Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases⋆

PubMed Central

Swendeman, Dallas; Basu, Ishika; Das, Sankari; Jana, Smarajit; Rotheram-Borus, Mary Jane

2010-01-01

The Sonagachi Project was initiated in Kolkata, India in 1992 as a STD/HIV intervention for sex workers. The project evolved to adopt strategies common to women’s empowerment programs globally (i.e., community mobilization, rights-based framing, advocacy, micro-finance) to address common factors that support effective, evidence-based HIV/STD prevention. The Sonagachi model is now a broadly diffused evidence-based empowerment program. We previously demonstrated significant condom use increases among female sex workers in a 16 month replication trial of the Sonagachi empowerment intervention (n = 110) compared to a control community (n = 106) receiving standard care of STD clinic, condom promotion, and peer education in two randomly assigned rural towns in West Bengal, India (Basu et al., 2004). This article examines the intervention’s impacts on 21 measured variables reflecting five common factors of effective HIV/STD prevention programs to estimate the impact of empowerment strategies on HIV/STD prevention program goals. The intervention which was conducted in 2000–2001 significantly: 1) improved knowledge of STDs and condom protection from STD and HIV, and maintained STD/HIV risk perceptions despite treatment; 2) provided a frame to motivate change based on reframing sex work as valid work, increasing disclosure of profession, and instilling a hopeful future orientation reflected in desire for more education or training; 3) improved skills in sexual and workplace negotiations reflected in increased refusal, condom decision-making, and ability to change work contract, but not ability to take leave; 4) built social support by increasing social interactions outside work, social function participation, and helping other sex workers; and 5) addressed environmental barriers of economic vulnerabilities by increasing savings and alternative income, but not working in other locations, nor reduced loan taking, and did not increase voting to build social capital. This study’s results demonstrate that, compared to narrowcast clinical and prevention services alone, empowerment strategies can significantly impact a broader range of factors to reduce vulnerability to HIV/STDs. PMID:19716639

Empowering sex workers in India to reduce vulnerability to HIV and sexually transmitted diseases.

PubMed

Swendeman, Dallas; Basu, Ishika; Das, Sankari; Jana, Smarajit; Rotheram-Borus, Mary Jane

2009-10-01

The Sonagachi Project was initiated in Kolkata, India in 1992 as a STD/HIV intervention for sex workers. The project evolved to adopt strategies common to women's empowerment programs globally (i.e., community mobilization, rights-based framing, advocacy, micro-finance) to address common factors that support effective, evidence-based HIV/STD prevention. The Sonagachi model is now a broadly diffused evidence-based empowerment program. We previously demonstrated significant condom use increases among female sex workers in a 16 month replication trial of the Sonagachi empowerment intervention (n=110) compared to a control community (n=106) receiving standard care of STD clinic, condom promotion, and peer education in two randomly assigned rural towns in West Bengal, India (Basu et al., 2004). This article examines the intervention's impacts on 21 measured variables reflecting five common factors of effective HIV/STD prevention programs to estimate the impact of empowerment strategies on HIV/STD prevention program goals. The intervention which was conducted in 2000-2001 significantly: 1) improved knowledge of STDs and condom protection from STD and HIV, and maintained STD/HIV risk perceptions despite treatment; 2) provided a frame to motivate change based on reframing sex work as valid work, increasing disclosure of profession, and instilling a hopeful future orientation reflected in desire for more education or training; 3) improved skills in sexual and workplace negotiations reflected in increased refusal, condom decision-making, and ability to change work contract, but not ability to take leave; 4) built social support by increasing social interactions outside work, social function participation, and helping other sex workers; and 5) addressed environmental barriers of economic vulnerabilities by increasing savings and alternative income, but not working in other locations, nor reduced loan taking, and did not increase voting to build social capital. This study's results demonstrate that, compared to narrowcast clinical and prevention services alone, empowerment strategies can significantly impact a broader range of factors to reduce vulnerability to HIV/STDs.

Comparison of clients of a mobile health van and a traditional STD clinic.

PubMed

Ellen, Jonathan M; Bonu, Sekhar; Arruda, Jaime S; Ward, Michael A; Vogel, Ruth

2003-04-01

The objective of this study was to determine if there were any demographic, behavioral, and clinical differences between clients seen aboard a mobile sexually transmitted disease (STD)/HIV clinic compared with those seen in a traditional municipal STD/HIV health clinic for receipt of STD/HIV services. Clients seen in the two different settings were interviewed about demographic characteristics, reasons for their visit, STD history, their HIV/STD risk factors, and the risk factors of their sex partners. Clients in both settings were also offered testing for syphilis, gonorrhea, chlamydia, and HIV. Results suggested that clients seen at the mobile clinic were older, more likely to be injecting drug users themselves and/or to have sex partners who were, or had engaged in prostitution for money or drugs. Over half (54.4%) of the mobile clinic clients sought testing for HIV, and they were far less likely to be seeking care for symptoms of an STD. In contrast, only 7.1% of municipal clinic clients indicated HIV testing as the reason for their visit, whereas nearly two thirds (64.5%) reported symptoms of disease. Two percent of municipal clinic clients and 5.4% of mobile clinic clients had a positive HIV test ( p<.001), and 17.8% of STD clinic clients and 5.6% of mobile van clients had a positive gonorrhea and/or test ( p<.001). These data suggest that a mobile STD/HIV clinic may be an effective strategy to reach individuals at high risk for HIV who are not being served by traditional municipal STD/HIV health clinics.

US Public Sexually Transmitted Disease Clinical Services in an Era of Declining Public Health Funding: 2013-14.

PubMed

Leichliter, Jami S; Heyer, Kate; Peterman, Thomas A; Habel, Melissa A; Brookmeyer, Kathryn A; Arnold Pang, Stephanie S; Stenger, Mark R; Weiss, Gretchen; Gift, Thomas L

2017-08-01

We examined the infrastructure for US public sexually transmitted disease (STD) clinical services. In 2013 to 2014, we surveyed 331 of 1225 local health departments (LHDs) who either reported providing STD testing/treatment in the 2010 National Profile of Local Health Departments survey or were the 50 local areas with the highest STD cases or rates. The sample was stratified by jurisdiction population size. We examined the primary referral clinics for STDs, the services offered and the impact of budget cuts (limited to government funding only). Data were analyzed using SAS, and analyses were weighted for nonresponse. Twenty-two percent of LHDs cited a specialty STD clinic as their primary referral for STD services; this increased to 53.5% of LHDs when combination STD-family planning clinics were included. The majority of LHDs (62.8%) referred to clinics providing same-day services. Sexually transmitted disease clinics more frequently offered extragenital testing for chlamydia and/or gonorrhea (74.7%) and gonorrhea culture (68.5%) than other clinics (52.9%, 46.2%, respectively; P < 0.05). The majority of LHDs (61.5%) reported recent budget cuts. Of those with decreased budgets, the most common impacts were fewer clinic hours (42.8%; 95% confidence interval [CI], 24.4-61.2), reduced routine screening (40.2%; 95% CI, 21.7-58.8) and reductions in partner services (42.1%; 95% CI, 23.6-60.7). One quarter of those with reduced STD budgets increased fees or copays for clients. Findings demonstrate gaps and reductions in US public STD services including clinical services that play an important role in reducing disease transmission. Furthermore, STD clinics tended to offer more specialized STD services than other public clinics.

[Screening of sexually transmitted diseases in clinical and non-clinical settings in Salvador, Bahia, Brazil].

PubMed

de Codes, José Santiago; Cohen, Deborah Ann; de Melo, Neli Almeida; Teixeira, Guilherme Gonzaga; Leal, Alexandre dos Santos; Silva, Tiago de Jesus; de Oliveira, Miucha Pereira Rios

2006-02-01

The objectives were to study: (1) acceptance of STD screening in non-clinical settings for asymptomatic individuals; (2) risk factors and STD prevalence among individuals in non-clinical and clinical settings; and (3) non-clinical screening of asymptomatic populations as a feasible method for STD control. We recruited 139 males and 486 females between 18 and 30 years of age from a family planning clinic, schools, and community centers in low-income neighborhoods. We asked about STD symptoms and STD/HIV risk behaviors and tested the individuals for gonorrhea, Chlamydia, syphilis, and HIV. Except for HIV, women recruited directly from the community had higher STD rates than those who came in for care at the clinic. Screening in non-clinical settings in Brazil is feasible and has a high yield among young adults in low-income communities. Infected participants would likely never have otherwise sought care or been tested or treated. STD control efforts could be implemented in any site that can reach populations at risk and become a routine procedure in health care settings where people report for problems unrelated to STDs.

Unintended Pregnancy and Its Correlates among Female Attendees of Sexually Transmitted Disease Clinics in Eastern China

PubMed Central

Ma, Qiaoqin; Pan, Xiaohong; Cai, Gaofeng; Yan, Jiezhe; Xu, Yun; Ono-Kihara, Masako; Kihara, Masahiro

2013-01-01

This study is to determine the prevalence of unintended pregnancy and its risk factors among the female attendees of sexually transmitted disease (STD) clinics in Zhejiang Province, China. A self-administered questionnaire survey of a cross-sectional design was administered to attendees at four STD clinics in 2007. Of the 313 female STD clinic attendees, 42.5% reported that they had at least one unintended pregnancy; the induced abortion rate was 39.0%. Over their lifetime, 12.1% responded “use condoms always/often” and 5.4% “always/often used oral contraceptives.” The risk factors for the unintended pregnancy identified by the multivariate analysis were as follows: being married, experience of nonconsensual sex, and a history of STD, having two and over two sexual partners. Unintended pregnancies and induced abortion by female STD clinic attendees have reached an alarming prevalence. Doctors at STD clinics should attach importance not only to the STD problem of the female attendees, but also to the unintended pregnancy and the associated factors. Targeted contraceptive counseling and intervention should be promoted at STD clinics as a strategy to improve the efficiency and effectiveness of the reproductive health services in China. PMID:23841063

Unintended pregnancy and its correlates among female attendees of sexually transmitted disease clinics in Eastern China.

PubMed

Ma, Qiaoqin; Pan, Xiaohong; Cai, Gaofeng; Yan, Jiezhe; Xu, Yun; Ono-Kihara, Masako; Kihara, Masahiro

2013-01-01

This study is to determine the prevalence of unintended pregnancy and its risk factors among the female attendees of sexually transmitted disease (STD) clinics in Zhejiang Province, China. A self-administered questionnaire survey of a cross-sectional design was administered to attendees at four STD clinics in 2007. Of the 313 female STD clinic attendees, 42.5% reported that they had at least one unintended pregnancy; the induced abortion rate was 39.0%. Over their lifetime, 12.1% responded "use condoms always/often" and 5.4% "always/often used oral contraceptives." The risk factors for the unintended pregnancy identified by the multivariate analysis were as follows: being married, experience of nonconsensual sex, and a history of STD, having two and over two sexual partners. Unintended pregnancies and induced abortion by female STD clinic attendees have reached an alarming prevalence. Doctors at STD clinics should attach importance not only to the STD problem of the female attendees, but also to the unintended pregnancy and the associated factors. Targeted contraceptive counseling and intervention should be promoted at STD clinics as a strategy to improve the efficiency and effectiveness of the reproductive health services in China.

High-risk behaviour in young men attending sexually transmitted disease clinics in Pune, India

PubMed Central

BRAHME, R. G.; SAHAY, S.; MALHOTRA-KOHLI, R.; DIVEKAR, A. D.; GANGAKHEDKAR, R. R.; PARKHE, A. P.; KHARAT, M. P.; RISBUD, A. R.; BOLLINGER, R. C.; MEHENDALE, S. M.; PARANJAPE, R. S.

2012-01-01

The present study reports sexual risk factors associated with HIV infection among men attending two sexually transmitted disease (STD) clinics in Pune, India and compares these behaviours between young and older men. Between April 1998 and May 2000, 1,872 STD patients were screened for HIV infection. Data on demographics, medical history and sexual behaviour were collected at baseline. The overall HIV prevalence was 22.2%. HIV risk was associated with being divorced or widowed, less educated, living away from the family, having multiple sexual partners and initiation of sex at an early age. The risk behaviours in younger men were different to older men. Younger men were more likely to report early age of initiation of sex, having friends, acquaintances or commercial sex workers as their regular partners, having premarital sex and bisexual orientation. Young men were more educated and reported condom use more frequently compared with the older men. Similar high HIV prevalence among younger and older men highlights the need for focused targeted interventions aimed at adolescents and young men and also appropriate interventions for older men to reduce the risk of HIV and STD acquisition. PMID:15832886

STD education: challenge for the 80s.

PubMed

Kroger, F; Wiesner, P J

1981-04-01

Discussion focuses on 3 aspects of sexually transmitted diseases (STD) education: the need for and appropriateness of school-based STD education; some elements of timely, high quality STD education; and strategies for dealing constructively with controversy. More than half of the estimated 20 million STD victims in the US this year will be persons under age 25. Almost 1/4 will be victims of STD before they receive their high school diplomas. STD are the most pervasive, destructive, and expensive communicable disease problems facing American youth. If the twin criteria of true experimental design and of measuring appropriate outcomes are applied to published studies, then the effectiveness of classroom STD education has not as yet been properly evaluated. The evaluation criteria which should be applied to health education programs are uniquely based on nonacademic goals, that is, ultimate outcomes are generally not observable in the academic environment. The federal government has been virtually precluded from supporting or conducting appropriate behavioral studies because of laws protecting individual privacy, and most school systems are similarly restricted when it comes to asking students about their personal or family lives, of which sexual matters are among the most intimate. Programs designed according to accepted concepts of learning and decision making need to be implemented, even if their benefits must be regarded as potential, until such time as research obstacles can be resolved. STD education objectives should be drawn from the behaviors relevant to the prevention, acquisition, transmission, and disposition of an STD. The behaviors are organized into 5 behavioral sets and described here as decision steps: decisions about when, how, and with whom to engage in sexual behavior; decisions specific to health protection if sexual behavior includes genital contact; decisions in response to suspected illness; decisions in response to diagnosed disease; and decisions related to other people. Within each decision step are various alternative choices, some that enhance health and others that jeopardize it. Once behavioral objectives have been formulated, decisions about content should be directed toward predisposing, enabling, or reinforcing those behaviors. Emphasis should be on the following: risk reduction; recognition; response; referral; and responsible resource. No particular instructional methods possess inherent superiority. It is questionable whether young people derive a maximum benefit from STD instruction if they have not initially learned rudimentary physiological and sociological facts of sexual life and how to discuss such matters. School systems should not delay efforts to meet the 1990 goal of high quality, timely STD education for every child in the US. Guidelines for community leaders who plan education programs are listed.

Early awareness and uptake of an effective waiting room video intervention by STD clinics.

PubMed

DeShazo, Jonathan P; Richardson, Douglas B; Malotte, C Kevin; Rietmeijer, Cornelis A

2011-12-01

Successful diffusion and adoption is critical for the effectiveness and impact of a new intervention. The objective of this research was to evaluate the uptake and implementation of a newly released educational waiting room video in US sexually transmitted diseases (STD) Clinics. A telephone survey was administered to a random sample of 73 clinic directors representing 76 US STD clinics 3 to 5 months following the availability of the intervention. A qualitative analysis was used to categorize survey responses and detect associations among them. Of the 76 clinics, 22% were aware of the intervention and 17% had ordered the intervention kit. The most frequently reported sources for hearing about the video were interpersonal communication/word of mouth, national conferences, and the STDPreventionOnline.org Website. The majority (74%) of clinic directors reported using state or local entities as primary sources of new information; however, reporting these channels was associated with unawareness of the new intervention. Facilitators to adoption included having adequate video/DVD equipment (55%) and a separate, nonshared waiting room for STD services in which to show the video (47%). The data from this sample suggest that making greater use of prominent thought leaders and interpersonal communication, including social networking, and professional groups may improve awareness of new interventions. Some barriers to adoption, such as lack of equipment, have relatively inexpensive solutions yet bureaucratic or technical support issues may still play a role. However, some structural barriers, such as shared waiting areas, will require innovative alternatives to conventional practice.

Effectiveness of HIV/STD Sexual Risk Reduction Groups for Women in Substance Abuse Treatment Programs: Results of a NIDA Clinical Trials Network Trial

PubMed Central

Tross, Susan; Campbell, Aimee N. C.; Cohen, Lisa R.; Calsyn, Donald; Pavlicova, Martina; Miele, Gloria; Hu, Mei-Chen; Haynes, Louise; Nugent, Nancy; Gan, Weijin; Hatch-Maillette, Mary; Mandler, Raul; McLaughlin, Paul; El-Bassel, Nabila; Crits-Christoph, Paul; Nunes, Edward V.

2009-01-01

Context Since drug-involved women are among the fastest growing groups with AIDS, sexual risk reduction intervention for them is a public health imperative. Objective Test effectiveness of HIV/STD safer sex skills building (SSB) groups for women in community drug treatment. Design Randomized trial of SSB versus standard HIV/STD Education (HE); assessments at baseline, 3- and 6- months Participants Women recruited from 12 methadone or psychosocial treatment programs in NIDA’s Clinical Trials Network. 515 women with ≥ one unprotected vaginal or anal sex occasion (USO) with a male partner in the past 6 months were randomized. Interventions In SSB, five 90-minute groups used problem-solving and skills rehearsal to increase HIV/STD risk awareness, condom use and partner negotiation skills. In HE, one 60-minute group covered HIV/STD disease, testing, treatment, and prevention information. Main Outcome Number of USOs at follow up. Results A significant difference in mean USOs was obtained between SSB and HE over time (F=67.2, p<.0001). At 3 months, significant decrements were observed in both conditions. At 6 months SSB maintained the decrease, HE returned to baseline (p<.0377). Women in SSB had 29% fewer USOs than those in HE. Conclusions Skills building interventions can produce ongoing sexual risk reduction in women in community drug treatment. PMID:18645513

Effectiveness of HIV/STD sexual risk reduction groups for women in substance abuse treatment programs: results of NIDA Clinical Trials Network Trial.

PubMed

Tross, Susan; Campbell, Aimee N C; Cohen, Lisa R; Calsyn, Donald; Pavlicova, Martina; Miele, Gloria M; Hu, Mei-Chen; Haynes, Louise; Nugent, Nancy; Gan, Weijin; Hatch-Maillette, Mary; Mandler, Raul; McLaughlin, Paul; El-Bassel, Nabila; Crits-Christoph, Paul; Nunes, Edward V

2008-08-15

Because drug-involved women are among the fastest growing groups with AIDS, sexual risk reduction intervention for them is a public health imperative. To test effectiveness of HIV/STD safer sex skills building (SSB) groups for women in community drug treatment. Randomized trial of SSB versus standard HIV/STD Education (HE); assessments at baseline, 3 and 6 months. Women recruited from 12 methadone or psychosocial treatment programs in Clinical Trials Network of National Institute on Drug Abuse. Five hundred fifteen women with >or=1 unprotected vaginal or anal sex occasion (USO) with a male partner in the past 6 months were randomized. In SSB, five 90-minute groups used problem solving and skills rehearsal to increase HIV/STD risk awareness, condom use, and partner negotiation skills. In HE, one 60-minute group covered HIV/STD disease, testing, treatment, and prevention information. Number of USOs at follow-up. A significant difference in mean USOs was obtained between SSB and HE over time (F = 67.2, P < 0.0001). At 3 months, significant decrements were observed in both conditions. At 6 months, SSB maintained the decrease and HE returned to baseline (P < 0.0377). Women in SSB had 29% fewer USOs than those in HE. Skills building interventions can produce ongoing sexual risk reduction in women in community drug treatment.

Reportable STDs in Young People 15-24 Years of Age, by State

MedlinePlus

... STD 101 in a Box Home Script for Sex in the City Video STD Clinical Slides STD Clinical Slides STD Picture ... include: line graphs by year; pie charts for sex; bar charts by state and country; bar charts for age, race/ethnicity, and transmission ... Quicktime file RealPlayer file Text file ...

STDs & HIV: A Guide for Today's Teens. 2nd Edition. Instructor's Guide.

ERIC Educational Resources Information Center

Yarber, William L.

This curriculum represents the current approach to prevention education about sexually transmitted diseases (STD) for students in grades 7-12, combining health messages about STD, including HIV/AIDS, into one curriculum. The instructor's guide discusses adolescents' need for STD/HIV prevention education; presents information about the…

Health system and personal barriers resulting in decreased utilization of HIV and STD testing services among at-risk black men who have sex with men in Massachusetts.

PubMed

Mimiaga, Matthew J; Reisner, Sari L; Bland, Sean; Skeer, Margie; Cranston, Kevin; Isenberg, Deborah; Vega, Benny A; Mayer, Kenneth H

2009-10-01

Testing for HIV and other sexually transmitted diseases (STD) remains a cornerstone of public health prevention interventions. This analysis was designed to explore the frequency of testing, as well as health system and personal barriers to testing, among a community-recruited sample of Black men who have sex with men (MSM) at risk for HIV and STDs. Black MSM (n = 197) recruited via modified respondent-driven sampling between January and July 2008 completed an interviewer-administered assessment, with optional voluntary HIV counseling and testing. Logistic regression procedures examined factors associated with not having tested in the 2 years prior to study enrollment for: (1) HIV (among HIV-uninfected participants, n = 145) and (2) STDs (among the entire mixed serostatus sample, n = 197). The odds ratios and their 95% confidence intervals obtained from this analysis were converted to relative risks. (1) HIV: Overall, 33% of HIV-uninfected Black MSM had not been tested for HIV in the 2 years prior to study enrollment. Factors uniquely associated with not having a recent HIV test included: being less educated; engaging in serodiscordant unprotected sex; and never having been HIV tested at a community health clinic, STD clinic, or jail. (2) STDs: Sixty percent had not been tested for STDs in the 2 years prior to study enrollment, and 24% of the sample had never been tested for STDs. Factors uniquely associated with not having a recent STD test included: older age; having had a prior STD; and never having been tested at an emergency department or urgent care clinic. Overlapping factors associated with both not having had a recent HIV or STD test included: substance use during sex; feeling that using a condom during sex is "very difficult"; less frequent contact with other MSM; not visiting a health care provider (HCP) in the past 12 months; having a HCP not recommend HIV or STD testing at their last visit; not having a primary care provider (PCP); current PCP never recommending they get tested for HIV or STDs. In multivariable models adjusting for relevant demographic and behavioral factors, Black MSM who reported that a HCP recommended getting an HIV test (adjusted relative risk [ARR] = 0.26; p = 0.01) or STD test (ARR = 0.11; p = 0.0004) at their last visit in the past 12 months were significantly less likely to have not been tested for HIV or STDs in the past 2 years. Many sexually active Black MSM do not regularly test for HIV or STDs. HCPs play a pivotal role in encouraging testing for Black MSM. Additional provider training is warranted to educate HCPs about the specific health care needs of Black MSM, in order to facilitate access to timely, culturally competent HIV and STD testing and treatment services for this population.

Sexually transmitted diseases in women--something can be done!

PubMed

Felman, Y M

1981-03-01

Women with sexually transmitted diseases (STDs) are largely asymptomatic, and even in the presence of symptoms are frequently misdiagnosed. The "stigma of VD" perpetuates this problem, such that both patient and physician are too embarrassed to suggest appropriate STD diagnostic tests. Imperatives for the reduction of STDs include increasing federal appropriations for STD control, improving STD training for health professionals, openly advertising condoms, and equipping clinical facilities likely to see women harboring STDs with the means to diagnose and treat. The development of serologic tests and vaccines against gonorrhea, chlamydia and herpes is an additional objective that would benefit women. A multifaceted approach combining the efforts of women's groups, family physicians, gynecologists, nurse practitioners and public health educators will be required to effectively handle the problem of STDs in women.

Risk behaviors and sexually transmitted diseases in gay and heterosexual men attending an STD clinic in Tel Aviv, Israel: a cross-sectional study.

PubMed

Mor, Zohar; Shohat, Tamy; Goor, Yael; Dan, Michael

2012-03-01

The increase in human immunodeficiency virus (HIV) among men who have sex with men (MSM) in Israel during the last decade raises concerns regarding other sexuallytransmitted diseases (STD) in MSM, which are yet undetermined. To evaluate the STD burden among MSM and heterosexuals visiting the Tel Aviv walk-in STD clinic. Records of all male patients who attended the clinic once were reviewed to identify demographic characteristics, behavioral attributes, and test results. Between 2002 and 2008, 1064 MSM (22%) and 3755 heterosexuals (78%) visited the clinic once. Positivity rates in MSM for HIV, urethral Neisseria gonorrhoea and infectious syphilis were higher than in heterosexuals (2.5%, 2.5%. 0.7% vs. 0.6%, 1.3%, 0.3%, respectively), while urethral Chlamydia trachomatis was higher in heterosexuals than in MSM (2.7% and 1.4%, respectively). MSM tested in our clinic were younger than heterosexuals (P<0.001), more commonly circumcised (P=0.03) and Israeli-born (P<0.001), used substances during sex (P=0.04), and had prior STD (P<0.001), a greater number of sexual partners (P<0.001), and earlier sexual debut (P=0.02). The final multivariate results for MSM to be diagnosed with HIV/STD were greater number of sexual contacts, previous diagnosis with STD, and infrequent use of condom during anal intercourse. MSM visiting the Levinsky Clinic had higher rates of HIV/STD than heterosexual males, which correlated with their higher-risk behaviors. The unique characteristics of MSM found in our study, such as sex work, substance use, previous diagnosis of STD, multiple partners and inconsistent use of condom during anal sex should be addressed with innovative interventions to prevent STD/HIV in the gay community in Israel.

Assessing the effects of a sexually transmitted disease educational intervention on fraternity and sorority members' knowledge and attitudes toward safe sex behaviors.

PubMed

Goldsberry, Jennifer; Moore, Leslie; MacMillan, Deborah; Butler, Scott

2016-04-01

College years are a time young adults examine high-risk sexual behaviors, increasing their risk for sexually transmitted diseases (STDs). Fraternity/sorority membership has been identified as one factor contributing to increased risky sexual behavior in college students. This study measured the effectiveness of an educational intervention targeting STD prevention in fraternity and sorority members, and examined relationships between STD knowledge, attitudes, and demographics. A descriptive, correlational design was used. Pre- and posttest data were collected from fraternity and sorority members (N = 132). Instruments measured demographic characteristics, STD knowledge, and attitudes toward safe sex behaviors. There was a significant increase in STD knowledge from baseline (M = 13.03, SD = 6.5) to 1 week (M = 20.27, SD = 4.9) t (131) = -13.53, p = .000. Males were more likely to report attitudes toward risky sexual behavior rs(132) = .323, p = .000, and as knowledge increased, attitudes became more favorable to safe sex behaviors (pre-STD knowledge and preintervention attitudes, r(132) = -.249, p = .004; post-STD knowledge and postintervention attitudes, rs(132) = -.307, p = .000). Results support that brief STD educational interventions can increase STD knowledge. College health centers must aim to provide sexual health education to all students at every visit. ©2016 American Association of Nurse Practitioners.

The intersection of violence, substance use, depression, and STDs: testing of a syndemic pattern among patients attending an urban STD clinic.

PubMed

Senn, Theresa E; Carey, Michael P; Vanable, Peter A

2010-07-01

High rates of psychosocial and health problems have been identified among patients attending sexually transmitted disease (STD) clinics, who are disproportionately urban, have low income, and are racial/ethnic minorities. This study sought to determine whether these problems co-occurred and whether they indicated the presence of a syndemic. Patients (N = 1557, 46% female, 64% African American) attending an urban STD clinic completed a computerized survey assessing childhood sexual abuse (CSA), depressive symptoms, binge drinking, marijuana use, intimate partner violence (IPV), and sexual risk behavior. Medical records were reviewed to determine incident STD diagnosis. The psychosocial and health problems were interrelated. Endorsing more psychosocial problems was associated with a greater likelihood of having multiple sexual partners and STD diagnosis. Interactions between CSA and marijuana use and between CSA and IPV predicted STD diagnosis. Numerous psychosocial and health problems co-occur among urban STD clinic patients. There was some evidence of a syngergistic relationship (i.e., a syndemic) between these conditions, resulting in worsened sexual health outcomes. Health care needs to be multidisciplinary to address the multiple psychosocial and health problems faced by STD clinic patients. Research needs to identify factors that may underlie these comorbid conditions.

A CLINICAL AND BEHAVIOURAL STUDY OF HIV INFECTED SUBJECTS-A COMPARISON WITH STD SUBJECTS

PubMed Central

Rao, A. Venkoba; Swaminathan, R.; Venkataram, M.K.; Ramajayam, S.; Parhee, Rashmi; Kumar, Narendra; Luthra, Usha K.

1991-01-01

SUMMARY Eightyfive HIV seropositive subjects (M: 42;F:43) were compared with an equal number STD subjects negative for HIV. They formed 1.6% of the total number (N =5287) screened in the STD OP. Heterosexual transmission was predominant. A significantly higher promiscuity and a larger number of sex partners and contacts were observed in the female but not the male HIV subjects. The ages at first coital experience were similar in both the groups. There was no difference in the occurrence of either STDs or psychiatric illness at index examination between the two groups. The symptom profile of psychiatric illness in the HIV subjects did not differ from that of the controls. The HIV subjects had more of physical diagnoses than the controls. The psychological responses to the ‘disclosure’ of seropositivity were noted. The closeness of HIV and STD groups on many factors and its implication for management and health education are commented upon. PMID:21897463

Reducing AIDS and other STDs among inner-city Hispanics: the use of qualitative research in the development of video-based patient education.

PubMed

O'Donnell, L; San Doval, A; Vornfett, R; DeJong, W

1994-04-01

We report on the use of qualitative research in the design of video-based interventions aimed at reducing AIDS and other sexually transmitted diseases (STDs) among inner-city Hispanics. Focus groups, personal interviews, and clinic observations were conducted in the South Bronx and Queens, New York, to inform the development of culturally sensitive video-based materials for improving prevention education provided at inner-city STD clinics. Findings elucidate culturally defined gender roles and responsibilities regarding the introduction of condom use into primary and nonprimary relationships, as well as other norms, attitudes, and behaviors reducing the effectiveness of current AIDS and other STD prevention efforts. Too often, educational materials--including an increasing number of videos--are based on untested assumptions about what information should be provided rather than adequate formative research. One reason may be that the literature contains few accounts of how the empirical evidence obtained through such research can be translated into theoretically sound interventions. This paper explicates such a process.

Completing the circle: follow-up screening of STD patients in three clinics of the United States Indian Health Service.

PubMed

Reilley, B; Redd, J T; Giberson, S; Sunde, S; Cullen, T

2011-01-01

We reviewed charts of newly diagnosed STD patients in three health facilities to determine the proportion who received follow-up STD screening. In a 12-month period, the three facilities had 140 STD cases. STD screening was not indicated for 50 (36%) patients. Among the 90 remaining STD patients, 29 (32%) were screened and 61 (68%) not screened. Among non-screened patients, 36% (22/61) were tested, but outside the time parameters allowed by the audit. The remaining 64% (39/61) received no screening at all, and represented clinical missed opportunities; in this group, nearly all (95%) had chlamydia but were not screened for HIV or syphilis. Linking chlamydia patients with a screen for HIV and syphilis using a clinical reminder in the facilities' electronic health record (EHR) or other tool, would eliminate 95% of the missed opportunities in this sample.

Insurance and billing concerns among patients seeking free and confidential sexually transmitted disease care: New York City sexually transmitted disease clinics 2012.

PubMed

Washburn, Kate; Goodwin, Chris; Pathela, Preeti; Blank, Susan

2014-07-01

Historically, New York City (NYC) Department of Health and Mental Hygiene (DOHMH) sexually transmitted disease (STD) clinics have operated completely free of charge but will soon begin billing patients for services. To inform billing strategies, we surveyed NYC DOHMH STD clinic patients in fall 2012 to examine response to the prospect of billing insurance and charging sliding-scale fees for services. A total of 5017 individuals were surveyed from all patients accessing clinic services between September and December 2012 at 8 NYC DOHMH STD clinics. The anonymous survey was provided at registration to all patients, in English or Spanish. The data were analyzed to determine patient insurance status and other characteristics related to billing for STD services. More than half of respondents (51.0%) were uninsured, and 42.3% were unemployed. For 20.2% of respondents, billing would pose a considerable barrier to care. Nearly half of those insured (48.4%) said that they would not be willing to share insurance information with the STD clinics. Respondents who said they would not access STD clinic services if charged represent approximately 13,600 individuals each year who, if not promptly diagnosed and treated elsewhere, could be a continuing source of STIs including HIV. Confidentiality concerns and income are potential obstacles to billing insurance or charging a direct fee for STD services. New York City DOHMH plans to take the concerns raised in the survey findings into account when designing our billing system and carefully evaluate its impact to ensure that the need for accessible, confidential STD services continues to be met.

Examining the themes of STD-related Internet searches to increase specificity of disease forecasting using Internet search terms.

PubMed

Johnson, Amy K; Mikati, Tarek; Mehta, Supriya D

2016-11-09

US surveillance of sexually transmitted diseases (STDs) is often delayed and incomplete which creates missed opportunities to identify and respond to trends in disease. Internet search engine data has the potential to be an efficient, economical and representative enhancement to the established surveillance system. Google Trends allows the download of de-identified search engine data, which has been used to demonstrate the positive and statistically significant association between STD-related search terms and STD rates. In this study, search engine user content was identified by surveying specific exposure groups of individuals (STD clinic patients and university students) aged 18-35. Participants were asked to list the terms they use to search for STD-related information. Google Correlate was used to validate search term content. On average STD clinic participant queries were longer compared to student queries. STD clinic participants were more likely to report using search terms that were related to symptomatology such as describing symptoms of STDs, while students were more likely to report searching for general information. These differences in search terms by subpopulation have implications for STD surveillance in populations at most risk for disease acquisition.

Can experiential-didactic training improve clinical STD practices?

PubMed

Dreisbach, Susan; Devine, Sharon; Fitch, John; Anderson, Teri; Lee, Terry; Rietmeijer, Cornelis; Corbett, Kitty K

2011-06-01

High rates of sexually transmitted diseases (STDs) present an ongoing costly public health challenge. One approach to reduce STD transmission is to increase the number of clinicians adopting the Centers for Disease Control and Prevention's STD Treatment Guidelines. This evaluation assesses the effectiveness of a 3-day experiential and didactic training to translate recommendations into practice by increasing clinician knowledge and skills and helping participants anticipate and overcome barriers to implementation. Between 2001 and 2004, 110 direct care clinicians from 10 states participated in one of 27 standardized 3-day interactive trainings offered by the Denver STD/human immunodeficiency virus (HIV) Prevention Training Center. STD/HIV knowledge and clinical skills were measured before, immediately after, and 6 months after training. Practice patterns were assessed before training and after 6 months. Structural barriers to implementation were identified 6 months post-training. Trainees demonstrated significant post-training gains in mean knowledge scores immediately post-training (P < 0.001) and 6 months post-training (P = 0.002). After 6 months, self-reported mean skill levels remained significantly improved compared to precourse (P < 0.05) for each of 27 skills including STD risk assessment, clinical examination, diagnosis, and treatment. Self-reported improvement in practice patterns was significant for 23 of 35 practices (P < 0.05) 6 months post-training. Participants indicated that inadequate time (52.9%), facilities/equipment (51.5%), and staffing (47.1%) interfered with implementation of recommended practices. Experiential-didactic STD/HIV training can modestly improve knowledge, clinical skills, and implementation of STD recommended practices 6 months after training. Further research is needed to identify the impact of improved clinical practices on STD/HIV transmission.

PowerON: the use of instant message counseling and the Internet to facilitate HIV/STD education and prevention.

PubMed

Moskowitz, David A; Melton, Dan; Owczarzak, Jill

2009-10-01

In recent years, Internet-based or online counseling has emerged as an effective way to assess psychological disorders and discuss destructive behaviors with individuals or groups of individuals. This study explores the application of online counseling to HIV/STD risk-taking behavior among men who have sex with men (MSM). PowerON, an organization that provides sexual health information to MSM exclusively online, used instant message technology to counsel MSM in real time through computer-mediated means. A sample of 279 transcripts of instant message exchanges between PowerON counselors and Gay.com users were recorded and qualitatively analyzed. Approximately 43% of the instant message sessions discussed information about HIV/STD testing. Risk-taking behaviors were addressed in 39% of the sessions. Information about HIV/STDs and general counseling were given in 23% and 18% of the counseling sessions, respectively. The data showed these instant message sessions to be a potentially feasible forum for HIV/STD counseling. Information ordinarily disseminated at health clinics could be successfully distributed through the Internet to MSM. 2009 Elsevier Ireland Ltd.

PowerON: The use of instant message counseling and the Internet to facilitate HIV/STD education and prevention

PubMed Central

Moskowitz, David A.; Melton, Dan; Owczarzak, Jill

2015-01-01

Objective In recent years, Internet-based or online counseling has emerged as an effective way to assess psychological disorders and discuss destructive behaviors with individuals or groups of individuals. This study explores the application of online counseling to HIV/STD risk-taking behavior among men who have sex with men (MSM). Methods PowerON, an organization that provides sexual health information to MSM exclusively online, used instant message technology to counsel MSM in real time through computer-mediated means. A sample of 279 transcripts of instant message exchanges between PowerON counselors and Gay.com users were recorded and qualitatively analyzed. Results Approximately 43% of the instant message sessions discussed information about HIV/STD testing. Risk-taking behaviors were addressed in 39% of the sessions. Information about HIV/STDs and general counseling were given in 23% and 18% of the counseling sessions respectively. Conclusion The data showed these instant message sessions to be a potentially feasible forum for HIV/STD counseling. Practice Implications Information ordinarily disseminated at health clinics could be successfully distributed through the Internet to MSM. PMID:19217742

Effect of a Brief Video Intervention on Incident Infection among Patients Attending Sexually Transmitted Disease Clinics

PubMed Central

Warner, Lee; Klausner, Jeffrey D; Rietmeijer, Cornelis A; Malotte, C. Kevin; O'Donnell, Lydia; Margolis, Andrew D; Greenwood, Gregory L; Richardson, Doug; Vrungos, Shelley; O'Donnell, Carl R; Borkowf, Craig B

2008-01-01

Background Sexually transmitted disease (STD) prevention remains a public health priority. Simple, practical interventions to reduce STD incidence that can be easily and inexpensively administered in high-volume clinical settings are needed. We evaluated whether a brief video, which contained STD prevention messages targeted to all patients in the waiting room, reduced acquisition of new infections after that clinic visit. Methods and Findings In a controlled trial among patients attending three publicly funded STD clinics (one in each of three US cities) from December 2003 to August 2005, all patients (n = 38,635) were systematically assigned to either a theory-based 23-min video depicting couples overcoming barriers to safer sexual behaviors, or the standard waiting room environment. Condition assignment alternated every 4 wk and was determined by which condition (intervention or control) was in place in the clinic waiting room during the patient's first visit within the study period. An intent-to-treat analysis was used to compare STD incidence between intervention and control patients. The primary endpoint was time to diagnosis of incident laboratory-confirmed infections (gonorrhea, chlamydia, trichomoniasis, syphilis, and HIV), as identified through review of medical records and county STD surveillance registries. During 14.8 mo (average) of follow-up, 2,042 patients (5.3%) were diagnosed with incident STD (4.9%, intervention condition; 5.7%, control condition). In survival analysis, patients assigned to the intervention condition had significantly fewer STDs compared with the control condition (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.84 to 0.99). Conclusions Showing a brief video in STD clinic waiting rooms reduced new infections nearly 10% overall in three clinics. This simple, low-intensity intervention may be appropriate for adoption by clinics that serve similar patient populations. Trial registration: http://www.ClinicalTrials.gov (#NCT00137670). PMID:18578564

Development and Evaluation of a Multimedia-Enhanced STD/HIV Curriculum for Middle Schools

ERIC Educational Resources Information Center

Goldsworthy, Richard; Schwartz, Nancy

2008-01-01

STD infection among adolescents is a significant public health concern. Surveys indicate that parents believe STD and HIV/AIDS are appropriate topics for middle school and high school students; however, school-based STD education efforts remain inconsistent, perhaps in part as a result of the lack of standardized, well-distributed curricula.…

STD coinfections in The Netherlands: Specific sexual networks at highest risk.

PubMed

van Veen, Maaike G; Koedijk, Femke D H; van der Sande, Marianne A B

2010-07-01

Specific subpopulations infected with multiple bacterial sexually transmitted diseases (STDs) may facilitate ongoing STD transmission. To identify these subpopulations we determined the extent of concurrent incident STD infections and their risk factors among the high-risk population seen at Dutch STD clinics. STD surveillance data submitted routinely by STD clinics to the National Institute for Public Health on demographics, sexual behavior, STD testing, and diagnoses for the period 2004-2007 were analyzed. Bacterial STD coinfections were diagnosed concurrently in 2120 (7%) of the 31,754 incident bacterial STD diagnoses (chlamydia, gonorrhea, infectious syphilis). In univariate logistic regression analyses, coinfections were significantly more often diagnosed in men who have sex with men (MSM, OR = 5.4) than in heterosexuals. Multivariate analyses showed a significant interaction between age and sexual preference. Subsequent stratified analyses by sexual preference showed a linear rise in coinfections with age in MSM. In heterosexuals, by contrast, bacterial coinfections peaked in those aged 19 or less; they had 27% of coinfections, while having only 14% of monodiagnoses and 10% of consultations. Heterosexual STD clinic attendees of Surinamese or Antillean origin were significantly at higher risk for coinfection (OR = 6.5) than all other ethnicities. Attendees belonging to specific sexual networks, such as MSM, ethnic groups, and young heterosexuals were at increased risk for STD coinfections. The different trend with age in MSM versus heterosexuals suggests that these 2 high-risk networks have different determinants of higher risk, such as age-related sexual risk-taking, biologic susceptibility, and insufficient knowledge or compliance with prevention measures. Prevention should therefore be targeted differently towards specific sexual networks.

Cervical cancer screening among women who attend sexually transmitted diseases (STD) clinics: background paper for 2010 STD Treatment Guidelines.

PubMed

Datta, S Deblina; Saraiya, Mona

2011-12-01

In April 2008, experts reviewed updates on sexually transmitted disease (STD) prevention and treatment in preparation for the revision of the Centers for Disease Control and Prevention (CDC) STD Treatment Guidelines. This included a review of cervical cancer screening in the STD clinical setting. Key questions were identified with assistance from an expert panel. Reviews of the literature were conducted using the PubMed computerized database and shared with the panel. Updated information was incorporated in the 2010 CDC STD Treatment Guidelines. We recommend that STD clinics offering cervical screening services screen and treat women according to guidelines by the American College of Obstetrics and Gynecology, the American Cancer Society, the US Preventive Services Task Force, and the American Society for Colposcopists and Cervical Pathologists. New to the 2010 guidelines are higher age for initiating cervical screening (age ≥ 21 years) and less frequent intervals of screening (at least every 3 years). New recommendations include new technologies, such as liquid-based cytology and high-risk human papillomavirus (HPV) DNA tests. Liquid-based technologies are not recommended over conventional testing. HPV DNA tests are recommended as adjunct tests and with new indications for use in cervical screening and management. Stronger recommendations were issued for STD clinics offering cervical screening services to have protocols in place for follow-up of test results and referral (eg, colposcopy). Important additions to the 2010 STD Treatment Guidelines include information on updated algorithms for screening and management of women and recommendations for use of liquid-based cytology and high-risk HPV testing.

Antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from peripheral health centres and STD clinic attendees of a tertiary care centre in India.

PubMed

Bala, M; Ray, K; Gupta, S M

2008-06-01

The aim of the study was to compare the antimicrobial resistance pattern of Neisseria gonorrhoeae isolates from urban and rural peripheral health centres and from sexually transmitted disease (STD) clinic attendees. Antimicrobial susceptibility testing of 191 N. gonorrhoeae isolates (165 isolates from STD clinic attendees and 26 from peripheral health centres) was carried out in Delhi, India, using the calibrated dichotomous sensitivity technique for penicillin, tetracycline, ceftriaxone, ciprofloxacin, spectinomycin and nalidixic acid, and minimum inhibitory concentrations were determined using E-test. Penicillin-resistant, ciprofloxacin-resistant, penicillinase-producing N. gonorrhoeae and tetracycline-resistant N. gonorrhoeae strains were higher in STD clinic attendees than in peripheral health centres, probably because of less antibiotic pressure in the peripheral areas. High-level resistance to ciprofloxacin and multiresistant strains were also higher in STD clinic attendees. The present study emphasizes the importance of surveillance of antimicrobial resistance of N. gonorrhoeae in different population subgroups in order to monitor the spread of multiresistant strains and to update the national treatment recommendations.

The Relationship between STD Locus of Control and STD Acquisition among Adolescent Girls.

ERIC Educational Resources Information Center

Rosenthal, Susan L.; Griffith, Jennifer O.; Succop, Paul A.; Biro, Frank M.; Lewis, Lisa M.; DeVellis, Robert F.; Stanberry, Lawrence R.

2002-01-01

Adolescent girls from an urban-based clinic participated in a longitudinal study about psychosexual development and risk of STD acquisition. The girls were asked about their perceptions of loci of control (parents, internal control) as it relates to STD acquisition. Responses to locus of control correlated over time but variations were not found…

"Testing-only" visits: an assessment of missed diagnoses in clients attending sexually transmitted disease clinics.

PubMed

Xu, Fujie; Stoner, Bradley P; Taylor, Stephanie N; Mena, Leandro; Martin, David H; Powell, Suzanne; Markowitz, Lauri E

2013-01-01

At sexually transmitted disease (STD) clinics, advances in testing technology coupled with increasing demands and diminishing resources have promoted the use of testing-only visits (clinic visits with testing for STDs but no full examination) to meet increasing demands for STD services. The aims of the present study were to estimate the prevalence of STD diagnoses that could become "missed diagnoses" if patients would use testing-only visits and to examine patient characteristics associated with these potential missed diagnoses. We conducted a self-administered survey of STD-related symptoms and sexual risk behaviors in patients seeking routine clinical care at 3 STD clinics. Medical charts were abstracted to estimate the prevalence of viral STDs, trichomoniasis, and other diagnoses from standard clinical services that could become missed diagnoses. Of 2582 patients included, the median age was 24 years and 50% were women. In women, overall, 3.2% were diagnosed as having a viral STD; 9.6%, trichomoniasis; and 41.0%, vulvovaginal candidiasis or symptomatic bacterial vaginosis. The prevalence of these potential missed diagnoses varied by patient characteristics, but in women who reported no symptoms, the prevalence of trichomoniasis was still 6.3%. In men, 19.3% received a diagnosis of urethritis but tested negative for both gonorrhea and chlamydia; this prevalence varied from 15.7% in those who reported no symptoms to 32.6% in those who reported malodor. A high proportion of STD clients received diagnoses from standard care visits that would be missed by testing-only visits. When patients, even those asymptomatic, use testing-only visits, missed diagnoses of STDs or related genital tract conditions can be substantial. The potential disadvantages of testing-only visits should be weighed against the advantages of such visits.

STDs & HIV: A Guide for Today's Teens. 2nd Edition. Student Manual.

ERIC Educational Resources Information Center

Yarber, William L.

This student workbook describes a prevention education curriculum about sexually transmitted diseases (STDs), including HIV/AIDS, discussing: "Why Learn About STD/HIV?"; "Objectives"; "Self-Test: Discovering What I Know - 1"; Self-Test: Discovering What I Believe - 1"; "STD/HIV Fact #1: The STD/HIV…

The characteristics of heterosexual STD clinic attendees who practice oral sex in Zhejiang Province, China.

PubMed

Ma, Qiaoqin; Pan, Xiaohong; Cai, Gaofeng; Yan, Jiezhe; Xu, Yun; Ono-Kihara, Masako; Kihara, Masahiro

2013-01-01

The characteristics of heterosexual attendees who visit sexually transmitted disease (STD) clinics and practice oral sex have not been revealed in China. This information is important for the development of targeted STD prevention programmes for this population. A self-administered questionnaire survey with a cross-sectional design was administered to consecutive attendees at four STD clinics in Zhejiang Province, China, between October and December in 2007. Demographic, psychosocial, and behavioural factors associated with oral sex over a lifetime were identified using univariate and multivariate analyses. Of the 872 attendees, 6.9% engaged in oral sex over their lifetimes. Of the oral-sex group, 96.6% also engaged in vaginal sex. The correlates for oral sex over a lifetime as determined by the multivariate analysis were high income (odds ratio [OR] = 2.53, 95% confidence interval [CI] 1.39-4.59), high human immunodeficiency virus (HIV)-related knowledge (OR = 2.71, 95% CI 1.26-5.81), early sex initiation (OR = 2.42, 95% CI 1.37-4.27), multiple sexual partners (OR = 3.09, 95% CI 1.58-6.06), and sexually active in the previous 6 months (OR = 7.73, 95% CI 1.04-57.39). Though the prevalence of oral sex is low, the heterosexual STD clinic attendees practicing oral sex was found to have higher risks associated with STD/HIV transmission than those not. Behavioural and medical interventions conducted by clinicians in Chinese STD clinics should take into account the characteristics and related risks of those who practice oral sex.

The Process of Planning and Designing Research for an Educational Telecommunications Effort. Satellite Technology Demonstration, Technical Report No. 0209.

ERIC Educational Resources Information Center

Connolly, A. J.; And Others

The Satellite Technology Demonstration (STD) designed research for a satellite-based communication system that would transmit educational television programs. Their procedures were subject to a series of external and internal evaluations by the project sponsors, the National Institute of Education. In regard to external evaluation, STD recommended…

Developing a Motion Comic for HIV/STD Prevention for Young People Ages 15-24, Part 1: Listening to Your Target Audience.

PubMed

Willis, Leigh A; Kachur, Rachel; Castellanos, Ted J; Spikes, Pilgrim; Gaul, Zaneta J; Gamayo, Ashley C; Durham, Marcus; Jones, Sandra; Nichols, Kristen; Han Barthelemy, Solange; LaPlace, Lisa; Staatz, Colleen; Hogben, Matthew; Robinson, Susan; Brooks, John T; Sutton, Madeline Y

2018-02-01

Young people (15-24 years) in the United States are disproportionately affected by infection with human immunodeficiency virus (HIV) and sexually transmitted diseases (STD). Shortfalls in HIV/STD-related knowledge, attitudes, beliefs, and behavioral intentions (KABI) likely contribute to this discrepancy. In this report we describe our experience developing a novel means of health communication combining entertainment-education theory and recent technological advances to create a HIV/STD-focused "motion comic." We also report the audience satisfaction and acceptance of the intervention. We used the Health Belief Model (HBM), entertainment-education (EE) principles, and the Sabido Method (SM) and conducted three rounds of focus groups to develop a 38-minute HIV/STD focused motion comic for young people between the ages 15 and 24 years. Participants indicated that motion comics were an acceptable method of delivering HIV/STD prevention messages. They also expressed satisfaction with motion comics plot, story settings, the tone of humor, and drama. Our results suggest that motion comics are a viable new method of delivering health communication messages about HIV/STD and other public health issues, and warrant further development and broader evaluation.

[Association of knowledge about STD and level of schooling among conscripts upon enlistment in the Brazilian Army, Brazil, 2007].

PubMed

Miranda, Angelica Espinosa; Ribeiro, Denis; Rezende, Erika Fazito; Pereira, Gerson Fernando Mendes; Pinto, Valdir Monteiro; Saraceni, Valeria

2013-02-01

The scope of this study was to describe knowledge of military conscripts about STD in relation to level of schooling upon enlistment in the Brazilian Army. A self-administered questionnaire with demographic and clinical aspects, forms of transmission, sexual behavior and access to STD information was applied in a national sample in 2007. Variables associated with low schooling were: being 19-20 years old [OR=1.2(95%CI:1.18-1.32)]; saying that STD can be transmitted by: eating contaminated food [OR=2.2(95%CI:1,96-2.55)]; bathing in rivers/beaches [OR=1.5(95%CI:1.27-1.88)]; mosquito bites [OR=1.5(95%CI:1.38-1.65)]; sexual intercourse <=14 years old [OR=1.4 (95%CI:1.33-1.55)]. Variables inversely associated with low schooling were: being white [OR=0.9 (95%CI:0.82-0.91)]; stating that STD can be transmitted by: sharing syringes/needles [OR=0.7(95%CI: 0.62-0.78)]; mother-to-child transmission [OR=0.6(95%CI:0.58-0.69)]; having used a condom in the last sexual intercourse [OR=0.8(95%CI:0.71-0.85)]; being MSM [OR=0.7(95% CI: 0.60-0.92)]; knowing that sex without condoms increases risk of transmission [OR=0.4 (95%CI:0,37-0,51)]. Given the association of low schooling with less knowledge about STD, educational policies geared to this population are needed because they are more vulnerable.

An Interactive Internet-Based Continuing Education Course on Sexually Transmitted Diseases for Physicians and Midwives in Peru

PubMed Central

Canchihuaman, Fredy A.; Garcia, Patricia J.; Gloyd, Stephen S.; Holmes, King K.

2011-01-01

Background Clinicians in developing countries have had limited access to continuing education (CE) outside major cities, and CE strategies have had limited impact on sustainable change in performance. New educational tools could improve CE accessibility and effectiveness. Methodology/Principal Findings The objective of this study was to evaluate an interactive Internet-based CE course on Sexually Transmitted Diseases (STDs) management for clinicians in Peru. Participants included physicians and midwives in private practice drawn from a census of 10 Peruvian cities. The CE included a three-hour workshop for improving Internet skills, followed by a 22-hour online course on STD-syndrome-management, with subsequent educational support. The course used case-based clinical vignettes tailored to local STD problems. Knowledge and reported practices on STD management were assessed before, immediately after and at four months after completion of the course. Statistical analysis included parametric tests-linear regression multivariate analysis, paired t-test and repeated measures ANOVA using SPSS 14.0. Of 1,071 eligible clinicians, 510 agreed to participate, as did an additional 132 public sector clinicians. Of these 642 participants, 619 (96.4%) completed the course, and 596 (96.3%) took the four-month follow-up evaluation. Physician and midwife scores improved from 64.2% correct answers on the pre-test to 77.9% correct on the four-month follow-up test (p<0.001). Most participants (95%) found the online course useful for their work needs. Self reported STD management practices did not change. Conclusions/Significance Among physicians and midwives in Peru, an Internet-based CE course was feasible, acceptable with high participation rates, and led to sustained improvement in knowledge at four months. Further studies are needed to test it as a model for improving the training of physicians, midwives, and other health care providers. PMID:21573054

Assessing Patient Exposure to a Video-Based Intervention in STD Clinic Waiting Rooms: Findings From the Safe in the City Trial.

PubMed

Besera, Ghenet T; Cox, Shanna; Malotte, C Kevin; Rietmeijer, Cornelis A; Klausner, Jeffrey D; O'Donnell, Lydia; Margolis, Andrew D; Warner, Lee

2016-09-01

Safe in the City, a video intervention for clinic waiting rooms, was previously shown to reduce sexually transmitted disease (STD) incidence. However, little is known about patients' recall of exposure to the intervention. Using data from a nested study of patients attending clinics during the trial, we assessed whether participants recalled Safe in the City, and, if so, how the intervention affected subsequent attitudes and behaviors. Analyses were restricted to responses to a 3-month follow-up questionnaire among participants who were exposed to the video (n = 708). Impact was measured as participants' reports of the video's effect on behaviors and attitudes. Associations were evaluated using multivariable logistic regression. Of participants who were exposed, 685 (97%) recalled viewing the video, and 68% recalled all three vignettes. After watching the video, participants felt more positive about condoms (69%) and comfortable acquiring condoms (56%), were reminded of important information about STDs and condoms (90%), and tried to apply what they learned to their lives (59%). Compared with those who recalled viewing one or two vignettes, participants who recalled viewing all three vignettes reported more positive attitudes toward condoms and peer/provider communication. These findings demonstrate that a low-resource video intervention for waiting rooms can provide sufficient exposure to positively influence STD-related attitudes/behaviors. © 2016 Society for Public Health Education.

HIV/STD pattern and its associated risk factors among male STD clinic attendees in China: a foci for HIV intervention

PubMed Central

2011-01-01

Background Previous studies suggested a high prevalence of STDs including HIV among female sex workers and men who have sex with men in China, but little was known about the prevalence in male patients attending public STD clinics. The aim of this study was to investigate STD patterns and HIV prevalence among male STD clinic attendees in different areas in China and the associated risk factors. The feasibility of Provider-initiated HIV testing and counseling (PITC) was evaluated as well. Methods A cross-sectional study was conducted at 46 public STD clinics in 4 provinces in China. Between July 2009 and September 2009, a total of 3243 eligible subjects were invited to participate in an interview with a structured-questionnaire for collecting socio-demographic characteristics and sexual behavioral information. They also were asked to provide venous blood samples for serological determinations of HIV and syphilis infection, and first void urine specimens for detecting Chlamydia trachomatis and Neisseria gonorrhoeae infections, Results Out of the 3243 eligible patients, 2951(91%) men agreed to take part in the HIV and syphilis testing. The overall prevalence rate of HIV infection was 0.7% while the rates of syphilis, N. gonorrhoeae, C. trachomatis infections were 10.7%, 4.3% and 6.9%, respectively, with the highest syphilis and N. gonorrhoeae rates in Jiangsu Province. Patients from Guangxi province, homosexual/bisexual practices and intravenous drug use were significantly associated with HIV infection in multivariate logistic regression analyses. Provider-initiated HIV testing and counseling (PITC) was well accepted by attendees, with 91% of eligible attendees agreeing to undergo HIV testing and counseling. All HIV positive patients were properly managed accordingly. Conclusions A modest prevalence of HIV infection and substantial prevalence of other STD infections were found among male patients attending public STD clinics in China. The findings further support the introduction of HIV and syphilis PITC strategy into this important setting. PMID:22200257

[HIV/STD prevalence and related behaviors among male STD clinic attendees in Xi'an and Xianyang cities, Shaanxi province].

PubMed

Hu, T; Dong, L F; Ding, Z W; Jia, H; Li, X; Zhang, J S; Song, Y L; Chang, W H

2017-12-10

Objective: To compare the prevalence of HIV/STD and related health care seeking behaviors among male STD clinic attendees between Xi'an and Xianyang cities. Methods: During June and July 2016, 206 male STD clinic attendees were studied in Xi'an city, with another 221 male STD clinic attendees in Xianyang city. Cross-sectional questionnaire survey was used to collect attendees'behavioral information. Blood samples were collected via HIV/HCV/Syphilis testing. Results: The prevalence rate of HIV infection was 2.4% (5/206) in Xi'an and 0.9% (2/221) in Xianyang, with no statistical significant difference between the two cities. The prevalence rate of syphilis was 4.9% (10/206) in Xi'an, which was significantly lower than 13.6% (30/221) in Xianyang. The proportion of respondents, diagnosed with other sexually transmitted diseases, in Xi'an was higher than that of Xianyang. The proportions of commercial heterosexual sex and sex with temporary sexual partners in the past 3 months were 18.0% (37/206) and 15.5% (32/206) in Xi'an, lower than 46.6% (103/221) and 15.8% (35/221) in Xianyang ( χ (2)=39.70, Р <0.01; χ (2)=0.01, P =0.93) . The proportions of condom use with commercial sex workers or temporary sexual partners in the past 3 months among Xi'an were 37.8% (14/37) and 6.3% (2/32) , lower than 93.1% (95/102) and 57.1% (20/35) in Xianyang ( χ (2)=49.06, Р <0.01; χ (2)=19.63, Р <0.01) . Conclusion: Differences were noticed between Xi'an and Xianyang city in terms of STD and HIV prevalences, behaviors related to commercial sex and use of condoms among the male STD clinic attendees that calling for targeted actions in control of high risk behavlors in both HIV/AIDS and STDs transmission.

HIV/STD pattern and its associated risk factors among male STD clinic attendees in China: a foci for HIV intervention.

PubMed

Wang, Qian-Qiu; Chen, Xiang-Sheng; Yin, Yue-Ping; Liang, Guo-Jun; Jiang, Ning; Dai, Ting; Huan, Xi-Ping; Yang, Bing; Liu, Qiao; Zhou, Yu-Jiao; Wang, Bao-Xi

2011-12-26

Previous studies suggested a high prevalence of STDs including HIV among female sex workers and men who have sex with men in China, but little was known about the prevalence in male patients attending public STD clinics. The aim of this study was to investigate STD patterns and HIV prevalence among male STD clinic attendees in different areas in China and the associated risk factors. The feasibility of Provider-initiated HIV testing and counseling (PITC) was evaluated as well. A cross-sectional study was conducted at 46 public STD clinics in 4 provinces in China. Between July 2009 and September 2009, a total of 3243 eligible subjects were invited to participate in an interview with a structured-questionnaire for collecting socio-demographic characteristics and sexual behavioral information. They also were asked to provide venous blood samples for serological determinations of HIV and syphilis infection, and first void urine specimens for detecting Chlamydia trachomatis and Neisseria gonorrhoeae infections, Out of the 3243 eligible patients, 2951(91%) men agreed to take part in the HIV and syphilis testing. The overall prevalence rate of HIV infection was 0.7% while the rates of syphilis, N. gonorrhoeae, C. trachomatis infections were 10.7%, 4.3% and 6.9%, respectively, with the highest syphilis and N. gonorrhoeae rates in Jiangsu Province. Patients from Guangxi province, homosexual/bisexual practices and intravenous drug use were significantly associated with HIV infection in multivariate logistic regression analyses. Provider-initiated HIV testing and counseling (PITC) was well accepted by attendees, with 91% of eligible attendees agreeing to undergo HIV testing and counseling. All HIV positive patients were properly managed accordingly. A modest prevalence of HIV infection and substantial prevalence of other STD infections were found among male patients attending public STD clinics in China. The findings further support the introduction of HIV and syphilis PITC strategy into this important setting.

The Characteristics of Heterosexual STD Clinic Attendees Who Practice Oral Sex in Zhejiang Province, China

PubMed Central

Ma, Qiaoqin; Pan, Xiaohong; Cai, Gaofeng; Yan, Jiezhe; Xu, Yun; Ono-Kihara, Masako; Kihara, Masahiro

2013-01-01

Background The characteristics of heterosexual attendees who visit sexually transmitted disease (STD) clinics and practice oral sex have not been revealed in China. This information is important for the development of targeted STD prevention programmes for this population. Study Design A self-administered questionnaire survey with a cross-sectional design was administered to consecutive attendees at four STD clinics in Zhejiang Province, China, between October and December in 2007. Demographic, psychosocial, and behavioural factors associated with oral sex over a lifetime were identified using univariate and multivariate analyses. Results Of the 872 attendees, 6.9% engaged in oral sex over their lifetimes. Of the oral-sex group, 96.6% also engaged in vaginal sex. The correlates for oral sex over a lifetime as determined by the multivariate analysis were high income (odds ratio [OR] = 2.53, 95% confidence interval [CI] 1.39–4.59), high human immunodeficiency virus (HIV)-related knowledge (OR = 2.71, 95% CI 1.26–5.81), early sex initiation (OR = 2.42, 95% CI 1.37–4.27), multiple sexual partners (OR = 3.09, 95% CI 1.58–6.06), and sexually active in the previous 6 months (OR = 7.73, 95% CI 1.04–57.39). Conclusions Though the prevalence of oral sex is low, the heterosexual STD clinic attendees practicing oral sex was found to have higher risks associated with STD/HIV transmission than those not. Behavioural and medical interventions conducted by clinicians in Chinese STD clinics should take into account the characteristics and related risks of those who practice oral sex. PMID:23825627

A novel integration effort to reduce the risk for alcohol-exposed pregnancy among women attending urban STD clinics.

PubMed

Hutton, Heidi E; Chander, Geetanjali; Green, Patricia P; Hutsell, Catherine A; Weingarten, Kimberly; Peterson, Karen L

2014-01-01

Alcohol-exposed pregnancy (AEP) is a significant public health problem in the United States. Sexually transmitted disease (STD) clinics serve female clients with a high prevalence of heavy alcohol consumption coupled with ineffective contraceptive use. Project CHOICES (Changing High-Risk AlcOhol Use and Increasing Contraception Effectiveness) is an evidence-based, brief intervention to lower risk of AEP by targeting alcohol and contraceptive behaviors through motivational interviewing and individualized feedback. We describe our experience integrating and implementing CHOICES in STD clinics. This endeavor aligns with CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's program collaboration and service integration strategic priority to strengthen collaborative work across disease areas and integrate services provided by related programs at the client level.

A Novel Integration Effort to Reduce the Risk for Alcohol-Exposed Pregnancy Among Women Attending Urban STD Clinics

PubMed Central

Hutton, Heidi E.; Chander, Geetanjali; Green, Patricia P.; Hutsell, Catherine A.; Weingarten, Kimberly

2014-01-01

Alcohol-exposed pregnancy (AEP) is a significant public health problem in the United States. Sexually transmitted disease (STD) clinics serve female clients with a high prevalence of heavy alcohol consumption coupled with ineffective contraceptive use. Project CHOICES (Changing High-Risk AlcOhol Use and Increasing Contraception Effectiveness) is an evidence-based, brief intervention to lower risk of AEP by targeting alcohol and contraceptive behaviors through motivational interviewing and individualized feedback. We describe our experience integrating and implementing CHOICES in STD clinics. This endeavor aligns with CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's program collaboration and service integration strategic priority to strengthen collaborative work across disease areas and integrate services provided by related programs at the client level. PMID:24385650

Trends in Receipt of Sexually Transmitted Disease Services Among Women 15 to 44 Years Old in the United States, 2002 to 2006–2010

PubMed Central

Haderxhanaj, Laura T.; Gift, Thomas L.; Loosier, Penny S.; Cramer, Ryan C.; Leichliter, Jami S.

2018-01-01

Background To describe recent trends in the receipt of sexually transmitted disease (STD) services among women (age, 15–44 years) from 2002 to 2006–2010 using the National Survey of Family Growth. Methods We analyzed trends in demographics, health insurance, and visit-related variables of women reporting receipt of STD services (counseling, testing, or treatment) in the past 12 months. We also analyzed trends in the source of STD services and the payment method used. Results Receipt of STD services reported by women in the past 12 months increased from 2002 (12.6%) to 2006–2010 (16.0%; P < 0.001). Receipt of services did not increase among adolescents (P = 0.592). Among women receiving STD services from a private doctor/HMO, the percentage with private insurance decreased over time (74.6%–66.8%), whereas the percentage with Medicaid increased (12.8%–19.7%; P = 0.020). For women receiving STD services at a public clinic or nonprimary care facility, there were no statistically significant differences by demographics, except that fewer adolescents but more young adults reported using a public clinic over time (P = 0.038). Among women who reported using Medicaid as payment, receipt of STD services at a public clinic significantly decreased (36.8%–25.4%; P = 0.019). For women who paid for STD services with private insurance, the only significant difference was an increase in having a copay over time (61.3%–70.1%; P = 0.012). Conclusions Despite a significant increase in receipt of STD services over time, many women at risk for STDs did not receive services including adolescents. In addition, we identified important shifts in payment methods during this time frame. PMID:24335746

[Anonymous STD counselling versus mandatory checks for prostitutes--what is effective in STD prevention?].

PubMed

Nitschke, H; Ludwig-Diouf, B; Knappik, A; Leidel, J

2006-11-01

When in 2001 in Germany the new act for control of infectious diseases came into force, mandatory checks for prostitutes were abolished. The consequences of this paradigm shift in STD prevention are being judged controversially even today. The public health department of the city of Cologne, like others, adapted its programme, staff, equipment, and diagnostic procedures to the new requirements. The department for venereal disease control was converted into a walk-in-clinic for STD and now forms part of a comprehensive STD and Aids prevention unit. The present article illustrates the changes by comparing the clients and the STD numbers of the years 1994 and 2004. The following data were compared: number of consultations, number of clients regarding sex, occupation in sex business, health insurance, national or ethnic background, frequency of consultation, number of STD. In 1994, almost all clients of the department for venereal disease control were female prostitutes. 74% of them worked in established sex business venues with a high grade of professionalism, few STD cases were diagnosed. In 2004, the STD clinic was open for anybody considered to be at risk and not having access to the regular health care system. Only 49% of the patients were prostitutes, either female or male. 25% of the clients were male. 68% of the patients were migrants, many of them without any legal status and without any access to regular health care. A high number of acute STD and subsequent disorders that required treatment was registered. Besides the STD-related services, a great need for gynaecological and urological differential diagnostics as well as a high demand for counselling and provision of other problems of sexual health were observed. The data show that an STD department providing comprehensive services anonymously and free of charge will reach a broader range of highly vulnerable persons in comparison with an obligatory VD check of prostitutes. The high numbers of STD and STD-related disorders demonstrate the improved effectiveness of the new service.

[The practice guideline 'The STD consultation' from the Dutch College of General Practitioners; a response from the perspective of dermatology].

PubMed

Neumann, H A M

2005-08-06

Sexually transmitted diseases (STDs) constitute an important health problem in the Netherlands. Although there are several STD outpatient clinics, such facilities remain unavailable outside the larger cities. The members of the Dutch College of General Practitioners, who published the practice guideline on STD consultation, provide the majority of STD care. An important aspect of this guideline is the fact that GPs are able to assess the risk by taking a sexual history and then determine their own policy on additional investigations. This prevents the omission of investigations that would exclude an STD, but carries the risk, at least theoretically, that it may be missed. It is noteworthy that scabies is not discussed in these guidelines. The most important difference between the guidelines followed by dermatological/STD clinics throughout the Netherlands is the level of triage practiced by GPs. It seems that GPs have a well-thought out and responsible policy, which also merits attention from dermatologists/venereologists.

Facility based cross-sectional study of self stigma among people with mental illness: towards patient empowerment approach

PubMed Central

2013-01-01

Background Self stigma among people with mental illness results from multiple cognitive and environmental factors and processes. It can negatively affect adherence to psychiatric services, self esteem, hope, social integration and quality of life of people with mental illness. The purpose of this study was to measure the level of self stigma and its correlates among people with mental illness at Jimma University Specialized Hospital, Psychiatry clinic in southwest Ethiopia. Methods Facility based cross-sectional study was conducted on 422 consecutive samples of people with mental illness using interviewer administered and pretested internalized stigma of mental illness (ISMI) scale. Data was entered using EPI-DATA and analysis was done using STATA software. Bivariate and multivariate linear regressions were done to identify correlates of self stigma. Results On a scale ranging from 1 to 4, the mean self stigma score was 2.32 (SD = 0.30). Females had higher self stigma (std. β = 0.11, P < 0.05) than males. Patients with a history of traditional treatment had higher self stigma (std. β = 0.11, P < 0.05). There was an inverse relationship between level of education and self-stigma (std. β = −0.17, P < 0.01). Perceived signs (std. β = 0.13, P < 0.05) and supernatural causes of mental illness (std. β = 0.16, P < 0.01) were positively correlated with self stigma. Higher number of drug side effects were positively correlated (std. β = 0.15, P < 0.05) while higher self esteem was negatively correlated (std. β = −0.14, P < 0.01) with self stigma. Conclusions High feeling of inferiority (alienation) but less agreement with common stereotypes (stereotype endorsement) was found. Female showed higher self stigma than male. History of traditional treatment and higher perceived supernatural explanation of mental illness were associated with higher self stigma. Drug side effects and perceived signs of mental illness were correlated with increased self stigma while education and self esteem decreased self stigma among people with mental illness. Patient empowerment psychosocial interventions and strategies to reduce drug side effects can be helpful in reducing self stigma among people with mental illnesses. PMID:24004512

Utilization of information and communication technology (ICT) among sexually transmitted disease clinics attendees with coexisting drinking problems

PubMed Central

2014-01-01

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

Utilization of information and communication technology (ICT) among sexually transmitted disease clinics attendees with coexisting drinking problems.

PubMed

Hu, Xingdi; Dodd, Virginia J; Oliverio, James C; Cook, Robert L

2014-03-26

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. 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. 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. 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.

Early detection and treatment of sexually transmitted disease in pregnant adolescents of low socioeconomic status.

PubMed

Matson, S C; Pomeranz, A J; Kamps, K A

1993-10-01

This study evaluated the prevalence of sexually transmitted disease (STD) in adolescents presenting to a primary pediatric care clinic (PPCC) for the diagnosis of pregnancy and our ability to eradicate identified infections. We followed 168 pregnant adolescents of low socioeconomic status from their original pregnancy diagnosis until their first prenatal clinic visit. We collected screening cervical cultures for Neisseria gonorrhoeae and Chlamydia trachomatis by completing a pelvic examination on 91 patients at our PPCC. At the PPCC visit, 29% were positive for gonorrhea, chlamydia, or both. Screening tests for these infections were collected on all patients at the initial prenatal clinic visit. The risk for presenting to the prenatal clinic with a STD was significantly greater in patients not screened and treated for STD at the PPCC. Average delay from diagnosis to first prenatal clinic visit was 35.7 days. Thus, in this adolescent population, primary care providers are missing an important therapeutic opportunity by failing to identify and treat STD at initial diagnosis of pregnancy.

Sexually Transmitted Disease Program Evolution in Response to Changes in the Public Health Environment: A Massachusetts Example.

PubMed

Carter, Marion W; Hsu, Katherine K; Loosier, Penny S; Maddox, Brandy L Peterson; Doshi, Sonal R; Kroeger, Karen; Cranston, Kevin

2016-11-01

In 2008, the line item supporting sexually transmitted disease (STD) services in the Massachusetts state budget was cut as a result of budget shortfalls. Shortly thereafter, direct provision of STD clinical services supported by the Massachusetts Department of Public Health (MDPH) was suspended. Massachusetts Department of Public Health requested an initial assessment of its internal response and impact in 2010. A follow-up assessment occurred in September 2013. In 2010 and 2013, 39 and 46 staff, respectively, from MDPH and from clinical partner agencies, were interviewed about changes in the role of the MDPH, partnerships, STD services, challenges, and recommendations. Interview notes were summarized, analyzed, and synthesized by coauthors using qualitative analysis techniques and NVivo software. The withdrawal of state funding for STD services, and the subsequent reduction in clinical service hours, erected numerous barriers for Disease Intervention Specialists (DIS) seeking to ensure timely STD treatment for index cases and their partners. After initial instability, MDPH operations stabilized due partly to strong management, new staff, and intensified integration with human immunodeficiency virus services. Existing contracts with human immunodeficiency virus providers were leveraged to support alternative STD testing and care sites. Massachusetts Department of Public Health strengthened its clinical and epidemiologic expertise. The DIS expanded their scope of work and were outposted to select new sites. Challenges remained, however, such as a shortage of DIS staff to meet the needs. Although unique in many ways, MA offers experiences and lessons for how a state STD program can adapt to a changing public health context.

[A survey on AIDS knowledge rate and sexual behavior among men who have sex with men population at sexually transmitted disease clinic].

PubMed

Jian, Dan; Xie, Hongfu; Yi, Mei; Li, Ji; Chen, Mingliang; Feng, Hao; Cheng, Xiaoming; Zhang, Guiying

2010-07-01

To survey on men who have sex with men (MSM) population's sexual behaviors, condom-service condition, HIV related knowledge and other issues among MSM population at sexually transmitted disease (STD) clinics to understand the characteristics of behaviors and offer suggestions for effective health education and behavior intervention. From January to December, 2009, we used anonymous questionnaires which involved in their mastery of demographic characteristics, sexual behavior, condom-service condition, HIV related knowledge, and so one, to investigate 200 MSM at 3 STD clinics of comprehensive hospital. The average age of informant was (26.7+/- 8.9) years and 121 individuals (62.6%) had confirmed with STD in recent one year. In the recent 6 months, the average number of homosexual partners was 9.2+/- 4.8 and 102 (52.8%) had heterosexual partners. In the sexual intercourse with homosexual, 123 individuals had anal intercourse (63.7 %) and 117 had oral intercourse (60.6%). In the sexual intercourse with heterosexual, 92 (90.2%) individuals had vaginal intercourse, 37 (36.2%) had anal intercourse, and 59 (57.8%) had oral sex behavior.There were a statistical difference between heterosexual and homosexual sex behaviors (P<0.01). The condom-using frequency had statistic difference in different sexual behaviors(χ²=188.396, P<0.001). There was no linear correlation between HIV related knowledge and condom-using condition in sexual behaviors except the heterosexual anal intercourse. High AIDS knowledge mastery rate is found in our survey. The respondents get HIV/AIDS knowledge through various ways actively. There is no obvious relation between the mastery of HIV related knowledge and condom-using frequency. The ratio of non-protected sexual behaviors is high in heterosexuals. How to adopt effective methods for behavior intervention to MSM at STD clinic needs to be further studied.

Standard symptom- and sexual history-based testing misses anorectal Chlamydia trachomatis and neisseria gonorrhoeae infections in swingers and men who have sex with men.

PubMed

van Liere, Geneviève A F S; Hoebe, Christian J P A; Niekamp, Anne-Marie; Koedijk, Femke D H; Dukers-Muijrers, Nicole H T M

2013-04-01

Currently, individuals at risk for sexually transmitted diseases (STDs) are tested extragenitally only if indicated, most often when there is a history of self-reported symptoms or self-reported anal sex. The sensitivity of such selective symptom- and sexual history-based testing for detection of anorectal STD has not been determined. All men having sex with men (MSM) and swingers (heterosexual couples who have sex with other heterosexual couples and their self-identified heterosexual sex partners) attending our STD clinic (consults: n = 1690) from January 2010 until February 2011 were universally tested for urogenital, anorectal, and oropharyngeal Chlamydia trachomatis and Neisseria gonorrhoeae infections (STD). We compared STD prevalence at anorectal site based on universal versus selective testing. Sensitivity of selective symptom- and sexual history-based testing for anorectal STD was 52% for homosexual MSM, 40% for bisexual MSM, 43% for bisexual male swingers, 40% for heterosexual male swingers, and 47% for female swingers. Universal testing of STD clinic clients who were MSM and swingers yielded more than half of all anorectal STD infections and is more sensitive for identifying anorectal STD infections compared with selective testing. Universal testing may be a more effective strategy for interrupting the ongoing transmission in high-risk sexual networks.

Feasibility of a Tailored Intervention Targeting STD-Related Behaviors.

ERIC Educational Resources Information Center

Bellis, Jeffery M.; Grimely, Diane M.; Alexander, Leah R.

2002-01-01

Investigated whether high risk populations would be receptive to tailored, multimedia interventions to promote adoption of health-protective behaviors related to sexually transmitted disease (STD) prevention and control. Feedback from predominantly African American, urban participants aged 16-50 years, recruited from a STD clinic, indicated that…

Client Preferences for STD/HIV Prevention Programs.

ERIC Educational Resources Information Center

Hennessy, Michael; Mercier, Michele M.; Williams, Samantha P.; Arno, Janet N.

2002-01-01

Conducted a formative research study designed to elicit preferences for sexually transmitted disease (STD)/HIV prevention programs from clients at a midwestern STD clinic. Responses of 126 participants show preferences for mixed group or individual meetings with counselors, with extensive intervention less favored than single sessions. Discusses…

New Human Immunodeficiency Virus diagnoses among Men Who Have Sex with Men attending STD clinics, STD Surveillance Network, January 2010 to June 2013.

PubMed

Llata, Eloisa; Braxton, Jim; Asbel, Lenore; Kerani, Roxanne P; Murphy, Ryan; Pugsley, River; Pathela, Preeti; Schumacher, Christina; Tabidze, Irina; Weinstock, Hillard S

2018-02-07

To estimate new HIV diagnosis rates among HIV negative MSM who are repeatedly tested for HIV in sexually transmitted disease (STD) clinics, and assess the impact of demographic and disease-specific characteristics that are associated with higher HIV diagnosis rates. Retrospective analysis using 2010-2013 data from the STD Surveillance Network (SSuN), a sentinel surveillance system comprised of health departments in 12 cities conducting sentinel surveillance in 40 STD clinics. We analyzed data from all MSM repeatedly (≥2 times) tested for HIV, with an initial negative HIV test required for staggered cohort entry. Follow-up time was accrued from the date of the first negative HIV test to the most recent negative test or the first positive HIV test. STD diagnoses during the follow-up period were reviewed. We estimated HIV diagnoses rates (number of HIV diagnoses/total number of person-years at risk) by demographic and clinical characteristics with 95% confidence intervals (CI) using an inverse variance weighted random effects model, adjusting for heterogeneity between SSuN jurisdictions. Overall, 640 HIV diagnoses occurred among 14,824 individuals and 20,951.6 person-years (PY) of observation, for an adjusted incidence of HIV diagnosis of 3.0 per 100 PY (95% CI 2.6, 3.4). Rates varied across race/ethnicity groups with the highest rate among Blacks (4.7/100 PY; 95% CI 4.1-5.3) followed by Hispanics, Whites and persons of other races/ethnicities. MSM having a diagnosis of P&S syphilis on or after the first negative HIV test had a higher new HIV diagnosis rate (7.2/100 PY; 95% CI 5.8-9.0) compared to MSM who did not have a P&S syphilis diagnosis (2.8/100 PY; 95% CI 2.6-3.1). MSM who tested positive for rectal gonorrhea (6.3/100 PY; 95% CI 5.7-6.9) or rectal chlamydia (5.6/100 PY; 95% CI 4.6-6.6) had higher rates of new HIV diagnosis when compared to those with negative test results. MSM attending SSuN STD clinics have high rates of new HIV diagnoses, particularly those with a previous diagnosis of P&S syphilis, rectal chlamydia and/or gonorrhea. STD clinics continue to be important clinical setting for diagnosing HIV among MSM populations.

Multidimensional family therapy HIV/STD risk-reduction intervention: an integrative family-based model for drug-involved juvenile offenders.

PubMed

Marvel, Francoise; Rowe, Cynthia L; Colon-Perez, Lissette; DiClemente, Ralph J; Liddle, Howard A

2009-03-01

Drug and juvenile justice involved youths show remarkably high rates of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk behaviors. However, existing interventions aimed at reducing adolescent HIV risk behavior have rarely targeted these vulnerable young adolescents, and many approaches focus on individual-level change without attention to family or contextual influences. We describe a new, family-based HIV/ STD prevention model that embeds HIV/STD focused multifamily groups within an adolescent drug abuse and delinquency evidence-based treatment, Multidimensional Family Therapy (MDFT). The approach has been evaluated in a multisite randomized clinical trial with juvenile justice involved youths in the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies (www.cjdats.org). Preliminary baseline to 6-month outcomes are promising. We describe research on family risk and protective factors for adolescent problem behaviors, and offer a rationale for family-based approaches to reduce HIV/STD risk in this population. We describe the development and implementation of the Multidimensional Family Therapy HIV/STD risk-reduction intervention (MDFT-HIV/ STD) in terms of using multifamily groups and their integration in standard MDFT and also offers a clinical vignette. The potential significance of this empirically based intervention development work is high; MDFT-HIV/STD is the first model to address largely unmet HIV/STD prevention and sexual health needs of substance abusing juvenile offenders within the context of a family-oriented evidence-based intervention.

Influence of Professional Preparation and Class Structure on HIV, STD, and Pregnancy Prevention Education

ERIC Educational Resources Information Center

Rhodes, Darson L.; Jozkowski, Kristen N.; Hammig, Bart J.; Ogletree, Roberta J.; Fogarty, Erin C.

2014-01-01

Objective: The purpose of this study was to determine if education about human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy prevention is dependent on professional preparation and/or class structure. Design: A secondary data analysis of the 2006 School Health Policies and Programmes Study (SHPPS) was conducted.…

Skills training versus health education to prevent STDs/HIV in heterosexual women: a randomized controlled trial utilizing biological outcomes.

PubMed

Baker, Sharon A; Beadnell, Blair; Stoner, Susan; Morrison, Diane M; Gordon, Judith; Collier, Cheza; Knox, Kay; Wickizer, Lauren; Stielstra, Sorrel

2003-02-01

We compared the effectiveness of two different 16-session group interventions for reducing new STD infection among heterosexual women. Two hundred twenty-nine at-risk heterosexual women were randomly assigned to skills training (ST) based on the relapse prevention model or health education (HE). Participants were monitored during the year following intervention for STD acquisition, self-reports of sexual behavior, and risk reduction skills. Participants in the ST intervention were significantly less likely to be diagnosed with a STD in the year following intervention and demonstrated superior risk reduction skills at 12-month follow-up. Both conditions showed statistically significant reductions in self reports of risky sexual behavior following intervention and at 12-month follow-up. In this sample, the ST intervention was superior to HE for reducing STD acquisition.

Young African American Men Having Sex with Multiple Partners Are More Likely to Use Condoms Incorrectly: A Clinic-Based Study

PubMed Central

Crosby, Richard; DiClemente, Ralph J.; Yarber, William L.; Snow, Gregory; Troutman, Adewale

2009-01-01

This study tested the research hypothesis that men’s errors using condoms would be associated with having multiple sex partners. Specifically, men engaging in sex with three or more women were compared to those having sex with two or fewer women. Recruitment (N=271) occurred in a publicly-funded STD clinic located in a metropolitan area of the Southern U.S. All men were clinically diagnosed with a STD. Men completed a self-reported questionnaire (using a three-month recall period). Those reporting sex with men were excluded from the analysis leaving an analytic sample of 264 men. About one-half of the men (48.5%) reporting penetrative sex with three or more women during the recall period. Compared to those men reporting sex with two or fewer women, men having ≥3 women sex partners were significantly more likely to report: 1) not using condoms from start to finish of sex (P=.005); 2) that condoms slipped off during sex or withdrawal (P=.04); and 3) that condoms broke during sex (P=.03). A summary measure of condom use errors indicated that men with ≥3 women partners reported significantly greater numbers of errors than their counterparts reporting sex with ≤ 2 sex partners (Mean difference 1.7; P=.009). Among young African American men, newly diagnosed with an STD, reporting recent (past three months) sex with multiple partners may be emblematic of condom errors. These men may benefit from, clinic-based, targeted counseling and education designed to foster improved quality of condom use. PMID:19477797

Subclinical thyroid disease in elderly subjects.

PubMed

Ceresini, Graziano; Morganti, Simonetta; Maggio, Marcello; Usberti, Elisa; Fiorino, Ilaria; Artoni, Andrea; Teresi, Giulio; Belli, Serena; Ridolfi, Valentina; Valenti, Giorgio; Ceda, Gian Paolo

2010-01-01

Subclinical thyroid disease (STD) is defined as circulating concentrations of free T4 and free T3 within their respective reference ranges in the presence of abnormal circulating concentrations of TSH. SCD is being diagnosed more frequently in clinical practice and is reported to be more prevalent in elderly as compared to young or adult subjects. The clinical impact of subclinical thyroid dysfunction is still a matter of debate, although it has been associated with various negative clinical outcomes, such as increased cardiovascular risk, reduction in bone density, decline in cognitive function, and increased risk of overt thyroid dysfunction. The treatment of STD is controversial and there is no consensus on the TSH cutoff values which can be used as indicators for treatment, especially in elderly subjects. In the present review, we report data on the prevalence of STD and on the potential clinical consequences of these disorders. Also, data of the Literature regarding the issue of the treatment of STD in relation to the age of the patient are reported.

Integrating intervention for substance use disorder in a healthcare setting: practice and outcomes in New York City STD clinics.

PubMed

Yu, Jiang; Appel, Phil; Rogers, Meighan; Blank, Susan; Davis, Carrie; Warren, Barbara; Freeman, Anthony; Harris, Brett; Hussain, Shazia

2016-01-01

This article reports the integration and outcomes of implementing intervention services for substance use disorder (SUD) in three New York City public sexually transmitted disease (STD) clinics. The screening, brief intervention, and referral to treatment (SBIRT) service model was implemented in the STD clinics in 2008. A relational database was developed, which included screening results, service dispositions, face-to-face interviews with 6-month follow-ups, and treatment information. From February 2008 to the end of September 2012, 146,657 STD clinic patients 18 years or older were screened for current or past substance use disorders; 15,687 received a brief intervention; 954 received referrals to formal substance abuse treatment; 2082 were referred to substance abuse support services such as Alcoholics Anonymous (AA), and 690 were referred to mental health, social or HIV awareness services. Intervention services delivered through SBIRT resulted in improvements in multiple outcomes at 6 month follow-up. Patients who received interventions had reduced SUD risks, fewer mental health problems, and fewer unprotected sexual contacts. Delivery of SUD services in a public health setting represents a significant policy and practice change and benefits many individuals whose SUDs might otherwise be overlooked. Intervention services for substance use disorder were integrated and highly utilized in the STD setting. Further research needs to focus on the long-term impact of SUD interventions in the STD setting, their cost effectiveness, and the extent they are financially sustainable under the new healthcare law.

Adoption and implementation of a computer-delivered HIV/STD risk-reduction intervention for African American adolescent females seeking services at county health departments: implementation optimization is urgently needed.

PubMed

DiClemente, Ralph J; Bradley, Erin; Davis, Teaniese L; Brown, Jennifer L; Ukuku, Mary; Sales, Jessica M; Rose, Eve S; Wingood, Gina M

2013-06-01

Although group-delivered HIV/sexually transmitted disease (STD) risk-reduction interventions for African American adolescent females have proven efficacious, they require significant financial and staffing resources to implement and may not be feasible in personnel- and resource-constrained public health clinics. We conducted a study assessing adoption and implementation of an evidence-based HIV/STD risk-reduction intervention that was translated from a group-delivered modality to a computer-delivered modality to facilitate use in county public health departments. Usage of the computer-delivered intervention was low across 8 participating public health clinics. Further investigation is needed to optimize implementation by identifying, understanding, and surmounting barriers that hamper timely and efficient implementation of technology-delivered HIV/STD risk-reduction interventions in county public health clinics.

Adoption and Implementation of a Computer-delivered HIV/STD Risk-Reduction Intervention for African American Adolescent Females Seeking Services at County Health Departments: Implementation Optimization is Urgently Needed

PubMed Central

DiClemente, Ralph J.; Bradley, Erin; Davis, Teaniese L.; Brown, Jennifer L.; Ukuku, Mary; Sales, Jessica M.; Rose, Eve S.; Wingood, Gina M.

2013-01-01

Although group-delivered HIV/STD risk-reduction interventions for African American adolescent females have proven efficacious, they require significant financial and staffing resources to implement and may not be feasible in personnel- and resource-constrained public health clinics. We conducted a study assessing adoption and implementation of an evidence-based HIV/STD risk-reduction intervention that was translated from a group-delivered modality to a computer-delivered modality to facilitate use in county public health departments. Usage of the computer-delivered intervention was low across eight participating public health clinics. Further investigation is needed to optimize implementation by identifying, understanding and surmounting barriers that hamper timely and efficient implementation of technology-delivered HIV/STD risk-reduction interventions in county public health clinics. PMID:23673891

Urinary symptoms, sexual intercourse and significant bacteriuria in male patients attending STD clinics.

PubMed Central

David, L M; Natin, D; Walzman, M; Stocker, D

1996-01-01

OBJECTIVE: To assess the relationship between sexual behaviour, urinary symptoms, urinalysis and bacteriuria in men attending STD clinics. DESIGN: A prospective study recording sexual behaviour, urinary symptoms and collecting mid-stream urine specimens. SETTING: Two West Midlands STD clinics, UK. SUBJECTS: 1086 new male patients. RESULTS: 704 patients had had sexual intercourse (SI) within 14 days of testing, 424 had urinary symptoms and 122 had pyuria. All 13 patients with positive culture had SI < 14 days before testing, urinary symptoms and pyuria. No association was found between sexual orientation, type of SI, number of sexual partners, condom usage and bacteriuria. CONCLUSION: Bacteriuria does not behave as an STD but SI may be a factor in acquiring bacteriuria. Dysuria with or without urethral discharge is the most predictive symptom of bacteriuria. Pyuria has a high sensitivity for predicting bacteriuria among males. PMID:8976831

Risk Factors for Sexually Transmitted Disease Among Rural-to-Urban Migrants in China: Implications for HIV/Sexually Transmitted Disease Prevention

PubMed Central

LIU, HONGJIE; LI, XIAOMING; STANTON, BONITA; LIU, HUI; LIANG, GUOJUN; CHEN, XINGUANG; YANG, HONGMEI; HONG, YAN

2007-01-01

The objective of the study was to identify risk factors associated with sexually transmitted diseases (STDs) among rural-to-urban migrants in Beijing in 2002. Migrants with STDs consisted of 432 migrants who sought STD care in two public STD clinics. Migrants without STDs included 892 migrants recruited from 10 occupational clusters. Multiple logistic regression was used for data analysis. Compared to migrants without STDs, migrants with STDs were more likely to report having engaged in commercial sex (selling or buying sex) (odds ratio [OR] = 2.70, 95% confidence interval [CI]: 1.71–4.25), multiple sex partners in the previous month (OR = 6.50, 95% CI: 3.73–11.32) and higher perceived HIV-related stigma (OR = 1.89, 95% CI: 1.30–2.75). Being a migrant with an STD was also associated with female gender (OR = 4.10, 95% CI: 2.89–5.82), higher education (OR = 2.92, 95% CI: 1.40–6.06), and higher monthly salary (OR = 1.68. 95% CI: 1.23–2.29). Migrants with STDs visited their hometowns more frequently and had more stable jobs than migrants without STDs. Approximately 10% of the migrants with STDs and 7.7% of the migrants without STDs always used condoms. This study suggests that among migrants, acquisition of an STD is associated with higher participation in risk behaviors as would be expected, but also with higher perceived stigma, education, stable jobs, salary, and with female gender. Appropriate behavioral intervention programs are advocated to reduce the risk and stigma among the special population. PMID:15665635

Country watch: India.

PubMed

Mukhopadhyay, A; Sehgal, P N

1995-01-01

Linking more than 3000 health and development organizations, the Voluntary Health Association of India (VHAI) is one of the largest networks in the country. In 1990 VHAI began incorporating HIV/STD-related activities into its broader programs. An existing infrastructure for intersectoral collaboration in the areas of community health promotion, public policy, information and documentation, and communications facilitated inclusion of the new activities. Several VHAI departments collaborate in offering training courses, workshops, and seminars at the state and community levels to involve nongovernmental organizations and professional groups in HIV/STD prevention and counseling. More than 950 persons have been trained so far, including trainers of primary health care workers, family physicians, medical practitioners, social scientists, teachers, community volunteer workers, and youth leaders. Local experts act as training resource persons; materials produced locally, abroad, and by VHAI itself are used. Training facilities are offered free of charge to member organizations; VHAI also awards fellowships for field training and financial support for approved projects. VHAI suggests intervention measures to governmental and nongovernmental organizations related to drug users, youth, truck drivers, blood donors, and people living with HIV/AIDS. The information, documentation, and communications departments provide members with a wide variety of information, education, and communication (IEC) materials that can be translated into local languages: posters, folders, flip charts, stickers, and folk songs. VHAI advocacy issues that have been highlighted through the press include: confidentiality, protection against discrimination, the right of all persons to health care, and the need to make properly-equipped STD clinics available. VHAI has established sub-networks in Tamil Nadu (155 organizations) and Manipur (55 organizations) states. VHAI has found that incorporating HIV/STD activities into its general health education programs is more cost-effective than having a vertical program.

Evaluating the opinions of staff and health care service provision of an STD/HIV clinic in Africa: indications for recovery.

PubMed

Cooper, Ross G

2010-06-01

Zimbabwe has an incidence of STD/HIV infection and measures are needed to explore the efficiency of clinics in providing adequate patient care. To explore the views or opinions of the currently employed staff of an STD/HIV clinic, and suggest a means for improvement thereof. A current position analysis was determined through observation of an STD/HIV clinic. An assessment was made using an adapted, designed questionnaire as interviews of 125 staff. Responses to questions were given as Yes or No responses. Data were analysed according to gender, using a two-sample t-test and chi-square tests. Yates' correction was made for continuity of smaller samples. A value of p < 0.05 was taken a significant. The mean average age of all staff was 31.7 years and 75% of the respondents were female. Notably, there were massive shortages of staff, poor communication with the Ministry of Health, little or no training of staff, poor infrastructure and quality, and a drop in safety standards. There is poor communication in the clinic, insufficient staff and inadequate training in place. Monitoring of STD incidence needs drastic improvement. Operational research needs to be conducted. There is little or no direct communication between committee members and decision makers with the staff and power-distance relationships are great.

The Development of a Materials Distribution Service for a Satellite-Based Educational Telecommunications Experiment. Satellite Technology Demonstration, Technical Report No. 0501.

ERIC Educational Resources Information Center

Lonsdale, Helen C.

Because 16mm film programs for classroom use are expensive and distribution is unpredictable, the Satellite Technology Demonstration (STD) established a Materials Distribution Service (MDS) to transmit material via satellite to rural sites in the Rocky Mountains. The STD leased 300 programs from Encyclopedia Britannica Educational Corporation and…

AIDS phobia: report of 4 cases.

PubMed

Ross, M W

1988-01-01

Psychological reactions to sexually transmissible disease (STD) infection are common, occurring in up to 85% of some patients with STDs: Hart has suggested that they are among the most common conditions encountered in venereology. Previous psychiatric disturbances in STD patients, however, are relatively uncommon and differ in both etiology and management from such psychological sequelae of STD infection, although both Catalan et al. and Fitzpatrick et al. report that in the United Kingdom, some 40% of STD clinic attenders had General Health Questionnaire scores indicating they were psychiatric cases.

Posttraumatic stress disorder: Often missed in primary care.

PubMed

Williams, Adrienne A

2017-10-01

DeSean W, a 47-year-old man, returned to his primary care clinic with a new complaint of epigastric burning that had been bothering him for the past 4 months. He had tried several over-the-counter remedies, which provided no relief. He also remained concerned--despite assurances to the contrary at previous clinic visits--that he had contracted a sexually-transmitted disease (STD) after going to a bar one night 4 to 5 months ago. At 2 other clinic visits since that time, STD test results were negative. At this current visit, symptoms and details of sexual history were unchanged since the last visit, with the exception of the epigastric pain. When asked if he thought he had contracted an STD through a sexual encounter the night he went to the bar, he emphatically said he would not cheat on his wife. Surprisingly, given his concern, he avoided further discussion on modes of contracting an STD. The physician prescribed ranitidine 150 mg bid for the epigastric burning and explained, once more, the significance of the STD test results. However, he also decided to further examine Mr. W's concern about STDs and the night he may have contracted one. HOW WOULD YOU PROCEED WITH THIS PATIENT?

Improving STD testing behavior among high-risk young adults by offering STD testing at a vocational school.

PubMed

Spauwen, Laura W L; Hoebe, Christian J P A; Brouwers, Elfi E H G; Dukers-Muijrers, Nicole H T M

2011-09-30

Chlamydia trachomatis infection (CT) is the most prevalent bacterial STD. Sexually active adolescents and young adults are the main risk group for CT. However, STD testing rates in this group are low since exposed individuals may not feel at risk, owing-at least in part-to the infection's largely asymptomatic nature. Designing new testing environments that are more appealing to young people who are most at risk of acquiring chlamydia can be an important strategy to improve overall testing rates. Here we evaluate the effect of a school-based sexual health program conducted among vocational school students, aiming to obtain better access for counseling and enhance students' STD testing behavior. Adolescents (median age 19 years) attending a large vocational school were provided with sexual health education. Students filled in a questionnaire measuring CT risk and were offered STD testing. Using univariate and multivariate analysis, we assessed differences between men and women in STD-related risk behavior, sexual problems, CT testing behavior and determinants of CT testing behavior. Of 345 participants, 70% were female. Of the 287 sexually active students, 75% were at high risk for CT; one third of women reported sexual problems. Of sexually active participants, 61% provided a self-administered specimen for STD testing. Independent determinants for testing included STD related symptoms and no condom use. All CT diagnoses were in the high-CT-risk group. In the high-risk group, STD testing showed an increased uptake, from 27% (previous self-reported test) to 65% (current test). CT prevalence was 5.7%. Vocational school students are a target population for versatile sexual health prevention. When provided with CT testing facilities and education, self selection mechanisms seemed to increase CT testing rate dramatically in this high-CT-risk population expressing sexual problems. Considering the relative ease of testing and treating large numbers of young adults, offering tests at a vocational school is feasible in reaching adolescents for STD screening. Although cost-effectiveness remains an issue counseling is effective in increasing test rates.

Preventing Sexually Transmitted Diseases

PubMed Central

Kieren, Dianne; Cumming, Ceinwen E.; Cumming, David C.

1992-01-01

The discouraging results of early efforts to educate the public about sexually transmitted diseases indicated that the goals of STD preventive action must be longer term and must change attitudes and behaviour as well as educate. They must also avoid an ostrich mentality about the sexual involvement of young people. This article examines more recent approaches to teaching about sexuality in general and STD prevention in particular. PMID:21221351

Condom use relative to knowledge of sexually transmitted disease prevention, method of birth control, and past or present infection.

PubMed

Fleisher, J M; Senie, R T; Minkoff, H; Jaccard, J

1994-12-01

The purpose of this study was to assess knowledge regarding STD spread and prevention, and to assess motivational and behavioral factors that influence the use of condoms to prevent STD acquisition among inner-city women at high risk for STD infection. In addition, the effect of past and/or current STD infection on a woman's knowledge of the mechanism of STD acquisition and subsequent use of a condom to prevent STD infection was explored. We utilized three inner-city clinics offering family planning or gynecologic care located in Brooklyn, New York. Our study linked clinical findings regarding current infection with chlamydia or Trichomonas vaginalis. One thousand four hundred and four sexually active black and Hispanic women participated in the study. A past history of STD (37%) or current infection (29%) was recorded for 54% of the study population (12% were positive for both past and current infection). On average, only 60% of women who reported prior treatment for STD infection reported receiving any information regarding prevention of re-infection during the course of treatment. Depending on the specific STD, from 6.8% to 42.9% of women reporting prior treatment for an STD did not know the disease they were being treated for was sexually transmitted. Condom use for disease prevention was more frequently reported by women who had previously been treated for an STD (OR = 1.62, 95% CI 1.23-2.13). However, condom use for contraception was a stronger predictor of use for STD prevention. Women who relied on condoms for contraception were almost 10 times more likely to also report condom use for STD prevention relative to women who did not use condoms for contraceptive purposes (OR = 9.71, 95% CI 7.0-13.5). In addition, condom use was associated with the perceived attitude of their sexual partner toward such use. Condom use to prevent STD acquisition was more than twice as frequently reported when a favorable attitude was perceived by a male sexual partner (OR = 2.30, 95% CI 1.54-3.43). Our findings suggest that prevention of unplanned pregnancy was a stronger motivator for condom use than disease prevention among the women comprising our study group. The findings also indicate the need for more extensive information regarding STD prevention among women at high risk for STD acquisition.(ABSTRACT TRUNCATED AT 400 WORDS)

Likelihood of Condom Use When Sexually Transmitted Diseases Are Suspected: Results from a Clinic Sample

ERIC Educational Resources Information Center

Crosby, Richard A.; Milhausen, Robin R.; Graham, Cynthia A.; Yarber, William L.; Sanders, Stephanie A.; Charnigo, Richard; Shrier, Lydia A.

2014-01-01

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:…

Comparing Study Populations of Men Who Have Sex with Men: Evaluating Consistency Within Repeat Studies and Across Studies in the Seattle Area Using Different Recruitment Methodologies

PubMed Central

Burt, Richard D.; Oster, Alexandra M.; Golden, Mathew R.; Thiede, Hanne

2013-01-01

There is no gold standard for recruiting unbiased samples of men who have sex with men (MSM). To assess differing recruitment methods, we compared Seattle-area MSM samples from: venue-day-time sampling-based National HIV Behavioral Surveillance (NHBS) surveys in 2008 and 2011, random-digit-dialed (RDD) surveys in 2003 and 2006, and STD clinic patient data 2001–2011. We compared sociodemographics, sexual and drug-associated behavior, and HIV status and testing. There was generally good consistency between the two NHBS surveys and within STD clinic data across time. NHBS participants reported higher levels of drug-associated and lower levels of sexual risk than STD clinic patients. RDD participants differed from the other study populations in sociodemographics and some risk behaviors. While neither NHBS nor the STD clinic study populations may be representative of all MSM, both appear to provide consistent samples of MSM subpopulations across time that can provide useful information to guide HIV prevention. PMID:23900958

Provision of test results and posttest counseling at STD clinics in 24 health departments: U.S., 2007.

PubMed

Begley, Elin; VanHandel, Michelle

2012-01-01

We determined the demographic and HIV test characteristics of tests conducted in CDC-funded sexually transmitted disease (STD) clinics with provision of test results and posttest counseling. We used CDC's HIV Counseling and Testing System data from 2007 for the 24 U.S. health departments that reported test-level data from STD clinics. We calculated and analyzed newly identified HIV positivity and the percentage of tests with provision of test results and posttest counseling (provision of posttest counseling), by demographic and HIV-related characteristics. Of 372,757 tests conducted among people without a previous HIV diagnosis by self-report, provision of posttest counseling was documented for 191,582 (51.4%) HIV tests overall and 1,922 (71.2%) newly identified HIV-positive test results. At these STD clinics, provision of posttest counseling varied by HIV serostatus, age, race/ethnicity, test type, and risk category; however, documentation of posttest counseling was missing for more than 20% of tests. The newly identified HIV positivity among all testers was 0.7%. One of the main goals of HIV counseling and testing is to inform people of their HIV status, because knowledge of one's HIV-positive serostatus can result in a reduction in risk behaviors and allow the person to access HIV medical care and treatment. STD clinics offering HIV testing may need to further their emphasis on increasing the proportion of clients who are provided posttest counseling and on improving documentation of this information.

Cost-effectiveness of a brief video-based HIV intervention for African American and Latino sexually transmitted disease clinic clients.

PubMed

Sweat, M; O'Donnell, C; O'Donnell, L

2001-04-13

Decisions about the dissemination of HIV interventions need to be informed by evidence of their cost-effectiveness in reducing negative health outcomes. Having previously shown the effectiveness of a single-session video-based group intervention (VOICES/VOCES) in reducing incidence of sexually transmitted diseases (STD) among male African American and Latino clients attending an urban STD clinic, this study estimates its cost-effectiveness in terms of disease averted. Cost-effectiveness was calculated using data on effectiveness from a randomized clinical trial of the VOICES/VOCES intervention along with updated data on the costs of intervention from four replication sites. STD incidence and self-reported behavioral data were used to make estimates of reduction in HIV incidence among study participants. The average annual cost to provide the intervention to 10 000 STD clinic clients was estimated to be US$447 005, with a cost per client of US$43.30. This expenditure would result in an average of 27.69 HIV infections averted, with an average savings from averted medical costs of US$5 544 408. The number of quality adjusted life years saved averaged 387.61, with a cost per HIV infection averted of US$21 486. This brief behavioral intervention was found to be feasible and cost-saving when targeted to male STD clinic clients at high risk of contracting and transmitting infections, indicating that this strategy should be considered for inclusion in HIV prevention programming.

Missed opportunities for concurrent HIV-STD testing in an academic emergency department.

PubMed

Klein, Pamela W; Martin, Ian B K; Quinlivan, Evelyn B; Gay, Cynthia L; Leone, Peter A

2014-01-01

We evaluated emergency department (ED) provider adherence to guidelines for concurrent HIV-sexually transmitted disease (STD) testing within an expanded HIV testing program and assessed demographic and clinical factors associated with concurrent HIV-STD testing. We examined concurrent HIV-STD testing in a suburban academic ED with a targeted, expanded HIV testing program. Patients aged 18-64 years who were tested for syphilis, gonorrhea, or chlamydia in 2009 were evaluated for concurrent HIV testing. We analyzed demographic and clinical factors associated with concurrent HIV-STD testing using multivariate logistic regression with a robust variance estimator or, where applicable, exact logistic regression. Only 28.3% of patients tested for syphilis, 3.8% tested for gonorrhea, and 3.8% tested for chlamydia were concurrently tested for HIV during an ED visit. Concurrent HIV-syphilis testing was more likely among younger patients aged 25-34 years (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] 0.78, 2.10) and patients with STD-related chief complaints at triage (AOR=11.47, 95% CI 5.49, 25.06). Concurrent HIV-gonorrhea/chlamydia testing was more likely among men (gonorrhea: AOR=3.98, 95% CI 2.25, 7.02; chlamydia: AOR=3.25, 95% CI 1.80, 5.86) and less likely among patients with STD-related chief complaints at triage (gonorrhea: AOR=0.31, 95% CI 0.13, 0.82; chlamydia: AOR=0.21, 95% CI 0.09, 0.50). Concurrent HIV-STD testing in an academic ED remains low. Systematic interventions that remove the decision-making burden of ordering an HIV test from providers may increase HIV testing in this high-risk population of suspected STD patients.

Youth United through Health Education: Building Capacity through a Community Collaborative Intervention to Prevent HIV/STD in Adolescents Residing in a High STD Prevalent Neighborhood

ERIC Educational Resources Information Center

Sieverding, John; Boyer, Cherrie B.; Siller, Jacqueline; Gallaread, Alonzo; Krone, Melissa; Chang, Y. Jason

2005-01-01

The early detection and treatment of STDs is an effective strategy for slowing the sexual transmission of HIV. The goal of the YUTHE (Youth United Through Health Education) program, a collaborative effort between the San Francisco Department of Public Health (SFDPH) and the University of California, San Francisco, is to increase sexually…

The decentralisation of the sexually transmitted diseases service and its integration into primary health care.

PubMed

Latif, A S; Mbengeranwa, O L; Marowa, E; Paraiwa, E; Gutu, S

1986-10-01

As part of National Health Policy, the City Health Department in Harare, Zimbabwe decentralized sexually transmitted diseases (STD) services and integrated it into primary health care. A central referral STD clinic was created to concentrate expertise. Simplified treatment protocols were distributed to primary care clinics, and nurses in these clinics received an intensive 2-week training course at the central clinic. This was part of a larger plan to provide comprehensive health care in easily accessible settings. The Harare City Health Department has 14 primary care clinics and 9 polyclinics staffed mainly by nursing personnel. The training course taught curative treatment of STDs and prevention by patient education and locating sexual contacts. Participants were expected to be able to utilize physical and laboratory diagnostic techniques accurately to identify common STDs, and to order appropriate treatment. The program emphasized "bedside" teaching with continuous exposure to clinical problems and discussion of those problems. The textbook used included management guidelines in the form of flow charts adapted from World Health Organization guidelines. Over 16 weeks, 49 trainees attended the course. Trainees were mainly female, while patients are mainly male. Trainees performed well, gaining self confidence and ability to manage STDs. The main problems encountered were overwork of staff in clinics when 1 lest for the program, and reluctance of male patients to be examined by female trainees.

Delay in Seeking Care for Sexually Transmitted Diseases in Young Men and Women Attending a Public STD Clinic.

PubMed

Malek, Angela M; Chang, Chung-Chou H; Clark, Duncan B; Cook, Robert L

2013-01-01

Delay in seeking care for sexually transmitted diseases (STDs) has adverse consequences for both the individual and population. We sought to identify factors associated with delay in seeking care for STDs. Subjects included 300 young men and women (aged 15-24) attending an urban STD clinic for a new STD-related problem due to symptoms or referral for an STD screening. Subjects completed a structured interview that evaluated STD history, attitudes and beliefs about STDs, depression, substance use, and other factors possibly associated with delay. Delay was defined as waiting > 7 days to seek and obtain care for STDs. Nearly one-third of participants delayed seeking care for > 7 days. Significant predictors for delay included self-referral for symptoms as the reason for visit (OR 5.3, 95% CI: 2.58 - 10.98), and the beliefs "my partner would blame me if I had an STD" (OR 2.44, 95% CI: 1.30 - 4.60) and "it's hard to find time to get checked for STDs" (OR 3.62, 95% CI: 1.95 - 6.69), after adjusting for age, race, sex, and other factors. Agreeing with the statement "would use a STD test at home if one were available" was associated with a decrease in delay (OR 0.24, 95% CI: 0.09 - 0.60). Many young persons delay seeking care for STDs for a number of reasons. Strategies to improve STD care-seeking include encouragement of symptomatic persons to seek medical care more rapidly, reduction of social stigmas, and improved access to testing options.

Association Between Sexually Transmitted Diseases and Young Adults' Self-reported Abstinence

PubMed Central

DiClemente, Ralph J.; Danner, Fred; Crosby, Richard A.

2011-01-01

OBJECTIVE: Self-reported behavior has been the cornerstone of sexual health research and clinical practice, yet advances in sexually transmitted disease (STD) screening provide researchers with the opportunity to objectively quantify sexual risk behaviors. However, the extent to which young adults' laboratory-confirmed STD results and self-reported sexual behaviors are consistent has not been assessed in a nationally representative sample. PATIENTS AND METHODS: Data are derived from participants who completed wave 3 in the National Longitudinal Study of Adolescent Health. Young adults (N = 14 012) completed an audio computer-assisted self-interviewing survey and provided a urine specimen to detect the presence of Chlamydia trachomatis and Neisseria gonorrhoeae, and a polymerase chain reaction assay to detect Trichomonas vaginalis. RESULTS: More than 10% of young adults with a laboratory-confirmed positive STD result reported abstaining from sexual intercourse in the 12 months before assessment and STD testing. After controlling for several sociodemographic factors, self-reported sex (versus those who reported abstinence) in the previous 12 months was significantly associated with testing positive, but the odds of testing positive were only slightly more than twofold (adjusted odds ratio: 2.11 [95% confidence interval: 2.097–2.122]). CONCLUSIONS: Findings indicate discrepancy between young adults' positive STD status and self-reported sexual behavior. No significant correlates of discrepant reporting were identified. From a clinical standpoint, the discrepancies between STD positivity and self-reported sexual behavior observed in this nationally representative sample suggest that routine STD screening may be beneficial and necessary to reduce STD morbidity among young adults. PMID:21199852

Chancroid detected by polymerase chain reaction--Jackson, Mississippi, 1994-1995.

PubMed

1995-08-04

Chancroid is a sexually transmitted disease (STD) caused by infection with Haemophilus ducreyi and is characterized by genital ulceration. Chancroid is underreported in the United States (1), reflecting, in part, difficulties in diagnosis because of clinical similarities between chancroid and other ulcerative STDs. In addition, laboratory confirmation by culture is 53%-84% sensitive and often is unavailable in clinical settings (2). In September 1994, clinicians at the District V STD clinic of the Mississippi State Department of Health (MSDH) in Jackson reported examining patients with genital ulcers characteristic of chancroid but lacked capacity to confirm the diagnosis. To determine the cause of the ulcers, MSDH, in conjunction with CDC, conducted an investigation of all patients with genital ulcers examined at the Jackson STD clinic during October 20, 1994-February 1, 1995. This report summarizes the findings of the investigation.

Microbiological evaluation of female patients in STD clinics.

PubMed

Iyer, S V; Deodhar, L; Gogate, A

1991-03-01

A total of 215 women patients attending the STD clinic were evaluated in an attempt to isolate the different microorganisms in sexually transmitted diseases (STD). Mycoplasmas (30.22%), Candida species (20.00%), Trichomonas vaginalis (wet mount study; 15.81%), beta haemolytic streptococci (13.48%), Neisseria gonorrhoeae (9.30%), Staphylococcus aureus (13.95%), inclusion bodies of Chlamydia trachomatis (11.60%) and Gram negative organisms (9.30%) were isolated from these patients. Sera of all patients screened for HBsAg by ELISA showed a carrier rate of 12.5 per cent; 29.8 per cent sera were reactive in the VDRL test at the dilutions varying from 1:4 to 1:64.

Interventions to Improve Sexually Transmitted Disease Screening in Clinic-Based Settings.

PubMed

Taylor, Melanie M; Frasure-Williams, Jessica; Burnett, Phyllis; Park, Ina U

2016-02-01

The asymptomatic nature and suboptimal screening rates of sexually transmitted diseases (STD) call for implementation of successful interventions to improve screening in community-based clinic settings with attention to cost and resources. We used MEDLINE to systematically review comparative analyses of interventions to improve STD (chlamydia, gonorrhea, or syphilis) screening or rescreening in clinic-based settings that were published between January 2000 and January 2014. Absolute differences in the percent of the target population screened between comparison groups or relative percent increase in the number of tests or patients tested were used to score the interventions as highly effective (>20% increase) or moderately effective (5%-19% increase) in improving screening. Published cost of the interventions was described where available and, when not available, was estimated. Of the 4566 citations reviewed, 38 articles describing 42 interventions met the inclusion criteria. Of the 42 interventions, 16 (38.1%) were categorized as highly effective and 14 (33.3%) as moderately effective. Effective low-cost interventions (<$1000) included the strategic placement of specimen collection materials or automatic collection of STD specimens as part of a routine visit (7 highly effective and 1 moderately effective) and the use of electronic health records (EHRs; 3 highly effective and 4 moderately effective). Patient reminders for screening or rescreening (via text, telephone, and postcards) were highly effective (3) or moderately effective (2) and low or moderate cost (<$1001-10,000). Interventions with dedicated clinic staff to improve STD screening were highly effective (2) or moderately effective in improving STD screening (1) but high-cost ($10,001-$100,000). Successful interventions include changing clinic flow to routinely collect specimens for testing, using EHR screening reminders, and reminding patients to get screened or rescreened. These strategies can be tailored to different clinic settings to improve screening at a low cost.

Evaluation of the Positive Prevention HIV/STD Curriculum

ERIC Educational Resources Information Center

LaChausse, Robert G.

2006-01-01

This study evaluated the effectiveness of Positive Prevention, a theory-based, HIV/STD prevention education curriculum for high school youth. Three hundred fifty-three students participated in a longitudinal experimental design to determine the impact of the curriculum on HIV/AIDS knowledge, self-efficacy to abstain from sex, self-efficacy of…

Vulnerable Women’s Self-Care Needs in Knowledge, Attitude and Practice Concerning Sexually Transmitted Diseases

PubMed Central

Alimohammadi, Nasrollah; Baghersad, Zahra; Boroumandfar, Zahra

2016-01-01

Background: Vulnerable women are prone to sexually transmitted diseases (STD) due to their special conditions and poor knowledge about these diseases in the society. Therefore, the present study aimed to determine the vulnerable women’s self-care needs in knowledge, attitude and practice concerning STD. Methods: This is a cross-sectional-descriptive study conducted in 2014. The data collection was carried out using a self-administered structured questionnaire. 120 vulnerable women referring to centers affiliated to health and well-being center in Isfahan participated in this study. They were selected through proportional rationing sampling and filled out a researcher developed questionnaire containing information on personal characteristics, self-care knowledge, attitude, and practice needs toward the STD. The data were analyzed using statistical methods including Spearman & Pearson correlation co-efficient, independent t-test and ANOVA. All analyses were carried out using SPSS, 20. Results: Based on the results, most of the subjects mentioned that their priorities of self-care needs in domains of knowledge, attitude and practice were “familiarization with the types and contamination ways of sexually transmitted diseases” (57.9%); “diagnosis of STD only makes us anxious” (24.8), and “the method of washing the genital area before and after intercourse” 41.3%), respectively. There was a significant association among marital status, education, history of addiction, and self-care needs in domains of knowledge, attitude and practice (P<0.05). Conclusion: Results showed that vulnerable women not only knew their need about STD, but also paid attention to their attitude and practice needs toward STD. Therefore, educational programs should be designed and administrated by the experts, based on vulnerable women’s self-care needs concerning their knowledge, attitude and practice to prevent and control STD in vulnerable individuals. PMID:27382588

Improved STD Syndrome Management by a Network of Clinicians and Pharmacy Workers in Peru: The PREVEN Network

PubMed Central

García, Patricia J.; Carcamo, Cesar P.; Garnett, Geoff P.; Campos, Pablo E.; Holmes, King K.

2012-01-01

Background Sexually Transmitted diseases (STD) syndrome management has been one cornerstone of STD treatment. Persons with STD symptoms in many countries, especially those with limited resources, often initially seek care in pharmacies. The objective of the study was to develop and evaluate an integrated network of physicians, midwives and pharmacy workers trained in STD syndromic management (The PREVEN Network) as part of a national urban community-randomized trial of sexually transmitted infection prevention in Peru. Methods and Findings After a comprehensive census of physicians, midwives, and pharmacies in ten intervention and ten control cities, we introduced seminars and workshops for pharmacy workers, and continuing education for physicians and midwives in intervention cities and invited graduates to join the PREVEN Network. “Prevention Salespersons” visited pharmacies, boticas and clinicians regularly for educational support and collection of information on numbers of cases of STD syndromes seen at pharmacies and by clinicians in intervention cities. Simulated patients evaluated outcomes of training of pharmacy workers with respect to adequate STD syndrome management, recommendations for condom use and for treatment of partners. In intervention cities we trained, certified, and incorporated into the PREVEN Network the workers at 623 (80.6%) of 773 pharmacies and 701 (69.6%) of 1007 physicians and midwives in private practice. Extremely high clinician and pharmacy worker turnover, 13.4% and 44% respectively in the first year, dictated continued training of new pharmacy workers and clinicians. By the end of the intervention the Network included 792 pharmacies and 597 clinicians. Pharmacies reported more cases of STDs than did clinicians. Evaluations by simulated patients showed significant and substantial improvements in the management of STD syndromes at pharmacies in intervention cities but not in control cities. Conclusions Training pharmacy workers linked to a referral network of clinicians proved feasible and acceptable. High turn-over was challenging but over come. PMID:23082208

Improved STD syndrome management by a network of clinicians and pharmacy workers in Peru: The PREVEN Network.

PubMed

García, Patricia J; Carcamo, Cesar P; Garnett, Geoff P; Campos, Pablo E; Holmes, King K

2012-01-01

Sexually Transmitted diseases (STD) syndrome management has been one cornerstone of STD treatment. Persons with STD symptoms in many countries, especially those with limited resources, often initially seek care in pharmacies. The objective of the study was to develop and evaluate an integrated network of physicians, midwives and pharmacy workers trained in STD syndromic management (The PREVEN Network) as part of a national urban community-randomized trial of sexually transmitted infection prevention in Peru. After a comprehensive census of physicians, midwives, and pharmacies in ten intervention and ten control cities, we introduced seminars and workshops for pharmacy workers, and continuing education for physicians and midwives in intervention cities and invited graduates to join the PREVEN Network. "Prevention Salespersons" visited pharmacies, boticas and clinicians regularly for educational support and collection of information on numbers of cases of STD syndromes seen at pharmacies and by clinicians in intervention cities. Simulated patients evaluated outcomes of training of pharmacy workers with respect to adequate STD syndrome management, recommendations for condom use and for treatment of partners. In intervention cities we trained, certified, and incorporated into the PREVEN Network the workers at 623 (80.6%) of 773 pharmacies and 701 (69.6%) of 1007 physicians and midwives in private practice. Extremely high clinician and pharmacy worker turnover, 13.4% and 44% respectively in the first year, dictated continued training of new pharmacy workers and clinicians. By the end of the intervention the Network included 792 pharmacies and 597 clinicians. Pharmacies reported more cases of STDs than did clinicians. Evaluations by simulated patients showed significant and substantial improvements in the management of STD syndromes at pharmacies in intervention cities but not in control cities. Training pharmacy workers linked to a referral network of clinicians proved feasible and acceptable. High turn-over was challenging but over come.

Health education and promotion for STD prevention: lessons for the next millennium.

PubMed Central

Darrow, W W

1997-01-01

OBJECTIVE: To review the evolution of health promotion for STD prevention. MAIN OBSERVATIONS: Information and education programmes were provided at the beginning of the 20th century to warn the public about the dangers of venereal infection and to support the medical model of case identification and case management under the care of qualified physicians. The public health approach offered advice about chemical, chemotherapeutic, and barrier prophylaxis, but avoided the issue of social prophylaxis. With the failure of antimicrobial agents to eradicate syphilis in the 1960s, rapid increases of viral sexually transmitted diseases (STDs) and resistant strains of gonorrhoea in the 1970s, and the discovery of AIDS in the 1980s, alternatives to the traditional public health approach were sought and supported with a modest increase of resources. Three major innovations have been introduced to STD prevention as a result: social marketing, community involvement, and behaviour change programmes based on social and psychological concepts and theoretical models. CONCLUSIONS: Health promotion for STD prevention in the future will be characterised by careful assessments of the social and behavioural determinants of sexual risk taking, development and implementation of targeted interventions designed to reduce risk taking, and evaluation of social and behavioural interventions for improvements in STD prevention. Images PMID:9215087

STD/AIDS prevention in Portuguese-speaking Africa: a review of the recent literature in the social sciences and health.

PubMed

Monteiro, Simone

2009-03-01

The article reviews academic literature in the social sciences and health on the problems and challenges of STD/AIDS prevention in Portuguese-speaking African countries. Based on a bibliographic survey of the SciELO, PubMed, and Sociological Abstracts databases between 1997 and 2007, the research under review was organized into two groups, according to content. The first group of studies sought to understand STD/AIDS vulnerability among social groups by examining local cultural and socioeconomic factors as related to gender dynamics, sexuality, color/race, religion and health care. The second group encompassed critical assessments of shortcomings in the STD/AIDS educational messages delivered by governments and international agencies. Attention is called to the way in which the presence of traditional medicine systems and the occurrence of civil wars in the post-colonial period impact the STD/AIDS epidemic in the African countries under study.

HIV and STD testing in prisons: perspectives of in-prison service providers.

PubMed

Grinstead, Olga; Seal, David W; Wolitski, Richard; Flanigan, Timothy; Fitzgerald, Christine; Nealey-Moore, Jill; Askew, John

2003-12-01

Because individuals at risk for HIV and STDs are concentrated in prisons and jails, incarceration is an opportunity to provide HIV and STD testing. We interviewed 72 service providers working in U.S. prisons in four states about their experiences with and perceptions regarding HIV and STD testing in prison. Providers' job duties represented administration, education, security, counseling, and medical care. Providers' knowledge of prison procedures and programs related to HIV and STD testing was narrowly limited to their specific job duties, resulting in many missed opportunities for prevention counseling and referral. Suggestions include increasing health care and counseling staff so posttest counseling can be provided for those with negative as well as positive test results, providing additional prevention programs for incarcerated persons, improving staff training about HIV and STD testing, and improving communication among in-prison providers as well as between corrections and public health staff.

Predicting Condom Use among STD Clinic Patients Using the Information-Motivation-Behavioral Skills (IMB) Model

PubMed Central

Scott-Sheldon, Lori A. J.; Carey, Michael P.; Vanable, Peter A.; Senn, Theresa E.; Coury-Doniger, Patricia; Urban, Marguerite A.

2010-01-01

We assessed determinants of condom use postulated by the IMB model among STD patients (N = 1,474). The model provided acceptable fit to the data (CFI = .99, RMSEA = .04). Information was unrelated to condom use but had a negative effect on behavioral skills. Motivation had a positive effect on behavioral skills and condom use. Behavioral skills had a positive effect on condom use. In multiple-groups analyses, stronger associations between motivation and condom use were found among participants reporting no prior STD treatment. Interventions among STD patients should include activities addressing condom use motivation and directly enhancing condom skills. PMID:20453055

SU-F-T-87: Comparison of Advanced Radiotherapy Techniques for Post- Mastectomy Breast Cancer Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Heins, D; Zhang, R; Hogstrom, K

2016-06-15

Purpose: To determine if bolus electron conformal therapy (Bolus-ECT) combined with intensity modulated x-ray therapy (IMXT) and flattening filter free volumetric modulated arc therapy (FFF-VMAT (6x and 10x)) can maintain equal or better dose coverage than standard volumetric modulated arc therapy (Std-VMAT) while reducing doses to organs at risk (OARs). Methods: Bolus-ECT with IMXT, FFF-VMAT, and Std-VMAT treatment plans were produced for ten post-mastectomy radiotherapy (PMRT) patients previously treated at our clinic. The treatment plans were created on commercially available treatment planning system (TPS) and all completed treatment plans were reviewed and approved by a radiation oncologist. The plans weremore » evaluated based on planning target volume (PTV) coverage, tumor control probability (TCP), dose homogeneity index (DHI), conformity index (CI), and dose to organs at risk (OAR). Results: All techniques produced clinically acceptable PMRT plans. Overall, Bolus-ECT with IMXT exhibited higher maximum dose compared to all VMAT techniques. Bolus-ECT with IMXT and FFF-VMAT10x had slightly improved TCP over FFF-VMAT6x and Std-VMAT. However, all VMAT techniques showed improved CI and DHI over Bolus-ECT with IMXT. All techniques showed very similar mean lung dose. Bolus-ECT with IMXT exhibited a reduced mean heart dose over Std-VMAT. Both FFF-VMAT techniques had higher mean heart dose compared to Std-VMAT. In addition, Bolus-ECT with IMXT was able to reduce mean dose to the contralateral breast compared to Std-VMAT and both FFF-VMAT techniques had comparable but slightly reduced dose compared to Std-VMAT. Conclusion: This work has shown that Bolus-ECT with IMXT produces clinically acceptable plans while reducing OAR doses. Both FFF-VMAT techniques are comparable to Std-VMAT with slight improvements. Even though all VMAT techniques produce more homogenous and conformal dose distributions, Bolus-ECT with IMXT is a viable option for treating post-mastectomy patients possibly leading to reduced risks of normal tissue complications.« less

Clinical profile of STD clinic patients seropositive for HIV antibodies.

PubMed

Krishnaiah, Y R; Babu, V S; Lakshmi, N; Kumar, A G

1989-01-01

This article provides clinical profiles for HIV seropositive patients discovered at an STD clinic in Tirupati, India. Considering that sexual contact is the most common mode of transmission of HIV, researchers from the SV Medical College at Tirupati conducted a surveillance for HIV infection among patients attending an STD clinic. From January 1988 to April 1989, the researchers collected serum samples from 2320 patients. 11 people were found to be infected with HIV, 1 of whom exhibited the AIDS Related Complex (ARC). 9 out the HIV-infected patients were 20-30 year-old males categorized as heterosexually promiscuous; the remaining 2 seropositive patients were female prostitutes. The seropositivity rate among heterosexually promiscuous males was 0.58%, and 6.7% among female prostitutes (the total seropositivity rate was 0.47%). Among the HIV-infected patients, the most commonly associated STD was syphilis. 5 of the patients had syphilis alone, and 2 others had syphilis and another STD. One of the HIV-infected patients, a 50 year-old heterosexual male with a history of multiple partners, suffered from a nonhealing genital ulcer and inguinal buboes of 1 month duration. A biopsy of the genital ulcer revealed a pattern consistent with that of granuloma venereum. He also developed angular stomatitis which did not respond to B complex therapy. Furthermore, suffering from persistent lymphadenopathy, weight loss, slight thrombo-cytopenia, an opportunistic infection in the form of oral candidosis and persistent seropositivity for HIV antibodies, the patient was deemed to have the AIDS Related Complex. Tirupati's seropositivity rate of .47% was higher that noticed in other parts of the country, leading the authors call for a plan to investigate the problems of HIV-infected people.

U.S. Young Adults STDs, Risk Perception, Risk Behaviors, and Health Information Seeking

ERIC Educational Resources Information Center

Robison-Chadwell, Amanda

2017-01-01

Sexually transmitted diseases (STD) are preventable conditions for which treatment failure (specifically in gonorrhea) is becoming problematic. U.S. young adults (20-29 years) have high rates of STD incidence and prevention of these diseases, but reaching them to provide primary prevention educations is challenging due to low perceived…

Age Differences in STDs, Sexual Behaviors, and Correlates of Risky Sex Among Sexually Experienced Adolescent African-American Females

PubMed Central

Brown, Jennifer L.; DiClemente, Ralph J.; Davis, Teaniese L.; Kottke, Melissa J.; Rose, Eve S.

2012-01-01

Objective To explore age differences in factors associated with positive sexually transmitted diseases (STD) status among a sample of African-American adolescent females. Methods Data were collected via ACASI from 701 African-American adolescent females (14–20 years) seeking services at reproductive health clinics. Adolescents provided self-collected vaginal swabs assayed using NAAT to assess the prevalence of three STDs. Results Younger adolescents (14–17 years) had significantly higher rates of STDs than older adolescents (18–20 years), but older adolescents had significantly higher levels of STD-associated risk behavior. In controlled analysis, having a casual sex partner was the only variable significantly associated with a positive STD test for younger adolescents, and prior history of STD and higher impulsivity were significantly associated with testing STD positive among older adolescents. Conclusions These findings suggest that developmentally tailored STD/HIV prevention interventions are needed for younger and older subgroups of adolescent females to help reduce their risk of infection. PMID:21933811

Observations of sexually transmitted disease consultations in India.

PubMed

Mertens, T E; Smith, G D; Kantharaj, K; Mugrditchian, D; Radhakrishnan, K M

1998-03-01

To assess the quality of sexually transmitted disease (STD) case management provided in public and private health facilities in selected areas of Madras, Tamil Nadu, India, in order to make recommendations for improving the quality of care and promote the syndromic approach to STD treatment. Structured observations of consultations for STDs in health care facilities. Scoring of the observations according to standards for history taking, examination, treatment and provision of basic health promotion advice allows evaluation of STD case management. With STD treatment adequacy scored against Indian national guidelines (which recommend aetiologic treatment), history taking, examination and treatment were satisfactory in 76 out of 108 (70%) of observed consultations. However, if STD treatment adequacy is scored with respect to the syndrome approach towards selected STD (male urethritis and non herpetic genital ulcer for both sexes), only 8 out of 81 (10%) of the patients were satisfactory managed. During 32 out of 108 (30%) of the consultations, advice on the use of condoms in order to prevent STD or HIV/AIDS was given. Instructions regarding how to use condoms were offered to seven (6%) patients and condoms were only provided to one patient (1%). Patients were urged to refer their partner(s) for treatment during 29 (27%) of consultations. A criterion of adequate use of the STD consultation for health promotion, requiring both promotion of condoms and encouragement to refer partner(s) for treatment, was met during 13 (12%) of consultations. Monitoring and improving the standards of care at facilities at which STDs are treated have become key roles of STD/HIV/AIDS programmes. The present report suggests that in Madras the activities of medical practitioners who treat STD patients are far from ideal at present. Improvements would involve simplifying existing treatment guidelines by promoting the syndromic approach to STD management, continuing education programmes for health care providers in the public and private sectors and repeat assessments and feedback of the quality of STD care.

SHPPS 2006: School Health Policies and Programs Study--Sexually Transmitted Disease (STD) Prevention

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2007

2007-01-01

The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of sexually transmitted disease (STD) prevention, covering the following topics (1) Health Education; and…

A Study of the Awareness of Selected College Students Concerning Sexually Transmitted Diseases.

ERIC Educational Resources Information Center

Frazer, Gregory H.; Klein, Daniel

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,…

76 FR 66721 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-27

... Advisory Committee on HIV and STD Prevention and Treatment In accordance with section l0(a)(2) of the... the Administrator, HRSA, regarding activities related to prevention and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health...

75 FR 39264 - CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-08

... Resources and Services Administration CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment In... and control of HIV/AIDS and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health professionals and the public about HIV/AIDS and other STDs. Matters To Be...

78 FR 32392 - CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention and Treatment

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-30

... Resources and Services Administration CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD Prevention.../AIDS, Viral Hepatitis and other STDs, the support of health care services to persons living with HIV/AIDS, and education of health professionals and the public about HIV/AIDS, Viral Hepatitis and other...

[Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence].

PubMed

Silva, Ítalo Rodolfo; Gomes, Antonio Marcos Tosoli; Valadares, Glaucia Valente; dos Santos, Nereida Lúcia Palko; da Silva, Thiago Privado; Leite, Joséte Luzia

2015-09-01

to understand the perception of nurses on the vulnerabilities to STD/AIDS in light of the process of adolescence. qualitative research conducted with 15 nurses in a centre for the studies of adolescent healthcare of a university hospital in Rio de Janeiro/Brazil. The adopted theoretical and methodological frameworks were the Complexity Theory and the Grounded Theory, respectively. The semi-structured interview was used to collect data from January to August 2012. this research presents the category: Nurses' perceptions of the vulnerabilities to STD/AIDS in light of the process of adolescence, and the subcategories: Risks and uncertainties of the process of adolescence: paths to STD/AIDS; Age-adolescence complex: expanding knowledge from the perception of nurses. once the nurses understand the complexity of adolescence, they create strategies to reduce the vulnerability of adolescents to STD/AIDS. This signals the need to invest in education, assistance and the management of nursing care for adolescents.

Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men--STD Surveillance Network, United States, 2010-2012.

PubMed

Patton, Monica E; Kidd, Sarah; Llata, Eloisa; Stenger, Mark; Braxton, Jim; Asbel, Lenore; Bernstein, Kyle; Gratzer, Beau; Jespersen, Megan; Kerani, Roxanne; Mettenbrink, Christie; Mohamed, Mukhtar; Pathela, Preeti; Schumacher, Christina; Stirland, Ali; Stover, Jeff; Tabidze, Irina; Kirkcaldy, Robert D; Weinstock, Hillard

2014-06-01

Gonorrhea (GC) and chlamydia (CT) are the most commonly reported notifiable diseases in the United States. The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) be screened for urogenital GC/CT, rectal GC/CT, and pharyngeal GC. We describe extragenital GC/CT testing and infections among MSM attending sexually transmitted disease (STD) clinics. The STD Surveillance Network collects patient data from 42 STD clinics. We assessed the proportion of MSM attending these clinics during July 2011-June 2012 who were tested and positive for extragenital GC/CT at their most recent visit or in the preceding 12 months and the number of extragenital infections that would have remained undetected with urethral screening alone. Of 21 994 MSM, 83.9% were tested for urogenital GC, 65.9% for pharyngeal GC, 50.4% for rectal GC, 81.4% for urogenital CT, 31.7% for pharyngeal CT, and 45.9% for rectal CT. Of MSM tested, 11.1% tested positive for urogenital GC, 7.9% for pharyngeal GC, 10.2% for rectal GC, 8.4% for urogenital CT, 2.9% for pharyngeal CT, and 14.1% for rectal CT. More than 70% of extragenital GC infections and 85% of extragenital CT infections were associated with negative urethral tests at the same visit and would not have been detected with urethral screening alone. Extragenital GC/CT was common among MSM attending STD clinics, but many MSM were not tested. Most extragenital infections would not have been identified, and likely would have remained untreated, with urethral screening alone. Efforts are needed to facilitate implementation of extragenital GC/CT screening recommendations for MSM.

Extragenital Gonorrhea and Chlamydia Testing and Infection Among Men Who Have Sex With Men—STD Surveillance Network, United States, 2010–2012

PubMed Central

Patton, Monica E.; Kidd, Sarah; Llata, Eloisa; Stenger, Mark; Braxton, Jim; Asbel, Lenore; Bernstein, Kyle; Gratzer, Beau; Jespersen, Megan; Kerani, Roxanne; Mettenbrink, Christie; Mohamed, Mukhtar; Pathela, Preeti; Schumacher, Christina; Stirland, Ali; Stover, Jeff; Tabidze, Irina; Kirkcaldy, Robert D.; Weinstock, Hillard

2015-01-01

Background Gonorrhea (GC) and chlamydia (CT) are the most commonly reported notifiable diseases in the United States. The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) be screened for urogenital GC/CT, rectal GC/CT, and pharyngeal GC. We describe extragenital GC/CT testing and infections among MSM attending sexually transmitted disease (STD) clinics. Methods The STD Surveillance Network collects patient data from 42 STD clinics. We assessed the proportion of MSM attending these clinics during July 2011–June 2012 who were tested and positive for extragenital GC/CT at their most recent visit or in the preceding 12 months and the number of extragenital infections that would have remained undetected with urethral screening alone. Results Of 21 994 MSM, 83.9% were tested for urogenital GC, 65.9% for pharyngeal GC, 50.4% for rectal GC, 81.4% for urogenital CT, 31.7% for pharyngeal CT, and 45.9% for rectal CT. Of MSM tested, 11.1% tested positive for urogenital GC, 7.9% for pharyngeal GC, 10.2% for rectal GC, 8.4% for urogenital CT, 2.9% for pharyngeal CT, and 14.1% for rectal CT. More than 70% of extragenital GC infections and 85% of extragenital CT infections were associated with negative urethral tests at the same visit and would not have been detected with urethral screening alone. Conclusions Extragenital GC/CT was common among MSM attending STD clinics, but many MSM were not tested. Most extragenital infections would not have been identified, and likely would have remained untreated, with urethral screening alone. Efforts are needed to facilitate implementation of extragenital GC/CT screening recommendations for MSM. PMID:24647015

Performance of serological tests for syphilis in sexually transmitted diseases clinics in Guangxi Autonomous Region, China: implications for syphilis surveillance and control.

PubMed

Yin, Yue-Ping; Wei, Wan-Hui; Wang, Hong-Chun; Zhu, Bang-Yong; Yu, Yan-Hua; Chen, Xiang-Sheng; Peeling, Rosanna W; Cohen, Myron S

2009-03-01

China is experiencing a growing syphilis epidemic. Individuals are currently screened and cases are confirmed using traditional serological testing methods. A total of 11 558 serum specimens from patients at 14 sexually transmitted diseases (STD) clinics at provincial, prefecture and county levels in Guangxi Autonomous Region were tested at local clinics using the toluidine red unheated serum test (TRUST) and the SD Bioline Syphilis 3.0 Treponema Pallidum (SD-TP) test and then transported to the National STD Reference Laboratory for TRUST and confirmatory Treponema pallidum particle assay (TPPA) testing. In local clinics, 13.2% of specimens were TRUST positive and 12.8% were TRUST and SD-TP positive. At the Reference Laboratory, 15.4% of specimens were TRUST positive and 11.8% were TRUST and TPPA positive. Local clinics showed a significantly higher prevalence of active syphilis compared with results from the Reference Laboratory (12.8 v. 11.8%, chi(2) = 4.59, P = 0.03). The local TRUST tests had consistent results with Reference Laboratory tests qualitatively among 96.2% of the specimens and quantitatively among 95.5% of the specimens. The algorithm of TRUST screening and then SD-TP confirmation among positive TRUST specimens at local STD clinics had 96.6% sensitivity and 99.3% specificity in diagnosing active syphilis compared with the 'gold standard' based on TRUST and TPPA positivity at the Reference Laboratory (positive predictive value 95.1% and negative predictive value 99.5%). The TRUST screening and SD-TP confirmation in combination can be used at local STD clinics for the efficient diagnosis of serologically active syphilis. However, continuing capacity building and quality assurance remain critical in ensuring the quality of syphilis diagnosis at local clinics.

[Factors associated with condom use and knowledge about STD/AIDS among teenagers in public and private schools in São Paulo, Brazil].

PubMed

Martins, Laura B Motta; da Costa-Paiva, Lúcia Helena S; Osis, Maria José D; de Sousa, Maria Helena; Pinto-Neto, Aarão M; Tadini, Valdir

2006-02-01

This study aimed to compare knowledge about STD/AIDS and identify the factors associated with adequate knowledge and consistent use of male condoms in teenagers from public and private schools in the city of São Paulo, Brazil. We selected 1,594 adolescents ranging 12 to 19 years of age in 13 public schools and 5 private schools to complete a questionnaire on knowledge of STD/AIDS and use of male condoms. Prevalence ratios were computed with a 95% confidence interval. The score on STD knowledge used a cutoff point corresponding to 50% of correct answers. Statistical tests were chi-square and Poisson multiple regression. Consistent use of male condoms was 60% in private and 57.1% in public schools (p > 0.05) and was associated with male gender and lower socioeconomic status. Female gender, higher schooling, enrollment in private school, Caucasian race, and being single were associated with higher knowledge of STDs. Teenagers from public and private schools have adequate knowledge of STD prevention, however this does not include the adoption of effective prevention. Educational programs and STD/AIDS awareness-raising should be expanded in order to minimize vulnerability.

Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions

PubMed Central

Tilson, Elizabeth C; Sanchez, Victoria; Ford, Chandra L; Smurzynski, Marlene; Leone, Peter A; Fox, Kimberley K; Irwin, Kathleen; Miller, William C

2004-01-01

Background Sexually transmitted diseases (STDs) are a major public health problem among young people and can lead to the spread of HIV. Previous studies have primarily addressed barriers to STD care for symptomatic patients. The purpose of our study was to identify perceptions about existing barriers to and ideal services for STDs, especially asymptomatic screening, among young people in a southeastern community. Methods Eight focus group discussions including 53 White, African American, and Latino youth (age 14–24) were conducted. Results Perceived barriers to care included lack of knowledge of STDs and available services, cost, shame associated with seeking services, long clinic waiting times, discrimination, and urethral specimen collection methods. Perceived features of ideal STD services included locations close to familiar places, extended hours, and urine-based screening. Television was perceived as the most effective route of disseminating STD information. Conclusions Further research is warranted to evaluate improving convenience, efficiency, and privacy of existing services; adding urine-based screening and new services closer to neighborhoods; and using mass media to disseminate STD information as strategies to increase STD screening. PMID:15189565

The Development of a Field Services Network for a Satellite-Based Educational Telecommunications Experiment. Satellite Technology Demonstration, Technical Report No. 0333.

ERIC Educational Resources Information Center

Anderson, Frank; And Others

The Satellite Technology Demonstration (STD) of the Federation of Rocky Mountain States (FRMS) employed a technical delivery system to merge effectively hardware and software, products and services. It also needed a nontechnical component to insure product and service acceptance. Accordingly, the STD's Utilization Component was responsible for…

Sexuality education policies and sexually transmitted disease rates in the United States of America.

PubMed

Hogben, M; Chesson, H; Aral, S O

2010-04-01

The aim of the study was to test for relationships between state-level sex educational policies and sexually transmitted disease (STD) rates. We analysed US case reports of gonorrhoea and chlamydial infection for 2001-2005 against state policies for abstinence coverage in sexuality education, using the proportion of the population per state who identified as black (aged 15-24 years) as a covariate. We also tested for effects on 15-19 year olds versus 35-39 year olds and tuberculosis rates (the latter to ensure findings applied only to STD). States with no mandates for abstinence had the lowest mean rates of infection among the overall population and among adolescents. States with mandates emphasizing abstinence had the highest rates; states with mandates to cover (but not emphasize) abstinence fell in between. Rates in some states covering abstinence changed faster than in others, as reflected in sharper declines (gonorrhoea) or slower increases (chlamydial infection). These effects were not shown for tuberculosis or 35-39 year olds. Having no abstinence education policy has no apparent effect on STD rates for adolescents. For states with elevated rates, policies mandating coverage may be useful, although policies emphasizing abstinence show no benefit.

Importance of alcohol-related expectations and emotional expressivity for prediction of motivation to refuse alcohol in alcohol-dependent patients.

PubMed

Slavinskienė, Justina; Žardeckaitė-Matulaitienė, Kristina

2014-01-01

The aim of this study was to evaluate the importance of alcohol-dependent patients' emotional expressivity, alcohol-related expectations and socio-demographic factors for prediction of motivation to refuse alcohol consumption. The study sample consisted of 136 alcohol-dependent patients (100 men and 36 women) undergoing treatment in Kaunas center for addictive disorders. Only higher expression of negative alcohol-related expectations (std. beta=0.192, P=0.023), higher emotional impulse intensity (std. beta=0.229, P=0.021) and higher expression of positive emotional expressiveness (std. beta=0.021, P=0.020) as well as gender (std. beta=0.180, P=0.049), education (std. beta=-0.137, P=0.038) and alcohol dependency treatment conditions (members of support group after rehabilitation program) (std. beta=0.288, P=0.001; std. beta=0.608, P=0.001) were significant factors for predicting the different level of alcohol-dependent patients motivation to refuse alcohol consumption. Negative alcohol-related expectations, emotional impulse intensity and positive emotional expressiveness were significant even though quite weak triggers for alcohol-dependent patients' different level of motivation to refuse alcohol consumption. An assumption could be made that by changing these triggers it is possible to change addictive behavior. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Std trends in chengalpattu hospital.

PubMed

Krishnamurthy, V R; Ramachandran, V

1996-01-01

A retrospective data analysis was carried out to find the trends in frequency and distribution of different STDs at Chengalpattu during 1988-1994. Of the 4549 patients who attended the clinic 3621 (79.6%) were males and 928 (20.4%) were females. The commonest STD was Chancroid (24.4%) in men and Syphillis (29%) in women. Balanoposthitis (11.4%) ranked third among STDs in males. Though the STD attendance showed a declining trend, most diseases showed a constant distribution. The percentage composition of secondary and latent syphillis, Genital Warts, Genital Herpes and the Non-Venereal group showed an increased composition in recent years. Primary syphillis in females showed a definite declining trend. The HIV sero-positive detection rate was 2.06%. Of the 1116 patients screened for HIV antibody, 23 patients were detected sero-positive. Time Series Regression Analysis was used to predict the number of patients who would attend the STD clinic with various STDs in 1995 and 1996 to help in the understanding of the disease load and pattern in future, in resources management and in developing and evaluating preventive measures.

Characterization of Mexican Americans with mild cognitive impairment and Alzheimer's disease.

PubMed

O'Bryant, Sid E; Johnson, Leigh; Balldin, Valerie; Edwards, Melissa; Barber, Robert; Williams, Benjamin; Devous, Michael; Cushings, Blair; Knebl, Janice; Hall, James

2013-01-01

The purpose of the study was to provide characterization of Mexican Americans who meet criteria for Alzheimer's disease (AD) and mild cognitive impairment (MCI). For the study, 1,069 participants ages 40 and above who self-identified as either non-Hispanic white (n = 633) or Mexican American (n = 436) were recruited using a community-based participatory research approach. Global cognition was assessed via the Mini-Mental State Examination (MMSE), dementia severity by the Clinical Dementia Rating Scale, and depression via the Geriatric Depression Scale 30-item version. Age, gender, education, ApoE ε4 allele frequency, and diabetic diagnoses were also analyzed. The findings showed that Mexican Americans (normal controls, MCI, and AD) were younger, less highly educated, performed more poorly on the MMSE, endorsed more symptoms of depression, were more likely to be diagnosed with diabetes, and possessed the ApoE ε4 allele less frequently. Age was the only significant risk factor for cognitive dysfunction (AD/MCI) among Mexican Americans (OR = 1.06, 95% CI = 1.03-1.09). Age (B = 0.07, std = 0.02, p < 0.001) and ApoE ε4 presence (B = 0.9, std = 0.4, p = 0.02) were significantly related to increased disease severity. Given the rapidly growing and aging Mexican American population, there is a substantial need for research into cognitive aging, MCI, and AD among this ethnic group. The current findings hold important implications for both clinic and research settings and point to additional research needs.

Prevalence of asymptomatic infections in sexually transmitted diseases attendees diagnosed with bacterial vaginosis, vaginal candidiasis, and trichomoniasis.

PubMed

Rajalakshmi, R; Kalaivani, S

2016-01-01

Sexually transmitted diseases (STD) are a major health problem affecting mostly young people in both developing and developed countries. STD in women causes both acute morbidity and complications such as infertility, ectopic pregnancy, low-birth weight, and prematurity. The aim of the study is to assess the prevalence of bacterial vaginosis, vaginal candidiasis, and trichomoniasis among asymptomatic females attending STD outpatient department in a tertiary care hospital in South India. A retrospective analysis of data collected from clinical records of 3000 female patients of age 18 to 49 over a period of 12 months (July 2014 to June 2015) was carried out at the Institute of Venereology, Madras Medical College. Complete epidemiological, clinical, and investigational data were recorded and analyzed for the prevalence of bacterial vaginosis, vaginal candidiasis, and trichomoniasis among asymptomatic patients. About 48.37% (228/470) of bacterial vaginosis patients were asymptomatic. Nearly 45.38% (116/235) of vaginal candidiasis patients were asymptomatic and 30.35% (26/87) of trichomoniasis patients were asymptomatic. The above infections were common in the age group 25-35. Holistic screening protocol was incorporated for all female patients attending STD clinic even if asymptomatic and should be treated accordingly to prevent the acquisition of other serious sexually transmitted infections.

Incidence of herpes simplex virus type 2 infection in 5 sexually transmitted disease (STD) clinics and the effect of HIV/STD risk-reduction counseling.

PubMed

Gottlieb, Sami L; Douglas, John M; Foster, Mark; Schmid, D Scott; Newman, Daniel R; Baron, Anna E; Bolan, Gail; Iatesta, Michael; Malotte, C Kevin; Zenilman, Jonathan; Fishbein, Martin; Peterman, Thomas A; Kamb, Mary L

2004-09-15

The seroincidence of herpes simplex virus type 2 (HSV-2) infection was determined among 1766 patients attending sexually transmitted disease (STD) clinics and enrolled in a randomized, controlled trial of human immunodeficiency virus (HIV)/STD risk-reduction counseling (RRC). Arm 1 received enhanced RRC (4 sessions); arm 2, brief RRC (2 sessions); and arm 3, the control arm, brief informational messages. The overall incidence rate was 11.7 cases/100 person-years (py). Independent predictors of incidence of HSV-2 infection included female sex; black race; residence in Newark, New Jersey; <50% condom use with an occasional partner; and, in females, incident trichomoniasis and bacterial vaginosis. Only 10.8% of new HSV-2 infections were diagnosed clinically. Incidence rates were 12.9 cases/100 py in the control arm, 11.8 cases/100 py in arm 2, and 10.3 cases/100 py in arm 1 (hazard ratio, 0.8 [95% confidence interval, 0.6-1.1], vs. controls). The possible benefit of RRC in preventing acquisition of HSV-2 infection offers encouragement that interventions more specifically tailored to genital herpes may be useful and should be an important focus of future studies.

A Network Analysis of Sexually Transmitted Diseases and Online Hookup Sites Among Men Who Have Sex With Men.

PubMed

Chan, Philip A; Crowley, Christina; Rose, Jennifer S; Kershaw, Trace; Tributino, Alec; Montgomery, Madeline C; Almonte, Alexi; Raifman, Julia; Patel, Rupa; Nunn, Amy

2018-07-01

Sexually transmitted diseases (STDs) are increasing among gay, bisexual, and other men who have sex with men (MSM). Little is known about the use of websites and mobile phone applications to meet sexual partners ("hookup sites") and association with STD diagnoses. We performed a demographic and behavioral assessment of 415 MSM presenting to the Rhode Island STD clinic. Bivariate and multivariable analyses assessed associations between using hookup sites and testing positive for syphilis, gonorrhea, or chlamydia. Venue-based affiliation networks were created to evaluate hookup sites and their association with STD diagnoses. Among 415 MSM, 78% reported meeting a partner online in the last 12 months, and 25% tested positive for at least one STD. Men who met partners online were more likely to be white (67% vs. 54%, P = 0.03) and have more than 10 lifetime partners (87% vs. 58%, P < 0.05). The most commonly used hookup sites included Grindr (78%), Scruff (35%), and Tinder (22%). In the multivariable analysis, only Scruff use was associated with testing positive for an STD (odds ratio, 2.28; 95% confidence interval, 1.09-4.94). However, among men who met partners online, 75% of men diagnosed as having an STD had met a sexual partner on Grindr, including 100% of those who were diagnosed as having gonorrhea. Use of hookup sites was nearly ubiquitous among MSM undergoing STD screening. Specific hookup sites were significantly associated with STD diagnoses among MSM. Greater efforts are needed to promote STD screening and prevention among MSM who meet partners online.

Methodological Overview of an African American Couple-Based HIV/STD Prevention Trial

PubMed Central

2010-01-01

Objective To provide an overview of the NIMH Multisite HIV/STD Prevention Trial for African American Couples conducted in four urban areas: Atlanta, Los Angeles, New York, and Philadelphia. The rationale, study design methods, proposed data analyses, and study management are described. Design This is a two arm randomized Trial, implementing a modified randomized block design, to evaluate the efficacy of a couples based intervention designed for HIV serodiscordant African American couples. Methods The study phases consisted of formative work, pilot studies, and a randomized clinical trial. The sample is 535 HIV serodiscordant heterosexual African American couples. There are two theoretically derived behavioral interventions with eight group and individual sessions: the Eban HIV/STD Risk Reduction Intervention (treatment) versus the Eban Health Promotion Intervention (control). The treatment intervention was couples based and focused on HIV/STD risk reduction while the control was individual based and focused on health promotion. The two study conditions were structurally similar in length and types of activities. At baseline, participants completed an Audio Computer-assisted Self Interview (ACASI) interview as well as interviewer-administered questionnaire, and provided biological specimens to assess for STDs. Similar follow-up assessments were conducted immediately after the intervention, at 6 months, and at 12 months. Results The Trial results will be analyzed across the four sites by randomization assignment. Generalized estimating equations (GEE) and mixed effects modeling (MEM) are planned to test: (1) the effects of the intervention on STD incidence and condom use as well as on mediator variables of these outcomes, and (2) whether the effects of the intervention differ depending on key moderator variables (e.g., gender of the HIV-seropositive partners, length of relationship, psychological distress, sexual abuse history, and substance abuse history). Conclusions The lessons learned from the design and conduct of this clinical trial provide guidelines for future couples based clinical trials in HIV/STD risk reduction and can be generalized to other couples based behavioral interventions. PMID:18724188

AIDSCAP seeks a private sector solution to the STD self-treatment dilemma.

PubMed

Henry, K

1995-03-01

Many people in developing countries faced with long waits at health clinics, expensive prescriptions and laboratory tests, stigma associated with sexually transmitted disease (STD) clinic attendance, and the disdain of some health providers opt to buy over-the-counter drugs against their STDs at pharmacies and in markets, and treat themselves. Such self-treatment may lead to partially treated infections and serious complications, not to mention the associated increased risk of contracting or transmitting HIV from having sexual intercourse while still infected with a STD. Population Services International in collaboration with Family Health International's AIDSTECH Project developed a standard prepackaged therapy for male urethritis to be tested in a pilot program in Cameroon. The package was named MSTOP, with MST being the French acronym for STD, and consisted of a pouch containing antibiotics to treat gonorrhea and chlamydia, the two most common causes of urethritis in Cameroon, an educational brochure, detailed instructions on how to take the medication, two cards for referring sexual partners for diagnosis and treatment, and eight Prudence condoms. Medication included two tablets of cefuroxime axetil to be taken in a single oral dose and 20 tablets of doxycycline to be taken orally twice daily for ten days. The kit retailed for US$17, at the low end of what people were willing to pay for urethritis treatment on the market, with Glaxo and Ciba-Geigy supplying the drugs at a preferential price. By the completion of all necessary preliminary studies and consultations, however, new Ministry of Health (MOH) officials had come to power who opposed the original plan of selling MSTOP without prescriptions in pharmacies and health care centers. MSTOP was therefore approved for sale March 1993 only by prescription in 21 health care facilities which served mainly university students and the military and in three private pharmacies near the university campus. More than 86% of the patients who bought the kit reported being satisfied with it, 82% reported treatment compliance, more than 50% notified sex partners, and 84% of those who had sex during treatment used some or all of the condoms in the kit. Subsequent to the ten-month pilot ending March 1994, the MOH failed to support expanding MSTOP sales to more pharmacies to increase its accessibility. Plans for a second phase of the pilot project in Cameroon were abandoned. Change in MOH leadership, resistance from physicians and pharmacy associations, the country's drug registration laws, which precluded use of the cheapest and most effective drug, and lack of acceptance of the syndromic approach to STD management thwarted the potential success of this pilot and its future widespread programmatic expansion. Health officials in six other countries have expressed their interest in working with AIDSCAP to test prepackaged STD therapy.

HIV/STD Stigmatization Fears as Health Seeking Barriers in China

PubMed Central

Lieber, Eli; Li, Li; Wu, Zunyou; Rotheram-Borus, Mary Jane; Guan, Jihui

2005-01-01

Internationally, stigma prohibits effective HIV/STD identification, prevention, and care. Interviews with 106 persons in an urban center in Eastern China, some know to have engaged in stigmatized risk acts (sex workers, STD clinic patients) and some vulnerable for stigmatization fears to influence health seeking behaviors (market employees, rural-to-urban migrants). Interviews focused on community norms, values, beliefs, and emotional and behavioral reactions to HIV/STD stigmatization related events. Attributions for infection were found to: mark individual's failure to adhere to sexuality norms; define a condition warranting the avoidance of infected persons and dismissal by medical professionals; and promote anticipation of negative emotions (i.e., shame, fear, and embarrassment) and devalued social roles and status. Strategies reported to avoid stigmatization include: avoiding HIV/STD knowledge; avoiding health care professionals, particularly in public settings; and conforming to community norms of shunning those suspected of risky behaviors. Results have direct implications for community marketing campaigns in China. PMID:16374668

Brief sexual histories and routine HIV/STD testing by medical providers.

PubMed

Lanier, Yzette; Castellanos, Ted; Barrow, Roxanne Y; Jordan, Wilbert C; Caine, Virginia; Sutton, Madeline Y

2014-03-01

Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts.

Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy.

PubMed

Kohler, Pamela K; Manhart, Lisa E; Lafferty, William E

2008-04-01

The role that sex education plays in the initiation of sexual activity and risk of teen pregnancy and sexually transmitted disease (STD) is controversial in the United States. Despite several systematic reviews, few epidemiologic evaluations of the effectiveness of these programs on a population level have been conducted. Among never-married heterosexual adolescents, aged 15-19 years, who participated in Cycle 6 (2002) of the National Survey of Family Growth and reported on formal sex education received before their first sexual intercourse (n = 1719), we compared the sexual health risks of adolescents who received abstinence-only and comprehensive sex education to those of adolescents who received no formal sex education. Weighted multivariate logistic regression generated population-based estimates. Adolescents who received comprehensive sex education were significantly less likely to report teen pregnancy (OR(adj) = .4, 95% CI = .22- .69, p = .001) than those who received no formal sex education, whereas there was no significant effect of abstinence-only education (OR(adj) = .7, 95% CI = .38-1.45, p = .38). Abstinence-only education did not reduce the likelihood of engaging in vaginal intercourse (OR(adj) = .8, 95% CI = .51-1.31, p = .40), but comprehensive sex education was marginally associated with a lower likelihood of reporting having engaged in vaginal intercourse (OR(adj) = .7, 95% CI = .49-1.02, p = .06). Neither abstinence-only nor comprehensive sex education significantly reduced the likelihood of reported STD diagnoses (OR(adj) = 1.7, 95% CI = .57-34.76, p = .36 and OR(adj) = 1.8, 95% CI = .67-5.00, p = .24 respectively). Teaching about contraception was not associated with increased risk of adolescent sexual activity or STD. Adolescents who received comprehensive sex education had a lower risk of pregnancy than adolescents who received abstinence-only or no sex education.

"Something of an adventure": postwar NIH research ethos and the Guatemala STD experiments.

PubMed

Spector-Bagdady, Kayte; Lombardo, Paul A

2013-01-01

The STD experiments in Guatemala from 1946-1948 have earned a place of infamy in the history of medical ethics. But if the Guatemala STD experiments were so "ethically impossible," how did the U.S. government approve their funding? Although much of the literature has targeted the failings of Dr. John Cutler, we focus on the institutional context and research ethos that shaped the outcome of the research. After the end of WWII, Dr. Cassius Van Slyke reconstructed the federal research contracts process into a grant program. The inaugural NIH study section recommended approval of the Guatemala STD experiments at its first meeting. The funding and oversight process of the Guatemala research was marked with serious conflicts of interest and a lack of oversight, and it was this structure, as opposed to merely a maleficent individual, that allowed the Guatemala STD experiments to proceed. We conclude that while current research regulations are designed to prevent the abuses perpetrated on the subjects of the Guatemala STD experiments, it takes a comprehensive understanding of research ethics through professional education to achieve the longstanding ideal of the responsible investigator, and ensure ethical research under any regulatory scheme. © 2013 American Society of Law, Medicine & Ethics, Inc.

Improvement of Sexually Transmitted Disease Screening Among HIV-Infected Men Who Have Sex With Men Through Implementation of a Standardized Sexual Risk Assessment Tool.

PubMed

Scarborough, Ashley P; Slome, Sally; Hurley, Leo B; Park, Ina U

2015-10-01

Screening for gonorrhea (GC) and chlamydia (CT) and syphilis among HIV-positive (HIV+) men who have sex with men (MSM) is recommended at least annually. However, significant gaps in screening coverage exist. We conducted a quality improvement intervention to determine whether informing providers of preintervention screening rates and routinizing sexual risk assessment would improve sexually transmitted disease (STD) screening in a large HIV care clinic. In partnership with Kaiser Permanente Northern California, we developed and implemented a 10-item assessment addressing sexual and other behavioral risk factors among HIV+ MSM. We analyzed the proportion of patients screened for GC/CT and syphilis in a preintervention period (June 25-September 26, 2012) and during the intervention period (June 25-September 26, 2013). Of 364 HIV+ MSM seen for care during the intervention period, 47.3% completed the sexual risk assessment. Improvements in GC/CT screening and syphilis screening were observed; when comparing the preintervention period with the intervention period, the proportion of HIV+ MSM receiving GC/CT screening increased by 26.8% (31.6%-40.1%, P = 0.01) at any anatomical site and by 45% (19.5%-28.3%, P = 0.003) at the pharyngeal site. Syphilis screening significantly increased by 18.8% (48.7%-58.0%, P = 0.009). Overall STD screening increases were observed after this intervention that included didactic training on the urgency of STD screening needs for HIV+ MSM, a presentation of preintervention clinic STD screening data, and the implementation of self-reported sexual risk assessment. Additional efforts are needed to determine feasible ways to accurately assess the appropriateness of STD screening and success of interventions to improve STD screening.

Comparacion de modelos de Educacion Sexual en el conocimiento y cambio de actitudes en practicas sexuales por alumnos de nivel superior en la region de Caguas, Puerto Rico

NASA Astrophysics Data System (ADS)

Juan, Vallejo Ramos L.

In opposition to the Sexual Education Traditional Model (SETM) that is used in the state schools of Puerto Rico, the Health Beliefs Model (HBM) appears. It facilitates a curricular design that improves the ability of the students to respond to the group pressure by means of attitudes that stimulate sexual conducts of smaller risk of propagation of the Sexually Transmitted Diseases (STD). In addition, it provides activities to increase the self-esteem, the communication and the decision making. This investigation had the intention to compare the SETM and the HBM in the increase of knowledge and change of attitudes of high risk of propagation of the STD using a validated questionnaire (Agency of the United States for the International-USAID Development), named "Endesa 2007" and, adapted to Puerto Rico by the Dra.Marta Collazo to a sample of students between the 17 and 19 years of 2 state schools of San Lorenzo, as a pretest, and, selected by convenience. Then, a 10 hours training was administered to half of the students using the SETM to STD and condom use lessons. The other half of the students received additional lessons using the HBM. Finally, both groups took the questionnaire again as a posttest. The sample of students, in average, did not reach the knowledge and basic levels of attitudes towards the STD in the pretest. This reflected 2 possible implications on the SETM. In first place, that the way in which the STD is implemented as part of the Sexual Education curriculum is inefficient. Secondly, the possibility that the acquired information or attitudes does not have permanence. Culminated the questionnaire, the HBM increase the knowledge of the STD in 0.41 points (average) over the SETM. There was not a significant difference between both models, in attitudes, implying that both models are equally effective. The findings suggests that the HBM is more effective increasing the knowledge on the STD, but equally effective than the SETM in attitude change for the Puerto Rican youth.

Effects of military service and deployment on clinical symptomatology: The role of trauma exposure and social support.

PubMed

Moore, Tyler M; Risbrough, Victoria B; Baker, Dewleen G; Larson, Gerald E; Glenn, Daniel E; Nievergelt, Caroline M; Maihofer, Adam; Port, Allison M; Jackson, Chad T; Ruparel, Kosha; Gur, Ruben C

2017-12-01

The Marine Resiliency Study-II examined changes in symptomatology across a deployment cycle to Afghanistan. U.S. Servicemembers (N = 1041) received clinical testing at two time points either bracketing a deployment (855) or not (186). Factor analyses were used to generate summary and change scores from Time 1 to Time 2. A between-subject design was used to examine changes across the deployment cycle with deployment (low-trauma, high-trauma, and non-deployed) and social support (low vs. high) as the grouping variables. Insomnia increased post-deployment regardless of deployment trauma (std. effect for high-trauma and low-trauma = 0.39 and 0.26, respectively). Only the high-trauma group showed increased PTSD symptoms and non-perspective-taking (std. effect = 0.40 and 0.30, respectively), while low-trauma showed decreased anxiety symptoms after deployment (std. effect = -0.17). These associations also depend on social support, with std. effects ranging from -0.22 to 0.51. When the groups were compared, the high-trauma deployed group showed significantly worse PTSD and non-perspective-taking than all other groups. Similar to studies in other military divisions, increased clinical symptoms were associated with high deployment stress in active duty Servicemembers, and social support shows promise as a moderator of said association. Copyright © 2017 Elsevier Ltd. All rights reserved.

HIV and STD status among MSM and attitudes about Internet partner notification for STD exposure.

PubMed

Mimiaga, Matthew J; Tetu, Ashley M; Gortmaker, Steven; Koenen, Karestan C; Fair, Andrew D; Novak, David S; Vanderwarker, Rodney; Bertrand, Thomas; Adelson, Stephan; Mayer, Kenneth H

2008-02-01

This study assessed the acceptability and perceived utility of Internet-based partner notification (PN) of sexually transmitted disease (STD) exposure for men who have sex with men (MSM) by human immunodeficiency virus (HIV) serostatus. We recruited 1848 US MSM via a banner advertisement posted on an MSM website for meeting sexual partners between October and November 2005. Even though there was broad acceptance of a PN e-mail across HIV serostatus groups, HIV-infected men rated the importance of each component (e.g., information about where to get tested/treated, additional education regarding the STD exposed to, a mechanism for verifying the authenticity of the PN e-mail) lower than HIV-uninfected or status-unknown participants (all P's <0.01). Additionally, HIV-infected participants were less likely to use the services offered within a PN e-mail (if they were to receive an e-mail notifying them of possible STD exposure in the future), and were less likely to inform their partners of possible STD exposure via an Internet notification system in the future (all P's <0.01). A similar trend emerged about men who reported not having a previous STD compared with those who did. Men who reported no previous STD found Internet PN more acceptable. Overall, this study documents broad acceptance of Internet PN by at-risk MSM, regardless of HIV serostatus, including a willingness to receive or initiate PN-related e-mail. If public health officials consider using Internet notification services, they may need to anticipate and address concerns of HIV-infected MSM, and will need to use a culturally-sensitive, social marketing campaign to ensure that those who may benefit from these services are willing to use this modality for PN. Internet PN should be considered as a tool to decrease rising STD and HIV rates among MSM who use the Internet to meet sexual partners.

Effectiveness of syndromic management for male patients with urethral discharge symptoms in Amazonas, Brazil.

PubMed

Menezes Filho, Jonas Rodrigues de; Sardinha, José Carlos Gomes; Galbán, Enrique; Saraceni, Valéria; Talhari, Carolina

2017-01-01

Urethral discharge syndrome (UDS) is characterized by the presence of purulent or mucopurulent urethral discharge.The main etiological agents of this syndrome are Neisseria gonorrhoeae and Chlamydia trachomatis. To evaluate the effectiveness of the syndromic management to resolve symptoms in male urethral discharge syndrome cases in Manaus, Amazonas, Brazil. Retrospective cohort of male cases of urethral discharge syndrome observed at a clinic for sexually transmitted disease (STD) in 2013. Epidemiological and clinical data, as well as the results of urethral swabs, bacterioscopy, hybrid capture for C.trachomatis, wet-mount examination, and culture for N.gonorrhoeae, were obtained through medical chart reviews. Of the 800 urethral discharge syndrome cases observed at the STD clinic, 785 (98.1%) presented only urethral discharge syndrome, 633 (79.1%) returned for follow-up, 579 (91.5%) were considered clinically cured on the first visit, 41(6.5 %) were considered cured on the second visit, and 13(2.0%) did not reach clinical cure after two appointments. Regarding the etiological diagnosis, 42.7% of the patients presented a microbiological diagnosis of N.gonorrhoeae, 39.3% of non-gonococcal and non-chlamydia urethritis, 10.7% of C.trachomatis and 7.3% of co-infection with chlamydia and gonococcus. The odds of being considered cured in the first visit were greater in those who were unmarried, with greater schooling, and with an etiological diagnosis of gonorrhea. The diagnosis of non-gonococcal urethritis reduced the chance of cure in the first visit. A study conducted at a single center of STD treatment. Syndromic management of male urethral discharge syndrome performed in accordance with the Brazilian Ministry of Health STD guidelines was effective in resolving symptoms in the studied population. More studies with microbiological outcomes are needed to ensure the maintenance of the syndromic management.

Brief Sexual Histories and Routine HIV/STD Testing by Medical Providers

PubMed Central

Lanier, Yzette; Castellanos, Ted; Barrow, Roxanne Y.; Jordan, Wilbert C.; Caine, Virginia

2014-01-01

Abstract Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts. PMID:24564387

Analysis of patients with Chlamydia trachomatis genital infection in an STD clinic.

PubMed

Repiso-Jiménez, J B; Fernandez-Morano, T; Rivas-Ruiz, F; de Troya-Martin, M

2014-10-01

Chlamydia trachomatis genital infection is common in our setting and early treatment can prevent complications. The aim of this study was to report on patients diagnosed with C trachomatis genital infection in a sexually transmitted disease (STD) clinic. This was a descriptive, cross-sectional, observational study of patients diagnosed with C. trachomatis infection between 2010 and 2011. We recorded demographic data and information on sexual habits, concomitant sexually transmitted infections (STIs), and various aspects of treatment. In total, 12.3% of the samples analyzed were positive for C trachomatis genital infection. Sixty-two patients (43 men) with a mean age of 31 years were studied; 75% were heterosexual and 87% had had a sexual partner in the previous 2 months. Condom use was inconsistent in 81%, 79%, and 65% of patients who practiced vaginal, oral, and anal sex, respectively. Thirteen percent of the patients had symptoms and anogenital warts were the most common associated STI. The most widely used treatment was doxycycline. A high prevalence of genital C. trachomatis infection was detected in our STD clinic, and the majority of cases were found in young men. We observed a high rate of asymptomatic infection in patients who do not engage in high-risk sexual behavior and who had come to the clinic for another reason. Systematic screening of C. trachomatis infection should be implemented in STD units to enable the early treatment of patients and their recent sexual partners. Copyright © 2014 Elsevier España, S.L.U. y AEDV. All rights reserved.

[Community-based intervention to control STD/AIDS in the Amazon region, Brazil].

PubMed

Benzaken, Adele Schwartz; Galbán Garcia, Enrique; Sardinha, José Carlos Gomes; Pedrosa, Valderiza Lourenço; Paiva, Vera

2007-12-01

To describe a case study of community-based intervention, developed in a constructionist-emancipatory framework to control STD/AIDS. Descriptive study developed in the town of Manacapuru, in the state of Amazonas, from 1997 to 2004, focusing on procedures designed in collaboration with government agents, health professionals and the community. Data on the dynamics of prostitution and condom sales in this town, preventive practices and STD/AIDS care and process assessment were collected. Actions targeting STD prevention and care in the public healthcare system, a testing center, an epidemiological surveillance system and sex workers' qualification were established concomitantly. It was observed the strengthening of sex workers as peer educators and their legitimization as citizens and health agents in projects involving transvestites, homosexuals and students. There was an increase in condom sales in town, as well as in condom use among sex workers; reduction in bacterial STD; and stabilization of the incidence of HIV/AIDS infections and congenital syphilis. The sustainability of the intervention program studied, organized within the sphere of action of the Sistema Unico de Saúde (National Health System), was promoted by a political pact, which guaranteed headquarters and municipal law-regulated budget, as well as by the constant debate over the process and program results. The study strengthened the notion that effective control of STD/AIDS depends on a synergic approach that combines interventions on individual (biological-behavioral), sociocultural and programmatic levels.

Measuring Adolescent Human Papillomavirus Vaccine Coverage: A Match of Sexually Transmitted Disease Clinic and Immunization Registry Data.

PubMed

Pathela, Preeti; Jamison, Kelly; Papadouka, Vikki; Kabir, Rezaul; Markowitz, Lauri E; Dunne, Eileen F; Schillinger, Julia A

2016-12-01

Human papillomavirus (HPV) vaccine is recommended for adolescents. By the end of 2013, 64% of female and 40% of male New York City residents aged 13-18 years had received ≥1 HPV vaccine dose. Adolescents attending sexually transmitted disease (STD) clinics are at high risk for HPV exposure and could benefit from vaccination. Our objective was to estimate HPV vaccination coverage for this population. We matched records of New York City's STD clinic patients aged 13-18 years during 2010-2013 with the Citywide Immunization Registry. We assessed HPV vaccine initiation (≥1 dose) and series completion (≥3 doses among those who initiated) as of clinic visit date and by patient demographics. We compared receipt of ≥1 dose for HPV, tetanus-diphtheria-acellular pertussis, and meningococcal conjugate vaccine. Eighty-two percent of clinic attendees (13,505/16,364) had records in the Citywide Immunization Registry. Receipt of ≥1 HPV dose increased during 2010-2013 (females: 57.6%-69.7%; males: 1.5%-36.3%). Among females, ≥1-dose coverage was lowest among whites (53.4%) and highest among Hispanics (73.3%); among males, ≥1-dose coverage was lowest among whites (6.9%) and highest among Asians (20.9%). Series completion averaged 57.7% (females) and 28.0% (males), with little variation by race/ethnicity or poverty level. Receipt of ≥1 dose was 59.7% for HPV, 82% for tetanus-diphtheria-acellular pertussis, and 76% for meningococcal conjugate vaccines. HPV vaccine initiation and completion were low among adolescent STD clinic patients; coverage was lower compared with other recommended vaccines. STD clinics may be good venues for delivering HPV vaccine, thereby enhancing efforts to improve HPV vaccination. Copyright © 2016 Society for Adolescent Health and Medicine. All rights reserved.

Correlates of Correct Condom Use Among High-Risk African American Men Attending an Urban STD Clinic in the South

PubMed Central

Crosby, Richard; DiClemente, Ralph J.; Yarber, William L.

2011-01-01

The purpose of this cross-sectional study was to assess prevalence and correlates of correct condom use among high-risk African American men attending a publicly-funded sexually transmitted disease (STD) clinic. Men 18 through 29 years of age and newly diagnosed with a sexually transmitted disease were further assessed for study eligibility. Of 296 meeting eligibility criteria, 271 agreed to participate thereby yielding a participation rate of 91.5%. Correct use, assessed by an index, was reported by 38%. Correct use was associated with having sex with 3 or fewer female sex partners (AOR=3.1), being in an exclusive relationship (AOR=3.2), not indicating problems with the fit or feel of condoms (AOR=2.9), and not being drunk/high while using condoms (AOR=2.6). The correct use of condoms among young African American men newly diagnosed with an STD may be a function of situational factors. These factors could potentially be addressed in the context of clinic-based behavioral intervention programs. PMID:21297891

Telediagnostic 3D school screening of back curvatures and posture using structured light method - pilot study.

PubMed

Glinkowski, Wojciech; Michoński, Jakub; Glinkowska, Bożena; Zukowska, Agnieszka; Sitnik, Robert; Górecki, Andrzej

2012-01-01

Several studies consider the school scoliosis screening as controversial. Many authors postulate to improve its clinical effectiveness. Authors assumed that three dimensional telediagnostic surface topography measurements allowing measuring several postural deformity indexes and angles of curvatures in sagittal plane may enhance current practice. The study was designed to determine usefulness of school screening back evaluation performed utilizing the three dimensional telediagnostic measurement system. The measurement module is based on structured light method using "3D Orthoscreen" system. The technique for 3D image acquisition of back shape is based on temporal phase shifting and Gray codes. Measurement data was securely archived for remote access by investigator over the secure Internet connection. Acquired "images" were transferred to Telediagnostic Center for clinical evaluation. Spine parameters and deformation indexes like Posterior Trunk Symmetry Index (POTSI), Deformity in the Axial Plane Index (DAPI), kyphosis and lordosis angle were measured. The preliminary study was performed in 2 selected schools (basic and middle schools). The study was approved by Bioethical Committee. Clouds of points representing back topography of assessed subjects were acquired at schools in March and May 2011 and stored for remote evaluation and analysis. 758 children averagely aged 11.1 years (from 5 to 16), 387 females and 371 males, were examined. Their average body mass was 45.13 kg [16-105; STD 16.4] and average height was 151.43 cm, [110-192; STD 18.3]. The average values of back assessment parameters were as follows: POTSI 15.97% [0-73.4; STD 10.3]; DAPI 0.88% [0-5.9; STD 0.76]; kyphosis angle 10.19° [0-32; STD 5.82]; and lordosis angle 32,82° [0-56; STD 9.86]. Technical and clinical issues of the practical implementation allowed to elaborate preliminary protocol for cohort studies addressed to subject (i.e. parents acceptance of examination of undressed back) and technical issues (i.e. upload data and retrieval, network transfer velocity). Postural telediagnostics was found sufficiently feasible for further implementation of remote, cohort 3D back shape evaluations including school screening. Permanently saved 3D data allow monitoring back surface of the individual subjects.

Recent sexually transmitted disease prevention efforts and their implications for AIDS health education.

PubMed

Solomon, M Z; DeJong, W

1986-01-01

In the absence of a cure or vaccine for acquired immune deficiency syndrome (AIDS) educational and social marketing efforts to reduce the transmission of Human T-lymphotropic type III/lymphadenopathy-associated virus (HTLV-III/LAV) are currently our best hope for controlling the disease. Since 1983, the Centers for Disease Control (CDC) has funded a series of research studies to determine whether education efforts can successfully motivate the adoption of key behaviors relevant to the control of a variety of sexually transmitted diseases (STDs). Analysis of the first two studies which are now completed, and preliminary data from a third study, have documented dramatic changes in behavior, knowledge, and attitudes among clients in inner-city public health clinics. The authors describe the principles and underlying assumptions that have guided the design of their STD initiatives, drawing special attention to the implications for AIDS health education efforts.

Robotic Assistance for Ultrasound-Guided Prostate Brachytherapy

PubMed Central

Fichtinger, Gabor; Fiene, Jonathan P.; Kennedy, Christopher W.; Kronreif, Gernot; Iordachita, Iulian; Song, Danny Y.; Burdette, Everette C.; Kazanzides, Peter

2016-01-01

We present a robotically assisted prostate brachytherapy system and test results in training phantoms and Phase-I clinical trials. The system consists of a transrectal ultrasound (TRUS) and a spatially co-registered robot, fully integrated with an FDA-approved commercial treatment planning system. The salient feature of the system is a small parallel robot affixed to the mounting posts of the template. The robot replaces the template interchangeably, using the same coordinate system. Established clinical hardware, workflow and calibration remain intact. In all phantom experiments, we recorded the first insertion attempt without adjustment. All clinically relevant locations in the prostate were reached. Non-parallel needle trajectories were achieved. The pre-insertion transverse and rotational errors (measured with a Polaris optical tracker relative to the template’s coordinate frame) were 0.25mm (STD=0.17mm) and 0.75° (STD=0.37°). In phantoms, needle tip placement errors measured in TRUS were 1.04mm (STD=0.50mm). A Phase-I clinical feasibility and safety trial has been successfully completed with the system. We encountered needle tip positioning errors of a magnitude greater than 4mm in only 2 out of 179 robotically guided needles, in contrast to manual template guidance where errors of this magnitude are much more common. Further clinical trials are necessary to determine whether the apparent benefits of the robotic assistant will lead to improvements in clinical efficacy and outcomes. PMID:18650122

SU-F-T-629: Effect of Multi-Leaf Collimator (MLC) Width On Plan Quality of Single-Isocenter VMAT Intracranial Stereotactic Radiosurgery for Multiple Metastases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kraus, J; Thomas, E; Wu, X

2016-06-15

Purpose: Single-isocenter VMAT has been shown able to create high quality plans for complex intracranial multiple metastasis SRS cases. Linacs capable of the technique are typically outfitted with an MLC that consists of a combination of 5 mm and 10 mm leaves (standard) or 2.5 mm and 5 mm leaves (high-definition). In this study, we test the hypothesis that thinner collimator leaves are associated with improved plan quality. Methods: Ten multiple metastasis cases were identified and planned for VMAT SRS using a 10 MV flattening filter free beam. Plans were created for a standard (std) and a high-definition (HD) MLC.more » Published values for leaf transmission factor and dosimetric leaf gap were utilized. All other parameters were invariant. Conformity (plan and individual target), moderate isodose spill (V50%), and low isodose spill (mean brain dose) were selected for analysis. Results: Compared to standard MLC, HD-MLC improved overall plan conformity (median: Paddick CI-HD = 0.83, Paddick CI-std = 0.79; p = 0.004 and median: RTOG CI-HD =1.18, RTOG CI-std =1.24; p = 0.01 ), improved individual lesion conformity (median: Paddick CI-HD,i =0.77, Paddick CI-std,i =0.72; p < 0.001 and median: RTOG CI-HD,i = 1.28, RTOG CI-std,i =1.35; p < 0.001), improved moderate isodose spill (median: V50%-HD = 37.0 cc, V50%-std = 45.7 cc; p = 0.002), and improved low dose spill (median: dmean-HD = 2.90 Gy, dmean-std = 3.19 Gy; p = 0.002). Conclusion: For the single-isocenter VMAT SRS of multiple metastasis plans examined, use of HD-MLC modestly improved conformity, moderate isodose, and low isodose spill compared to standard MLC. However, in all cases we were able to generate clinically acceptable plans with the standard MLC. More work is need to further quantify the difference in cases with higher numbers of small targets and to better understand any potential clinical significance. This research was supported in part by Varian Medical Systems.« less

Standard deviation of carotid young's modulus and presence or absence of plaque improves prediction of coronary heart disease risk.

PubMed

Niu, Lili; Zhang, Yanling; Qian, Ming; Xiao, Yang; Meng, Long; Zheng, Rongqin; Zheng, Hairong

2017-11-01

The stiffness of large arteries and the presence or absence of plaque are associated with coronary heart disease (CHD). Because arterial walls are biologically heterogeneous, the standard deviation of Young's modulus (YM-std) of the large arteries may better predict coronary atherosclerosis. However, the role of YM-std in the occurrence of coronary events has not been addressed so far. Therefore, this study investigated whether the carotid YM-std and the presence or absence of plaque improved CHD risk prediction. One hundred and three patients with CHD (age 66 ± 11 years) and 107 patients at high risk of atherosclerosis (age 61 ± 7 years) were recruited. Carotid YM was measured by the vessel texture matching method, and YM-std was calculated. Carotid intima-media thickness was measured by the MyLab 90 ultrasound Platform employed dedicated software RF-tracking technology. In logistic regression analysis, YM-std (OR = 1·010; 95% CI = 1·003-1·016), carotid plaque (OR = 16·759; 95% CI = 3·719-75·533) and YM-std plus plaque (OR = 0·989; 95% CI = 0·981-0·997) were independent predictors of CHD. The traditional risk factors (TRF) plus YM-std plus plaque model showed a significant improvement in area under the receiver-operating characteristic curve (AUC), which increased from 0·717 (TRF only) to 0·777 (95% CI for the difference in adjusted AUC: 0·010-0·110). Carotid YM-std is a powerful independent predictor of CHD. Adding plaque and YM-std to TRF improves CHD risk prediction. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Simultaneous multislice diffusion-weighted MRI of the liver: Analysis of different breathing schemes in comparison to standard sequences.

PubMed

Taron, Jana; Martirosian, Petros; Erb, Michael; Kuestner, Thomas; Schwenzer, Nina F; Schmidt, Holger; Honndorf, Valerie S; Weiβ, Jakob; Notohamiprodjo, Mike; Nikolaou, Konstantin; Schraml, Christina

2016-10-01

To systematically evaluate image characteristics of simultaneous-multislice (SMS)-accelerated diffusion-weighted imaging (DWI) of the liver using different breathing schemes in comparison to standard sequences. DWI of the liver was performed in 10 healthy volunteers and 12 patients at 1.5T using an SMS-accelerated echo planar imaging sequence performed with respiratory-triggering and free breathing (SMS-RT, SMS-FB). Standard DWI sequences served as reference (STD-RT, STD-FB). Reduction of scan time by SMS-acceleration was measured. Image characteristics of SMS-DWI and STD-DWI with both breathing schemes were analyzed quantitatively (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR]) and qualitatively (5-point Likert scale, 5 = excellent). Qualitative and quantitative parameters were compared using Friedman test and Dunn-Bonferroni post-hoc method with P-values < 0.05 considered statistically significant. SMS-DWI provided diagnostic image quality in volunteers and patients both with RT and FB with a reduction of scan time of 70% (0:56 vs. 3:20 min in FB). Overall image quality did not significantly differ between FB and RT acquisition in both STD and SMS sequences (median STD-RT 5.0, STD-FB 4.5, SMS-RT: 4.75; SMS-FB: 4.5; P = 0.294). SNR in the right hepatic lobe was comparable between the four tested sequences. ADC values were significantly lower in SMS-DWI compared to STD-DWI irrespective of the breathing scheme (1.2 ± 0.2 × 10(-3) mm(2) /s vs. 1.0 ± 0.2 × 10(-3) mm(2) /s; P < 0.001). SMS-acceleration provides considerable scan time reduction for hepatic DWI with equivalent image quality compared to the STD technique both using RT and FB. Discrepancies in ADC between STD-DWI and SMS-DWI need to be considered when transferring the SMS technique to clinical routine reading. J. MAGN. RESON. IMAGING 2016;44:865-879. © 2016 International Society for Magnetic Resonance in Medicine.

Sexual health and use of condoms among local and international sex workers in Sydney.

PubMed

O'Connor, C C; Berry, G; Rohrsheim, R; Donovan, B

1996-02-01

To compare indicators of sexual health and predictors of condom use for commercial sex among local and international female sex workers first attending an STD clinic. A public STD clinic in Sydney, Australia. All sex workers first attending between June 1991 and May 1993. Cross-sectional analysis of demographic, behavioural and morbidity data from proforma medical records. 91 local sex workers and 123 international sex workers (predominantly from Thailand, Malaysia and China) first presented during the study period. There were significantly higher prevalences of chlamydia (0 v. 15%, p = 0.0002), gonorrhoea (0 v. 14%, p = 0.0006), syphilis (0 v. 10%, p = 0.006) and clinical genital herpes (0 v. 5%, p = 0.04) among international sex workers. The only case of HIV infection was in an international sex worker. Inconsistent condom use for commercial sex was significantly more common among international sex workers (RR = 4.5; 95% CI 3.1-6.5). On multivariate analysis, inconsistent condom use in international sex workers was associated with a recent history of prostitution outside Australia (p = 0.04), while inconsistent condom usage among local sex workers was associated with increasing age (p = 0.003). These data illustrate the efficacy of condoms and the success of targeted education programmes in local sex workers in Sydney. By contrast, international sex workers continued to be at high risk of STDs. The international sex industry in Sydney requires enhanced culture-specific interventions. Immigration laws as they affect sex workers should also be reviewed.

What about money? Effect of small monetary incentives on enrollment, retention, and motivation to change behaviour in an HIV/STD prevention counselling intervention. The Project RESPECT Study Group.

PubMed

Kamb, M L; Rhodes, F; Hoxworth, T; Rogers, J; Lentz, A; Kent, C; MacGowen, R; Peterman, T A

1998-08-01

We studied the effect of small monetary incentives and non-monetary incentives of similar value on enrollment and participation in clinic based HIV/STD prevention counselling. We examined incident STDs to try to assess whether participants offered money may be less motivated to change risky behaviours than those offered other incentives. Patients from five US STD clinics were invited to enroll in a multisession risk reduction counselling intervention and, based on their enrollment date, were offered either $15 for each additional session or non-monetary incentives worth $15. The two incentive groups were compared on participants' enrollment, completion of intervention sessions, and new STDs over the 24 months after enrollment. Of 648 patients offered money, 198 (31%) enrolled compared with 160 (23%) of 696 patients offered other incentives (p = 0.002). Enrollees in the two incentive groups had similar baseline characteristics, including condom use. Of the 198 participants offered money, 109 (55%) completed all sessions compared with 59 (37%) of the participants offered other incentives (p < 0.0001). Comparing those offered money with those offered other incentives STD rates were similar after 6, 12, and 24 months. Small monetary incentives enhanced enrollment and participation compared with other incentives of similar value. Regardless of incentive offered, participants had similar post-enrollment STD rates, suggesting that the type of incentive does not adversely affect motivation to change behaviour. Money may be useful in encouraging high risk individuals to participate in and complete counselling or other public health interventions.

STD Testing: What's Right for You

MedlinePlus

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Home screening for sexually transmitted diseases in high‐risk young women: randomised controlled trial

PubMed Central

Cook, Robert L; Østergaard, Lars; Hillier, Sharon L; Murray, Pamela J; Chang, Chung‐Chou H; Comer, Diane M; Ness, Roberta B

2007-01-01

Objective Home screening tests could eliminate several barriers to testing sexually transmitted diseases (STDs). Aim To determine whether offering repeated home screening tests would increase the rate of testing for chlamydia and gonorrhoea in a high‐risk sample of young women. Methods In this randomised controlled trial, 403 young women (mean age 18.9 years, 70% black) with a recent STD or with STD‐related risk factors were enrolled. Participants were recruited from clinics and high‐prevalence neighbourhoods and then randomly assigned to receive either a home testing kit or an invitation to attend a medical clinic for testing at 6, 12 and 18 months after enrollment. Over 80% of women were followed for 2 years. The trial is registered with ClinicalTrials.gov, number NCT 00177437. Results Of 197 women in the intervention group, 140 (71%) returned at least one home test and 25 of 249 (10%) home tests were positive. Women who received home screening tests completed significantly more STD tests overall (1.94 vs 1.41 tests per woman‐year, p<0.001) and more STD tests in the absence of symptoms (1.18 vs 0.75 tests per woman‐year, p<0.001). More women in the intervention group completed at least one test when asymptomatic (162 (82.2%) vs 117 (61.3%), p<0.001). The intervention was most effective among women recruited outside medical clinics. There was no significant difference in the overall rate of STDs detected. Conclusions Home screening significantly increased the utilisation of chlamydia and gonorrhoea testing in this sample of high‐risk young women, and thus represents a feasible strategy to facilitate STD testing in young women. PMID:17301105

Treatment of sexually transmitted diseases in Estonia: consistency with the evidence-based medicine principles.

PubMed

Uusküla, Anneli; McNutt, Louise Anne; Dehovitz, Jack

2004-10-01

Estonia is among those Eastern European countries that have witnessed an explosive intravenous drug use-driven HIV epidemic. Early sexually transmitted disease (STD) diagnosis and appropriate treatment is essential to prevent an STD-driven HIV epidemic. The objectives of this study were to define the schedule of antibiotic treatment doctors in Estonia used to treat STDs, and to determine if the treatments used correspond to evidence-based medicine treatment principles. Using an administrative database of the Estonian Health Insurance Fund on pharmaceuticals reimbursement, we obtained information on: drug (ATC 1998) prescribed with an STD diagnosis (International Classification of Diseases and Related Health Problems, syphilis, gonorrhea, genital Chlamydia trachomatis and Trichomonas vaginalis infections, and genital herpes), prescribing physician specialty, and patient demographics (date of birth, gender). To evaluate the correspondence of STD treatment to evidence-based medicine principles, the therapeutic regimens used were compared with recommendations from the European Sexually Transmitted Infections Management Guidelines. In 2001 and 2002, physicians ordered 17,077 prescriptions for systemic antibacterial medications to treat STDs in 12,823 different individuals: 2942 men (mean age, 31.8 years) and 9880 women (mean age, 29.5 years). The majority of STD treatments were prescribed by gynecologists (60%) or dermatovenerologists (29%); general practitioners treated 8% of STDs. In 11% of treatment episodes, the drug prescribed was inconsistent with guideline recommendations; additionally, in 9% of episodes, the recommended drug was chosen but the prescribed dose was too low. At least 20% of treatment episodes could therefore be considered inappropriate. Educational efforts are needed to increase physician awareness of evidence-based approaches for STD management and treatment to assure effective STD care.

A Bayesian predictive two-stage design for phase II clinical trials.

PubMed

Sambucini, Valeria

2008-04-15

In this paper, we propose a Bayesian two-stage design for phase II clinical trials, which represents a predictive version of the single threshold design (STD) recently introduced by Tan and Machin. The STD two-stage sample sizes are determined specifying a minimum threshold for the posterior probability that the true response rate exceeds a pre-specified target value and assuming that the observed response rate is slightly higher than the target. Unlike the STD, we do not refer to a fixed experimental outcome, but take into account the uncertainty about future data. In both stages, the design aims to control the probability of getting a large posterior probability that the true response rate exceeds the target value. Such a probability is expressed in terms of prior predictive distributions of the data. The performance of the design is based on the distinction between analysis and design priors, recently introduced in the literature. The properties of the method are studied when all the design parameters vary.

Telephone-based continuing care counseling in substance abuse treatment: economic analysis of a randomized trial

PubMed Central

Daley, Marilyn C.; Neuman, Matthew J.; Blaakman, Aaron P.; McKay, James R.

2016-01-01

Purpose To investigate whether telephone-based continuing care (TEL) is a promising alternative to traditional face-to-face counseling for clients in treatment for substance abuse. Methods Patients with alcohol and/or cocaine dependence who had completed a 4-week intensive outpatient program were randomly assigned through urn randomization into one of three 12-week interventions: standard continuing care (STD), in-person relapse prevention (RP), or telephone-based continuing care (TEL). This study performed cost, cost-effectiveness, and cost-benefit analyses of TEL and RP compared to STD, using results from the randomized clinical trial with two years of follow up (359 participants). In addition, the study examined the potential moderating effect of baseline patient costs on economic outcomes. Results The study found that TEL was less expensive per client from the societal perspective ($569) than STD ($870) or RP ($1,684). TEL also was also significantly more effective, with an abstinence rate of 57.1% compared to 46.7% for STD (p<0.05). Thus TEL dominated STD, with a highly favorable negative incremental cost-effectiveness ratio (−$1,400 per abstinent year). TEL also proved favorable under a benefit-cost perspective. Conclusions TEL proved to be a cost-effective and cost-beneficial contributor to long-term recovery over two years. Because TEL dominated STD care interventions, wider adoption should be considered. PMID:26718395

Telephone-based continuing care counseling in substance abuse treatment: Economic analysis of a randomized trial.

PubMed

Shepard, Donald S; Daley, Marilyn C; Neuman, Matthew J; Blaakman, Aaron P; McKay, James R

2016-02-01

To investigate whether telephone-based continuing care (TEL) is a promising alternative to traditional face-to-face counseling for clients in treatment for substance abuse. Patients with alcohol and/or cocaine dependence who had completed a 4-week intensive outpatient program were randomly assigned through urn randomization into one of three 12-week interventions: standard continuing care (STD), in-person relapse prevention (RP), or telephone-based continuing care (TEL). This study performed cost, cost-effectiveness, and cost-benefit analyses of TEL and RP compared to STD, using results from the randomized clinical trial with two years of follow up (359 participants). In addition, the study examined the potential moderating effect of baseline patient costs on economic outcomes. The study found that TEL was less expensive per client from the societal perspective ($569) than STD ($870) or RP ($1684). TEL also was also significantly more effective, with an abstinence rate of 57.1% compared to 46.7% for STD (p<0.05). Thus TEL dominated STD, with a highly favorable negative incremental cost-effectiveness ratio (-$1400 per abstinent year). TEL also proved favorable under a benefit-cost perspective. TEL proved to be a cost-effective and cost-beneficial contributor to long-term recovery over two years. Because TEL dominated STD care interventions, wider adoption should be considered. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Noninvasive screening for genital chlamydial infections in asymptomatic men: Strategies and costs using a urine PCR assay

PubMed Central

Peeling, Rosanna W; Toye, Baldwin; Jessamine, Peter; Gemmill, Ian

1998-01-01

OBJECTIVE: To evaluate cost saving strategies to screen for genital chlamydial infection in men using polymerase chain reaction (PCR) technology. METHODS: Men with no urethral symptoms presenting to a sexually transmitted disease (STD) clinic were recruited. Study participants underwent a questionnaire interview. Urethral swabs were taken to perform a smear for polymorphonuclear leucocytes (PMN) and for the detection of Chlamydia trachomatis by culture and PCR. First-catch urine was collected for a leukocyte esterase test (LET) and PCR. RESULTS: C trachomatis infection was detected in 36 of 463 (7.8%) men. LET and PMN were positive in 10 (28%) and 12 (33%) infected men, respectively. Risk factors for chlamydial infection were younger than age 25 years, LET-positive, PMN-positive and STD contact (P<0.001). The direct cost of genital chlamydial infection in men in Canada has been previously estimated at $381/case. Based on a sensitivity of 90% for urine PCR, the estimated direct cost of testing all participants to detect 32 cases was $453/case. Using risk factors recommended in the Canadian STD Guidelines (age younger than 25 years, new partner, STD contact or unprotected sex), the same number of cases would have been detected by testing only 384 men at $376/case. Using age younger than 25 years or STD contact as the screening criterion, 78% of those infected would have been detected at $259/case, and no new cases would have been detected by adding LET-positive or PMN-positive as risk factors. CONCLUSION: Targeted screening for chlamydial infection using urine PCR assay and risk factors recommended in the Canadian guidelines could substantially reduce the cost of screening at a STD clinic setting. LET and PMN smear did not appear to be useful indicators of chlamydial infection in this population. PMID:22346549

Receipt of HIV/STD prevention counseling by HIV-infected adults receiving medical care in the United States.

PubMed

Mizuno, Yuko; Zhu, Julia; Crepaz, Nicole; Beer, Linda; Purcell, David W; Johnson, Christopher H; Valverde, Eduardo E; Skarbinski, Jacek

2014-01-28

Guidelines recommend risk-reduction counseling by HIV providers to all HIV-infected persons. Among HIV-infected adults receiving medical care in the United States, we estimated prevalence of exposure to three types of HIV/sexually transmitted disease (STD) risk-reduction interventions and described the characteristics of persons who received these interventions. Data were from the Medical Monitoring Project (MMP), a supplemental HIV surveillance system designed to produce nationally representative estimates of behavioral and clinical characteristics of HIV-infected adults receiving medical care in the United States. Descriptive analyses were conducted to estimate the exposure to each type of HIV/STD risk-reduction intervention. Bivariate and multivariable analyses were conducted to assess associations between the selected correlates with each exposure variable. About 44% of participants reported a one-on-one conversation with a healthcare provider about HIV/STD prevention, 30% with a prevention program worker, 16% reported participation in a small group risk-reduction intervention, and 52% reported receiving at least one of the three interventions in the past 12 months. Minority race/ethnicity, low income, and risky sexual behavior consistently predicted greater intervention exposure. However, 39% of persons who reported risky sex did not receive any HIV/STD risk-reduction interventions. HIV-infected persons in care with fewer resources or those who engaged in risk behaviors were more likely to receive HIV/STD risk-reduction interventions. However, less than half of HIV-infected persons in care received HIV/STD prevention counseling from their provider, an intervention that has been shown to be effective and is supported by guidelines.

The cost of implementing rapid HIV testing in sexually transmitted disease clinics in the United States.

PubMed

Eggman, Ashley A; Feaster, Daniel J; Leff, Jared A; Golden, Matthew R; Castellon, Pedro C; Gooden, Lauren; Matheson, Tim; Colfax, Grant N; Metsch, Lisa R; Schackman, Bruce R

2014-09-01

Rapid HIV testing in high-risk populations can increase the number of persons who learn their HIV status and avoid spending clinic resources to locate persons identified as HIV infected. We determined the cost to sexually transmitted disease (STD) clinics of point-of-care rapid HIV testing using data from 7 public clinics that participated in a randomized trial of rapid testing with and without brief patient-centered risk reduction counseling in 2010. Costs included counselor and trainer time, supplies, and clinic overhead. We applied national labor rates and test costs. We calculated median clinic start-up costs and mean cost per patient tested, and projected incremental annual costs of implementing universal rapid HIV testing compared with current testing practices. Criteria for offering rapid HIV testing and methods for delivering nonrapid test results varied among clinics before the trial. Rapid HIV testing cost an average of US $22/patient without brief risk reduction counseling and US $46/patient with counseling in these 7 clinics. Median start-up costs per clinic were US $1100 and US $16,100 without and with counseling, respectively. Estimated incremental annual costs per clinic of implementing universal rapid HIV testing varied by whether or not brief counseling is conducted and by current clinic testing practices, ranging from a savings of US $19,500 to a cost of US $40,700 without counseling and a cost of US $98,000 to US $153,900 with counseling. Universal rapid HIV testing in STD clinics with same-day results can be implemented at relatively low cost to STD clinics, if brief risk reduction counseling is not offered.

Investigating stakeholders' perceptions of the link between high STD rates and the current Baltimore City Public Schools' sex education curriculum

NASA Astrophysics Data System (ADS)

Bolden, Shenell L. T.

The purpose of this exploratory study was to examine key stakeholders' perceptions of the current Baltimore City Public Schools' (BCPS) sex education curriculum and to gain insight into how they believe the curriculum could be modified to be more effective. A mixed methods approach using qualitative and quantitative data collection consisting of a survey, focus group interview, and individual interviews was conducted to gather information on stakeholders' perceptions. The stakeholders included: (1) former students who received their sex education courses in the Baltimore City Public School system (BCPS); (2) teachers in BCPS who were affiliated with the sex education curriculum; (3) health care professionals who screened and/or treated East Baltimore City residents for a sexually transmitted disease (STD) and; (4) one policy maker who was responsible for creating sex education curriculum at the national level. Analysis of the quantitative data from former Baltimore City Public School students revealed a general satisfaction with the current sex education curriculum. However, qualitative data from the same group of stakeholders revealed several changes they thought should be implemented into the program in an effort to improve the current curriculum. Findings from the other groups after qualitative analysis of the interviews suggest three major themes in support of curriculum change: (1) a blended curriculum that integrates both the cognitive and affective learning domains; (2) knowledge of prevention of STD's and pregnancy; and (3) authentic teaching and learning. Results from this study strongly suggest that the Baltimore City Public School system is apathetic to the sexual health needs of students and, therefore, is inadvertently contributing to the high rate of sexually transmitted diseases among young people. Keywords: Abstinence, Affective domain, Indoctrination, Behavior Modification, Cognitive domain, Sex education curriculum, Sexually Transmitted Diseases.

Public Stigma against People with Mental Illness in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia

PubMed Central

Girma, Eshetu; Tesfaye, Markos; Froeschl, Guenter; Möller-Leimkühler, Anne Maria; Müller, Norbert; Dehning, Sandra

2013-01-01

Background Public understanding about mental illnesses and attitudes towards people with mental illness (PWMI) play a paramount role in the prevention and treatment of mental illness and the rehabilitation of PWMI. The aim of this study was to measure public stigma against PWMI and the factors associated with stigma in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia. Methods This community-based, cross-sectional study was conducted from June to August 2012 among 845 randomly selected respondents by using the Community Attitudes towards the Mentally Ill (CAMI) scale, an interviewer-administered questionnaire. Data was entered with EPI-DATA and then exported to STATA for analysis. Simple descriptive and linear regression analyses were performed to identify predictors of stigma against PWMI. Results Of the total of 845 respondents, 68.17% were from rural districts. The mean stigma score was 2.62 on a 5-point score. The majority of the respondents (75.27%) believed that mental illness can be cured. Stress, poverty, and rumination were the most often perceived causes of mental illness. Rural residents had significantly higher stigma scores (std. β = 0.61, P<0.001). A statistically significant inverse relationship was found between the level of education and degree of stigma (std. β = −0.14, P<0.01), while higher income was significantly associated with more stigma (std. β = 0.07, P<0.05). Respondents with higher scores for perceived supernatural causes (std. β = −0.09, P<0.01) and perceived psychosocial and biological causes (std. β = −0.14, P<0.001) had significantly lower stigma levels. Conclusions The study found a more undermining but less avoidant attitude towards PWMI. Rural residents showed higher levels of stigma. Stigma against PWMI was lower in people with an explanatory concept about the causes of mental illness and a higher level of education. Information, education, and communication about the causes, signs, and nature of mental illnesses would help to reduce stigma. PMID:24324756

Public stigma against people with mental illness in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia.

PubMed

Girma, Eshetu; Tesfaye, Markos; Froeschl, Guenter; Möller-Leimkühler, Anne Maria; Müller, Norbert; Dehning, Sandra

2013-01-01

Public understanding about mental illnesses and attitudes towards people with mental illness (PWMI) play a paramount role in the prevention and treatment of mental illness and the rehabilitation of PWMI. The aim of this study was to measure public stigma against PWMI and the factors associated with stigma in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia. This community-based, cross-sectional study was conducted from June to August 2012 among 845 randomly selected respondents by using the Community Attitudes towards the Mentally Ill (CAMI) scale, an interviewer-administered questionnaire. Data was entered with EPI-DATA and then exported to STATA for analysis. Simple descriptive and linear regression analyses were performed to identify predictors of stigma against PWMI. Of the total of 845 respondents, 68.17% were from rural districts. The mean stigma score was 2.62 on a 5-point score. The majority of the respondents (75.27%) believed that mental illness can be cured. Stress, poverty, and rumination were the most often perceived causes of mental illness. Rural residents had significantly higher stigma scores (std. β = 0.61, P<0.001). A statistically significant inverse relationship was found between the level of education and degree of stigma (std. β = -0.14, P<0.01), while higher income was significantly associated with more stigma (std. β = 0.07, P<0.05). Respondents with higher scores for perceived supernatural causes (std. β = -0.09, P<0.01) and perceived psychosocial and biological causes (std. β = -0.14, P<0.001) had significantly lower stigma levels. The study found a more undermining but less avoidant attitude towards PWMI. Rural residents showed higher levels of stigma. Stigma against PWMI was lower in people with an explanatory concept about the causes of mental illness and a higher level of education. Information, education, and communication about the causes, signs, and nature of mental illnesses would help to reduce stigma.

Brain structural alterations associated with young women with subthreshold depression

PubMed Central

Li, Haijiang; Wei, Dongtao; Sun, Jiangzhou; Chen, Qunlin; Zhang, Qinglin; Qiu, Jiang

2015-01-01

Neuroanatomical abnormalities in patients with major depression disorder (MDD) have been attracted great research attention. However, the structural alterations associated with subthreshold depression (StD) remain unclear and, therefore, require further investigation. In this study, 42 young women with StD, and 30 matched non-depressed controls (NCs) were identified based on two-time Beck Depression Inventory scores. Whole-brain voxel-based morphometry (VBM) and region of interest method were used to investigate altered gray matter volume (GMV) and white matter volume (WMV) among a non-clinical sample of young women with StD. VBM results indicated that young women with StD showed significantly decreased GMV in the right inferior parietal lobule than NCs; increased GMV in the amygdala, posterior cingulate cortex, and precuneus; and increased WMV in the posterior cingulate cortex and precuneus. Together, structural alterations in specific brain regions, which are known to be involved in the fronto-limbic circuits implicated in depression may precede the occurrence of depressive episodes and influence the development of MDD. PMID:25982857

Miniaturized thermocycler based on thermoelectric heating for diagnosis of sexually transmitted disease by DNA amplification

NASA Astrophysics Data System (ADS)

Lim, Hyunjung; Jo, Ga Eun; Kim, Kyong Soo; Back, Seung Min; Choi, Hyuk

2017-05-01

Sexually transmitted disease (STD) is among the most common infectious diseases; therefore, it is necessary to develop sensitive early diagnostic techniques. As the gold standard, polymerase chain reaction (PCR) has been most widely employed for STD diagnosis; however, PCR requires large and expensive instruments. In this study, miniaturized thermal cycler using Peltier modules was developed for the PCR analysis. In comparison with the conventional PCR instrument, the Peltier-based micro-PCR (P-mPCR) device developed in this study enables one to amplify and successfully distinguish between DNA of different sizes. Furthermore, by using the clinical vaginal sample collected with the vaginal swab and tampon, different kinds of STD bacteria could be detected with high accuracy (˜94.19%) and high sensitivity (˜95.6%). Therefore, the P-mPCR device will be applicable in STD diagnosis as well as the detection of other bacteria/viruses using DNA amplification in regions including those with limited resources.

The contribution of a urine-based jail screening program to citywide male Chlamydia and gonorrhea case rates in New York City.

PubMed

Pathela, Preeti; Hennessy, Robin R; Blank, Susan; Parvez, Farah; Franklin, Woodman; Schillinger, Julia A

2009-02-01

With noninvasive specimen types, males can be more easily screened for Chlamydia trachomatis and Neisseria gonorrhoeae infections. Long-standing universal screening of males attending New York City (NYC) sexually transmitted diseases (STD) clinics has yielded a substantial number of chlamydia cases. In 2005, screening was expanding to another large group at high risk for STD: males

Acceptability and feasibility of using established geosocial and sexual networking mobile applications to promote HIV and STD testing among men who have sex with men

PubMed Central

Sun, Christina J.; Stowers, Jason; Miller, Cindy; Bachmann, Laura H.; Rhodes, Scott D.

2014-01-01

This study is the first published multi-app study, of which we are aware, to evaluate both the acceptability and feasibility of providing sexual health information and HIV/STD testing referrals via established geosocial and sexual networking apps for MSM. Data were collected using an online survey and through four apps (A4A Radar, Grindr, Jack’d, and Scruff). Two-thirds (64%) found apps to be an acceptable source for sexual health information. MSM who found apps as acceptable were more likely non-white men, not sure of their current HIV status, and have low HIV testing self-efficacy. One-quarter (26%) of informational chats with the health educator resulted in users requesting and being referred to local HIV/STD testing sites. There were significant differences in the number and types of interactions across apps. Established apps for MSM may be both an acceptable and feasible platform to promote HIV/STD testing. Future research should evaluate interventions that leverage this technology. PMID:25381563

Acceptability and feasibility of using established geosocial and sexual networking mobile applications to promote HIV and STD testing among men who have sex with men.

PubMed

Sun, Christina J; Stowers, Jason; Miller, Cindy; Bachmann, Laura H; Rhodes, Scott D

2015-03-01

This study is the first published multi-app study, of which we are aware, to evaluate both the acceptability and feasibility of providing sexual health information and HIV/STD testing referrals via established geosocial and sexual networking apps for MSM. Data were collected using an online survey and through four apps (A4A Radar, Grindr, Jack'd, and Scruff). Two-thirds (64 %) found apps to be an acceptable source for sexual health information. MSM who found apps as acceptable were more likely non-white, not sure of their current HIV status, and have low HIV testing self-efficacy. One-quarter (26 %) of informational chats with the health educator resulted in users requesting and being referred to local HIV/STD testing sites. There were significant differences in the number and types of interactions across apps. Established apps designed for MSM may be both an acceptable and feasible platform to promote HIV/STD testing. Future research should evaluate interventions that leverage this technology.

Cost-Effectiveness of HIV Screening in STD Clinics, Emergency Departments, and Inpatient Units: A Model-Based Analysis

PubMed Central

Prabhu, Vimalanand S.; Farnham, Paul G.; Hutchinson, Angela B.; Soorapanth, Sada; Heffelfinger, James D.; Golden, Matthew R.; Brooks, John T.; Rimland, David; Sansom, Stephanie L.

2011-01-01

Background Identifying and treating persons with human immunodeficiency virus (HIV) infection early in their disease stage is considered an effective means of reducing the impact of the disease. We compared the cost-effectiveness of HIV screening in three settings, sexually transmitted disease (STD) clinics serving men who have sex with men, hospital emergency departments (EDs), settings where patients are likely to be diagnosed early, and inpatient diagnosis based on clinical manifestations. Methods and Findings We developed the Progression and Transmission of HIV/AIDS model, a health state transition model that tracks index patients and their infected partners from HIV infection to death. We used program characteristics for each setting to compare the incremental cost per quality-adjusted life year gained from early versus late diagnosis and treatment. We ran the model for 10,000 index patients for each setting, examining alternative scenarios, excluding and including transmission to partners, and assuming HAART was initiated at a CD4 count of either 350 or 500 cells/µL. Screening in STD clinics and EDs was cost-effective compared with diagnosing inpatients, even when including only the benefits to the index patients. Screening patients in STD clinics, who have less-advanced disease, was cost-effective compared with ED screening when treatment with HAART was initiated at a CD4 count of 500 cells/µL. When the benefits of reduced transmission to partners from early diagnosis were included, screening in settings with less-advanced disease stages was cost-saving compared with screening later in the course of infection. The study was limited by a small number of observations on CD4 count at diagnosis and by including transmission only to first generation partners of the index patients. Conclusions HIV prevention efforts can be advanced by screening in settings where patients present with less-advanced stages of HIV infection and by initiating treatment with HAART earlier in the course of infection. PMID:21625489

Effectiveness of syndromic management for male patients with urethral discharge symptoms in Amazonas, Brazil*

PubMed Central

de Menezes Filho, Jonas Rodrigues; Sardinha, José Carlos Gomes; Galbán, Enrique; Saraceni, Valéria; Talhari, Carolina

2017-01-01

Background Urethral discharge syndrome (UDS) is characterized by the presence of purulent or mucopurulent urethral discharge.The main etiological agents of this syndrome are Neisseria gonorrhoeae and Chlamydia trachomatis. Objectives To evaluate the effectiveness of the syndromic management to resolve symptoms in male urethral discharge syndrome cases in Manaus, Amazonas, Brazil. Methods Retrospective cohort of male cases of urethral discharge syndrome observed at a clinic for sexually transmitted disease (STD) in 2013. Epidemiological and clinical data, as well as the results of urethral swabs, bacterioscopy, hybrid capture for C.trachomatis, wet-mount examination, and culture for N.gonorrhoeae, were obtained through medical chart reviews. Results Of the 800 urethral discharge syndrome cases observed at the STD clinic, 785 (98.1%) presented only urethral discharge syndrome, 633 (79.1%) returned for follow-up, 579 (91.5%) were considered clinically cured on the first visit, 41(6.5 %) were considered cured on the second visit, and 13(2.0%) did not reach clinical cure after two appointments. Regarding the etiological diagnosis, 42.7% of the patients presented a microbiological diagnosis of N.gonorrhoeae, 39.3% of non-gonococcal and non-chlamydia urethritis, 10.7% of C.trachomatis and 7.3% of co-infection with chlamydia and gonococcus. The odds of being considered cured in the first visit were greater in those who were unmarried, with greater schooling, and with an etiological diagnosis of gonorrhea. The diagnosis of non-gonococcal urethritis reduced the chance of cure in the first visit. Study limitation A study conducted at a single center of STD treatment. Conclusion Syndromic management of male urethral discharge syndrome performed in accordance with the Brazilian Ministry of Health STD guidelines was effective in resolving symptoms in the studied population. More studies with microbiological outcomes are needed to ensure the maintenance of the syndromic management. PMID:29364432

Adherence to CDC Recommendations for the Treatment of Uncomplicated Gonorrhea - STD Surveillance Network, United States, 2016.

PubMed

Weston, Emily J; Workowski, Kimberly; Torrone, Elizabeth; Weinstock, Hillard; Stenger, Mark R

2018-04-27

Gonorrhea, the sexually transmitted disease (STD) caused by Neisseria gonorrhoeae, is the second most common notifiable disease in the United States after chlamydia; 468,514 cases were reported to state and local health departments in 2016, an increase of 18.5% from 2015 (1). N. gonorrhoeae has progressively developed resistance to most antimicrobials used to treat the infection (2). As a result, CDC recommends two antimicrobials (250 mg of ceftriaxone [IM] plus 1 g of azithromycin [PO]) for treating uncomplicated gonorrhea to improve treatment efficacy and, potentially, to slow the emergence and spread of antimicrobial resistance. To monitor adherence to the current CDC-recommended regimen for uncomplicated gonorrhea, CDC reviewed enhanced data collected on a random sample of reported cases of gonorrhea in seven jurisdictions participating in the STD Surveillance Network (SSuN) and estimated the proportion of patients who received the CDC-recommended regimen for uncomplicated gonorrhea, by patient characteristics and diagnosing facility type. In 2016, the majority of reported patients with gonorrhea (81%) received the recommended regimen. There were no differences in the proportion of patients receiving the recommended regimen by age or race/ethnicity; however, patients diagnosed with gonorrhea in STD (91%) or family planning/reproductive health (94%) clinics were more likely to receive this regimen than were patients diagnosed in other provider settings (80%). These data document high provider adherence to CDC gonorrhea treatment recommendations in specialty STD clinics, indicating high quality of care provided in those settings. Local and state health departments should monitor adherence with recommendations in their jurisdictions and consider implementing interventions to improve provider and patient compliance with gonorrhea treatment recommendations where indicated.

Dialysis Dose Scaled to Body Surface Area and Size-Adjusted, Sex-Specific Patient Mortality

PubMed Central

Kapke, Alissa; Port, Friedrich K.; Wolfe, Robert A.; Saran, Rajiv; Pearson, Jeffrey; Hirth, Richard A.; Messana, Joseph M.; Daugirdas, John T.

2012-01-01

Summary Background and objectives When hemodialysis dose is scaled to body water (V), women typically receive a greater dose than men, but their survival is not better given a similar dose. This study sought to determine whether rescaling dose to body surface area (SA) might reveal different associations among dose, sex, and mortality. Design, setting, participants, & measurements Single-pool Kt/V (spKt/V), equilibrated Kt/V, and standard Kt/V (stdKt/V) were computed using urea kinetic modeling on a prevalent cohort of 7229 patients undergoing thrice-weekly hemodialysis. Data were obtained from the Centers for Medicare & Medicaid Services 2008 ESRD Clinical Performance Measures Project. SA-normalized stdKt/V (SAN-stdKt/V) was calculated as stdKt/V × ratio of anthropometric volume to SA/17.5. Patients were grouped into sex-specific dose quintiles (reference: quintile 1 for men). Adjusted hazard ratios (HRs) for 1-year mortality were calculated using Cox regression. Results spKt/V was higher in women (1.7±0.3) than in men (1.5±0.2; P<0.001), but SAN-stdKt/V was lower (women: 2.3±0.2; men: 2.5±0.3; P<0.001). For both sexes, mortality decreased as spKt/V increased, until spKt/V was 1.6–1.7 (quintile 4 for men: HR, 0.62; quintile 3 for women: HR, 0.64); no benefit was observed with higher spKt/V. HR for mortality decreased further at higher SAN-stdKt/V in both sexes (quintile 5 for men: HR, 0.69; quintile 5 for women: HR, 0.60). Conclusions SA-based dialysis dose results in dose-mortality relationships substantially different from those with volume-based dosing. SAN-stdKt/V analyses suggest women may be relatively underdosed when treated by V-based dosing. SAN-stdKt/V as a measure for dialysis dose may warrant further study. PMID:22977208

Interactions of HIV, other sexually transmitted diseases, and genital tract inflammation facilitating local pathogen transmission and acquisition.

PubMed

Mayer, Kenneth H; Venkatesh, Kartik K

2011-03-01

Despite several decades of clinical trials assessing the impact of etiological treatment of sexually transmitted diseases (STDs) to decrease HIV acquisition and transmission, almost all of these trials have not proven to be efficacious. Increasing evidence suggests that specific STD treatment alone may not be sufficient to alter the genital tract inflammatory milieu that is created by STDs. This paper examines the associations between STDs and HIV susceptibility and infectiousness, and considers the role of chronic and refractory inflammation to create an environment that potentiates HIV and STD transmission and acquisition by reviewing biological, observational, and clinical trial data. © 2011 John Wiley & Sons A/S.

Evaluation of an HIV/STD Sexual Risk-Reduction Intervention for Pregnant African American Adolescents Attending a Prenatal Clinic in an Urban Public Hospital: Preliminary Evidence of Efficacy

PubMed Central

Diclemente, R.J.; Wingood, G. M.; Rose, E.; Sales, J. M.; Crosby, R.A.

2009-01-01

Study Objective To evaluate an intervention to reduce HIV/STD-associated behaviors and enhance psychosocial mediators for pregnant African-American adolescents. Design A randomized controlled trial. Participants completed baseline and follow-up assessments. Setting An urban public hospital in the Southeastern U.S. Participants Pregnant African-American adolescents (N=170), 14-20 years of age, attending a prenatal clinic. Intervention Intervention participants received two 4-hour group sessions enhancing self-concept and self-worth, HIV/STD prevention skills, and safer sex practices. Participants in the comparison condition received a 2-hour session on healthy nutrition. Main Outcome Measures Consistent condom use. Results Intervention participants reported greater condom use at last intercourse (AOR = 3.9, P = .05) and consistent condom use (AOR = 7.9, P = .05), higher sexual communication frequency, enhanced ethnic pride, higher self-efficacy to refuse risky sex, and were less likely to fear abandonment as a result of negotiating safer sex. Conclusion Interventions for pregnant African-American adolescents can enhance condom use and psychosocial mediators. PMID:19643646

Prevention as policy: how Thailand reduced STD and HIV transmission.

PubMed

Hanenberg, R; Rojanapithayakorn, W

1996-05-01

In 1989, in response to growing HIV seroprevalences among intravenous drug users and low-fee commercial sex workers in northern Chiang Mai, the Government of Thailand launched a massive expansion of its HIV/AIDS Prevention and Control Program. The most ambitious, innovative aspect of this effort was the 100% Condom Program established in 1991 to enforce universal condom use in all commercial sex establishments. Every sex worker is presented with a box of 100 condoms or more when she reports for a regular sexually transmitted disease (STD) checkup at a government clinic. When health officials visit commercial sex establishments, they take along boxes of condoms. Strong pressure, often from the police, is placed on brothel owners who fail to support the campaign. By 1994, over 90% of commercial sex acts were protected by condoms and the number of men presenting to government clinics for STD treatment dropped by 90% from 1989 to 1995. Moreover, the number of commercial sex workers has declined by 25% since 1989. Models of the AIDS epidemic indicate that Thai health authorities should continue to focus on commercial sex for the control of HIV.

Cost of Health Education to Increase STD Awareness in Female Garment Workers in Bangladesh

ERIC Educational Resources Information Center

Rianon, Nahid; Selwyn, Beatrice; Shahidullah, S. M.; Swint, J. Michael; Franzini, Luisa; Rasu, Rafia

2009-01-01

Risk of sexually transmitted diseases (STDs) and the need for health education in the female garment workers in Bangladesh have been emphasized in the past. Interventions were more acceptable when considered cost-effective. This preliminary study reported on the cost-effectiveness of a health education program that successfully improved knowledge…

Internet FAQ Archives - Online Education - faqs.org

Science.gov Websites

faqs.org Internet FAQ Archives - Online Education faqs.org faqs.org - Internet FAQ Archives Internet FAQ Archives Online Education Internet RFC Index Usenet FAQ Index Other FAQs Documents Tools IFC Rated FAQs Internet RFC/STD/FYI/BCP Archives The Internet RFC series of documents is also available from

2012 Sexually Transmitted Diseases Surveillance

MedlinePlus

... Data Appendix Tables A1 - A4 STD Surveillance Case Definitions Contributors Related Links STD Home STD Data & Statistics NCHHSTP Atlas Interactive STD Data - 1996-2013 STD Health Equity HIV/AIDS Surveillance & Statistics Follow STD STD on Twitter STD on Facebook File Formats Help: How do I view different ...

Reaching Suburban Men Who Have Sex With Men for STD and HIV Services Through Online Social Networking Outreach: A Public Health Approach.

PubMed

Lampkin, Darryl; Crawley, Adam; Lopez, Teresa P; Mejia, Christopher M; Yuen, Wesley; Levy, Vivian

2016-05-01

Technology-enabled approaches may reach suburban and rural men who have sex with men (MSM) who lack physical venues, where they live for sexually transmitted disease (STD)/HIV prevention efforts. We evaluated using Grindr, an all-male social networking platform, for STD/HIV prevention services to MSM by a suburban Public Health department. Phase 1 (October 2012-March 2013) focused on acceptability of prevention messages by MSM on Grindr and phase 2 (October 2013-March 2014) Grindr use for implementing testing and linkage-to-care. We compared the number of Public Health encounters with MSM before and after initiation of Grindr use and the proportion of users who remained engaged with Public Health staff after being told they were interacting with a health educator. For a 6-month period before Grindr outreach, Public Health had 60 contacts with MSM. Contacts increased to 305 MSM in phase 1, of which 168/213 (79%) remained engaged. In phase 2, among 903 MSM contacts, 69% remained engaged. Asian and Hispanic MSM were more likely to remain engaged with outreach staff; white men were more likely to be not engaged. No significant difference in age between engaged and nonengaged MSM was seen. Grindr outreach by Public Health in a suburban county seems acceptable to MSM and leads to a 14-fold increase in MSM reached for counseling and education compared with a traditional outreach period. Further evaluation of technology-enabled approaches for STD/HIV prevention in suburban and rural MSM is warranted.

Gender, sexual health and reproductive health promotion.

PubMed

Moeti, M R

1995-01-01

The underlying factors of poverty, migration, marginalization, lack of information and skills, disempowerment, and poor access to services which affect HIV/STD risk are also closely related to those which affect sexual and reproductive health. Reproductive health problems include unplanned and unwanted pregnancies, unsafe abortions, pregnancy-related illness and death, and STDs including HIV/AIDS. This interrelationship between factors is leading increasingly to the integration of HIV/STD education and prevention within the broader framework of sexual and reproductive health promotion. Such intervention allows the possible reinforcement of the impact of interventions upon important underlying factors and behaviors linked to individual, family, and community vulnerability to HIV/STDs as well as other reproductive health problems. Integration will also optimize the use of increasingly scarce resources and increase the likelihood of responses, interventions, and programs being sustainable. Sexual and reproductive health, placing HIV/STD prevention into context, and focus upon men are discussed.

STD Uplink Complex. Satellite Technology Demonstration, Technical Report No. 0418.

ERIC Educational Resources Information Center

Potter, James G.

The Health, Education, Telecommunications (HET) experiment, and the Federation of Rocky Mountain States have collaborated with the National Aeronautics and Space Administration to provide health education and other community service broadcasts to rural areas of the Rocky Mountains. In order to access the signal of the ATS-6 (Applications…

Relationships between perceived STD-related stigma, STD-related shame and STD screening among a household sample of adolescents.

PubMed

Cunningham, Shayna D; Kerrigan, Deanna L; Jennings, Jacky M; Ellen, Jonathan M

2009-12-01

Important barriers to STD testing may include individuals' perceptions of STD-related stigma (negative societal attitudes toward STD infection) and expectations of STD-related shame (negative personal feelings) that would result from a positive STD test. Obtaining a clear understanding of the relationship between STD-related stigma, STD-related shame and STD testing may help inform programs and policies aimed at reducing STD transmission. Measures derived from previously published scales were used to assess perceived STD-related stigma, anticipated STD-related shame and receipt of an STD test in the past year in an urban, household sample of 594 sexually active 15-24-year-olds interviewed in 2004-2007. Logistic regression was used to examine associations between recent STD testing and perceived stigma, shame and other participant characteristics. Thirty-seven percent of males and 70% of females reporting having had an STD test in the past year; the largest proportions of tests (42% among males and 59% among females) had occurred in the context of a routine health care visit, not because adolescents had had disease symptoms or were concerned about exposure to infection. For both males and females, the level of STD-related stigma was negatively associated with the odds of having been tested (odds ratio, 0.5 for each). STD-related shame was not related to STD testing. Adolescents who view STDs as stigmatizing have a reduced likelihood of being screened, but it is unclear whether this relationship reflects their care seeking or providers' practice of offering STD screening at a routine health visit.

Differing identities, but comparably high HIV and bacterial sexually transmitted disease burdens, among married and unmarried men who have sex with men in Mumbai, India

PubMed Central

Mayer, Kenneth H.; Gangakhedkar, Raman; Sivasubramanian, Murugesan; Biello, Katie B.; Abuelezam, Nadia; Mane, Sandeep; Risbud, Arun; Anand, Vivek; Safren, Steven; Mimiaga, Matthew J.

2015-01-01

Background Although HIV incidence has declined in India, men and transgender women who have sex with men (MSM) continue to have high rates of HIV and STD. Indian MSM face substantial pressures to marry and have families, but the HIV/STD burden among married Indian MSM is not well-characterized. Methods A diverse sample of Indian MSM was recruited through respondent driven sampling (RDS). Independent variables that produced a p-value of 0.10 or less were then added to a multivariable logistic regression model. Results Most of the 307 MSM (95 married, and 212 unmarried) recruited into the study were less than 30, and less than 1/3 had more than a high school education. Almost two thirds of the married men had children, compared to 1.4% of the unmarried men (p<0.001). The numbers of condomless anal sex acts did not differ by marriage status. Although unmarried MSM more often identified themselves as “kothi” (receptive role), their rates of HIV or bacterial STD were similar to married MSM, with 14.3% being HIV-infected. The RDS-adjusted prevalence of any bacterial STD was 18.3% for married MSM and 20% for unmarried MSM (NS). Participants reported high levels of psychological distress, with 27.4% of married and 20.1% of unmarried MSM reporting depressive symptoms (NS). Conclusions MSM in Mumbai had high rates of HIV, STD and behavioral health concerns. Clinicians need to become more comfortable in eliciting sexual histories so that they can identify MSM who need HIV/STD treatment and/or prevention services. PMID:26462187

Developing and Implementing a Content Structure for Educational Television Programming in the Area of Career Education. Satellite Technology Demonstration, Technical Report No. 0506.

ERIC Educational Resources Information Center

Lonsdale, Helen C.; McWilliams, Alfred E., Jr.

The Program Component of the Satellite Technology Demonstration (STD) developed the programing for a television series on career planning for junior high school students. A program called "Time Out" was designed, developed, and implemented to be broadcast throughout the Rocky Mountain States. A staff of educators and communicators…

Sexually transmitted diseases in Ethiopia. Social factors contributing to their spread and implications for developing countries.

PubMed

Plorde, D S

1981-12-01

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.

HIV/AIDS/STD. Education for Prevention.

ERIC Educational Resources Information Center

Mayes, Jane Ruthven, Ed.

The contents of this booklet come from contributions to the 1995 Global Conference on School Health and HIV/AIDS Prevention. The objectives of the booklet are: (1) to strengthen the awareness of teachers and education personnel regarding the importance of developing school health and HIV/AIDS prevention curricula; (2) to show the specific roles of…

Crosstalk between virulence loci: regulation of Salmonella enterica pathogenicity island 1 (SPI-1) by products of the std fimbrial operon.

PubMed

López-Garrido, Javier; Casadesús, Josep

2012-01-01

Invasion of intestinal epithelial cells is a critical step in Salmonella infection and requires the expression of genes located in Salmonella pathogenicity island 1 (SPI-1). A key factor for SPI-1 expression is DNA adenine (Dam) methylation, which activates synthesis of the SPI-1 transcriptional activator HilD. Dam-dependent regulation of hilD is postranscriptional (and therefore indirect), indicating the involvement of unknown cell functions under Dam methylation control. A genetic screen has identified the std fimbrial operon as the missing link between Dam methylation and SPI-1. We show that all genes in the std operon are part of a single transcriptional unit, and describe three previously uncharacterized ORFs (renamed stdD, stdE, and stdF). We present evidence that two such loci (stdE and stdF) are involved in Dam-dependent control of Salmonella SPI-1: in a Dam(-) background, deletion of stdE or stdF suppresses SPI-1 repression; in a Dam(+) background, constitutive expression of StdE and/or StdF represses SPI-1. Repression of SPI-1 by products of std operon explains the invasion defect of Salmonella Dam(-) mutants, which constitutively express the std operon. Dam-dependent repression of std in the ileum may be required to permit invasion, as indicated by two observations: constitutive expression of StdE and StdF reduces invasion of epithelial cells in vitro (1,000 fold) and attenuates Salmonella virulence in the mouse model (>60 fold). In turn, crosstalk between std and SPI-1 may play a role in intestinal infections by preventing expression of SPI-1 in the caecum, an intestinal compartment in which the std operon is known to be expressed.

High-risk sexual behavior among drug-using men.

PubMed

Seidman, S N; Sterk-Elifson, C; Aral, S O

1994-01-01

Drug-using men are at high risk for acquisition and transmission of STD, presumably due to the risky behaviors practiced in environments of drug use. To study behaviors associated with STD transmission among drug-using men. Drug outreach workers distributed vouchers to self-identified drug-using men in urban Atlanta. Vouchers could be redeemed for cash at a storefront clinic where subjects provided urine for a urethritis screening test (leukocyte esterase test) and a drug screen, and were interviewed. Of 382 voucher recipients, 252 (66%) came to the clinic. Subjects were predominantly black (92%), homeless (70%), and aged 20 to 40 (88%). All used illicit drugs; none were currently receiving drug abuse treatment. Urine drug screen confirmed recent cocaine use in 63%, and recent opiate use in 4%. Three-fourths reported a history of STD, mostly gonorrhea. In the preceding 3 months, 14% had not had sex, 80% had sex exclusively with women, 4% had sex with both men and women, and 2% had sex exclusively with men. Of the heterosexually active men, 29% had 5 or more recent partners. Compared to other heterosexually active men, these men were more likely to always use alcohol or crack before having sex (prevalence ratio [PR] = 2.0, 95% CI = 1.3-2.5) and to drink alcohol every day (PR = 2.0, 95% CI = 1.2-3.3). Daily crack use was associated with choosing partners at elevated STD risk; daily alcohol use with having more partners. Positive drug screen for cocaine was associated with self-reported crack use. Urethritis, detected in 16%, was not correlated with behavior. A substantial number of drug-using men practice high-risk sexual behavior and should be targeted for intervention. Monetary and other incentives should be considered for recruitment. Further study is needed to clarify the relationship between sexual behavior, cocaine use, and STD.

HIV / AIDS, STDs and the workplace.

PubMed

Jackson, H

1995-01-01

Even though the workplace is ideal for promoting HIV/STD (sexually transmitted disease) prevention to benefit workers and employers, many workplaces are not convinced that they should be involved in HIV/AIDS and STD education, prevention, and support. They do not realize that time and money spent on health programs save them money. Perhaps they do not feel obligated to protect the health of their employees. The AIDS epidemic adversely affects society and the economy at both the macro and micro level. AIDS tends to strike the productive age group, thereby seriously affecting the workplace. In many Sub-Saharan African countries, at least 20% of the urban workforce may be infected with HIV. Persons living with HIV include top management, skilled professionals, general hands, and farm laborers. HIV/AIDS costs for formal employment are assumed through reduced productivity; increased costs of occupational benefits and social security measures; loss of skilled labor, professionals, and managerial expertise as well as the experience among workers; increased costs of training and recruitment; and low morale from stigmatization, discrimination, and subsequent industrial relation problems. Needed are comprehensive HIV/AIDS and STD workplace programs that ensure the rights of persons with HIV and compassionate treatment of these persons. Trade union or other labor representatives, management, and appropriate government departments should work together and build on existing health legislation and policy to bring about effective negotiation and policy development concerning AIDS and employment. Training of peer educators, support services (counseling, STD referral and/or treatment), community action, management commitment, monitoring and evaluation, and supportive workplace conditions make for effective comprehensive workplace programs. Successful programs operate in fishing villages in Tanzania, tea plantations in India, the University of Papua New Guinea, and Ugandan army camps.

HIV, other STD, and pregnancy prevention education in public secondary schools -- 45 states, 2008-2010.

PubMed

2012-04-06

In the United States, 46% of high school students have had sexual intercourse and potentially are at risk for human immunodeficiency virus (HIV) infection, other sexually transmitted diseases (STDs), and pregnancy. The National HIV/AIDS Strategy for the United States recommends educating young persons about HIV before they begin engaging in behaviors that place them at risk for HIV infection. The Community Preventive Services Task Force (CPSTF) also recommends risk reduction interventions to prevent HIV, other STDs, and pregnancy among adolescents. To estimate changes in the percentage of secondary schools that teach specific HIV, other STD, and pregnancy risk reduction topics, a key intervention consistent with those supported by the National HIV/AIDS Strategy and CPSTF, CDC analyzed 2008 and 2010 School Health Profiles data for public secondary schools in 45 states. This report summarizes the results of those analyses, which indicated that in 2010, compared with 2008, the percentage of secondary schools teaching 11 topics on HIV, other STD, and pregnancy prevention in a required course in grades 6, 7, or 8 was significantly lower in 11 states and significantly higher in none; the percentage of secondary schools teaching eight topics in a required course in grades 9, 10, 11, or 12 was significantly lower in one state and significantly higher in two states; and the percentage of secondary schools teaching three condom-related topics in a required course in grades 9, 10, 11, or 12 was significantly lower in eight states and significantly higher in three states. Secondary schools can increase efforts to teach all age-appropriate HIV, other STD, and pregnancy prevention topics to help reduce risk behaviors among students.

The Fourth Special Issue on HIV/AIDS Education and Prevention in Rural Communities. The Health Education Monograph Series, Volume 18, Number 1.

ERIC Educational Resources Information Center

Torabi, Mohammad R., Ed.

This collection of papers on HIV/AIDS prevention and education in rural communities includes: "Understudied HIV/STD Risk Behaviors among a Sample of Rural South Carolina Women: A Descriptive Pilot Study" (William L. Yarber, Richard A. Crosby, and Stephanie A. Sanders); "Risk and Co-Factors among Women Related to HIV Infection and…

[Subclinical thyroid diseases].

PubMed

Zamrazil, V

2007-01-01

Subclinical thyroids disease (STD) is recently defined term in clinical thyroidology, which includes mainly functional disorders. Basic diagnostic signs are: normal values of thyroid hormones (fT4, fT3) and elevated TSH level (subclinical hypothyroidism) or suppresed TSH level (subclinical hyperthyroidism). In a category of STD may be included subclinical autoimunne thyroiditis (elevated level of thyroid antigens antibodies and/or hypoechogenity in sonographic screen, increased volume of the thyroid without clinical symptoms and/or autoimminity) and microscopic lesions of papillary thyroid carcinoma. Subclinical hypothyroidism may be dangerous for tendency to development of manifest hypothyroidism and for risk of disorders of lipid profile and development of atherosclerosis and its organ complication (esp. myocardial infarction). Subclinical hyperthyroidism is a risk factor of cardiac arythmias and probably can increase a risk of cardiovascular mortality) as well for osteoporosis (esp. in peri- and post-climacteric women), and last but not least for degenerative diseases of brain (?). Indication of treatment of STD is a matter of controversies. Recomendations of experts, varied from "no therapy, monitoring only" to "treat always". Treatment of risk groups (esp. pregnant women) is probably nowadays a most rationale recommendations since results of sofisticated prospective studies will be available.

Test-retest reliability of sit-to-stand and stand-to-sit analysis in people with and without chronic non-specific low back pain.

PubMed

Pourahmadi, Mohammad Reza; Ebrahimi Takamjani, Ismail; Jaberzadeh, Shapour; Sarrafzadeh, Javad; Sanjari, Mohammad Ali; Bagheri, Rasool; Jannati, Elham

2018-06-01

Sit-to-stand (STD) and stand-to-sit (SIT) analysis can provide information on functional independence in daily activities in patients with low back pain (LBP). However, in order for measurements to be clinically useful, data on psychometric properties should be available. The main purpose was to investigate intra-rater reliability of STD and SIT tasks in participants with and without chronic non-specific LBP (CNLBP). The second purpose was to detect any differences in lumbar spine and hips sagittal plane kinematics and coordination between asymptomatic individuals and CNLBP patients during STD and SIT. Cross-sectional study. Twenty-three CNLBP patients and 23 demographically-matched controls were recruited. Ten markers were placed on specific anatomical landmarks. Participants were asked to perform STD and SIT at a preferred speed. Peak flexion angles, mean angular velocities, lumbar to hip movement ratios, and relative phase angles were measured. The procedure was repeated after 2 h and 6-8 days. Differences between two groups were analyzed using independent t-test. Intraclass correlation coefficient (ICC 3,k), standard error of measurement (SEM), and limits of agreement (LOAs) were also estimated. The ICC values showed moderate to excellent intra-rater reliability, with relatively low SEM values (≤10.17°). The 95% LOAs demonstrated that there were no differences between the measured parameters. Furthermore, CNLBP patients had limited sagittal plane angles, smaller angular velocities, and lumbar-hip dis-coordination compared to asymptomatic participants. The results indicated moderate to excellent test-retest reliability of STD and SIT analysis. Moreover, CNLBP patients had altered kinematics during STD and its reverse. Copyright © 2017 Elsevier Ltd. All rights reserved.

Estimating the population of female sex workers in two Chinese cities on the basis of the HIV/AIDS behavioural surveillance approach combined with a multiplier method

PubMed Central

Zhang, Dapeng; Lv, Fan; Wang, Liyan; Sun, Liangxian; Zhou, Jian; Su, Wenyi; Bi, Peng

2007-01-01

Objective To estimate the size of the population of female sex workers (FSWs) on the basis of the HIV/AIDS behavioural surveillance approach in two Chinese cities, using a multiplier method. Method Relevant questions were inserted into the questionnaires given to two behavioural surveillance groups—female attendees of sexually transmitted disease (STD) clinics and FSWs. The size of the FSW population was derived by multiplying the number of FSWs in selected STD clinics during the study period by the proportion of FSW population who reported having attended the selected STD clinics during the same period. Results The size of the FSW population in the urban area of Xingyi, China, was estimated to be about 2500 (95% CI 2000 to 3400). This accounted for 3.6% of the total urban adult female population. There were an estimated 17 500 FSWs in the urban area of Guiyang, China (95% CI 10 300 to 31 900) or about 3.4% of its total urban adult female population (rounded to the nearest 100). Conclusions The multiplier method could be a useful and cost‐effective approach to estimate the FSW population, especially suitable in countries where HIV behavioural surveillance has been established in high‐risk populations. PMID:17090568

Assessing Patient Exposure to a Video-Based Intervention in STD Clinic Waiting Rooms: Findings From the Safe in the City Trial

PubMed Central

Besera, Ghenet T.; Cox, Shanna; Malotte, C. Kevin; Rietmeijer, Cornelis A.; Klausner, Jeffrey D.; O’Donnell, Lydia; Margolis, Andrew D.; Warner, Lee

2016-01-01

Safe in the City , a video intervention for clinic waiting rooms, was previously shown to reduce sexually transmitted disease (STD) incidence. However, little is known about patients’ recall of exposure to the intervention. Using data from a nested study of patients attending clinics during the trial, we assessed whether participants recalled Safe in the City, and, if so, how the intervention affected subsequent attitudes and behaviors. Analyses were restricted to responses to a 3-month follow-up questionnaire among participants who were exposed to the video (n = 708). Impact was measured as participants’ reports of the video’s effect on behaviors and attitudes. Associations were evaluated using multivariable logistic regression. Of participants who were exposed, 685 (97%) recalled viewing the video, and 68% recalled all three vignettes. After watching the video, participants felt more positive about condoms (69%) and comfortable acquiring condoms (56%), were reminded of important information about STDs and condoms (90%), and tried to apply what they learned to their lives (59%). Compared with those who recalled viewing one or two vignettes, participants who recalled viewing all three vignettes reported more positive attitudes toward condoms and peer/provider communication. These findings demonstrate that a low-resource video intervention for waiting rooms can provide sufficient exposure to positively influence STD-related attitudes/behaviors. PMID:27091608

Support for safer behaviour.

PubMed

Pujari, S

1994-01-01

Counseling persons about human immunodeficiency virus (HIV) testing and safe sex practices is performed in India at acquired immunodeficiency syndrome (AIDS) counseling centers, such as the one in Pune. The center provides counseling to clients, primarily men, before and after HIV testing. Support groups are offered for HIV-positive persons. Clients are referred by doctors, sexually transmitted disease (STD) clinics, and health care institutions. Advertising is by word of mouth. Previously, when blood banks were sending HIV-positive persons for counseling, confirmatory testing had not been performed, and 30% were actually HIV negative. Now the center, in cooperation with the blood banks, contacts all HIV-positive patients. After counseling, a confirmatory test is performed, if the patient agrees. HIV-positive persons are encouraged, but not pressured, to contact partners. Breaking confidentially is avoided. The center also counsels patients at the local government STD clinic. Again, these are mainly men. All patients have a follow up session after diagnosis to discuss sexual practices, risk reduction practices, disease prevention, and condom use. In India, culture constrains open discussion about sex. However, if counselors begin with neutral topics, such as work or children, men are more willing to speak about sexual practices and lifestyles. Counselors discuss the possible reasons for unsafe behavior and offer practical solutions. Counseling men in STD clinics also indirectly reaches their partners, the wives and sex workers who are in less of a position to protect themselves.

Boko Haram: Developing New Strategies to Combat Terrorism in Nigeria

DTIC Science & Technology

2013-03-01

by the Commission on Higher Education of the Middle States Association of Colleges and Schools, 3624 Market Street, Philadelphia, PA 19104, (215) 662...5606. The Commission on Higher Education is an institutional accrediting agency recognized by the U.S. Secretary of Education and the Council for...Higher Education Accreditation. Standard Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18 REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704

Fecal microbiota transplantation in puppies with canine parvovirus infection

PubMed Central

Pereira, Giorgio Q.; Gomes, Lucas A.; Santos, Iago S.; Alfieri, Alice F.; Weese, J. S.

2018-01-01

Background Diarrhea associated with parvovirus infection is common in dogs. Supportive care is the mainstay of treatment, but recovery may be prolonged and mortality rate can be high. Modification of the intestinal bacterial microbiota has been promising in human and veterinary medicine as an adjunctive treatment of various enteric diseases. Objectives To investigate the safety and efficacy of fecal microbiota transplantation (FMT) on the clinical recovery of puppies with acute hemorrhagic diarrhea syndrome. Animals Sixty‐six puppies with parvovirus infection were evaluated at 2 veterinary hospitals. Methods Randomized clinical trial. Puppies were randomly distributed into 2 groups: standard treatment (STD) and standard treatment + FMT (STD + FMT). The STD puppies (n = 33) received only treatment with IV fluids and antimicrobials and the STD + FMT puppies (n = 33) received FMT in addition to standard treatment. For FMT, 10 g of feces from a healthy dog diluted in 10 mL of saline were administered rectally 6‐12 hours post‐admission. Results Among survivors, treatment with FMT was associated with faster resolution of diarrhea (P < .001) and shorter hospitalization time (P = .001; median, 3 days in STD + FMT; median, 6 days in STD) compared to standard treatment. Mortality in STD was 36.4% (12/33) as compared to 21.2% (7/33) in puppies treated with FMT, but there was no statistical difference between groups (P = .174). Polymerase chain reaction indicated that all animals carried canine parvovirus, strain CPV‐2b. Conclusions Fecal microbiota transplantation in parvovirus‐infected puppies was associated with faster resolution of diarrhea. PMID:29460302

Preliminary comparison between real-time in-vivo spectral and transverse oscillation velocity estimates

NASA Astrophysics Data System (ADS)

Pedersen, Mads Møller; Pihl, Michael Johannes; Haugaard, Per; Hansen, Jens Munk; Lindskov Hansen, Kristoffer; Bachmann Nielsen, Michael; Jensen, Jørgen Arendt

2011-03-01

Spectral velocity estimation is considered the gold standard in medical ultrasound. Peak systole (PS), end diastole (ED), and resistive index (RI) are used clinically. Angle correction is performed using a flow angle set manually. With Transverse Oscillation (TO) velocity estimates the flow angle, peak systole (PSTO), end diastole (EDTO), and resistive index (RITO) are estimated. This study investigates if these clinical parameters are estimated equally good using spectral and TO data. The right common carotid arteries of three healthy volunteers were scanned longitudinally. Average TO flow angles and std were calculated { 52+/-18 ; 55+/-23 ; 60+/-16 }°. Spectral angles { 52 ; 56 ; 52 }° were obtained from the B-mode images. Obtained values are: PSTO { 76+/-15 ; 89+/-28 ; 77+/-7 } cm/s, spectral PS { 77 ; 110 ; 76 } cm/s, EDTO { 10+/-3 ; 14+/-8 ; 15+/-3 } cm/s, spectral ED { 18 ; 13 ; 20 } cm/s, RITO { 0.87+/-0.05 ; 0.79+/-0.21 ; 0.79+/-0.06 }, and spectral RI { 0.77 ; 0.88 ; 0.73 }. Vector angles are within +/-two std of the spectral angle. TO velocity estimates are within +/-three std of the spectral estimates. RITO are within +/-two std of the spectral estimates. Preliminary data indicates that the TO and spectral velocity estimates are equally good. With TO there is no manual angle setting and no flow angle limitation. TO velocity estimation can also automatically handle situations where the angle varies over the cardiac cycle. More detailed temporal and spatial vector estimates with diagnostic potential are available with the TO velocity estimation.

Entertainment Venue Visiting and Commercial Sex in China.

PubMed

Lin, Chunqing; Li, Li; Wu, Zunyou; Guan, Jihui; Xu, Yu; Wu, Di; Lieber, Eli; Rotheram-Borus, Mary Jane

2010-01-01

Entertainment venues in China play an important role in the sexually transmitted disease (STD)/HIV epidemic. Most previous studies have focused on sex workers working in entertainment venues, but little is known about their clients. This study investigated the perceptions and behavior of the patrons visiting entertainment venues. Qualitative in-depth interviews were conducted with 30 male market vendors who visited entertainment venues at least once in the past 3 months in an eastern city in China. Information about their risky behavior, attitude toward commercial sex, and STD/HIV prevention approaches was collected. Saunas, karaoke bars, and massage centers are the most frequently visited entertainment venues. Seventy-three percent of study participants reported purchasing commercial sex at these entertainment venues. Participants expressed a very liberal attitude toward commercial sex. Seeking commercial sex was perceived as a characteristic of a male's nature. The perceived risks of STD/HIV infection do not deter participants from engaging in commercial sex. Commercial sex clients reported irregular condom use and a number of other misperceptions and improper practices toward preventing STD/HIV infection. Venue-based intervention is urgently needed to target the population. The sex workers themselves could potentially serve as "health educators" to communicate prevention information to their clients and encourage safer sex behavior.

The need for a comprehensive response to HIV/ AIDS in north-western Somalia: evidence from a seroprevalence survey.

PubMed

Abdalla, E; Ekanem, E; Said, D; Arube, P; Gboun, M; Mohammed, F

2010-02-01

The prolonged civil strife in the North-West Zone of Somalia (Somaliland) has hampered the development of social infrastructure and public health services. There are limited data on HIV/AIDS. In 2004, a sentinel HIV seroprevalence survey was conducted. Blood samples were collected from 1561 women attending antenatal care clinics, 249 tuberculosis (TB) patients and 243 people attending sexually transmitted disease (STD) clinics. Samples were tested for syphilis and HIV. Overall HIV prevalence was 1.4%, significantly higher than that observed in many other countries in the Region. Prevalence was 1.2% among pregnant women 15-24 years, 12.3% among patients with STD and 5.6% among TB patients. The prevalence of syphilis was 1.3% in the pregnant women.

Evidence on the Effectiveness of Abstinence Education: An Update. No. 2372

ERIC Educational Resources Information Center

Kim, Christine C.; Rector, Robert

2010-01-01

Teen sexual activity is costly, not just for teens, but also for society. Teens who engage in sexual activity risk a host of negative outcomes including STD infection, emotional and psychological harm, and out-of-wedlock childbearing. Genuine abstinence education is therefore crucial to the physical and psycho-emotional well-being of the nation's…

RELATIONSHIP OF STD-RELATED SHAME AND STIGMA TO FEMALE ADOLESCENTS’ CONDOM-PROTECTED INTERCOURSE

PubMed Central

Sales, Jessica M.; DiClemente, Ralph J.; Rose, Eve S.; Wingood, Gina M.; Klein, Jonathan D.; Woods, Elizabeth R.

2007-01-01

Purpose Shame and stigma associated with sexually transmitted diseases (STDs) are barriers to adolescents seeking prompt and appropriate diagnosis and treatment. However, little is known about how these constructs are related to STD-protective behaviors, such as condom-protected intercourse. Thus, we prospectively examined the relationship between shame and stigma and condom-use in adolescent females. Methods 192 African American females age 17.4 ± 1.7 years (range 15-21) were recruited for the study from local teen oriented health clinics. At baseline, participants completed demographic and psychosocial measures (including STD-related shame and stigma), and chart or laboratory confirmed history of STDs was obtained. At six months follow-up, rate of condom-protected intercourse in past 14 days prior to follow-up was assessed. Participants’ baseline shame and stigma scores, prior history of STDs, and select demographic and theoretically important psychosocial variables were entered into a hierarchical linear regression model to predict condom-protected intercourse in the 14 days prior to the 6 month follow-up assessment. Results After controlling for variables identified in bivariate correlations, STD-related shame was significantly predictive of condom-protected intercourse in the 14 days prior to follow-up, with higher shame predicting higher rates of condom-protected intercourse. Conclusions Future prevention efforts attempting to reduce adolescents’ risks for STDs and HIV may benefit from addressing STD-related shame and stigma in addition to explicitly linking health-promoting behavior changes (condom use) to a decreased likelihood of future infection with STDs. PMID:17531767

Evidence-based HIV/STD prevention intervention for black men who have sex with men.

PubMed

Herbst, Jeffrey H; Painter, Thomas M; Tomlinson, Hank L; Alvarez, Maria E

2014-04-18

This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC's Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HIV infection- and STD-related disparities in the United States. 3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs.

Responding to Cyber Attacks and the Applicability of Existing International Law

DTIC Science & Technology

2013-03-01

Hilfiker United States Army United States Army War College Class of 2013 DISTRIBUTION STATEMENT: A Approved for Public...Education is an institutional accrediting agency recognized by the U.S. Secretary of Education and the Council for Higher Education Accreditation...Standard Form 298 (Rev. 8/98) Prescribed by ANSI Std. Z39.18 REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 The public reporting burden for

New adaptive statistical iterative reconstruction ASiR-V: Assessment of noise performance in comparison to ASiR.

PubMed

De Marco, Paolo; Origgi, Daniela

2018-03-01

To assess the noise characteristics of the new adaptive statistical iterative reconstruction (ASiR-V) in comparison to ASiR. A water phantom was acquired with common clinical scanning parameters, at five different levels of CTDI vol . Images were reconstructed with different kernels (STD, SOFT, and BONE), different IR levels (40%, 60%, and 100%) and different slice thickness (ST) (0.625 and 2.5 mm), both for ASiR-V and ASiR. Noise properties were investigated and noise power spectrum (NPS) was evaluated. ASiR-V significantly reduced noise relative to FBP: noise reduction was in the range 23%-60% for a 0.625 mm ST and 12%-64% for the 2.5 mm ST. Above 2 mGy, noise reduction for ASiR-V had no dependence on dose. Noise reduction for ASIR-V has dependence on ST, being greater for STD and SOFT kernels at 2.5 mm. For the STD kernel ASiR-V has greater noise reduction for both ST, if compared to ASiR. For the SOFT kernel, results varies according to dose and ST, while for BONE kernel ASIR-V shows less noise reduction. NPS for CT Revolution has dose dependent behavior at lower doses. NPS for ASIR-V and ASiR is similar, showing a shift toward lower frequencies as the IR level increases for STD and SOFT kernels. The NPS is different between ASiR-V and ASIR with BONE kernel. NPS for ASiR-V appears to be ST dependent, having a shift toward lower frequencies for 2.5 mm ST. ASiR-V showed greater noise reduction than ASiR for STD and SOFT kernels, while keeping the same NPS. For the BONE kernel, ASiR-V presents a completely different behavior, with less noise reduction and modified NPS. Noise properties of the ASiR-V are dependent on reconstruction slice thickness. The noise properties of ASiR-V suggest the need for further measurements and efforts to establish new CT protocols to optimize clinical imaging. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Regulation of the Salmonella enterica std fimbrial operon by DNA adenine methylation, SeqA, and HdfR.

PubMed

Jakomin, Marcello; Chessa, Daniela; Bäumler, Andreas J; Casadesús, Josep

2008-11-01

DNA adenine methylase (dam) mutants of Salmonella enterica serovar Typhimurium grown under laboratory conditions express the std fimbrial operon, which is tightly repressed in the wild type. Here, we show that uncontrolled production of Std fimbriae in S. enterica serovar Typhimurium dam mutants contributes to attenuation in mice, as indicated by the observation that an stdA dam strain is more competitive than a dam strain upon oral infection. Dam methylation appears to regulate std transcription, rather than std mRNA stability or turnover. A genetic screen for std regulators showed that the GATC-binding protein SeqA directly or indirectly represses std expression, while the poorly characterized yifA gene product serves as an std activator. YifA encodes a putative LysR-like protein and has been renamed HdfR, like its Escherichia coli homolog. Activation of std expression by HdfR is observed only in dam and seqA backgrounds. These data suggest that HdfR directly or indirectly activates std transcription. Since SeqA is unable to bind nonmethylated DNA, it is possible that std operon derepression in dam and seqA mutants may result from unconstrained HdfR-mediated activation of std transcription. Derepression of std in dam and seqA mutants of S. enterica occurs in only a fraction of the bacterial population, suggesting the occurrence of either bistable expression or phase variation.

Higher prevalence of sexual transmitted diseases and correlates of genital warts among heterosexual males attending sexually transmitted infection clinics (MSCs) in Jiangmen, China: implication for the up-taking of STD related service.

PubMed

Huang, Shujie; Tang, Weiming; Zhu, Zhengjun; Lu, Hekun; Tan, Xueling; Zhang, Baoyuan; Best, John; Yang, Ligang; Zheng, Heping; Jiang, Ning; Yin, Yueping; Yang, Bin; Chen, Xiangsheng

2015-01-01

Increasing burden of STDs is one of China's major public health concerns. However, only a limited number of studies have ever investigated the prevalence of these STDs, particular for genital warts and its correlates among heterosexual males attending STD clinics in China. In order to fill this gap, we conducted a cross-sectional study among MSCs in Jiangmen, China, between the years of 2009 and 2010. The eligible participants were recruited from several STD-clinics in public hospitals. We collected demographic information and behaviors of the participants. After HIV and syphilis testing, we further checked whether the participants had genital warts and genital herpes. In addition, urine samples were collected from part of the participants for CT and NG testing. Of the 533 eligible participants, over three-fifths were aged 35 or below, nearly three quarters had no college degree, over three-fifths were residence of Jiangmen. The prevalence of HIV, syphilis, genital warts, genital herpes, CT and NG were 0.19%, 7.50%, 7.32%, 5.25%, 9.73% and 6.19%, respectively. Living with family members (versus living alone), no STD-related service in past year, experiencing STDs related symptoms in past year, and sex with FSWs in last three months were positively associated with genital warts, with adjusted ORs of 5.54 (95% CI 1.94-15.81), 2.26 (95% CI 1.08-4.74), 1.99 (95% CI 1.00-3.99) and 2.01 (95% CI 1.00-4.04), respectively. Our study indicates that the prevalence of STDs among MSCs in Jiangmen was high, which may further spread HIV among MSCs. Targeted interventions that focused on STDs related services uptake should be implemented urgently.

Higher Prevalence of Sexual Transmitted Diseases and Correlates of Genital Warts among Heterosexual Males Attending Sexually Transmitted Infection Clinics (MSCs) in Jiangmen, China: Implication for the Up-Taking of STD Related Service

PubMed Central

Zhu, Zhengjun; Lu, Hekun; Tan, Xueling; Zhang, Baoyuan; Best, John; Yang, Ligang; Zheng, Heping; Jiang, Ning; Yin, Yueping; Yang, Bin; Chen, Xiangsheng

2015-01-01

Background Increasing burden of STDs is one of China’s major public health concerns. However, only a limited number of studies have ever investigated the prevalence of these STDs, particular for genital warts and its correlates among heterosexual males attending STD clinics in China. In order to fill this gap, we conducted a cross-sectional study among MSCs in Jiangmen, China, between the years of 2009 and 2010. Method The eligible participants were recruited from several STD-clinics in public hospitals. We collected demographic information and behaviors of the participants. After HIV and syphilis testing, we further checked whether the participants had genital warts and genital herpes. In addition, urine samples were collected from part of the participants for CT and NG testing. Results Of the 533 eligible participants, over three-fifths were aged 35 or below, nearly three quarters had no college degree, over three-fifths were residence of Jiangmen. The prevalence of HIV, syphilis, genital warts, genital herpes, CT and NG were 0.19%, 7.50%, 7.32%, 5.25%, 9.73% and 6.19%, respectively. Living with family members (versus living alone), no STD-related service in past year, experiencing STDs related symptoms in past year, and sex with FSWs in last three months were positively associated with genital warts, with adjusted ORs of 5.54 (95% CI 1.94–15.81), 2.26 (95% CI 1.08–4.74), 1.99 (95% CI 1.00–3.99) and 2.01 (95% CI 1.00–4.04), respectively. Conclusion Our study indicates that the prevalence of STDs among MSCs in Jiangmen was high, which may further spread HIV among MSCs. Targeted interventions that focused on STDs related services uptake should be implemented urgently. PMID:25811185

Impact of a Routine, Opt-Out HIV Testing Program on HIV Testing and Case Detection in North Carolina Sexually-Transmitted Disease Clinics

PubMed Central

Klein, Pamela W.; Messer, Lynne C.; Myers, Evan R.; Weber, David J.; Leone, Peter A.; Miller, William C.

2016-01-01

The impact of routine, opt-out HIV testing programs in clinical settings is inconclusive. The objective of this study was to estimate the impact of an expanded, routine HIV testing program in North Carolina sexually transmitted disease (STD) clinics on HIV testing and case detection. Adults aged 18–64 who received an HIV test in a North Carolina STD clinic July 1, 2005 through June 30, 2011 were included in this analysis, dichotomized at the date of implementation on November 1, 2007. HIV testing and case detection counts and rates were analyzed using interrupted time series analysis, and Poisson and multilevel logistic regression. Pre-intervention, 426 new HIV-infected cases were identified from 128,029 tests (0.33%), whereas 816 new HIV-infected cases were found from 274,745 tests post-intervention (0.30%). Pre-intervention, HIV testing increased by 55 tests per month (95% confidence interval [CI]: 41, 72), but only 34 tests per month (95% CI: 26, 42) post-intervention. Increases in HIV testing rates were most pronounced in females and non-Hispanic whites. A slight pre-intervention decline in case detection was mitigated by the intervention (mean difference [MD]=0.01; 95% CI: −0.02, 0.05). Increases in case detection rates were observed among females and non-Hispanic blacks. The impact of a routine HIV screening in North Carolina STD clinics was marginal, with the greatest benefit among persons not traditionally targeted for HIV testing. The use of a pre-intervention comparison period identified important temporal trends that otherwise would have been ignored. PMID:24825338

Show me the money: state contributions toward STD prevention, 2007.

PubMed

Meyerson, Beth E; Gilbert, Lisa K

2010-01-01

The importance of state investment in sexually transmitted disease (STD) prevention has been discussed since the mid-1990s; however, little has become known about state public health funding for STD prevention. To establish a baseline understanding of state STD prevention funding, financial data for fiscal year 2007 were gathered by survey of state STD, immunization, laboratory, and hepatitis program directors. Results revealed that on average states funded 25.8 percent of their total STD prevention budgets and invested $0.23 per capita in STD prevention. The percentage of state funding in the total state STD prevention budget ranged from 0 percent to 70.2 percent, and state investment in STD prevention ranged from $0.00 to $1.55 per capita. The direction and expenditure of state STD prevention resources was also examined. This study strengthens the national understanding of what states are doing to fund STD prevention, and it broadens state public health awareness of the overall STD prevention investment at the state level. The inclusion of Medicaid data and expenditure of federal resources by states would strengthen the study and assist longitudinal analyses focused on the impact of investment on epidemiologic indicators.

Prevalence of HIV and syphilis co-infection and associated factors among non-commercial men who have sex with men attending a sexually transmitted disease clinic in Shenzhen, China.

PubMed

Dai, Wenjie; Luo, Zhenzhou; Xu, Ruiwei; Zhao, Guanglu; Tu, Dan; Yang, Lin; Wang, Feng; Cai, Yumao; Lan, Lina; Hong, Fuchang; Yang, Tubao; Feng, Tiejian

2017-01-18

Although HIV and syphilis co-infection has been frequently observed in men who have sex with men (MSM), only few studies have focused on it. Different subgroups of MSM might exhibit heterogeneous HIV and syphilis risk profiles, indicating that interventions for HIV and HIV-related co-infections may vary with different subgroups of MSM. However, no previous study has investigated HIV and syphilis co-infection among non-commercial MSM (ncMSM) attending a sexually transmitted disease (STD) clinic. Therefore, this study aimed to explore the prevalence of HIV and syphilis co-infection and associated factors among ncMSM attending an STD clinic in Shenzhen, China. NcMSM attending the STD clinic of Shenzhen Center for Chronic Disease Control were recruited in this cross-sectional study every Monday between March 2013 and August 2015 using a site based convenience sampling method. An anonymous questionnaire was used to collect data regarding socio-demographic characteristics, risky sexual behaviors and HIV-related knowledge. Blood samples were collected to perform HIV and syphilis tests. Totally 533 participants were enrolled in this study and the prevalence of HIV and syphilis co-infection among them was 13.13%. Multivariable analyses indicated that having lived in Shenzhen for less than one year (aOR = 2.80, 95% CI = 1.30-6.05), having first anal sexual intercourse before the age of 18 (aOR = 2.78, 95% CI = 1.29-5.89), having 3 to 5 anal sexual partners in the past six months (aOR = 2.54, 95% CI = 1.19-5.40), playing exclusively receptive (aOR = 6.87, 95% CI = 3.02-15.61) or both insertive and receptive (aOR = 3.65, 95% CI = 1.64-8.09) roles in anal sexual intercourse and not always using condom in anal sexual intercourse (aOR = 2.13, 95% CI = 1.08-4.19) were associated risk factors for HIV and syphilis co-infection, relative to the non-infected ncMSM. Compared with the mono-infected ncMSM, associated risk factors for the co-infection were being unmarried (aOR = 2.47, 95% CI = 1.03-5.89) and playing exclusively receptive role (aOR = 2.44, 95% CI = 1.04-5.73) in anal sexual intercourse. HIV and syphilis co-infection is quite prevalent among the study participants in Shenzhen. Integrated and intensified intervention strategies, specifically targeting at the non-infected and mono-infected ncMSM attending the STD clinic, are needed to reduce HIV and syphilis co-infection. Most importantly, non-infected and mono-infected ncMSM attending the STD clinic with the aforementioned associated risk factors should be given special concern.

A five-city trial of a behavioural intervention to reduce sexually transmitted disease/HIV risk among sex workers in China.

PubMed

Rou, Keming; Wu, Zunyou; Sullivan, Sheena G; Li, Fan; Guan, Jihui; Xu, Chen; Liu, Wei; Liu, Dahua; Yin, Yueping

2007-12-01

To explore and evaluate a sexually transmitted disease (STD)/HIV intervention program targeting female sex workers working in entertainment establishments in five different settings in China. A prospective, community-based, pre/post, intervention trial set in entertainment establishments (karaoke bars, massage parlours, dance halls, beauty parlours) where sex workers operate at sites in five provinces of China: Anhui, Beijing, Fujian, Guangxi and Xinjiang. The participants were all sex workers working in targeted entertainment establishments. A Women's Health Clinic was set up near participants' places of work at each site. Clinic-based outreach activities, including awareness-raising, condom promotion, and sexual health care, were developed and delivered to sex workers. Cross-sectional surveys at baseline and post-intervention were used to evaluate changes in condom use with the last three clients, and the prevalence of chlamydia and gonorrhoea. In total, 907 sex workers were surveyed at baseline and 782 at 12 months post-intervention. Outreach teams made 2552 visits to the target entertainment establishments, approached 13,785 female sex workers, and distributed 33,575 copies of education material and 5102 packets of condoms. The rate of condom use with the most recent three clients increased from 55.2% at baseline to 67.5% at 12 months evaluation. The prevalence of gonorrhoea fell from 26% at baseline to 4% after intervention, and that of chlamydia fell from about 41 to 26%. The intervention was effective for increasing condom use and reducing STD among sex workers. The results were used to develop national guidelines on sex worker interventions for nationwide scale up.

The "Healthy Teen Girls Project": Comparison of Health Education and STD Risk Reduction Intervention for Incarcerated Adolescent Females

ERIC Educational Resources Information Center

Robertson, Angela R.; St. Lawrence, Janet; Morse, David T.; Baird-Thomas, Connie; Liew, Hui; Gresham, Kathleen

2011-01-01

Adolescent girls incarcerated in a state reformatory (N = 246) were recruited and assigned to an 18-session health education program or a time-equivalent HIV prevention program. Cohorts were assigned to conditions using a randomized block design separated by a washout period to reduce contamination. Post intervention, girls in the HIV risk…

Pulsed Power Education

DTIC Science & Technology

1983-06-01

JUN 1983 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Pulsed Power Education 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...1976-2013, and Abstracts of the 2013 IEEE International Conference on Plasma Science. Held in San Francisco, CA on 16-21 June 2013. U.S. Government or...unclassified b. ABSTRACT unclassified c. THIS PAGE unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 PULSED POWER EDUCATION * M

A Tale of Two Gonorrhea Epidemics: Results from the STD Surveillance Network

PubMed Central

Newman, Lori Marie; Dowell, Deborah; Bernstein, Kyle; Donnelly, Jennifer; Martins, Summer; Stenger, Mark; Stover, Jeffrey; Weinstock, Hillard

2012-01-01

Objective An increasing proportion of gonorrhea in the United States is diagnosed in the private sector, posing a challenge to existing national surveillance systems. We described gonorrhea epidemiology outside sexually transmitted disease (STD) clinic settings. Methods Through the STD Surveillance Network (SSuN), health departments in the San Francisco, Seattle, Denver, Minneapolis, and Richmond, Virginia, metropolitan areas interviewed systematic samples of men and women reported with gonorrhea by non-STD clinic providers from 2006 through 2008. Results Of 2,138 interviews, 10.0% were from San Francisco, 26.4% were from Seattle, 25.2% were from Denver, 22.9% were from Minneapolis, and 15.5% were from Richmond. A total of 1,165 women were interviewed; 70.1% (815/1,163) were ≤24 years of age, 51.3% (598/1,165) were non-Hispanic black, and 19.0% (213/1,121) reported recent incarceration of self or sex partner. Among 610 men who have sex with only women, 50.9% were ≤24 years of age, 65.1% were non-Hispanic black, 14.1% reported incarceration of self or sex partner, and 16.7% reported anonymous sex. Among 363 men who have sex with men (MSM), 20.9% were ≤24 years of age, 61.6% were non-Hispanic white, 39.8% reported anonymous sex, 35.7% reported using the Internet to meet sex partners, and 12.1% reported methamphetamine use. Conclusions These data identified two concurrent gonorrhea epidemics in minority populations: a young, black, heterosexual epidemic with frequently reported recent incarceration, and an older, mostly white MSM epidemic with more frequently reported anonymous sex, Internet use to meet sex partners, and methamphetamine use. PMID:22547859

Ultralow dose dentomaxillofacial CT imaging and iterative reconstruction techniques: variability of Hounsfield units and contrast-to-noise ratio

PubMed Central

Bischel, Alexander; Stratis, Andreas; Kakar, Apoorv; Bosmans, Hilde; Jacobs, Reinhilde; Gassner, Eva-Maria; Puelacher, Wolfgang; Pauwels, Ruben

2016-01-01

Objective: The aim of this study was to evaluate whether application of ultralow dose protocols and iterative reconstruction technology (IRT) influence quantitative Hounsfield units (HUs) and contrast-to-noise ratio (CNR) in dentomaxillofacial CT imaging. Methods: A phantom with inserts of five types of materials was scanned using protocols for (a) a clinical reference for navigated surgery (CT dose index volume 36.58 mGy), (b) low-dose sinus imaging (18.28 mGy) and (c) four ultralow dose imaging (4.14, 2.63, 0.99 and 0.53 mGy). All images were reconstructed using: (i) filtered back projection (FBP); (ii) IRT: adaptive statistical iterative reconstruction-50 (ASIR-50), ASIR-100 and model-based iterative reconstruction (MBIR); and (iii) standard (std) and bone kernel. Mean HU, CNR and average HU error after recalibration were determined. Each combination of protocols was compared using Friedman analysis of variance, followed by Dunn's multiple comparison test. Results: Pearson's sample correlation coefficients were all >0.99. Ultralow dose protocols using FBP showed errors of up to 273 HU. Std kernels had less HU variability than bone kernels. MBIR reduced the error value for the lowest dose protocol to 138 HU and retained the highest relative CNR. ASIR could not demonstrate significant advantages over FBP. Conclusions: Considering a potential dose reduction as low as 1.5% of a std protocol, ultralow dose protocols and IRT should be further tested for clinical dentomaxillofacial CT imaging. Advances in knowledge: HU as a surrogate for bone density may vary significantly in CT ultralow dose imaging. However, use of std kernels and MBIR technology reduce HU error values and may retain the highest CNR. PMID:26859336

Effectiveness of the VOICES/VOCES sexually transmitted disease/human immunodeficiency virus prevention intervention when administered by health department staff: does it work in the "real world"?

PubMed

Neumann, Mary Spink; O'Donnell, Lydia; Doval, Alexi San; Schillinger, Julia; Blank, Susan; Ortiz-Rios, Elizabeth; Garcia, Trinidad; O'Donnell, Carl R

2011-02-01

Prevention providers wonder whether benefits achieved in the original, researcher-led, efficacy trials of interventions are replicated when the intervention is delivered in real-world settings by their agency's staff. A replication study was conducted at 2 public sexually transmitted disease (STD) clinics (New York City and San Juan, PR). Using a controlled trial design, intervention (VOICES/VOCES) and comparison conditions (regular clinic services) were assigned in alternating 4-week blocks. Trained agency staff delivered the intervention. Effectiveness was assessed for incident STDs, redemption of coupons for condoms at neighborhood location after the visit, and improved knowledge and attitudes about STDs and condoms. A total of 3365 patients were recruited, completed the protocol, and followed through STD surveillance systems for an average of 17 months. Of 397 with an incident infection, 226 (13.4%) were among those enrolled during comparison blocks; 171 were among those in the intervention condition (10.2%). Controlling for site and gender, participants enrolled during intervention blocks were significantly less likely to have an incident STD reported to the surveillance system (hazard ratio, 0.78; 95% confidence interval, 0.64-0.96). Intervention block participants scored higher on scales of STD knowledge (4.89 vs. 3.87, P < 0.001) and condom knowledge, attitude, and efficacy (10.98 vs. 9.16, P < 0.001). More of those exposed to VOICES/VOCES redeemed condoms (P < 0.05). Positive effects were more consistent in New York, which may be related to fidelity of implementation. A packaged human immunodeficiency virus prevention intervention can be delivered by agencies, with benefits similar to those achieved in the research setting.

Shanghai, China: Hotline for Sexual Minorities

ERIC Educational Resources Information Center

Gu, Steven

2005-01-01

Placed in the current political context of growing liberalization within China, this essay describes the Shanghai Hotline for Sexual Minorities. Funded by agencies outside the government, these services target LGBTs toward self-acceptance and AIDS/STD education while seeking to reduce social prejudice.

Understanding sex partner selection from the perspective of inner-city black adolescents.

PubMed

Andrinopoulos, Katherine; Kerrigan, Deanna; Ellen, Jonathan M

2006-09-01

Black adolescents in inner-city settings are at increased risk for HIV and other STDs. Sex partner characteristics, as well as individual behavior, influence individuals' STD risk, yet little is known about the process of sex partner selection for adolescents in this setting. Semistructured in-depth interviews were conducted during the summer and fall of 2002 with 50 inner-city black adolescents (26 females and 24 males) who had been purposively recruited from an STD clinic. Content analysis was used to study interview texts. Young women desire a monogamous romantic partner, rather than a casual sex partner; however, to fulfill their desire for emotional intimacy, they often accept a relationship with a nonmonogamous partner. Young men seek both physical and emotional benefits from being in a relationship; having a partner helps them to feel wanted, and they gain social status among their peers when they have multiple partners. For men, these benefits may help compensate for an inability to obtain jobs that would improve their financial and, as a result, social status. Both women and men assess partners' STD risk on the basis of appearance. HIV and other STD prevention initiatives must go beyond the scope of traditional messages aimed at behavior change and address the need for social support and socioeconomic opportunities among at-risk, inner-city adolescents.

Attenuation correction in 4D-PET using a single-phase attenuation map and rigidity-adaptive deformable registration

PubMed Central

Kalantari, Faraz; Wang, Jing

2017-01-01

Purpose Four-dimensional positron emission tomography (4D-PET) imaging is a potential solution to the respiratory motion effect in the thoracic region. Computed tomography (CT)-based attenuation correction (AC) is an essential step toward quantitative imaging for PET. However, due to the temporal difference between 4D-PET and a single attenuation map from CT, typically available in routine clinical scanning, motion artifacts are observed in the attenuation-corrected PET images, leading to errors in tumor shape and uptake. We introduced a practical method to align single-phase CT with all other 4D-PET phases for AC. Methods A penalized non-rigid Demons registration between individual 4D-PET frames without AC provides the motion vectors to be used for warping single-phase attenuation map. The non-rigid Demons registration was used to derive deformation vector fields (DVFs) between PET matched with the CT phase and other 4D-PET images. While attenuated PET images provide useful data for organ borders such as those of the lung and the liver, tumors cannot be distinguished from the background due to loss of contrast. To preserve the tumor shape in different phases, an ROI-covering tumor was excluded from non-rigid transformation. Instead the mean DVF of the central region of the tumor was assigned to all voxels in the ROI. This process mimics a rigid transformation of the tumor along with a non-rigid transformation of other organs. A 4D-XCAT phantom with spherical lung tumors, with diameters ranging from 10 to 40 mm, was used to evaluate the algorithm. The performance of the proposed hybrid method for attenuation map estimation was compared to 1) the Demons non-rigid registration only and 2) a single attenuation map based on quantitative parameters in individual PET frames. Results Motion-related artifacts were significantly reduced in the attenuation-corrected 4D-PET images. When a single attenuation map was used for all individual PET frames, the normalized root mean square error (NRMSE) values in tumor region were 49.3% (STD: 8.3%), 50.5% (STD: 9.3%), 51.8% (STD: 10.8%) and 51.5% (STD: 12.1%) for 10-mm, 20-mm, 30-mm and 40-mm tumors respectively. These errors were reduced to 11.9% (STD: 2.9%), 13.6% (STD: 3.9%), 13.8% (STD: 4.8%), and 16.7% (STD: 9.3%) by our proposed method for deforming the attenuation map. The relative errors in total lesion glycolysis (TLG) values were −0.25% (STD: 2.87%) and 3.19% (STD: 2.35%) for 30-mm and 40-mm tumors respectively in proposed method. The corresponding values for Demons method were 25.22% (STD: 14.79%) and 18.42% (STD: 7.06%). Our proposed hybrid method outperforms the Demons method especially for larger tumors. For tumors smaller than 20 mm, non-rigid transformation could also provide quantitative results. Conclusion Although non-AC 4D-PET frames include insignificant anatomical information, they are still useful to estimate the DVFs to align the attenuation map for accurate AC. The proposed hybrid method can recover the AC-related artifacts and provide quantitative AC-PET images. PMID:27987223

Intimate Partner Violence, Sexual Autonomy and Postpartum STD Prevention Among Young Couples: A Mediation Analysis.

PubMed

Willie, Tiara C; Callands, Tamora A; Kershaw, Trace S

2018-03-01

The transition to parenthood is a stressful time for young couples and can put them at risk for acquiring STDs. Mechanisms underlying this risk-particularly, intimate partner violence (IPV) and sexual autonomy-have not been well studied. Between 2007 and 2011, a prospective cohort study of the relationships and health of pregnant adolescents and their male partners recruited 296 couples at four hospital-based obstetrics and gynecology clinics in the U.S. Northeast; participants were followed up six and 12 months after the birth. Structural equation modeling identified associations among IPV at baseline and six months, sexual autonomy at six months and STD acquisition at 12 months. Mediating effects of sexual autonomy were tested via bootstrapping. Females were aged 14-21, and male partners were 14 or older. For females, IPV victimization at baseline was positively associated with the likelihood of acquiring a postpartum STD (coefficient, 0.4); level of sexual autonomy was inversely associated with the likelihood of acquiring an STD and of having a male partner who acquired one by the 12-month follow-up (-0.4 for each). For males, IPV victimization at baseline was negatively correlated with a female partner's sexual autonomy (-0.3) and likelihood of acquiring an STD (-0.7); victimization at six months was positively related to a partner's sexual autonomy (0.2). Sexual autonomy did not mediate these relationships. Females' sexual autonomy appears to protect against postpartum STDs for both partners. Future research should explore the efficacy of IPV-informed approaches to improving women's sexual and reproductive health. Copyright © 2018 by the Guttmacher Institute.

A community trial of the impact of improved sexually transmitted disease treatment on the HIV epidemic in rural Tanzania: 2. Baseline survey results.

PubMed

Grosskurth, H; Mosha, F; Todd, J; Senkoro, K; Newell, J; Klokke, A; Changalucha, J; West, B; Mayaud, P; Gavyole, A

1995-08-01

To determine baseline HIV prevalence in a trial of improved sexually transmitted disease (STD) treatment, and to investigate risk factors for HIV. To assess comparability of intervention and comparison communities with respect to HIV/STD prevalence and risk factors. To assess adequacy of sample size. Twelve communities in Mwanza Region, Tanzania: one matched pair of roadside communities, four pairs of rural communities, and one pair of island communities. One community from each pair was randomly allocated to receive the STD intervention following the baseline survey. Approximately 1000 adults aged 15-54 years were randomly sampled from each community. Subjects were interviewed, and HIV and syphilis serology performed. Men with a positive leucocyte esterase dipstick test on urine, or reporting a current STD, were tested for urethral infections. A total of 12,534 adults were enrolled. Baseline HIV prevalences were 7.7% (roadside), 3.8% (rural) and 1.8% (islands). Associations were observed with marital status, injections, education, travel, history of STD and syphilis serology. Prevalence was higher in circumcised men, but not significantly after adjusting for confounders. Intervention and comparison communities were similar in the prevalence of HIV (3.8 versus 4.4%), active syphilis (8.7 versus 8.2%), and most recorded risk factors. Within-pair variability in HIV prevalence was close to the value assumed for sample size calculations. The trial cohort was successfully established. Comparability of intervention and comparison communities at baseline was confirmed for most factors. Matching appears to have achieved a trial of adequate sample size. The apparent lack of a protective effect of male circumcision contrasts with other studies in Africa.

Comparison of Sexual Risky Factors of Men Who Have Sex With Men and Sex-buying Men as Groups Vulnerable to Sexually Transmitted Diseases

PubMed Central

Jung, Minsoo; Lee, Joongyub; Kwon, Dong Seok

2012-01-01

Objectives It is necessary to examine groups carrying out sexually risky behavior because the prevalence of sexually transmitted diseases (STDs) is high among them. In this study, the prevalence of STDs among homosexuals and sex-buying men in South Korea was investigated, along with their sexual risk factors. Methods Men who have sex with men (MSMs, n=108) were recruited in Seoul and Busan by applying the time location sampling method, while sex-buying men (n=118) were recruited from a john school in Gyeonggi province, the suburbs of Seoul. Dependent variables included past or present infection with syphilis, Chlamydia, gonorrhea, and human immunodeficiency virus. Independent variables included health behavior, social support, sexual behavior, and safe sex. Results It was found that when the MSMs were non-drunk while having sexual intercourse (odds ratio [OR], 0.132), they showed a higher STD infection rate when they had a higher number of anal sex partners (OR, 5.872), rarely used condoms (OR, 1.980), had lower self-efficacy (OR, 0.229), and were more anxious about becoming infected with an STD (OR, 3.723). However, the men who paid for sex showed high STD infections when they had more sex partners (OR, 2.286) and lower education levels (OR, 3.028). Conclusions STD infections among the two groups were high when they were engaged with many sex partners and not having protected sex. In other words, there was a gap in risky sex behavior within such groups, which was significantly related to the possibility of developing an STD. Therefore, the preventive intervention against STDs for these groups needs to be expanded to include management of sex behaviors. PMID:22712042

Comparison of sexual risky factors of men who have sex with men and sex-buying men as groups vulnerable to sexually transmitted diseases.

PubMed

Jung, Minsoo; Lee, Joongyub; Kwon, Dong Seok; Park, Byung-Joo

2012-05-01

It is necessary to examine groups carrying out sexually risky behavior because the prevalence of sexually transmitted diseases (STDs) is high among them. In this study, the prevalence of STDs among homosexuals and sex-buying men in South Korea was investigated, along with their sexual risk factors. Men who have sex with men (MSMs, n=108) were recruited in Seoul and Busan by applying the time location sampling method, while sex-buying men (n=118) were recruited from a john school in Gyeonggi province, the suburbs of Seoul. Dependent variables included past or present infection with syphilis, Chlamydia, gonorrhea, and human immunodeficiency virus. Independent variables included health behavior, social support, sexual behavior, and safe sex. It was found that when the MSMs were non-drunk while having sexual intercourse (odds ratio [OR], 0.132), they showed a higher STD infection rate when they had a higher number of anal sex partners (OR, 5.872), rarely used condoms (OR, 1.980), had lower self-efficacy (OR, 0.229), and were more anxious about becoming infected with an STD (OR, 3.723). However, the men who paid for sex showed high STD infections when they had more sex partners (OR, 2.286) and lower education levels (OR, 3.028). STD infections among the two groups were high when they were engaged with many sex partners and not having protected sex. In other words, there was a gap in risky sex behavior within such groups, which was significantly related to the possibility of developing an STD. Therefore, the preventive intervention against STDs for these groups needs to be expanded to include management of sex behaviors.

Club Drugs and HIV/STD Infection: An Exploratory Analysis among Men Who Have Sex with Men in Changsha, China.

PubMed

Chen, Xi; Li, Xingli; Zheng, Jun; Zhao, Junshi; He, Jianmei; Zhang, Guoqiang; Tang, Xuemin

2015-01-01

To evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM). A cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using "snowball" techniques, and internet advertisements were used to recruit study participants. Of the 826 participants, 177 (21.4%) reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users. Club drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM.

STD testing policies and practices in U.S. city and county jails.

PubMed

Parece, M S; Herrera, G A; Voigt, R F; Middlekauff, S L; Irwin, K L

1999-09-01

Studies have shown that sexually transmitted disease (STD) rates are high in the incarcerated population. However, little is known about STD testing policies or practices in jails. To assess STD testing policies and practices in jails. The Division of STD Prevention developed and distributed an e-mail survey to 94 counties reporting more than 40 primary and secondary cases in 1996 or having cities with more than 200,000 persons. State and local STD program managers completed the assessment in collaboration with health departments and the main jail facilities in the selected counties. Most facilities (52-77%) had a policy for STD screening based only on symptoms or by arrestee request, and in these facilities, 0.2% to 6% of arrestees were tested. Facilities having a policy of offering routine testing tested only 3% to 45% of arrestees. Large facilities, facilities using public providers, and facilities routinely testing for syphilis using Stat RPR tested significantly more arrestees (P<0.05). Approximately half of the arrestees were released within 48 hours after intake, whereas 45% of facilities did not have STD testing results until after 48 hours. Most facilities had a policy for STD screening based only on symptoms or by arrestee request. Facilities having a policy of routine STD testing are not testing most of the arrestees. There is a small window (<48 hours) for STD testing and treatment before release. Smaller jails and facilities using private providers may need additional resources to increase STD testing levels. Correctional facilities should be considered an important setting for STD public health intervention where routine rapid STD screening and treatment on-site could be implemented.

Efficacy and safety of etanercept in the treatment of sciatica: A systematic review and meta-analysis.

PubMed

Jing, Shangfei; Yang, Chenyuan; Zhang, Xiaofei; Wen, Shuzheng; Li, Yuankui

2017-10-01

Etanercept might be promising to alleviate sciatica caused by lumbar disc herniation and spinal stenosis. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the efficacy of etanercept in patients with sciatica. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) and Controlled clinical trials (CCT) assessing the efficacy of etanercept on sciatica caused by lumbar disc herniation and spinal stenosis were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was leg pain scores. Meta-analysis was performed using random-effect model. Four RCTs and one CCT involving 184 patients were included in the meta-analysis. Overall, compared with placebo, etanercept could significantly reduce leg pain (Std. mean difference=-0.83; 95% CI=-1.59 to -0.06; P=0.03) and back pain (Std. mean difference=-1.89; 95% CI=-3.34 to -0.43; P=0.01). However, when comparing etanercept to steroids there was no significant difference in the relief of leg pain (Std. mean difference=-1.18; 95% CI=-3.21 to 0.84; P=0.25) and back pain (Std. mean difference=-0.29; 95% CI=-1.26 to 0.67; P=0.55). Etanercept showed no increase in Oswestry Disability Index (ODI) compared with placebo (Std. mean difference=-0.83; 95% CI=-2.03 to 0.37; P=0.18) and steroids (Std. mean difference=-0.19; 95% CI=-1.15 to 0.77; P=0.70). Etanercept treatment was associated with a significantly reduced pain in leg and back compared to placebo and may possibly improve leg pain relief compared to steroids, but failed to improve ODI. Etanercept should be recommended for sciatica with caution because of heterogeneity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Antibiotic prophylaxis among commercial sex workers in Cebu City, Philippines. Patterns of use and perceptions of efficacy.

PubMed

Abellanosa, I; Nichter, M

1996-01-01

This study describes the extent to which commercial sex workers (CSW) in Cebu City, Philippines perceive prophylactic antibiotic use to be an effective form of prevention for sexually transmitted diseases (STD) and human immunodeficiency virus (HIV), as well as the prevalence of this self-treatment practice. A survey instrument was developed and pretested after 3 months of intensive ethnographic research on STD and acquired immune deficiency syndrome (AIDS). A multistage sampling procedure was followed to ensure that a representative sample of CSW from four distinct work environments would be interviewed. Commercial sex workers registered at the Cebu City social hygiene clinic were sampled randomly from coded work establishment lists, and a convenience sample of unregistered freelance CSW was secured. In total, 200 CSW were interviewed. Of these 200 CSW, all were sexually active, but only 160 had been engaged actively in commercial sexual exchange the month before their interviews. Popular use of antibiotics as prophylaxis against STD is commonplace in the Philippines among CSW, with 38% reporting routine or occasional use and 31% reporting use in the last 2 weeks. Unregistered CSW are five times more likely to use prophylactic antibiotics than registered CSW, and they are seven times less likely to use condoms with 80% or more of their customers. They also have sex with three times as many customers. Use of prophylactic antibiotics by CSW offers them a false sense of security in a high-risk work environment. Self-treatment with low-dose prophylactic antibiotics provides no protection against STD, impedes STD screening efforts, and contributes to antibiotic resistance. An alarming percentage of CSW consider antibiotics a potential means of protecting themselves against AIDS. Public health interventions focusing on STD and AIDS in developing countries must address current patterns of prophylactic antibiotic use.

Recent developments and applications of saturation transfer difference nuclear magnetic resonance (STD NMR) spectroscopy.

PubMed

Wagstaff, Jane L; Taylor, Samantha L; Howard, Mark J

2013-04-05

This review aims to illustrate that STD NMR is not simply a method for drug screening and discovery, but has qualitative and quantitative applications that can answer fundamental and applied biological and biomedical questions involving molecular interactions between ligands and proteins. We begin with a basic introduction to the technique of STD NMR and report on recent advances and biological applications of STD including studies to follow the interactions of non-steroidal anti-inflammatories, minimum binding requirements for virus infection and understating inhibition of amyloid fibre formation. We expand on this introduction by reporting recent STD NMR studies of live-cell receptor systems, new methodologies using scanning STD, magic-angle spinning STD and approaches to use STD NMR in a quantitative fashion for dissociation constants and group epitope mapping (GEM) determination. We finish by outlining new approaches that have potential to influence future applications of the technique; NMR isotope-editing, heteronuclear multidimensional STD and (19)F STD methods that are becoming more amenable due to the latest NMR equipment technologies.

75 FR 63844 - Health Resources and Services Administration CDC/HRSA Advisory Committee on HIV and STD...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-18

... to persons living with HIV/AIDS; and the education of health professionals and the public about HIV... HIV testing to females, older persons, and other patients determined to be at low risk; and (4...

Cyber Operations and the Warfighting Functions

DTIC Science & Technology

2013-03-01

United States Army War College Class of 2013 DISTRIBUTION STATEMENT: A Approved for Public Release Distribution is Unlimited...agency recognized by the U.S. Secretary of Education and the Council for Higher Education Accreditation. Standard Form 298 (Rev. 8/98) Prescribed by...ANSI Std. Z39.18 REPORT DOCUMENTATION PAGE Form Approved OMB No. 0704-0188 The public reporting burden for this collection of information is

Optimizing Partner Notification Programs for Men Who Have Sex with Men: Factorial Survey Results from South China

PubMed Central

Tucker, Joseph D.; Chakraborty, Hrishikesh; Cohen, Myron S.; Chen, Xiang-Sheng

2016-01-01

Background Syphilis is prevalent among men who have sex with men (MSM) in China. Syphilis partner notification (PN) programs targeting MSM has been considered as one of effective strategies to prevention and control of the infection in the population. We examined willingness and preferences for PN among MSM to measure feasibility and optimize uptake. Methods Participation in a syphilis PN program was measured using a factorial survey from both the perspective of the index patient and the partner. Respondents were recruited from April-July 2011 using convenience sampling at two sites—a MSM sexually transmitted disease (STD) clinic and a MSM community based organization (CBO). Respondents first evaluated three factorial survey vignettes to measure probability of participation and then an anonymous sociodemographic questionnaire. A two-level mixed linear model was fitted for the factorial survey analysis. Results In 372 respondents with mean age (± SD) 28.5 (± 6.0) years, most were single (82.0%) and closeted gays (66.7%). The Internet was the most frequent place to search for sex. Few (31.2%) had legal names for casual partners, but most had instant messenger (86.5%) and mobile phone numbers (77.7%). The mean probability of participation in a syphilis PN program was 64.5% (± 32.4%) for index patients and 63.7% (± 32.6%) for partners. Referral of the partner to a private clinic or MSM CBO for follow-up decreased participation compared to the local Center for Disease Control and Prevention (CDC) or public STD clinic. Conclusions Enhanced PN services may be feasible among MSM in South China. Internet and mobile phone PN may contact partners untraceable by traditional PN. Referral of partners to the local CDC or public STD clinic may maximize PN participation. PMID:27462724

Balneotherapy in rheumatoid arthritis-a systematic review.

PubMed

Santos, Isabel; Cantista, Pedro; Vasconcelos, Carlos

2016-08-01

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by persistent inflammation of synovial joints with pain, often leading to joint destruction and disability, and despite intensive research, the cause of RA remains unknown. Balneotherapy-also called mineral baths or spa therapy-uses different types of mineral water compositions like sulphur, radon, carbon dioxin, etc. The role of balneotherapy is on debate; Sukenik wrote that the sulphur mineral water has special proprieties to rheumatologic diseases, including in the course of active inflammatory phases in RA. The aim of this review is to summarize the available evidence on the effects of balneotherapy on patients with rheumatoid arthritis. We have made a systematic search of the articles published from 1980 to 2014 on this topic in PubMed, Scopus, CRD, PEDro, Web of Science and Embase databases. We have followed the method set by the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA). These that have compared balneotherapy with other therapeutic modalities or with no intervention were considered. The inclusion criteria of these papers were randomized control trial (RCT); languages: English, French, Spanish, Italian and Portuguese; evaluation of efficacy (analysis of outcomes); use of natural mineral water baths; and participants with RA. A total of eight articles documenting RCTs were found and included for full review and critical appraisal involving a total of 496 patients. The studies selected highlighted an important improvement and statistically significant in several clinical parameters, in spite of their heterogeneity between the various studies. One study emphasized an important improvement on functional capacity up to 6 months of follow-up (FU). Some of the studies (std.) reveal an improvement on morning stiffness (5 std.), number of active joints (3 std.), Ritchie index (2 std.) and activities of daily living (2 std.) up to 3 months of FU. Three studies reveal the improvement on handgrip strength up to 1 month of FU. About pain (VAS), the three studies which evaluated this parameter were inconclusive about real significant improvement. Our tables summarize the published papers about this topic. Different authors emphasize the same problems: methodologies differing from study to study, treatment modalities, outcomes and their analysis. On the one hand, it is particularly difficult to have homogeneity on this population in all the parameters (patient's clinical heterogeneity, diverse clinical course of the disease, variety of the drugs), and on the other hand, natural mineral water composition is always unique with potential specific biological effects. This comprehensive review has revealed that there are very few published studies about the use of natural mineral water in RA. International multicentre studies, using the same methodologies, could be achieved by carrying the scientific arguments to support our clinical practice.

Balneotherapy in rheumatoid arthritis—a systematic review

NASA Astrophysics Data System (ADS)

Santos, Isabel; Cantista, Pedro; Vasconcelos, Carlos

2016-08-01

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by persistent inflammation of synovial joints with pain, often leading to joint destruction and disability, and despite intensive research, the cause of RA remains unknown. Balneotherapy—also called mineral baths or spa therapy—uses different types of mineral water compositions like sulphur, radon, carbon dioxin, etc. The role of balneotherapy is on debate; Sukenik wrote that the sulphur mineral water has special proprieties to rheumatologic diseases, including in the course of active inflammatory phases in RA. The aim of this review is to summarize the available evidence on the effects of balneotherapy on patients with rheumatoid arthritis. We have made a systematic search of the articles published from 1980 to 2014 on this topic in PubMed, Scopus, CRD, PEDro, Web of Science and Embase databases. We have followed the method set by the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA). These that have compared balneotherapy with other therapeutic modalities or with no intervention were considered. The inclusion criteria of these papers were randomized control trial (RCT); languages: English, French, Spanish, Italian and Portuguese; evaluation of efficacy (analysis of outcomes); use of natural mineral water baths; and participants with RA. A total of eight articles documenting RCTs were found and included for full review and critical appraisal involving a total of 496 patients. The studies selected highlighted an important improvement and statistically significant in several clinical parameters, in spite of their heterogeneity between the various studies. One study emphasized an important improvement on functional capacity up to 6 months of follow-up (FU). Some of the studies (std.) reveal an improvement on morning stiffness (5 std.), number of active joints (3 std.), Ritchie index (2 std.) and activities of daily living (2 std.) up to 3 months of FU. Three studies reveal the improvement on handgrip strength up to 1 month of FU. About pain (VAS), the three studies which evaluated this parameter were inconclusive about real significant improvement. Our tables summarize the published papers about this topic. Different authors emphasize the same problems: methodologies differing from study to study, treatment modalities, outcomes and their analysis. On the one hand, it is particularly difficult to have homogeneity on this population in all the parameters (patient's clinical heterogeneity, diverse clinical course of the disease, variety of the drugs), and on the other hand, natural mineral water composition is always unique with potential specific biological effects. This comprehensive review has revealed that there are very few published studies about the use of natural mineral water in RA. International multicentre studies, using the same methodologies, could be achieved by carrying the scientific arguments to support our clinical practice.

Visiting Entertainment Venues and Sexual Health in China

PubMed Central

Li, Li; Wu, Zunyou; Rotheram-Borus, Mary Jane; Guan, Jihui; Yin, Yueping; Detels, Roger; Wu, Sheng; Lee, Sung-Jae; Cao, Haijun; Lin, Chunqing; Rou, Keming; Liu, Zhendong

2010-01-01

Entertainment venues in China are associated with risky sexual behavior. Most previous studies related to entertainment venues in China have focused on sex workers and commercial sex, but this study addressed sexual health in a sample of the general urban population. A randomly selected sample of market vendors (n = 4,510) from an eastern city was recruited and assessed to examine relationships between entertainment venue visits and sexual risk. Both behavioral (self-reports of unprotected sex) and biomedical (STD test results) measures were used. About 18% of the sample (26.8% of men and 9% of women) reported visiting entertainment venues in the past 30 days. Those who visited entertainment venues were more likely to be male, younger, single, with higher education, and to have more discretionary income. For both men and women, visiting entertainment venues was a significant predictor for unprotected sex and STD infection. Gender differences were observed in predicting unprotected sex and STD infections. Entertainment venues could be potential sites for place-based intervention programs and out-reach for the general population. PMID:18256918

Low prevalence of human immunodeficiency virus type-1 (HIV-1) infection in population attending a major hospital in New Delhi, India.

PubMed

Aggarwal, R K; Chattopadhya, D; Kumari, S

1996-03-01

During 4 year period between April 1990 and March 1994, 4120 specimens from the patients attending out patient departments of Medical, Surgical and Antenatal units of a major city hospital were tested for HIV infection as a part of an on-going sentinel surveillance programme. In addition, 1440 specimens from the patients attending STD clinic of the same hospital and 862 females seeking termination of pregnancy from a near by hospital were included for comparison. It was found that only 3 individuals with high risk behaviours out of 2002 females attending antenatal clinic showed evidence of HIV infection (rate 1.49 per 1000). The corresponding rate for the group of patients attending STD clinic and seeking termination of pregnancy were 3 out of 1440 (rate 2.15 per 1000) and 1 out of 862 (rate 1.16 per 1000) respectively. It was noted that prevalence of HIV infection in the hospital attending population with unspecified risk factor (medical, surgical and antenatal clinics) was not a matter of serious concern. The importance of finding out risk factors in females attending antenatal clinic is evident from the study.

By activating Fas/ceramide synthase 6/p38 kinase in lipid rafts, Stichoposide D inhibits growth of leukemia xenografts

PubMed Central

Yun, Seong-Hoon; Park, Eun-Seon; Shin, Sung-Won; Ju, Mi-Ha; Han, Jin-Yeong; Jeong, Jin-Sook; Kim, Sung-Hyun; Stonik, Valentin A.; Kwak, Jong-Young; Park, Joo-In

2015-01-01

Stichoposide D (STD) is a marine triterpene glycoside isolated from sea cucumbers. We examined the molecular mechanisms underlying the antitumor activity of STD in human leukemia cells. The role of Fas (CD95), ceramide synthase 6 (CerS6) and p38 kinase during STD-induced apoptosis was examined in human leukemia cells. In addition, the antitumor effects of STD in K562 and HL-60 leukemia xenograft models were investigated. We found that STD induces Fas translocation to lipid rafts, and thus mediates cell apoptosis. We also observed the activation of CerS6 and p38 kinase during STD-induced apoptosis. The use of methyl-β-cyclodextrin and nystatin to disrupt lipid rafts prevents the clustering of Fas and the activation of CerS6 and p38 kinase, and also inhibits STD-induced apoptosis. Specific inhibition by Fas, CerS6, and p38 kinase siRNA transfection partially blocked STD-induced apoptosis. In addition, STD has antitumor activity through the activation of CerS6 and p38 kinase without displaying any toxicity in HL-60 and K562 xenograft models. We observed that the anti-tumor effect of STD is partially prevented in CerS6 shRNA-silenced xenograft models. We first report that Fas/CerS6/p38 kinase activation in lipid rafts by STD is involved in its anti-leukemic activity. We also established that STD is able to enhance the chemosensitivity of K562 cells to etoposide or Ara-C. These data suggest that STD may be used alone or in combination with other chemotherapeutic agents to treat leukemia. PMID:26318294

Sexually Transmitted Diseases Surveillance, 2014: Syphilis

MedlinePlus

... 2014 Sexually Transmitted Diseases Surveillance Table of Contents Introductory Section Foreword Preface Acronyms Figures- National Profile Figures – ... GISP Profiles Related Links STD Home STD Data & Statistics NCHHSTP Atlas Interactive STD Data – 1996-2013 STD ...

2012 Sexually Transmitted Diseases Surveillance, Other Sexually Transmitted Diseases

MedlinePlus

... 2012 Sexually Transmitted Diseases Surveillance Table of Contents Introductory Section Foreword Preface Acronyms Figures- National Profile Figures - ... GISP Profiles Related Links STD Home STD Data & Statistics NCHHSTP Atlas Interactive STD Data - 1996-2013 STD ...

Sexonomics: a commentary and review of selected sexually transmitted disease studies in the economics literature.

PubMed

Chesson, Harrell W

2012-03-01

The purpose of this review is to highlight selected studies in the economics literature that address sexually transmitted disease (STD)-related topics that are typically not examined in the STD literature. Two databases (EconLit and Web of Science) were searched to locate STD-related articles in the economics journals. Relevant articles were also identified in other ways, such as informal discussions with colleagues familiar with the literature. To maintain a focus on unique STD-related topics, studies with topics common in the STD literature (e.g., cost-effectiveness, transmission modeling) were excluded. Selected STD-related studies in the economics literature were grouped into the following 8 topics: impact of abortion laws and policies on sexual health outcomes; same-sex marriage and syphilis rates; alcohol policy and STD rates; welfare laws and STD rates; discounting the future; HIV disclosure laws; the impact of tolerance for gays on HIV incidence; and economic versus epidemiologic models of HIV dynamics. A general theme of STD-related studies in the economics literature is that laws and policies that increased the "cost" of risky sex tended to reduce the demand for risky sex, and therefore reduce the incidence of STDs. Economic research can contribute in novel ways to our understanding of influences on risky sexual behavior at the individual level and STD incidence at the population level. Economists and STD experts could mutually benefit from increased collaboration.

HIV Intertest Interval among MSM in King County, Washington

PubMed Central

Katz, David A.; Dombrowski, Julia C.; Swanson, Fred; Buskin, Susan; Golden, Matthew R.; Stekler, Joanne D.

2012-01-01

OBJECTIVES We examined temporal trends and correlates of HIV testing frequency among men who have sex with men (MSM) in King County, WA. METHODS We evaluated data from MSM testing for HIV at the Public Health - Seattle & King County (PHSKC) STD Clinic and Gay City Health Project (GCHP) and testing history data from MSM in PHSKC HIV surveillance. The intertest interval (ITI) was defined as the number of days between the last negative HIV test and the current testing visit or first positive test. Correlates of the log10-transformed ITI were determined using GEE linear regression. RESULTS Between 2003 and 2010, the median ITI among MSM seeking HIV testing at the STD Clinic and GCHP were 215 (IQR: 124–409) and 257 (IQR: 148–503) days, respectively. In multivariate analyses, younger age, having only male partners, and reporting ≥10 male sex partners in the last year were associated with shorter ITIs at both testing sites (p<0.05). Among GCHP attendees, having a regular healthcare provider, seeking a test as part of a regular schedule, and inhaled nitrite use in the last year were also associated with shorter ITIs (p<0.001). Compared to MSM testing HIV-negative, MSM newly diagnosed with HIV had longer ITIs at the STD Clinic (median of 213 versus 278 days; p=0.01) and GCHP (median 255 versus 359 days; p=0.02). CONCLUSIONS Although MSM in King County appear to be testing at frequent intervals, further efforts are needed to reduce the time that HIV-infected persons are unaware of their status. PMID:22563016

HIV intertest interval among MSM in King County, Washington.

PubMed

Katz, David A; Dombrowski, Julia C; Swanson, Fred; Buskin, Susan E; Golden, Matthew R; Stekler, Joanne D

2013-02-01

The authors examined temporal trends and correlates of HIV testing frequency among men who have sex with men (MSM) in King County, Washington. The authors evaluated data from MSM testing for HIV at the Public Health-Seattle & King County (PHSKC) STD Clinic and Gay City Health Project (GCHP) and testing history data from MSM in PHSKC HIV surveillance. The intertest interval (ITI) was defined as the number of days between the last negative HIV test and the current testing visit or first positive test. Correlates of the log(10)-transformed ITI were determined using generalised estimating equations linear regression. Between 2003 and 2010, the median ITI among MSM seeking HIV testing at the STD Clinic and GCHP were 215 (IQR: 124-409) and 257 (IQR: 148-503) days, respectively. In multivariate analyses, younger age, having only male partners and reporting ≥10 male sex partners in the last year were associated with shorter ITIs at both testing sites (p<0.05). Among GCHP attendees, having a regular healthcare provider, seeking a test as part of a regular schedule and inhaled nitrite use in the last year were also associated with shorter ITIs (p<0.001). Compared with MSM testing HIV negative, MSM newly diagnosed with HIV had longer ITIs at the STD Clinic (median of 278 vs 213 days, p=0.01) and GCHP (median 359 vs 255 days, p=0.02). Although MSM in King County appear to be testing at frequent intervals, further efforts are needed to reduce the time that HIV-infected persons are unaware of their status.

A Comparison of Clinical Parameters and Outcomes over 1 Year in Home Hemodialysis Patients Using 2008K@home or NxStage System One.

PubMed

Brunelli, Steven M; Wilson, Steven M; Ficociello, Linda H; Mullon, Claudy; Diaz-Buxo, Jose A

2016-01-01

The prevalence of home hemodialysis (HHD) in the United States is growing, driven in part by improvements in dialysis machines for home use. We assessed clinical parameters and outcomes in HHD patients using either Fresenius 2008K@home or NxStage System One over 1 year. Patients were 18 years or older and received HHD for ≥30 days between January 1, 2009, and June 30, 2010. A propensity score match was used to control for differences in baseline characteristics, and 2008K@home patients were stratified by frequency of use. Data for outcome measures were analyzed using generalized linear mixed models. Treatment frequency was lower for 2008K@home groups than System One. Mean standardized Kt/V (stdKt/V) was 2.75 for 2008K@home ≥3.5x/week users and 1.99 for System One users (p < 0.001). Erythropoiesis-stimulating agent use tended to be lower for patients using System One. There were no statistically significant differences across groups in serum albumin, calcium, phosphorus, hemoglobin, or parathyroid hormone levels, normalized protein catabolic rate, body mass index, number of hospitalizations, or hospitalized days. Clinical parameters and outcomes for HHD patients using 2008K@home and System One were largely equivalent, although 2008K@home use was associated with higher stdKt/V. Further studies will be required to establish whether these differences in stdKt/V relate to differences in technology, treatment schedule, or a combination thereof.

HIV Services Provided by STD Programs in State and Local Health Departments - United States, 2013-2014.

PubMed

Cuffe, Kendra M; Esie, Precious; Leichliter, Jami S; Gift, Thomas L

2017-04-07

The incidence of human immunodeficiency virus (HIV) infection in the United States is higher among persons with other sexually transmitted diseases (STDs), and the incidence of other STDs is increased among persons with HIV infection (1). Because infection with an STD increases the risk for HIV acquisition and transmission (1-4), successfully treating STDs might help reduce the spread of HIV among persons at high risk (1-4). Because health department STD programs provide services to populations who are at risk for HIV, ensuring service integration and coordination could potentially reduce the incidence of STDs and HIV. Program integration refers to the combining of STD and HIV prevention programs through structural, service, or policy-related changes such as combining funding streams, performing STD and HIV case matching, or integrating staff members (5). Some STD programs in U.S. health departments are partially or fully integrated with an HIV program (STD/HIV program), whereas other STD programs are completely separate. To assess the extent of provision of HIV services by state and local health department STD programs, CDC analyzed data from a sample of 311 local health departments and 56 state and directly funded city health departments derived from a national survey of STD programs. CDC found variation in the provision of HIV services by STD programs at the state and local levels. Overall, 73.1% of state health departments and 16.1% of local health departments matched STD case report data with HIV data to analyze possible syndemics (co-occurring epidemics that exacerbate the negative health effects of any of the diseases) and overlaps. Similarly, 94.1% of state health departments and 46.7% of local health departments performed site visits to HIV care providers to provide STD information or public health updates. One fourth of state health departments and 39.4% of local health departments provided HIV testing in nonclinical settings (field testing) for STD contacts, and all of these programs linked HIV cases to care. STD programs are providing some HIV services; however, delivery of certain specific services could be improved.

The Addition of SPECT/CT Lymphoscintigraphy to Breast Cancer Radiation Planning Spares Lymph Nodes Critical for Arm Drainage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cheville, Andrea L., E-mail: Cheville.andrea@mayo.edu; Brinkmann, Debra H.; Ward, Shelly B.

2013-03-15

Background: This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. Methods: SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the secondmore » (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Results: Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. Conclusions: The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema.« less

The addition of SPECT/CT lymphoscintigraphy to breast cancer radiation planning spares lymph nodes critical for arm drainage.

PubMed

Cheville, Andrea L; Brinkmann, Debra H; Ward, Shelly B; Durski, Jolanta; Laack, Nadia N; Yan, Elizabeth; Schomberg, Paula J; Garces, Yolanda I; Suman, Vera J; Petersen, Ivy A

2013-03-15

This prospective cohort study was designed to determine whether the amount of radiation delivered to the nonpathological lymph nodes (LNs) that drain the arm can be significantly reduced by integrating single-photon emission computed tomography (SPECT)/computed tomography (CT) scans into radiation treatment planning. SPECT-CT scans were acquired for the 28 patients with stage I or II breast cancer and fused with the routinely obtained radiation oncology planning CT scans. Arm-draining LNs were contoured with 0.5-cm margins automatically using a threshold of 50% maximum intensity. Two treatment plans were generated: 1 per routine clinical practice (standard; STD) and the second (modified; MOD) with treatment fields modified to minimize dose to the arm-draining LNs visible on SPECT/CT images without interfering with the dosage delivered to target tissues. Participants were treated per the MOD plans. Arm volumes were measured prior to radiation and thereafter at least three subsequent 6-month intervals. Sixty-eight level I-III arm-draining LNs were identified, 57% of which were inside the STD plan fields but could be blocked in the MOD plan fields. Sixty-five percent of arm-draining LNs in the STD versus 16% in the MOD plans received a mean of ≥10 Gy, and 26% in the STD versus 4% in the MOD plans received a mean of ≥40 Gy. Mean LN radiation exposure was 23.6 Gy (standard deviation 18.2) with the STD and 7.7 Gy (standard deviation 11.3) with the MOD plans (P<.001). No participant developed lymphedema. The integration of SPECT/CT scans into breast cancer radiation treatment planning reduces unnecessary arm-draining LN radiation exposure and may lessen the risk of lymphedema. Copyright © 2013 Elsevier Inc. All rights reserved.

Correlates of HIV/STD testing and willingness to test among rural-to-urban migrants in China.

PubMed

Wang, Bo; Li, Xiaoming; Stanton, Bonita; McGuire, James

2010-08-01

This study investigates socio-demographic, behavioral, psychological, and structural factors associated with self-reported HIV/STD testing and willingness to test among 1,938 Chinese migrants. Overall, 6% and 14% of participants had ever been tested for HIV and STD, respectively. The results of multivariate analyses indicate that working at entertainment sectors, engaging in commercial sex, and utilization of health care were positively associated with both HIV and STD testing. Younger age, selling blood, perceived peer sexual risk involvement, and satisfaction with life were associated with HIV testing only. Female gender, early sexual debut, multiple sexual partners, and perceived vulnerability to HIV/STD were associated with STD testing only. Male gender, having premarital sex, perceived higher severity of and vulnerability to HIV/STD, and utilization of health care were associated with willingness to be tested for both HIV and STD. Interventions designed to raise the perception of vulnerability to HIV/STD and to improve access to and utilization of health care may be effective in encouraging more HIV testing in this vulnerable population.

Improving strategies for syphilis control in China: selective testing of sexually transmitted disease patients--too little, too late?

PubMed

Yin, Y-P; Wong, S P Y; Liu, M-S; Wei, W-H; Yu, Y-H; Gao, X; Chen, Q; Fu, Z-Z; Cheng, F; Chen, X-S; Cohen, M S

2008-12-01

Syphilis testing guidelines in China are usually based on symptomatic criteria, overlooking risk assessment and ultimately opportunities for disease detection and control. We used data from 10,695 sexually transmitted disease (STD) clinic patients in Guangxi, China, to assess the efficacy of a potential screening tool inquiring about behavioural and health risk factors in identifying the STD patients who should not be triaged for syphilis testing under current guidelines, but on the contrary receive such testing. Validity testing of the screening tool was performed and receiver-operating characteristic curves were plotted to determine an optimal total risk score cut-off for testing. About 40.9% of patients with positive toluidine red unheated serum test and Treponema pallidum particle agglutination test did not show hallmark signs of syphilis. The screening tool was more sensitive in detecting infection in non-triaged male versus female patients (highest sensitivity = 90% vs. 55%) and the cut-off score to warrant testing was lower in non-triaged female patients than in non-triaged male patients (cut-off = 1 vs. 2). Most of the cases were missed among female STD patients. In spite of selective testing based on behavioural and health indicators that improve case detection, cases were still missed. Our study supports universal testing for syphilis in the STD population.

[Chancroid in Algeria: the status of this sexually transmitted disease in 1995].

PubMed

Boudghène-Stambouli, O; Merad-Boudia, A

1997-01-01

Absent for several decades, the chancroid reappeared in Algeria in 1988. In the unique department of Dermatology and Venereology of the University Hospital of the country of Tlemcen (more than 700,000 inhabitants), we wanted to know the state of this STD seven years after the report of the first cases. The file of the consulting patients were examined. We looked for the principal characteristics of this STD: age, sex, incubation period, place infection contact, type of relation, clinical presentation, evolution without and with treatment, other associated STD (syphilis, HIV). From August 1988 (1st case) to December 1995, 144 cases of chancroid were collected = 1988: 6, 1989: 5, 1990: 7, 1991: 18, 1992: 11, 1993: 33, 1994: 48, 1995: 16. The presentation is quite stereotyped; it concerns males only, singles in must cases, having had sexual relations with prostitutes. The incubation period is short (less than 10 days), the characteristic ulceration presents, very often, some adenopathies. The treatment by cotrimoxazole is efficient. They are no concomitant syphilis or HIV infection. The chancroid is the first cause of genital ulceration in the world. Since 1991, it is the principal STD in our department. It spreads within a male population, young singles associated with prostitutes. It is well installed in Algeria, and its role, although minor, in the transmission of the HIV infection, should not be neglected.

Gender Differences in Associations between Exposure to School HIV Education and Protective Sexual Behaviors and Sexually Transmitted Disease/HIV Diagnosis among High School Students

ERIC Educational Resources Information Center

Raj, Anita; Decker, Michele R.; Murray, Jessica E.; Silverman, Jay G.

2007-01-01

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 =…

Domain-specific interactions between MLN8237 and human serum albumin estimated by STD and WaterLOGSY NMR, ITC, spectroscopic, and docking techniques.

PubMed

Yang, Hongqin; Liu, Jiuyang; Huang, Yanmei; Gao, Rui; Tang, Bin; Li, Shanshan; He, Jiawei; Li, Hui

2017-03-30

Alisertib (MLN8237) is an orally administered inhibitor of Aurora A kinase. This small-molecule inhibitor is under clinical or pre-clinical phase for the treatment of advanced malignancies. The present study provides a detailed characterization of the interaction of MLN8237 with a drug transport protein called human serum albumin (HSA). STD and WaterLOGSY nuclear magnetic resonance (NMR)-binding studies were conducted first to confirm the binding of MLN8237 to HSA. In the ligand orientation assay, the binding sites of MLN8237 were validated through two site-specific spy molecules (warfarin sodium and ibuprofen, which are two known site-selective probes) by using STD and WaterLOGSY NMR competition techniques. These competition experiments demonstrate that both spy molecules do not compete with MLN8237 for the specific binding site. The AutoDock-based blind docking study recognizes the hydrophobic subdomain IB of the protein as the probable binding site for MLN8237. Thermodynamic investigations by isothermal titration calorimetry (ITC) reveal that the non-covalent interaction between MLN8237 and HSA (binding constant was approximately 10 5  M -1 ) is driven mainly by favorable entropy and unfavorable enthalpy. In addition, synchronous fluorescence, circular dichroism (CD), and 3D fluorescence spectroscopy suggest that MLN8237 may induce conformational changes in HSA.

Domain-specific interactions between MLN8237 and human serum albumin estimated by STD and WaterLOGSY NMR, ITC, spectroscopic, and docking techniques

PubMed Central

Yang, Hongqin; Liu, Jiuyang; Huang, Yanmei; Gao, Rui; Tang, Bin; Li, Shanshan; He, Jiawei; Li, Hui

2017-01-01

Alisertib (MLN8237) is an orally administered inhibitor of Aurora A kinase. This small-molecule inhibitor is under clinical or pre-clinical phase for the treatment of advanced malignancies. The present study provides a detailed characterization of the interaction of MLN8237 with a drug transport protein called human serum albumin (HSA). STD and WaterLOGSY nuclear magnetic resonance (NMR)-binding studies were conducted first to confirm the binding of MLN8237 to HSA. In the ligand orientation assay, the binding sites of MLN8237 were validated through two site-specific spy molecules (warfarin sodium and ibuprofen, which are two known site-selective probes) by using STD and WaterLOGSY NMR competition techniques. These competition experiments demonstrate that both spy molecules do not compete with MLN8237 for the specific binding site. The AutoDock-based blind docking study recognizes the hydrophobic subdomain IB of the protein as the probable binding site for MLN8237. Thermodynamic investigations by isothermal titration calorimetry (ITC) reveal that the non-covalent interaction between MLN8237 and HSA (binding constant was approximately 105 M−1) is driven mainly by favorable entropy and unfavorable enthalpy. In addition, synchronous fluorescence, circular dichroism (CD), and 3D fluorescence spectroscopy suggest that MLN8237 may induce conformational changes in HSA. PMID:28358124

Domain-specific interactions between MLN8237 and human serum albumin estimated by STD and WaterLOGSY NMR, ITC, spectroscopic, and docking techniques

NASA Astrophysics Data System (ADS)

Yang, Hongqin; Liu, Jiuyang; Huang, Yanmei; Gao, Rui; Tang, Bin; Li, Shanshan; He, Jiawei; Li, Hui

2017-03-01

Alisertib (MLN8237) is an orally administered inhibitor of Aurora A kinase. This small-molecule inhibitor is under clinical or pre-clinical phase for the treatment of advanced malignancies. The present study provides a detailed characterization of the interaction of MLN8237 with a drug transport protein called human serum albumin (HSA). STD and WaterLOGSY nuclear magnetic resonance (NMR)-binding studies were conducted first to confirm the binding of MLN8237 to HSA. In the ligand orientation assay, the binding sites of MLN8237 were validated through two site-specific spy molecules (warfarin sodium and ibuprofen, which are two known site-selective probes) by using STD and WaterLOGSY NMR competition techniques. These competition experiments demonstrate that both spy molecules do not compete with MLN8237 for the specific binding site. The AutoDock-based blind docking study recognizes the hydrophobic subdomain IB of the protein as the probable binding site for MLN8237. Thermodynamic investigations by isothermal titration calorimetry (ITC) reveal that the non-covalent interaction between MLN8237 and HSA (binding constant was approximately 105 M-1) is driven mainly by favorable entropy and unfavorable enthalpy. In addition, synchronous fluorescence, circular dichroism (CD), and 3D fluorescence spectroscopy suggest that MLN8237 may induce conformational changes in HSA.

Exposure to Different Types of Violence and Subsequent Sexual Risk Behavior among Female STD Clinic Patients: A Latent Class Analysis

PubMed Central

Walsh, Jennifer L.; Senn, Theresa E.; Carey, Michael P.

2013-01-01

Objective Diverse forms of violence, including childhood maltreatment (CM), intimate partner violence (IPV), and exposure to community violence (ECV), have been linked separately with sexual risk behaviors. However, few studies have explored multiple experiences of violence simultaneously in relation to sexual risk-taking, especially in women who are most vulnerable to violent experiences. Methods Participants were 481 women (66% African American, Mage = 27 years) attending a publicly-funded STD clinic who reported on their past and current experiences with violence and their current sexual risk behavior. We identified patterns of experience with violence using latent class analysis (LCA) and investigated which combinations of experiences were associated with the riskiest sexual outcomes. Results Four classes of women with different experiences of violence were identified: Low Violence (39%), Predominantly ECV (20%), Predominantly CM (23%), and Multiply Victimized (18%). Women in the Multiply Victimized and Predominantly ECV classes reported the highest levels of sexual risk behavior, including more lifetime sexual partners and a greater likelihood of receiving STD treatment and using substances before sex. Conclusions Women with different patterns of violent experiences differed in their sexual risk behavior. Interventions to reduce sexual risk should address violence against women, focusing on experiences with multiple types of violence and experiences specifically with ECV. Additional research is needed to determine the best ways to address violence in sexual risk reduction interventions. PMID:23626921

Schools, Society, and "Teen" Pregnancy.

ERIC Educational Resources Information Center

Males, Mike

1993-01-01

Reality of widespread adult/teen sex--as revealed through age-specific pregnancy, birth, and sexually transmitted disease (STD) statistics--has profound implications for public school sex education and efforts to reduce incidence of teen pregnancy and STDs. Many public school "prevention" measures have failed because male half of "teen" pregnancy…

Progress toward achieving the national 1990 objectives for sexually transmitted diseases.

PubMed

1987-04-03

A summary evaluation of the status of 5 sexually transmitted disease (STD) goals is presented by the U.S. Public Health Service. 1st, gonorrhea cases, after a rapid rise in the early 1970s, have been steadily declining on the whole. Female cases, however, have been increasing, and resistant strains have spread dramatically. Thus it seems the goal of 280 cases per 100,000 by 1990 will not be met. 2nd, the pelvic inflammatory disease rate is declining toward the goal, even though Chlamydia infections remain a problem. 3rd, the incidence of syphilis, especially in males, is approaching the target of 7/100,000. Congenital syphilis is rising, due both to emphasis on reporting and to a real increase. 4th, the goal of effective diagnosis and treatment of STD by 95% of clinicians is being approached with postgraduate courses and medical school curricula, but this end is probably too ambitious. 5th, all junior and senior high school students should be receiving accurate education about STD. No information on these efforts is available. After these goals were in place, the STD burden has increased phenomenally because of the appearance of AIDS, the maturation of the baby boom generation, and the realization that over 50 different diseases, 13 million cases and 7000 deaths occur annually, excluding AIDS. The cost of treating pelvic inflammatory disease alone is estimated at $2.6 billion annually. Primary prevention is the only feasible priority.

Club Drugs and HIV/STD Infection: An Exploratory Analysis among Men Who Have Sex with Men in Changsha, China

PubMed Central

Zheng, Jun; Zhao, Junshi; He, Jianmei; Zhang, Guoqiang; Tang, Xuemin

2015-01-01

Objective To evaluate current club drug use and its potential association with the transmission of HIV/STD among Changsha men who have sex with men (MSM). Method A cross-sectional survey was conducted by using self-administered questionnaires including information regarding socio-demographics, club drug use, high-risk behaviors, and HIV/STD infections. Multiple methods including venue-based, peer referral using “snowball” techniques, and internet advertisements were used to recruit study participants. Results Of the 826 participants, 177 (21.4%) reported that they had used club drugs at some time before or during sex in the past six months. MSM with young age, low education level, and seeking partners through the internet or bars were the main population who used drugs. Poppers were the most common drug used among Changsha MSM. The prevalence of HIV, syphilis, and herpes simplex virus-2 were higher among drug users. There were no significant differences in unprotected sexual intercourse and condom use between drug users and non-users. Compared with non-users, risk behaviors such as group sex, multiple sex partners, and sex with foreigners were more frequent among drug users. Conclusion Club drug use is common among Changsha MSM, and is related to unsafe sex activities and HIV/STD infection. It is necessary to build novel targeted HIV prevention strategies to monitor and reduce club drug use among MSM. PMID:25950912

Associations of sense of coherence with psychological distress and quality of life in inflammatory bowel disease.

PubMed

Freitas, Thiago H; Andreoulakis, Elias; Alves, Gilberto S; Miranda, Hesley L L; Braga, Lúcia L B C; Hyphantis, Thomas; Carvalho, André F

2015-06-07

To investigate the relationship between sense of coherence, psychological distress and health related quality of life in inflammatory bowel disease (IBD). This cross-sectional study enrolled a consecutive sample of 147 IBD (aged 45.1 ± 14.1 years; 57.1% female) patients recruited from a tertiary gastroenterology service. Sixty-four participants met diagnostic criteria for Crohn's disease, while eighty-three patients had ulcerative colitis. Socio-demographic data (education, age, race, gender, gross monthly income and marital status), disease-related variables (illness activity, relapse rate in past 2 years, history of surgery and time since diagnosis), sense of coherence (Antonovsky's SOC scale), psychological distress symptoms (Hospital Anxiety and Depression Scale) and health-related quality of life (HRQoL; WHOQOL-Bref) were assessed. Hierarchical multiple regression analyses were performed to identify factors that are independently associated with psychological distress and HRQoL in patients with IBD and to provide indications for possible moderating or mediating effects. In addition, formal moderation and mediation analyses (Sobel tests) were performed to confirm potential moderators/mediators of the relationship between SOC, psychological distress symptoms and HRQoL. Lower SOC scores (std beta= -0.504; P < 0.001), female gender (std beta = 0.176; P = 0.021) and White race (std beta = 0.164; P = 0.033) were independently associated with higher levels of depressive symptoms, while lower levels of SOC (std beta = -0.438; P < 0.001) and higher relapse rate (std beta = 0.161; P = 0.033) were independently associated with more severe anxiety symptoms. A significant interaction between time since diagnosis and SOC was found with regard to the severity of depressive or anxiety symptoms, as the interaction term (time since diagnosis X SOC) had beta coefficients of -0.191 (P = 0.009) and -0.172 (P = 0.026), respectively. Lower levels of anxiety symptoms (std beta = -0.369; P < 0.001), higher levels of SOC (std beta = 0.231; P = 0.016) and non-White race (std beta = -0.229; P = 0.006), i.e., mixed-race, which represented the reference category, were independently associated with higher levels of overall HRQoL. Anxiety symptoms were the most potent independent correlate of most aspects of HRQoL. In addition, anxiety mediated the association between SOC and satisfaction with health, as well as its relationship with physical, mental, and social relations HRQoL. Depressive symptoms also mediated the association between SOC and mental HRQoL. Our data indicated that SOC is an important construct, as it influences psychological distress and has significant albeit indirect effects on several HRQoL domains in IBD.

A review and assessment of non-governmental organization-based STD/AIDS education and prevention projects for marginalized groups.

PubMed

Crane, S F; Carswell, J W

1992-06-01

A review of projects run by non-governmental organizations (NGOs) in primarily developing countries, which have aimed to provide STD/AIDS education and prevention skills to various marginalized groups, reveals that past quantitative and formative research has failed to identify key programmatic factors which lead to more successful project implementation and sustainability. In observations, interviews with field staff, visits to program sites and information drawn from the literature, a variety of methods to reach a wide range of groups such as men who have sex with men, prostitutes, clients of prostitutes, prisoners, street children, migrant workers and refugees are explored. Factors found to facilitate project success include the following: at least one full-time committed staff member; respectful treatment and appropriate motivation of the target group; suitable and sufficient equipment and supplies (particularly condoms); planning ahead for the participation of HIV-positive individuals and ways to meet their needs; focusing on qualitative rather than quantitative evaluation; planning in advance beyond a 9 or 12 month 'model'. Despite some evidence that marginalized groups can be successfully motivated to practise safer sex through prevention education, long-term behaviour change still presents major challenges--even when specific conditions are met.

Mapping an HIV/STD prevention curriculum for Zambian in-school settings.

PubMed

Mpofu, Elias; Lawrence, Frank; Ngoma, Mary Shilalukey; Siziya, Seter; Malungo, Jacob R S

2008-04-01

HIV/AIDS poses grave risk to human development in sub-Saharan Africa. Evidence-based interventions that are rooted in local culture could help efforts to prevent threats to human development from HIV/AIDS. We used concept mapping (Concept System, 2006 ) to construct the components and content of a locally developed HIV/AIDS curriculum for use by secondary schools in Lusaka, Zambia. Participants were school counsellors (n = 14), youth health program officers (n = 7), and regular education teachers (n = 3) from the education, health, and youth development agencies in Lusaka, Zambia (males = 11; females = 13; mean age 38; SD = 15 years). Concept mapping yielded six statement clusters defining preliminary components of a locally grounded in-school HIV/AIDS prevention curriculum and the content items that define these components: (1) life skills education (18 items), (2) sexuality and reproductive health (10 items), (3) treatment, care and support (13 items), (4) counselling (12 items), (5) basic facts about HIV/AIDS (11 items), and (6) dissemination of information about HIV/AIDS (11 items). Zambian locally constructed constructs for an HIV/STD prevention curriculum overlap those promoted by public health programs in the country and internationally.

High performance 1553

NASA Astrophysics Data System (ADS)

Hegarty, Michael G.

2005-05-01

The U.S. Air Force is currently in the process of developing a revision to MIL-STD-1553 that will provide additional digital communication bandwidth beyond MIL-STD-1553B's 1 Megabit per second (Mbps) rate. The proposed revision to MIL-STD-1553 (referred to as MIL-STD-1553C) is targeting 200 Mbps as a baseline data rate. This paper explores the feasibility of the U.S. Air Force's proposed revision to MIL-STD-1553 based on studies conducted by Data Device Corporation (DDC). A combination of empirical and theoretical methods is used to determine if a MIL-STD-1553B network contains sufficient capacity to support the proposed 200 Mbps data rate. The results of DDC's analysis is that for some MIL-STD-1553 buses there is sufficient bandwidth to implement a broadband system in which legacy 1 Mbps 1553B waveforms could coexist with new 200 Mbps waveforms, thus providing an incremental high speed communication channel to existing MIL-STD-1553 buses.

STD Prevention. Health Facts.

ERIC Educational Resources Information Center

Stang, Lucas; Miner, Kathleen R.

The 10-volume "Health Facts" series is intended to supplement health education curricula and provide a handy reference for individuals who would like additional background information on particular health topics. The emphasis is placed on topics and examples relevant to youth of middle and high school age. The five sections in this book…

How can we improve online HIV and STD prevention for men who have sex with men? Perspectives of hook-up website owners, website users, and HIV/STD directors.

PubMed

Wohlfeiler, Dan; Hecht, Jennifer; Volk, Jonathan; Fisher Raymond, H; Kennedy, Tom; McFarland, Willi

2013-11-01

Internet-based interventions have potential to reduce HIV and STD transmission among men who meet male sexual partners online. From November 2009 to May 2010 we surveyed dating and hook-up website users (n = 3,050), website owners (n = 18), and health department HIV/STD directors (n = 81) to identify structural and behavioral prevention interventions that could be implemented online and which a majority of website users were willing to use, owners were willing to implement, and HIV/STD directors perceived to be effective. A majority of each of the three stakeholder groups agreed on the following: (1) automated HIV/STD testing reminders, (2) local STD test site directories, (3) links to sex-positive safe sex videos, (4) access to sexual health experts, (5) profile options to include safer sex preference, (6) chat rooms for specific sexual interests, (7) filtering partners by their profile information, and (8) anonymous e-card partner notification for STD exposure. Findings help build consensus about how to prioritize resources for implementing online HIV and STD prevention interventions and highlight differences between stakeholders to guide future discussion about how to advance prevention efforts.

Factors associated with the content of sex education in U.S. public secondary schools.

PubMed

Landry, David J; Darroch, Jacqueline E; Singh, Susheela; Higgins, Jenny

2003-01-01

While sex education is almost universal in U.S. schools, its content varies considerably. Topics such as abstinence, and basic information on HIV and other sexually transmitted diseases (STDs), are commonly taught; birth control and how to access STD and contraceptive services are taught less often. Factors potentially associated with these variations need to be examined. Data on 1,657 respondents to a 1999 national survey of teachers providing sex education in grades 7-12 were assessed for variation in topics covered. Logistic regression was used to ascertain factors associated with instruction on selected topics. The content of sex education varied by region and by instructors' approach to teaching about abstinence and contraception. For example, teaching abstinence as the only means of pregnancy and STD prevention was more common in the South than in the Northeast (30% vs. 17%). Emphasizing the ineffectiveness of contraceptives was less common in the Northeast (17%) than in other regions (27-32%). Instructors teaching that methods are ineffective and presenting abstinence as teenagers' only option had significantly reduced odds of teaching various skills and topics (odds ratios, 0.1-0.5). Instructors' approach to teaching about methods is a very powerful indicator of the content of sex education. Given the well-documented relationship between what teenagers learn about safer sexual behavior and their use of methods when they initiate sexual activity, sex education in all U.S. high schools should include accurate information about condoms and other contraceptives.

Ordered versus Unordered Map for Primitive Data Types

DTIC Science & Technology

2015-09-01

mapped to some element. C++ provides two types of map containers within the standard template library, the std ::map and the std ::unordered_map...classes. As the name implies, the containers main functional difference is that the elements in the std ::map are ordered by the key, and the std ...unordered_map are not ordered based on their key. The std ::unordered_map elements are placed into “buckets” based on a hash value computed for their key

23 CFR 637.205 - Policy.

Code of Federal Regulations, 2014 CFR

2014-04-01

.... Each STD shall develop a quality assurance program which will assure that the materials and workmanship... criteria in § 637.207 and be approved by the FHWA. (b) STD capabilities. The STD shall maintain an adequate... qualified sampling and testing personnel employed by the STD or its designated agent. (d) Verification...

23 CFR 637.205 - Policy.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... Each STD shall develop a quality assurance program which will assure that the materials and workmanship... criteria in § 637.207 and be approved by the FHWA. (b) STD capabilities. The STD shall maintain an adequate... qualified sampling and testing personnel employed by the STD or its designated agent. (d) Verification...

23 CFR 637.205 - Policy.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... Each STD shall develop a quality assurance program which will assure that the materials and workmanship... criteria in § 637.207 and be approved by the FHWA. (b) STD capabilities. The STD shall maintain an adequate... qualified sampling and testing personnel employed by the STD or its designated agent. (d) Verification...

10 CFR 431.447 - Department of Energy recognition of nationally recognized certification programs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... IEEE Std 112-2004 Test Methods A and B, IEEE Std 114-2010, CSA C390-10, and CSA C747 (incorporated by... IEEE Std 112-2004 Test Methods A and B, IEEE Std 114-2010, CSA C390-10, and CSA C747- (incorporated by...

10 CFR 431.447 - Department of Energy recognition of nationally recognized certification programs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... IEEE Std 112-2004 Test Methods A and B, IEEE Std 114-2010, CSA C390-10, and CSA C747 (incorporated by... IEEE Std 112-2004 Test Methods A and B, IEEE Std 114-2010, CSA C390-10, and CSA C747- (incorporated by...

23 CFR 637.205 - Policy.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... Each STD shall develop a quality assurance program which will assure that the materials and workmanship... criteria in § 637.207 and be approved by the FHWA. (b) STD capabilities. The STD shall maintain an adequate... qualified sampling and testing personnel employed by the STD or its designated agent. (d) Verification...

23 CFR 637.205 - Policy.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... Each STD shall develop a quality assurance program which will assure that the materials and workmanship... criteria in § 637.207 and be approved by the FHWA. (b) STD capabilities. The STD shall maintain an adequate... qualified sampling and testing personnel employed by the STD or its designated agent. (d) Verification...

The variable target model: a paradigm shift in the incremental haemodialysis prescription.

PubMed

Casino, Francesco Gaetano; Basile, Carlo

2017-01-01

The recent interest in incremental haemodialysis (HD) is hindered by the current prescription based on a fixed target model (FTM) for the total (dialytic + renal) equivalent continuous clearance (ECC). The latter is expressed either as standard Kt/V (stdKt/V), i.e. the pre-dialysis averaged concentration of urea-based ECC, or EKRc, i.e. the time averaged concentration-based ECC, corrected for volume (V) = 40 L. Accordingly, there are two different targets: stdKt/V = 2.3 volumes per week (v/wk) and EKRc = 13 mL/min/40 L. However, fixing the total ECC necessarily implies perfect equivalence of its components-the residual renal urea clearance (Kru) and dialysis clearance (Kd). This assumption is wrong because Kru has much greater clinical weight than Kd. Here we propose that the ECC target varies as an inverse function of Kru, from a maximum value in anuria to a minimum value at Kru levels not yet requiring dialysis. The aim of the present study was to compare the current FTM with the proposed variable target model (VTM). The double pool urea kinetic model was used to model dialysis sessions for 360 virtual patients and establish equations predicting the ECC as a function of Kd, Kru and the number of sessions per week. An end-dialysis urea distribution V of 35 L (corresponding to a body surface area of 1.73 m 2 ) was used, so that the current EKRc target of 13 mL/min/40 L could be recalculated at an EKRc 35 value of 12 mL/min/35 L equal to 12 mL/min/1.73 m 2 . The latter also coincides with the maximum value of the EKRc 35 variable target in anuria. The minimum target value of EKRc 35 was assumed to coincide with Kru corrected for V = 35 L (i.e. Krc 35 = 6 mL/min/1.73 m 2 ). The corresponding target for stdKt/V was assumed to vary from 2.3 v/wk at Krc 35 = 0 to 1.7 v/wk at Krc 35 = 6 mL/min/1.73 m 2 . On this basis, the variable target values can be obtained from the following linear equations: target EKRc 35 = 12 - Krc 35 ; target stdKt/V = 2.3 - 0.1 × Krc 35 . Two versions of stdKt/V were considered: the classic version (stdKt/V Gotch ) with Kru at 70%, and the current version (stdKt/V Daug ) with Kru at 100%. The VTM with stdKt/V Gotch produces results very close to those using the FTM with stdKt/V Daug . Once-weekly HD is virtually not allowed by the FTM. In contrast, the VTM allows dialysis to start at Krc 35 ∼5 mL/min/1.73 m 2 on a once-weekly HD schedule, at least in relatively healthy patients; this schedule can be maintained until Krc 35 falls below 4 mL/min/1.73 m 2 , at which point the schedule should be changed to a twice-weekly HD schedule, that, in turn, could be maintained until Krc 35 falls below 2 mL/min/1.73 m 2 . A paradigm shift from the FTM to the VTM in the prescription of incremental HD is proposed, whereby the VTM would allow less frequent treatments at lower Kru, with important clinical and economic implications. This approach is likely to be safe but needs to be confirmed by randomized controlled trials. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Word-of-mouth marketing: low-cost technique proves an effective way to promote teen clinic.

PubMed

2006-01-01

From the outset, the team at the Longmont (CO) Teen Clinic faced a two-fold marketing dilemma. The first problem was a small budget. As a nonprofit with limited funds, the staff knew that they would have to get creative to effectively reach their target audience and fulfill the clinic's mission of battling unwanted teen pregnancies and sexually transmitted diseases (STD) among area women aged 19 and younger.

SU-F-R-07: Radiomics of CT Features and Associations and Correlation with Outcomes Following Lung SBRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schreibmann, E; Iwinski Sutter, A; Whitaker, D

Objective: To investigate the prognostic significance of image gradients and in predicting clinical outcomes in a patients with non-small cell lung cancer treated with stereotactic body radiotherapy (SBRT) on 71 patients with 83 treated lesions. Methods: The records of patients treated with lung SBRT were retrospectively reviewed. When applicable, SBRT target volumes were modified to exclude any overlap with pleura, chestwall, or mediastinum. The ITK software package was utilized to generate quantitative measures of image intensity, inhomogeneity, shape morphology and first and second-order CT textures. Multivariate and univariate models containing CT features were generated to assess associations with clinicopathologic factors.more » Results: On univariate analysis, tumor size (HR 0.54, p=0.045) sumHU (HR 0.31, p=0.044) and short run grey level emphasis STD (HR 0.22, p=0.019) were associated with regional failure-free survival; meanHU (HR 0.30, p=0.035), long run emphasis (HR 0.21, p=0.011) and long run low grey level emphasis (HR 0.14, p=0.005) was associated with distant failure-free survival (DFFS). No features were significant on multivariate modeling however long run low grey level emphasis had a hazard ratio of 0.12 (p=0.061) for DFFS. Adenocarcinoma and squamous cell carcinoma differed with respect to long run emphasis STD (p=0.024), short run low grey level emphasis STD (p<0.001), and long run low grey level emphasis STD (p=0.024). Multivariate modeling of texture features associated with tumor histology was used to estimate histologies of 18 lesions treated without histologic confirmation. Of these, MVA suggested the same histology as a prior metachronous lung malignancy in 3/7 patients. Conclusion: Extracting radiomics features on clinical datasets was feasible with the ITK package with minimal effort to identify pre-treatment quantitative CT features with prognostic factors for distant control after lung SBRT.« less

Inventory of File sref.t03z.pgrb212.spread_3hrly.grib2

Science.gov Websites

ground UGRD analysis U-Component of Wind [m/s] std dev 002 10 m above ground VGRD analysis V-Component of Wind [m/s] std dev 003 1000 mb UGRD analysis U-Component of Wind [m/s] std dev 004 850 mb UGRD analysis U-Component of Wind [m/s] std dev 005 700 mb UGRD analysis U-Component of Wind [m/s] std dev 006 600

Inventory of File sref.t03z.pgrb216.spread_3hrly.grib2

Science.gov Websites

ground UGRD analysis U-Component of Wind [m/s] std dev 002 10 m above ground VGRD analysis V-Component of Wind [m/s] std dev 003 1000 mb UGRD analysis U-Component of Wind [m/s] std dev 004 850 mb UGRD analysis U-Component of Wind [m/s] std dev 005 700 mb UGRD analysis U-Component of Wind [m/s] std dev 006 600

Inventory of File sref.t03z.pgrb243.spread_3hrly.grib2

Science.gov Websites

ground UGRD analysis U-Component of Wind [m/s] std dev 002 10 m above ground VGRD analysis V-Component of Wind [m/s] std dev 003 1000 mb UGRD analysis U-Component of Wind [m/s] std dev 004 850 mb UGRD analysis U-Component of Wind [m/s] std dev 005 700 mb UGRD analysis U-Component of Wind [m/s] std dev 006 600

Inventory of File sref.t03z.pgrb132.spread_3hrly.grib2

Science.gov Websites

ground UGRD analysis U-Component of Wind [m/s] std dev 002 10 m above ground VGRD analysis V-Component of Wind [m/s] std dev 003 1000 mb UGRD analysis U-Component of Wind [m/s] std dev 004 850 mb UGRD analysis U-Component of Wind [m/s] std dev 005 700 mb UGRD analysis U-Component of Wind [m/s] std dev 006 600

Assessing the role of prevention partnerships in STD prevention: a review of comprehensive STD prevention systems progress reports.

PubMed

Hogben, Matthew; Hood, Julia; Collins, Dayne; McFarlane, Mary

2013-11-01

Systematic analysis of STD programme data contributes to a national portrait of sexually transmitted disease (STD) prevention activities, including research and evaluation specifically designed to optimise programme efficiency and impact. We analysed the narrative of the 2009 annual progress reports of the US Comprehensive STD Prevention Systems cooperative agreement for 58 STD programmes, concentrating on programme characteristics and partnerships. Programmes described 516 unique partnerships with a median of seven organisations cited per STD programme. Non-profit organisations (including service providers) were most frequently cited. Higher gonorrhoea morbidity was associated with reporting more partnerships; budget problems were associated with reporting fewer. Challenges to engaging in partnerships included budget constraints, staff turnover and low interest. Data provide a source of information for judging progress in programme collaboration and for informing a sustained programme-focused research and evaluation agenda.

Determinants of STD epidemics: implications for phase appropriate intervention strategies.

PubMed

Aral, S O

2002-04-01

Determinants of evolving epidemics of sexually transmitted diseases (STD) are equally influenced by the evolution of the STD epidemics themselves and by the evolution of human societies. A temporal approach to STD transmission dynamics suggests the need to monitor infectivity, rate of exposure between infected and susceptible individuals, and duration of infectiousness in societies. Different indicators may be used to monitor rate of exposure in the general population and in core groups. In addition, underlying determinants of STD epidemics such as poverty, inequality, racial/ethnic discrimination, unemployment, sex ratio, volume of migration, and health care coverage and quality are important variables to monitor through a surveillance system focused on social context. Ongoing large scale societal changes including urbanisation, globalisation, increasing inequality, and increasing volume of migrant populations may affect the evolution of STD epidemics. Globalised STD epidemics could pose a major challenge to local public health systems.

40 CFR 1066.630 - PDP, SSV, and CFV flow rate calculations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... per revolution, as determined in paragraph (a)(2) of this section. T std = standard temperature = 293.... p std = standard pressure= 101.325 kPa. (2) Calculate V rev using the following equation: ER28AP14... std = standard temperature. p std = standard pressure. Z = compressibility factor. M mix = molar mass...

23 CFR 635.116 - Subcontracting and contractor responsibilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... provisions. (b) The STD shall not permit any of the contract work to be performed under a subcontract, unless such arrangement has been authorized by the STD in writing. Prior to authorizing a subcontract, the STD... and requirements of the prime contract. The Division Administrator may permit the STD to satisfy the...

23 CFR 635.116 - Subcontracting and contractor responsibilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... provisions. (b) The STD shall not permit any of the contract work to be performed under a subcontract, unless such arrangement has been authorized by the STD in writing. Prior to authorizing a subcontract, the STD... and requirements of the prime contract. The Division Administrator may permit the STD to satisfy the...

40 CFR 1037.705 - Generating and calculating emission credits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... equations: (1) For vocational vehicles: Emission credits (Mg) = (Std-FEL) × (Payload Tons) × (Volume) × (UL) × (10−6) Where: Std = the emission standard associated with the specific tractor regulatory subcategory... credits (Mg) = (Std-FEL) × (Payload tons) × (Volume) × (UL) × (10−6) Where: Std = the emission standard...

40 CFR 1037.705 - Generating and calculating emission credits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... equations: (1) For vocational vehicles: Emission credits (Mg) = (Std-FEL) × (Payload Tons) × (Volume) × (UL) × (10−6) Where: Std = the emission standard associated with the specific tractor regulatory subcategory... credits (Mg) = (Std-FEL) × (Payload tons) × (Volume) × (UL) × (10−6) Where: Std = the emission standard...

40 CFR 1037.705 - Generating and calculating emission credits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... equations: (1) For vocational vehicles: Emission credits (Mg) = (Std-FEL) × (Payload Tons) × (Volume) × (UL) × (10−6) Where: Std = the emission standard associated with the specific tractor regulatory subcategory... credits (Mg) = (Std-FEL) × (Payload tons) × (Volume) × (UL) × (10−6) Where: Std = the emission standard...

23 CFR 635.116 - Subcontracting and contractor responsibilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... provisions. (b) The STD shall not permit any of the contract work to be performed under a subcontract, unless such arrangement has been authorized by the STD in writing. Prior to authorizing a subcontract, the STD... and requirements of the prime contract. The Division Administrator may permit the STD to satisfy the...

23 CFR 635.116 - Subcontracting and contractor responsibilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... provisions. (b) The STD shall not permit any of the contract work to be performed under a subcontract, unless such arrangement has been authorized by the STD in writing. Prior to authorizing a subcontract, the STD... and requirements of the prime contract. The Division Administrator may permit the STD to satisfy the...

(15)N and (13)C group-selective techniques extend the scope of STD NMR detection of weak host-guest interactions and ligand screening.

PubMed

Kövér, Katalin E; Wéber, Edit; Martinek, Tamás A; Monostori, Eva; Batta, Gyula

2010-10-18

Saturation transfer difference (STD) is a valuable tool for studying the binding of small molecules to large biomolecules and for obtaining detailed information on the binding epitopes. Here, we demonstrate that the proposed (15)N/(13)C variants of group-selective, "GS-STD" experiments provide a powerful approach to mapping the binding epitope of a ligand even in the absence of efficient spin diffusion within the target protein. Therefore, these experimental variants broaden the scope of STD studies to smaller and/or more-dynamic targets. The STD spectra obtained in four different experimental setups (selective (1)H STD, (15)N GS-STD, (13)C(Ar) and (13)C(aliphatic) GS-STD approaches) revealed that the signal-intensity pattern of the difference spectra is affected by both the type and the spatial distribution of the excited "transmitter" atoms, as well as by the efficiency of the spin-diffusion-mediated magnetization transfer. The performance of the experiments is demonstrated on a system by using the lectin, galectin-1 and its carbohydrate ligand, lactose.

Prevalence of human papillomavirus among STD clinic attenders in Jamaica: association of younger age and increased sexual activity.

PubMed

Figueroa, J P; Ward, E; Luthi, T E; Vermund, S H; Brathwaite, A R; Burk, R D

1995-01-01

Human papillomavirus is the major etiologic agent of cervical cancer. Although the incidence of cancer of the cervix is high in Jamaica, the prevalence of human papillomavirus among Jamaican women has not been defined. To estimate the prevalence of human papillomavirus infection and associated risk factors in women attending an STD clinic in Kingston, Jamaica. A cross-sectional survey was done of 202 women attending an STD clinic in Kingston in 1990. Cervical and vaginal cells were collected by lavage, and human papillomavirus genomes were detected in extracted DNA using low-stringency Southern blot hybridization. Fifty-eight (28.7%) women were identified as HPV positive. Prevalence of HPV by age group was 39% in women 15-19 years old, 33% of women 20-24 years old, 31% in women 25-29 years old, and 17% in those 30 years or older. Increasing age was significantly associated with a lower prevalence of human papillomavirus infection (test for trend, P = 0.025). The effect of age was independent of years of sexual activity. Women reporting more than one sexual partner per month on average were found to have a significantly higher HPV prevalence (odds ratio 2.87, 95% confidence Interval 1.29-6.38), as were women who reported more frequent sex (test for trend, P = 0.006). Sexual behavior is associated with risk of human papillomavirus infection. The decrease of human papillomavirus prevalence in older women agrees with other studies that argue in favor of a biological effect, such as increased immunity to human papillomavirus with age. A better understanding of why immunity to human papillomavirus may develop in older women may provide the basis for developing an effective vaccine to prevent cancer of the cervix.

Human Papillomavirus Vaccination Among Young Men Who Have Sex With Men and Transgender Women in 2 US Cities, 2012-2014.

PubMed

Gorbach, Pamina M; Cook, Ryan; Gratzer, Beau; Collins, Thomas; Parrish, Adam; Moore, Janell; Kerndt, Peter R; Crosby, Richard A; Markowitz, Lauri E; Meites, Elissa

2017-07-01

Since 2011, in the United States, quadrivalent human papillomavirus (HPV) vaccine has been recommended for boys aged 11 to 12 years, men through age 21, and men who have sex with men (MSM) through age 26. We assessed HPV vaccination coverage and factors associated with vaccination among young MSM (YMSM) and transgender women (TGW) in 2 cities. During 2012-2014, 808 YMSM and TGW aged 18 to 26 years reported vaccination status in a self-administered computerized questionnaire at 3 sexually transmitted disease (STD) clinics in Los Angeles and Chicago. Associations with HPV vaccination were assessed using bivariate and multivariable models to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Few of the diverse participants (Hispanic/Latino, 38.0%; white, 27.0%; and black/African American, 17.9%) reported receiving 1 or more HPV vaccine doses (n = 111 [13.7%]) and even fewer reported 3 doses (n = 37 [4.6%]). A multivariable model found associations between vaccination and having a 4-year college degree or higher (aOR, 2.83; CI, 1.55-5.17) and self-reported STDs (aOR, 1.21; CI, 1.03-1.42). In a model including recommendation variables, the strongest predictor of vaccination was a health care provider recommendation (aOR, 11.85; CI, 6.70-20.98). Human papillomavirus vaccination coverage was low among YMSM and TGW in this 2-US city study. Our findings suggest further efforts are needed to reach YMSM seeking care in STD clinics, increase strong recommendations from health care providers, and integrate HPV vaccination with other clinical services such as STD testing.

Routine brief risk-reduction counseling with biannual STD testing reduces STD incidence among HIV-infected men who have sex with men in care.

PubMed

Patel, Pragna; Bush, Tim; Mayer, Kenneth; Milam, Joel; Richardson, Jean; Hammer, John; Henry, Keith; Overton, Turner; Conley, Lois; Marks, Gary; Brooks, John T

2012-06-01

We evaluated whether routine biannual sexually transmitted disease (STD) testing coupled with brief risk-reduction counseling reduces STD incidence and high-risk behaviors. The SUN study is a prospective observational HIV cohort study conducted in 4 US cities. At enrollment and every 6 months thereafter, participants completed a behavioral survey and were screened for STDs, and if diagnosed, were treated. Medical providers conducted brief risk-reduction counseling with all patients. Among men who have sex with men (MSM), we examined trends in STD incidence and rates of self-reported risk behaviors before and after exposure to the risk-reduction intervention. The "preintervention" visit was the study visit that was at least 6 months after enrollment STD screening and treatment and at which the participant was first exposed to the intervention. The "postintervention" visit was 12 months later. Among 216 MSM with complete STD and behavioral data, median age was 44.5 years; 77% were non-Hispanic white; 83% were on highly active antiretroviral treatment; 84% had an HIV RNA level <400 copies/mL and the median CD4 (cluster of differentiation 4) count was 511 cells/mm. Twelve months after first exposure to the risk-reduction intervention, STD incidence declined from 8.8% to 4.2% (P = 0.041). Rates of unprotected receptive or insertive anal intercourse with HIV-positive partners increased (19% to 25%, P = 0.024), but did not change with HIV-negative partners or partners of unknown HIV status (24% to 22%, P = 0.590). STD incidence declined significantly among HIV-infected MSM after implementing frequent, routine STD testing coupled with risk-reduction counseling. These findings support adoption of routine STD screening and risk-reduction counseling for HIV-infected MSM.

Investigation of the binding of a carbohydrate-mimetic peptide to its complementary anticarbohydrate antibody by STD-NMR spectroscopy and molecular-dynamics simulations.

PubMed

Szczepina, Monica G; Bleile, Dustin W; Pinto, B Mario

2011-10-04

Saturation transfer difference (STD)-NMR spectroscopy was used to probe experimentally the bioactive solution conformation of the carbohydrate mimic MDWNMHAA 1 of the O-polysaccharide of Shigella flexneri Y when bound to its complementary antibody, mAb SYA/J6. Molecular dynamics simulations using the ZymeCAD™ Molecular Dynamics platform were also undertaken to give a more accurate picture of the conformational flexibility and the possibilities for bound ligand conformations. The ligand topology, or the dynamic epitope, was mapped with the CORCEMA-ST (COmplete Relaxation and Conformational Exchange Matrix Analysis of Saturation Transfer) program that calculates a total matrix analysis of relaxation and exchange effects to generate predicted STD-NMR intensities from simulation. The comparison of these predicted STD enhancements with experimental data was used to select a representative binding mode. A protocol that employed theoretical STD effects calculated at snapshots during the entire course of a molecular dynamics (MD) trajectory of the peptide bound to the Fv portion of the antibody, and not the averaged atomic positions of receptor-ligand complexes, was also examined. In addition, the R factor was calculated on the basis of STD (fit) to avoid T1 bias, and an effective R factor, R(eff), was defined such that if the calculated STD (fit) for proton k was within error of the experimental STD (fit) for proton k, then that calculated STD (fit) for proton k was not included in the calculation of the R factor. This protocol was effective in deriving the antibody-bound solution conformation of the peptide which also differed from the bound conformation determined by X-ray crystallography; however, several discrepancies between experimental and calculated STD (fit) values were observed. The bound conformation was therefore further refined with a simulated annealing refinement protocol known as STD-NMR intensity-restrained CORCEMA optimization (SICO) to give a more accurate representation of the bound peptide epitope. Further optimization was required in this case, but a satisfactory correlation between experimental and calculated STD values was obtained. Attempts were also made to obtain STD enhancements with a synthetic pentasaccharide hapten, corresponding to the O-polysaccharide, while bound to the antibody. However, unfavorable kinetics of binding in this system prevented sufficient STD build-up, which, in turn, hindered a rigorous analysis via full STD build-up curves. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Sexually Transmitted Diseases in a specialized STD healthcare center: epidemiology and demographic profile from January 1999 to December 2009*

PubMed Central

Fagundes, Luiz Jorge; Vieira Junior, Elso Elias; Moysés, Ana Carolina Marteline Cavalcante; de Lima, Fernão Dias; de Morais, Fátima Regina Borges; Vizinho, Natalina Lima

2013-01-01

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

Studies of the Binding of Modest Modulators of the Human Enzyme, Sirtuin 6, by STD NMR.

PubMed

Bolívar, Beatriz E; Welch, John T

2017-05-18

Pyrazinamide (PZA), an essential constituent of short-course tuberculosis chemotherapy, binds weakly but selectively to Sirtuin 6 (SIRT6). Despite the structural similarities between nicotinamide (NAM), PZA, and pyrazinoic acid (POA), these inhibitors modulate SIRT6 by different mechanisms and through different binding sites, as suggested by saturation transfer difference (STD) NMR. Available experimental evidence, such as that derived from crystal structures and kinetic experiments, has been of only limited utility in elucidation of the mechanistic details of sirtuin inhibition by NAM or other inhibitors. For instance, crystallographic structural analysis of sirtuin binding sites does not help us understand important differences in binding affinities among sirtuins or capture details of such dynamic process. Hence, STD NMR was utilized throughout this study. Our results not only agreed with the binding kinetics experiments but also gave a qualitative insight into the binding process. The data presented herein suggested some details about the geometry of the binding epitopes of the ligands in solution with the apo- and holoenzyme. Recognition that SIRT6 is affected selectively by PZA, an established clinical agent, suggests that the rational development of more potent and selective NAM surrogates might be possible. These derivatives might be accessible by employing the malleability of this scaffold to assist in the identification by STD NMR of the motifs that interact with the apo- and holoenzymes in solution. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

Should family planning include STD services?

PubMed

Finger, W R

1994-05-01

Recent reviews suggest that the addition of programs aimed at preventing and controlling sexually transmitted diseases (STDs), specifically human immunodeficiency virus (HIV), to existing family planning programs does not necessarily dilute overall program effectiveness. In Colombia, Mexico, and Jamaica, where condom distribution and/or information to prevent HIV transmission was integrated into the activities of family planning field workers, no negative effect on the image of condoms as a pregnancy prevention method was observed and there was a great demand on the part of family planning clients for information about acquired immunodeficiency syndrome (AIDS). In Brazil, family planning staff are receiving training in HIV risk assessment and the counseling of women in partner negotiation skills. However, steps must be taken to reach men since it is their high-risk behavior that puts most women at risk of HIV. Both separate STD clinics for men and condom social marketing projects have yielded promising results. Obstacles to the addition of STD services to family planning programs include the need to treat male partners as well as female clients, a shortage of diagnostic tools and antibiotics for treatment, and the fact that the majority of women with STDs are asymptomatic. Indicative of the increased attention being given this approach, however, is the recent release of guidelines by the US Agency for International Development Office of Population on how family planning programs should approach integration. Suggested activities include condom promotion, behavior change, counseling, information, contraceptive development, and selected efforts at STD treatment.

Development of Engineering Design Education in the Department of Mechanical Engineering at Kanazawa Technical College

NASA Astrophysics Data System (ADS)

Yamada, Hirofumi; Ten-Nichi, Michio; Mathui, Hirosi; Nakamura, Akizi

This paper introduces a method of the engineering design education for college of technology mechanical engineering students. In order to teach the practical engineering design, the MIL-STD-499A process is adapted and improved upon for a Mechatronics hands-on lesson used as the MOT method. The educational results in five years indicate that knowledge of the engineering management is useful for college students in learning engineering design. Portfolio for lessons and the hypothesis method also have better effects on the understanding of the engineering specialty.

Childhood Sexual Abuse and Sexual Risk Behavior among Men and Women Attending a Sexually Transmitted Disease Clinic

ERIC Educational Resources Information Center

Senn, Theresa E.; Carey, Michael P.; Vanable, Peter A.; Coury-Doniger, Patricia; Urban, Marguerite A.

2006-01-01

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,…

23 CFR 635.114 - Award of contract and concurrence in award.

Code of Federal Regulations, 2014 CFR

2014-04-01

... STD in accordance with § 635.110. Award shall be within the time established by the STD and subject to the prior concurrence of the Division Administrator. (b) The STD shall formally request concurrence by.... (c) Following the opening of bids, the STD shall examine the unit bid prices of the apparent low bid...

23 CFR 710.603 - Direct Federal acquisition.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the STD to commence right-of-way acquisition, the date of the project agreement and a statement that... negotiations which have been conducted by the STD with landowners; (9) An agreement that the STD will pay its... required by State law any time before the FHWA makes a determination that the STD is unable to acquire the...

40 CFR 211.206-2 - Alternative test data.

Code of Federal Regulations, 2013 CFR

2013-07-01

... according to ANSI STD Z24.22-1957 or ANSI STD S3.19-1974 to determine the mean attenuation and standard... based on the ANSI STD Z24.22-1957 measurement procedure must state in the supporting information... are based on ANSI STD -Z24.22-1957. (b) Manufacturers who initially use available data based on ANSI...

40 CFR 211.206-2 - Alternative test data.

Code of Federal Regulations, 2014 CFR

2014-07-01

... according to ANSI STD Z24.22-1957 or ANSI STD S3.19-1974 to determine the mean attenuation and standard... based on the ANSI STD Z24.22-1957 measurement procedure must state in the supporting information... are based on ANSI STD -Z24.22-1957. (b) Manufacturers who initially use available data based on ANSI...

40 CFR 211.206-2 - Alternative test data.

Code of Federal Regulations, 2011 CFR

2011-07-01

... according to ANSI STD Z24.22-1957 or ANSI STD S3.19-1974 to determine the mean attenuation and standard... based on the ANSI STD Z24.22-1957 measurement procedure must state in the supporting information... are based on ANSI STD -Z24.22-1957. (b) Manufacturers who initially use available data based on ANSI...

23 CFR 635.114 - Award of contract and concurrence in award.

Code of Federal Regulations, 2013 CFR

2013-04-01

... STD in accordance with § 635.110. Award shall be within the time established by the STD and subject to the prior concurrence of the Division Administrator. (b) The STD shall formally request concurrence by.... (c) Following the opening of bids, the STD shall examine the unit bid prices of the apparent low bid...

23 CFR 635.114 - Award of contract and concurrence in award.

Code of Federal Regulations, 2011 CFR

2011-04-01

... STD in accordance with § 635.110. Award shall be within the time established by the STD and subject to the prior concurrence of the Division Administrator. (b) The STD shall formally request concurrence by.... (c) Following the opening of bids, the STD shall examine the unit bid prices of the apparent low bid...

40 CFR 211.206-2 - Alternative test data.

Code of Federal Regulations, 2012 CFR

2012-07-01

... according to ANSI STD Z24.22-1957 or ANSI STD S3.19-1974 to determine the mean attenuation and standard... based on the ANSI STD Z24.22-1957 measurement procedure must state in the supporting information... are based on ANSI STD -Z24.22-1957. (b) Manufacturers who initially use available data based on ANSI...

23 CFR 635.114 - Award of contract and concurrence in award.

Code of Federal Regulations, 2012 CFR

2012-04-01

... STD in accordance with § 635.110. Award shall be within the time established by the STD and subject to the prior concurrence of the Division Administrator. (b) The STD shall formally request concurrence by.... (c) Following the opening of bids, the STD shall examine the unit bid prices of the apparent low bid...

23 CFR 710.603 - Direct Federal acquisition.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the STD to commence right-of-way acquisition, the date of the project agreement and a statement that... negotiations which have been conducted by the STD with landowners; (9) An agreement that the STD will pay its... required by State law any time before the FHWA makes a determination that the STD is unable to acquire the...

23 CFR 710.603 - Direct Federal acquisition.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the STD to commence right-of-way acquisition, the date of the project agreement and a statement that... negotiations which have been conducted by the STD with landowners; (9) An agreement that the STD will pay its... required by State law any time before the FHWA makes a determination that the STD is unable to acquire the...

Partner notification of sexually transmitted diseases: practices and preferences.

PubMed

Gursahaney, Priya R; Jeong, Kwonho; Dixon, Bruce W; Wiesenfeld, Harold C

2011-09-01

Timely notification and treatment of sex partners exposed to a sexually transmitted disease (STD) is essential to reduce reinfection and transmission. Our objectives were to determine factors associated with patient-initiated notification of sex partners and preferences regarding standard partner referral versus expedited partner therapy (EPT). Participants diagnosed with gonorrhea, chlamydia, trichomoniasis, or nongonococcal urethritis within the previous year were administered a baseline survey asking about demographics, sexual history, and partner treatment preferences (standard partner referral vs. EPT). They identified up to 4 sex partners within the past 2 months, and answered questions on relationship characteristics, quality, and notification self-efficacy. At follow-up, participants with a current STD were asked whether they notified their partners. Generalized estimating equations were used to evaluate the associations between predictor variables and partner notification. Of the 201 subjects enrolled, 157 had a current STD diagnosis, and 289 sex partners were identified. The rate of successful partner notification was 77.3% (157/203 sex partners). Partner notification was increased if the subject had a long-term relationship with a sex partner (odds ratio: 3.07; 95% confidence interval: 1.43, 6.58), considered the partner to be a main partner (odds ratio: 2.53; 95% confidence interval: 1.43, 6.58), or had increased notification self-efficacy. Overall, participants did not prefer EPT over standard referral; however, females, those with higher education levels, and those with a prior STD preferred EPT. Patient-initiated partner referral is more successful in patients with increased self-efficacy who have stronger interpersonal relationships with their sex partners.

A comparison between audio computer-assisted self-interviews and clinician interviews for obtaining the sexual history.

PubMed

Kurth, Ann E; Martin, Diane P; Golden, Matthew R; Weiss, Noel S; Heagerty, Patrick J; Spielberg, Freya; Handsfield, H Hunter; Holmes, King K

2004-12-01

The objective of this study was to compare reporting between audio computer-assisted self-interview (ACASI) and clinician-administered sexual histories. The goal of this study was to explore the usefulness of ACASI in sexually transmitted disease (STD) clinics. The authors conducted a cross-sectional study of ACASI followed by a clinician history (CH) among 609 patients (52% male, 59% white) in an urban, public STD clinic. We assessed completeness of data, item prevalence, and report concordance for sexual history and patient characteristic variables classified as socially neutral (n=5), sensitive (n=11), or rewarded (n=4). Women more often reported by ACASI than during CH same-sex behavior (19.6% vs. 11.5%), oral sex (67.3% vs. 50.0%), transactional sex (20.7% vs. 9.8%), and amphetamine use (4.9% vs. 0.7%) but were less likely to report STD symptoms (55.4% vs. 63.7%; all McNemar chi-squared P values <0.003). Men's reporting was similar between interviews, except for ever having had sex with another man (36.9% ACASI vs. 28.7% CH, P <0.001). Reporting agreement as measured by kappas and intraclass correlation coefficients was only moderate for socially sensitive and rewarded variables but was substantial or almost perfect for socially neutral variables. ACASI data tended to be more complete. ACASI was acceptable to 89% of participants. ACASI sexual histories may help to identify persons at risk for STDs.

History of Childhood Abuse, Drinking Motives, Alcohol Use, and Sexual Risk Behavior among STD clinic patients in St. Petersburg, Russia: a cross-sectional study

PubMed Central

Abdala, Nadia; Li, Fangyong; Shaboltas, Alla V.; Skochilov, Roman V.; Krasnoselskikh, Tatiana V.

2015-01-01

The relationship between level of childhood abuse (physical and emotional) and sexual risk behavior of sexually transmitted disease (STD) clinic patients in St. Petersburg, Russia was examined through path analyses. Mediating variables investigated were: Alcohol Use Disorder Identification Test (AUDIT), drinking motives (for social interaction, to enhance mood, to facilitate sexual encounters), intimate partner violence (IPV), anxiety, and depression symptoms. Results showed a significant indirect effect of childhood abuse on women’s sexual risk behavior: higher level of childhood abuse was associated with a greater likelihood of IPV, motivations to drink, leading to higher AUDIT scores and correlated to higher likelihood of having multiple, new or casual sexual partner(s). No significant effect was identified in paths to condom use. Among men, childhood abuse had no significant effect on sexual risk behavior. Reduction in alcohol-related sexual risk behavior may be achieved by addressing the effects of childhood abuse among female participants. PMID:25801476

STD Clinic Patients' Awareness of Non-AIDS Complications of HIV Infection.

PubMed

Castro, José Guillermo; Granovsky, Inna; Jones, Deborah; Weiss, Stephen M

2015-01-01

Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered before and after a brief information session on non-AIDS conditions associated with HIV infection. Participants included men (n = 46) and women (n = 51). Prior to the information session, at baseline, only 34% of the participants were worried about HIV infection. Most participants (82%) agreed that HIV could be treated with antiretroviral therapy (ART), while only 38% were aware that HIV-associated conditions cannot be easily treated with ART. After the information session, almost all participants reported they were concerned regarding the risk of HIV infection. High-risk patients may have limited knowledge about the consequences of HIV infection beyond the traditional AIDS-associated conditions. Increased awareness of these less known consequences of HIV infection may decrease the potential for complacency regarding acquiring HIV infection. © The Author(s) 2014.

STD Clinic Patients' Awareness of Non-AIDS Complications of HIV Infection

PubMed Central

Castro, José Guillermo; Granovsky, Inna; Jones, Deborah; Weiss, Stephen M.

2016-01-01

Participants were recruited from a sexually transmitted disease (STD) clinic in Florida and were assessed regarding the knowledge and awareness of non-AIDS conditions associated with HIV infection. Questionnaires were administered before and after a brief information session on non-AIDS conditions associated with HIV infection. Participants included men (n = 46) and women (n = 51). Prior to the information session, at baseline, only 34% of the participants were worried about HIV infection. Most participants (82%) agreed that HIV could be treated with antiretroviral therapy (ART), while only 38% were aware that HIV-associated conditions cannot be easily treated with ART. After the information session, almost all participants reported they were concerned regarding the risk of HIV infection. High-risk patients may have limited knowledge about the consequences of HIV infection beyond the traditional AIDS-associated conditions. Increased awareness of these less known consequences of HIV infection may decrease the potential for complacency regarding acquiring HIV infection. PMID:25331221

Quantitative analysis of rectal cancer by spectral domain optical coherence tomography

NASA Astrophysics Data System (ADS)

Zhang, Q. Q.; Wu, X. J.; Tang, T.; Zhu, S. W.; Yao, Q.; Gao, Bruce Z.; Yuan, X. C.

2012-08-01

To quantify OCT images of rectal tissue for clinic diagnosis, the scattering coefficient of the tissue is extracted by curve fitting the OCT signals to a confocal single model. A total of 1000 measurements (half and half of normal and malignant tissues) were obtained from 16 recta. The normal rectal tissue has a larger scattering coefficient ranging from 1.09 to 5.41 mm-1 with a mean value of 2.29 mm-1 (std:±0.32), while the malignant group shows lower scattering property and the values ranging from 0.25 to 2.69 mm-1 with a mean value of 1.41 mm-1 (std:±0.18). The peri-cancer of recta has also been investigated to distinguish the difference between normal and malignant rectal tissue. The results demonstrate that the quantitative analysis of the rectal tissue can be used as a promising diagnostic criterion of early rectal cancer, which has great value for clinical medical applications.

Integrating Existing Material Into Educational Television Programming. Satellite Technology Demonstration, Technical Report No. 0502.

ERIC Educational Resources Information Center

Beard, Karen L.; Lonsdale, Helen C.

The Satellite Technology Demonstration (STD) produced a series of 81 television programs called the "J-series" for junior high school students. This material was used to illustrate real life situations for a career development program. Because materials were expensive, the decision was made to produce "in-house" programs and…

Sexually Transmitted Disease Services at US Colleges and Universities

ERIC Educational Resources Information Center

Koumans, Emilia H.; Sternberg, Maya R.; Motamed, Cathy; Kohl, Katrin; Schillinger, Julia A.; Markowitz, Lauri E.

2005-01-01

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…

Risk factors for human papillomavirus infection among women in Portugal: the CLEOPATRE Portugal Study.

PubMed

Pista, Angela; de Oliveira, Carlos F; Cunha, Maria J; Paixao, Maria T; Real, Odete

2012-08-01

To investigate demographic, socioeconomic, lifestyle, and medical factors that might predispose women to cervical human papillomavirus (HPV) infection. A cross-sectional population-based study was performed. Women aged 18-64 years who attended selected obstetrics and gynecology or sexually transmitted disease (STD) clinics in mainland Portugal between February 2008 and March 2009 were recruited, according to an age-stratified sampling strategy. Liquid-based cytology samples were analyzed centrally for HPV genotype and for cytologic features. Univariate and multivariate logistic regression analyses identified risk factors for HPV infection. Among the 2326 women evaluated, the crude prevalence of HPV infection was 19.4%. Lifetime number of sexual partners was a strong predictor of HPV infection (odds ratio 5.44 for 5-10 partners versus 1 partner; P<0.001). Other risk factors were young age (particularly among women aged 20-24 years; P<0.001); country of birth other than mainland Portugal (P=0.002); education up to secondary school level (P=0.010); smoking history (≤ 10 years; P=0.004); and any STD in the past 12 months (P=0.052). Data from the present study may aid identification of women at increased risk of HPV infection and target prevention strategies. National Commission of Data Protection (CNPD) registration number 5346/2007; Sanofi Pasteur MSD study number HPV-E05. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Public stigma against family members of people with mental illness: findings from the Gilgel Gibe Field Research Center (GGFRC), Southwest Ethiopia.

PubMed

Girma, Eshetu; Möller-Leimkühler, Anne Maria; Müller, Norbert; Dehning, Sandra; Froeschl, Guenter; Tesfaye, Markos

2014-02-21

Public stigma against family members of people with mental illness is a negative attitude by the public which blame family members for the mental illness of their relatives. Family stigma can result in self social restrictions, delay in treatment seeking and poor quality of life. This study aimed at investigating the degree and correlates of family stigma. A quantitative cross-sectional house to house survey was conducted among 845 randomly selected urban and rural community members in the Gilgel Gibe Field Research Center, Southwest Ethiopia. An interviewer administered and pre-tested questionnaire adapted from other studies was used to measure the degree of family stigma and to determine its correlates. Data entry was done by using EPI-DATA and the analysis was performed using STATA software. Unadjusted and adjusted linear regression analysis was done to identify the correlates of family stigma. Among the total 845 respondents, 81.18% were female. On a range of 1 to 5 score, the mean family stigma score was 2.16 (± 0.49). In a multivariate analysis, rural residents had significantly higher stigma scores (std. β = 0.43, P < 0.001) than urban residents. As the number of perceived signs (std. β = -0.07, P < 0.05), perceived supernatural (std. β = -0.12, P < 0.01) and psychosocial and biological (std. β = -0.11, P < 0.01) explanations of mental illness increased, the stigma scores decreased significantly. High supernatural explanation of mental illness was significantly correlated with lower stigma among individuals with lower level of exposure to people with mental illness (PWMI). On the other hand, high exposure to PWMI was significantly associated with lower stigma among respondents who had high education. Stigma scores increased with increasing income among respondents who had lower educational status. Our findings revealed moderate level of family stigma. Place of residence, perceived signs and explanations of mental illness were independent correlates of public stigma against family members of people with mental illness. Therefore, mental health communication programs to inform explanations and signs of mental illness need to be implemented.

The Importance of School Staff Referrals and Follow-Up in Connecting High School Students to HIV and STD Testing

ERIC Educational Resources Information Center

Rasberry, Catherine N.; Liddon, Nicole; Adkins, Susan Hocevar; Lesesne, Catherine A.; Hebert, Andrew; Kroupa, Elizabeth; Rose, India D.; Morris, Elana

2017-01-01

This study examined predictors of having received HIV and sexually transmitted disease (STD) testing and having been referred by school staff for HIV/STD testing. In 2014, students in seven high schools completed paper-and-pencil questionnaires assessing demographic characteristics, sexual behavior, referrals for HIV/STD testing, and HIV/STD…

Predicting HIV/STD risk level and substance use disorders among incarcerated adolescents.

PubMed

Rowe, Cynthia L; Wang, Wei; Greenbaum, Paul; Liddle, Howard A

2008-12-01

Incarcerated adolescents are among the most vulnerable groups for STD infection, and substance abuse is prevalent in over half of this population. Substance abuse and HIV/STD-associated risk behaviors are closely linked among juvenile justice-involved youth, but it is unclear whether common antecedents explain these different problems. The current study examined predictors of HIV/STD risk level and substance use disorders, and investigated whether family variables added unique predictive variance for these problems among incarcerated youth. The sample included 154 substance-involved youth ages 13 to 17 recruited in detention facilities in Miami and Tampa, FL and was primarily male (82%) and African-American (58%). Using a comprehensive assessment strategy with data obtained from youth report, parent report, and laboratory confirmed STD testing, the results show that delinquency is a consistent predictor of both HIV/STD risk level and substance use disorders, and also that substance use directly predicts HIV/STD risk level among incarcerated adolescents. Consistent with previous research, family conflict is an important predictor of substance use disorders even after controlling for other factors. The results suggest the need for integrated family-based interventions addressing delinquency, substance abuse, and HIV/STD-associated risk factors with juvenile justice-involved adolescents.

Estimating the Size and Cost of the STD Prevention Services Safety Net.

PubMed

Gift, Thomas L; Haderxhanaj, Laura T; Torrone, Elizabeth A; Behl, Ajay S; Romaguera, Raul A; Leichliter, Jami S

2015-01-01

The Patient Protection and Affordable Care Act is expected to reduce the number of uninsured people in the United States during the next eight years, but more than 10% are expected to remain uninsured. Uninsured people are one of the main populations using publicly funded safety net sexually transmitted disease (STD) prevention services. Estimating the proportion of the uninsured population expected to need STD services could help identify the potential demand for safety net STD services and improve program planning. In 2013, an estimated 8.27 million people met the criteria for being in need of STD services. In 2023, 4.70 million uninsured people are expected to meet the criteria for being in need of STD services. As an example, the cost in 2014 U.S. dollars of providing chlamydia screening to these people was an estimated $271.1 million in 2013 and is estimated to be $153.8 million in 2023. A substantial need will continue to exist for safety net STD prevention services in coming years.

Estimating the Size and Cost of the STD Prevention Services Safety Net

PubMed Central

Haderxhanaj, Laura T.; Torrone, Elizabeth A.; Behl, Ajay S.; Romaguera, Raul A.; Leichliter, Jami S.

2015-01-01

The Patient Protection and Affordable Care Act is expected to reduce the number of uninsured people in the United States during the next eight years, but more than 10% are expected to remain uninsured. Uninsured people are one of the main populations using publicly funded safety net sexually transmitted disease (STD) prevention services. Estimating the proportion of the uninsured population expected to need STD services could help identify the potential demand for safety net STD services and improve program planning. In 2013, an estimated 8.27 million people met the criteria for being in need of STD services. In 2023, 4.70 million uninsured people are expected to meet the criteria for being in need of STD services. As an example, the cost in 2014 U.S. dollars of providing chlamydia screening to these people was an estimated $271.1 million in 2013 and is estimated to be $153.8 million in 2023. A substantial need will continue to exist for safety net STD prevention services in coming years. PMID:26556931

75 FR 13550 - Office of Clinical and Preventive Services: National HIV Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-22

... (CDC) guidelines, and pre- and post-test counseling (when appropriate). Purpose These cooperative... tests with sexually transmitted diseases (STD) screening. II. Award Information Type of Awards... existing public health statutes. Test at least one previously-untested (not tested in the prior five years...

Albania: STDs and youth culture.

PubMed

Legins, K; Saraci, O

1999-01-01

The exposure of Albania to the popular culture of the modern world has paved the way for the emergence of STDs that were practically unknown some 20 years ago. Ever since the first cases of HIV and syphilis were diagnosed in 1994 and 1995, respectively, physicians have had difficulty in assessing patients due to their lack of knowledge of STDs. Together with emerging health concerns, traditional stereotypes of individuals with STDs have also surfaced in Albania; these usually associate STDs with prostitutes and refugees. Lack of STD knowledge, lack of anonymity in health care centers, current myths about STD transmission, and the return of Albanian refugees are among the challenges which Albanian youth have to overcome. In response to this, the UNFPA (United Nations Population Fund), WHO and the Academy for Educational Development are launching a project that will educate Albanians about the risks of STDs and HIV, in addition to its maternal health projects. A recent information, education, and communication (IEC) roundtable participated in by over a hundred Albanian professionals has discussed problems and priorities that will facilitate a national IEC strategy. STDs, HIV, AIDS, maternal mortality, unwanted pregnancy, and abortion are the problems of greatest concern. The roundtable identified young people, women and service providers in rural areas as target groups with the greatest need of IEC interventions.

Developing a Motion Comic for HIV/STD Prevention for Young People Ages 15-24, Part 2: Evaluation of a Pilot Intervention.

PubMed

Willis, Leigh A; Kachur, Rachel; Castellanos, Ted J; Nichols, Kristen; Mendoza, Maria C B; Gaul, Zaneta J; Spikes, Pilgrim; Gamayo, Ashley C; Durham, Marcus D; LaPlace, Lisa; Straw, Julie; Staatz, Colleen; Buge, Hadiza; Hogben, Matthew; Robinson, Susan; Brooks, John; Sutton, Madeline Y

2018-03-01

In the United States, young people (ages 15-24 years) are disproportionately affected by human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), due at least in part to inadequate or incorrect HIV/STD-related knowledge, attitudes, beliefs, and behavioral intentions (KABI). Comic book narratives are a proven method of HIV/STD prevention communication to strengthen KABI for HIV/STD prevention. Motion comics, a new type of comic media, are an engaging and low-cost means of narrative storytelling. The objective of this study was to quantitatively evaluate the effectiveness of a pilot six-episode HIV/STD-focused motion comic series to improve HIV/STD-related KABI among young people. We assessed change in HIV/STD knowledge, HIV stigma, condom attitudes, HIV/STD testing attitudes, and behavioral intentions among 138 participants in 15 focus groups immediately before and after viewing the motion comic series. We used paired t-tests and indicators of overall improvement to assess differences between surveys. We found a significant decrease in HIV stigma (p < .001) and increases in both HIV knowledge (p = .002) and behavioral intentions to engage in safe sex (p < .001). In summary, this motion comic intervention improved HIV/STD-related KABI of young adult viewers by reducing HIV stigma and increasing behavioral intentions to engage in safer sex. Our results demonstrate the promise of this novel intervention and support its use to deliver health messages to young people.

Associations of a Sexually Transmitted Disease Diagnosis During a Relationship with Condom Use and Psychosocial Outcomes: (Short) Windows of Opportunity

PubMed Central

Magriples, Urania; Niccolai, Linda M.; Gordon, Derrick M.; Divney, Anna A.; Kershaw, Trace S.

2013-01-01

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

Antimicrobial resistant gonorrhea in Atlanta: 1988-2006.

PubMed

Dionne-Odom, Jodie; Tambe, Pradnya; Yee, Eileen; Weinstock, Hillard; del Rio, Carlos

2011-08-01

Gonococcal isolates (n = 4336) were collected from men with urethritis at the Fulton County STD Clinic between 1988 and 2006. Antimicrobial susceptibility was performed by agar dilution. Increasing numbers of isolates from men who have sex with men and with fluoroquinolone resistance were noted. New antimicrobials effective against gonorrhea are urgently needed.

Antimicrobial Resistant Gonorrhea in Atlanta: 1988 – 2006

PubMed Central

Dionne-Odom, Jodie; Tambe, Pradnya; Yee, Eileen; Weinstock, Hillard; del Rio, Carlos

2011-01-01

Gonococcal isolates (n = 4336) were collected from men with urethritis at the Fulton County STD Clinic from 1988 – 2006. Antimicrobial susceptibility was performed by agar dilution. Increasing numbers of isolates from MSM and with fluoroquinolone resistance were noted. New antimicrobials effective against gonorrhea are urgently needed. PMID:21844728

What College Students Want To Learn about Contraception/STD: Marketing Your Services.

ERIC Educational Resources Information Center

Griffith, Jeanne A.; Kile, Marilyn J.

This paper describes a health education program developed by Planned Parenthood of Wisconsin for students at a university health center. Three goals of the program, which was targeted at 2,000 incoming first-year students, are listed: (1) to increase student awareness of existing services related to contraception and prevention/treatment of…

Feasibility and Acceptability of a Web-Based HIV/STD Prevention Program for Adolescent Girls Targeting Sexual Communication Skills

ERIC Educational Resources Information Center

Widman, L.; Golin, C. E.; Kamke, K.; Massey, J.; Prinstein, M. J.

2017-01-01

Adolescent girls are at substantial risk of sexually transmitted diseases including HIV. To reduce these risks, we developed Health Education And Relationship Training (HEART), a web-based intervention focused on developing sexual assertiveness skills and enhancing sexual decision-making. This study assessed the feasibility and acceptability of…

23 CFR 710.501 - Early acquisition.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., requires the STD to demonstrate that: (1) Prior to acquisition, the STD made the certifications and determinations required by 23 U.S.C. 108(c)(2)(C) and (D); and (2) The STD obtained concurrence from the...

23 CFR 710.501 - Early acquisition.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., requires the STD to demonstrate that: (1) Prior to acquisition, the STD made the certifications and determinations required by 23 U.S.C. 108(c)(2)(C) and (D); and (2) The STD obtained concurrence from the...

Sexual Risk Behavior: HIV, STD, & Teen Pregnancy Prevention

MedlinePlus

... Connect Sexual Health STD Teen Pregnancy Sexual Risk Behaviors: HIV, STD, & Teen Pregnancy Prevention Recommend on Facebook ... No Fear Act OIG 1600 Clifton Road Atlanta , GA 30329-4027 USA 800-CDC-INFO (800-232- ...

Differential Epitope Mapping by STD NMR Spectroscopy To Reveal the Nature of Protein-Ligand Contacts.

PubMed

Monaco, Serena; Tailford, Louise E; Juge, Nathalie; Angulo, Jesus

2017-11-27

Saturation transfer difference (STD) NMR spectroscopy is extensively used to obtain epitope maps of ligands binding to protein receptors, thereby revealing structural details of the interaction, which is key to direct lead optimization efforts in drug discovery. However, it does not give information about the nature of the amino acids surrounding the ligand in the binding pocket. Herein, we report the development of the novel method differential epitope mapping by STD NMR (DEEP-STD NMR) for identifying the type of protein residues contacting the ligand. The method produces differential epitope maps through 1) differential frequency STD NMR and/or 2) differential solvent (D 2 O/H 2 O) STD NMR experiments. The two approaches provide different complementary information on the binding pocket. We demonstrate that DEEP-STD NMR can be used to readily obtain pharmacophore information on the protein. Furthermore, if the 3D structure of the protein is known, this information also helps in orienting the ligand in the binding pocket. © 2017 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA.

NASA-STD-3001, Space Flight Human-System Standard and the Human Integration Design Handbook

NASA Technical Reports Server (NTRS)

Whitmore, Mihriban; Boyer, Jennifer; Holubec, Keith

2012-01-01

NASA-STD-3001 Space Flight Human-System Standard Volume 1, Crew Health, Volume 2, Human Factors, Habitability and Environmental Health, and the Human Integration Design Handbook (HIDH) have replaced the Man-Systems Integration Standards (MSIS), NASA-STD-3000. For decades, NASA-STD-3000 was a significant contribution to human spaceflight programs and to human-systems integration. However, with research program and project results being realized, advances in technology, and the availability of new information in a variety of topic areas, the time had arrived to update this extensive suite of standards and design information. NASA-STD-3001, Volume 2 contains the Agency level standards from the human and environmental factors disciplines that ensure human spaceflight operations are performed safely, efficiently, and effectively. The HIDH is organized in the same sequence and serves as the companion document to NASA-STD-3001, Volume 2, providing a compendium of human spaceflight history and knowledge. The HIDH is intended to aid interpretation of NASA-STD-3001, Volume 2 standards and to provide guidance for requirement writers and vehicle and habitat designers. Keywords Human Factors, Standards, Environmental Factors, NASA

Employing a teen advisory board to adapt an evidence-based HIV/STD intervention for incarcerated African-American adolescent women.

PubMed

Latham, Teaniese P; Sales, Jessica M; Renfro, Tiffaney L; Boyce, Lorin S; Rose, Eve; Murray, Colleen C; Wingood, Gina M; DiClemente, Ralph J

2012-10-01

This manuscript assesses priorities and challenges of adolescent females by conducting a meeting with teen advisory board (TAB) members to collect information regarding their lives and experiences pre-, during and post-incarceration in a juvenile detention facility. Multiple themes emerged regarding the impact of incarceration on young African-American females, including experiencing a loss of personal liberties, the importance of making money upon release, unfaithfulness by partners on the 'outside', substance use and lack of control over their environment upon release, including parents, peers and male sexual partners. Based on feedback from TAB members, unique barriers and challenges were identified that suggested areas where adaptations to an evidenced-based HIV/sexually transmitted disease (STD) intervention would be justified to more adequately meet the needs of this particular subgroup of young African-American women. Adaptations to the evidence-based interventions included enhancing activities related to goal setting, emotion regulation skills, decision-making, recognizing and utilizing support networks and addressing the relationship between substance use and risky sexual behavior. Future health education efforts focusing on either the creation of new HIV/STD interventions or adaptations to existing interventions should consider utilizing advisory boards with members of the priority population at the earliest stages of intervention planning.

Pelvic inflammatory disease: a clinical syndrome with social causes.

PubMed

Brabin, L; Raleigh, V S; Dumella, S

1992-08-01

Prevalence of pelvic inflammatory disease (PID) reflects community and individual risk factors. Cultural and behavioural factors influence community prevalence of sexually transmitted disease (STD), illegal abortion, puerperal sepsis and contraceptive usage--all of which influence risk of PID. The relative importance of these factors will vary by region. Individual risk factors for the ascent of a lower genital tract infection are still poorly understood but are thought to be behavioural and immunological. Prevention of PID must be undertaken at several levels. At primary level, it requires a reduction in community risk. At secondary level, individual risk can be modified by ensuring diagnosis and treatment of STD before damage of the upper genital tract occurs. More attention to cultural factors should increase the potential for prevention at both levels.

Accuracy of lesion boundary tracking in navigated breast tumor excision

NASA Astrophysics Data System (ADS)

Heffernan, Emily; Ungi, Tamas; Vaughan, Thomas; Pezeshki, Padina; Lasso, Andras; Gauvin, Gabrielle; Rudan, John; Engel, C. Jay; Morin, Evelyn; Fichtinger, Gabor

2016-03-01

PURPOSE: An electromagnetic navigation system for tumor excision in breast conserving surgery has recently been developed. Preoperatively, a hooked needle is positioned in the tumor and the tumor boundaries are defined in the needle coordinate system. The needle is tracked electromagnetically throughout the procedure to localize the tumor. However, the needle may move and the tissue may deform, leading to errors in maintaining a correct excision boundary. It is imperative to quantify these errors so the surgeon can choose an appropriate resection margin. METHODS: A commercial breast biopsy phantom with several inclusions was used. Location and shape of a lesion before and after mechanical deformation were determined using 3D ultrasound volumes. Tumor location and shape were estimated from initial contours and tracking data. The difference in estimated and actual location and shape of the lesion after deformation was quantified using the Hausdorff distance. Data collection and analysis were done using our 3D Slicer software application and PLUS toolkit. RESULTS: The deformation of the breast resulted in 3.72 mm (STD 0.67 mm) average boundary displacement for an isoelastic lesion and 3.88 mm (STD 0.43 mm) for a hyperelastic lesion. The difference between the actual and estimated tracked tumor boundary was 0.88 mm (STD 0.20 mm) for the isoelastic and 1.78 mm (STD 0.18 mm) for the hyperelastic lesion. CONCLUSION: The average lesion boundary tracking error was below 2mm, which is clinically acceptable. We suspect that stiffness of the phantom tissue affected the error measurements. Results will be validated in patient studies.

Distribution of sexually transmitted diseases and risk factors by work locations among female sex workers in Tijuana, Mexico.

PubMed

Rusch, Melanie L A; Brouwer, Kimberly C; Lozada, Remedios; Strathdee, Steffanie A; Magis-Rodríguez, Carlos; Patterson, Thomas L

2010-10-01

Sex work is regulated in the Zona Roja (red light district) in Tijuana, Mexico, where HIV and sexually transmitted disease (STD) prevalence is high among female sex workers (FSWs). We examined the spatial distribution of STDs by work venue among FSWs in Tijuana. FSWs aged 18 years and older who reported unprotected sex with ≥ 1 client in the past 2 months underwent testing for HIV, syphilis, gonorrhea, and Chlamydia. HIV/STDs were mapped by venue (i.e., bar, hotel) and Getis-Ord Gi statistics were used to identify geographic hotspots. High-risk venues were then identified using a standardized STD ratio (high risk defined as a ratio ≥ 1.25). Logistic regression was used to assess correlates of working at a high risk venue. Of 474 FSWs, 176 (36.4%) had at least 1 bacterial sexually transmitted infection (STI); 36 (7.6%) were HIV-positive. Within the Zona Roja, 1 venue was identified as a geographic "hotspot," with a higher than expected number of HIV/STD-positive FSW (P < 0.05) as compared to neighboring venues. Using the STD ratio definition, 11 venues were identified as high-risk; FSWs working in these locations had higher education, were more likely to report always using drugs with sex, and having mostly US clients. They were less likely to be registered FSWs or to live at their work venue. A relatively few number of sex work venues accounted for a large proportion of the HIV/STI burden among FSWs in Tijuana. Structural interventions that focus on sex work venues could help increase STI diagnosis, prevention, and treatment among FSWs in Tijuana.

The cost-effectiveness of treating male trichomoniasis to avert HIV transmission in men seeking sexually transmitted disease care in Malawi.

PubMed

Price, Matthew A; Stewart, Scott R; Miller, William C; Behets, Frieda; Dow, William H; Martinson, Francis E A; Chilongozi, David; Cohen, Myron S

2006-10-01

Allocation of funds to program areas where they may have an impact is critical to the success of any HIV control program. We examined the cost-effectiveness of providing first-line treatment for male trichomoniasis in Malawi, a condition not commonly considered in syndromic management throughout sub-Saharan Africa. We used decision tree analysis to assess program costs and outcomes among a 1-year population of male sexually transmitted disease (STD) clinic attendees estimated at 10,000 in Lilongwe. Our main outcomes were program costs from the government perspective and HIV infections averted. We conducted univariate and multivariate sensitivity analyses on selected parameters. In our study population of male STD clinic attendees with an HIV prevalence of 44% and a Trichomonas vaginalis prevalence of 20%, including universal metronidazole as a first-line treatment for trichomoniasis at $0.05 per dose would increase program costs by $277 (year 2000 US dollars) and avert 23 cases of HIV. The incremental cost-effectiveness ratio (ICER) over the current STD management guidelines was $15.42 per case of HIV averted. The number of HIV infections averted under sensitivity analysis ranged from 2 to 52, with attendant ICERs varying from cost savings to $162.92. Consideration of wider social benefits, such as the costs of HIV infections to the individual or the government, would further enhance the cost-effectiveness of this program. As part of a larger program to control STDs, incorporating metronidazole to treat male trichomoniasis could represent a cost-effective means to reduce HIV transmission in this high-risk group.

Sex education in schools in Denmark. Does Foreningen for Familieplanlaegning (the Danish PPA) have a role to play?

PubMed

Risor, H

1991-05-01

The Danish Foreningen for Familieplanlaegning (FF), planned parenthood, has a role to play as a watchdog for human sexuality education in schools and teacher training and development of educational material. Sex education has been in the school system since the 1900's, but in 1970 it was made compulsory. Sex education must be integrated in all subjects, and teacher or student may introduce a sex topic/question at any time. Minimum requirements are information on contraceptives and STD's. In 1970, the Curriculum Committee provided Guidelines for Sex Education in Public Schools which stated the following limitations for teachers: no vulgar terminology, no pupil counseling, no information on sexual intercourse techniques, and no erotic photographic material. In 1986, the Committee on Health and Sex Education was formed to work out subject and guide materials; these curriculum guidelines will be available in August 1991. FF was invited only to address the committee, at which time it was advised that teachers not lump health and sex together, and that specific issues such as sex anatomy, contraception, STD's, AIDs, and abortion be addressed as well as the rights of saying no, first sexual experiences, emotions and feelings, and being in love. After some insistence and negotiation, the final draft included more on sex education. The FF Education Committee plans to hold a 3-day training course for teachers at teacher training colleges in the Fall, 1991. One of the first tasks of the Sex Education Committee was to form a workshop with representatives from 10 schools. Their conclusions were that 1) the class teacher be responsible for sex education, 2) cross professional collaboration needs to be implemented with, for example, guest speakers who are homosexuals, prostitutes, AID's related persons. 3) Parents must be given information and sought out for advice. 4) The limitations in the 1970 Guidelines need to be cancelled. 5) Teacher training must be expanded and improved.

President Rawlings stays silent despite OAU challenge -- an "absence of interest"?

PubMed

Dodd, R

1995-12-01

Ghana's response to AIDS lacks high-level political commitment. This complacency is dangerous. Since 1986 about 16,000 AIDS cases in Ghana have been reported. HIV infection affects about 4% of the adult population; 2-4% of women at prenatal clinics and 6-8% of sexually transmitted disease (STD) patients are infected. Ghana's annual economic growth of 5% induces rural-urban migration and the spread of prostitution. The National Technical Committee on AIDS was formed in 1985, and the first plan of action ran from 1989 to 1993. It covered information, education, and communication, safety of blood supply, and training for health workers in AIDS care. A 1993 survey showed that 90-95% of people know that AIDS is an STD, but only 20% had ever used condoms. The National AIDS Program (NAP) experienced delay in getting its second medium-term plan finalized once the first plan expired in 1993. About 80% of NAP is financed by external donors, and similarly, a greater part of Ghana's health budget is financed externally. International financial institutions have put pressure on Ghana to boost its economic performance as a favorite model. This also means that while the government focuses on economic growth, social sectors are less well-cared for. NAP developed an AIDS impact model to try to get more government help, but without much success. The ministries of education and agriculture carry out some AIDS work, but other activities remain minimal. The minister of health has instituted an annual AIDS awareness month and exempted AIDS patients from paying hospital fees. The AIDS awareness month is each November just prior to World AIDS Day. Despite the availability of donor money, the existing infrastructure cannot absorb it. The main indicator of progress about AIDS is the increased openness about sexual issues. Religious leaders have been silently supportive of condom promotion, and its use is increasing.

23 CFR 710.401 - General.

Code of Federal Regulations, 2013 CFR

2013-04-01

... acquired property along the Interstate, the STD shall secure an approval from the FHWA for such change or use. The STD shall specify in the State's ROW operations manual, procedures for the rental, leasing... procedures if approved for use by the STD. ...

23 CFR 710.401 - General.

Code of Federal Regulations, 2014 CFR

2014-04-01

... acquired property along the Interstate, the STD shall secure an approval from the FHWA for such change or use. The STD shall specify in the State's ROW operations manual, procedures for the rental, leasing... procedures if approved for use by the STD. ...

Ligand-receptor binding affinities from saturation transfer difference (STD) NMR spectroscopy: the binding isotherm of STD initial growth rates.

PubMed

Angulo, Jesús; Enríquez-Navas, Pedro M; Nieto, Pedro M

2010-07-12

The direct evaluation of dissociation constants (K(D)) from the variation of saturation transfer difference (STD) NMR spectroscopy values with the receptor-ligand ratio is not feasible due to the complex dependence of STD intensities on the spectral properties of the observed signals. Indirect evaluation, by competition experiments, allows the determination of K(D), as long as a ligand of known affinity is available for the protein under study. Herein, we present a novel protocol based on STD NMR spectroscopy for the direct measurements of receptor-ligand dissociation constants (K(D)) from single-ligand titration experiments. The influence of several experimental factors on STD values has been studied in detail, confirming the marked impact on standard determinations of protein-ligand affinities by STD NMR spectroscopy. These factors, namely, STD saturation time, ligand residence time in the complex, and the intensity of the signal, affect the accumulation of saturation in the free ligand by processes closely related to fast protein-ligand rebinding and longitudinal relaxation of the ligand signals. The proposed method avoids the dependence of the magnitudes of ligand STD signals at a given saturation time on spurious factors by constructing the binding isotherms using the initial growth rates of the STD amplification factors, in a similar way to the use of NOE growing rates to estimate cross relaxation rates for distance evaluations. Herein, it is demonstrated that the effects of these factors are cancelled out by analyzing the protein-ligand association curve using STD values at the limit of zero saturation time, when virtually no ligand rebinding or relaxation takes place. The approach is validated for two well-studied protein-ligand systems: the binding of the saccharides GlcNAc and GlcNAcbeta1,4GlcNAc (chitobiose) to the wheat germ agglutinin (WGA) lectin, and the interaction of the amino acid L-tryptophan to bovine serum albumin (BSA). In all cases, the experimental K(D) measured under different experimental conditions converged to the thermodynamic values. The proposed protocol allows accurate determinations of protein-ligand dissociation constants, extending the applicability of the STD NMR spectroscopy for affinity measurements, which is of particular relevance for those proteins for which a ligand of known affinity is not available.

Translating Patient Safety Research Into Clinical Practice

DTIC Science & Technology

2005-01-01

AIM approach is being used to evaluate a pharmacy alert intervention designed to detect and correct medication prescribing errors for all patients ...Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Advances in Patient Safety: Vol. 2 164 patients .6, 9 Medication use in the ambulatory care...subjects and patients with chronic illnesses) and settings (e.g., schools, worksites, and medical clinics).32 We illustrate each of the RE-AIM dimensions

Psychosocial Correlates of Adolescent Males’ Pregnancy Intention

PubMed Central

Rosengard, Cynthia; Phipps, Maureen G.; Adler, Nancy E.; Ellen, Jonathan M.

2005-01-01

Objective To identify psychosocial differences between sexually experienced male adolescents who indicate intentions to get someone pregnant and those who do not. Methodology Cross-sectional study of 101 sexually experienced adolescent males recruited from an STD clinic in northern California. Student’s t-tests and regressions examined psychosocial differences between males who reported any intention versus no intention to get someone pregnant in the next six months. ANOVAs examined differences among different combinations of pregnancy plans/likelihood. Results Adolescents’ reports of their plans for getting someone pregnant differed from their assessments of the likelihood that they would do so (χ2 = 24.33, df = 1, p < .0001). Attitudes toward pregnancy and participants’ mothers’ educational attainment differentiated those with clear pregnancy intentions (Planning, and Likely) from those with clear intentions to avoid pregnancy (Not Planning & Not Likely) Conclusions To reduce the rates of adolescent childbearing, males’ pregnancy intentions must be assessed and asked about in multiple ways. PMID:16140687

Assessment of Geographic Information Systems and Data Confidentiality Guidelines in STD Programs.

PubMed

Bissette, Jennifer M; Stover, Jeffrey A; Newman, Lori M; Delcher, Philip Christopher; Bernstein, Kyle T; Matthews, Lindsey

2009-01-01

Advancements in technology, such as geographic information systems (GIS), expand sexually transmitted disease (STD) program capacity for data analysis and visualization, and introduce additional confidentiality considerations. We developed a survey to examine GIS use among STD programs and to better understand existing data confidentiality practices. A Web-based survey of eight to 22 questions, depending on program-specific GIS capacity, was e-mailed to all STD program directors through the National Coalition of STD Directors in November 2004. Survey responses were accepted until April 15, 2005. Eighty-five percent of the 65 currently funded STD programs responded to the survey. Of those, 58% used GIS and 54% used geocoding. STD programs that did not use GIS (42%) identified lack of training and insufficient staff as primary barriers. Mapping, spatial analyses, and targeting program interventions were the main reasons for geocoding data. Nineteen of the 25 programs that responded to questions related to statistical disclosure rules employed a numerator rule, and 56% of those used a variation of the "Rule of 5." Of the 28 programs that responded to questions pertaining to confidentiality guidelines, 82% addressed confidentiality of GIS data informally. Survey findings showed the increasing use of GIS and highlighted the struggles STD programs face in employing GIS and protecting confidentiality. Guidance related to data confidentiality and additional access to GIS software and training could assist programs in optimizing use of spatial data.

Salmonella enterica serotype Typhimurium Std fimbriae bind terminal alpha(1,2)fucose residues in the cecal mucosa.

PubMed

Chessa, Daniela; Winter, Maria G; Jakomin, Marcello; Bäumler, Andreas J

2009-02-01

The std operon encodes a fimbrial adhesin of Salmonella enterica serotype Typhimurium that is required for attachment to intestinal epithelial cells and for cecal colonization in the mouse. To study the mechanism by which this virulence factor contributes to colonization we characterized its binding specificity. Std-mediated binding to human colonic epithelial (Caco-2) cells could be abrogated by removing N-linked glycans. Adherence of Std fimbriated S. Typhimurium to Caco-2 cells could be blocked by co-incubation with H type 2 oligosaccharide (Fucalpha1-2Galbeta1-4GlcNAc) or by pretreatment of cells with alpha1-2 fucosidase. In contrast, pretreatment of Caco-2 cells with neuraminidase or co-incubation with the type 2 disaccharide precursor (Galbeta1-4GlcNAc) did not reduce adherence of Std fimbriated S. Typhimurium. Binding of purified Std fimbriae to Fucalpha1-2Galbeta1-4GlcNAc in a solid phase binding assay was competitively inhibited by Ulex europaeus agglutinin-I (UEA-I), a lectin specific for Fucalpha1-2 moieties. Purified Std fimbriae and UEA both bound to a receptor localized in the mucus layer of the murine cecum. These data suggest that the std operon encodes an adhesin that binds an alpha1-2 fucosylated receptor(s) present in the cecal mucosa.

Salmonella enterica serotype Typhimurium Std fimbriae bind terminal α (1,2)fucose residues in the cecal mucosa

PubMed Central

Chessa, Daniela; Winter, Maria G.; Jakomin, Marcello; Bäumler, Andreas J.

2013-01-01

SUMMARY The std operon encodes a fimbrial adhesin of Salmonella enterica serotype Typhimurium that is required for attachment to intestinal epithelial cells and for cecal colonization in the mouse. To study the mechanism by which this virulence factor contributes to colonization we characterized its binding specificity. Std-mediated binding to human colonic epithelial (Caco-2) cells could be abrogated by removing N-linked glycans. Adherence of Std fimbriated S. Typhimurium to Caco-2 cells could be blocked by co-incubation with H type 2 oligosaccharide (Fucα1-2Galβ1-4GlcNAc) or by pretreatment of cells with α1-2 fucosidase. In contrast, pretreatment of Caco-2 cells with neuraminidase or co-incubation with the type 2 disaccharide precursor (Galβ1-4GlcNAc) did not reduce adherence of Std fimbriated S. Typhimurium. Binding of purified Std fimbriae to Fucα1-2Galβ1-4GlcNAc in a solid phase binding assay was competitively inhibited by Ulex europaeus agglutinin-I (UEA-I), a lectin specific for Fucα1-2 moieties. Purified Std fimbriae and UEA both bound to a receptor localized in the mucus layer of the murine cecum. These data suggest that the std operon encodes an adhesin that binds an α1-2 fucosylated receptor(s) present in the cecal mucosa. PMID:19183274

Presumptive specific clinical diagnosis of genital ulcer disease (GUD) in a primary health care setting in Nairobi.

PubMed

Ndinya-Achola, J O; Kihara, A N; Fisher, L D; Krone, M R; Plummer, F A; Ronald, A; Holmes, K K

1996-01-01

Of 22,274 patients 12 years of age or older attending a primary health care clinic in Nairobi, 1076 (4.8%) complained of symptoms suggesting a sexually transmitted disease (STD). Of these, 518 females and 462 males underwent complete clinical evaluation, and 78% had objective microbiologic or clinical evidence of STD, including 168 (17.1%) with genital ulcer disease (GUD). Presumptive specific clinical diagnoses on initial physical examination in cases of GUD were chancroid (131 patients), syphilis (25), genital herpes (15) and lymphogranuloma venereum (LGV) (1). Clinical diagnoses correlated only weakly with microbiological and serological diagnoses. Haemophilus ducreyi was isolated from 51 (41%) of the 125 with a clinical diagnosis of chancroid, and 4 (22%) of 18 with a diagnosis of syphilis, herpes, or LGV (P = 0.13). The rapid plasma reagin (RPR) test was reactive in 6 (24%) of 25 with a clinical diagnosis of syphilis, 18 (12.3%) of 146 with a diagnosis of chancroid or herpes, and 37 (4.7%) of 786 without a genital ulcer (P < 0.001, GUD vs no GUD). Sensitivity, specificity, and positive predictive value for presumptive clinical diagnosis of chancroid, relative to H. ducreyi isolation, were 93%, 16%, and 41%; and for diagnosis of syphilis, relative to reactive RPR, were 25%, 88% and 25%. Specific treatment based on presumptive specific clinical diagnosis frequently was inadequate for syphilis among patients with GUD and reactive RPR test. Syndromic treatment of GUD with antimicrobial combinations active against both chancroid and syphilis would be preferable to treatment with single drugs based on presumptive specific clinical diagnoses for this population.

23 CFR 637.203 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... program. All factors that comprise the State transportation department's (STD) determination of the... which are performed in the STD's central laboratory would not be covered by an independent assurance... STD. As a minimum, the qualification program shall include provisions for checking test equipment and...

23 CFR 637.203 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... program. All factors that comprise the State transportation department's (STD) determination of the... which are performed in the STD's central laboratory would not be covered by an independent assurance... STD. As a minimum, the qualification program shall include provisions for checking test equipment and...

23 CFR 637.203 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... program. All factors that comprise the State transportation department's (STD) determination of the... which are performed in the STD's central laboratory would not be covered by an independent assurance... STD. As a minimum, the qualification program shall include provisions for checking test equipment and...

23 CFR 637.203 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... program. All factors that comprise the State transportation department's (STD) determination of the... which are performed in the STD's central laboratory would not be covered by an independent assurance... STD. As a minimum, the qualification program shall include provisions for checking test equipment and...

Wide coverage by volume CT: benefits for cardiac imaging

NASA Astrophysics Data System (ADS)

Sablayrolles, Jean-Louis; Cesmeli, Erdogan; Mintandjian, Laura; Adda, Olivier; Dessalles-Martin, Diane

2005-04-01

With the development of new technologies, computed tomography (CT) is becoming a strong candidate for non-invasive imaging based tool for cardiac disease assessment. One of the challenges of cardiac CT is that a typical scan involves a breath hold period consisting of several heartbeats, about 20 sec with scanners having a longitudinal coverage of 2 cm, and causing the image quality (IQ) to be negatively impacted since beat to beat variation is high likely to occur without any medication, e.g. beta blockers. Because of this and the preference for shorter breath hold durations, a CT scanner with a wide coverage without the compromise in the spatial and temporal resolution of great clinical value. In this study, we aimed at determining the optimum scan duration and the delay relative to beginning of breath hold, to achieve high IQ. We acquired EKG data from 91 consecutive patients (77 M, 14 F; Age: 57 +/- 14) undergoing cardiac CT exams with contrast, performed on LightSpeed 16 and LightSpeed Pro16. As an IQ metric, we adopted the standard deviation of "beat-to-beat variation" (stdBBV) within a virtual scan period. Two radiologists evaluated images by assigning a score of 1 (worst) to 4 best). We validated stdBBV with the radiologist scores, which resulted in a population distribution of 9.5, 9.5, 31, and 50% for the score groups 1, 2, 3, and 4, respectively. Based on the scores, we defined a threshold for stdBBV and identified an optimum combination of virtual scan period and a delay. With the assumption that the relationship between the stdBBV and diagnosable scan IQ holds, our analysis suggested that the success rate can be improved to 100% with scan durations equal or less than 5 sec with a delay of 1 - 2 sec. We confirmed the suggested conclusion with LightSpeed VCT (GE Healthcare Technologies, Waukesha, WI), which has a wide longitudinal coverage, fine isotropic spatial resolution, and high temporal resolution, e.g. 40 mm coverage per rotation of 0.35 sec. Under the light of this study, LightSpeed VCT lends itself to be a clinically tested unique platform to achieve routine cardiac imaging.

Fast response and high sensitivity to microsaccades in a cascading-adaptation neural network with short-term synaptic depression

NASA Astrophysics Data System (ADS)

Yuan, Wu-Jie; Zhou, Jian-Fang; Zhou, Changsong

2016-04-01

Microsaccades are very small eye movements during fixation. Experimentally, they have been found to play an important role in visual information processing. However, neural responses induced by microsaccades are not yet well understood and are rarely studied theoretically. Here we propose a network model with a cascading adaptation including both retinal adaptation and short-term depression (STD) at thalamocortical synapses. In the neural network model, we compare the microsaccade-induced neural responses in the presence of STD and those without STD. It is found that the cascading with STD can give rise to faster and sharper responses to microsaccades. Moreover, STD can enhance response effectiveness and sensitivity to microsaccadic spatiotemporal changes, suggesting improved detection of small eye movements (or moving visual objects). We also explore the mechanism of the response properties in the model. Our studies strongly indicate that STD plays an important role in neural responses to microsaccades. Our model considers simultaneously retinal adaptation and STD at thalamocortical synapses in the study of microsaccade-induced neural activity, and may be useful for further investigation of the functional roles of microsaccades in visual information processing.

Sexually transmitted diseases in Operation Iraqi Freedom/Operation Enduring Freedom.

PubMed

Wright, Johnnie; Albright, Todd S; Gehrich, Alan P; Dunlow, Susan G; Lettieri, Christine F; Buller, Jerome L

2006-10-01

To identify the incidence of sexually transmitted diseases (STDs) in a female active duty population deployed in support of Operation Iraqi Freedom/Operation Enduring Freedom was the objective of this study. Retrospective chart review was completed on all soldiers seeking outpatient gynecologic care at Camp Doha, Kuwait, from September 2003 through March 2004. Descriptive statistical analysis was performed on data from all patients identified as having an STD. Forty-four soldiers (2.5% of all encounters) were diagnosed with STDs during the study period. Genital herpes, Condyloma acuminata, and chlamydia were the most commonly identified infections accounting for 30, 25, and 21% of the diagnoses, respectively. Transmission of STDs in the deployed environment continues to be problematic. Viral infections were more commonly encountered than were bacterial infections. Patient education and prevention should be emphasized. Consideration should be given to STD screening upon redeployment.

Replicating MISTERS: an epidemiological criminology framework analysis of a program for criminal justice-involved minority males in the community.

PubMed

Potter, Roberto Hugh; Akers, Timothy A; Bowman, Daniel Richard

2013-01-01

The Men in STD Training and Empowerment Research Study (MISTERS) program and epidemiological criminology began their development in Atlanta at about the same time. MISTERS focuses on men recently released from jail to reduce both HIV/STD and crime-related risk factors through a brief educational intervention. This article examines ways in which MISTERS and epidemiological criminology have been used to inform one another in the replication of the MISTERS program in Orange County, Florida. Data from 110 MISTERS participants during the first 10 months of operation are analyzed to examine the overlapping occurrence of health and criminal risk behaviors in the men's lives. This provides a test of core hypotheses from the epidemiological criminology framework. This article also examines application of the epidemiological criminology framework to develop interventions to address health and crime risk factors simultaneously in Criminal Justice-Involved populations in the community.

23 CFR 710.201 - State responsibilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... REAL ESTATE Program Administration § 710.201 State responsibilities. (a) Organization. Each STD shall... responsibilities. (b) Program oversight. The STD shall have overall responsibility for the acquisition, management... Federal laws and regulations. (c) Right-of-way (ROW) operations manual. Each STD which receives funding...

23 CFR 637.207 - Quality assurance program.

Code of Federal Regulations, 2012 CFR

2012-04-01

... program. (a) Each STD's quality assurance program shall provide for an acceptance program and an independent assurance (IA) program consisting of the following: (1) Acceptance program. (i) Each STD's... STD shall establish a dispute resolution system. The dispute resolution system shall address the...

23 CFR 637.207 - Quality assurance program.

Code of Federal Regulations, 2014 CFR

2014-04-01

... program. (a) Each STD's quality assurance program shall provide for an acceptance program and an independent assurance (IA) program consisting of the following: (1) Acceptance program. (i) Each STD's... STD shall establish a dispute resolution system. The dispute resolution system shall address the...

23 CFR 637.207 - Quality assurance program.

Code of Federal Regulations, 2013 CFR

2013-04-01

... program. (a) Each STD's quality assurance program shall provide for an acceptance program and an independent assurance (IA) program consisting of the following: (1) Acceptance program. (i) Each STD's... STD shall establish a dispute resolution system. The dispute resolution system shall address the...

23 CFR 710.201 - State responsibilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... REAL ESTATE Program Administration § 710.201 State responsibilities. (a) Organization. Each STD shall... responsibilities. (b) Program oversight. The STD shall have overall responsibility for the acquisition, management... Federal laws and regulations. (c) Right-of-way (ROW) operations manual. Each STD which receives funding...

Inventory of File sref.t03z.pgrb197.spread_ds_3hrly.grib2

Science.gov Websites

3 hour fcst U-Component of Wind [m/s] std dev 002 10 m above ground VGRD 3 hour fcst V-Component of Wind [m/s] std dev 003 2 m above ground TMP 3 hour fcst Temperature [K] std dev 004 2 m above ground SPFH 3 hour fcst Specific Humidity [kg/kg] std dev 005 10 m above ground WIND 3 hour fcst Wind Speed [m

Knowledge of sexually transmitted diseases and sexual behaviours among Malaysian male youths.

PubMed

Awang, Halimah; Wong, Li Ping; Jani, Rohana; Low, Wah Yun

2014-03-01

This study examines the knowledge of sexually transmitted diseases (STDs) among male youths in Malaysia. A self-administered survey was carried out on a sample of 952 never-married males aged 15-24 years. The respondents were asked about their knowledge of STDs, how these diseases get transmitted and their sexual behaviours. The data showed that 92% of the respondents knew of at least one STD (syphilis, gonorrhoea, chlamydia, herpes, genital warts, yeast infection, trichomoniasis or HIV/AIDS). About 95% of them knew of at least one method of STD transmission. Urban and tertiary-educated male youths showed a substantially higher proportion of awareness of STDs and transmission methods compared with their rural and less-educated counterparts. The data also indicated that 10% of the study sample admitted to having had sexual experiences. There were still a large proportion of the respondents who were not aware of STDs other than syphilis and HIV/AIDS and the means of transmission, such as multiple sex partners, including those who claimed to be sexually active. Thus there is a need for more concerted efforts to disseminate information on STDs and transmission methods to a wider audience in Malaysia, especially youths in rural areas.

Myths about AIDS in Cambodia.

PubMed

Nariddh, M C

1994-08-01

HIV has been reported in the capital city of Cambodia, Phnom Penh, as well as in the northwestern provinces of Banteay Meanchey, Battambang, Pursat, and Kompong Chhnang. Unofficial reports indicate the presence of HIV in three northeastern provinces. According to World Health Organization data, 382 people were infected with HIV in Cambodia as of March 1994, but the national AIDS program estimates that 2000-4000 Cambodians may be HIV-seropositive. Small surveys in 1992 identified HIV infection rates to be 4.5% among patients of sexually transmitted disease (STD) clinics and 9.2% among prostitutes. A seroprevalence rate of 4.3% was found in 1993 among clients of STD clinics and others requesting HIV testing. These rather marked levels of infection exist in Cambodia even though HIV was first identified in the country as recently as 1991 among screened blood from volunteer donors. By December 1993, the rate of positive results from blood donors had increased to 1.97%.; the rate of infection among blood donors is expected to double to approximately 4% in 1994. People in Cambodia variously believe that AIDS is nonexistent, AIDS is a problem of other countries, can be transmitted by mosquitoes, healthy people do not have AIDS, a cure exists for AIDS, AIDS can be contracted only from prostitutes, AIDS is the most severe state of syphilis, and AIDS is only a propaganda ploy of condom producers to market their products. It is therefore proving extremely difficult to convince people that AIDS is a truly threatening disease against which they should protect themselves, especially when symptoms are rarely present during the early stage of infection. Health education campaigns, videos, posters, and accurate reporting in the media will, however, help change minds and hopefully induce HIV-preventive behaviors. Of interest, the article notes that virtually every prostitute in Cambodia has at least two-three STDs.

Narrative Review: Sexually Transmitted Diseases and Homeless Youth-What Do We Know About Sexually Transmitted Disease Prevalence and Risk?

PubMed

Caccamo, Alexandra; Kachur, Rachel; Williams, Samantha P

2017-08-01

Homelessness affects an estimated 1.6 million US youth annually. Compared with housed youth, homeless youth are more likely to engage in high-risk behaviors, including inconsistent condom use, multiple sex partners, survival sex, and alcohol/drug use, putting them at increased sexually transmitted disease (STD) risk. However, there is no national estimate of STD prevalence among this population. We identified 10 peer-reviewed articles (9 unique studies) reporting STD prevalence among homeless US youth (2000-2015). Descriptive and qualitative analyses identified STD prevalence ranges and risk factors among youth. Eight studies reported specific STD prevalence estimates, mainly chlamydia, gonorrhea, and syphilis. Overall STD prevalence among homeless youth ranged from 6% to 32%. STD rates for girls varied from 16.7% to 46%, and from 9% to 13.1% in boys. Most studies were conducted in the Western United States, with no studies from the Southeast or Northeast. Youths who experienced longer periods of homelessness were more likely to engage in high-risk sexual behaviors. Girls had lower rates of condom use and higher rates of STDs; boys were more likely to engage in anal and anonymous sex. Additionally, peer social networks contributed to protective effects on individual sexual risk behavior. Sexually transmitted disease prevalence estimates among homeless youth fluctuated greatly by study. Sexually transmitted disease risk behaviors are associated with unmet survival needs, length of homelessness, and influence of social networks. To promote sexual health and reduce STD rates, we need better estimates of STD prevalence, more geographic diversity of studies, and interventions addressing the behavioral associations identified in our review.

Narrative Review: Sexually Transmitted Diseases and Homeless Youth—What Do We Know About Sexually Transmitted Disease Prevalence and Risk?

PubMed Central

Caccamo, Alexandra; Kachur, Rachel; Williams, Samantha P.

2018-01-01

Background Homelessness affects an estimated 1.6 million US youth annually. Compared with housed youth, homeless youth are more likely to engage in high-risk behaviors, including inconsistent condom use, multiple sex partners, survival sex, and alcohol/drug use, putting them at increased sexually transmitted disease (STD) risk. However, there is no national estimate of STD prevalence among this population. Methods We identified 10 peer-reviewed articles (9 unique studies) reporting STD prevalence among homeless US youth (2000–2015). Descriptive and qualitative analyses identified STD prevalence ranges and risk factors among youth. Results Eight studies reported specific STD prevalence estimates, mainly chlamydia, gonorrhea, and syphilis. Overall STD prevalence among homeless youth ranged from 6% to 32%. STD rates for girls varied from 16.7% to 46%, and from 9% to 13.1% in boys. Most studies were conducted in the Western United States, with no studies from the Southeast or Northeast. Youths who experienced longer periods of homelessness were more likely to engage in high-risk sexual behaviors. Girls had lower rates of condom use and higher rates of STDs; boys were more likely to engage in anal and anonymous sex. Additionally, peer social networks contributed to protective effects on individual sexual risk behavior. Conclusions Sexually transmitted disease prevalence estimates among homeless youth fluctuated greatly by study. Sexually transmitted disease risk behaviors are associated with unmet survival needs, length of homelessness, and influence of social networks. To promote sexual health and reduce STD rates, we need better estimates of STD prevalence, more geographic diversity of studies, and interventions addressing the behavioral associations identified in our review. PMID:28703725

Use of sexually transmitted disease risk assessment algorithms for selection of intrauterine device candidates.

PubMed

Morrison, C S; Sekadde-Kigondu, C; Miller, W C; Weiner, D H; Sinei, S K

1999-02-01

Sexually transmitted diseases (STD) are an important contraindication for intrauterine device (IUD) insertion. Nevertheless, laboratory testing for STD is not possible in many settings. The objective of this study is to evaluate the use of risk assessment algorithms to predict STD and subsequent IUD-related complications among IUD candidates. Among 615 IUD users in Kenya, the following algorithms were evaluated: 1) an STD algorithm based on US Agency for International Development (USAID) Technical Working Group guidelines: 2) a Centers for Disease Control and Prevention (CDC) algorithm for management of chlamydia; and 3) a data-derived algorithm modeled from study data. Algorithms were evaluated for prediction of chlamydial and gonococcal infection at 1 month and complications (pelvic inflammatory disease [PID], IUD removals, and IUD expulsions) over 4 months. Women with STD were more likely to develop complications than women without STD (19% vs 6%; risk ratio = 2.9; 95% CI 1.3-6.5). For STD prediction, the USAID algorithm was 75% sensitive and 48% specific, with a positive likelihood ratio (LR+) of 1.4. The CDC algorithm was 44% sensitive and 72% specific, LR+ = 1.6. The data-derived algorithm was 91% sensitive and 56% specific, with LR+ = 2.0 and LR- = 0.2. Category-specific LR for this algorithm identified women with very low (< 1%) and very high (29%) infection probabilities. The data-derived algorithm was also the best predictor of IUD-related complications. These results suggest that use of STD algorithms may improve selection of IUD users. Women at high risk for STD could be counseled to avoid IUD, whereas women at moderate risk should be monitored closely and counseled to use condoms.

Sexual Lifestyle, Risk Factors and Socioeconomic Status of the STD Patients in Bangladesh.

PubMed

Nandi, A K; Hossain, K J; Islam, A S

2017-01-01

Sexually transmitted diseases (STDs) are increasing alarmingly with time among the young-adults in Bangladesh. The objective of the study was to investigate Sexual lifestyle, Risk Factors and Socioeconomic Status of the STD Patients. A total of 205 STD patients were selected following convenient method of sampling consistent with defined selection criteria from outpatient department of Skin and Venereal Disease of Mymensingh Medical College Hospital, Mymensingh. Period of data collection was from July 2014 to June 2015. The research instrument was an interviewer questionnaire and laboratory investigation reports. Results showed that the mean age of the respondents was 27±5.9 years of which 104(50.7%) unmarried and 95(46.3%) married. Level of education, 168(82.0%) of the STD patients were literate. Occupation of the STD patients, 201(98.0%) had specific occupation of which 74(36.1%) were businessmen, 48(23.4%) student, 24(11.7%) technical jobs, 20(9.8%) day labourer, 15(7.3%) household workers, 14(6.8%) service holders and 6(2.9%) were transport workers. Their average monthly income was Tk. 7892±6763. Majority of the STD patients 115((56.1%) expressed that they enjoyed extra-marital sex or illegal sex out of curiosity, 32(15.6%) habitual, 24(11.7%) to test sexual performance, 18(8.8%) inadequate response of the legal sex partners, 8(3.9%) hyper-sexuality and 8(3.9%) family disharmony. Most of the patients 200(97.6%) were heterosexual of which 165(80.5%) visited 1-10 sex partners, 18(8.8%) 11-20 sex partners and 22(10.7%) visited 21-100 sex partners in lifetime. In category of sex partners, 60(29.3%) were hotel-based sex partners, 111(54.1%) brothel-based, 20(9.8%) friends sex partners, 10(4.9%) street sex sellers and 4(2.0%) were residential sex partners respectively. Of them, 132(64.4%) did not use condom during sex, 65(31.7%) use it occasionally and only 8(3.9%) use condom regularly. Most of them 170((82.8%) had been suffering from gonococcal urethritis, 19(9.3%) non-gonococcal urethritis, 12(5.9%) genital herpes, and rest other specific infections. STDs were significantly (p<0.05) associated with category of sex partners and use of condom. Altering sexual lifestyle is still the only applicable way to stop this human catastrophe.

23 CFR 710.503 - Protective buying and hardship acquisition.

Code of Federal Regulations, 2013 CFR

2013-04-01

... hardship acquisition. (a) General conditions. Prior to the STD obtaining final environmental approval, the STD may request FHWA agreement to provide reimbursement for advance acquisition of a particular parcel... the currently approved STIP; (2) The STD has complied with applicable public involvement requirements...

23 CFR 710.503 - Protective buying and hardship acquisition.

Code of Federal Regulations, 2011 CFR

2011-04-01

... hardship acquisition. (a) General conditions. Prior to the STD obtaining final environmental approval, the STD may request FHWA agreement to provide reimbursement for advance acquisition of a particular parcel... the currently approved STIP; (2) The STD has complied with applicable public involvement requirements...

23 CFR 710.503 - Protective buying and hardship acquisition.

Code of Federal Regulations, 2014 CFR

2014-04-01

... hardship acquisition. (a) General conditions. Prior to the STD obtaining final environmental approval, the STD may request FHWA agreement to provide reimbursement for advance acquisition of a particular parcel... the currently approved STIP; (2) The STD has complied with applicable public involvement requirements...

Hidden costs associated with venous thromboembolism: impact of lost productivity on employers and employees.

PubMed

Page, Robert L; Ghushchyan, Vahram; Gifford, Brian; Read, Richard Allen; Raut, Monika; Bookhart, Brahim K; Naim, Ahmad B; Damaraju, C V; Nair, Kavita V

2014-09-01

To determine productivity loss and indirect costs with deep vein thrombosis (DVT) and pulmonary embolism (PE). Medical and pharmacy claims with short-term disability (STD) and long-term disability (LTD) claims from 2007 to 2010 were analyzed from the Integrated Benefits Institute's Health and Productivity Benchmarking (IBI-HPB) database (STD and LTD claims) and IMS LifeLink™ data (medical and pharmacy claims), which were indirectly linked using a weighting approach matching from IBI-HPB patients' demographic distribution. A total of 5442 DVT and 6199 PE claims were identified. Employees with DVT lost 57 STD and 440 LTD days per disability incident. The average per claim productivity loss from STD and LTD was $7414 and $58181, respectively. Employees with PE lost 56 STD and 364 LTD days per disability incident. The average per claim productivity loss from STD and LTD was $7605 and $48,751, respectively. Deep vein thrombosis and PE impose substantial economic burdens.

A qualitative study of rural black adolescents' perspectives on primary STD prevention strategies.

PubMed

Akers, Aletha Y; Gold, Melanie A; Coyne-Beasley, Tamera; Corbie-Smith, Giselle

2012-06-01

Primary STD prevention relies on five key strategies: practicing abstinence, choosing low-risk partners, discussing partners' sexual history, using condoms consistently and not having multiple partners. Few studies have examined all of these strategies simultaneously, and few have focused on rural black adolescents, whose rates of early sexual initiation and STDs are among the highest in the nation. In 2006, a sample of 37 black adolescents (20 female, 17 male) from two rural North Carolina counties participated in focus groups that explored their understanding of how primary prevention strategies reduce STD transmission, the common barriers they encounter in trying to adopt these strategies and the risk reduction strategies that they employ. Transcripts were analyzed using a grounded theory approach. Adolescents understood how primary prevention strategies reduce STD transmission. However, they perceived sex as normal and abstinence as unlikely during adolescence. Furthermore, they considered the remaining primary prevention strategies difficult to implement because these strategies depend on partner cooperation and incorrectly assume that STD prevention is paramount when adolescents make sexual decisions. Adolescents reported using alternative strategies to reduce their STD risk; the most commonly used approaches were indirect assessments of partner characteristics (e.g., evaluating partners' physical appearance and sexual history) and STD testing (to identify and treat infections). Adolescents try to reduce their STD risk, but do so by using ineffective practices. Promoting primary prevention strategies requires helping adolescents to identify opportunities to successfully employ these strategies. Copyright © 2012 by the Guttmacher Institute.

23 CFR 635.105 - Supervising agency.

Code of Federal Regulations, 2012 CFR

2012-04-01

... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.105 Supervising agency. (a) The STD has responsibility... authorizing performance of the work by a local public agency or other Federal agency. The STD shall be... projects are completed in conformance with approved plans and specifications. (b) Although the STD may...

23 CFR 635.104 - Method of construction.

Code of Federal Regulations, 2013 CFR

2013-04-01

... STD demonstrates to the satisfaction of the Division Administrator that some other method is more cost effective or that an emergency exists. The STD shall assure opportunity for free, open, and competitive... this chapter. Before such finding is made, the STD shall determine that the organization to undertake...

23 CFR 635.104 - Method of construction.

Code of Federal Regulations, 2011 CFR

2011-04-01

... STD demonstrates to the satisfaction of the Division Administrator that some other method is more cost effective or that an emergency exists. The STD shall assure opportunity for free, open, and competitive... this chapter. Before such finding is made, the STD shall determine that the organization to undertake...

23 CFR 635.105 - Supervising agency.

Code of Federal Regulations, 2013 CFR

2013-04-01

... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.105 Supervising agency. (a) The STD has responsibility... authorizing performance of the work by a local public agency or other Federal agency. The STD shall be... projects are completed in conformance with approved plans and specifications. (b) Although the STD may...

23 CFR 635.105 - Supervising agency.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.105 Supervising agency. (a) The STD has responsibility... authorizing performance of the work by a local public agency or other Federal agency. The STD shall be... projects are completed in conformance with approved plans and specifications. (b) Although the STD may...

23 CFR 635.104 - Method of construction.

Code of Federal Regulations, 2012 CFR

2012-04-01

... STD demonstrates to the satisfaction of the Division Administrator that some other method is more cost effective or that an emergency exists. The STD shall assure opportunity for free, open, and competitive... this chapter. Before such finding is made, the STD shall determine that the organization to undertake...

23 CFR 635.105 - Supervising agency.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CONSTRUCTION AND MAINTENANCE Contract Procedures § 635.105 Supervising agency. (a) The STD has responsibility... authorizing performance of the work by a local public agency or other Federal agency. The STD shall be... projects are completed in conformance with approved plans and specifications. (b) Although the STD may...

23 CFR 635.104 - Method of construction.

Code of Federal Regulations, 2014 CFR

2014-04-01

... STD demonstrates to the satisfaction of the Division Administrator that some other method is more cost effective or that an emergency exists. The STD shall assure opportunity for free, open, and competitive... this chapter. Before such finding is made, the STD shall determine that the organization to undertake...

Public stigma against family members of people with mental illness: findings from the Gilgel Gibe Field Research Center (GGFRC), Southwest Ethiopia

PubMed Central

2014-01-01

Background Public stigma against family members of people with mental illness is a negative attitude by the public which blame family members for the mental illness of their relatives. Family stigma can result in self social restrictions, delay in treatment seeking and poor quality of life. This study aimed at investigating the degree and correlates of family stigma. Methods A quantitative cross-sectional house to house survey was conducted among 845 randomly selected urban and rural community members in the Gilgel Gibe Field Research Center, Southwest Ethiopia. An interviewer administered and pre-tested questionnaire adapted from other studies was used to measure the degree of family stigma and to determine its correlates. Data entry was done by using EPI-DATA and the analysis was performed using STATA software. Unadjusted and adjusted linear regression analysis was done to identify the correlates of family stigma. Results Among the total 845 respondents, 81.18% were female. On a range of 1 to 5 score, the mean family stigma score was 2.16 (±0.49). In a multivariate analysis, rural residents had significantly higher stigma scores (std. β = 0.43, P < 0.001) than urban residents. As the number of perceived signs (std. β = -0.07, P < 0.05), perceived supernatural (std. β = -0.12, P < 0.01) and psychosocial and biological (std. β = -0.11, P < 0.01) explanations of mental illness increased, the stigma scores decreased significantly. High supernatural explanation of mental illness was significantly correlated with lower stigma among individuals with lower level of exposure to people with mental illness (PWMI). On the other hand, high exposure to PWMI was significantly associated with lower stigma among respondents who had high education. Stigma scores increased with increasing income among respondents who had lower educational status. Conclusions Our findings revealed moderate level of family stigma. Place of residence, perceived signs and explanations of mental illness were independent correlates of public stigma against family members of people with mental illness. Therefore, mental health communication programs to inform explanations and signs of mental illness need to be implemented. PMID:24555444

[Diagnosis and treatment of STDs].

PubMed

Latif, A

1995-07-01

Even though laboratory tests can easily diagnose sexually transmitted diseases (STDs), they require expensive, sophisticated equipment, which is lacking in many countries, and they take several days to obtain the results. In most cases, these tests require a sample for culture or the patient must be transferred to a hospital or an STD treatment center. Often patients do not want to return for test results or for treatment or they refuse to be transferred to another health facility. Thus, the STD goes untreated. The syndromic approach addresses these obstacles to STD diagnosis and treatment at the primary health care level. Nurses, midwives, health assistants, and clinical personnel undergo training in order to be able to diagnose and treat STDs during the first visit, at a reasonable cost, and without lab tests. They identify principal groups of signs and symptoms (i.e., syndromes) common to certain STDs. Prescribed drugs must be effective, cause no side effects, be available at the same center as the first consultation, and, preferably, be administered orally or by one dose. STD control programs need to identify the most prevalent syndromes and etiologic agents in the area and determine the most effective antibiotics for those syndromes. Donovanosis, syphilis, and soft chancre are responsible for genital ulcers in India and in Papua New Guinea; only syphilis and soft chancre are in other areas. Thus, it is important to provide treatment for all three causes in India and Papua New Guinea. It is easier to diagnose and treat penal discharge and genital ulcers in men and women than vaginal discharge and/or symptoms of pelvic inflammation in women. Thus, health workers need to ask a series of questions on risk factors for gonorrhea and chlamydia.

23 CFR 645.103 - Applicability.

Code of Federal Regulations, 2014 CFR

2014-04-01

... apply to reimbursement claimed by a State transportation department (STD) for costs incurred under an... cost-to-cure. (d) The FHWA's reimbursement to the STD will be governed by State law (or State... differs from this regulation, a determination shall be made by the STD subject to the concurrence of the...

46 CFR 58.50-10 - Diesel fuel tanks.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (USSG 18) 0.107 (USSG 12). Steel or iron 4 0.0747 (MfgStd 14) 0.1046 (MfgStd 12) 0.179 (MfgStd 7). 1 Gauges used are U.S. standard “USSG” for aluminum and nickel-copper and “MfgStd” for steel or iron. 2...

23 CFR 630.108 - Preparation of agreement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... PRECONSTRUCTION PROCEDURES Project Authorization and Agreements § 630.108 Preparation of agreement. (a) The STD shall prepare a project agreement for each Federal-aid project. (b) The STD may develop the project agreement in a format acceptable to both the STD and the FHWA provided the following are included: (1) A...

23 CFR 645.107 - Eligibility.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Relocations, Adjustments, and Reimbursement § 645.107 Eligibility. (a) When requested by the STD, Federal... made under one or more of the following conditions when: (1) The STD certifies that the utility has the... occupies privately or publicly owned land, including public road or street right-of-way, and the STD...

23 CFR 645.103 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-04-01

... apply to reimbursement claimed by a State transportation department (STD) for costs incurred under an... cost-to-cure. (d) The FHWA's reimbursement to the STD will be governed by State law (or State... differs from this regulation, a determination shall be made by the STD subject to the concurrence of the...

23 CFR 630.108 - Preparation of agreement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PRECONSTRUCTION PROCEDURES Project Authorization and Agreements § 630.108 Preparation of agreement. (a) The STD shall prepare a project agreement for each Federal-aid project. (b) The STD may develop the project agreement in a format acceptable to both the STD and the FHWA provided the following are included: (1) A...

46 CFR 58.50-10 - Diesel fuel tanks.

Code of Federal Regulations, 2014 CFR

2014-10-01

... (USSG 18) 0.107 (USSG 12). Steel or iron 4 0.0747 (MfgStd 14) 0.1046 (MfgStd 12) 0.179 (MfgStd 7). 1 Gauges used are U.S. standard “USSG” for aluminum and nickel-copper and “MfgStd” for steel or iron. 2...

23 CFR 630.108 - Preparation of agreement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... PRECONSTRUCTION PROCEDURES Project Authorization and Agreements § 630.108 Preparation of agreement. (a) The STD shall prepare a project agreement for each Federal-aid project. (b) The STD may develop the project agreement in a format acceptable to both the STD and the FHWA provided the following are included: (1) A...

23 CFR 645.119 - Alternate procedure.

Code of Federal Regulations, 2011 CFR

2011-04-01

... section, the STD is to act in the relative position of the FHWA for reviewing and approving the... prerequisites for authorizing the utility to proceed with and complete the work. (b) The scope of the STD's... alternate procedure, the STD must file a formal application for approval by the FHWA. The application must...

23 CFR 645.119 - Alternate procedure.

Code of Federal Regulations, 2014 CFR

2014-04-01

... section, the STD is to act in the relative position of the FHWA for reviewing and approving the... prerequisites for authorizing the utility to proceed with and complete the work. (b) The scope of the STD's... alternate procedure, the STD must file a formal application for approval by the FHWA. The application must...

23 CFR 630.108 - Preparation of agreement.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PRECONSTRUCTION PROCEDURES Project Authorization and Agreements § 630.108 Preparation of agreement. (a) The STD shall prepare a project agreement for each Federal-aid project. (b) The STD may develop the project agreement in a format acceptable to both the STD and the FHWA provided the following are included: (1) A...

23 CFR 645.119 - Alternate procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... section, the STD is to act in the relative position of the FHWA for reviewing and approving the... prerequisites for authorizing the utility to proceed with and complete the work. (b) The scope of the STD's... alternate procedure, the STD must file a formal application for approval by the FHWA. The application must...

23 CFR 645.107 - Eligibility.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Relocations, Adjustments, and Reimbursement § 645.107 Eligibility. (a) When requested by the STD, Federal... made under one or more of the following conditions when: (1) The STD certifies that the utility has the... occupies privately or publicly owned land, including public road or street right-of-way, and the STD...

23 CFR 645.119 - Alternate procedure.

Code of Federal Regulations, 2013 CFR

2013-04-01

... section, the STD is to act in the relative position of the FHWA for reviewing and approving the... prerequisites for authorizing the utility to proceed with and complete the work. (b) The scope of the STD's... alternate procedure, the STD must file a formal application for approval by the FHWA. The application must...

23 CFR 645.103 - Applicability.

Code of Federal Regulations, 2013 CFR

2013-04-01

... apply to reimbursement claimed by a State transportation department (STD) for costs incurred under an... cost-to-cure. (d) The FHWA's reimbursement to the STD will be governed by State law (or State... differs from this regulation, a determination shall be made by the STD subject to the concurrence of the...

23 CFR 710.407 - Leasing.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the United States Code, funds shall be covered by an agreement between the STD and lessee which... insurance to hold the State and the FHWA harmless, nondiscrimination, access by the STD and the FHWA for... otherwise specifically agreed to by the STD and the FHWA. (c) Proposed uses of real property shall conform...

23 CFR 710.505 - Real property donations.

Code of Federal Regulations, 2014 CFR

2014-04-01

...-aid project may donate the property to the STD. Prior to accepting the property, the owner must be... be informed of his/her right to an appraisal of the property by a qualified appraiser, unless the STD... STD shall develop sufficient documentation to indicate compliance with paragraph (a) of this section...

23 CFR 645.107 - Eligibility.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Relocations, Adjustments, and Reimbursement § 645.107 Eligibility. (a) When requested by the STD, Federal... made under one or more of the following conditions when: (1) The STD certifies that the utility has the... occupies privately or publicly owned land, including public road or street right-of-way, and the STD...

23 CFR 645.103 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-04-01

... apply to reimbursement claimed by a State transportation department (STD) for costs incurred under an... cost-to-cure. (d) The FHWA's reimbursement to the STD will be governed by State law (or State... differs from this regulation, a determination shall be made by the STD subject to the concurrence of the...

23 CFR 710.407 - Leasing.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the United States Code, funds shall be covered by an agreement between the STD and lessee which... insurance to hold the State and the FHWA harmless, nondiscrimination, access by the STD and the FHWA for... otherwise specifically agreed to by the STD and the FHWA. (c) Proposed uses of real property shall conform...

23 CFR 710.505 - Real property donations.

Code of Federal Regulations, 2011 CFR

2011-04-01

...-aid project may donate the property to the STD. Prior to accepting the property, the owner must be... be informed of his/her right to an appraisal of the property by a qualified appraiser, unless the STD... STD shall develop sufficient documentation to indicate compliance with paragraph (a) of this section...

23 CFR 630.108 - Preparation of agreement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... PRECONSTRUCTION PROCEDURES Project Authorization and Agreements § 630.108 Preparation of agreement. (a) The STD shall prepare a project agreement for each Federal-aid project. (b) The STD may develop the project agreement in a format acceptable to both the STD and the FHWA provided the following are included: (1) A...

23 CFR 710.407 - Leasing.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the United States Code, funds shall be covered by an agreement between the STD and lessee which... insurance to hold the State and the FHWA harmless, nondiscrimination, access by the STD and the FHWA for... otherwise specifically agreed to by the STD and the FHWA. (c) Proposed uses of real property shall conform...

23 CFR 645.119 - Alternate procedure.

Code of Federal Regulations, 2012 CFR

2012-04-01

... section, the STD is to act in the relative position of the FHWA for reviewing and approving the... prerequisites for authorizing the utility to proceed with and complete the work. (b) The scope of the STD's... alternate procedure, the STD must file a formal application for approval by the FHWA. The application must...

23 CFR 645.107 - Eligibility.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Relocations, Adjustments, and Reimbursement § 645.107 Eligibility. (a) When requested by the STD, Federal... made under one or more of the following conditions when: (1) The STD certifies that the utility has the... occupies privately or publicly owned land, including public road or street right-of-way, and the STD...

23 CFR 710.407 - Leasing.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the United States Code, funds shall be covered by an agreement between the STD and lessee which... insurance to hold the State and the FHWA harmless, nondiscrimination, access by the STD and the FHWA for... otherwise specifically agreed to by the STD and the FHWA. (c) Proposed uses of real property shall conform...

23 CFR 645.103 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... apply to reimbursement claimed by a State transportation department (STD) for costs incurred under an... cost-to-cure. (d) The FHWA's reimbursement to the STD will be governed by State law (or State... differs from this regulation, a determination shall be made by the STD subject to the concurrence of the...

23 CFR 710.505 - Real property donations.

Code of Federal Regulations, 2013 CFR

2013-04-01

...-aid project may donate the property to the STD. Prior to accepting the property, the owner must be... be informed of his/her right to an appraisal of the property by a qualified appraiser, unless the STD... STD shall develop sufficient documentation to indicate compliance with paragraph (a) of this section...

Assessing STD Partner Services in State and Local Health Departments.

PubMed

Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L

2018-02-07

State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.

A Study to Identify the Transitional Training Needs for United States Army Medical Residents

DTIC Science & Technology

1988-07-29

34 workshops in the earlv 1970s, the issues cOn tinleld to have onlv ma rg ina l interests from teach ing inst itut ions for nearlv a decade. In 1982, the...Perspectives ( PRO VIEWS): These were presentations typically given by senior physicians who occupy positions of considerable administrative...n) JCAHO std day PRO -VIFW! %td dev I NE-VIEWS std dev qPAD-VIEWS std dev CAREI std oev Family Pract 27 3.4074 0 95 35769 I 12 36296 095 35185 1.03 3

Inventory of File sref.t03z.pgrb212.spread_1hrly.grib2

Science.gov Websites

UGRD 1 hour fcst U-Component of Wind [m/s] std dev 002 10 m above ground VGRD 1 hour fcst V-Component of Wind [m/s] std dev 003 1000 mb UGRD 1 hour fcst U-Component of Wind [m/s] std dev 004 850 mb UGRD 1 hour fcst U-Component of Wind [m/s] std dev 005 700 mb UGRD 1 hour fcst U-Component of Wind [m/s

The Importance of School Staff Referrals and Follow-Up in Connecting High School Students to HIV and STD Testing.

PubMed

Rasberry, Catherine N; Liddon, Nicole; Adkins, Susan Hocevar; Lesesne, Catherine A; Hebert, Andrew; Kroupa, Elizabeth; Rose, India D; Morris, Elana

2017-04-01

This study examined predictors of having received HIV and sexually transmitted disease (STD) testing and having been referred by school staff for HIV/STD testing. In 2014, students in seven high schools completed paper-and-pencil questionnaires assessing demographic characteristics, sexual behavior, referrals for HIV/STD testing, and HIV/STD testing. The analytic sample ( n = 11,303) was 50.7% female, 40.7% Hispanic/Latino, 34.7% Black/African American (non-Hispanic), and mean age was 15.86 ( SD = 1.22). After controlling for demographic characteristics, significant predictors of reporting having been tested for HIV or STDs were reporting having received a referral for HIV/STD testing (odds ratio [ OR] = 3.18; 95% CI = [2.14, 4.70]) and reporting staff following-up on the referral ( OR = 3.29; 95% CI = [1.31, 8.23]). Students reporting referrals had significantly higher odds of being male ( OR = 2.49; 95% CI = [1.70, 3.65]), "other" or multiracial (non-Hispanic; compared to White, non-Hispanic; OR = 2.72; 95% CI = [1.35, 5.46]), sexual minority ( OR = 3.80; 95% CI = [2.57, 5.62]), and sexually experienced ( OR = 2.58; 95% CI = [1.76, 3.795]). School staff referrals with follow-up may increase HIV/STD testing among students.

Effectiveness of an HIV/STD risk-reduction intervention for adolescents when implemented by community-based organizations: a cluster-randomized controlled trial.

PubMed

Jemmott, John B; Jemmott, Loretta S; Fong, Geoffrey T; Morales, Knashawn H

2010-04-01

We evaluated the effectiveness of an HIV/STD risk-reduction intervention when implemented by community-based organizations (CBOs). In a cluster-randomized controlled trial, 86 CBOs that served African American adolescents aged 13 to 18 years were randomized to implement either an HIV/STD risk-reduction intervention whose efficacy has been demonstrated or a health-promotion control intervention. CBOs agreed to implement 6 intervention groups, a random half of which completed 3-, 6-, and 12-month follow-up assessments. The primary outcome was consistent condom use in the 3 months prior to each follow-up assessment, averaged over the follow-up assessments. Participants were 1707 adolescents, 863 in HIV/STD-intervention CBOs and 844 in control-intervention CBOs. HIV/STD-intervention participants were more likely to report consistent condom use (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.06, 1.84) than were control-intervention participants. HIV/STD-intervention participants also reported a greater proportion of condom-protected intercourse (beta = 0.06; 95% CI = 0.00, 0.12) than did the control group. This is the first large, randomized intervention trial to demonstrate that CBOs can successfully implement an HIV/STD risk-reduction intervention whose efficacy has been established.

Can variation in HIV/STD-related risk be explained by individual SES? Findings from female sex workers in a rural Chinese county.

PubMed

Fang, Xiaoyi; Li, Xiaoming; Yang, Hongmei; Hong, Yan; Stanton, Bonita; Zhao, Ran; Dong, Baiqing; Liu, Wei; Zhou, Yuejiao; Liang, Shaoling

2008-03-01

Low socioeconomic status (SES) has been linked to HIV and sexually transmitted disease (STD) at a macro level because the majority of new cases of HIV infection in the world have been reported in underdeveloped or developing countries. However, empirical data on the relationship between individual SES and HIV/STD related risk have been mixed. Employing quantitative data from 454 female sex workers (FSWs), this study was designed to examine the profile of the study sample in terms of their individual SES, HIV/STD-related sexual risk across work locations with different social, cultural, and economic conditions; and to examine the relationship between work location and HIV-related risk behaviors, controlling for individual SES. We have shown in the current study that both SES and HIV/STD-related risk behaviors significantly differed by work location. However, the difference in individual SES was not sufficient to explain the difference of HIV/STD-related risk across the work locations. The findings underscore the need for effective prevention intervention efforts targeting FSWs in rural areas. Based on the findings, we also suggest that HIV/STD intervention efforts among FSWs should take the social and cultural contextual factors of their working environment (and sexual risks) into consideration.

Effectiveness of an HIV/STD Risk-Reduction Intervention for Adolescents When Implemented by Community-Based Organizations: A Cluster-Randomized Controlled Trial

PubMed Central

Jemmott, Loretta S.; Fong, Geoffrey T.; Morales, Knashawn H.

2010-01-01

Objectives. We evaluated the effectiveness of an HIV/STD risk-reduction intervention when implemented by community-based organizations (CBOs). Methods. In a cluster-randomized controlled trial, 86 CBOs that served African American adolescents aged 13 to 18 years were randomized to implement either an HIV/STD risk-reduction intervention whose efficacy has been demonstrated or a health-promotion control intervention. CBOs agreed to implement 6 intervention groups, a random half of which completed 3-, 6-, and 12-month follow-up assessments. The primary outcome was consistent condom use in the 3 months prior to each follow-up assessment, averaged over the follow-up assessments. Results. Participants were 1707 adolescents, 863 in HIV/STD-intervention CBOs and 844 in control-intervention CBOs. HIV/STD-intervention participants were more likely to report consistent condom use (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.06, 1.84) than were control-intervention participants. HIV/STD-intervention participants also reported a greater proportion of condom-protected intercourse (β = 0.06; 95% CI = 0.00, 0.12) than did the control group. Conclusions. This is the first large, randomized intervention trial to demonstrate that CBOs can successfully implement an HIV/STD risk-reduction intervention whose efficacy has been established. PMID:20167903

Anatomical brain difference of subthreshold depression in young and middle-aged individuals.

PubMed

Li, Jing; Wang, Zengjian; Hwang, JiWon; Zhao, Bingcong; Yang, Xinjing; Xin, Suicheng; Wang, Yu; Jiang, Huili; Shi, Peng; Zhang, Ye; Wang, Xu; Lang, Courtney; Park, Joel; Bao, Tuya; Kong, Jian

2017-01-01

Subthreshold depression (StD) is associated with substantial functional impairments due to depressive symptoms that do not fully meet the diagnosis of major depressive disorder (MDD). Its high incidence in the general population and debilitating symptoms has recently put it at the forefront of mood disorder research. In this study we investigated common volumetric brain changes in both young and middle-aged StD patients. Two cohorts of StD patients, young and middle-aged, ( n  = 57) and matched controls ( n  = 76) underwent voxel-based morphometry (VBM). VBM analysis found that: 1) compared with healthy controls, StD patients showed decreased gray matter volume (GMV) in the bilateral globus pallidus and precentral gyrus, as well as increased GMV in the left thalamus and right rostral anterior cingulate cortex/medial prefrontal cortex; 2) there is a significant association between Center for Epidemiological Studies Depression Scale scores and the bilateral globus pallidus (negative) and left thalamus (positive); 3) there is no interaction between age (young vs. middle-age) and group (StD vs. controls). Our findings indicate significant VBM brain changes in both young and middle-aged individuals with StD. Individuals with StD, regardless of age, may share common neural characteristics.

Can variation in HIV/STD-related risk be explained by individual SES? Findings from female sex workers in a rural Chinese county

PubMed Central

Fang, Xiaoyi; Li, Xiaoming; Yang, Hongmei; Hong, Yan; Stanton, Bonita; Zhao, Ran; Dong, Baiqing; Liu, Wei; Zhou, Yuejiao; Liang, Shaoling

2007-01-01

Low socioeconomic status (SES) has been linked to HIV and sexually transmitted disease (STD) at a macro level because the majority of new cases of HIV infection in the world have been reported in underdeveloped or developing countries. However, empirical data on the relationship between individual SES and HIV/STD related risk have been mixed. Employing quantitative data from 454 female sex workers, this study was designed to examine the profile of the study sample in terms of their individual SES, HIV/STD-related sexual risk across work locations with different social, cultural and economic conditions; and examine the relationship between work location and HIV-related risk behaviors, controlling for individual SES. We have shown in the current study that both SES and HIV/STD-related risk behaviors significantly differed by work location. However, the difference in individual SES was not sufficient to explain the difference of HIV/STD-related risk across the work locations. The findings underscore the need for effective prevention intervention efforts targeting female sex workers in rural area. Based on the findings, we also suggest that HIV/STD intervention efforts among female sex workers should take the social and cultural contextual factors of their working environment (and sexual risks) into consideration. PMID:18350430

Women's health: potential for better coordination of services.

PubMed Central

Queen, H F; Ward, H; Smith, C; Woodroffe, C

1991-01-01

OBJECTIVE: To determine the proportion of women attending a genitourinary medicine clinic (GUMC) who are in need of contraception and the proportion of women attending a family planning clinic (FPC) who may require screening or treatment for sexually transmitted disease (STD). DESIGN: Cross-sectional survey. SETTING: A large FPC (17,600 attendances by women a year) and a large GUMC (20,060 attendances by women a year) in an inner London health district. SUBJECTS: All clients attending the two clinics in consecutive weeks (356 GUMC and 335 FPC). In addition a non-random cluster of other women attending the same clinics later in the year were interviewed in depth (21 GUMC and 20 FPC). RESULTS: Of women at the GUMC 10.4% (95% CI 7.2-13.6) were at risk of unwanted pregnancy and not using contraception. Women aged under 20 years and women not registered with a general practitioner (GP) were more likely to be in this group. A further 13.8% may have been using contraception unreliably as they were not obtaining contraception from a GP or FPC. Of women at the FPC 1.8% (95% CI 0.3-3.2) complained of symptoms of genitourinary infection. In-depth interviews showed that some women assumed the staff at both clinics would counsel them in all aspects of sexual health. CONCLUSIONS: The opportunities presented at GUMCs to reduce the incidence of unwanted pregnancy and the opportunities presented at FPCs to reduce the incidence and prevalence of STD should not be missed. PMID:2071123

Effectiveness of an intervention promoting the female condom to patients at sexually transmitted disease clinics.

PubMed Central

Artz, L; Macaluso, M; Brill, I; Kelaghan, J; Austin, H; Fleenor, M; Robey, L; Hook, E W

2000-01-01

OBJECTIVES: This study evaluated a behavioral intervention designed to promote female condoms and reduce unprotected sex among women at high risk for acquiring sexually transmitted diseases (STDs). METHODS: The effect of the intervention on barrier use was evaluated with a pretest-posttest design with 1159 female STD clinic patients. RESULTS: Among participants with follow-up data, 79% used the female condom at least once and often multiple times. More than one third of those who completed the study used female condoms throughout follow-up. Use of barrier protection increased significantly after the intervention, and high use was maintained during a 6-month follow-up. To account for attrition, the use of protection by all subjects was projected under 3 conservative assumptions. The initial visit and termination visit projections suggest that use increased sharply after the intervention and declined during follow-up but remained elevated compared with the baseline. CONCLUSIONS: Many clients of public STD clinics will try, and some will continue, to use female condoms when they are promoted positively and when women are trained to use them correctly and to promote them to their partners. A behavioral intervention that promotes both female and male condoms can increase barrier use. PMID:10667185

Risk factors for laparoscopically confirmed pelvic inflammatory disease: findings from Mumbai (Bombay), India.

PubMed

Gogate, A; Brabin, L; Nicholas, S; Gogate, S; Gaonkar, T; Naidu, A; Divekar, A; Karande, A; Hart, C A

1998-12-01

Sexually transmitted diseases (STDs) are an important cause of pelvic inflammatory disease (PID) but have often not been detected in microbiological studies of Indian women admitted to hospital gynaecology wards or private clinics. In this cross sectional study, women living in the inner city of Mumbai (Bombay) were investigated for socioeconomic, clinical, and microbiological risk factors for PID. Microbiological tests and laparoscopic examination were carried out on 2736 women aged < or = 35 years who came to a health facility with suspected acute salpingitis or infertility or for laparoscopic sterilisation. 86 women with a clinical diagnosis of PID were not referred for laparoscopy although their characteristics are described. Associations between various risk factors and PID status were investigated and logistic regression performed on all factors that remained significant. Of women with a laparoscopically confirmed evaluation, 26 women had acute and 48 chronic pelvic infection. Independent risk factors for PID were later age at menarche (> or = 14 years), a history of stillbirth and no previous pregnancy, history of tuberculosis, STD, dilatation and curettage or previous laparoscopy, and presence of Gardnerella vaginalis. It is concluded that STD related risk factors applied to only a small proportion of PID cases and that other determinants of PID are important, including obstetric complications, invasive surgical procedures such as laparoscopy, and tuberculosis.

Assessment of multi-criteria optimization (MCO) for volumetric modulated arc therapy (VMAT) in hippocampal avoidance whole brain radiation therapy (HA-WBRT).

PubMed

Zieminski, Stephen; Khandekar, Melin; Wang, Yi

2018-03-01

This study compared the dosimetric performance of (a) volumetric modulated arc therapy (VMAT) with standard optimization (STD) and (b) multi-criteria optimization (MCO) to (c) intensity modulated radiation therapy (IMRT) with MCO for hippocampal avoidance whole brain radiation therapy (HA-WBRT) in RayStation treatment planning system (TPS). Ten HA-WBRT patients previously treated with MCO-IMRT or MCO-VMAT on an Elekta Infinity accelerator with Agility multileaf collimators (5-mm leaves) were re-planned for the other two modalities. All patients received 30 Gy in 15 fractions to the planning target volume (PTV), namely, PTV30 expanded with a 2-mm margin from the whole brain excluding hippocampus with margin. The patients all had metastatic lesions (up to 12) of variable sizes and proximity to the hippocampus, treated with an additional 7.5 Gy from a simultaneous integrated boost (SIB) to PTV37.5. The IMRT plans used eight to eleven non-coplanar fields, whereas the VMAT plans used two coplanar full arcs and a vertex half arc. The averaged target coverage, dose to organs-at-risk (OARs) and monitor unit provided by the three modalities were compared, and a Wilcoxon signed-rank test was performed. MCO-VMAT provided statistically significant reduction of D100 of hippocampus compared to STD-VMAT, and Dmax of cochleas compared to MCO-IMRT. With statistical significance, MCO-VMAT improved V30 of PTV30 by 14.2% and 4.8%, respectively, compared to MCO-IMRT and STD-VMAT. It also raised D95 of PTV37.5 by 0.4 Gy compared to both MCO-IMRT and STD-VMAT. Improved plan quality parameters such as a decrease in overall plan Dmax and total monitor units (MU) were also observed for MCO-VMAT. MCO-VMAT is found to be the optimal modality for HA-WBRT in terms of PTV coverage, OAR sparing and delivery efficiency, compared to MCO-IMRT or STD-VMAT. © 2018 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

Adapting the Get Yourself Tested Campaign to Reach Black and Latino Sexual-Minority Youth.

PubMed

Garbers, Samantha; Friedman, Allison; Martinez, Omar; Scheinmann, Roberta; Bermudez, Dayana; Silva, Manel; Silverman, Jen; Chiasson, Mary Ann

2016-09-01

Culturally appropriate efforts are needed to increase sexually transmitted disease (STD) testing and care among Black and Latino sexual-minority youth, who are at high risk for STDs. Get Yourself Tested, a national testing campaign, has demonstrated success among youth, but it has yet to be assessed for relevance or impact among this population. This effort included (1) formative and materials-testing research through focus groups; (2) adaptation of existing Get Yourself Tested campaign materials to be more inclusive of Black and Latino sexual-minority youth; (3) a 3-month campaign in four venues of New York City, promoting STD testing at events and through mobile testing and online and social media platforms; (4) process evaluation of outreach activities; and (5) an outcome evaluation of testing at select campaign venues, using a preexperimental design. During the 3-month campaign period, the number of STD tests conducted at select campaign venues increased from a comparable 3-month baseline period. Although testing uptake through mobile vans remained low in absolute numbers, the van drew a high-prevalence sample, with positivity rates of 26.9% for chlamydia and 11.5% for gonorrhea. This article documents the process and lessons learned from adapting and implementing a local campaign for Black and Latino sexual-minority youth. © 2016 Society for Public Health Education.

Screening of oropharynx and anorectum increases prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection in female STD clinic visitors.

PubMed

Peters, Remco P H; Nijsten, Noëmi; Mutsaers, Johan; Jansen, Casper L; Morré, Servaas A; van Leeuwen, A Petra

2011-09-01

The relevance of screening of oropharynx and anorectum in addition to endocervical tests for detection of Chlamydia trachomatis and Neisseria gonorrhoeae infection is unclear in women, while there is a documented benefit of this approach in men who have sex with men. Female visitors to the sexually transmitted disease (STD) clinic were asked about their sexual practice as a part of the routine electronic patient file. In addition to tests for endocervical infection, swabs were taken from the oropharynx and anorectum to test for C. trachomatis and N. gonorrhoeae based on the history of sexual contact. Routinely, all electronic patient files are anonymously included in a database for surveillance purposes. In this observational study, we analyzed all consultations in the database over an 18 months period. A total of 4299 consultations were registered; 10% of women had endocervical chlamydia and 1.1% had gonorrhea. The detection rates for C. trachomatis and N. gonorrhoeae from oropharyngeal samples were 1.9% and 0.8%, and from anorectal samples 8.7% and 1.7%, respectively. Except for 2 cases of pharyngeal gonorrhea, all oropharyngeal and anorectal infections were asymptomatic. Inclusion of oropharyngeal and anorectal tests in the screening protocol was associated with a percentage increase in prevalence of chlamydia by 9.5% and gonorrhea by 31%, relative to tests for endocervical tests alone. The percentage increase in prevalence was higher than that for the symptom-based approach (3.7% and 10.4%, respectively). Inclusion of oropharyngeal and anorectal tests in the STD screening protocol increases the prevalence of chlamydia and gonorrhea in women. Screening of anatomical sites based on sexual history is preferred over a symptom-based protocol.

Prevalence of Chlamydia trachomatis infection among patients attending infertility and sexually transmitted diseases clinic (STD) in Kano, North Western Nigeria.

PubMed

Nwankwo, E O; Sadiq, Magaji N

2014-09-01

Chlamydia trachomatis is the most common bacterial sexually transmitted disease in the world with severe complications. The aim of this study was to determine the prevalence and possible risk factors of C. trachomatis in Kano. There is dearth of information on this subject in this locality. Urine samples, Endocervical swabs and Urethral swab were collected from consecutive patients attending the Infertility and STD clinics in Aminu Kano Teaching Hospital (AKTH) between June and December 2012, after administering a questionnaire by the attending physician and also obtaining an informed consent.Samples were analyzed using Diaspot Chlamydia kit, a rapid immunoassay test for the detection of genital chlamydial antigen in urinogenital samples. A total of 125 consecutive samples were collected, comprising 69 females and 56 males aged between 14 - 55 years. Twelve samples tested positive for C. trachomatis antigen giving a prevalence rate of 9.6%. The age group prevalence were as follows 25 - 29 yrs (17.1%), 20 - 24 (16.7%), 15 - 19 (12.5%), 30 - 34 (11.1%) and > 49 years (9.0%). Married patients were associated with higher infection rate than single (8.3%), and divorced patients (33.3%). A higher percentage of the patients (95.2%) were not aware of the existence of C. trachomatis infection and its complications. Previous STD exposure was associated with increased risk of Chlamydia infection. C. trachomatis infection if unchecked will continue to pose a threat to reproductive life with its established complications. Since asymptomatic cases are common in the population regular screening should be encouraged for every adult especially before commencement of marital life.

Developing Printed Supplementary Materials to Accompany Satellite Programming for Junior High School Students. Satellite Technology Demonstration, Technical Report No. 0508.

ERIC Educational Resources Information Center

Lonsdale, Helen C.; O'Neill, Donald W.

To implement a career education program for junior high school students in the rural, isolated areas of the Rocky Mountain States, Satellite Technology Demonstration (STD) tested the use of a satellite-assisted communications system for the delivery of social services. A magazine was designed to promote acceptance of the television programing and…

The Use of a Satellite Human Interaction System in Conjunction with a Satellite Media Distribution System. Satellite Technology Demonstration, Technical Report No. 0217.

ERIC Educational Resources Information Center

Dale, Joyce B.

Satellite Technology Demonstration (STD) was designed to provide data on the use of a satellite to deliver educational programs to 56 rural-isolated schools in eight Rocky Mountain States. Three series were broadcast: (1) a junior high school career development, (2) career development for public school administrators and teachers, and (3) topical…

Methods for Sexually Transmitted Disease Prevention Programs to Estimate the Health and Medical Cost Impact of Changes in Their Budget.

PubMed

Chesson, Harrell W; Ludovic, Jennifer A; Berruti, Andrés A; Gift, Thomas L

2018-01-01

The purpose of this article was to describe methods that sexually transmitted disease (STD) programs can use to estimate the potential effects of changes in their budgets in terms of disease burden and direct medical costs. We proposed 2 distinct approaches to estimate the potential effect of changes in funding on subsequent STD burden, one based on an analysis of state-level STD prevention funding and gonorrhea case rates and one based on analyses of the effect of Disease Intervention Specialist (DIS) activities on gonorrhea case rates. We also illustrated how programs can estimate the impact of budget changes on intermediate outcomes, such as partner services. Finally, we provided an example of the application of these methods for a hypothetical state STD prevention program. The methods we proposed can provide general approximations of how a change in STD prevention funding might affect the level of STD prevention services provided, STD incidence rates, and the direct medical cost burden of STDs. In applying these methods to a hypothetical state, a reduction in annual funding of US $200,000 was estimated to lead to subsequent increases in STDs of 1.6% to 3.6%. Over 10 years, the reduction in funding totaled US $2.0 million, whereas the cumulative, additional direct medical costs of the increase in STDs totaled US $3.7 to US $8.4 million. The methods we proposed, though subject to important limitations, can allow STD prevention personnel to calculate evidence-based estimates of the effects of changes in their budget.

Reducing Sexual Risk Behaviors for HIV/STDs in Women with Alcohol Use Disorders

ERIC Educational Resources Information Center

Langhorst, Diane M.; Choi, Y. Joon; Keyser-Marcus, Lori; Svikis, Dace S.

2012-01-01

Objective: A pilot randomized clinical trial (RCT) examined effectiveness of HIV/STD Safer Sex Skills Building + Alcohol (SSB+A) intervention for women with Alcohol Use Disorders (AUDs) in a residential treatment setting. Method: After randomizing thirty-six women with AUDs and reporting having intercourse with a male partner in the past 180 days…

78 FR 56708 - Announcement of Requirements and Registration for Game On!: HIV/STD Prevention Mobile Application...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-13

... Requirements and Registration for Game On!: HIV/ STD Prevention Mobile Application (App) Video Game Challenge... Services (HHS) announces the launch of the Game On!: HIV/STD Prevention Mobile Application (App) Video Game Challenge. We invite video game developers to create an original, innovative, and highly entertaining game...

23 CFR 710.405 - Air rights on the Interstate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... airspace contemplated by a STD must assure that such occupancy, use, or reservation is in the public... 140, subparts E and H. (iv) Bikeways and pedestrian walkways as covered in 23 CFR part 652. (b) A STD may grant rights for temporary or permanent occupancy or use of Interstate system airspace if the STD...

23 CFR 635.122 - Participation in progress payments.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Federal funds will participate in the costs to the STD of construction accomplished as the work progresses... receiving payment from the STD; and (3) The quantity of a stockpiled material eligible for Federal... the contractor at a location not in the vicinity of the project, if the STD determines that because of...

23 CFR 630.110 - Modification of original agreement.

Code of Federal Regulations, 2012 CFR

2012-04-01

... unless specifically authorized by statute. (b) The STD may develop the modification of project agreement in a format acceptable to both the STD and the FHWA provided the following are included: (1) The... of officials from both the State and the FHWA and date executed. (c) The STD may use an electronic...

23 CFR 635.113 - Bid opening and bid tabulations.

Code of Federal Regulations, 2013 CFR

2013-04-01

... permitted. (b) The STD shall prepare and forward tabulations of bids to the Division Administrator. These tabulations shall be certified by a responsible STD official and shall show: (1) Bid item details for at least... opened and reviewed in accordance with the terms of the solicitation. The STD must use its own procedures...

23 CFR 630.110 - Modification of original agreement.

Code of Federal Regulations, 2014 CFR

2014-04-01

... unless specifically authorized by statute. (b) The STD may develop the modification of project agreement in a format acceptable to both the STD and the FHWA provided the following are included: (1) The... of officials from both the State and the FHWA and date executed. (c) The STD may use an electronic...

23 CFR 635.413 - Guaranty and warranty clauses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... CONSTRUCTION AND MAINTENANCE General Material Requirements § 635.413 Guaranty and warranty clauses. The STD may... obligation on the contractor for items over which the contractor has no control. (d) A STD may follow its own...) Performance warranties for specific products on NHS projects may be used at the STD's discretion. If...

23 CFR 710.405 - Air rights on the Interstate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... airspace contemplated by a STD must assure that such occupancy, use, or reservation is in the public... 140, subparts E and H. (iv) Bikeways and pedestrian walkways as covered in 23 CFR part 652. (b) A STD may grant rights for temporary or permanent occupancy or use of Interstate system airspace if the STD...

23 CFR 635.413 - Guaranty and warranty clauses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... CONSTRUCTION AND MAINTENANCE General Material Requirements § 635.413 Guaranty and warranty clauses. The STD may... obligation on the contractor for items over which the contractor has no control. (d) A STD may follow its own...) Performance warranties for specific products on NHS projects may be used at the STD's discretion. If...

23 CFR 635.122 - Participation in progress payments.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Federal funds will participate in the costs to the STD of construction accomplished as the work progresses... receiving payment from the STD; and (3) The quantity of a stockpiled material eligible for Federal... the contractor at a location not in the vicinity of the project, if the STD determines that because of...

23 CFR 635.125 - Termination of contract.

Code of Federal Regulations, 2011 CFR

2011-04-01

... contract may be terminated because of circumstances beyond the control of the contractor. (b) The STD prior..., advertising, and award procedures are to be followed when a STD awards the contract for completion of a terminated Federal-aid contract. (d) When a STD awards the contract for completion of a Federal-aid contract...

23 CFR 635.115 - Agreement estimate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... prepared by the STD and submitted to the Division Administrator as soon as practicable for use in the... submitted by the STD for each force account project (see 23 CFR part 635, subpart B) when the plans and... estimated quantities and the unit prices agreed upon in advance between the STD and the Division...

23 CFR 635.413 - Guaranty and warranty clauses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... CONSTRUCTION AND MAINTENANCE General Material Requirements § 635.413 Guaranty and warranty clauses. The STD may... obligation on the contractor for items over which the contractor has no control. (d) A STD may follow its own...) Performance warranties for specific products on NHS projects may be used at the STD's discretion. If...

23 CFR 635.113 - Bid opening and bid tabulations.

Code of Federal Regulations, 2014 CFR

2014-04-01

... permitted. (b) The STD shall prepare and forward tabulations of bids to the Division Administrator. These tabulations shall be certified by a responsible STD official and shall show: (1) Bid item details for at least... opened and reviewed in accordance with the terms of the solicitation. The STD must use its own procedures...

23 CFR 635.113 - Bid opening and bid tabulations.

Code of Federal Regulations, 2012 CFR

2012-04-01

... permitted. (b) The STD shall prepare and forward tabulations of bids to the Division Administrator. These tabulations shall be certified by a responsible STD official and shall show: (1) Bid item details for at least... opened and reviewed in accordance with the terms of the solicitation. The STD must use its own procedures...

23 CFR 635.113 - Bid opening and bid tabulations.

Code of Federal Regulations, 2011 CFR

2011-04-01

... permitted. (b) The STD shall prepare and forward tabulations of bids to the Division Administrator. These tabulations shall be certified by a responsible STD official and shall show: (1) Bid item details for at least... opened and reviewed in accordance with the terms of the solicitation. The STD must use its own procedures...

23 CFR 635.122 - Participation in progress payments.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Federal funds will participate in the costs to the STD of construction accomplished as the work progresses... receiving payment from the STD; and (3) The quantity of a stockpiled material eligible for Federal... the contractor at a location not in the vicinity of the project, if the STD determines that because of...

23 CFR 630.110 - Modification of original agreement.

Code of Federal Regulations, 2013 CFR

2013-04-01

... unless specifically authorized by statute. (b) The STD may develop the modification of project agreement in a format acceptable to both the STD and the FHWA provided the following are included: (1) The... of officials from both the State and the FHWA and date executed. (c) The STD may use an electronic...

23 CFR 635.122 - Participation in progress payments.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Federal funds will participate in the costs to the STD of construction accomplished as the work progresses... receiving payment from the STD; and (3) The quantity of a stockpiled material eligible for Federal... the contractor at a location not in the vicinity of the project, if the STD determines that because of...

15 CFR 272.3 - Approved markings.

Code of Federal Regulations, 2014 CFR

2014-01-01

... approved by the Secretary of Commerce: (a) A blaze orange (Fed-Std-595B 12199) or orange color brighter... from the muzzle end of the barrel. (b) A blaze orange (Fed-Std-595B 12199) or orange color brighter..., December 1989, color number 12199 (Fed-Std-595B 12199), may be obtained from the General Services...

23 CFR 635.115 - Agreement estimate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... prepared by the STD and submitted to the Division Administrator as soon as practicable for use in the... submitted by the STD for each force account project (see 23 CFR part 635, subpart B) when the plans and... estimated quantities and the unit prices agreed upon in advance between the STD and the Division...

23 CFR 635.125 - Termination of contract.

Code of Federal Regulations, 2012 CFR

2012-04-01

... contract may be terminated because of circumstances beyond the control of the contractor. (b) The STD prior..., advertising, and award procedures are to be followed when a STD awards the contract for completion of a terminated Federal-aid contract. (d) When a STD awards the contract for completion of a Federal-aid contract...

23 CFR 635.125 - Termination of contract.

Code of Federal Regulations, 2013 CFR

2013-04-01

... contract may be terminated because of circumstances beyond the control of the contractor. (b) The STD prior..., advertising, and award procedures are to be followed when a STD awards the contract for completion of a terminated Federal-aid contract. (d) When a STD awards the contract for completion of a Federal-aid contract...

23 CFR 710.405 - Air rights on the Interstate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... airspace contemplated by a STD must assure that such occupancy, use, or reservation is in the public... 140, subparts E and H. (iv) Bikeways and pedestrian walkways as covered in 23 CFR part 652. (b) A STD may grant rights for temporary or permanent occupancy or use of Interstate system airspace if the STD...

23 CFR 635.115 - Agreement estimate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... prepared by the STD and submitted to the Division Administrator as soon as practicable for use in the... submitted by the STD for each force account project (see 23 CFR part 635, subpart B) when the plans and... estimated quantities and the unit prices agreed upon in advance between the STD and the Division...

23 CFR 630.110 - Modification of original agreement.

Code of Federal Regulations, 2011 CFR

2011-04-01

... unless specifically authorized by statute. (b) The STD may develop the modification of project agreement in a format acceptable to both the STD and the FHWA provided the following are included: (1) The... of officials from both the State and the FHWA and date executed. (c) The STD may use an electronic...

23 CFR 635.413 - Guaranty and warranty clauses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... CONSTRUCTION AND MAINTENANCE General Material Requirements § 635.413 Guaranty and warranty clauses. The STD may... obligation on the contractor for items over which the contractor has no control. (d) A STD may follow its own...) Performance warranties for specific products on NHS projects may be used at the STD's discretion. If...

23 CFR 635.125 - Termination of contract.

Code of Federal Regulations, 2014 CFR

2014-04-01

... contract may be terminated because of circumstances beyond the control of the contractor. (b) The STD prior..., advertising, and award procedures are to be followed when a STD awards the contract for completion of a terminated Federal-aid contract. (d) When a STD awards the contract for completion of a Federal-aid contract...

std::string Append

DTIC Science & Technology

2015-10-01

UNCLASSIFIED AD-E403 689 Technical Report ARWSE-TR-14026 STD::STRING APPEND Tom Nealis...DATES COVERED (From – To) 4. TITLE AND SUBTITLE STD::STRING APPEND 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...DISTRIBUTION/AVAILABILITY STATEMENT Approved for public release; distribution is unlimited. 13. SUPPLEMENTARY NOTES 14. ABSTRACT Appending

AGOR 28

DTIC Science & Technology

2015-03-12

R/ASR) 227/0 AGOR27 A031- 03 STD Report - TEST PROCEDURES ( 264-002-03 Waste Oil & Oily Waste Systems Operational Test)(R/ASR) 229/0 AGOR27...106/0 AGOR27 A031- 04 STD Report - TEST REPORT ( 529-004-3 Ballast Treatment System Demonstration)(R/ASR) 110/0 AGOR27 A031- 04 STD Report - TEST

77 FR 72868 - The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-06

... Hepatitis and STD Prevention and Treatment Notice of Charter Renewal This gives notice under the Federal..., Viral Hepatitis and STD Prevention and Treatment, Department of Health and Human Services, has been..., M.D., Ph.D., Designated Federal Officer, CDC/HRSA Advisory Committee on HIV, Viral Hepatitis and STD...

Local Public Health Systems and the Incidence of Sexually Transmitted Diseases

PubMed Central

Chen, Jie; Owusu-Edusei, Kwame; Suh, Allen; Bekemeier, Betty

2012-01-01

Objectives. We examined the associations of local public health system organization and local health department resources with county-level sexually transmitted disease (STD) incidence rates in large US health jurisdictions. Methods. We linked annual county STD incidence data (2005–2008) to local health department director responses (n = 211) to the 2006 wave of the National Longitudinal Study of Local Public Health Systems, the 2005 national Local Health Department Profile Survey, and the Area Resource File. We used nested mixed effects regression models to assess the relative contribution of local public health system organization, local health department financial and resource factors, and sociodemographic factors known to be associated with STD incidence to county-level (n = 307) STD incidence. Results. Jurisdictions with local governing boards had significantly lower county-level STD incidence. Local public health systems with comprehensive services where local health departments shoulder much of the effort had higher county-level STD rates than did conventional systems. Conclusions. More integration of system partners in local public health system activities, through governance and interorganizational arrangements, may reduce the incidence and burden of STDs. PMID:22813090

Shifted Transversal Design smart-pooling for high coverage interactome mapping

PubMed Central

Xin, Xiaofeng; Rual, Jean-François; Hirozane-Kishikawa, Tomoko; Hill, David E.; Vidal, Marc; Boone, Charles; Thierry-Mieg, Nicolas

2009-01-01

“Smart-pooling,” in which test reagents are multiplexed in a highly redundant manner, is a promising strategy for achieving high efficiency, sensitivity, and specificity in systems-level projects. However, previous applications relied on low redundancy designs that do not leverage the full potential of smart-pooling, and more powerful theoretical constructions, such as the Shifted Transversal Design (STD), lack experimental validation. Here we evaluate STD smart-pooling in yeast two-hybrid (Y2H) interactome mapping. We employed two STD designs and two established methods to perform ORFeome-wide Y2H screens with 12 baits. We found that STD pooling achieves similar levels of sensitivity and specificity as one-on-one array-based Y2H, while the costs and workloads are divided by three. The screening-sequencing approach is the most cost- and labor-efficient, yet STD identifies about twofold more interactions. Screening-sequencing remains an appropriate method for quickly producing low-coverage interactomes, while STD pooling appears as the method of choice for obtaining maps with higher coverage. PMID:19447967

Gender and racial differences in risk factors for sexually transmitted diseases among justice-involved youth

PubMed Central

Dembo, Richard; Childs, Kristina; Belenko, Steven; Schmeidler, James; Wareham, Jennifer

2010-01-01

Gender and racial differences in infection rates for chlamydia and gonorrhea have been reported within community-based populations, but little is known of such differences within juvenile offending populations. Moreover, while research has demonstrated that certain individual-level and community-level factors affect risky behaviors associated with sexually transmitted disease (STD), less is known about how multi-level factors affect STD infection, particularly among delinquent populations. The present study investigated gender and racial differences in STD infection among a sample of 924 juvenile offenders. Generalized linear model regression analyses were conducted to examine the influence of individual-level factors such as age, offense history, and substance use and community-level factors such as concentrated disadvantage, ethnic heterogeneity, and family disruption on STD status. Results revealed significant racial and STD status differences across gender, as well as interaction effects for race and STD status for males only. Gender differences in individual-level and community-level predictors were also found. Implications of these findings for future research and public health policy are discussed. PMID:20700475

Correlating the EMC analysis and testing methods for space systems in MIL-STD-1541A

NASA Technical Reports Server (NTRS)

Perez, Reinaldo J.

1990-01-01

A study was conducted to improve the correlation between the electromagnetic compatibility (EMC) analysis models stated in MIL-STD-1541A and the suggested testing methods used for space systems. The test and analysis methods outlined in MIL-STD-1541A are described, and a comparative assessment of testing and analysis techniques as they relate to several EMC areas is presented. Suggestions on present analysis and test methods are introduced to harmonize and bring the analysis and testing tools in MIL-STD-1541A into closer agreement. It is suggested that test procedures in MIL-STD-1541A must be improved by providing alternatives to the present use of shielded enclosures as the primary site for such tests. In addition, the alternate use of anechoic chambers and open field test sites must be considered.

Understanding the Effects of Forced Sex on Sexually Transmitted Disease Acquisition and Sexually Transmitted Disease Care: Findings From the National Survey of Family Growth (2011-2013).

PubMed

Brookmeyer, Kathryn A; Beltran, Oscar; Abad, Neetu

2017-10-01

Although there is evidence for heightened sexually transmitted disease (STD) acquisition among women who experienced sexual violence, little is known about their patterns of STD testing, STD diagnosis, and STD treatment. Data was drawn from cycle eight of the National Survey of Family Growth (2011-2013). Logistic regression analyses used SUDAAN to examine the link between forced sex and risky sexual behavior as well as forced sex and STD testing, diagnoses, treatment, and connection to care. Women who experienced forced sex were more likely to have risky sex (adjusted odds ratio [AOR], 1.56; 95% confidence interval [CI], 1.08-2.24), risky partners (AOR, 1.90; 95% CI, 1.11-3.23), and report substance abuse (AOR, 1.80; 95% CI, 1.28-2.53) than women who never experienced forced sex. Women who reported forced sex were more likely to be tested for an STD (AOR, 1.67; 95% CI, 1.34-2.09), and be diagnosed with herpes (AOR, 1.94; 95% CI, 1.13-3.32), genital warts (AOR, 2.55; 95% CI, 1.90-3.41), and chlamydia (AOR, 1.83; 95% CI, 1.03-3.25) than those who have never had forced sex. Results indicated a direct relationship between particular STD diagnoses and treatment in the past 12 months (AOR, 6.81; 95% CI, 4.50-10.31). Further analyses indicate that forced sex moderated the link between STD diagnoses and STD treatment (AOR, 0.43; 95% CI, 0.19-0.98). Results indicate that women who reported experiencing forced sex were more likely to be diagnosed with chlamydia, herpes, and genital warts than women who never had forced sex. There may be a need to pay particular attention to women who experienced forced sex and a history of STDs to ensure that they are retained in care.

Innovation in sexually transmitted disease and HIV prevention: internet and mobile phone delivery vehicles for global diffusion.

PubMed

Swendeman, Dallas; Rotheram-Borus, Mary Jane

2010-03-01

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 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. 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.

23 CFR 645.113 - Agreements and authorizations.

Code of Federal Regulations, 2014 CFR

2014-04-01

...), authorization by the FHWA to the STD to proceed with the physical relocation of a utility's facilities may be... under the provisions of this regulation, the STD shall submit its proposal and a full report of the... FHWA to the STD with the understanding that Federal funds will not be paid for work done by the utility...

23 CFR 645.215 - Approvals.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... (d) When a utility files a notice or makes an individual application or request to a STD to use or occupy the right-of-way of a Federal-aid highway project, the STD is not required to submit the matter to... regulation or with the STD's utility accommodation policy approved by the FHWA for use on Federal-aid highway...

23 CFR 710.601 - Federal land transfer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the transfer of lands or interests in lands owned by the United States to an STD or its nominee for highway purposes. (c) The STD may file an application with the FHWA, or can make application directly to... conveyance of lands or interests in lands owned by the United States shall be prepared by the STD and...

23 CFR 645.113 - Agreements and authorizations.

Code of Federal Regulations, 2011 CFR

2011-04-01

...), authorization by the FHWA to the STD to proceed with the physical relocation of a utility's facilities may be... under the provisions of this regulation, the STD shall submit its proposal and a full report of the... FHWA to the STD with the understanding that Federal funds will not be paid for work done by the utility...

23 CFR 645.113 - Agreements and authorizations.

Code of Federal Regulations, 2013 CFR

2013-04-01

...), authorization by the FHWA to the STD to proceed with the physical relocation of a utility's facilities may be... under the provisions of this regulation, the STD shall submit its proposal and a full report of the... FHWA to the STD with the understanding that Federal funds will not be paid for work done by the utility...

23 CFR 710.601 - Federal land transfer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the transfer of lands or interests in lands owned by the United States to an STD or its nominee for highway purposes. (c) The STD may file an application with the FHWA, or can make application directly to... conveyance of lands or interests in lands owned by the United States shall be prepared by the STD and...

10 CFR 431.444 - Test procedures for the measurement of energy efficiency.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the following test methods: (1) Single-phase small electric motors: either IEEE Std 114, (incorporated...) Polyphase small electric motors less than or equal to 1 horsepower (0.746 kW): IEEE Std 112 (incorporated by... (0.746 kW): IEEE Std 112 (incorporated by reference, see § 431.443), Test Method B. ...

23 CFR 645.215 - Approvals.

Code of Federal Regulations, 2012 CFR

2012-04-01

.... (d) When a utility files a notice or makes an individual application or request to a STD to use or occupy the right-of-way of a Federal-aid highway project, the STD is not required to submit the matter to... regulation or with the STD's utility accommodation policy approved by the FHWA for use on Federal-aid highway...

23 CFR 630.112 - Agreement provisions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the fiscal year in which the project is authorized, the STD will repay to the FHWA the sum or sums of... which the project is authorized, the STD will repay to the FHWA the sum or sums of Federal funds paid to... certification. By signing the project agreement, the STD agrees to provide a drug-free workplace as required by...

23 CFR 645.113 - Agreements and authorizations.

Code of Federal Regulations, 2012 CFR

2012-04-01

...), authorization by the FHWA to the STD to proceed with the physical relocation of a utility's facilities may be... under the provisions of this regulation, the STD shall submit its proposal and a full report of the... FHWA to the STD with the understanding that Federal funds will not be paid for work done by the utility...

23 CFR 645.215 - Approvals.

Code of Federal Regulations, 2013 CFR

2013-04-01

.... (d) When a utility files a notice or makes an individual application or request to a STD to use or occupy the right-of-way of a Federal-aid highway project, the STD is not required to submit the matter to... regulation or with the STD's utility accommodation policy approved by the FHWA for use on Federal-aid highway...