 2002 include some specific indications aiming to grant the reliability of the results of technical investigations and authenticity of the statements of the alleged victims. PMID:23007211
Argo, A; Zerbo, S; Triolo, V; Averna, L; D'Anna, T; Nicosia, A; Procaccianti, P
A cross-sectional study was conducted among youth clients of hotel-based female sex workers (YCHBFSWs) in nine randomly selected hotels in Bangladesh to examine sexual-risk behaviour, condom use and determinants of condom use in last sex, knowledge of HIV, sexually transmitted infection (STI) prevalence and STI care-seeking behaviour. A prestructured questionnaire was used to collect sociodemographic, behavioural, clinical information; urine specimens (before sex) and blood were collected for diagnosis of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and herpes simplex virus 2 (HSV2) infection. One thousand and thirteen participants were enroled in the study. Approximately half of them reported visiting female sex workers (FSWs) at least once a month and 25% visited FSWs at least once a week. Only 12% of participants reported regular condom use. The prevalence of N. gonorrhoeae, C. trachomatis, T. vaginalis, syphilis and HSV2 was 2.2%, 3.9%, 7.2%, 2.6% and 12.9%, respectively. Only 15.3% of the YCHBFSW sought STI care in the past year. Negotiation of condom use with FSWs was the main determinant (odds ratio = 17.95) for condom use at last sex. Male clients of FSWs, including YCHBFSW, are an important bridge population for HIV transmission in Bangladesh and HIV interventions should be designed and implemented for them. PMID:22930291
Haseen, F; Chawdhury, F A H; Hossain, M E; Huq, M; Bhuiyan, M U; Imam, H; Rahman, D M M; Gazi, R; Khan, S I; Kelly, R; Ahmed, J; Rahman, M
Research on interventions to prevent HIV and other sexually transmitted infections (STIs) is heavily influenced by participant reporting of sexual behavior, despite uncertainty about its validity. Exclusive reliance on participant self-report often is based, overtly or by implication, on 4 assumptions: (1) no feasible alternatives exist; (2) misreporting can be minimized to levels that can be disregarded; (3) misreporting tends to underreport sensitive behaviors; and (4) misreporting tends to be nondifferential with respect to the groups being compared. The objective of this review are to evaluate these assumptions, including a review of studies using semen biomarkers to evaluate the validity of self-reported data, and to make recommendations for applying biological markers of semen exposure detectable in women to further strengthen research on HIV/STI prevention. Increasing evidence shows that semen biomarkers provide an important means of assessing and augmenting the validity of studies on HIV/STI prevention. Additional biomarkers are needed to assess male exposure to vaginal sex and both male and female exposure to anal sex. Methods and study designs that incorporate biomarkers into studies collecting self-reported behavioral data should be considered where possible. PMID:23677018
Gallo, Maria F.; Steiner, Markus J.; Hobbs, Marcia M.; Warner, Lee; Jamieson, Denise J.; Macaluso, Maurizio
Abstract Background Recent studies have examined the relationship between body mass index (BMI) and sexual behaviors, but little information exists on this relationship among racially diverse, low-income women using objectively measured clinical data. The purpose of this study was to examine the association between BMI and sexual behaviors, rates of sexually transmitted infections (STIs) and unintended pregnancy, and contraceptive adherence among adolescent and young adult women. Methods As part of a larger study, 1,015 Hispanic (54.2%), Black (18.6%) and White (24.8%) women aged 16 to 24 years seeking family planning services at publicly funded reproductive health clinics provided data on their baseline sexual behaviors, and contraceptive use and pregnancy history over 12 months. Objective clinical data were available from medical records at baseline (i.e., height, weight, and Papanicolaou [Pap] smear results), and over a 12-month period (i.e., STI results). Multivariable analyses were used to compare sexual behaviors, STI rates, contraceptive compliance, and unintended pregnancy rates between obese, overweight, and normal weight participants after adjusting for age, race/ethnicity, and other confounders. Results Overall, 423 (36.6%), 304 (26.3%), and 288 (24.9%) participants were classified as normal weight, overweight, and obese, respectively. No statistically significant association was observed between BMI and sexual behaviors, STI rates (overweight odds ratio [OR] 0.67; 95% confidence interval [95% CI] [0.4, 1.08]; obese OR 0.68; 95% CI [0.42, 1.10]); contraceptive compliance (overweight OR 0.89; 95% CI [0.69, 1.16]; obese OR 0.89; 95% CI 0.68, 1.16]), or unintended pregnancy (overweight OR 1.08 95% CI [0.73, 1.60]; obese OR 1.09; 95% CI [0.72, 1.63]). Conclusion STI history and contraceptive compliance did not vary by BMI. Therefore, all women should receive equal contraceptive counseling (including condoms) to reduce the risk of unplanned pregnancy and STIs. PMID:24093760
DeMaria, Andrea L.; Lugo, Jonathan M.; Rahman, Mahbubur; Pyles, Richard B.
Objectives:To evaluate trends in the HIV epidemic among men who have sex with men (MSM) in San Francisco and the implications for HIV prevention.Methods:An ecological approach assessed temporal trends in sexual risk behaviour, sexually transmitted infections (STI), HIV incidence and prevalence from multiple data sources between 1998 and 2007.Results:By 2007, there were over 13 000 HIV-infected MSM living in San
S Scheer; T Kellogg; J D Klausner; S Schwarcz; G Colfax; K Bernstein; B Louie; J W Dilley; J Hecht; H-H M Truong; M H Katz; W McFarland
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
At present very little information is available on the prevalence and pattern of sexually transmitted diseases (STDs) in many countries of tropical Africa. The available evidence does, however, suggest that these diseases are highly prevalent and that a considerable reservoir of infection exists among the female population. Gonorrhoea is probably the most commonly recognised STD in tropical Africa, frequently causing epididymitis and urethral stricture in men and salpingitis and pelvic inflammatory disease in women. The prevalence of a infectious syphilis is still high, particularly the late manifestations of the disease. The prevalence of the other STDs is also high. Thus, the problem is clearly very serious and the need for improving facilities for diagnosis and treatment urgent; some attempt also must be made to initiate control measures. PMID:6894260
Osoba, A O
This paper provides a brief history of sexually transmitted diseases (STDs) in Thailand. The presentation is divided into three main sections: the period up to the 1930s; the period from the 1930s until the end of the early 1980s; and the period from the early 1980s until the present, the so-called 'AIDS Era'. The discussion in each of these sections focuses, as far as sources permit, on the epidemiological picture, as well as describing public and official responses to these diseases. In the final part of the paper consideration is given to these findings in relation to the present situation in Thailand regarding the HIV/AIDS epidemic. PMID:8509097
Bamber, S D; Hewison, K J; Underwood, P J
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
Objective Characterization of HIV-1 sequences in newly infected individuals is important for elucidating the mechanisms of viral sexual transmission. We report the identification of transmitted/founder viruses in eight pairs of HIV-1 sexually-infected patients enrolled at the time of primary infection (“recipients”) and their transmitting partners (“donors”). Methods Using a single genome-amplification approach, we compared quasispecies in donors and recipients on the basis of 316 and 376 C2V5 env sequences amplified from plasma viral RNA and PBMC-associated DNA, respectively. Results Both DNA and RNA sequences indicated very homogeneous viral populations in all recipients, suggesting transmission of a single variant, even in cases of recent sexually transmitted infections (STIs) in donors (n?=?2) or recipients (n?=?3). In all pairs, the transmitted/founder virus was derived from an infrequent variant population within the blood of the donor. The donor variant sequences most closely related to the recipient sequences were found in plasma samples in 3/8 cases and/or in PBMC samples in 6/8 cases. Although donors were exclusively (n?=?4) or predominantly (n?=?4) infected by CCR5-tropic (R5) strains, two recipients were infected with highly homogeneous CXCR4/dual-mixed-tropic (X4/DM) viral populations, identified in both DNA and RNA. The proportion of X4/DM quasispecies in donors was higher in cases of X4/DM than R5 HIV transmission (16.7–22.0% versus 0–2.6%), suggesting that X4/DM transmission may be associated with a threshold population of X4/DM circulating quasispecies in donors. Conclusions These suggest that a severe genetic bottleneck occurs during subtype B HIV-1 heterosexual and homosexual transmission. Sexually-transmitted/founder virus cannot be directly predicted by analysis of the donor’s quasispecies in plasma and/or PBMC. Additional studies are required to fully understand the traits that confer the capacity to transmit and establish infection, and determine the role of concomitant STIs in mitigating the genetic bottleneck in mucosal HIV transmission. PMID:23874894
Frange, Pierre; Meyer, Laurence; Jung, Matthieu; Goujard, Cecile; Zucman, David; Abel, Sylvie; Hochedez, Patrick; Gousset, Marine; Gascuel, Olivier; Rouzioux, Christine; Chaix, Marie-Laure
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
Hakre, Shilpa; Arteaga, Griselda B; Núñez, Aurelio E; Arambu, Nelson; Aumakhan, Bulbulgul; Liu, Michelle; Peel, Sheila A; Pascale, Juan M; Scott, Paul T
Sexually transmitted diseases (STDs) are caused by several pathogens, including bacteria, viruses and protozoa, and can induce male infertility through multiple pathophysiological mechanisms. Additionally, horizontal transmission of STD pathogens to sexual partners or vertical transmission to fetuses and neonates is possible. Chlamydia trachomatis, Ureaplasma spp., human papillomavirus, hepatitis B and hepatitis C viruses, HIV-1 and human cytomegalovirus have all been detected in semen from symptomatic and asymptomatic men with testicular, accessory gland and urethral infections. These pathogens are associated with poor sperm quality and decreased sperm concentration and motility. However, the effects of these STD agents on semen quality are unclear, as are the effects of herpes simplex virus type 1 and type 2, Neisseria gonorrhoeae, Mycoplasma spp., Treponema pallidum and Trichomonas vaginalis, because few studies have evaluated the influence of these pathogens on male infertility. Chronic or inadequately treated infections seem to be more relevant to infertility than acute infections are, although in many cases the exact aetiological agents remain unknown. PMID:25330794
Gimenes, Fabrícia; Souza, Raquel P; Bento, Jaqueline C; Teixeira, Jorge J V; Maria-Engler, Silvya S; Bonini, Marcelo G; Consolaro, Marcia E L
Objective. To better understand preferences and practices regarding partner notification of sexually transmitted infection (STI) among female, African-American adolescents. Methods. Participants completed a questionnaire and STI testing at baseline. Those diagnosed with Chlamydia or gonorrhea were recruited for a follow-up study, involving another questionnaire and repeat STI testing after three months. Results. At baseline, most participants (85.1%) preferred to tell their partner about an STI diagnosis themselves instead of having a health care provider inform him, and 71.0% preferred to bring their partner for clinic treatment instead of giving him pills or a prescription. Two-thirds of participants were classified as having high self-efficacy for partner notification of a positive STI diagnosis. In the multivariable analysis, older participants and those with fewer lifetime sexual partners were more likely to have high self-efficacy. Ninety-three participants (26.6%) had Chlamydia or gonorrhea and, of this subset, 55 participated in the follow-up study. Most adolescents in the follow-up study (76.4%) notified their partner about their infection. Conclusion. Although participants were willing to use most methods of partner notification, most preferred to tell partners themselves and few preferred expedited partner therapy. Traditional methods for partner notification and treatment may not be adequate for all adolescents in this population. PMID:25609905
Buchsbaum, Anna; Gallo, Maria F; Whiteman, Maura K; Cwiak, Carrie; Goedken, Peggy; Kraft, Joan Marie; Jamieson, Denise J; Kottke, Melissa
The combination of high sexually transmitted infection (STI) prevalence and low HIV prevalence has been described as the Indian Ocean paradox. To investigate current epidemiology of HIV and STI in the Comoros, we conducted cross-sectional surveys of a representative sample of the adult population, and convenience samples of female sex workers and male STI patients. Only one (0.025%) of 3990 community participants was HIV-infected, while 142 (3.6%) had treponemal antibodies. Treponemal antibodies were not associated with past genital ulcers, number of sexual partners or adverse outcomes of pregnancies; their prevalence did not increase with age and there was no concordance within couples. Thus, most individuals with treponemal antibodies were probably infected during childhood with a non-venereal treponematosis. Only 1/70 (1.4%) and 0/83 sex workers sampled in 2004 and 2005 were HIV-infected. The Comoros have been protected by their insular status, male circumcision and paucity of syphilis. HIV control should focus on sex workers. PMID:17785001
Dada, Yasmina; Milord, François; Frost, Eric; Manshande, Jean-Pierre; Kamuragiye, Aloys; Youssouf, Jean; Khelifa, Mejdi; Pépin, Jacques
Objective. To better understand preferences and practices regarding partner notification of sexually transmitted infection (STI) among female, African-American adolescents. Methods. Participants completed a questionnaire and STI testing at baseline. Those diagnosed with Chlamydia or gonorrhea were recruited for a follow-up study, involving another questionnaire and repeat STI testing after three months. Results. At baseline, most participants (85.1%) preferred to tell their partner about an STI diagnosis themselves instead of having a health care provider inform him, and 71.0% preferred to bring their partner for clinic treatment instead of giving him pills or a prescription. Two-thirds of participants were classified as having high self-efficacy for partner notification of a positive STI diagnosis. In the multivariable analysis, older participants and those with fewer lifetime sexual partners were more likely to have high self-efficacy. Ninety-three participants (26.6%) had Chlamydia or gonorrhea and, of this subset, 55 participated in the follow-up study. Most adolescents in the follow-up study (76.4%) notified their partner about their infection. Conclusion. Although participants were willing to use most methods of partner notification, most preferred to tell partners themselves and few preferred expedited partner therapy. Traditional methods for partner notification and treatment may not be adequate for all adolescents in this population. PMID:25609905
Buchsbaum, Anna; Gallo, Maria F.; Whiteman, Maura K.; Cwiak, Carrie; Goedken, Peggy; Kraft, Joan Marie; Jamieson, Denise J.; Kottke, Melissa
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
Zhong, Weihao; McClure, Colin D; Evans, Cara R; Mlynski, David T; Immonen, Elina; Ritchie, Michael G; Priest, Nicholas K
Objectives To prospectively evaluate the protective value of consistent and correct use of latex condoms against the acquisition of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. Methods Patients (N=929) attending clinics that treat sexually transmitted infections (STIs) were prospectively followed for up to six months. Urine STI nucleic acid amplification testing was performed at baseline, three months, and six months. Participants were instructed to respond to daily prompts from a hand-held device by completing a report for each penile-vaginal sexual intercourse event. Generalized estimating equation models examined associations of consistent as well as consistent and correct condom use with STI incidence over 3-month intervals. Results Consistent condom use was not significantly associated with STI incidence (Estimated Odds Ratio [EOR]=.75; 95% confidence interval [CI]=.43-1.30; P=.31). However, individuals who used condoms both correctly and consistently were estimated to have 59% lower odds of acquiring an STI (EOR = .41; 95% CI = .19-.90; P = .026), compared to those who did not. Conclusions The correct as well as the consistent use of condoms greatly reduces the odds of non-viral STI acquisition. PMID:23002192
Crosby, Richard; Charnigo, Richard A.; Weathers, Chandra; Caliendo, Angela M.; Shrier, Lydia A.
Objective The authors evaluated the use of conditional cash transfers as an HIV and sexually transmitted infection prevention strategy to incentivise safe sex. Design An unblinded, individually randomised and controlled trial. Setting 10 villages within the Kilombero/Ulanga districts of the Ifakara Health and Demographic Surveillance System in rural south-west Tanzania. Participants The authors enrolled 2399 participants, aged 18–30?years, including adult spouses. Interventions Participants were randomly assigned to either a control arm (n=1124) or one of two intervention arms: low-value conditional cash transfer (eligible for $10 per testing round, n=660) and high-value conditional cash transfer (eligible for $20 per testing round, n=615). The authors tested participants every 4?months over a 12-month period for the presence of common sexually transmitted infections. In the intervention arms, conditional cash transfer payments were tied to negative sexually transmitted infection test results. Anyone testing positive for a sexually transmitted infection was offered free treatment, and all received counselling. Main outcome measures The primary study end point was combined prevalence of the four sexually transmitted infections, which were tested and reported to subjects every 4?months: Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Mycoplasma genitalium. The authors also tested for HIV, herpes simplex virus 2 and syphilis at baseline and month 12. Results At the end of the 12-month period, for the combined prevalence of any of the four sexually transmitted infections, which were tested and reported every 4?months (C trachomatis, N gonorrhoeae, T vaginalis and M genitalium), unadjusted RR for the high-value conditional cash transfer arm compared to controls was 0.80 (95% CI 0.54 to 1.06) and the adjusted RR was 0.73 (95% CI 0.47 to 0.99). Unadjusted RR for the high-value conditional cash transfer arm compared to the low-value conditional cash transfer arm was 0.76 (95% CI 0.49 to 1.03) and the adjusted RR was 0.69 (95% CI 0.45 to 0.92). No harm was reported. Conclusions Conditional cash transfers used to incentivise safer sexual practices are a potentially promising new tool in HIV and sexually transmitted infections prevention. Additional larger study would be useful to clarify the effect size, to calibrate the size of the incentive and to determine whether the intervention can be delivered cost effectively. Trial registration number NCT00922038 ClinicalTrials.gov. PMID:22318666
Dow, William H; Nathan, Rose; Abdul, Ramadhani; Abilahi, Faraji; Gong, Erick; Isdahl, Zachary; Jamison, Julian; Jullu, Boniphace; Krishnan, Suneeta; Majura, Albert; Miguel, Edward; Moncada, Jeanne; Mtenga, Sally; Mwanyangala, Mathew Alexander; Packel, Laura; Schachter, Julius; Shirima, Kizito; Medlin, Carol A
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
Adeyemi, Ezekiel Oluwagbemiga
Aim To estimate the prevalence of self-reported sexually transmitted infections (STIs) and examine the associations between self-reported STIs and sociodemographic and behavioral factors among sexually active Slovenians aged 18-49 years. Methods Data were collected during 1999-2001 from a probability sample of the general population at respondents’ homes by a combination of face-to-face interviews and anonymous self-administered questionnaires. Statistical methods for complex survey data were used to account for stratification, clustered sampling, and weighing. Results The proportion of sexually active Slovenian population that reported ever being diagnosed with an STI, excluding pelvic inflammatory disease and vaginal discharge for women, was 5.5% for men and 5.1% for women. Gonorrhea was the most commonly self-reported STI among men (3.7%) and hepatitis B among women (1.7%). Independent risk factors associated with self-reported STIs included having concurrent heterosexual relationships during lifetime [adjusted odds ratio (AOR) for men 3.3 (CI 1.3-8.6) and for women 2.3 (CI 1.0-5.3)], ever having paid for sex for men (AOR 4.0, CI 1.5-10.7), and having at least 10 lifetime heterosexual partners for women (AOR 4.7, CI 1.7-13.0). Conclusion Our estimates of lifetime prevalence of self-reported STIs in a probability sample of Slovenian men and women aged 18 to 49 indicate a substantial national burden of STIs. The results could be used in shaping national STI prevention and control policies and strategies. Identification of risk factors associated with self-reported STIs provide a basis for targeting prevention and control efforts to individuals at higher risk. PMID:17042064
Grgi?-Vitek, Marta; Švab, Igor; Klavs, Irena
Objectives To identify partner attributes associated with sexually transmitted infections (STIs) among adolescents and summarize implications for research and prevention. Design Systematic review. Methods We identified peer-reviewed studies published 1990–2010 which assessed ?1 partner attribute in relation to a biologically-confirmed STI among adolescents (15–24 years) by searching MEDLINE and included articles. Studies which included adolescents but >50% of the sample or with mean or median age ?25 years were excluded. Results Sixty-four studies met eligibility criteria; 59% were conducted in high-income countries; 80% were cross-sectional; 91% enrolled females and 42% males. There was no standard “partner” definition. Partner attributes assessed most frequently included: age, race/ethnicity, multiple sex partners and STI symptoms. Older partners were associated with prevalent STIs but largely unrelated to incidence. Black race was associated with STIs but not uniformly. Partners with multiple partners and STI symptoms appear to be associated with STIs predominantly among females. Although significant associations were reported, weaker evidence exists for: other partner sociodemographics; sexual and other behaviors (sexual concurrency, sex worker, intimate partner violence, substance use, travel) and STI history. There were no apparent differences by STI. Conclusions Partner attributes are independently associated with STIs among male and female adolescents worldwide. These findings reinforce the importance of assessing partner attributes when determining STI risk. Prevention efforts should continue to promote and address barriers to condom use. Increased efforts are needed to screen and treat STIs and reduce risky behavior among men. A standard “partner” definition would facilitate interpretation of findings in future studies. PMID:23588126
Swartzendruber, Andrea; Zenilman, Jonathan M.; Niccolai, Linda M.; Kershaw, Trace S.; Brown, Jennifer L.; DiClemente, Ralph J.; Sales, Jessica M.
BACKGROUND: Sexually transmitted infection (STI) prevention programs can mitigate the health and economic burden of STIs. A tool to estimate the economic benefits of STI programs could prove useful to STI program personnel. METHODS: We developed formulas that can be applied to estimate the direct medical costs and indirect costs (lost productivity) averted by STI programs in the United States.
Harrell W Chesson; Dayne Collins; Kathryn Koski
Our study focused on two topics, Sexually Transmitted Infections (STIs) and their control using condoms. For this, we analysed and compared 42 school textbooks from 16 countries on the general topic "Human Reproduction and Sex Education" using a specific grid designed by the BIOHEAD-Citizen project. Acquired Immune Deficiency Syndrome (AIDS) was a…
Bernard, Sandie; Clement, Pierre; Carvalho, Graca; Gilda, Alves; Berger, Dominique; Thiaw, Seyni Mame; Sabah, Selmaoui; Salaheddine, Khzami; Skujiene, Grita; Abdelli, Sami; Mondher, Abrougui; Calado, Florbela; Bogner, Franz; Assaad, Yammine
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…
Barth, Karen R.; Cook, Robert L.; Downs, Julie S.; Switzer, Galen E.; Fischhoff, Baruch
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…
Leston, Jessica D.; Jessen, Cornelia M.; Simons, Brenna C.
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…
Norton, Wynne E.; Fisher, Jeffrey D.; Amico, K. Rivet; Dovidio, John F.; Johnson, Blair T.
Evidence suggests that nurses can struggle to care for patients with sexually transmitted infections in a non-judgemental way. It is unknown how targeted education can influence the knowledge and attitudes of student nurses towards caring for patients with sexually transmitted infections. This study aimed to investigate how a change in curriculum influenced the reported sexual health knowledge and attitudes of pre-registration adult student nurses in a University in the UK. A two phase mixed methods study, using a sequential explanatory strategy, collected quantitative questionnaire data (n = 117) followed by qualitative group data (n = 12). Data were collected from one cohort of students before a curriculum change and then from a subsequent cohort of students. Those students who had increased educational input in relation to sexual health reported higher degrees of knowledge and demonstrated a more positive attitude towards patients with a sexually transmitted infection. Both cohorts of students identified that education in this subject area was essential to challenge negative attitudes and positively influence patient care. Active learning approaches in the curriculum such as small group debates and service user involvement have the ability to allow students to express and challenge their beliefs in a safe and supportive environment. PMID:24875840
Bell, Amelia; Bray, Lucy
BackgroundRecreational drug use (RDU) may result in sexual disinhibition and higher risk for HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) in China. We assessed whether RDU was associated with HIV, syphilis, and herpes simplex virus type 2 (HSV-2) within the context of multiple sexual partnerships and unprotected sex.MethodsWe conducted a cross-sectional study among sexually-active MSM in six Chinese cities (Kunming, Jinan, Changsha, Zhengzhou, Nanjing, and Shanghai) in 2012¿2013. We interviewed participants regarding RDU and sexual activity and drew blood for HIV, syphilis, and HSV-2. We fit multiple logistic regression models to assess associations of drug use and HIV, syphilis and HSV-2 infections, controlling for number of sexual partners and unprotected sex.ResultsOf 3830 participants, 28% reported ever using ¿1 of these drugs in the past 6 months: popper (alkyl nitrites), ecstasy, ice (methamphetamine), amphetamine, tramadol, and ketamine. In the past six months, 62% of MSM reported ¿2 sexual partners and 76% did not use condoms at last sexual encounter. HIV, syphilis and HSV-2 prevalences were 9.2%, 12.2%, and 10.3%, respectively.RDU was associated with HIV infection (aOR¿=¿1.67; 95% CI, 1.31-2.13). Men with RDU were more likely to report multiple sexual partners (OR¿=¿1.69; 95% CI, 1.44-1.98) and unprotected sex (aOR¿=¿1.25; 95% CI, 1.05-1.49). The RDU-HIV association persisted (aOR¿=¿1.58; 95% CI¿=¿1.23-2.02) after adjusting for numbers of partners.ConclusionsRDU was associated with multiple sexual partnerships, unprotected sex, and HIV among Chinese MSM. It is plausible that RDU is a driver of increased sexual/HIV risk and/or may be an associated behavior with sexually risky lifestyles. Community engagement is needed. PMID:25443542
Xu, Jun-Jie; Zhang, Chen; Hu, Qing-Hai; Chu, Zhen-Xing; Zhang, Jing; Li, Yong-Ze; Lu, Lin; Wang, Zhe; Fu, Ji-Hua; Chen, Xi; Yan, Hong-Jing; Zhuang, Ming-Hua; Jiang, Yong-Jun; Geng, Wen-Qing; Vermund, Sten H; Qian, Han-Zhu; Shang, Hong
Objectives. We sought to investigate independent contributions of risky sexual behaviors and bleeding caused by intimate partner violence to prediction of HCV infection. Methods. We conducted a case–control study of risk factors among patients of a sexually transmitted disease clinic with and without HCV antibodies, group-matched by age. Results. Multivariate analyses indicated that Black race (odds ratio [OR] = 2.4; 95% confidence interval [CI] = 1.3, 4.4), injection drug use (OR = 20.3; 95% CI = 10.8, 37.8), sharing straws to snort drugs (OR = 1.8; 95% CI = 1.01, 3.0), sharing razors (OR = 7.8; 95% CI = 2.0, 31.0), and exposure to bleeding caused by intimate partner violence (OR = 5.5; 95% CI = 1.4, 22.8) contributed significantly to the prediction of HCV infection; risky sexual behavior and exposure to blood or sores during sexual intercourse did not. Conclusions. HCV risk among patients of a sexually transmitted disease clinic can be explained by direct blood exposure, primarily through injection drug use. Exposure to bleeding caused by intimate partner violence may be a previously unrecognized mechanism for HCV transmission associated with risky sexual behavior. PMID:19218181
Chen, Meng-Jinn; Nochajski, Thomas H.; Testa, Maria; Zimmerman, Scott J.; Hughes, Patricia S.
The immune system in the female reproductive tract (FRT) does not mount an attack against 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 female reproductive tract. Working together, these antimicrobials along with mucosal antibodies attack many different viral, bacterial and fungal targets. Within the FRT, the unique challenges of protection against sexually transmitted pathogens coupled with the need to sustain the development of an allogeneic fetus have evolved in such a way that sex hormones precisely regulate immune function to accomplish both tasks. The studies presented in this review demonstrate that estradiol and progesterone secreted during the menstrual cycle act both directly and indirectly on epithelial cells and other immune cells in the reproductive tract to modify immune function in a way that is unique to specific sites throughout the FRT. As presented in this review, studies from our laboratory and others demonstrate that the innate immune response is under hormonal control, varies with the stage of the menstrual cycle, and as such is suppressed at mid-cycle to optimize conditions for successful fertilization and pregnancy. In doing so, a window of STI vulnerability is created during which potential pathogens including HIV enter the reproductive tract to infect host targets. PMID:20367623
Wira, Charles R.; Fahey, John V.; Ghosh, Mimi; Patel, Mickey V.; Hickey, Danica K.; Ochiel, Daniel O.
Animals have a number of behavioral defenses against infection. For example, they typically avoid sick conspecifics, especially during mating. Most animals also alter their behavior after infection and thereby promote recovery (i.e., sickness behavior). For example, sick animals typically reduce the performance of energetically demanding behaviors, such as sexual behavior. Finally, some animals can increase their reproductive output when they face a life-threatening immune challenge (i.e., terminal reproductive investment). All of these behavioral responses probably rely on immune/neural communication signals for their initiation. Unfortunately, this communication channel is prone to manipulation by parasites. In the case of sexually transmitted infections (STIs), these parasites/pathogens must subvert some of these behavioral defenses for successful transmission. There is evidence that STIs suppress systemic signals of immune activation (e.g., pro-inflammatory cytokines). This manipulation is probably important for the suppression of sickness behavior and other behavioral defenses, as well as for the prevention of attack by the host's immune system. For example, the cricket, Gryllus texensis, is infected with an STI, the iridovirus IIV-6/CrIV. The virus attacks the immune system, which suffers a dramatic decline in its ability to make proteins important for immune function. This attack also hampers the ability of the immune system to activate sickness behavior. Infected crickets cannot express sickness behavior, even when challenged with heat-killed bacteria. Understanding how STIs suppress sickness behavior in humans and other animals will significantly advance the field of psychoneuroimmunology and could also provide practical benefits. PMID:24813461
Adamo, Shelley A
Criminal justice involvement (CJI) disrupts social and sexual networks, and sexually transmitted infections (STIs) thrive on network disruption. Adolescent CJI may be a particularly important determinant of STI because experiences during adolescence influence risk trajectories into adulthood. We used Wave III (2001-2002: young adulthood) of the National Longitudinal Study of Adolescent Health (N?=?14,322) to estimate associations between history of adolescent (younger than 18 years) CJI and adult STI risk. Respondents who reported a history of repeat arrest in adolescence, adolescent conviction, and arrest both as an adolescent and an adult (persistent arrest) had between two to seven times the odds of STI (biologically confirmed infection with chlamydia, gonorrhea, or trichomoniasis) in adulthood and between two to three times the odds of multiple partnerships and inconsistent condom use in the past year in adulthood. In analyses adjusting for sociodemographic and behavioral factors, history of having six or more adolescent arrests was associated with more than five times the odds of STI (adjusted odds ratio (AOR) 5.44, 95 % confidence interval (CI) 1.74-17.1). Both adolescent conviction and persistent CJI appeared to remain independent correlates of STI (conviction: AOR 1.90, 95 % CI 1.02-3.55; persistent CJI: AOR 1.60, 95 % CI 0.99-2.57). Adolescents who have repeat arrests, juvenile convictions, and persist as offenders into adulthood constitute priority populations for STI treatment and prevention. The disruptive effect of adolescent CJI may contribute to a trajectory associated with STI in adulthood. PMID:22815054
Khan, Maria R; Rosen, David L; Epperson, Matthew W; Goldweber, Asha; Hemberg, Jordana L; Richardson, Joseph; Dyer, Typhanye Penniman
The World Health Organization estimates that 340 million new cases of curable sexually transmitted infections (STIs) occur every year, while 33 million individuals are estimated to be living with HIV. The AIDS and STI epidemics are not independent with untreated STIs increasing HIV acquisition and transmission. Female sex workers have increased prevalence of untreated STIs and have been hypothesized to affect the health and HIV incidence of the general population. This paper aims to investigate why some female sex workers who experience symptoms of vaginal discharge or genital ulcers seek treatment while others do not. Data were collected from a cohort study conducted between 2002 and 2005 among female bar and hotel workers in Moshi, Tanzania. Study subjects were recruited from 7 out of 15 administrative wards in Moshi as part of the Moshi's Women's Health Project. Data were restricted to women self-reporting symptoms of vaginal discharge or genital ulcers (n=459) within the past year. Logistic regression was performed with SAS 9.1. Qualitative analysis was performed using in-depth interviews and focus group discussions among a convenience sample (n=42) of women already enrolled in the study. All interviews and focus group discussions were tape-recorded and transcribed, and data were analyzed thematically. Sixty-four percent of the sample sought treatment for either ailment. Multivariate analysis identified relationship to man of last sexual intercourse, ever experiencing a pregnancy, and age as significant predictors to seeking treatment. Four salient themes of threats to fertility, stigma correlated with prostitution, discomfort with the physical exam, and perceived views of clients were revealed as predictors to why women seek or intentionally ignore symptoms. Understanding the motivations and barriers for seeking treatment of STIs has far ranging public health implications that could help curtail the unnecessary associated morbidity and mortality and curtail the transmission of HIV. PMID:20635239
Rosenheck, Rachel; Ngilangwa, David; Manongi, Rachael; Kapiga, Saidi
The population of Sikkim is a unique blend of multi-tribal and metropolitan culture. However, till date, no data regarding prevalence of sexually transmitted diseases (henceforth abbreviated as STDs) among this population is available and hence requires attention. Hence the objective is to determine the prevalence of STDs in Sikkim and to describe associated risk factors. A cross-sectional study involving 'Questionnaire-based anonymous feedback system' was followed to collect data from 2,000 individuals across the society. The four most common STDs, gonorrhea, syphilis, chlamydia and HIV, were considered for the study. Total 69 (3.6%) cases of STDs were found in 1,918 individuals was affected by at least one of the STDs, out of which 43 were males and 26 were females. Cases of gonorrhea, syphilis, chlamydiasis and HIV were 25, 22, 4 and 18 respectively. Out of total 69 cases of STDs, 20 individuals were also suffering from some kind of hepatitis. Addictions like alcoholism, smoking and drugs were also found in significant number, with 1,019 (>50%) individuals with at least one of these addictions. Relative risk analysis indicates that gender-wise females are more vulnerable to STDs than males. The number of partners, addictions, especially alcohol and drug abuse, also contribute to STD cases. STDs act as a significant risk factor in transmitting some of the types of hepatitis. In such cases, females are more vulnerable than males. The results suggest that new community health programs are essential for both, HIV and non-HIV STDs in Sikkim. PMID:22811073
Rajapure, Vikram; Tirwa, Ranjan; Poudyal, Hemant; Thakur, Nagendra
Prostate cancer (PC) is the second most incident cancer and the sixth cause of death by cancer in men worldwide. Despite extensive research efforts, no modifiable risk factors have been consistently identified for PC risk. A number of studies have focused on possible relationships between sexually transmitted infections (STIs) and PC. We performed a meta-analysis to explore the association between infection caused by Neisseria gonorrheae, Treponema pallidum, Chlamydia trachomatis, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Herpes Simplex Virus types 1 and 2, Human Herpes Virus 8 and Cytomegalovirus, and PC. We conducted a comprehensive, systematic bibliographic search of medical literature to identify relevant studies. We calculated summary relative risk (SRR) and 95% confidence intervals (CI) for the association between each STI and PC through random effect models. Subgroup, meta-regression and sensitivity analyses were carried out to detect between-study heterogeneity and bias. We included 47 studies published between 1971 and 2011. Men who reported having ever had any STI in lifetime had an increased PC (SRR 1.49, 95% CI 1.19-1.92). We found a significantly increased PC risk in men having had gonorrhoea (SRR 1.20, 95% CI 1.05-1.37). No other single STI was significantly associated with PC. Due to high incidence of both STIs and PC worldwide, prevention of STIs may help preventing a considerable number of PC cases. PMID:24986642
Caini, Saverio; Gandini, Sara; Dudas, Maria; Bremer, Viviane; Severi, Ettore; Gherasim, Alin
This paper analyzes the relationship between same-sex marriage laws and sexually transmitted infections in the United States using state-level data from 1981 to 2008. We hypothesize that same-sex marriage laws may directly affect risky homosexual behavior; may affect or mirror social attitudes toward gays, which in turn may affect homosexual behavior; and may affect or mirror attitudes toward non-marital sex, which may affect risky heterosexual behavior. Our findings may be summarized as follows. Laws banning same-sex marriage are unrelated to gonorrhea rates, which are a proxy for risky heterosexual behavior. They are more closely associated with syphilis rates, which are a proxy for risky homosexual behavior. However, these estimates are smaller and less statistically significant when we exclude California, the state with the largest gay population. Also, laws permitting same-sex marriage are unrelated to gonorrhea or syphilis, but variation in these laws is insufficient to yield precise estimates. In sum, the findings point to a modest positive association--if any at all--between same-sex marriage bans and syphilis. PMID:22789462
Francis, Andrew M; Mialon, Hugo M; Peng, Handie
Background The feasibility and acceptability of partner notification (PN) for sexually transmitted infections (STIs) in developing countries was assessed through a comprehensive literature review, to help identify future intervention needs. Methods The Medline, Embase, and Google Scholar databases were searched to identify studies published between January 1995 and December 2007 on STI PN in developing countries. A systematic review of the research extracted information on: (1) willingness of index patients to notify partners; (2) the proportion of partners notified or referred; (3) client-reported barriers in notifying partners; (4) infrastructure barriers in notifying partners; and (5) PN approaches that were evaluated in developing countries. Results Out of 609 screened articles, 39 met our criteria. PN outcome varied widely and was implemented more often for spousal partners than for casual or commercial partners. Reported barriers included sociocultural factors such as stigma, fear of abuse for having an STI, and infrastructural factors related to the limited number of STD clinics, and trained providers and reliable diagnostic methods. Client-oriented counselling was found to be effective in improving partner referral outcomes. Conclusions STD clinics can improve PN with client-oriented counselling, which should help clients to overcome perceived barriers. The authors speculate that well-designed PN interventions to evaluate the impact on STI prevalence and incidence along with cost-effectiveness components will motivate policy makers in developing countries to allocate more resources towards STI management. PMID:20082718
This article reports on the prevalence of AIDS and sexually transmitted diseases (STDs) in Southeast Asia. The spread of HIV infection in this region has been predicted to be worse than that of Africa. The high-prevalence countries are Thailand, Cambodia, and Myanmar, where prevalence rates in the population at risk (15-49 year olds) are up to 2%; while low prevalence countries with rates of 0.1% include the Philippines, Indonesia, Laos, Brunei, and Singapore. Heterosexual transmission in Southeast Asia is the main mode of spread of HIV. Another route is through migration, rural-to-urban or international migration of people seeking jobs; with concurrent loneliness and anonymity, they become vulnerable to STDs and HIV infection. Intravenous drug use poses an increasing risk of transmission. The unavailability of data in some countries makes it difficult to evaluate the extent of the epidemic or if there's an impending epidemic. There are a number of caveats to the data compilation from various countries. These include the following: under-reporting of cases; underdiagnosis; missed diagnosis; and differences in the time of data collection. It is clear that poverty, illiteracy, and poor access to educational information in most countries in this region facilitate the rapid spread of HIV. These coupled with lack of primary health care services, and in most instances, enormously high cost of drugs make the pain and suffering due to the HIV/AIDS epidemic a human disaster far worse than the ravages of war. PMID:10330595
Objective This study was conducted to determine the prevalence of selected sexually transmitted infections (STIs) and their risk factors among workers in and near a truck stand in Dhaka, Bangladesh. Study Design A random sample of 696 men and 206 women were recruited into a cross-sectional study using a census that enumerated transport agents, motor mechanics, laborers, and vendors in Tejgaon truck stand. Results The prevalence rates of syphilis (rapid plasma reagin and Treponema pallidum hemagglutination), gonorrhea (polymerase chain reaction [PCR]), and chlamydial infections (PCR) among men were 4.1%, 7.7%, and 2.3%, respectively, and among women were 2.9%, 8.3%, and 5.2%. Multivariable analysis revealed that having ?2 sex partners in the last month, never using a condom with sex workers, and ever injecting narcotics were significant predictors of STI among men. Being never married, working as a laborer, older age, and living within the truck stand were significant predictors of practicing high-risk behaviors among men, but none predicted infection with STIs. Conclusions Both behavioral and STI data suggest that truck stand workers should be included in the STI/HIV intervention programs. PMID:16837827
Alam, Nazmul; Rahman, Motiur; Gausia, Kaniz; Yunus, Md; Islam, Nazrul; Chaudhury, Parwez; Monira, Shirajum; Funkhouser, Ellen; Vermund, Sten H.; Killewo, Japhet
Understanding the demographic, behavioural and psychosocial factors associated with partner referral for patients with sexually transmitted infections (STIs) is important for designing appropriate intervention strategies. A survey was conducted among STI clients in three government and three non-governmental organization-operated clinics in Dhaka and Chittagong city in Bangladesh. Demographic and psychosocial information was collected using a questionnaire guided by the Attitude-Social Influence-Self Efficacy model. Partner referral data were collected by verification of referral cards when partners appeared at the clinics within one month of interviewing the STI clients. Of the 1339 clients interviewed, 81% accepted partner referral cards but only 32% actually referred their partners; 37% of these referrals were done by clients randomly assigned to a single counselling session vs. 27% by clients not assigned to a counselling session (p < 0.0001). Among psychosocial factors, partner referral intention was best predicted by attitudes and perceived social norms of the STI clients. Actual partner referral was significantly associated with intention to refer partner and attitudes of the index clients. Married clients were significantly more likely to refer their partners, and clients with low income were less likely to refer partners. Intervention programmes must address psychosocial and socio-economic issues to improve partner referral for STIs in Bangladesh. PMID:20943297
Alam, Nazmul; Streatfield, Peter Kim; Khan, Sharful Islam; Momtaz, Dalia; Kristensen, Sibylle; Vermund, Sten H.
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
Green, M; Hoffman, I F; Brathwaite, A; Wedderburn, M; Figueroa, P; Behets, F; Dallabetta, G; Hoyo, C; Cohen, M S
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
Ding, Honglei; Gong, Siqi; Tian, Yingxin; Yang, Zhangsheng; Brunham, Robert; Zhong, Guangming
Floral traits endowing high reproductive fitness can also affect the probability of plants contracting sexually transmitted diseases. We explore how variations in floral traits influence the fitness of Silene dioica females in their interactions with pollinators carrying pollen or spores of the sterilizing anther-smut fungus Microbotryum violaceum. We collected healthy and infected plants in a highly diseased population and grew them under conditions that 'cure' infected individuals, and used standard regression methods to detect natural selection on floral traits. Narrow-sense heritabilities, coefficients of additive genetic variation (CV(A)) and genetic correlations among traits were estimated from paternal half-sib groups. Pollinator preferences imposed strong direct and directional selection on traits affecting female attractiveness and pollen-/spore-capturing abilities. Levels of additive genetic variance were high in these traits, suggesting that rapid responses to selection are possible. By considering our results in the light of spatial and temporal heterogeneity resulting from the colonization dynamics typical for this species, we suggest that the conflicting selective effects of pollen/spore loads lead to the maintenance of genetic variation in these traits. PMID:16441754
Giles, Barbara E; Pettersson, Tor Mikael; Carlsson-Granér, Ulla; Ingvarsson, Pär K
This study was conducted to determine the sexually transmitted diseases in domestic expatriate workers (DEWs) screened for pre-employment in the general clinics of a teaching hospital. The study included 1648 domestic expatriate workers who were reviewed by a general practitioner, and who underwent serological tests for treponemal infections and human immunodeficiency virus (HIV). Screening for hepatitis B surface antigen (HBsAg) was also done routinely as part of the requirement of the pre-employment screening. The relative frequencies for syphilis and HIV were 23.8% and 19% respectively. HIV was detected more frequently in DEWs from Africa, and syphilis in DEWs from Indonesia and the Philippines, whereas HGsAg was more frequently detected in DEWs from the African subcontinent, and was significant among males (2.8%), compared to females (1.0%), where P7lt;0.05. These findings indicate that pre-employment screening is a viable means of identifying major STDs (venereal syphilis, HIV) and communicable diseases such as hepatitis B in the DEWs. It is recommended that stringent measures be adopted to prevent fraudulent reporting from laboratories and health care providers locally, and from the home country of the DEW. PMID:17377460
Hamdi, S A; Ibrahim, M A
BACKGROUND Sexually Transmitted Diseases are still considered a serious public health problem in Brazil and worldwide. OBJECTIVE To examine Sexually Transmitted Diseases prevalence and the sickness impact profile of STDs in a reference health center specializing in the treatment of Sexually Transmitted Diseases. METHOD We collected epidemiological, demographic, clinical and laboratory data from the medical records and interviews of 4,128 patients who had attended the center from January 1999 to December 2009. RESULTS Male patients outnumbered (76%) females (24%), Caucasians outnumbered (74.3%) those of mixed race (14.8%), blacks (10.8%) and Asians (0.1%). STD occurrence was higher in the 20-29 age group (46.2%) This population included 34.7% high school graduates, 8.7% college graduates and 0.8% illiterates. As for affective-sexual orientation, 86.5% were heterosexual, 7.8% homosexual and 5.5% bisexual. Regarding patients' sexual practices over the previous 30 days, 67.7% reported sexual intercourse with one person, 8.6% had had sex with two persons and 3.9%, with three or more people. The highest incidence of STD was condyloma acuminata, affecting 29.4% of all the patients, genital candidiasis 14.2%, and genital herpes 10.6%. Of the 44.3% who submitted to serologic testing for HIV detection 5% were positive, with a ratio of 6.8 males to 1 female. CONCLUSIONS STD prevalence remains high in Brazil and it is necessary to invest in early detection, prevention and treatment. PMID:24068122
Fagundes, Luiz Jorge; Vieira Junior, Elso Elias; Moysés, Ana Carolina Marteline Cavalcante; de Lima, Fernão Dias; de Morais, Fátima Regina Borges; Vizinho, Natalina Lima
Psychological pathways from childhood sexual and physical abuse to HIV/sexually transmitted infection outcomes among homeless women: the role of posttraumatic stress disorder and borderline personality disorder symptoms.
This study examines the psychological factors linking childhood abuse and HIV/sexually transmitted infection outcomes among 190 single homeless women in New York City. Participants were assessed for mental health symptoms, sexually transmitted infections, and exposure to childhood sexual and physical abuse. Findings indicate that the relationship between childhood abuse and HIV/sexually transmitted infection diagnoses during adulthood is mediated by a combination of posttraumatic stress disorder and borderline personality disorder symptoms. Screening single homeless women who report childhood abuse histories for symptoms of both disorders may aid in the identification of individuals particularly vulnerable for HIV infection. Implications for clinical interventions are discussed. PMID:23180873
Houston, Eric; Sandfort, Theo G M; Watson, Kalycia T; Caton, Carol L M
This study sought to assess the knowledge and attitudes of young unmarried women regarding family size and sexually transmitted diseases, including HIV, in three residential regional institutes of northeastern India. The data is expected to help in reinforcing various methods of Information, Education and Communication (IEC) implementation. A representative sample of 574 female students, 16-25 years of age, were interviewed by a pretested questionnaire to assess their knowledge of the determinants of family size and sexually transmitted diseases. Of the participants, 48.43% stated that the suitable age for marriage is > 18 years old for women. More than half the respondents stated that the interval between child birth should be 3-5 years. Most of the respondents (96.17%) were of the opinion that both parents are responsible for determining the number of children. Knowledge of STDs and HIV was found in 91.8% and 74.04% of respondents, respectively. PMID:15906675
Hazarika, N C; Mahanta, J
We sought to describe: (1) the prevalence of internet, cellular phone, and text message use among women attending an urban\\u000a sexually transmitted infections (STI) clinic, (2) the acceptability of health advice by each mode of information and communication\\u000a technology (ICT), and (3) demographic characteristics associated with ICT use. This study is a cross-sectional survey of 200\\u000a English-speaking women presenting to
Lipika Samal; Heidi E. Hutton; Emily J. Erbelding; Elizabeth S. Brandon; Joseph Finkelstein; Geetanjali Chander
The aim of this study is to elucidate and review the risk of sexually transmitted infections (STIs) among condom users. Men\\u000a and women of reproductive age are the subjects of this study. Data were extracted from the literature through the MEDLINE\\u000a service for the period 2000–2006. Female condoms (0.1%) were reported to be less liable to break than male condoms
Narendra Nath Sarkar
We describe a nucleic acid testing (NAT) platform for infectious disease diagnostics at the point-of-care, using surface acoustic waves (SAW) to perform a multiplexed loop-mediated isothermal amplification (LAMP) test for sexually transmitted diseases. The ultrasonic actuation not only enables faster NAT reactions but also provides a route towards integrating low-cost, low-power molecular diagnostics into disposable sensors. PMID:25569801
Xu, Gaolian; Gunson, Rory N; Cooper, Jonathan M; Reboud, Julien
Objective To investigate the epidemiological characteristics of human papillomavirus (HPV) infection in men attending a sexually transmitted diseases (STD) clinic in Hangzhou area. Methods Male subjects (n=375) aged 18-70 years, attending the STD clinic were recruited. Urethral swabs were assessed for HPV DNA using polymerase chain reaction (PCR) with the consensus primers MY09\\/11. HPV genotypes of positive PCR products were
XU TANG; AI-E XU; XIAO-PING DONG; XIU-KUN SUN; HONG SHEN; JI-FENG LIU
BackgroundSexually transmitted infections (STIs) such as herpes simplex virus (HSV)-2 are associated with an increased risk of HIV infection. Human papillomavirus (HPV) is a common STI, but little is know about its role in HIV transmission. The objective of this study was to determine whether cervico-vaginal HPV infection increases the risk of HIV acquisition in women independent of other common
Karen K. Smith-McCune; Stephen Shiboski; Mike Z. Chirenje; Tsitsi Magure; Jennifer Tuveson; Yifei Ma; Maria da Costa; Anna-Barbara Moscicki; Joel M. Palefsky; Rudo Makunike-Mutasa; Tsungai Chipato; Ariane van der Straten; George F. Sawaya; Joy Sturtevant
The effectiveness of syndromic management of sexually transmitted disease (STD) patients--a strategy that has been proposed for introduction to South Africa's public health sector--depends on both the quality of case management and health-seeking behavior patterns. These issues were assessed in 10 rural primary care clinics in South Africa's Hlabisa district. Field workers trained to present with STD syndromes (simulation patients) made a total of 44 clinic visits. In addition, 49 actual STD patients were interviewed when exiting clinics, facilities were checked for availability of essential drugs and equipment, 10 focus group discussions were held with staff, and STD syndrome surveillance was performed. Among simulated patients, only 9% were correctly managed (i.e., given correct drugs, condoms, and partner notification cards); appropriate counseling was provided in just 48% of visits. All clients interviewed as they left the clinic reported satisfactory or good staff attitudes, even though 39% waited over 1 hour to be seen and only 37% were seen in privacy. Only 6 clinics had syndromic management cards available, 3 reported intermittent drug shortages, and 7 lacked partner notification cards. In focus groups, staff demonstrated adequate knowledge of STDs, but poor morale and a lack of training in syndromic management. Finally, surveillance data revealed that, although 75% of patients presented within 1 week of symptom onset, 27% had been treated for an STD in the past 3 months and only 6% of those treated were contacts. An intervention comprised of staff training and STD syndrome packets has been designed to improve the quality of STD case management in South Africa. PMID:9863876
Harrison, A; Wilkinson, D; Lurie, M; Connolly, A M; Karim, S A
Objective. To determine the event-level associations between perceived risk of sexually transmitted disease (STD) acquisition/transmission and condom use during penile-vaginal intercourse (PVI) among STD clinic attendees. Method. A convenience sample (N = 622) completed daily electronic assessments. Two questions were proxies of perceived risk: suspicion that the partner might currently have an STD and that "you" might currently have an STD. Participants reported whether condoms were used with PVI events in the past 24 hours. Generalized estimating equations determined the association between each of the perceived risk variables and event-level condom use. Results. For the model pertaining to suspicion of sex partner infection, there were 16,674 events of PVI, with condom use during 10,552 of these events. The effect of current suspicion was significant after adjusting for gender and whether participants identified as African American/Black (estimated odds ratio = 2.17, 95% confidence interval = 1.57-3.00, P = .0001). The model pertaining to suspicion of self-infection included 16,679 events of penile-vaginal sex, with condom use during 10,557 of these events. Again, the effect of current suspicion was significant after adjusting for gender and African American/Black race (estimated odds ratio = 2.05, 95% confidence interval = 1.43-2.40, P = .0001). Tests for interactions with gender and with race were nonsignificant (all Ps > .25). Conclusion. Using an event-level research design, strong associations were found between perceptions of STD risk and condom use in a clinical population. Health care providers and other professionals may indirectly promote condom use by helping clinic patients realistically evaluate their risk of having sex with infected partners or of being a source of STD transmission to others. PMID:24722217
Crosby, Richard A; Milhausen, Robin R; Graham, Cynthia A; Yarber, William L; Sanders, Stephanie A; Charnigo, Richard; Shrier, Lydia A
Objective China’s sexually transmitted infection (STI) epidemic requires comprehensive control programmes. Partner services are traditional pillars of STI control but have not been widely implemented in China. This study was a systematic literature review to examine STI partner notification (PN) uptake in China. Methods Four English and four Chinese language databases were searched up to March 2011 to identify articles on PN of STIs including HIV in China. PN uptake was defined as the number of partners named, notified, evaluated or diagnosed per index patient. Results A total of 11 studies met inclusion criteria. For STI (excluding HIV) PN, a median 31.6% (IQR 27.4%–65.8%) of named partners were notified, 88.8% (IQR 88.4%–90.8%) of notified partners were evaluated and 37.9% (IQR 33.1%–43.6%) of evaluated partners were diagnosed. For HIV PN, a median 15.7% (IQR 13.2%–36.5%) of named partners were notified, 86.7% (IQR 72.9%–90.4%) of notified partners were evaluated and 27.6% (IQR 24.1%–27.7%) of evaluated partners were diagnosed. A mean of 80.6% (SD=12.6%) of patients attempted PN, and 72.4% (IQR 63.8%–81.1%) chose self-referral when offered more than one method of PN. Perceived patient barriers included social stigma, fear of relationship breakdown, uncertainty of how to notify and lack of partner contact information. Perceived infrastructure barriers included limited time and trained staff, mistrust of health workers and lack of PN guidelines. Conclusion PN programmes are feasible in China. Further research on STI PN, particularly among men who have sex with men and other high-risk groups, is an important public health priority. PN policies and guidelines are urgently needed in China. PMID:22427489
Wang, Alberta L; Peng, Rui-Rui; Tucker, Joseph D; Cohen, Myron S; Chen, Xiang-Sheng
Background With the advent of molecular techniques, self?collected specimens without a clinician's examination are often adequate to detect common genital infections. Objective To evaluate the additional information that speculum and bimanual examinations provides clinicians in the routine evaluation of genital infections among attendees of a sexually transmitted disease (STD) clinic. Methods Cross?sectional study from a database of all visit records to two STD clinics in Baltimore between 1996 and 2002. Women were stratified on the basis of reason for visit. Proportional and likelihood ratio estimates of the speculum examination in detecting clinically relevant cervicovaginal lesions (leading to a diagnosis of other infections or outside referral for further management) and bimanual examination in detecting abnormalities (leading to a diagnosis of pelvic inflammatory disease or referral) are presented. Results 15?918 of 21?703 records were included: 12?073 were symptomatic (SYM; discharge, rash, abdominal pain, dysuria, genital irritation or odour), 1676 were asymptomatic contacts of an infected partner (CON) and 2169 were asymptomatic and presented for checkup (ASYM). The median age was 26?years; 94% were black. 11.8% of SYM, 4.6% of CON and 3.9% of ASYM patients had clinically meaningful lesions detected on speculum examination. The bimanual examination detected clinically relevant abnormalities in 6.5% of SYM, 0.8% of CON and 0.6% of ASYM patients. Conclusion Symptomatic women are most likely to benefit from speculum and bimanual examinations. However, their yield in evaluating asymptomatic women is low. Prospective studies are needed to determine whether eliminating speculum and bimanual examinations in a subset of women would offer an operational advantage without compromising patient safety. PMID:17108005
Singh, Rameet H; Erbelding, Emily J; Zenilman, Jonathan M; Ghanem, Khalil G
Background Prostatitis and sexually transmitted diseases (STDs) have been positively associated with prostate cancer in previous case-control studies. However, results from recent prospective studies have been inconclusive. Methodogy/Principal Findings We investigated the association between prostatitis, STDs, and prostate cancer among African American, Asian American, Latino, and White participants of the California Men's Health Study. Our analysis included 68,675 men, who completed a detailed baseline questionnaire in 2002–2003. We identified 1,658 incident prostate cancer cases during the follow-up period to June 30, 2006. Cox proportional hazards models were used to estimate relative risks and 95% confidence intervals. Overall, men having a history of prostatitis had an increased risk of prostate cancer than men with no history (RR?=?1.30; 95% CI: 1.10–1.54). Longer duration of prostatitis symptoms was also associated with an increased risk of prostate cancer (P trend?=?0.003). In addition, among men screened for prostate cancer (1 or 2 PSA tests), a non-significant positive association was observed between prostatitis and prostate cancer (RR?=?1.10; 95% CI: 0.75–1.63). STDs were not associated with overall prostate cancer risk. In racial/ethnic stratified analysis, Latinos reporting any STDs had an increased risk of disease than those with no STDs (RR?=?1.43; 95% CI: 1.07–1.91). Interestingly, foreign-born Latinos displayed a larger risk associated with STDs (RR?=?1.87; 95% CI: 1.16–3.02) than U.S. born Latinos (RR?=?1.15; 95% CI: 0.76–3.02). Conclusion In summary, results from this prospective study suggest that prostatitis and STDs may be involved in prostate cancer susceptibility. While we cannot rule out the possible influence of incidental detection, future studies are warranted to further investigate the role of infectious agents related to prostatitis and STDs in prostate cancer development. PMID:20090948
Cheng, Iona; Witte, John S.; Jacobsen, Steven J.; Haque, Reina; Quinn, Virginia P.; Quesenberry, Charles P.; Caan, Bette J.; Van Den Eeden, Stephen K.
The study attempts to define socioeconomic, clinical, and laboratory correlates in vaginitis and other sexually transmitted infections in rural southwestern Haiti. A convenience sample of subjects recruited from a rural women's health clinic and attending an established clinic at the Haitian Health Foundation (HHF) clinic was studied. A standardized history and physical examination, including speculum examination, and collection of blood, urine, and vaginal swabs were obtained from the women at the rural clinic. Additional vaginal swab samples only for Nucleic Acid Amplification Test (NAAT) testing were obtained from women at the HHF clinic in Jérémie. Laboratory results from Leon subjects were positive for Gardnerella vaginalis in 41% (41 of 100), Trichomonas vaginalis in 13.5% (14 of 104), Candida sp. in 9% (9 of 100), Mycoplasma genitalium in 6.7% (7 of 104), Chlamydia trachomatis in 1.9% (2 of 104), and Neisseria gonorrhea in 1% (1 of 104) of patients. Human immunodeficiency virus (HIV) antibody tests were negative in 100% (103 of 103) of patients, and syphilis antibody testing was positive for treponemal antibodies in 7.7% (8 of 104) patients. For subjects from the HHF, 19.9% were positive for T. vaginalis, 11.9% were positive for C. trachomatis, 10.1% were positive for M. genitalium, and 4.1% were positive for N. gonorrhea. Infections with G. vaginalis, T. vaginalis, and Candida were the most common. N. gonorrhea, C. trachomatis, Candida sp., T. vaginalis, and M. genitalium infections were associated with younger age (less than 31 years old). PMID:25200263
Jobe, Kathleen A; Downey, Robert F; Hammar, Donna; Van Slyke, Lori; Schmidt, Terri A
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
Gorbach, Pamina M.; Weiss, Robert E.; Fuchs, Edward; Jeffries, Robin A.; Hezerah, Marjan; Brown, Stephen; Voskanian, Alen; Robbie, Edward; Anton, Peter; Cranston, Ross D.
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
Mutha, Sonali A; Baghel, Paritosh J; Patil, Ramanand J; Bhagat, Sagar B; Patel, Sadiq B; Watsa, Mahinder C
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
Aim To examine the effectiveness of interventions seeking to prevent the spread of sexually transmitted infections (STI), including HIV, among young people in the European Union. Methods For this systematic review, we examined interventions that aimed at STI risk reduction and health promotion conducted in schools, clinics, and in the community for reported effectiveness (in changing sexual behavior and/or knowledge) between 1995 and 2005. We also reviewed study design and intervention methodology to discover how these factors affected the results, and we compiled a list of characteristics associated with successful and unsuccessful programs. Studies were eligible if they employed a randomized control design or intervention-only design that examined change over time and measured behavioral, biologic, or certain psychosocial outcomes. Results Of the 19 studies that satisfied our review criteria, 11 reported improvements in the sexual health knowledge and/or attitudes of young people. Ten of the 19 studies aimed to change sexual risk behavior and 3 studies reported a significant reduction in a specific aspect of sexual risk behavior. Two of the interventions that led to behavioral change were peer-led and the other was teacher-led. Only 1 of the 8 randomized controlled trials reported any statistically significant change in sexual behavior, and then only for young females. Conclusion The young people studied were more accepting of peer-led than teacher-led interventions. Peer-led interventions were also more successful in improving sexual knowledge, though there was no clear difference in their effectiveness in changing behavior. The improvement in sexual health knowledge does not necessarily lead to behavioral change. While knowledge may help improve health-seeking behavior, additional interventions are needed to reduce STIs among young people. PMID:20162748
Lazarus, Jeffrey V.; Sihvonen-Riemenschneider, Henna; Laukamm-Josten, Ulrich; Wong, Fiona; Liljestrand, Jerker
Background Chlamydia infection is the most common notifiable sexually transmitted infection (STI) in Australia and mostly affects young people (15 – 25 years). This paper presents baseline data from a randomised controlled trial that aimed to increase chlamydia testing among sexually active young people. The objectives were to identify associations between sexual behaviour, substance use and STI history and explore attitudes to chlamydia testing. Methods This study was conducted in cyberspace. Study recruitment, allocation, delivery of interventions and baseline and follow up data collection all took place online. Participants were 16 – 25 years old and resided in Australia. Substance use correlates of sexual activity; predictors of history of STIs; barriers to and facilitators of chlamydia testing were analysed. Results Of 856 participants (79.1% female), 704 had experienced penetrative intercourse. Sexually active participants were more likely to smoke regularly or daily, to drink alcohol, or to have binge drunk or used marijuana or other illicit substances recently. Risk factors for having a history of any STI were 3 or more sexual partners ever, 6 or more partners in the past 12 months, condom non-use and being 20 years or older. Almost all sexually active participants said that they would have a chlamydia test if their doctor recommended it. Conclusions Sexually active young people are at risk of STIs and may engage in substance use risk behaviours. Where one health risk behaviour is identified, it is important to seek information about others. Chlamydia testing can be facilitated by doctors and nurses recommending it. Primary care providers have a useful role in chlamydia control. Trial Registration Australian and New Zealand Trials Registry ACTRN12607000582459 PMID:24400743
Randomized Controlled Trial on the Effectiveness of Counseling Messages for Avoiding Unprotected Sexual Intercourse During Sexually Transmitted Infection and Reproductive Tract Infection Treatment Among Female Sexually Transmitted Infection Clinic Patients
Background The effectiveness of counseling messages to avoid unprotected sex during short-term treatment for curable sexually transmitted infections is unknown. Methods We randomized 300 female STI clinic patients 18 years or older with cervicitis and/or vaginal discharge in Kingston, Jamaica, in 2010 to 2011, to 1 of 2 counseling messages for their course of syndromic treatment: abstinence only or abstinence backed up by condom use. At a follow-up visit 6 days afterward, we collected vaginal swabs to test for prostate-specific antigen (PSA), a biological marker of recent semen exposure, and administered a questionnaire assessing sexual behavior. Results No differences were found in the proportions of women testing positive for PSA at follow-up in the abstinence-plus-condom group (11.9%) and abstinence-only group (8.4%) (risk difference, 3.5; 95% confidence interval, ?3.5 to 10.5). There also was no significant difference in reporting of unprotected sex between groups. Reporting a history of condom use before enrollment significantly modified the effect of counseling arm on PSA positivity (P = 0.03). Among those reporting recent condom use, 10.3% in the abstinence-only arm and 4.8% in the abstinence-plus-condom arm tested positive for PSA. Conversely, among those not reporting recent condom use, 6.5% in the abstinence-only arm and 17.3% in the abstinence-plus-condom arm had PSA detected. Conclusions We found no evidence to support the superiority of either counseling message. Post hoc analyses suggest that women with recent condom experience may benefit significantly more from abstinence-plus-condom messages, whereas women without such experience may benefit significantly more from abstinence-only messages. Providers should weigh individual condom use history when determining the most appropriate counseling message. PMID:23321990
Anderson, Clive; Gallo, Maria F.; Hylton-Kong, Tina; Steiner, Markus J.; Hobbs, Marcia M.; Macaluso, Maurizio; Figueroa, J. Peter; Jamieson, Denise J.; Legardy-Williams, Jennifer; Wiener, Jeffrey; Warner, Lee
Objectives. We sought to assess the effectiveness of approaches targeting improved sexually transmitted infection (STI) sexual partner notification through patient referral. Methods. From January 2002 through December 2004, 600 patients with Neisseria gonorrhoeae or Chlamydia trachomatis were recruited from STI clinics and randomly assigned to either a standard-of-care group or a group that was counseled at the time of diagnosis and given additional follow-up contact. Participants completed an interview at baseline, 1 month, and 6 months and were checked at 6 months for gonorrhea or chlamydial infection via nucleic acid amplification testing of urine. Results. Program participants were more likely to report sexual partner notification at 1 month (86% control, 92% intervention; adjusted odds ratio [AOR] = 1.8; 95% confidence interval [CI] = 1.02, 3.0) and were more likely to report no unprotected sexual intercourse at 6 months (38% control, 48% intervention; AOR = 1.5; 95% CI = 1.1, 2.1). Gonorrhea or chlamydial infection was detected in 6% of intervention and 11% of control participants at follow-up (AOR = 2.2; 95% CI = 1.1, 4.1), with greatest benefits seen among men (for gender interaction, P = .03). Conclusions. This patient-based sexual partner notification program can help reduce risks for subsequent STIs among urban, minority patients presenting for care at STI clinics. PMID:18556619
Hogben, Matthew; Malka, Edmond S.; Liddon, Nicole; McCormack, William M.; Rubin, Steve R.; Augenbraun, Michael A.
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
Jemmott, John B.; Jemmott, Loretta S.; O'Leary, Ann; Ngwane, Zolani; Icard, Larry D.; Heeren, G. Anita; Mtose, Xoliswa; Carty, Craig
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
Cingolani, Antonella; Zona, Stefano; Girardi, Enrico; Cozzi Lepri, Alessandro; Monno, Laura; Quiros Roldan, Eugenia; Guaraldi, Giovanni; Antinori, Andrea; d'Arminio Monforte, Antonella; Marcotullio, Simone
This ethnographic research among rural South African men and women seeking care for STDs explores constraints to communication among partners and defines predominant patterns of sexual networking. A series of fifteen open-ended interviews explored topics related to sexual networking and partner communication. Patterns of sexual networking showed clear gender variation, with men more likely to discuss multiple partners. Both men and women believed they should tell one partner about their STD, most often a steady partner. Strong distinctions were made between regular and casual partners, with an emphasis on the role of trust in a steady relationship. Men and women expressed anxiety about telling their partners of their illness, but women more often expressed fear whereas men felt embarrassed. Multi-partnered sexuality is common and is widely accepted for men. While the importance of regular partnerships is clear for both men and women, sexual relationships appear to be highly unstable. Communication among partners could be facilitated by stronger health promotion messages, such as the importance of telling a partner about an STD. Prevailing patterns of communication and sexual networking have profound implications for the STD epidemic. PMID:10175971
Harrison, A; Lurie, M; Wilkinson, N
Adenoviruses (Ads) are an important cause of respiratory illness, conjunctivitis, and gastroenteritis, but they are seldom recognized as a potential cause of sexually transmitted disease. We performed virus cultures on approximately 7,000 patients attending a sexually transmitted disease clinic or other health department clinics for the evaluation of genital ulcers, urethritis, or conjunctivitis. Ads were isolated from genital or conjunctival specimens obtained from 23 (0.33%) patients. Among the 20 Ad-positive men, 15 (75%) had urethritis, 12 (60%) had conjunctivitis, and 10 (50%) had both. All three Ad-positive women had vaginal discharge and genital ulcers or fissures. Ad isolates from 17 patients were available for serotyping. Ad type 37 was isolated from 14 patients, Ad type 8 was isolated from 2 patients, and Ad type 2 was isolated from 1 patient. In three of the Ad type 37 cases, Ad was recovered from both urethral and conjunctival specimens. One of the Ad type 8 cases had conjunctivitis, but the Ad type 2 case did not. Ads, particularly type 37, may be a sexually transmissible cause of genital ulcers, urethritis, and conjunctivitis. PMID:8567914
Swenson, P D; Lowens, M S; Celum, C L; Hierholzer, J C
Objective: Sexually transmitted disease (STD) and HIV infection are occurring at epidemic rates in the southern region of the United States. Depression and substance use disorders are associated with sexual risk behavior, so we investigated whether regionwide societal rates of major depression or substance use disorders could explain the higher southern rates. Methods: Data came from two surveys, the National
Sherry D. Broadwell; Peikang Yao; Deborah Hasin
This study explored the relationships among personal factors, family structure and family function, adolescents’ self-efficacy for safe sex, and sexual behaviors among sexually active adolescents. A subset sample from the first three waves of the National Longitudinal Study of Adolescent Health (Add Health) was selected for this exploratory…
Kao, Tsui-Sui Annie; Manczak, Melissa
Alcohol is related to HIV risk behaviors in southern Africa and these behaviors are correlated with sensation seeking personality and alcohol outcome expectancies. Here we report for the first time the associations among sensation seeking, substance use, and sexual risks in a prospective study in Africa. Sexually transmitted infection clinic patients in Cape Town South Africa (157 men and 64 women) completed (a) baseline measures of sensation seeking, sexual enhancement alcohol outcome expectancies, alcohol use in sexual contexts, and unprotected sexual behaviors and (b) 6-month follow-up measures of alcohol use in sexual contexts and unprotected sexual acts. Results confirmed that sensation seeking predicts HIV risk behavior and sensation seeking is related to alcohol outcome expectancies which in turn predict alcohol use in sexual contexts. HIV prevention counseling that addresses drinking in relation to sex is urgently needed in southern Africa. PMID:18790575
Kalichman, Seth C.; Simbayi, Leickness; Jooste, Sean; Vermaak, Redwaan; Cain, Demetria
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
Fogel, Catherine I; Gelaude, Deborah J; Carry, Monique; Herbst, Jeffrey H; Parker, Sharon; Scheyette, Anna; Neevel, A
In 2010, Senate Bill 1309 included language to repeal an existing Arizona law that enables minors younger than 18 years of age to seek diagnosis and treatment of sexually transmitted diseases (STDs) without parental consent. Numerous implications were identified that would have stemmed from parental consent provisions originally proffered in Senate Bill 1309. These implications included diminished access to essential health services among minors, exacerbated existing health disparities, increased health-care spending costs, and thwarted efforts to curb the spread of STDs. Lastly, minors would have been deprived of existing privacy protections concerning their STD-related medical information. This case study describes how collaborative advocacy efforts resulted in the successful amendment of Senate Bill 1309 to avert the negative sexual and reproductive health outcomes among adolescents stemming from the potential repeal of their existing legal right to seek STD treatment without parental consent. PMID:22547855
Goodwin, Kimberly D.; Taylor, Melanie M.; Brown, Erin C. Fuse; Winscott, Michelle; Scanlon, Megan; Hodge, James G.; Mickey, Tom; England, Bob
Objectives: To address the role of men who have sex with men (MSM) in the human immunodeficiency virus (HIV)/sexually transmitted disease (STD) epidemic in China. Goal: To explore the prevalence of risky sexual behaviors and the existing prevention efforts among men who have sex with men (MSM) in China. Study Design: Review of behavioral and STD/HIV prevention studies addressing MSM in China. Results: Sexual risk behaviors including unprotected group sex, anal sex, casual sex, and commercial sex were prevalent among Chinese MSM. Many Chinese MSM also engaged in unprotected sex with both men and women. Most MSM either did not perceive that they were at risk of HIV/AIDS or underestimated their risk of infection. Surveillance and intervention research among these men are still in the preliminary stages. Conclusions: Chinese MSM are at risk for HIV/STD infection and potential transmission of HIV to the general population. In addition to sexual risk reduction among MSM, reduction of homosexualityrelated stigma should be part of effective intervention efforts. Volunteers from the MSM community and health care workers in primary health care system may serve as valuable resources for HIV/STD prevention and control among MSM. PMID:16354560
LIU, HUI; YANG, HONGMEI; LI, XIAOMING; WANG, NING; LIU, HONGJIE; WANG, BO; ZHANG, LAN; WANG, QIANQIU; STANTON, BONITA
We performed a systematic screening of HIV infection and five other sexually transmitted infections on a consecutive sample of 529 female sex workers from Niamey. HIV seroprevalence rate was 30.1%, with HIV-1 profile in 93.1% of the cases. For curable STI, 4.7% of women had treponematosis, 7% gonorrhoea, 16.8% Gardnerella vaginalis, 36.9% Mycoplasma hominis and 68.2% Chlamydia trachomatis infection. The percentage of women with at least one STI was significantly higher in HIV positive's: 95.6% against 87.9%. Only 7.9% of women were free of any infection. PMID:16568677
Mamadou, S; Laouel Kader, A; Rabiou, S; Aboubacar, A; Soumana, O; Garba, A; Delaporte, E; Mboup, S
Experience of disease differs across ethnic groups, and ethnicity is a relevant personal characteristic for descriptive epidemiology. Information about ethnicity and country of birth is omitted from the routine notification of many diseases. HIV infection and AIDS, other sexually transmitted diseases, and tuberculosis have different incidence rates in different ethnic groups in the United Kingdom. Omission of ethnic data from surveillance activities allows such differences in incidence to go undetected and unaddressed. Surveillance data that included ethnic details could guide interventions to reduce inequalities in health between different subpopulations. PMID:9202508
De Cock, K. M.; Low, N.
Data from 1087 adolescent participants in three waves of the National Longitudinal Study of Adolescent Health was used to examine the effects of peer selection and socialization processes in adolescence on later reports of sexually-transmitted infections (STI) and unintended pregnancies. Friends’ attitudes and behavior were assessed with friends’ reports. Among males, there was evidence for selection effects on STI diagnoses and socialization effects on reports of unintended pregnancy, both involving friends’ attitudes. Among females, there was evidence for long-term effects of both socialization and selection processes involving same-sex friends’ attitudes. Discussion focuses on the importance of peer and individual attitudes as potential intervention targets. PMID:22563148
Henry, David B.; Deptula, Daneen P.; Schoeny, Michael E.
This article discusses how process indicators can complement outcomes as part of a comprehensive explanatory evaluation framework, using the example of skills-based behavioural interventions to prevent sexually transmitted infections and promote sexual health among young people in schools. A systematic review was conducted, yielding 12 eligible outcome evaluations, 9 of which included a process evaluation. There were few statistically significant effects in terms of changes in sexual behaviour outcomes, but statistically significant effects were more common for knowledge and self-efficacy. Synthesis of the findings of the process evaluations identified a range of factors that might explain outcomes, and these were organized into two overarching categories: the implementation of interventions, and student engagement and intervention acceptability. Factors which supported implementation and engagement and acceptability included good quality teacher training, involvement and motivation of key school stakeholders and relevance and appeal to young people. Factors which had a negative impact included teachers' failure to comprehend the theoretical basis for behaviour change, school logistical problems and omission of topics that young people considered important. It is recommended that process indicators such as these be assessed in future evaluations of school-based sexual health behavioural interventions, as part of a logic model. PMID:24488650
Shepherd, J; Harden, A; Barnett-Page, E; Kavanagh, J; Picot, J; Frampton, G K; Cooper, K; Hartwell, D; Clegg, A
... Parents can help their adolescent make healthy choices Sexual Health News & Information Understanding Sexual Health Public Health Reports ... infectious diseases, reproductive health and sexual violence prevention. Sexual Health Topics Sexually Transmitted Diseases Up-to-date information ...
Background Control of sexually transmitted infections (STIs) is an important part of the effort to reduce the risk of HIV/AIDS. STI clinics in the government hospitals in India provide services predominantly to the poor. Data on the cost and efficiency of providing STI services in India are not available to help guide efficient use of public resources for these services. Methods Standardised methods were used to obtain detailed cost and output data for the 2003–2004 fiscal year from written records and interviews in 14 government STI clinics in the Indian state of Andhra Pradesh. The economic cost per patient receiving STI treatment was calculated, and the variations of total and unit costs across the STI clinics analysed. Multivariate regression technique was used to estimate incremental unit costs. The optimal number of STIs that could be handled by the clinics was estimated. Results 18807 STIs were diagnosed and treated at the 14 STI clinics in fiscal year 2003–2004 (range 323–2784, median 1199). The economic cost of treating each STI varied 5-fold from Indian Rupees (INR) 225.5 (US$ 4.91) to INR 1201.5 (US$ 26.15) between 13 clinics, with one other clinic having a very high cost of INR 2478.5 (US$ 53.94). The average cost per STI treated for all 14 clinics combined was INR 729.5 (US$ 15.88). Personnel salaries made up 76.2% of the total cost. The number of STIs treated per doctor full-time equivalent and cost-efficiency for each STI treated had a significant direct non-linear relation (p < 0.001, R2 = 0.81; power function). With a multiple regression model, apart from the fixed costs, the incremental cost for each STI detected and cost of treatment was INR 55.57 (US$ 1.21) and for each follow-up visit was INR 3.75 (US$ 0.08). Based on estimates of optimal STI cases that could be handled without compromising quality by each doctor full-time equivalent available, it was projected that at 8 of the 14 clinics substantially more STI cases could be handled, which could increase the total STI cases treated at the 14 clinics combined by 38% at an additional cost of only 3.5% for service provision. Conclusion There is un-utilised capacity in the public sector STI clinics in this Indian state. Efforts to facilitate utilisation of this capacity would be useful, as this would enable more poor patients with STIs to be served at minimal additional cost, and would also reduce the cost per STI treated leading to more efficient use of public resources. PMID:16271151
Dandona, Lalit; Sisodia, Pratap; Prasad, TLN; Marseille, Elliot; Chalapathi Rao, M; Kumar, A Anod; Kumar, SG Prem; Ramesh, YK; Over, Mead; Someshwar, M; Kahn, James G
Rapid Assessment of Sexual Behavior, Drug Use, Human Immunodeficiency Virus, and Sexually Transmitted Diseases in Northern Thai Youth Using Audio-Computer-Assisted Self-Interviewing and Noninvasive Specimen Collection
Background. Drug use, unwanted preg- nancy, human immunodeficiency virus (HIV) infection, and sexually transmitted diseases are serious health problems among Thai youth. The gravity of these prob- lems demands high-quality data to direct public health policy and prevention programs. Previous studies of stig- matized behaviors have been hampered by participation bias and underreporting. To evaluate sexual behavior, disease, and drug
Frits van Griensven; Somsak Supawitkul; Peter H. Kilmarx; Khanchit Limpakarnjanarat; Nancy L. Young; Philip A. Mock; Supaporn Korattana; Timothy D. Mastro
Objectives. We tested the efficacy of an adapted evidence-based HIV-sexually transmitted infection (STI) behavioral intervention (Providing Opportunities for Women's Empowerment, Risk-Reduction, and Relationships, or POWER) among incarcerated women. Methods. We conducted a randomized trial with 521 women aged 18 to 60 years in 2 correctional facilities in North Carolina in 2010 and 2011. Intervention participants attended 8 POWER sessions; control participants received a single standard-of-care STI prevention session. We followed up at 3 and 6 months after release. We examined intervention efficacy with mixed-effects models. Results. POWER participants reported fewer male sexual partners than did control participants at 3 months, although this finding did not reach statistical significance; at 6 months they reported significantly less vaginal intercourse without a condom outside of a monogamous relationship and more condom use with a main male partner. POWER participants also reported significantly fewer condom barriers, and greater HIV knowledge, health-protective communication, and tangible social support. The intervention had no significant effects on incident STIs. Conclusions. POWER is a behavioral intervention with potential to reduce risk of acquiring or transmitting HIV and STIs among incarcerated women returning to their communities. (Am J Public Health. Published online ahead of print September 11, 2014: e1-e8. doi:10.2105/AJPH.2014.302105). PMID:25211714
Fogel, Catherine I; Crandell, Jamie L; Neevel, A M; Parker, Sharon D; Carry, Monique; White, Becky L; Fasula, Amy M; Herbst, Jeffrey H; Gelaude, Deborah J
The distribution of Chlamydia trachomatis serovars among 157 heterosexual male patients with urethritis and the presence of coinfections with other sexually transmitted infections were studied. One hundred seventeen (74.5%) patients, with a mean age of 33.7 years, were Italians, whereas 40 (25.5%) were immigrants coming from eastern European countries, Africa, and South America. All the immigrants and 82 (70.0%) Italian patients reported sex with prostitutes. Out of 157 patients, 73 (46.5%) were found positive for C. trachomatis in urethral secretions and eight different C. trachomatis serovars were identified. The most common serovars were E (n = 18; 24.7%), D (n = 15; 20.5%), G (n = 14;19.2%), and F (n = 12; 16.4%). The sequencing data showed a high degree of conservation of the omp1 gene. Thirty-six (46.7%) out of the 73 C. trachomatis-positive patients were coinfected with another sexually transmitted infection. The most common coinfection was gonorrhoea detected in 22 (30.1%) patients, followed by condyloma in eight (8.2%) patients, syphilis in five (6.8%), and HIV in three (4.1%). PMID:18958506
Donati, M; Di Francesco, A; D'Antuono, A; Pignanelli, S; Shurdhi, A; Moroni, A; Baldelli, R; Cevenini, R
The accuracy and suitability of use of a single intravaginal swab (SIS) for polymerase chain reaction detection of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, and human papillomavirus infection was assessed in a cross-sectional study of 841 active-duty military women. The SIS, compared with standard diagnostic tests, allowed detection of more gonorrhea, more chlamydial infection, and more trichomoniasis. Sensitivity and specificity of SIS detection compared with adjudicated true-positive diagnoses were 95.8% and 97.8%, respectively, for gonorrhea, 94.6% and 99.3% for chlamydial infection, and 92.2% and 98.2% for trichomonal infection. Results with SISs were comparable to those with cervical swabs tested for human papillomavirus. Assay of clinician-collected and self-collected SISs yielded prevalences similar to those of standard diagnostic tests for all sexually transmitted infections. Therefore, the use of SISs is acceptable for the simultaneous diagnosis of multiple sexually transmitted infections and has potential for use as a self-administered diagnostic tool with widespread applicability among women. PMID:11568849
Rompalo, A M; Gaydos, C A; Shah, N; Tennant, M; Crotchfelt, K A; Madico, G; Quinn, T C; Daniel, R; Shah, K V; Gaydos, J C; McKee, K T
Patient-initiated partner notification of sexually transmitted infection (STI), i.e. patients informing their sexual partners of a diagnosis, is a cornerstone of STI prevention. Growing evidence suggests that women exposed to intimate partner violence (IPV) may fear such notification, or face negative consequences in response to STI disclosure. The current study assessed associations of IPV with fear of partner notification, and experiences of partner notification, among adolescent and young adult female family planning clinic patients. Women aged 16-29 years attending five family planning clinics in Northern California, USA (n = 1282) participated in a cross-sectional survey. A history of physical or sexual IPV was associated with fear of partner notification. Moreover, participants exposed to IPV were more likely to have partners say that it was not from them or otherwise accuse them of cheating in response to partner notification. Such partners were less likely to seek indicated STI treatment or testing. Current findings suggest that partner notification for STI may be compromised by IPV. Clinical practices and policies to support effective partner notification should include IPV assessment, and provide mechanisms to address related fears concerning partner notification. PMID:21680673
Decker, M R; Miller, E; McCauley, H L; Tancredi, D J; Levenson, R R; Waldman, J; Schoenwald, P; Silverman, J G
Few studies have examined whether and how receiving an sexually transmitted disease (STD) diagnosis while in a romantic relationship relates to condom use and psychosocial sexual outcomes. Using dyadic data, we examined associations of a personal or a partner’s STD diagnosis during a relationship with condom use, monogamy intentions, condom intentions and attitudes, and STD susceptibility and communication. Because beliefs about how the STD was acquired may shape associations with behavior and cognitions, gender and suspecting that one’s partner had other sexual partners (i.e., partner concurrency) were examined as moderators. Participants were 592 individuals in 296 couples expecting a baby; 108 individuals had been diagnosed with an STD during the relationship. Personal STD diagnosis was unrelated to outcomes or was associated with increased risk. A partner’s diagnosis related to more positive condom intentions and attitudes. Among men who suspected concurrency, both a personal and a partner’s STD diagnosis were associated with less condom use. Receiving the STD diagnosis during pregnancy was associated with greater susceptibility and marginally greater condom use. Results suggest potential benefits of enhancing communication and encouraging joint risk reduction counseling among couples, engaging men more fully in preventive efforts, and capitalizing on the short window during which risk reduction occurs. PMID:23321987
Magriples, Urania; Niccolai, Linda M.; Gordon, Derrick M.; Divney, Anna A.; Kershaw, Trace S.
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
Spiwak, Rae; Afifi, Tracie O; Halli, Shiva; Garcia-Moreno, Claudia; Sareen, Jitender
The global impact of sexually transmitted infections (STIs) is significant. The sexual transmission of viruses such as herpes simplex virus type-2 (HSV-2) and the human immunodeficiency virus type-1 (HIV-1), has been especially difficult to control. To date, no effective vaccines have been developed to prevent the transmission of these STIs. Although antiretroviral drugs have been remarkably successful in treating the symptoms associated with these viral infections, the feasibility of their widespread use for prevention purposes may be more limited. Microbicides might provide an attractive alternative option to reduce their spread. In particular, topically applied small inhibitory RNAs (siRNAs) have been shown to not only block transmission of viral STIs to mucosal tissues both in vitro and in vivo, but also confer durable knockdown of target gene expression, thereby circumventing the need to apply a microbicide around the time of sexual encounter, when compliance is mostly difficult. Despite numerous clinical trials currently testing the efficacy of siRNA-based therapeutics, they have yet to be approved for use in the treatment of viral STIs. While several obstacles to their successful implementation in the clinic still exist, promising preclinical studies suggest that siRNAs are a viable modality for the future prevention and treatment of HSV and HIV. PMID:24526828
Wheeler, Lee Adam
at FSU Your college years can be some of the most memorable years of your life, but you won't be able) is not only to keep you safe and healthy during your years at FSU so you can get the most out of your college at FSU, we offer alcohol, nutrition, sexual health and smoking cessation services in addition to basic
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…
OBJECTIVE--To determine the progression rates to AIDS in women in Dublin. SUBJECTS AND METHODS--109 HIV-1 seropositive women who presented to the Department of Genitourinary Medicine, St. James's Hospital, Dublin, were included in a retrospective analysis. Of these 101 (93%) were intravenous drug users (IVDUs), 7 were heterosexual partners of IVDUs and one had a hetero-sexual partner of no known risk
F Mulcahy; G Kelly; M Tynan
Purpose: To evaluate the effectiveness of the Youth United Through Health Education (YUTHE) program, a community-level, peer-led outreach program to increase awareness and improve non- invasive sexually transmitted infection (STI) screening in youth residing in the targeted community. Methods: Sexually experienced youth, aged 12-22 years, anonymously participated in the YUTHE program (a 15-minute encounter, including a risk assessment with feedback
Cherrie B. Boyer; John Sieverding; Jacqueline Siller; Alonzo Gallareadc; Y. Jason Chang
South Africa urgently needs HIV prevention interventions that can be disseminated for use in clinical and community settings. A brief theory-based HIV risk reduction counselling intervention originally developed in the USA has recently been adapted for use in a South African sexually transmitted infection clinic. The 60-minute risk reduction counselling intervention was grounded in the Information-Motivation-Behavioural Skills (IMB) model of HIV preventive behaviour change, adapted through a series of interdisciplinary collaborative workshops. This paper reports the process of developing and culturally adapting the brief risk reduction counselling intervention. The processes used for adapting the HIV risk reduction counselling for South Africa provides a potential model for conducting technology transfer activities with other HIV prevention interventions. Several lessons learned from this process may help guide future efforts to transfer HIV prevention technologies. PMID:17601009
Mathiti, V; Simbayi, L C; Jooste, S; Kekana, Q; Nibe, X P; Shasha, L; Bidla, P; Magubane, P; Cain, D; Cherry, C; Kalichman, S C
Evidence-based, single-session behavioral interventions are urgently needed for preventing the spread of HIV and other sexually transmitted infections (STIs). To estimate the efficacy of single-session, behavioral interventions for STI prevention, we collected data from 29 single-session interventions (20 studies; n?=?52?465) with an STI outcome. Infection with an STI was 35% less likely (odds ratio?=?0.65; 95% confidence interval?=?0.55–0.77) among intervention group participants than among control group participants. Single-session interventions offer considerable benefits in terms of disease prevention and create minimal burden for both the patient and the provider. Brief and effective STI prevention interventions are a valuable tool and can be readily adapted to bolster the benefits of biomedical technologies focusing on the prevention of HIV and other STIs. PMID:22994247
Huedo-Medina, Tania B.; Kalichman, Seth C.; Pellowski, Jennifer A.; Sagherian, Michael J.; Warren, Michelle; Popat, Ami R.; Johnson, Blair T.
We determined the prevalence of seven clinically important pathogens that cause sexually transmitted infections (STIs) (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, herpes simplex virus 1 [HSV-1], HSV-2, and Treponema pallidum), by using a multiplex polymerase chain reaction (M-PCR) in samples from Brazilian woman infected with human immunodeficiency virus 1 (HIV-1) and uninfected Brazilian women (controls). The M-PCR assay identified all STIs tested for and surprisingly, occurred association between the control and STIs. This association was probably caused by excellent HIV infection control and regular monitoring in these women established by public health strategies in Brazil to combat HIV/acquired immunodeficiency syndrome. Studies using this M-PCR in different populations may help to better elucidate the roles of STIs in several conditions. PMID:24080632
Souza, Raquel P.; de Abreu, André L. P.; Ferreira, Érika C.; Rocha-Brischiliari, Sheila C.; de B. Carvalho, Maria D.; Pelloso, Sandra M.; Bonini, Marcelo G.; Gimenes, Fabrícia; Consolaro, Marcia E. L.
We determined the prevalence of seven clinically important pathogens that cause sexually transmitted infections (STIs) (Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, herpes simplex virus 1 [HSV-1], HSV-2, and Treponema pallidum), by using a multiplex polymerase chain reaction (M-PCR) in samples from Brazilian woman infected with human immunodeficiency virus 1 (HIV-1) and uninfected Brazilian women (controls). The M-PCR assay identified all STIs tested for and surprisingly, occurred association between the control and STIs. This association was probably caused by excellent HIV infection control and regular monitoring in these women established by public health strategies in Brazil to combat HIV/acquired immunodeficiency syndrome. Studies using this M-PCR in different populations may help to better elucidate the roles of STIs in several conditions. PMID:24080632
Souza, Raquel P; de Abreu, André L P; Ferreira, Érika C; Rocha-Brischiliari, Sheila C; de B Carvalho, Maria D; Pelloso, Sandra M; Bonini, Marcelo G; Gimenes, Fabrícia; Consolaro, Marcia E L
The WHO recommends the administration of sulfadoxine-pyrimethamine (SP) to all pregnant women living in areas of moderate (stable) to high malaria transmission during scheduled antenatal visits, beginning in the second trimester and continuing to delivery. Malaria parasites have lost sensitivity to SP in many endemic areas, prompting the investigation of alternatives that include azithromycin-based combination (ABC) therapies. Use of ABC therapies may also confer protection against curable sexually transmitted infections and reproductive tract infections (STIs/RTIs). The magnitude of protection at the population level would depend on the efficacy of the azithromycin-based regimen used and the underlying prevalence of curable STIs/RTIs among pregnant women who receive preventive treatment. This systematic review summarizes the efficacy data of azithromycin against curable STIs/RTIs. PMID:24191955
Chico, R Matthew; Hack, Berkin B; Newport, Melanie J; Ngulube, Enesia; Chandramohan, Daniel
The WHO recommends the administration of sulfadoxine-pyrimethamine (SP) to all pregnant women living in areas of moderate (stable) to high malaria transmission during scheduled antenatal visits, beginning in the second trimester and continuing to delivery. Malaria parasites have lost sensitivity to SP in many endemic areas, prompting the investigation of alternatives that include azithromycin-based combination (ABC) therapies. Use of ABC therapies may also confer protection against curable sexually transmitted infections and reproductive tract infections (STIs/RTIs). The magnitude of protection at the population level would depend on the efficacy of the azithromycin-based regimen used and the underlying prevalence of curable STIs/RTIs among pregnant women who receive preventive treatment. This systematic review summarizes the efficacy data of azithromycin against curable STIs/RTIs. PMID:24191955
Chico, R Matthew; Hack, Berkin B; Newport, Melanie J; Ngulube, Enesia; Chandramohan, Daniel
Little is known about Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) rates in community-supervised juvenile justice-involved (CSJJI) females, or how to best provide screening for sexually transmitted infections in this population. A pilot intervention allowed case managers to offer optional CT/GC screening to CSJJI females during mandated visits. Anonymous satisfaction surveys and discussion groups assessed intervention acceptability. Case managers met with 514 CSJJI females; 102 (20%) agreed to screening and 117 tests were completed. Among those screened, 21 (18%) had CT and 3 (3%) had GC. Intervention feedback from case managers and clients was positive, but there were barriers to recruitment. Lessons learned from this case manager-facilitated intervention may increase the acceptability and effectiveness of future screening methods in this setting. PMID:23983235
Donaldson, Abigail A.; Burns, Jessica; Bradshaw, Catherine P.; Ellen, Jonathan M.; Maehr, Jennifer
Background Female sex workers have been the target of numerous sexually transmitted infection (STI) prevention strategies in China, but their male clients have attracted considerably less public health attention and resources. We sought to systematically assess the prevalence of HIV, syphilis, gonorrhea, and chlamydia among heterosexual male clients of female sex workers in China. Methods/Principal Findings Original research manuscripts were identified by searching Chinese and English language databases, and 37 studies analyzing 26,552 male clients were included in the review. Client STI prevalence across studies was heterogeneous. Pooled prevalence estimates and 95% confidence intervals were 0.68% (0.36–1.28%) for HIV, 2.91% (2.17–3.89%) for syphilis, 2.16% (1.46–3.17%) for gonorrhea, and 8.01% (4.94–12.72%) for chlamydia. Conclusions/Significance The pooled prevalence estimates of HIV, syphilis, gonorrhea, and chlamydia among clients in this review exceed the prevalences previously reported among population-representative samples and low-risk groups in China. However, heterogeneity across studies and sampling limitations prevent definitive conclusions about how the prevalence of STIs in this population compares to the general population. These findings suggest a need for greater attention to clients’ sexual risk and disease prevalence in China’s STI research agenda in order to inform effective prevention policies. PMID:23951153
McLaughlin, Megan M.; Chow, Eric P. F.; Wang, Cheng; Yang, Li-Gang; Yang, Bin; Huang, Jennifer Z.; Wang, Yanjie; Zhang, Lei; Tucker, Joseph D.
There is limited information on the prevalence of sexually transmitted infections and the prevalence of cervical neoplasia in rural sub-Saharan Africa. This study describes the prevalence and the etiology of STIs and the prevalence of cervical neoplasia among women in southern Mozambique. An age-stratified cross-sectional study was performed where 262 women aged 14 to 61 years were recruited at the antenatal clinic (59%), the family-planning clinic (7%), and from the community (34%). At least one active STI was diagnosed in 79% of women. Trichomonas vaginalis was present in 31% of all study participants. The prevalence of Neisseria gonorrhea and Chlamydia trachomatis were 14% and 8%, respectively, and Syphilis was diagnosed in 12% of women. HPV DNA was detected in 40% of women and cervical neoplasia was diagnosed in 12% of all women. Risk factors associated with the presence of some of the STIs were being divorced or widowed, having more than one sexual partner and having the partner living in another area. A higher prevalence was observed in the reproductive age group and some of the STIs were more frequently diagnosed in pregnant women. STI control programs are a priority to reduce the STIs burden, including HIV and cervical neoplasia. PMID:20706691
Menéndez, Clara; Castellsagué, Xavier; Renom, Montse; Sacarlal, Jahit; Quintó, Llorenç; Lloveras, Belen; Klaustermeier, Joellen; Kornegay, Janet R; Sigauque, Betuel; Bosch, F Xavier; Alonso, Pedro L
SUMMARY In 2009, we examined HIV and sexually transmitted infections (STIs) in 750 female sex workers (FSWs) in Shanghai using a cross-sectional survey. Participants (mean age 27 years) were interviewed and tested for HIV and selected STIs. Prevalence was: HIV 0·13%, chlamydia 14·7%, gonorrhoea 3·5% and syphilis 1·3%. In a demographic multivariate model, younger age, higher income and originating from provinces other than Zhejiang and Shanghai were independently associated with STI. In a social and sexual behavioural model, women working in small venues with fewer clients per week, use of drugs, and higher price charged per sex act indicated a greater risk for STI. Although HIV appears rare in Shanghai FSWs, chlamydial infection is common, especially in women aged <25 years (prevalence 19·6%). Since STI and HIV share similar risk factors, preventive intervention measures should be implemented immediately based on the venues and characteristics of FSWs to prevent future spread of HIV. PMID:24759515
Remis, R S; Kang, L; Calzavara, L; Pan, Q; Liu, J; Myers, T; Ren, J; Tang, X
OBJECTIVES. The purpose of this study was to determine how the method of assessment affects patient report of human immunodeficiency virus (HIV) risks. METHODS. Patients at a sexually transmitted disease clinic randomly received either a written self-administered questionnaire or an audio self-administered questionnaire delivered by cassette player and headset. These questionnaires were followed by face-to-face interviews. RESULTS. Audio questionnaires had fewer missing responses than written questionnaires. Audio questionnaires also identified more unprotected vaginal intercourse and sexual partners suspected or known to have HIV infection or acquired immunodeficiency syndrome than did written questionnaires. Although both the audio and written questionnaires identified more risks than the face-to-face interviews, the difference in the mean number of reported risks between the audio questionnaires and the face-to-face interviews was greater than that between the written questionnaires and the face-to-face interviews. CONCLUSIONS. Audio questionnaires may obtain more complete data and identify more HIV risk than written questionnaires. Research is warranted about whether audio questionnaires overcome barriers to the completion and accuracy of HIV risk surveys. This study emphasizes the need to elucidate the relative strengths and weaknesses of written questionnaires, audio questionnaires, and face-to-face interviews for HIV risk assessment. PMID:8179044
Boekeloo, B O; Schiavo, L; Rabin, D L; Conlon, R T; Jordan, C S; Mundt, D J
Globally, sexually transmitted infections (STIs) represent a significant source of morbidity and disproportionately impact the health of women and children. The number of randomized controlled trials testing interventions to prevent STIs has dramatically increased over time. To assess their impact, the authors conducted a systematic review of interventions to prevent sexual transmission or acquisition of STIs other than human immunodeficiency virus, published in the English-language, peer-reviewed literature through December 2009. Ninety-three papers reporting data from 74 randomized controlled trials evaluating 75 STI prevention interventions were identified. Eight intervention modalities were used: behavioral interventions (36% of interventions), vaginal microbicides (16%), vaccines (16%), treatment (11%), partner services (9%), physical barriers (5%), male circumcision (5%), and multicomponent (1%). Overall, 59% of interventions demonstrated efficacy in preventing infection with at least 1 STI. Treatment interventions and vaccines for viral STIs showed the most consistently positive effects. Male circumcision protected against viral STIs and possibly trichomoniasis. Almost two-thirds of behavioral interventions were effective, but the magnitude of effects ranged broadly. Partner services yielded similarly mixed results. In contrast, vaginal microbicides and physical barrier methods demonstrated few positive effects. Future STI prevention efforts should focus on enhancing adherence within interventions, integrating new technologies, ensuring sustainable behavior change, and conducting implementation research. PMID:20519264
Wetmore, Catherine M.; Manhart, Lisa E.; Wasserheit, Judith N.
We examined the rates of sexually transmitted diseases (STDs) in women with borderline personality disorder (BPD) (using PDE and SCID-II) and substance abuse or dependence (SCID-I) (BPD-SUD) (N=82) compared with those with BPD-only (N=102), exploring mediators of this relationship. Participants were interviewed about STD history (gonorrhea, genital herpes, syphilis, trichomonas, human papillomavirus, and HIV), condom use, number of sexual partners, poverty, and prostitution. BPD-SUD appeared to be particularly at high risk for STDs, reporting significantly more STDs than BPD (F[1,172]=11.74, p=0.001, d=.27), particularly for gonorrhea, trichomonas, and human papillomavirus. The relationship between BPD-SUD and STDs is mediated by poverty, prostitution in the last year, recent unprotected sex with two or more partners, and >20 lifetime partners (z=-2.16 which is p=0.03), with prostitution alone making a significant contribution to this relationship (z=-2.49, p=0.01). PMID:17299299
Chen, Eunice Y; Brown, Milton Z; Lo, Tracy T Y; Linehan, Marsha M
Toxoplasma gondii infects about 30% of the human population. Common sources of infection are oocysts in cat faeces contaminating drinking water or unwashed vegetables, undercooked meat containing tissue cysts, and organ transplants from infected donors containing tissue cysts. However, very often, it is not possible to identify any potential source of infection in mothers of children with congenital toxoplasmosis. Here we present a hypothesis suggesting that toxoplasmosis is transmitted from infected men to noninfected women during unprotected sexual intercourse, which can result in the most serious form of disease, congenital toxoplasmosis. Arguments for the hypothesis: (1) Toxoplasma tachyzoites are present in the seminal fluid and tissue of the testes of various animals including humans. In some species infection of females by artificial insemination with semen from infected males has been observed. (2) Up to two thirds of Toxoplasma infections in pregnant women cannot be explained by the known risk factors. (3) Prevalence of toxoplasmosis in women in child-bearing age covaries with the incidence of sexually transmitted diseases in particular countries. (4) In some countries, an increased incidence of toxoplasmosis has been reported in women (but not men) aged 25-35 years. This second peak of infection could be associated with women having regular unprotected sex after marriage. (5) Toxoplasmosis triggers schizophrenia in predisposed subjects. Onset of schizophrenia is about 2-3 years earlier in men than in women. However, this difference in the onset can be found only between Toxoplasma-infected patients. The increased onset of schizophrenia in infected women could be associated with the already mentioned second peak of toxoplasmosis incidence. (6) The prevalence of toxoplasmosis decreases in developed countries in last 20 years. This trend could be a result of decrease in promiscuity and increase in safe sex practices, both associated with the AIDS pandemics. (7) In women, probability of being Toxoplasma-infected correlates positively with the amount of unprotected sex with the child's father before the conception. Evidence against the hypothesis: Questionnaire study showed negative association between Toxoplasma infection and the number of earlier partners with whom the woman had unprotected sex. If our hypothesis turns out to be true, then sexual route of transmission, even if rare, could be responsible for a large part of cases of congenital toxoplasmosis. Women should be warned that having unprotected sex with men of positive or unknown toxoplasmosis status should be avoided during pregnancy. PMID:24986706
Flegr, J; Klapilová, K; Ka?ková, S
When syphilis first appeared in Europe in 1495, it was an acute and extremely unpleasant disease. After only a few years it was less severe than it once was, and it changed over the next 50 years into a milder, chronic disease. The severe early symptoms may have been the result of the disease being introduced into a new host population without any resistance mechanisms, but the change in virulence is most likely to have happened because of selection favouring milder strains of the pathogen. The symptoms of the virulent early disease were both debilitating and obvious to potential sexual partners of the infected, and strains that caused less obvious or painful symptoms would have enjoyed a higher transmission rate. PMID:15252975
Knell, Robert J
Background/objectives: Increases in STIs have been reported from the United States and Europe. Since 2001, only syphilis and HIV are notifiable in Germany. A sentinel surveillance system has been set up to assess the occurrence and trends of STIs and identify risk groups. Methods: Through the sentinel system data are collected from local health offices (LHO), hospital based STI clinics and private practitioners (dermato-venerology, urology, gynaecology, or HIV). For every newly diagnosed laboratory confirmed infection of HIV, gonorrhoea, chlamydia, syphilis, or trichomoniasis physicians complete a standardised questionnaire regarding diagnosis, source of infection, and demographic information. Patients complete a questionnaire about sexual risk behaviour. The patient form is matched with the diagnosis form using a unique identifier number. Characteristics of sentinel patients were compared with those reported through the HIV and syphilis national notification system. Results: 58 LHO, 14 hospital based STI clinics, and 160 private practitioners (53.1% dermato-venerologists) from all federal states participated in the study. 176 (75.9%) sentinel sites are located in cities of >100 000 inhabitants. From 1 March 2003–29 February 2004, a total of 1833 STIs have been reported, among them 452 chlamydia, 321 syphilis (10.9% of notified syphilis), 343 gonorrhoea, 269 HIV (15.7% of notified HIV). 925 (50.5%) of the patients were male, the median age was 31 years. Female patients were more often of foreign origin (?2 test; 70.0% v 26.3%; p<0.001). Conclusions: Our sentinel system will provide a base for detection of STI trends in Germany. In addition, information about sexual risk behaviour will enable us to target prevention at those most at risk for STIs. PMID:15800099
Bremer, V; Marcus, U; Hofmann, A; Hamouda, O
SUMMARY Community health education played a major role in a study of sexually transmitted diseases (STDs) and other reproductive tract infections which we conducted in rural and periurban communities of the Asaro Valley near Goroka in the Eastern Highlands Province of Papua New Guinea. We found that most women had little knowledge about STDs, which they often did not realize
SEBEYA LUPIWA; NATHAN SUVE; KAREN HORTON; MEGAN PASSEY
The high sensitivity of nucleic acid amplification tests such as ligase chain reaction (LCR) has the potential to simplify specimen collection for the microbiologic diagnosis of gonorrhea. We screened first-void urine specimens from 283 women attending a Birmingham, Ala., sexually transmitted disease (STD) clinic by using LCR and compared the results to those of cervical and urethral cultures for gonorrhea
KIM R. SMITH; SHANFUN CHING; HELEN LEE; YOSHIHIRO OHHASHI; HSIANG-YUN HU; HENRY C. FISHER; ANDEDWARD W. HOOK
Objectives: Urinary tract infections (UTIs) and early pelvic infections due to sexually transmitted disease (STD) may cause similar symptoms. Therefore, a simple history and urine dip to establish a diagnosis of UTI may result in overtreatment of UTIs and undertreatment of STDs. The objective of this study was to determine the proportion of women with symptoms suggestive of a UTI
Tara Shapiro; Mark Dalton; John Hammock; Robert Lavery; John Matjucha; David F. Salo
Objective To investigate associations between prostate cancer and sexually transmitted diseases (STDs), prostatitis, benign prostatic hyperplasia (BPH), and vasectomy in a population-based case–control study in Wayne County, Michigan, among African American and white men aged 50–74 years.
Divya A. Patel; Cathryn H. Bock; Kendra Schwartz; Angela S. Wenzlaff; Raymond Y. Demers; Richard K. Severson
The goals of the current study were to: (1) estimate the prevalence of forced sex among women accessing services at a women's health clinic in rural Haiti; and (2) examine factors associated with forced sex in this population. Based on data from a case-control study of risk factors for sexually transmitted diseases (STDs), a cross-sectional analysis to examine factors associated
M. C. Smith Fawzi; W. Lambert; J. M. Singler; Y. Tanagho; F. Léandre; P. Nevil; D. Bertrand; M. S. Claude; J. Bertrand; M. Louissaint; L. Jeannis; J. S. Mukherjee; S. Goldie; J. J. Salazar; P. E. Farmer
Objective To describe the contribution of primary care to the diagnosis and management of sexually transmitted infections in the United Kingdom, 1990-2000, in the context of increasing incidence of infections in genitourinary medicine clinics. Design Population based study. Setting UK primary care. Participants Patients registered in the UK general practice research database. Main outcome measures Incidence of diagnosed sexually transmitted infections in primary care and estimation of the proportion of major such infections diagnosed in primary care. Results An estimated 23.0% of chlamydia cases in women but only 5.3% in men were diagnosed and treated in primary care during 1998-2000, along with 49.2% cases of non-specific urethritis and urethral discharge in men and 5.7% cases of gonorrhoea in women and 2.9% in men. Rates of diagnosis in primary care rose substantially in the late 1990s. Conclusions A substantial and increasing number of sexually transmitted infections are diagnosed and treated in primary care in the United Kingdom, with sex ratios differing from those in genitourinary medicine clinics. Large numbers of men are treated in primary care for presumptive sexually transmitted infections. PMID:16439371
Cassell, Jackie A; Mercer, Catherine H; Sutcliffe, Lorna; Petersen, Irene; Islam, Amir; Brook, M Gary; Ross, Jonathan D; Kinghorn, George R; Simms, Ian; Hughes, Gwenda; Majeed, Azeem; Stephenson, Judith M; Johnson, Anne M; Hayward, Andrew C
Background: Sexually-transmitted disease (STD) is a facilitating cofactor that contributes to human immunodeficiency virus (HIV) transmission. Previous studies indicated a high prevalence of STDs among men who have sex with men (MSM) in China. To date, limited data are available for correlates of STD infection among young migrant MSM in China. The…
Song, Yan; Li, Xiaoming; Zhang, Liying; Liu, Yingjie; Jiang, Shulin; Stanton, Bonita
This investigation examines the source preferences and the displacement/supplement effect of traditional and new channel usage as Taiwanese college students search for information about sexually transmitted diseases and HIV/AIDS from the Internet. The study involved 535 junior and senior college students from four universities. Analytical results…
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
The correlation between sexually transmitted infections and cervicovaginal dysplasia has been evaluated in a cohort of 135 women who tested positive for human immunodeficiency virus type I (HIV-1) and were admitted to Amedeo di Savoia Hospital of Turin during the years 1997 and 1998 (stages B2 and B3 or C2 and C3). Of these women. 31 presented with sexually transmitted diseases (STDs; mean age, 33.5 +/- 5.9 years). Among them, 14 were affected by cervicovaginal dysplasia of differing severity; human papillomavirus (HPV) infection was found in 13 subjects (10 with cervicovaginal dysplasia). Herpes simplex virus type 2 (HSV-2) infection was detected in six women. Finally, Trichomonas vaginalis and Candida albicans were found in 10 and in 6 patients, respectively. Immunologic and hematologic evaluations were performed in the patients affected by STDs; in 28 patients of our case report unaffected by STDs but of similar ages (34.1 +/- 5.6 years) and stage of infection; and in 20 HIV-negative women unaffected by STDs. A significant reduction among the patients affected by STDs, as compared to those unaffected, was found in the case of white cells, CD4+ T cells, and ratio values (CD4 +/ and CD8 + T cells). Moreover, red cell count and hemoglobin concentration were lower in those women in the STD group. A lack of correlation was found between HIV RNA loads and CD4 + T cell counts and between HIV RNA and hemoglobin concentration in the patients with cervicovaginal dysplasia and in those affected by HSV-2 infection, which differed from the findings in subjects affected only by trichomoniasis or candidiasis. This suggests that the two former pathologic conditions (cervico-vaginal dysplasia and HSV-2 infection), other than HIV- I infection, may contribute to the impairment of these values. Moreover in our case report, T vaginalis and HSV-2 infections, which are suspected to have an oncogenic potential, do not seem to be relevant in the induction or facilitation of genital neoplastic diseases. Noteworthy is that the patients affected by HSV-2 infection, such as those affected by genital neoplastic diseases, showed the most compromised values of total white cells, CD4+ T cells, ratio index, red cells, and hemoglobin concentration. PMID:11270419
Pugliese, A; Saini, A; Andronico, L; Pagliano, G; Gallo, G
This cross-sectional, descriptive, correlational study performed a structured questionnaire survey of a Taiwan population of male prison inmates to determine the prevalence of sexually transmitted infections (STIs), intravenous drug users (IDUs), and drug abuse and to assess their knowledge of HIV/AIDS. The objective was to obtain data needed to control the spread of HIV. Out of 1000 questionnaires distributed, 908 valid questionnaires were returned. Inmates were classified into three groups: IDUs with HIV (13.5%), IDUs without HIV (49.3%), and non-IDUs without HIV (37.2%). A total of 115 (12.7%) inmates had contracted STIs other than HIV. Compared with inmates without HIV, those with HIV were more likely to have a junior high school education level or lower and a history of the following: employment as a blue-collar laborer, STI, unprotected sexual activity, and needle sharing during intravenous drug use. The longer they have used intravenous drugs, the higher the probability that they shared needles, and the more likely they contracted with HIV. Taiwanese male inmates had a low level of knowledge about safe sex and HIV transmission routes, except for sharing needles. The three groups did not significantly differ in HIV-related knowledge. Given the high percentage of IDU and HIV infection in male prison inmates in Taiwan, interventions are needed to educate this population in the increased risk of contracting HIV/AIDS associated with unsafe sex and needle sharing during illicit drug use. Such interventions are crucial for limiting the spread of HIV as this population reintegrates with the community. PMID:23217358
Feng, Ming-Chu; Feng, Jui-Ying; Chen, Yen-Hsu; Chang, Pi-Yen; Lu, Po-Liang
Abstract There are reports of increased sexual risk behaviors in the HIV-positive population since the introduction of highly active antiretroviral therapy (HAART). Little is known about the effects of the case management (CM) program and HAART on sexually transmitted diseases (STDs) in Taiwan. HIV-positive subjects, who visited the outpatient clinics of Taoyuan General Hospital between 2007 and 2010, were enrolled. A total of 574 subjects and 14,462 person-months were reviewed. Incident STDs occurred in 104 (18.1%) subjects, and the incidence rate was 8.6 (95% confidence interval [CI], 7.1–10.5) per 100 person-years (PY). For men who have sex with men (MSM), heterosexual men and women, and injection drug users (IDU), 19.4 per 100 PY(95% CI, 15.7–24.0), 3.5 per 100 PY (95% CI, 1.4–7.3), and 1.1 per 100 PY (95% CI, 0.4–2.4) of STDs were noted, respectively; (MSM versus IDU and MSM versus heterosexual subjects, p<0.000001; heterosexual subjects versus IDU, p=0.061). Syphilis (59.6%) was the most common STD. Regular CM and no HAART (hazard ratio, 2.58; 95% CI, 1.14–5.84; p=0.02) was significantly associated with STDs in MSM. Though this retrospective study might underestimate the incidence of STDs and not draw the conclusion of causality, we concluded that the CM program and HAART are associated with lower acquisition of STDs in the Taiwanese HIV-positive population. PMID:23442028
Cheng, Shu-Hsing; Yang, Chin-Hui
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
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
Morris, Jessica L; Lippman, Sheri A; Philip, Susan; Bernstein, Kyle; Neilands, Torsten B; Lightfoot, Marguerita
Background Extensive evidence from observational studies suggests a role for genital herpes in the HIV epidemic. A number of herpes vaccines are under development and several trials of the efficacy of HSV-2 treatment with acyclovir in reducing HIV acquisition, transmission, and disease progression have just reported their results or will report their results in the next year. The potential impact of these interventions requires a quantitative assessment of the magnitude of the synergy between HIV and HSV-2 at the population level. Methods and Findings A deterministic compartmental model of HIV and HSV-2 dynamics and interactions was constructed. The nature of the epidemiologic synergy was explored qualitatively and quantitatively and compared to other sexually transmitted infections (STIs). The results suggest a more substantial role for HSV-2 in fueling HIV spread in sub-Saharan Africa than other STIs. We estimate that in settings of high HSV-2 prevalence, such as Kisumu, Kenya, more than a quarter of incident HIV infections may have been attributed directly to HSV-2. HSV-2 has also contributed considerably to the onward transmission of HIV by increasing the pool of HIV positive persons in the population and may explain one-third of the differential HIV prevalence among the cities of the Four City study. Conversely, we estimate that HIV had only a small net impact on HSV-2 prevalence. Conclusions HSV-2 role as a biological cofactor in HIV acquisition and transmission may have contributed substantially to HIV particularly by facilitating HIV spread among the low-risk population with stable long-term sexual partnerships. This finding suggests that prevention of HSV-2 infection through a prophylactic vaccine may be an effective intervention both in nascent epidemics with high HIV incidence in the high risk groups, and in established epidemics where a large portion of HIV transmission occurs in stable partnerships. PMID:18493617
Abu-Raddad, Laith J.; Magaret, Amalia S.; Celum, Connie; Wald, Anna; Longini, Ira M.; Self, Steven G.; Corey, Lawrence
The last 20 years have witnessed six striking changes in patterns of sexually transmitted diseases (STDs): emergence of new STD organisms and etiologies, reemergence of old STDs, shifts in the populations in which STDs are concentrated, shifts in the etiological spectra of STD syndromes, alterations in the incidence of STD complications, and increases in antimicrobial resistance. For example, human immunodeficiency virus (HIV) emerged to devastate the United States with a fatal pandemic involving at least 1 million people. The incidence of syphilis rose progressively after 1956 to reach a 40-year peak by 1990. In both cases, disease patterns shifted from homosexual men to include minority heterosexuals. Over the last decade, gonorrhea became increasingly concentrated among adolescents, and several new types of antimicrobial resistance appeared. Three interrelated types of environments affect STD patterns. The microbiologic, hormonal, and immunologic microenvironments most directly influence susceptibility, infectiousness, and development of sequelae. These microenvironments are shaped, in part, by the personal environments created by an individual's sexual, substance-use, and health-related behaviors. The personal environments are also important determinants of acquisition of infection and development of sequelae but, in addition, they mediate risk of exposure to infection. These are, therefore, the environments that most directly affect changing disease patterns. Finally, individuals' personal environments are, in turn, molded by powerful macroenvironmental forces, including socioeconomic, demographic, geographic, political, epidemiologic, and technological factors. Over the past 20 years, the profound changes that have occurred in many aspects of the personal environment and the macroenvironment have been reflected in new STD patterns. PMID:8146135
Wasserheit, J N
Background.?Diagnosis and treatment of sexually transmitted infections (STIs) is a public health priority, particularly in regions where the incidence of human immunodeficiency virus (HIV) infection is high. In most developing countries, STIs are managed syndromically. We assessed the adequacy of syndromic diagnosis of STIs, compared with laboratory diagnosis of STIs, and evaluated the association between STI diagnosis and the risk of HIV acquisition in a cohort of high-risk women. Methods.?HIV-uninfected high-risk women (n = 242) were followed for 24 months. Symptoms of STIs were recorded, and laboratory diagnosis of common STI pathogens was conducted every 6 months. Forty-two cytokines were measured by Luminex in cervicovaginal lavage specimens at enrollment. Human immunodeficiency virus type 1 (HIV-1) infection was evaluated monthly. Results.?Only 12.3% of women (25 of 204) who had a laboratory-diagnosed, discharge-causing STI had clinically evident discharge. Vaginal discharge was thus a poor predictor of laboratory-diagnosed STIs (sensitivity, 12.3%; specificity, 93.8%). Cervicovaginal cytokine concentrations did not differ between women with asymptomatic STIs and those with symptomatic STIs and were elevated in women with asymptomatic STIs, compared with women with no STIs or bacterial vaginosis. Although laboratory-diagnosed STIs were associated with increased risk of HIV infection (hazard ratio, 3.3 [95% confidence interval, 1.5–7.2)], clinical symptoms were not. Conclusions.?Syndromic STI diagnosis dependent on vaginal discharge was poorly predictive of laboratory-diagnosed STI. Laboratory-diagnosed STIs were associated with increased susceptibility to HIV acquisition, while vaginal discharge was not. PMID:22517910
Mlisana, Koleka; Naicker, Nivashnee; Werner, Lise; Roberts, Lindi; van Loggerenberg, Francois; Baxter, Cheryl; Passmore, Jo-Ann S.; Grobler, Anneke C.; Sturm, A. Willem; Williamson, Carolyn; Ronacher, Katharina; Walzl, Gerhard; Abdool Karim, Salim S.
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 (STIs). We sought to assess change in risk behaviors over time and the association of gender with risk behavior in the postrelease period. In this prospective cohort study, we interviewed 200 former inmates (51 women) approximately two weeks (baseline) and three 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 and 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) was 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 postrelease 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
Binswanger, Ingrid A; Mueller, Shane R; Beaty, Brenda L; Min, Sung-joon; Corsi, Karen F
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
NGUYEN, THUONG VU; VAN KHUU, NGHIA; LE, TRUC THANH THI; NGUYEN, ANH PHUONG; CAO, VAN; THAM, DUNG CHI; DETELS, ROGER
Sexually transmitted diseases (STDs) may impair sperm parameters and functions thereby promoting male infertility. To date limited molecular studies were conducted to evaluate the frequency and type of such infections in semen Thus, we aimed at conceiving and validating a multiplex PCR (M-PCR) assay for the simultaneous detection of the following STD pathogens in semen: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Herpes virus simplex (HSV) ?1 and ?2, and Treponema pallidum; We also investigated the potential usefulness of this M-PCR assay in screening programs for semen pathogens. In addition, we aimed: to detect human Papillomavirus (HPV) and genotypes by single PCR (sPCR) in the same semen samples; to determine the prevalence of the seven STDs, HPV and co-infections; to assess the possibility that these infections affect semen parameters and thus fertility. The overall validation parameters of M-PCR were extremely high including agreement (99.2%), sensitivity (100.00%), specificity (99.70%), positive (96.40%) and negative predictive values (100.00%) and accuracy (99.80%). The prevalence of STDs was very high (55.3%). Furthermore, associations were observed between STDs and changes in semen parameters, highlighting the importance of STD detection in semen. Thus, this M-PCR assay has great potential for application in semen screening programs for pathogens in infertility and STD clinics and in sperm banks. PMID:24921247
de Abreu, André Luelsdorf Pimenta; Irie, Mary Mayumi Taguti; Esquiçati, Isis Baroni; Malagutti, Natália; Vasconcellos, Vinícius Rodrigo Bulla; Discacciati, Michele Garcia; Bonini, Marcelo Gialluisi; Maria-Engler, Silvya Stuchi; Consolaro, Marcia Edilaine Lopes
Sexually transmitted diseases (STDs) may impair sperm parameters and functions thereby promoting male infertility. To date limited molecular studies were conducted to evaluate the frequency and type of such infections in semen Thus, we aimed at conceiving and validating a multiplex PCR (M-PCR) assay for the simultaneous detection of the following STD pathogens in semen: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Herpes virus simplex (HSV) -1 and -2, and Treponema pallidum; We also investigated the potential usefulness of this M-PCR assay in screening programs for semen pathogens. In addition, we aimed: to detect human Papillomavirus (HPV) and genotypes by single PCR (sPCR) in the same semen samples; to determine the prevalence of the seven STDs, HPV and co-infections; to assess the possibility that these infections affect semen parameters and thus fertility. The overall validation parameters of M-PCR were extremely high including agreement (99.2%), sensitivity (100.00%), specificity (99.70%), positive (96.40%) and negative predictive values (100.00%) and accuracy (99.80%). The prevalence of STDs was very high (55.3%). Furthermore, associations were observed between STDs and changes in semen parameters, highlighting the importance of STD detection in semen. Thus, this M-PCR assay has great potential for application in semen screening programs for pathogens in infertility and STD clinics and in sperm banks. PMID:24921247
Gimenes, Fabrícia; Medina, Fabiana Soares; Abreu, André Luelsdorf Pimenta de; Irie, Mary Mayumi Taguti; Esquiçati, Isis Baroni; Malagutti, Natália; Vasconcellos, Vinícius Rodrigo Bulla; Discacciati, Michele Garcia; Bonini, Marcelo Gialluisi; Maria-Engler, Silvya Stuchi; Consolaro, Marcia Edilaine Lopes
We critically evaluate a recent article by Van Howe involving 12 meta-analyses that concludes, contrary to current evidence, that male circumcision increases the risk of various common sexually transmitted infections (STIs). Our detailed scrutiny reveals that these meta-analyses (1) failed to include results of all relevant studies, especially data from randomized controlled trials, (2) introduced bias through use of inappropriate control groups, (3) altered original data, in the case of human papillomavirus (HPV), by questionable adjustments for “sampling bias,” (4) failed to control for confounders through use of crude odds ratios, and (5) used unnecessarily complicated methods without adequate explanation, so impeding replication by others. Interventions that can reduce the prevalence of STIs are important to international health. Of major concern is the global epidemic of oncogenic types of HPV that contribute to the burden of genital cancers. Meta-analyses, when well conducted, can better inform public health policy and medical practice, but when seriously flawed can have detrimental consequences. Our critical evaluation leads us to reject the findings and conclusions of Van Howe on multiple grounds. Our timely analysis thus reaffirms the medical evidence supporting male circumcision as a desirable intervention for STI prevention. PMID:24944836
Morris, Brian J.; Hankins, Catherine A.; Tobian, Aaron A. R.; Krieger, John N.; Klausner, Jeffrey D.
Sexually transmitted disease (STD) increases risk of HIV infection and has profound psychological consequences. The present study examined the mental health problems (poor emotional well-being, insomnia, probable depression) and their associated factors among monogamous Chinese female STD patients. A total of 537 Chinese female STD patients who self-reported having had only one male sex partner in the last 12 months were recruited from a STD clinic in Hong Kong. They completed a survey including measures of mental health, STD-related history, perceptions, feelings related to STD infection, and perceptions toward condom use. Results showed that 22% had poor emotional well-being, 25.7% had insomnia, and 43% were probable cases of depression. Unemployment, worsened relationship with partners after STD diagnosis, STD history in last three months, finding STD examinations embarrassing, and feelings of helplessness were significant risk factors for poor emotional well-being and insomnia. Also, unemployment, worsened relationships with partners after STD diagnosis, and perceived high chance of STD in the coming six months were significant risk factors for probable depression. Perceived efficacy of condom use for STD prevention was a significant protective factor against poor emotional well-being and probable depression. Findings suggest that interventions are warranted to improve the mental health among this population. PMID:25369553
Mo, Phoenix K H; Gu, Jing; Lau, Joseph T F; You, Hua
Objective Identify approaches for improving clinician provision of sexually transmitted diseases (STDs) prevention services among outpatient adolescents. Methods Reviewed all peer-reviewed, published clinical trials identified through computerized searches (MEDLINE, PsychINFO) evaluating STD prevention services to outpatient adolescents by clinicians. Results Five trials were identified examining changes in clinician provision of STD prevention services. Two of these trials resulted in adolescent self-reported risk reduction but neither of these trials effectively demonstrated reductions in objectively measured STD incidence. Nine clinical trials were identified that compared clinician with non-clinician provision of STD prevention services. Four of these trials resulted in adolescent self-reported risk reduction, and one of these trials demonstrated a reduction in objectively measured STD incidence. Conclusions Trials indicate that improvement in outpatient adolescent STD incidence is possible with non-clinicians as interventionists, and perhaps clinicians as interventionists if clinicians are supported by other educational resources. Opportunities for personalized, interactive adolescent education appears key to intervention success. The clinician role that is tested in most trials is confined to a single brief encounter with little attention to: development of clinician skills, quality of psychosexual risk assessment and tailoring to meet individual adolescent need, systems-level resources and supports, the parental role, or the impact of incorporating prevention into an ongoing adolescent-clinician relationship.
Griffin, Melinda A.
Objective. Control of sexually transmitted infections (STIs) among female sex workers (FSWs) is an important strategy to reduce HIV transmission. A study was conducted to determine the prevalence and assess the current clinical management of STIs in India. Methods. FSWs attending three clinics for regular checkups or symptoms were screened for study eligibility. A behavioral questionnaire was administered, clinical examination performed, and laboratory samples collected. Results. 417 study participants reported a mean number of 4.9 (SD 3.5) commercial clients in the last week. 14.6% reported anal sex in the last three months. Consistent condom use with commercial and regular partners was 70.1% and 17.5%, respectively. The prevalence of gonorrhea was 14.1%, chlamydia 16.1%, and trichomoniasis 31.1% with a third of all infections being asymptomatic. Syphilis seropositivity was 10.1%. Conclusions. At study sites, presumptive treatment for gonorrhea, chlamydia, and syphilis screening should continue. Presumptive treatment for trichomoniasis should be considered. Consistent condom use and partner treatment need to be reemphasized. PMID:21747642
Das, A.; Prabhakar, P.; Narayanan, P.; Neilsen, G.; Wi, T.; Kumta, S.; Rao, G.; Gangakhedkar, R.; Risbud, A.
Purpose of review Efficacious behavioral interventions and practices have not been universally accepted, adopted, or diffused by policy makers, administrators, providers, advocates, or consumers. Biomedical innovations for sexually transmitted disease (STD) and HIV prevention have been embraced but their effectiveness is hindered by behavioral factors. Behavioral interventions are required to support providers and consumers for adoption and diffusion of biomedical innovations, protocol adherence, and sustained prevention for other STDs. Information and communication technology such as the Internet and mobile phones can deliver behavioral components for STD/HIV prevention and care to more people at less cost. Recent findings Recent innovations in STD/HIV prevention with information and communication technology-mediated behavioral supports include STD/HIV testing and partner interventions, behavioral interventions, self-management, and provider care. Computer-based and Internet-based behavioral STD/HIV interventions have demonstrated efficacy comparable to face-to-face interventions. Mobile phone STD/HIV interventions using text-messaging are being broadly utilized but more work is needed to demonstrate efficacy. Electronic health records and care management systems can improve care, but interventions are needed to support adoption. Summary Information and communication technology is rapidly diffusing globally. Over the next 5–10 years smart-phones will be broadly disseminated, connecting billions of people to the Internet and enabling lower cost, highly engaging, and ubiquitous STD/HIV prevention and treatment support interventions. PMID:20087189
Swendeman, Dallas; Rotheram-Borus, Mary Jane
Background Curable, non-viral pathogens account for a significant burden of sexually transmitted infections (STIs), and there is established evidence that STIs increase both HIV acquisition and transmission. We investigated the prevalence, trends, and factors associated with Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Treponema pallidum, and the performance of syndromic management, among a cohort of women working in bars, hotels, and other food and recreational facilities near large-scale mines in northwestern Tanzania. Methods HIV-negative women aged 18–44 years (N?=?966) were enrolled and followed for 12 months in a microbicides feasibility study. We collected sociodemographic and behavioural data, performed clinical examinations, and tested for STIs, at enrolment and 3-monthly. Risk factors for STIs were investigated using logistic regression models with random effects. Sensitivity, specificity and predictive values of syndromic management were calculated. Results At enrolment, the prevalences of C. trachomatis, N. gonorrhoeae, T. vaginalis, and high-titre active syphilis were 111/956 (12%), 42/955 (4%), 184/945 (19%) and 46/965 (5%), respectively. There were significant decreases over time for C. trachomatis and T. vaginalis (OR trend per month: 0.94 [95% CI 0.91, 0.97]; and 0.95 [0.93, 0.98], respectively; both p<0.001). The majority of these infections were not diagnosed by the corresponding syndrome; therefore, most participants were not treated at the diagnosis visit. Syndromic management was poorly predictive of laboratory-diagnosed infections. We identified a number of risk factors for STIs, including low educational level, some sexual behaviours, and ever having been pregnant. Conclusions This analysis demonstrates that the prevalences of curable STIs are high among women who work in food and recreational facilities in northwestern Tanzania. Most of these infections are missed by syndromic management. Accurate and affordable rapid-point-of-care tests and innovative interventions are needed to reduce the burden of STIs in this population which is at increased risk for HIV. PMID:25025338
Francis, Suzanna C.; Ao, Trong T.; Vanobberghen, Fiona M.; Chilongani, Joseph; Hashim, Ramadhan; Andreasen, Aura; Watson-Jones, Deborah; Changalucha, John; Kapiga, Saidi; Hayes, Richard J.
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
Irena Jakopanec; Barbara Schimmer; Andrej M Grjibovski; Elise Klouman; Preben Aavitsland
Few studies have been conducted in developing countries to estimate the prevalence of hepatitis C virus (HCV) infection and its association with human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). We have screened for hepatitis B virus (HBV) and HCV markers 200 HIV-1-positive, 23 HIV-2-positive and 206 HIV-negative women attending gynaecology clinics in 1995\\/96 in Abidjan, Côte d'Ivoire,
Patrice Combe; Guy La Ruche; Dominique Bonard; Timothée Ouassa; Hortense Faye-Ketté; Fatoumata Sylla-Koko; François Dabis
BackgroundA point-of-care test (POCT) for sexually transmitted infections (STIs), which offers immediate diagnosis resulting in patients receiving diagnosis and treatment in a single visit, has the ability to address some of the STI control needs. However, needs assessment from STI experts and end users about currently available STI POCTs and their future new development has not been evaluated since World
Yu-Hsiang Hsieh; M. Terry Hogan; Mathilda Barnes; Mary Jett-Goheen; Jill Huppert; Anne M. Rompalo; Charlotte A. Gaydos; Patricia Kissinger
UK national audit against the key performance indicators in the British Association for Sexual Health and HIV Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.
A national audit of practice performance against the key performance indicators in the British Association for Sexual Health and HIV (BASHH) and HIV Medical Foundation for AIDS Sexual Health Standards for the Management of Sexually Transmitted Infections (STIs) was conducted in 2011. Approximately 60% and 8% of level 3 and level 2 services, respectively, participated. Excluding partner notification performance, the five lowest areas of performance for level 3 clinics were the STI/HIV risk assessment, care pathways linking care in level 2 clinics to local level 3 services, HIV test offer to patients with concern about STIs, information governance and receipt of chlamydial test results by clinicians within seven working days (the worst area of performance). The five lowest areas of performance for level 2 clinics were participating in audit, having an audit plan for the management of STIs for 2009-2010, the STI/HIV risk assessment, HIV test offer to patients with concern about STIs and information governance. The results are discussed with regard to the importance of adoption of the standards by commissioners of services because of their relevance to other national quality assurance drivers, and the need for development of a national system of STI management quality assurance measurement and reporting. PMID:23104750
McClean, H; Sullivan, A K; Carne, C A; Warwick, Z; Menon-Johansson, A; Clutterbuck, D
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
Luchters, Stanley; Chersich, Matthew F; Rinyiru, Agnes; Barasa, Mary-Stella; King'ola, Nzioki; Mandaliya, Kishorchandra; Bosire, Wilkister; Wambugu, Sam; Mwarogo, Peter; Temmerman, Marleen
The clinical features of sexually transmitted disease (STD) infection in female sex workers found in a community based study in different red light areas of Kolkata are discussed in this paper. Out of 867 sex workers clinically examined in the clinics in their respective areas, 80.16% were having different signs and symptoms of sexually transmitted diseases. The vaginal discharge was the commonest feature present in 49.6% sex workers. The chronic vaginal discharge of more than a month was found in 47.44%, while 37.90% sex workers had vaginal discharge of less than one month. The genital ulcer was present in 25.03% (217) sex workers. The other sexually transmitted infection that was found includes genital warts 13.73%, scabies 12.11 and Inguinal bubo in 1.73% sex workers. The sex workers were also having other symptoms e.g. chronic weight loss, prolonged fever and chronic diarrhoea in 13.73% (119), 10.03% (87) and in 1.96% (17) sex workers respectively. PMID:15909751
Raut, D K; Pal, D; Das, A
Context: About 490 million cases of curable Reproductive Tract Infections (RTI) occur throughout the world, of which 79 million cases occur in India annually. Sexually Transmitted Infections/Reproductive Tract Infections (STI/RTI) confers a huge economic burden on the individual and the health system. Complications of RTI/STI are many, ranging from chronic pain syndrome to infertility. Most of these complications can be prevented by early diagnosis and treatment. Aims: To assess knowledge, attitude and practices on STI/RTIs among married women aged 15-45 years in rural Haryana. Setting and Design: Cross-sectional study, conducted in selected villages under the primary health centre Mandi, Sonepat, Haryana. Subjects and Methods: Systematic sampling was used to cover 10 villages. In each village, every tenth house was sampled, taking first house from the center of the village. Face-to-face interview was conducted using pretested questionnaire. Statistical Analysis Used: Descriptive statistics and results were described in percentages. Results: A total of 344 women were interviewed. About 44% women had never heard of STI/RTI. The prevalence of self-reported symptoms of STI/RTI was very high (60%). Only 40% of them opted for treatment and most common cause for not opting for treatment was that they considered it as a minor problem. Advice for use of condom during the treatment was received by only 20% of patients and only 26.5% of their husbands also received treatment. Conclusions: Overall knowledge, attitude and practices relating to STI/RTI among married women in rural Haryana was poor. The prevalence of self-reported STI/RTI was found to be high and treatment seeking behavior was poor.
Rizwan, SA; Rath, Rama S.; Vivek, Gupta; Nitika; Anant, Gupta; Farhad, Ahamed; Vijay, Silan
The relative prevalence of sexually transmitted diseases and the agents available for the treatment of these diseases commonly presenting as genital discharges—namely, gonorrhoea, candidosis, trichomoniasis, and non-specific genital infection—are reviewed. The many agents that are active against gonorrhoea are listed, but none is ideal. Penicillin, in spite of its allergic side effects, has remained the drug of choice for 25 years because it is cheap, easily obtained, lacks toxicity even in pregnancy, and is effective. Its use is now threatened by the emergence of some strains that are able to produce penicillinase. At present the policy is to obtain the best results from penicillin while these are acceptable, but the clinician in some countries is badly served by the availability of procaine penicillin in aqueous suspension. There is a need for an effective penicillin or cephalosporin that is penicillinase resistant and cheap. Cefuroxime offers considerable hope but it is likely to be expensive in the immediate future. There are many preparations for the local treatment of candidosis. The confidence expressed by the manufacturers in recommending a three-day treatment is, it is hoped, based on a superior product. Nevertheless there is a need for a safe systemically absorbed fungicide which could be used orally, or some substance that could render the vagina an inhospitable environment for the organism. In the treatment of trichomoniasis the pharmaceutical industry in providing substances more than 90% effective in a single dose has done all that can be expected. Any further advances lie in the field of human behaviour rather than pharmaceutical research. In the treatment of non-specific genital infection the needs are more of research than of therapy. More knowledge is required of the cause of the condition and the relative role of contending pathogens, and of the results of treatment of patients and contacts in which Chlamydia or other suspect pathogens have been isolated. PMID:338125
Willcox, R. R.
Objectives: To evaluate the feasibility and impact of a health education intervention promoting partner notification for sexually transmitted diseases (STDs). Methods: The research setting was a busy public health clinic in a rural district in KwaZulu Natal, South Africa. A before/after quantitative study design was used to measure the effect of an audiovisual presentation of a compelling love drama, posters, and pamphlets. Measures collected from all consenting STD index patients during a 6 week pre-intervention (control) phase were compared with those collected during a 6 week intervention phase. A qualitative evaluation assessed whether the intervention accurately portrayed the intended educational messages. Results: 150 index patients (55% female) were interviewed in the control phase and 185 index patients (64% female) in the intervention phase. The intervention phase showed improvements on several measures of self efficacy about notifying casual partners, such as a belief among index patients that a greater proportion of their casual partners would see the importance of seeking treatment as a result of their notification interaction. The rate of contact cards returned per index patient was 0.27 in the intervention phase, compared with 0.20 in the control phase (95% CI for the rate difference: -0.05, 0.17). The qualitative research found that the intervention was thoroughly enjoyed by patients and clinicians, but a fundamental problem with it was that patients received confused messages about the relation between HIV/AIDS and other STDs. This has potentially negative consequences for partner notification. Conclusion: The intervention needs further development, and then could provide a highly acceptable, cost effective model for health education in clinics in developing countries. PMID:11872861
Mathews, C; Guttmacher, S; Coetzee, N; Magwaza, S; Stein, J; Lombard, C; Goldstein, S; Coetzee, D
Background: Sexually transmitted infections (STIs) promote Human immunodeficiency virus (HIV) transmission by augmenting HIV infectiousness and susceptibility. In our society, especially in rural areas, males are common visitors to STI clinic than females who are generally traced as a contact. This difference may be due to the asymptomatic nature of infections in females, lower awareness among women of need for availing medical facilities, or their frequent consultation in gynecological clinics instead of STI clinics. Aim: To determine the prevalence, clinical profile, and the pattern of STIs in males and the prevalence of HIV infection in them at a rural-based tertiary care center. Materials and Methods: A retrospective study of male cases attending STI clinic between January 2008 and December 2009 was carried out. Diseases were diagnosed on the basis of clinical morphology of the lesion, and HIV and Venereal disease research laboratory (VDRL) testing was done in all cases. Results: Of 23 433 male patients presenting at the Skin/VD department, 201 were diagnosed to have STI. Most common age group affected was 25 to 44 years (59.7%). Incidence of STI was high among married individuals (77.2%). Herpes genitalis was most common STI in 49 (24.37%) cases. Viral infections (herpes genitalis, genital warts, and molluscum contagiosum) accounted for 62.2% of cases. Prevalence of HIV in STI was 2.48%. Conclusions: The persistent and recurrent nature of viral infections is responsible for their increasing trend in the current STI scenario. HIV and STIs are perfect examples of epidemiologic synergy as they are core transmitters of each other. STI being higher in married individuals further underlines the importance of contact tracing, counseling, and prompt management of the partners. PMID:22021968
Vora, Rita; Anjaneyan, Gopikrishnan; Doctor, Chirag; Gupta, Rajat
A pilot project, ¿Youth Inform¿ endorsed by the Ministry of Health and Ministry of Education, Singapore, was undertaken in 1992 for 2 years. It aims to enhance sexually transmitted disease (STDs)/human immunodeficiency virus (HIV) control in Singapore by providing structured information for young people between the ages of 16 to 20 years in Polytechnics, Junior Colleges, Centralised Institutes and Pre-University Centres. Project Youth Inform comprises 8 components. They include a focus group discussion, a training seminar for teachers, a lecture/slide presentation cum question-and-answer session, an educational booklet/bookmark, exhibitions, a video, provisions for anonymous questions, and an evaluation. The programme is conducted during school hours at the premises of the institutions and the attendance per session is between 150 to 350 students. A total of 152 sessions have been completed for all the schools. It is ongoing and is currently administered by the School Health Service and Training and Health Education Department. Feedback from principals, teachers and students was gathered formally through surveys and informally through interviews and observations. One thousand students were randomly selected for the survey to assess their responses towards the programme. Eighty-six percent reported that they found it educational and informative. Indicators found to have an influence on the effectiveness of the programme were timing, vocabulary used (medical terms) and integration of the programme into the school's curriculum. In conclusion, Project Youth Inform was on the whole positively received. However, it is essential to constantly accommodate and adapt to new facts and methods of teaching and maintain close coordination with the Ministries and the schools. An effective STD/acquired immune deficiency syndrome programme is an important step towards the prevention, management and control of the epidemic. PMID:8849185
Soon, T; Chan, R K; Goh, C L
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
Munson, Erik; Wenten, David; Phipps, Paula; Gremminger, Roger; Schuknecht, Mary Kay; Napierala, Maureen; Hamer, Deb; Olson, Robin; Schell, Ronald F; Hryciuk, Jeanne E
Background antibiotic use (i.e., administration of antibiotics not directly related to Chlamydia trachomatis or Neisseria gonorrhoeae infections) has been associated with a lower prevalence of genital C. trachomatis infection in a clinical setting. Associations with specific antibiotic types or with N. gonorrhoeae are lacking. Here, we assessed the prevalence of antibiotic use, the different classes and agents used, and their association with a subsequent sexually transmitted infection (STI) clinic C. trachomatis and N. gonorrhoeae test result. At our STI clinic, we systematically registered whether antibiotics were used in the past month (in 29% of the cases, the specific antibiotic agent was named). Patients were screened for urogenital C. trachomatis and N. gonorrhoeae; a third of them were also screened for anorectal and oropharyngeal C. trachomatis and N. gonorrhoeae. The proportion of antibiotics used and their association with C. trachomatis and N. gonorrhoeae prevalence were assessed for heterosexual men, men who have sex with men (MSM), and women. During 14,775 clinic consultations, antibiotic use was reported by 12.2% (95% confidence interval [CI], 11.7% to 12.7%), i.e., 14.8% of women, 8.6% of heterosexual men, and 11.6% of MSM. The most reported antibiotics were penicillins, tetracyclines, and macrolides, respectively. The prevalence was 11.0% (95% CI, 10.3% to 11.3%) for C. trachomatis and 1.9% (95% CI, 1.7% to 2.1%) for N. gonorrhoeae. Only tetracycline use was associated with a lower C. trachomatis prevalence (3%). Overall antibiotic use was associated with lower anorectal C. trachomatis prevalence in MSM only (odds ratio, 0.4; 95% CI, 0.2 to 0.8). STI clinic visitors commonly report recent antibiotic use. Even in a country with low antibiotic consumption, tetracycline use impacted C. trachomatis prevalence, while there was a notable absence of association with azithromycin. PMID:25313220
Dukers-Muijrers, Nicole H T M; van Liere, Genevieve A F S; Wolffs, Petra F G; Den Heijer, Casper; Werner, Marita I L S; Hoebe, Christian J P A
, such as the infamous twofold cost of sex. In sexual reproduction, the unit of reproduction is the couple, whereas in asexual reproduction it is the individual. Unless the sexually reproducing couple can produce twice reproductive output per capita.At one extreme,if sexual couples and asexual individuals produce the same
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Objectives. We examined gender abuse and depressive symptoms as risk factors for HIV and other sexually transmitted infections (HIV/STI) among male-to-female transgender persons (MTFs). Methods. We conducted a 3-year prospective study of factors associated with incident HIV, syphilis, hepatitis B, chlamydia, and gonorrhea among 230 MTFs from the New York Metropolitan Area. Statistical techniques included Cox proportional hazards analysis with time varying covariates. Results. Among younger MTFs (aged 19–30 years), gender abuse predicted depressive symptoms (Center for Epidemiologic Studies Depression score ??20), and gender abuse combined with depressive symptoms predicted both high-risk sexual behavior (unprotected receptive anal intercourse) and incident HIV/STI. These associations were independent of socioeconomic status, ethnicity, sexual orientation, hormone therapy, and sexual reassignment surgery. Conclusions. Gender abuse is a fundamental distal risk factor for HIV/STI among younger MTFs. Interventions for younger MTFs are needed to reduce the psychological impact of gender abuse and limit the effects of this abuse on high-risk sexual behavior. Age differences in the impact of gender abuse on HIV/STI suggest the efficacy of peer-based interventions in which older MTFs teach their younger counterparts how to cope with this abuse. PMID:22698023
Bockting, Walter; Rosenblum, Andrew; Hwahng, Sel; Mason, Mona; Macri, Monica; Becker, Jeffrey
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
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
because many are infected unknowingly due to the behavior of their partner/spouse. Finally, sexually transmitted infections amplify the transmission rates of HIV/AIDS and should be studied specifically for this reason if none other... proliferation of certain infections such as HIV, now gaining footholds in the heterosexual populations in the United States and China. In the United States, current trends indicate that the fastest growing population of those infected with HIV is the young...
Garcia, Ginny Elizabeth
Background Alcohol misuse remains a major risk factor for contracting sexually transmitted diseases (STDs) not typically addressed in STD clinic settings. Information and communication technology (ICT) can offer new avenues to deliver evidence-based screening and treatment for problematic drinking, however, few data exists regarding the utilization of ICT among STD clinic attendees with coexisting drinking problems. The objectives of this study are to identify STD clinics attendees with hazardous drinking, to examine socio-demographic factors associated with ICT use, and to explore individuals’ interests in engaging in ICT-based health interventions. Methods Cross-sectional questionnaires examining alcohol consumption and ICT use were administered to 396 persons attending two non-urban STD clinics. Descriptive statistics for ICT use were calculated for both hazardous drinkers and the entire sample. Multivariable logistic regression models among hazardous drinkers identified factors significantly associated with use of each kind of ICT. Results The mean age of the 396 participants was 25 years, 66% were females and 60% were African-Americans. One third of the sample met the criteria of hazardous drinking. ICT use in hazardous drinkers included 94% reporting having internet access at least monthly, 82% reporting having an email account, 85% reporting currently owning a cell phone, and 91% reporting use of any cell phone application. More than two thirds (73%) of hazardous drinkers were willing to play health-related video games during clinic waiting time, slightly higher than the entire sample (69%). Multivariable analyses indicated that younger age were significantly related to monthly internet use, and multifunction cell phone use, while being males and younger age were significantly associated with monthly video game playing. Conclusions Our study demonstrates commonality of ICT use among STD clinic attendees with hazardous drinking, indicating the viability of using ICT to assist screening and behavioural intervention for alcohol misuse in STD clinic settings. Future research is needed to demonstrate the effectiveness of ICT-based health behavioural interventions in the STD clinic settings or other venues that serve populations at high risk for substance abuse, HIV or other STDs. PMID:24670037
Assessment of sexual risk behaviors and perception of vulnerability to sexually transmitted diseases/acquired immunodeficiency syndrome in women, 1999-2012: a population based survey in a medium-sized Brazilian city.
Sexual behavior is a key factor for susceptibility to sexually transmitted diseases. An evaluation of the sexual behavior of women at reproductive age was conducted in 1999. A replication of this study aims to evaluate the current situation and identify changes in sexual behavior, 13 years later. This is a population-based cross-sectional study, conducted with 1071 women in Pelotas, Brazil. Compared to the 1999 study, a 14% increase in early sexual debut and an 8% decrease in the non-use of condoms were observed in 2012. The proportion of women who reported anal sex doubled between these periods. There was no trend of increase or decrease in the prevalence of behaviors with distinct patterns being observed for each of them. Reduction of non-use of condoms may be an indicator of the effectiveness of campaigns to promote safe sex. However, the increased prevalence of early sexual debut and anal sex indicates the need for campaigns to continue and to expand their focus, especially among vulnerable groups. PMID:24780361
Mesenburg, Marilia Arndt; Muniz, Ludmila Correa; Silveira, Mariângela Freitas
Background Antiretroviral therapies (ART) offer promising new avenues for HIV prevention. Unfortunately, people infected with HIV who have co-occurring sexually transmitted infections (STI) are more infectious than suggested by the amount of virus in their peripheral blood. We examined the history of STI co-infections in people living with HIV. Methods People living with HIV/AIDS completed confidential computerized interviews that assessed history of STI, sexual behaviors, and STI knowledge. Results Among 414 men and 156 women currently receiving ART, 53% had been diagnosed with at least one STI since testing HIV positive; 24% women, 19% men, and 11% transgender persons had been diagnosed with an STI in the past year. History of STI was associated with younger age, greater STI knowledge, substance use, and ART non-adherence. Conclusions Aggressive strategies for detecting and treating STI in people receiving ART will be necessary to achieve protective benefits. PMID:21990610
Kalichman, Seth C.; Cherry, Chauncey; White, Denise; Jones, Mich’l; Kalichman, Moira
Abstract The goals of the current study were to: (1) estimate the prevalence of forced sex among,women,accessing services at a women’s,health clinic in rural Haiti; and,(2) examine,factors associated with forced sex in this population. Based on data from a case-control study of risk factors for sexually transmitted diseases (STDs), a cross-sectional analysis to examine,factors associated,with,forced,sex was,performed.,A number,of factors related to
M. c. Smith Fawzi; W. Lambert; J. m. Singler; Y. Tanagho; F. Le Andre; P. Nevil; D. Bertrand; M. s. Claude; J. Bertrand; M. Louissaint; L. Jeannis; J. s. Mukherjee; S. Goldie; J. j. Salazar; P. e. Farmer
The effects of a systematically developed photo-novella on knowledge, attitudes, communication and behavioural intentions with respect to sexually transmitted infections among secondary school learners in South Africa.
A pre-post test follow-up design was used to test the effects of a systematically developed photo-novella (Laduma) on knowledge, attitudes, communication and behavioural intentions with respect to sexually transmitted infections, after a single reading by 1168 secondary school learners in South Africa. The reading resulted in an increase in knowledge on the spread of sexually transmitted infections (STIs), change in attitude to condom use and towards people with STIs and/or HIV/AIDS, as well as increased intention to practice safe sex. Laduma did not influence communication about sexually transmitted infections and reported sexual behaviour and condom use. While print media proved to be an effective strategy to reach large numbers of youth and prepare them for adequate preventive behaviours, the study also identified the need to combine print media with other planned theory-based interventions that build confidence and skills to initiate the preventive behaviour. PMID:15764686
James, Shamagonam; Reddy, Priscilla S; Ruiter, Robert A C; Taylor, Myra; Jinabhai, Champaklal C; Van Empelen, Pepijn; Van den Borne, Bart
On June 27, 2006, the NIH conducted a workshop to review published data and current field practices supporting the use of self-obtained vaginal swabs (SOVs) as specimens for diagnosis of sexually transmitted infections (STIs). The workshop also explored the design of studies that could support FDA clearance of SOVs for STI testing, particularly for specimens collected in nonclinical settings including patients’ homes. This report summarizes the workshop findings and recommendations. Participants concluded that self-obtained vaginal swabs are well accepted by women of all ages and that SOVs perform as well as or better than other specimen types for Chlamydia trachomatis and Neisseria gonorrhoeae detection using transcription-mediated amplification. In addition, workshop participants recommended the validation of SOV testing by public health practitioners and manufacturers of STI diagnostic tests to expedite incorporation of SOVs as a diagnostic option in clinical and nonclinical settings for Chlamydia trachomatis and Neisseria gonorrhoeae testing. Similarly, SOVs should be explored for use in the diagnosis of other sexually transmitted pathogens. PMID:18157061
Hobbs, Marcia M.; Van Der Pol, Barbara; Totten, Patricia; Gaydos, Charlotte A.; Wald, Anna; Warren, Terri; Winer, Rachel L.; Cook, Robert L.; Deal, Carolyn D.; Rogers, M. Elizabeth; Schachter, Julius; Holmes, King K.; Martin, David H.
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
Keaveney, S; Sadlier, C; O'Dea, S; Delamere, S; Bergin, C
Reframing the Context of Preventive Health Care Services and Prevention of HIV and Other Sexually Transmitted Infections for Young Men: New Opportunities to Reduce Racial/Ethnic Sexual Health Disparities
Young Black males, aged 13 to 29 years, have the highest annual rates of HIV infections in the United States. Young Black men who have sex with men (MSM) are the only subgroup with significant increases in HIV incident infections in recent years. Black men, particularly MSM, are also disproportionately affected by other sexually transmitted infections (STIs). Therefore, we must strengthen HIV and STI prevention opportunities during routine, preventive health care visits and at other, nontraditional venues accessed by young men of color, with inclusive, nonjudgmental approaches. The Affordable Care Act and National HIV/AIDS Strategy present new opportunities to reframe and strengthen sexual health promotion and HIV and STI prevention efforts with young men of color. PMID:23237172
... 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 ...
A cross-sectional serosurvey for human immunodeficiency virus type 1 (HIV-1) was conducted during the first quarter of 1991 among high risk groups in Djibouti, East Africa, and compared with previous surveys in 1987, 1988, and 1990. The survey demonstrated evidence of HIV-1 infection in 36.0% (n = 292) of street prostitutes, 15.3% (n = 360) of prostitutes working as bar hostesses, and 10.4% (n = 193) of males diagnosed with a sexually transmitted disease. By multivariate modeling, HIV-1 seropositivity in prostitutes was associated with Ethiopian nationality, working as a street prostitute, and residing in Djibouti for two years or less. We suggest that prostitution, particularly street prostitution, is a major route of HIV-1 transmission in Djibouti. PMID:8517486
Rodier, G R; Couzineau, B; Gray, G C; Omar, C S; Fox, E; Bouloumie, J; Watts, D
Hawai'i Youth Services Network (HYSN) was founded in 1980 and is incorporated as a 501(c) (3) organization. HYSN plays a key role in the planning, creation, and funding of local youth services. One of HYSN's focuses is teen pregnancy and sexually transmitted infections (STI) prevention among foster youth. Foster youth are at a greater risk for teen pregnancy and STI due to a variety of complex factors including instability, trauma, and emancipation from the foster care system. This article highlights how HYSN is leveraging both federal and local funding, as well as other resources, in order to implement an evidence-based teen pregnancy and STI prevention program adapted for foster youth. PMID:25628980
Smith, Tamara; Clark, Judith F; Nigg, Claudio R
Little is known about sexually transmitted infection (STI) testing among Chinese men who have sex with men (MSM). This study describes the prevalence of STI testing, associated factors and the validity of STI self-reporting among Chinese MSM. Findings indicated a high prevalence of STIs and low testing rates among MSM in Shanghai. Monthly income was significantly associated with STI testing (odds ratio: 0.37, 95% confidence interval (CI): 0.18 to 0.76). Depression was significantly associated with STI testing for general MSM (odds ratio: 1.09, 95% CI: 1.01 to 1.17). Syphilis self-reported status had the highest validity (k = 0.33, ?2 = 3.76, 95% CI: ?0.003 to 0.65). Efforts are needed to ensure that STI testing services are accessible to MSM in China. Future HIV and STI interventions should be tailored to the needs of different subsets of MSM. PMID:24636349
Lin, Lavinia; Nehl, Eric J.; Tran, Alvin; He, Na; Zheng, Tony; Wong, Frank Y.
Recent literature has reported increased accuracy of Trichomonas vaginalis transcription-mediated amplification (TMA)-based analyte-specific reagent (ASR) testing in female populations. A retrospective investigation assessed 7,277 female first-void urine, cervical, or vaginal specimens submitted from a high-prevalence sexually transmitted infection (STI) community to characterize prevalence of disease etiologies. The most common STI phenotype reflected detection of solely T. vaginalis (54.2% of all health care encounters that resulted in STI detection). In females with detectable T. vaginalis, codetection of Chlamydia trachomatis and Neisseria gonorrhoeae occurred in 7.8% and 2.7% of health care encounters, respectively. The mean age of women with detectable T. vaginalis (30.6) was significantly higher than those for women with C. trachomatis or N. gonorrhoeae (22.3 and 21.6, respectively; P < 0.0001). T. vaginalis was the predominant sexually transmitted agent in women over the age of 20 (P < 0.0002). C. trachomatis was the most commonly detected agent in females under the age of 21, particularly from cervical specimens. However, first-void urine detection rates for T. vaginalis and C. trachomatis within this age demographic demonstrated no difference (P = 0.92). While overall and cervical specimen-derived detection of T. vaginalis within African American majority geographical locales outweighed that within majority Caucasian geographical regions (P ? 0.004), this difference was not noted with first-void urine screening (P = 0.54). Health care professionals can consider TMA-based T. vaginalis screening for a wide age range of patients; incorporation of first-void urine specimens into screening algorithms can potentiate novel insight into the epidemiology of trichomoniasis. PMID:23015673
Munson, Erik; Kramme, Timothy; Napierala, Maureen; Munson, Kimber L; Miller, Cheryl; Hryciuk, Jeanne E
Aims: This study compares the clinical and laboratory diagnosis of vaginal discharge syndrome. Settings and Design: This cross-sectional study was carried out at the gynaecology outpatient department of a tertiary care hospital in Gujarat, India. Material and Methods: Total of 180 females diagnosed as vaginal discharge or cervicitis based on syndromic approach and were recruited for the study. Their clinical profile was noted and they were investigated for bacterial vaginosis, trichomoniasis, candidiasis, gonorrhoea and chlamydia infection. Results: Lower abdominal pain (35%) followed by burning micturition (23.9%) were the common associated complaints. Bacterial vaginosis was the most common clinical diagnosis, while trichomoniasis was least common. Upon laboratory investigation, 35.6% of cases of vaginal discharge and 12% of cases of cervicitis tested positive. Percentage of cases confirmed by laboratory investigation was 50, 27.8 and 41.7 for bacterial vaginosis, trichomoniasis and candidiasis respectively. Conclusion: Among all the females diagnosed as vaginal discharge syndrome, a very small percentage actually turned out to be positive upon laboratory testing. PMID:25506555
Chauhan, Vidyalaxmi; Shah, Maitri; Thakkar, Sejal; Patel, Sangita V.; Marfatia, Yogesh
This study examined the prevalence of HIV and other sexually transmitted infections (STIs) in pregnant women in Kinshasa, the Democratic Republic of the Congo (DRC). Between April and July 2004, antenatal attendees at two of the largest maternity clinics in Kinshasa were tested to identify HIV status, syphilis, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). HIV seroprevalence was 1.9% in 2082 women. With PCR techniques, CT and NG infections were also uncommon in the first 529 women (1.7% and 0.4%, respectively). No active syphilis infection case was identified by Treponema pallidum haemagglutination assay (TPHA) and rapid plasma reagin test (RPR). A woman's risk of HIV infection was significantly associated with her reporting a male partner having had other female sexual partners (OR 2.7, 95% CI 1.2-6.2). The continuing low seroprevalence of HIV in pregnant women from Kinshasa was confirmed. Understanding factors associated with this phenomenon could help prevent a future HIV epidemic in low HIV transmission areas in Africa. PMID:18028581
Kinoshita-Moleka, R; Smith, J S; Atibu, J; Tshefu, A; Hemingway-Foday, J; Hobbs, M; Bartz, J; Koch, M A; Rimoin, A W; Ryder, R W
SUMMARY This study examined the prevalence of HIV and other sexually transmitted infections (STIs) in pregnant women in Kinshasa, the Democratic Republic of the Congo (DRC). Between April and July 2004, antenatal attendees at two of the largest maternity clinics in Kinshasa were tested to identify HIV status, syphilis, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). HIV seroprevalence was 1·9% in 2082 women. With PCR techniques, CT and NG infections were also uncommon in the first 529 women (1·7% and 0·4%, respectively). No active syphilis infection case was identified by Treponema pallidum haemagglutination assay (TPHA) and rapid plasma reagin test (RPR). A woman's risk of HIV infection was significantly associated with her reporting a male partner having had other female sexual partners (OR 2·7, 95% CI 1·2–6·2). The continuing low seroprevalence of HIV in pregnant women from Kinshasa was confirmed. Understanding factors associated with this phenomenon could help prevent a future HIV epidemic in low HIV transmission areas in Africa. PMID:18028581
KINOSHITA-MOLEKA, R.; SMITH, J. S.; ATIBU, J.; TSHEFU, A.; HEMINGWAY-FODAY, J.; HOBBS, M.; BARTZ, J.; KOCH, M. A.; RIMOIN, A. W.; RYDER, R. W.
The recent increases in acute STDs among MSM must be viewed in the context of a post-AIDS era that is characterized by demographic shifts,changing sexual attitudes, and rapidly changing social contexts. A key driver seems to be the growing prevalent pool of HIV-positive MSM for whom the crucial motivator for safer sex (primary HIV prevention) no longer exists and where, given the prevalence of seroconcordant sexual mixing, consider-able uncertainty and conflicting advice regarding the rationale and benefits for continued safer-sex practice are unclear [105,106]. Although it is tempting to ascribe these changes to increases in risk behavior, it is essential that the contexts in which the changes are occurring are also considered. It may also be appropriate to contemplate whether further changes to the social environment (eg, structural interventions) are a suitable adjunct to our traditional prevention activities that operate largely in isolation from each other. It seems natural to advocate that interventions that adopt holistic approaches to the sexual health of MSM and that address upstream factors such as mental health, drug use, discrimination, and internalized homophobia should be included in the efforts to create more healthy environments for MSM. However, there is still some way to go in identifying which of these upstream interventions are effective, how they may be implemented within or alongside existing health care systems, and what impact, if any, they are likely to have on STD transmission. Such interventions are also likely to belong on implementation time, require consider political will, and be extremely hard to evaluate, and the benefits may not be seen within the same generation in which they are implemented. Therefore, there must be confidence that this is the appropriate route of travel. The consistency of findings from across industrialized countries confirms an increasing connectivity within the global MSM community;a community that is decreasingly defined by geographic boundaries and, in the era of the Internet and easier foreign travel, increasingly linked by shared interests and social and sexual networks. This is powerfully demonstrated in the near-simultaneous syphilis and LGV outbreaks among MSM in Europe and the United States . In this regard, greater collaboration between researchers and providers working with MSM indifferent countries is now required. More specifically, consideration should be given to creating closer partnerships between sentinel cities, such as London, New York, San Francisco, Berlin, Paris, and Amsterdam, that have large MSM populations and are likely to be emerging, or rapid diffusion sites for new social and sexual trends that may impact on disease transmission. There are many benefits to such cross-national working,including earlier recognition and improved response to emerging threats,sharing innovative practice, avoiding duplication of effort, and creating a united front for dealing with what must be considered a cause for concern domestically and globally. PMID:15963874
Fenton, Kevin A; Imrie, John
Injection of crude lipopolysaccharide (LPS) from Eschericia 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
Sullivan, John T.; Belloir, Joseph A.
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
Richard Crosby; Jami S Leichliter; Robert Brackbill
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
Jennings, Jacky M; Woods, Stacy E; Curriero, Frank C
Objectives We used a Health in All Policies (HiAP) framework to determine what data, policy, and community efficacy opportunities exist for improving sexual health and reducing sexually transmitted diseases (STDs) in an area surrounding an Army base undergoing redevelopment in Atlanta, Georgia. Methods We conducted a literature review, consulted with experts, mapped social determinants in the community, conducted key informant interviews with community leaders to explore policy solutions, used Photovoice with community members to identify neighborhood assets, and shared data with all stakeholder groups to solicit engagement for next steps. Results We identified the following HiAP-relevant determinants of STD inequities in the literature: education, employment, male incarceration, drug and alcohol marketing, and social capital. Quantitative data confirmed challenges in education, employment, and male incarceration in the area. Interviews identified policy opportunities such as educational funding ratios, Community Hire Agreements, code and law enforcement, addiction and mental health resources, lighting for safety, and a nonemergency public safety number. Photovoice participants identified community assets to protect including family-owned businesses, green spaces, gathering places, public transportation resources, historical sites, and architectural elements. Stakeholder feedback provided numerous opportunities for next steps. Conclusions This study contributes to the HiAP literature by providing an innovative mixed-methods design that locates social determinants of STDs within a geographic context, identifies policy solutions from local leaders, highlights community assets through the lens of place attachment, and engages stakeholders in identifying next steps. Findings from this study could inform other redevelopments, community-based studies of STDs, and HiAP efforts. PMID:24179283
Fuller, Elizabeth; Branscomb, Jane; Cheung, Karen; Reed, Phillip Jackson; Wong, Naima; Henderson, Michael; Williams, Samantha
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
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:25587602
Oyekale, Abayomi Samuel
HIV prevention in the President's Emergency Plan for AIDS Relief (PEPFAR) began when both data on HIV prevalence and the toolbox of interventions for prevention of sexual transmission were relatively limited. PEPFAR's early focus was on scaling-up information, education, and communication programs that included messaging on abstinence for youth and faithfulness primarily through nongovernmental organizations, including faith-based organizations. Additional activities included condom promotion, distribution, and social marketing. In epidemics concentrated within key populations, PEPFAR's prevention efforts focused on a minimum package of services including outreach, information, education, and communication programs, STI treatment (where appropriate), and condom promotion and distribution. As more epidemiological data became available and with experience gleaned in these early efforts, the need for tailored and flexible approaches became evident. The next iteration of prevention efforts still emphasized behavioral interventions, but incorporated a sharper focus on key epidemic drivers, especially multiple partners; a data-driven emphasis on high transmission areas and populations, including prevention with people living with HIV; and a more strategic and coordinated approach at the national level. Recently, the paradigm for prevention efforts has shifted yet again. Evidence that biomedical interventions such as male circumcision, treatment for prevention of vertical and horizontal transmission, and treatment itself could lead to declines in incidence has refocused PEPFAR's prevention portfolio. New guidance on sexually transmitted HIV focuses on combination prevention, emphasizing biomedical, behavioral and structural approaches. Landmark speeches by the President and the Secretary of State and new ambitious targets for PEPFAR point toward a new goal: an AIDS-free generation. PMID:22797743
Ryan, Caroline A; Conly, Shanti R; Stanton, David L; Hasen, Nina S
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
Oyekale, Abayomi Samuel
To evaluate the prevalence and indicators of hepatitis C virus (HCV) infection in Houston and determine the effectiveness of targeted HCV screening in sexually transmitted disease (STD) clinics. We performed a cross-sectional survey in low-risk and high-risk groups in Houston. This included a blinded survey of HCV conducted in 1010 STD clinic clients having serological syphilis tests, and 1885 multi-speciality group practice patients having metabolic blood work. This was followed with a targeted hepatitis C survey of 822 high-risk clients from STD clinics. The seroprevalence of hepatitis C infection in the blinded survey was 3.9% (95% CI 3.0-4.8) in the multi-speciality group and 5.0% (95% CI 3.7-6.3) in the STD clinics. Prevalence of hepatitis C infection among targeted STD clinic clients was significantly higher at 15.3% (95% CI 12.7-17.7). Risk factors that correlated with HCV infection after logistic regression included: injection drug use (OR = 10, 95% CI = 3.4-30.3), heroin use (OR = 6.6, 95% CI = 2.2-20.5), non-transfusion/ transplantation blood exposure (OR = 3.0, 95% CI = 1.3-6.9), sharing equipment to snort drugs (OR = 2.5, 95% CI 1.2-5.4), and age above 25 years (OR = 51, 95% CI = 9-47). This study demonstrates that targeting clients in STD clinics for known risk behaviours is an effective way to identify cases of HCV infection. STD clinics allow access to clients with both drug use and sexual risk behaviours and are a useful location for targeting hepatitis C screening and prevention efforts. PMID:12614470
D'Souza, G; Arafat, R; Hwang, L; Cunningham, C; Shah, S; Reynolds, K
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
Objective The aims of this study were to investigate the frequency of male circumcision among men who have sex with men (MSM) in Buenos Aires, Argentina; the association between circumcision and sexually transmitted infections (STIs); and, among those uncircumcised, the willingness to be circumcised. Methods A cross-sectional study was conducted among 500 MSM recruited through the respondent-driven sampling (RDS) technique. Participants underwent a consent process, responded to a Web-based survey that included questions on demographic information, sexual behaviour, and circumcision and provided biological samples. HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum, and human papiloma virus (HPV) diagnoses were performed using standard methodologies. For all analyses, data were weighted based on participants’ network size. Results Only 64 (13%) of the 500 MSM in our study reported being circumcised. Among uncircumcised men (n=418), 302 (70.4%) said that they would not be willing to get circumcised even if the procedure could reduce the risk of HIV infection. When considering all participants, circumcision status was not significantly associated with HIV, HBV, HCV, T. pallidum or HPV infections. However, when we restricted the sample to men who do not practice receptive anal intercourse (RAI) and compared circumcised to uncircumcised men, the former (N=33) had no cases of HIV infection, while 34 of 231 (14.8%) uncircumcised men were HIV positive (p=0.020). Regarding HPV, uncircumcised men had a significantly larger number of different HPV types compared with circumcised men (mean 1.83 vs. 1.09, p<0.001) and a higher frequency of high-risk-HPV genotypes (47.6% vs. 12.5%, p=0.012). Conclusions Consistent with international evidence, male circumcision appears to have a partial protective effect among MSM. The efficacy of circumcision in reducing risk of HIV infection among MSM appears to be correlated with sexual practices. Given the lack of motivation among MSM with regard to circumcision, proper awareness on the risks and benefits of circumcision needs to be created, if circumcision has to be introduced as a prevention strategy. PMID:23746302
Pando, María A; Balan, Ivan C; Dolezal, Curtis; Marone, Ruben; Barreda, Victoria; Carballo-Dieguez, Alex; Avila, María M
Background Few data are available in Afghanistan to shape national military force health practices, particularly with regard to sexually-transmitted infections (STIs). We measured prevalence and correlates of HIV, syphilis, herpes simplex 2 virus (HSV-2), and hepatitis C virus (HCV) among Afghan National Army (ANA) recruits. Methods A cross-sectional sample of male ANA recruits aged 18–35 years were randomly selected at the Kabul Military Training Center between February 2010 and January 2011. Participants completed an interviewer-administered questionnaire and serum-based rapid testing for syphilis and hepatitis C virus antibody on-site; HIV and HSV-2 screening, and confirmatory testing were performed off-site. Prevalence of each infection was calculated and logistic regression analysis performed to identify correlates. Results Of 5313 recruits approached, 4750 consented to participation. Participants had a mean age of 21.8 years (SD±3.8), 65.5% had lived outside Afghanistan, and 44.3% had no formal education. Few reported prior marijuana (16.3%), alcohol (5.3%), or opiate (3.4%) use. Of sexually active recruits (58.7%, N?=?2786), 21.3% reported paying women for sex and 21.3% reported sex with males. Prevalence of HIV (0.063%, 95% CI: 0.013- 0.19), syphilis (0.65%, 95% CI: 0.44 – 0.93), and HCV (0.82%, 95% CI: 0.58 – 1.12) were quite low. Prevalence of HSV-2 was 3.03% (95% CI: 2.56 - 3.57), which was independently associated with age (Adjusted Odds Ratio (AOR)?=?1.04, 95% CI: 1.00 - 1.09) and having a television (socioeconomic marker) (AOR?=?1.46, 95% CI: 1.03 – 2.05). Conclusion Though prevalence of HIV, HCV, syphilis, and HSV-2 was low, sexual risk behaviors and intoxicant use were present among a substantial minority, indicating need for prevention programming. Formative work is needed to determine a culturally appropriate approach for prevention programming to reduce STI risk among Afghan National Army troops. PMID:22909128
Despite widespread biomedical advances in treatment, 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 China's HIV/STI epidemics and the government response; then synthesize findings from the 11 studies presented in this issues to extend seven recommendations for future HIV/STI prevention and care research in China. We discuss lessons learned from forging international collaborations between social science 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
Muessig, Kathryn E.; Smith, M. Kumi; Maman, Suzanne; Huang, Yingying; Chen, Xiang-sheng
Background 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. Methods A systematic review of studies examining STI co-infections in people living with HIV/AIDS. The review focuses on STI contracted after becoming HIV infected. Electronic database and manual searches located clinical and epidemiological studies of STI that increase HIV infectiousness. Results Thirty seven studies of STI-HIV co-infection prevalence were located. Studies of adults living with HIV/AIDS from developed and developing countries reported STI rates for 46 different samples (33 samples had clinical/laboratory confirmed STI). The overall mean point-prevalence for confirmed STI was16.3% (SD = 16.4), and median 12.4% STI prevalence in people living with HIV/AIDS. The most common STI studied were Syphilis with median 9.5% prevalence, gonorrhea 9.5%, Chlamydia 5%, and Trichamoniasis 18.8% prevalence. STI prevalence was greatest at the time of HIV diagnosis, reflecting the role of STI in HIV transmission. Prevalence of STI among individuals receiving HIV treatment was not appreciably different from untreated persons. Conclusions The prevalence of STI in people infected with HIV suggests that STI co-infections could undermine efforts to use HIV treatments for prevention by increasing genital secretion infectiousness. PMID:21330572
Kalichman, Seth C.; Pellowski, Jennifer; Turner, Christina
In preparation for the development of an individually tailored, multimedia, computerized sexually transmitted infection (STI)/HIV-risk reduction intervention software application for use in publicly funded STI clinics, we conducted a waiting-room survey among 583 inner-city patients (67% male; 79% African American; mean age = 30.3) at an STI clinic in Milwaukee, Wisconsin regarding their computer experience and opinions related to a computerized approach to HIV/STI-risk reduction counseling. A substantial minority of respondents indicated they would prefer having either a combined computerized and human counseling intervention (30%) or preferred a computerized intervention alone (13%). Perceived benefits of computerized counseling included impartiality of the response, privacy, accuracy of the information, convenience, and being able to control the dissemination of information. Perceived disadvantages included lack of human contact, inability to obtain necessary information, technical problems, threats to privacy, and failure to take information from a computer seriously. Despite their limited economic resources, participants reported relatively high levels of computer experience overall and a willingness to use an individually tailored computerized risk-reduction counseling approach. We discuss how participants' responses were used to inform the development of such an intervention. PMID:17028993
Weinhardt, Lance S; Mosack, Katie E; Swain, Geoffrey R
Background There is considerable evidence of racial/ethnic patterning of sexually transmitted infection (STI) risk in the United States (US). There is also evidence that poorer persons are at increased STI risk. Evidence regarding the interaction of race/ethnicity and income is limited, particularly nationally at the individual level. Methods We examined the pattern of socioeconomic gradients in STI infection amongst young people in a nationwide US study, and determined how these gradients varied by race/ethnicity. We estimated the cumulative diagnosis prevalence of Chlamydia, Gonorrhoea or Trichomoniasis (via self-report or laboratory confirmation) for young adults (ages 18-26) Hispanics and non-Hispanic Whites, Blacks, and Others across income quintiles in the Add Health dataset. We ran regression models to evaluate these relationships adjusting for individual- and school-level covariates. Results STI diagnosis was independently associated with both racial/ethnic identity and with low income, although the racial/ethnic disparities were much larger than income-based ones. A negative gradient of STI risk with increasing income was present within all racial/ethnic categories, but was stronger for non-Whites. Conclusions Both economic and racial/ethnic factors should be considered in deciding how to target STI prevention efforts in the US. Particular focus may be warranted for poor, racial/ethnic minority women. PMID:23965773
Harling, Guy; Subramanian, SV; Bärnighausen, Till; Kawachi, Ichiro
Objective To systematically review and critically appraise the economic evaluations of one to one interventions to reduce sexually transmitted infections (STIs) and teenage conceptions. Design Systematic review. Data sources Search of four electronic bibliographic databases from 1990 to January 2006. Search keywords included teenage, pregnancy, adolescent, unplanned, unwanted, cost benefit, cost utility, economic evaluation, cost effectiveness and all terms for STIs, including specific diseases. Review methods We included studies that evaluated a broad range of one to one interventions to reduce STIs. Outcomes included major outcomes averted, life years and quality adjusted life years (QALY). All studies were assessed against quality criteria. Results Of 3190 identified papers, 55 were included. The majority of studies found one to one interventions to be either cost saving or cost effective, although one highlighted the need to target the population to receive post?exposure prophylaxis to reduce transmission of HIV. Most studies used a static approach that ignores the potential re?infection of treated patients. Conclusion One to one interventions have been shown to be cost saving or cost effective but there are some limitations in applying this evidence to the UK policy context. More UK research using dynamic modelling approaches and QALYs would provide improved evidence, enabling more robust policy recommendations to be made about which one to one interventions are cost effective in reducing STIs in the UK setting. The results of this review can be used by policy makers, health economists and researchers considering further research in this area. PMID:17626115
Barham, L; Lewis, D; Latimer, N
... 1.9 to 9.5) for MSW. Pelvic Inflammatory Disease For data on pelvic inflammatory disease, see Special Focus Profiles, STDs in Women ... time, as suggested by NDTI data, may indicate increased recognition of infection. Trichomoniasis Trend data for this ...
Background Structural factors are known to affect individual risk and vulnerability to HIV. In the context of an HIV prevention programme for over 60,000 female sex workers (FSWs) in south India, we developed structural interventions involving policy makers, secondary stakeholders (police, government officials, lawyers, media) and primary stakeholders (FSWs themselves). The purpose of the interventions was to address context-specific factors (social inequity, violence and harassment, and stigma and discrimination) contributing to HIV vulnerability. We advocated with government authorities for HIV/AIDS as an economic, social and developmental issue, and solicited political leadership to embed HIV/AIDS issues throughout governmental programmes. We mobilised FSWs and appraised them of their legal rights, and worked with FSWs and people with HIV/AIDS to implement sensitization and awareness training for more than 175 government officials, 13,500 police and 950 journalists. Methods Standardised, routine programme monitoring indicators on service provision, service uptake, and community activities were collected monthly from 18 districts in Karnataka between 2007 and 2009. Daily tracking of news articles concerning HIV/AIDS and FSWs was undertaken manually in selected districts between 2005 and 2008. Results The HIV prevention programme is now operating at scale, with over 60,000 FSWs regularly contacted by peer educators, and over 17,000 FSWs accessing project services for sexually transmitted infections monthly. FSW membership in community-based organisations has increased from 8,000 to 37,000, and over 46,000 FSWs have now been referred for government-sponsored social entitlements. FSWs were supported to redress > 90% of the 4,600 reported incidents of violence and harassment reported between 2007-2009, and monitoring of news stories has shown a 50% increase in the number of positive media reports on HIV/AIDS and FSWs. Conclusions Stigma, discrimination, violence, harassment and social equity issues are critical concerns of FSWs. This report demonstrates that it is possible to address these broader structural factors as part of large-scale HIV prevention programming. Although assessing the impact of the various components of a structural intervention on reducing HIV vulnerability is difficult, addressing the broader structural factors contributing to FSW vulnerability is critical to enable these vulnerable women to become sufficiently empowered to adopt the safer sexual behaviours which are required to respond effectively to the HIV epidemic. PMID:21962115
Objectives To determine changes in the prevalence of sexually transmitted infection (STI)/HIV in female sex workers (FSWs) after a community HIV prevention intervention project in five border provinces of Vietnam. Methods The project focused on providing user?friendly STI services for FSWs using mobile teams operating at multiple sites depending on local client preferences. 911 FSWs were enrolled at baseline and 982 in the exit survey. Study participants were interviewed about sociodemographic characteristics, sexual behaviour, history of STIs and selected features of their husbands or cohabiting partners, and were tested for STIs. Results The overall prevalence rates of HIV, syphilis, herpes simplex virus 2 (HSV?2) antibodies, gonorrhoea (GC), Chlamydia trachomatis (CT), and GC and/or CT among FSWs in the five border provinces in 2004 were 3.6%, 12.9%, 24.9%, 2.9%, 9.1% and 11.3%, respectively. Compared with baseline values, GC and/or CT decreased significantly from 19.9% to 11.3%, GC from 10.7% to 2.9% and CT from 11.9% to 9.1%. HIV decreased from 4.5% to 3.6%, and HSV?2 antibodies from 27.7% to 24.9%. After adjustment for possible confounders, a significant overall decrease in having GC and/or CT (OR?=?0.46, 95% CI 0.33 to 0.65; p<0.001) and GC alone (OR?=?0.22, 95% CI 0.13 to 0.37; p<0.001) was found, and the overall prevalence of syphilis increased significantly (OR?=?1.55, 95% CI 1.11 to 2.17 p?=?0.011). A marked increase in syphilis from 1.0% to 14.1% was identified in the Lai Chau province. Conclusions Implementation of the project was associated with a reduction in GC and/or CT infections in FSWs, more so with GC than with CT. A notable increase in syphilis in Lai Chau was identified. HIV/STI interventions in FSWs can be implemented by government services and should be intensified and expanded to other provinces. PMID:17327262
Thuong, Nguyen Vu; Van Nghia, Khuu; Hau, Tran Phuc; Long, Nguyen Thanh; Van, Cao Thi Bao; Duc, Bui Hoang; Tram, Luong Thu; Tuan, Nguyen Anh; Tien, Nguyen Thi Kim; Godwin, Peter; Fylkesnes, Knut; O'Farrell, Nigel
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
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
Background National notification data for sexually transmitted infections (STIs) and blood borne viruses (BBVs) continue to have a high proportion of missing data on Indigenous status, potentially biasing estimates of notification rates by Aboriginality. We evaluated the use of data linkage to improve the accuracy of estimated notification rates for STIs and BBVs in Aboriginal and non-Aboriginal groups in Western Australia. Methods STI and BBV case notifications in Western Australia received in 2010 were linked with administrative health data collections in Western Australia to obtain additional data on Indigenous status. STI and BBV notification rates based on the pre- and post-linkage data among Aboriginal and non-Aboriginal groups were compared. Results Data linkage decreased the proportion of notifications with unknown Indigenous status by 74% from 10.2% to 2.7%. There was no significant difference in disease-specific age-adjusted notification rate ratio estimates based on pre-linkage data and post-linkage data for Aboriginal people compared with non-Aboriginal people. Conclusion Our findings suggest that reported STI and BBV disease-specific age-adjusted notification rates for 2010 in Western Australia are unlikely to be significantly biased by excluding notifications with unknown Indigenous status. This finding is likely to be dependent on recent improvements in the reporting of Indigenous status in notification data in Western Australia. Cost-effective and systematic solutions, including the better use of existing data linkage resources, are required to facilitate continued improvement in the completeness of reporting and accuracy of estimates for notifiable STIs and BBVs in Australia by Aboriginality. PMID:23621957
Background Decision Analytic Models (DAMs) are established means of evidence-synthesis to differentiate between health interventions. They have mainly been used to inform clinical decisions and health technology assessment at the national level, yet could also inform local health service planning. For this, a DAM must take into account the needs of the local population, but also the needs of those planning its services. Drawing on our experiences from stakeholder consultations, where we presented the potential utility of a DAM for planning local health services for sexually transmitted infections (STIs) in the UK, and the evidence it could use to inform decisions regarding different combinations of service provision, in terms of their costs, cost-effectiveness, and public health outcomes, we discuss the barriers perceived by stakeholders to the use of DAMs to inform service planning for local populations, including (1) a tension between individual and population perspectives; (2) reductionism; and (3) a lack of transparency regarding models, their assumptions, and the motivations of those generating models. Discussion Technological advances, including improvements in computing capability, are facilitating the development and use of models such as DAMs for health service planning. However, given the current scepticism among many stakeholders, encouraging informed critique and promoting trust in models to aid health service planning is vital, for example by making available and explicit the methods and assumptions underlying each model, associated limitations, and the process of validation. This can be achieved by consultation and training with the intended users, and by allowing access to the workings of the models, and their underlying assumptions (e.g. via the internet), to show how they actually work. Summary Constructive discussion and education will help build a consensus on the purposes of STI services, the need for service planning to be evidence-based, and the potential for mathematical tools like DAMs to facilitate this. PMID:22805183
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
Musyoki, Helgar; Kellogg, Timothy A; Geibel, Scott; Muraguri, Nicholas; Okal, Jerry; Tun, Waimar; Fisher Raymond, H; Dadabhai, Sufia; Sheehy, Meredith; Kim, Andrea A
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
Munson, Kimber L; Napierala, Maureen; Munson, Erik; Schell, Ronald F; Kramme, Timothy; Miller, Cheryl; Hryciuk, Jeanne E
... National Overview National Profile Chlamydia Figures Gonorrhea Figures Syphilis Figures Other STDs Figures Special Focus Profiles Women ... Case Definitions Case Definitions Part 2 Contributors Slides Syphilis Profiles GISP Profiles Related Links STD Home STD ...
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.
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
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 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
Hottes, Travis Salway; Kerr, Thomas; Taylor, Darlene; Fairley, Christopher K; Lester, Richard; Wong, Tom; Trussler, Terry; Marchand, Rick; Shoveller, Jean; Ogilvie, Gina
The primary objectives of this study were to assess the changing demographic characteristics of female sex workers (FSWs) in the urban Bangalore district, India, and trends in programme coverage, HIV/sexually transmitted infection prevalence rates and condom use. Cross-sectional, integrated behavioural and biological assessments of FSWs were conducted in 2006, 2009 and 2011. Univariate and multivariate analyses were used to describe trends over time. The results indicate the mean age of initiation into sex work has increased (26.9 years in 2006 vs 27.6 years in 2011, p<0.01), a higher proportion of FSWs reported being in 'stable' relationships in 2011 (70.2% vs 43.2% in 2006, p<0.01) and having conducted sex work outside the district in the past 6 months (10.0% in 2011 vs 16.0% in 2006 p=0.01). There was an increase in the proportion of FSWs using cellphones to solicit clients (4.4% in 2006 vs 57.5% in 2011, p<0.01) and their homes for sex work (61.4% in 2006 vs 77.8% in 2011, p<0.01). Reactive syphilis prevalence declined (12.6% in 2006 to 4% in 2011, p=0.02), as did high-titre syphilis prevalence (9.5% in 2006 to 2.5% in 2011, p=0.01). HIV prevalence declined but not significantly (12.7% in 2006 and 9.3% in 2011, p=0.39). Condom use remained above 90% increasing significantly among repeat (paying) clients (66.6% in 2006 to 93.6% in 2011, p<0.01). However, condom use remained low with non-paying partners when compared with occasional paying partners (17.6% vs 97.2% in 2011, p<0.01). Given the changing dynamics in the FSW population at multiple levels, there is a need to develop and customise strategies to meet local needs. PMID:24045090
Jayaraman, Gayatri C; Kumar, Shiv; Isac, Shajy; Javalkar, Prakash; Gowda, Pushpalatha Rama Narayana; Raghunathan, N; Gowda, Chandra Shekhar; Bhattacharjee, Parinita; Moses, Stephen; Blanchard, James F
Bacterial vaginosis is a common condition associated with increased risk of sexually transmitted diseases, including human immunodeficiency virus infections. In contrast, vulvovaginal candidiasis has a much weaker association with sexually transmitted diseases. We found that vaginal lavage fluid from women with bacterial vaginosis is deficient in antimicrobial polypeptides and antimicrobial activity compared to fluid from healthy women or women with vulvovaginal candidiasis. Effective treatment normalized the concentrations of antimicrobial polypeptides in both bacterial vaginosis and in vulvovaginal candidiasis, suggesting that the abnormalities were a result of the diseases. Unlike in vulvovaginal candidiasis, the neutrophil attractant chemokine interleukin-8 (IL-8) was not increased in bacterial vaginosis, accounting for low concentrations of neutrophil-derived defensins in vaginal fluid. In organotypic cultures of human vaginal epithelium containing dendritic cells, treatment with Lactobacillus jensenii, a typical vaginal resident, induced the synthesis of IL-8 mRNA and the epithelial human ?-defensin-2 mRNA, but a typical bacterial vaginosis pathogen, Gardnerella vaginalis, had no effect. When the two bacteria were combined, Gardnerella vaginalis did not interfere with the immunostimulatory effect of Lactobacillus jensenii. The loss of normal immunostimulatory flora in bacterial vaginosis is thus associated with a local deficiency of multiple innate immune factors, and this deficiency could predispose individuals to sexually transmitted diseases. PMID:16988245
Valore, Erika V.; Wiley, Dorothy J.; Ganz, Tomas
Background Geosocial networking applications (GSN apps) used to meet sexual partners have become increasingly popular with men who have sex with men (MSM) since 2009. The current study aimed to determine if self-identified HIV negative, MSM clinic attendees who used GSN apps have an increased incidence of sexually transmitted infections (STIs) compared to self-identified HIV negative, MSM attendees who met sexual partners via in-person venues such as bars or clubs or through MSM-specific hook-up websites. Methods Data were collected between August 2011 and January 2013 on all self-identified HIV-negative, MSM clients visiting the L.A. Gay & Lesbian Center for STI screening. A total of 7,184 individuals tested for STIs and self-reported behaviours on drug use and social networking methods to meet sexual partners. Multivariate logistic regression models were used to analyze the results. Results Individuals who used GSN apps to meet sexual partners had greater odds of testing positive for gonorrhoea (OR: 1.25; 95% CI: 1.06–1.48) and for chlamydia (OR: 1.37; 95% CI: 1.13–1.65) compared to individuals who met partners through in-person methods only. There were no significant differences in syphilis and HIV incidence between those who met partners via in-person venues only, on the internet or through GSN apps. Conclusions The present study concludes that sexual health clinic MSM attendees who are meeting on GSN apps are at greater risk for gonorrhoea and chlamydia than MSM attendees who meet in-person or on the internet. Future interventions should explore the use of these novel technologies for testing promotion, prevention and education. PMID:24926041
Beymer, Matthew R; Weiss, Robert E; Bolan, Robert K; Rudy, Ellen T; Bourque, Linda B; Rodriguez, Jeffrey P; Morisky, Donald E
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
Polymorphism in sexual versus non-sexual disease transmission PETER H. THRALL AND JANIS ANTONOVICS transmitted diseases (STDs) often consist of related strains that cause non- sexually transmitted, or `ordinary infectious', diseases (OIDs). We use differential equation models of single populations to derive
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
Magri, Vittorio; Montanari, Emanuele; Škerk, Višnja; Markoti?, Alemka; Marras, Emanuela; Restelli, Antonella; Naber, Kurt G; Perletti, Gianpaolo
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
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
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
Franco, Sandra; Tural, Cristina; Nevot, Maria; Moltó, José; Rockstroh, Jürgen Kurt; Clotet, Bonaventura; Martinez, Miguel Angel
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
Severe, Linda; Fitzgerald, Daniel W.; Deschamps, Marie M.; Reif, Lindsey; Post, Kendall; Johnson, Warren D.; Pape, Jean W.; Boutin-Foster, Carla
Sexual health is not merely the absence of disease, but the ability to have informed, consensual, safe, respectful, and pleasurable sexual relationships. The majority of the population are sexually active, most with someone of the opposite sex. The frequency and range of sexual practices that people engage in declines with age, but for many, sexual activity continues well into later life. Different aspects of sexual health affect people at different times throughout their lives. As people in the UK tend to first have sex around the age of 16, but do not start living with a partner until much later, the avoidance of sexually transmitted infections and unplanned pregnancy is necessary for many for a number of years. As people get older, their sexual health needs change and they become more concerned with the impact of their general health on their ability to have sex. Some people experience non-volitional sex (sex against their will); although this occurs typically in late teenage it may affect women and men at any age and so requires consideration throughout life. As many people find it difficult to talk about sex and sexual health matters, health professionals should make sexual health enquiry a component of their holistic healthcare. PMID:24966786
Mercer, Catherine H
A cross-sectional comparative study based on secondary data of 18 Demographic Health Surveys (DHS) carried out in Sub-Saharan Africa starting from 2003 was conducted to assess the protective effect of male circumcision from HIV infection and STDs. From all surveys, information on 70,554 males aged 15-59 years was extracted. The association between male circumcision and HIV infection and STD symptoms (Genital discharge or genital ulcer/sore) was assessed using binary logistic regression. Adjustment was made for sexual history and basic sociodemographic variables. The weighted prevalence of HIV among men 15-59 years was 3.1%. In the bivairate analysis being uncircumcised was significantly associated with risk of HIV with Odds Ratio (OR) of 4.12 aged (95% CI: 3.85-4.42). The association was even more significant, 4.95 (95% CI: 4.57-5.36), after adjustment for number of lifetime sexual partners and socio-demographic variables. The risk associated with uncircumcision is significantly lower among younger men aged 15-29 years than those in 30-59 years age category. About 5.5% of the study subjects reported either genital discharge or genital sore/ulcer in the preceding 12 months of the surveys. Circumcision was not significantly associated with either of the symptoms of STD with adjusted OR of 1.07 (95% CI: 0.99-1.15). The study concludes that male circumcision provides a strong protection against acquisition of HIV infection. Hence, it can be considered as a possible way of reducing the spread of HIV infection in areas where the practice is rare. A comprehensive study to assess the association between circumcision and different types STDs is recommended. PMID:22066324
Background As other countries, Switzerland experiences a high or even rising incidence of HIV and sexually transmitted infections (STI) among men who have sex with men (MSM). An outpatient clinic for gay men ("Checkpoint") was opened in 2006 in Zurich (Switzerland) in order to provide sexual health services. The clinic provides counselling, testing, medical treatment and follow-up at one location under an "open-door-policy" and with a high level of personal continuity. We describe first experiences with the new service and report the characteristics of the population that utilized it. Methods During the 6-month evaluation period, individuals who requested counselling, testing or treatment were asked to participate in a survey at their first visit prior to the consultation. The instrument includes questions regarding personal data, reasons for presenting, sexual behaviour, and risk situations. Number and results of HIV/STI tests and treatments for STI were also recorded. Results During the evaluation period, 632 consultations were conducted and 247 patients were seen by the physician. 406 HIV tests were performed (3.4% positive). 402 men completed the entry survey (64% of all consultations). The majority of respondents had 4 and more partners during the last 12 months and engaged in either receptive, insertive or both forms of anal intercourse. More than half of the responders used drugs or alcohol to get to know other men or in conjunction with sexual activity (42% infrequently, 10% frequently and 0.5% used drugs always). The main reasons for requesting testing were a prior risk situation (46.3%), followed by routine screening without a prior risk situation (24.1%) and clarification of HIV/STI status due to a new relationship (29.6%). A fifth of men that consulted the service had no history of prior tests for HIV or other STIs. Conclusion Since its first months of activity, the service achieved high levels of recognition, acceptance and demand in the MSM community. Contrary to common concepts of "testing clinics", the Checkpoint service provides post-exposure prophylaxis, HIV and STI treatment, psychological support and counselling and general medical care. It thus follows a holistic approach to health in the MSM community with the particular aim to serve as a "door opener" between the established system of care and those men that have no access to, or for any reason hesitate to utilize traditional health care. PMID:18505556
Schwappach, David LB; Bruggmann, Philip
Background Individuals of Asian heritage represent the largest ethnic minority in Canada. Approximately 10% of the new HIV diagnoses in men in British Columbia occur among Asian-Canadians. However, the HIV risk patterns of Asian men who have sex with men (MSM) have not been extensively studied. Methods Participants aged???19 years were enrolled in a venue-based HIV serobehavioural survey of MSM in Vancouver, Canada. We compared the demographic characteristics, risk behaviours, and prevalence of HIV and other sexual and blood borne infections between Asian and non-Asian MSM using bivariate analysis and logistic regression confounder modelling. Results Amongst 1132 participants, 110 (9.7%) self-identified as Asian. Asian participants were younger than non-Asian participants (median age 29 vs. 32 years; p?0.001), but otherwise did not differ from other study participants. HIV prevalence was lower among Asian MSM compared to Non-Asian MSM (3.7% vs 19.0%, p <0.001). Among men who self-reported as HIV negative or unknown we found no differences in unprotected anal intercourse (UAI) with a discordant or unknown serostatus partner in the previous six months (11 vs. 13%; p?=?0.503). However, Asian MSM were less likely to report ever using injection drugs (10.8% vs. 19.2%; p?=?0.043) or using alcohol before having sex (52% vs. 64.4%; p?=?0.017). Conclusions Asian MSM in our study reported similar rates of UAI as non-Asian MSM, but had a lower prevalence of HIV infection. Other factors, such as the use of drugs and alcohol, in relation to sex, may partly explain these differences. However this requires further investigation. PMID:23947623
A group-based HIV and sexually transmitted infections prevention intervention for lesbian, bisexual, queer and other women who have sex with women in Calgary and Toronto, Canada: study protocol for a non-randomised cohort pilot study
Introduction The limited research that exists suggests that lesbian, bisexual queer (LBQ) and other women who have sex with women are at similar risk for sexually transmitted infections (STI) as heterosexual women. However, scant research has evaluated HIV and STI prevention strategies for LBQ women. The authors present the rationale and study protocol for developing and pilot testing a psychoeducational group-based HIV and STI prevention intervention with LBQ women in Calgary and Toronto, Canada. Methods and analysis This is a multicentre non-randomised cohort pilot study. The target population is LBQ women in Calgary and Toronto, Canada. The authors aim to recruit 40 participants using purposive peer-driven recruitment methods. Participants will conduct a pretest followed by a 2-day group programme of six 2?h sessions addressing stigma, STI and HIV prevention, healthy relationships, safer sex self-efficacy, self-worth, social support and LBQ community engagement. Participants will conduct a post-test directly following the intervention and 6?weeks after the intervention. The primary outcome is safer sex practices; our prespecified index of clinically significant change is an effect size of 0.50. Secondary outcomes include: safer sex self-efficacy, STI testing frequency, STI knowledge, resilient coping, social support, sexual stigma, access to care, depression and self-esteem. We will conduct mixed-effects regression to calculate mean outcome pre–post test score change. Ethics and dissemination Research ethics approval was attained from the Office of Research Ethics (REB: 29291), University of Toronto, Toronto, Ontario, Canada. Trial results will be published according to the Transparent Reporting of Evaluations with Non-randomised Designs (TREND) statement, regardless of the outcomes. Trial registration number This study is registered at http://clinicaltrials.gov, registration number NCT02067845. PMID:24760356
Logie, Carmen H; Navia, Daniela; Rwigema, Marie-Jolie; Tharao, Wangari; Este, David; Loutfy, Mona R
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.
... 35 and 36 , Table 35 ). P&S Syphilis by Race/Ethnicity In 2012, among the 48 jurisdictions (47 ... other races/ethnicities ( Figure 40 ). P&S Syphilis by Race/Ethnicity and Sex In 2012, among the 48 ...
... Sex During 1995â€“2011, chlamydia rates among females increased each year ( Figure 1 ). In 2012, the overall rate of reported chlamydial infection among women in all 50 states and the District of Columbia (643.3 cases ...
A retrospective data analysis of one thousand STD patients from 1994 to 1998 at Medical College, Trivandrum was carried out. Males constituted 61.1% and females 38.9% in the study. Most of the STD patients were married (68%). In this group, 44.9% of males and 15% of females had extra marital contact (EMC). Of the 155 male married patients who had EMC, 128 (82%) had history of pre marital contact (PMC) as well. Commercial sex workers (CSWs) were the partners for most of the patients for EMC and PMC. The commonest STD was syphilis, both in men and women followed by herpes genitalis and condylomata acuminata. Latent syphilis was the most common type (54%) followed by sec- ondary. The prevalence of herpes genitalis and condylomata acuminata showed an increase with a def i-nite decline in the prevalence of gonorrhoea. HIV was detected in 3.2% of the patients. PMID:20877030
Nair, T G; Asha, L K; Leelakumari, P V
... colposcopy and cervical biopsy may be done. Genital Herpes Physical examination, including pelvic exam in young women, and thorough medical history, herpes virus blood test and culture. Syphilis Physical examination, ...
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
Jalal, Hamid; Delaney, Andrew; Bentley, Neil; Sonnex, Christopher; Carne, Christopher A
... Hepatitis B and Hepatitis C). How can STDs affect pregnancy? Having an STD during pregnancy can harm the baby if it is passed to him or her. Gonorrhea and chlamydia both can cause health problems in the infant ranging from eye infections to pneumonia. Syphilis may ...
Sexual compulsivity has been associated with higher frequencies of sexual behaviors that may increase risk for transmission of HIV and other sexually transmitted infections (STI). In a rural midwestern region where social and community resources...
Schnarrs, Phillip W.; Rosenberger, Joshua G.; Satinsky, Sonya; Brinegar, Emily; Stowers, Jill; Dodge, Brian; Reece, Michael
Patients in the perioperative period and intensive care unit are commonly exposed to blood transfusion (BT). They are at increased risk of transfusion transmitted bacterial, viral and protozoal diseases. The risk of viral transmission has decreased steadily, but the risk of bacterial transmission remains same. Bacterial contamination is more in platelet concentrates than in red cells and least in plasma. The chances of sepsis, morbidity and mortality depend on the number of transfusions and underlying condition of the patient. Challenges to safe BT continue due to new emerging pathogens and various management problems. Strategies to restrict BT, optimal surgical and anaesthetic techniques to reduce blood loss and efforts to develop transfusion alternatives should be made. Literature search was performed using search words/phrases blood transfusion, transfusion, transfusion transmitted diseases, transfusion transmitted bacterial diseases, transfusion transmitted viral diseases, transfusion transmitted protozoal diseases or combinations, on PubMed and Google Scholar from 1990 to 2014.
Das, Rekha; Hansda, Upendra
Integrated prevention services for HIV infection, viral hepatitis, sexually transmitted diseases, and tuberculosis for persons who use drugs illicitly: summary guidance from CDC and the U.S. Department of Health and Human Services.
This report summarizes current (as of 2011) guidelines or recommendations published by multiple agencies of the U.S. Department of Health and Human Services (DHHS) for prevention and control of human immunodeficiency virus (HIV) infection, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB) for persons who use drugs illicitly. It also summarizes existing evidence of effectiveness for practices to support delivery of integrated prevention services. Implementing integrated services for prevention of HIV infection, viral hepatitis, STDs, and TB is intended to provide persons who use drugs illicitly with increased access to services, to improve timeliness of service delivery, and to increase effectiveness of efforts to prevent infectious diseases that share common risk factors, behaviors, and social determinants. This guidance is intended for use by decision makers (e.g., local and federal agencies and leaders and managers of prevention and treatment services), health-care providers, social service providers, and prevention and treatment support groups. Consolidated guidance can strengthen efforts of health-care providers and public health providers to prevent and treat infectious diseases and substance use and mental disorders, use resources efficiently, and improve health-care services and outcomes in persons who use drugs illicitly. An integrated approach to service delivery for persons who use drugs incorporates recommended science-based public health strategies, including 1) prevention and treatment of substance use and mental disorders; 2) outreach programs; 3) risk assessment for illicit use of drugs; 4) risk assessment for infectious diseases; 5) screening, diagnosis, and counseling for infectious diseases; 6) vaccination; 7) prevention of mother-to-child transmission of infectious diseases; 8) interventions for reduction of risk behaviors; 9) partner services and contact follow-up; 10) referrals and linkage to care; 11) medical treatment for infectious diseases; and 12) delivery of integrated prevention services. These strategies are science-based, public health strategies to prevent and treat infectious diseases, substance use disorders, and mental disorders. Treatment of infectious diseases and treatment of substance use and mental disorders contribute to prevention of transmission of infectious diseases. Integrating prevention services can increase access to and timeliness of prevention and treatment. PMID:23135062
Assesses the current sexual health status of Canadian youth in relation to sexually transmitted diseases, pregnancy rates, and sexual practices, discussing the social and historical context of adolescence and adolescent sexuality in Canada. The paper draws insights from international comparisons of adolescent sexual health indicators and discusses…
Identification and vaccination of adults at risk for hepatitis B virus acquisition through sexual contact is a key strategy to reduce new hepatitis B virus infections among at-risk adults. Hepatitis C has emerged as a sexually transmitted infection among men with male sex partners (MSM). Several biological and behavioral factors have been linked to hepatitis C virus transmission among MSM, including human immunodeficiency virus coinfection; participation in sexual practices that result in mucosal damage or result in exposure to blood; presence of sexually transmitted diseases (STIs), particularly ulcerative STIs; multiple/casual sex partners; and unprotected anal intercourse. PMID:24275272
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
O’Hara, Ross E.; Gibbons, Frederick X.; Gerrard, Meg; Li, Zhigang; Sargent, James D.
This study examined the relationship of childhood sexual abuse to high-risk sexual behavior and between sexual abuse and expectations for condom use. Among 83 female clinic patients with sexually transmitted diseases, those sexually abused in childhood had more sexual partners, more positive hedonic outcome expectations for condom use, and fewer…
Thompson, Nancy J.; And Others
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
Ahmed, Asif; Rushworth, Jo V; Hirst, Natalie A; Millner, Paul A
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…
Quincy, Michael L.
VINCLOZOLIN (V) TREATMENT INDUCES REPRODUCTIVE MALFORMATIONS AND INFERTILITY IN F1 MALE RATS WHEN ADMINISTERED DURING SEXUAL BUT NOT GONADAL DIFFERENTIATION. THE EFFECTS ARE NOT TRANSMITTED TO THE SUBSEQUENT GENERATIONS.
V produces adverse reproductive effects in male rats when administered during sexual differentiation by acting as an androgen-antagonist. It was recently reported that four generations of SD rats, derived from dams dosed via ip injection GD8-15 with 100 mg V/kg/day, displayed pro...
UC Berkeley Sexually Transmitted Infection (STI) Risk Assessment Please answer these questions as honestly as possible. This risk assessment is for your personal use. If you would like to discuss this
experiencing symptoms, you should seek treatment. Call 642-2000 for an appointment. If you would like to learn more about STI prevention, consider making an appointment with a sexual health peer educator. Relationships 1. What is your current relationship status? No steady partner Multiple partners Steady partner
Researchers have identified a strong link between sexual compulsivity (SC) and risky sexual behavior among men who have sex with men (MSM). Meanwhile, affect\\/mood has also been connected with negative sexual health outcomes (sexually transmitted infection\\/human immunodeficiency virus [HIV] transmission, sexual risk, sex under the influence of drugs\\/alcohol). Given that SC is characterized by marked distress around one's own sexual
Christian Grov; Sarit A. Golub; Brian Mustanski; Jeffrey T. Parsons
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…
Barr, Elissa M.; Goldfarb, Eva S.; Russell, Susan; Seabert, Denise; Wallen, Michele; Wilson, Kelly L.
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…
Floyd, Leah J.; Latimer, William
Prevention and control of the sexual transmission of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) requires attention to the characteristics of the sexual interactions between people that determine whether or not sex can be protected. These interactions are influenced by a diversity of factors, including gender inequalities, societal norms, power, socioeconomic status, knowledge, and personality. The poor, the marginalized, the young, and many women are at a disadvantage in protecting themselves from sexual exploitation and sexually transmitted diseases. Programs that seek to instill self-confidence and sexual negotiation skills in individuals overlook the pervasive influence of cultural norms. The focus of AIDS prevention programs must shift from the empowerment of individuals to community-wide considerations of sexual health. Finally, any program that seeks to encourage young people to redefine social norms governing their sexual relationships must also reach out to the adults (from parents to community leaders) who wield power over these young people. PMID:12291984
An overview is presented of high-frequency (HF) broadcast transmitting antennas. For long-range broadcasting, high-power wideband directive antennas with slewing and beam shaping capabilities are needed. The design requirements, state-of-the-art, and the future trend of these antennas are discussed. Also discussed are the power-handling capability of the antenna, its mechanical requirements, and siting conditions. Currently available HF broadcast antennas are examined.
Staff from two neighbouring trusts working in the fields of family planning and sexual health worked together to develop joint guidelines and from this evolved a training initiative. It was acknowledged that staff were either primarily trained in family planning or in the management of sexually transmitted infections (ST1) and therefore the training would be interdisciplinary. In line with current educational thinking it was also decided to make it multiprofessional. A pilot training project was therefore set up to answer the question 'can self directed learning combined with facilitated small group study sessions provide theoretical updating for a range of health professionals within the field of reproductive and sexual health'. The project aimed to increase theoretical knowledge of contraception, sexually transmitted infections and termination of pregnancy for all relevant nursing and medical staff working within the two trusts. The stated outcome of the project was for all staff to achieve a wider core knowledge of the identified topics, regardless of whether their primary training and knowledge base was in family planning or sexually transmitted infection. The project spanned five months and offered professional development packages in hormonal contraception, non-hormonal contraception, termination of pregnancy, bacterial and minor STIs and viral STIs. The pilot project was well received and the process was shown to be an effective way of increasing the knowledge base. The knowledge shift was greatest in the opposing discipline to the primary discipline of each participant. There were added advantages in team building for staff within the same trust and networking across trusts. The strengths and weaknesses of the process were identified and used to develop ideas for future professional development initiatives. PMID:10023098
Reader, F C; Hunt, K; Passmore, H; Royce, S; Adapa, U
A broad definition of men's reproductive and sexual health (MRSH) includes medical (pathophysiological) matters such as sexually transmitted infections (STIs), developmental anomalies, malignancy, trauma, and infertility. It also includes psychosocial concerns: sexuality, contraception, disease prophylaxis, developmental and lifecycle issues, tobacco and drug use, sexual identity and orientation, and partnership issues. College men, of whom a large majority are sexually active, have a range of MRSH needs, including some that are particular to their age and social environment. To reach men effectively requires approaches that are somewhat different from those used with women. Clinicians in college health services are in an excellent position to help young men recognize the importance of reproductive health and sexual responsibility. College health services therefore should offer men screening; clinical diagnosis and treatment for MRSH conditions; and information, education, and counseling services, in a manner designed to meet their unique needs. PMID:11413943
Forrest, K A
The Deep Space Optical Terminal (DOT) transmit module demonstrates the DOT downlink signaling in a flight electronics assembly that can be qualified for deep space. The assembly has the capability to generate an electronic pulse-position modulation (PPM) waveform suitable for driving a laser assembly to produce the optical downlink signal. The downlink data enters the assembly through a serializer/ deserializer (SERDES) interface, and is encoded using a serially concatenated PPM (SCPPM) forward error correction code. The encoded data is modulated using PPM with an inter-symbol guard time to aid in receiver synchronization. Monitor and control of the assembly is via a low-voltage differential signal (LVDS) interface
Quirk, Kevin J.; Gin, Jonathan W.; Sahasrabudhe, Adit; Patawaran, Ferze D.; Nguyen, Danh H.; Nguyen, Huy
Purpose: In response to rising prevalence of sexually transmitted infection (STI) among teenagers, this study was designed to examine teenage perceptions of sex education, access to services, and attitudes relevant to STI. Design/methodology/approach: A focus group study was conducted in three schools to discuss the sexual health needs of…
Lester, Carolyn; Allan, Alexandra
In December 2013, during a Zika virus (ZIKV) outbreak in French Polynesia, a patient in Tahiti sought treatment for hematospermia, and ZIKV was isolated from his semen. ZIKV transmission by sexual intercourse has been previously suspected. This observation supports the possibility that ZIKV could be transmitted sexually. PMID:25625872
Roche, Claudine; Robin, Emilie; Nhan, Tuxuan; Teissier, Anita; Cao-Lormeau, Van-Mai
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…
Morales-Campos, Daisy Y.; Markham, Christine; Peskin, Melissa Fleschler; Fernandez, Maria E.
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…
King, Bruce M.
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…
Silver, Ellen Johnson; Bauman, Laurie J.
The epidemiology of HIV transmission, and hence AIDS, depends upon phenomena such as sexual mixing patterns, about which very little is known. Mathematical models of sexually transmitted HIV assume random mixing among susceptible and infected individuals, across differing levels of sexual activity. Given that this representation of sexual mixing is probably wrong (in the sense of descriptive accuracy), should such
Edward H. Kaplan
BACKGROUND: Risky sexual behaviors of young adults have received increasing attention during the last decades. However, few studies have focused on the sexual behavior of young adults in shantytowns of Latin America. Specifically, studies on the association between sexual behaviors and other risk factors for sexually transmitted infections (STI) and HIV\\/AIDS transmission, such as the consumption of illicit drugs or
Juan A Gálvez-Buccollini; Suzanne DeLea; Phabiola M Herrera; Robert H Gilman; Valerie Paz-Soldan
\\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
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…
Novilla, M. Lelinneth B.; Dearden, Kirk A.; Crookston, Benjamin T.; De La Cruz, Natalie; Hill, Susan; Torres, Scott B.
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
Gaspari, V; D'Antuono, A; Bellavista, S; Trimarco, R; Patrizi, A
Sexuality-related constructs such as sexual arousal, sexual sensation seeking (SSS) and sexual satisfaction have been related to sexual behaviors that place one at risk for adverse consequences such as sexually transmitted infections (STIs), HIV, and unintended pregnancy. The biopsychosocial model posits an array of factors, ranging from social environmental factors, biological, and psychological predispositions that may be associated with these sexuality constructs in adolescent samples. African-American females aged 14-20 were recruited from reproductive health clinics for an HIV intervention. Baseline survey and follow-up DNA data (N=304) was used to assess biological, psychological and social environmental associations with the sexuality constructs of arousal, SSS, and sexual satisfaction. In multivariable linear regressions, a higher depressive symptom rating was associated with higher arousability while short serotonin allele(s) status was associated with lower arousability. Impulsivity and perceived peer norms supportive of unsafe sexual behaviors were associated with increased SSS, and short serotonin allele(s) status was associated with lower SSS. Higher social support was also associated with higher levels of sexual satisfaction while short serotonin allele(s) status was associated with lower satisfaction. The sexuality constructs were also significantly related to number of sex partners, frequency of vaginal sex, and number of unprotected vaginal sex acts in the past six months. These findings emphasize the importance of understanding biopsychosocial factors, including the role of serotonin as an indicator of natural variations in sexual inclination and behaviors, that influence sexuality constructs, which in turn are associated with sexual behaviors, to allow further refinement of sexual health clinical services and programs and promote the development of healthy sexuality. PMID:24262218
Sales, Jessica M.; Smearman, Erica; Brody, Gene H.; Milhausen, Robin; Philibert, Robert A.; DiClemente, Ralph J.
Women of childbearing age have health-care needs related to sexuality. The health-care needs that are most obvious are the need for contraception and the need for the prevention and treatment of vaginal and sexually transmitted infections. Although providers may have questions related to sexual activity, sexual orientation, sexual practices, sexual satisfaction, and intimate partner violence on patient history forms, they often offer little discussion on issues related to sexuality unless the patient raises the issues. Women's sexuality is intensely personal and individual. Changes may occur in sexuality during pregnancy or as a response to infertility. These changes may be physical or emotional. During her prepregnancy and prenatal care, a woman may meet with a range of health-care providers, including childbirth educators, lactation consultants, nurses, midwives, and physicians. It is within the scope of practice of each of these clinicians to address sexuality concerns, validate women's feelings, and provide suggestions of modifications in sexual practices to meet women's needs for sexual expression within the range of activities that are safe and acceptable.
Lewis, Judith A.; Black, Jennifer J.
Human papillomaviruses (HPVs) are estimated to be the most common sexually transmitted virus in humans. The virus is of great interest as it is the etiological agent of cervical cancer. Sexual transmission of HPV is generally accepted, however, non-sexual transmission of the virus is often debated. Here, we review the evidence from basic research and clinical studies that show HPV can survive well outside of its host to potentially be transmitted by non-sexual means. In doing so, we hope to discover problems in current prevention practices and show a need for better disinfectants to combat the spread of HPV. PMID:25199987
Ryndock, Eric J; Meyers, Craig
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 ...
Gerber, Daniel L
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
Vatano?lu, Emine Elif; Ataman, Ahmet Do?an
... français) Hindi (??????) Japanese (???) Korean (???) Oromo (Afaan Oromo) Portuguese (português) Russian (???????) Somali (af Soomaali) Spanish ( ... Bilingual PDF Health Information Translations Return to top Oromo (Afaan Oromo) Chancroid English Murmuraa - Afaan Oromo (Oromo) ...
... be cured. Fact:STDs caused by viruses—genital herpes, genital warts, and HIV/AIDS—cannot , although some ... treated early. HIV: Certain STDs, like syphilis and herpes, can increase the risk of getting and spreading ...
and infertility. Although the microorganism can be cleared from infected individuals by antibiotic treatment infection, including treatment for infertility, has been estimated to be billions of dollars per year
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
Tracey Chapman; Göran Arnqvist; Jenny Bangham; Locke Rowe
This article discusses basic concepts of sexuality in children, adolescents, and young adults based on development stages. Sexual behavior of adolescents is a common phenomenon, leading to sexually transmitted diseases (STDs) and unwanted pregnancy. Clinicians should provide anticipatory guidance to help with healthy sexuality