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Gourab G, Sarwar G, Khan MNM, Hasan AMR, Irfan SD, Saha TK, Rahman L, Rana AKMM, Khan SI. Are we ready for a sustainable approach? A qualitative study of the readiness of the public health system to provide STI services to the key populations at risk of HIV in Bangladesh. BMC Health Serv Res 2023; 23:979. [PMID: 37697263 PMCID: PMC10496154 DOI: 10.1186/s12913-023-09996-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/31/2023] [Indexed: 09/13/2023] Open
Abstract
INTRODUCTION In Bangladesh, sexually transmitted infection (STI) services are available for all populations in public health facilities. However, STI services for key populations (KPs) at risk of HIV need specifically designed approaches that are predominantly administered to KPs through donor-supported service centers operated by non-government organizations (NGOs) and community-based organisations (CBOs). However, the steady decline in donor funding warrants a sustainable transition of STI services for the KPs into public health facilities. This article aimed to explore the service availability and readiness of public health facilities to provide STI services for the KPs. METHODS This qualitative study explored the service availability and readiness of public health facilities in three districts of Bangladesh by adapting the Service Availability and Readiness Assessment tool. We conducted 34 in-depth interviews,11 focus group discussions with KPs, and 29 key-informant interviews with healthcare providers, researchers, programme implementers and policy planners, in addition to series of direct observations at the public healthcare facilities. Data were analysed through thematic analysis, and categorised in relation to the WHO building blocks. RESULTS This study revealed that the public health system was generally not ready to serve the KPs' needs in terms of providing them with quality STI services. The 'service delivery' component, which is the most crucial facet of the public health system, was not ready to provide STI services to KPs. Findings also indicated that health workforce availability was limited in the primary and secondary healthcare layers but adequate in the tertiary layer, but needed to be oriented on providing culturally sensitised treatment. Counseling, an essential component of STI services, was neither ready nor available. However, health information systems and a few other components were partially ready, although this warrants systematic approaches to address these challenges. CONCLUSION The findings show that public health facilities are yet to be fully ready to render STI services to KPs, especially in terms of service delivery and human and health resources. Therefore, it is not only integral to mobilize communities towards the uptake of public health services, but health systems need to be prepared to cater to their needs.
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Affiliation(s)
- Gorkey Gourab
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Golam Sarwar
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Mohammad Niaz Morshed Khan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
- Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - A M Rumayan Hasan
- Universal Health Coverage, Health System and Population Studies Division, International Centre for Diarrhoeal Diseases Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
| | - Samira Dishti Irfan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Tarit Kumar Saha
- Institute of Public Health (IPH), Dhaka, Bangladesh
- Ministry of Health and Family Welfare, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh
| | - Lima Rahman
- HIV/AIDS Programme, Health, Nutrition and HIV/AIDS Sector, Save the Children, House 35, Road 43, Gulshan-2, Dhaka, Bangladesh
| | - A K M Masud Rana
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh
| | - Sharful Islam Khan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka, 1212, Bangladesh.
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Edwards A, Nuño A, Kemp C, Tillett E, Armington G, Fink R, Hamill MM, Manabe YC. A Web-Based, Mail-Order Sexually Transmitted Infection Te sting Program: Qualitative Analysis of User Feedback. JMIR Form Res 2023; 7:e48670. [PMID: 37695644 PMCID: PMC10520762 DOI: 10.2196/48670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/30/2023] [Accepted: 07/26/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND The incidence of sexually transmitted infections (STIs) is increasing in the United States. The COVID-19 pandemic resulted in significant reductions in access to health care services, including STI testing and treatment, leading to underreporting of STI cases and a need for alternatives to clinic-based testing. Moreover, concerns around confidentiality, accessibility, and stigma continue to limit access to clinic-based STI testing, particularly for high-priority populations. IWantTheKit (IWTK) is a web-based platform that mails free, confidential, self-administered sample collection kits for testing for gonorrhea, chlamydia (both genital and extragenital sites), and vaginal trichomonas. Individuals visiting the IWTK website may select genital, pharyngeal, and rectal samples for chlamydia and gonorrhea testing. Vaginal samples are tested for trichomoniasis. Self-collected samples are processed in a College of American Pathologists-accredited laboratory, and results are posted to an individual's secure digital account. OBJECTIVE This study aimed to (1) describe users' experience with the IWTK service through analysis of routine data and (2) optimize retention among current users and expand reach among high-priority populations by responding to user needs through programmatic and functional changes to the IWTK service. METHODS Free-text entries were submitted by IWTK users via a confidential "Contact Us" page on the IWTK website from May 17, 2021, to January 31, 2022. All entries were deidentified prior to analysis. Two independent analysts coded these entries using a predefined codebook developed inductively for thematic analysis. RESULTS A total of 254 free-text entries were analyzed after removing duplicates and nonsensical entries. Themes emerged regarding the functionality of the website and personal experiences using IWTK's services. Users' submissions included requests related to order status, address changes, replacement of old kits, clinical information (eg, treatment options and symptom reports), and reported risk behaviors. CONCLUSIONS This analysis demonstrates how routine data can be used to propose potential programmatic improvements. IWTK implemented innovations on the website based on the study results to improve users' experience, including a tracking system for orders, address verification for each order, a physical drop box, additional textual information, direct linkage to care navigation, and printable results. Web-based, mail-order STI testing programs can leverage user feedback to optimize implementation and retention among current users and potentially expand reach among high-priority populations. This analysis is supported by other data that demonstrate how comprehensive support and follow-up care for individuals testing positive are critical components of any self-testing service. Additional formal assessments of the IWTK user experience and efforts to optimize posttesting linkage to care may be needed.
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Affiliation(s)
- Abagail Edwards
- Center for Indigenous Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Aries Nuño
- Center for Indigenous Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Christopher Kemp
- Center for Indigenous Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Emily Tillett
- Center for Indigenous Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Gretchen Armington
- Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Rachel Fink
- Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Matthew M Hamill
- Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Yukari C Manabe
- Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
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Comeau N, Abdelnour A, Ashack K. Assessing Public Interest in Mpox via Google Trends, YouTube, and TikTok. JMIR Dermatol 2023; 6:e48827. [PMID: 37672322 PMCID: PMC10512109 DOI: 10.2196/48827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/07/2023] Open
Abstract
Public response to the recent Mpox outbreak was analyzed using internet search trends and social media posts.
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Affiliation(s)
- Nicholas Comeau
- Michigan State University College of Human Medicine, Grand Rapids, MI, United States
| | - Alyssa Abdelnour
- Michigan State University College of Human Medicine, Grand Rapids, MI, United States
| | - Kurt Ashack
- Michigan State University College of Human Medicine, Grand Rapids, MI, United States
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Elmi N, Marquez NG, Rucinski K, Lyons C, Turpin G, Ba I, Turpin N, Gouane E, Obodou E, Diouf D, Baral S. Meeting the reproductive health needs of female sex workers in Côte d'Ivoire: protecting the human right to dignified health. Reprod Health 2023; 20:133. [PMID: 37670305 PMCID: PMC10481554 DOI: 10.1186/s12978-023-01659-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/30/2023] [Indexed: 09/07/2023] Open
Abstract
The sexual and reproductive health needs of female sex workers (FSW) are often understudied and underserved in the context of HIV-related research in countries across Sub-Saharan Africa and West Africa. We assessed the lived experiences of FSW across Côte d'Ivoire to characterize unmet reproductive health needs and opportunities to address them. From February-August, 2020, ENDA Santé, Côte d'Ivoire conducted 75 in-depth interviews and 15 focus group discussions with FSW and community informants in five cities in Côte d'Ivoire. Themes that emerged included the inconsistent use of contraception services, a history of unintended pregnancies, and experiences of stigma at public healthcare facilities. Opportunities to increase the impact of both SRH and HIV services included strengthening existing HIV and family planning service integration for FSW. Taken together, the results highlight the importance of addressing the unmet reproductive health needs of FSW to both optimize the HIV response and increase the delivery of human-rights affirming sexual and reproductive health services for sex workers.
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Affiliation(s)
- Nika Elmi
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD USA
| | - Nuria Gallego Marquez
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD USA
| | - Katherine Rucinski
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD USA
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD USA
| | - Carrie Lyons
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD USA
| | - Gnilane Turpin
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD USA
| | | | | | - Emile Gouane
- ENDA Santé Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | | | | | - Stefan Baral
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD USA
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Kopp SA, Turk DE. Human Papillomavirus Vaccinations: Provider Education to Enhance Vaccine Uptake. Clin Pediatr (Phila) 2023; 62:840-848. [PMID: 36655653 DOI: 10.1177/00099228221147850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Human papillomavirus (HPV) is the number one sexually transmitted infection (STI) worldwide. The Centers for Disease Control and Prevention (CDC) approximated that 92% of HPV-related cancers might be prevented by receiving the HPV 9-valent vaccine (Gardasil 9). The 2-dose HPV vaccine for children ages 11 to 12 years provides almost 100% protection against strains affiliated with cervical, vaginal, and vulvar cancers. Provider education is essential to decrease clinical knowledge deficits and increase vaccination uptake. Evidence-based provider recommendations expressed to eligible individuals improves vaccination rates. Evidence-based approaches for vaccine-hesitant parents involve using the presumptive announcement approach, asking for and addressing main concerns, and trying again if the parent initially declines. Seventy percent of parents who initially decide not to get their child vaccinated later agree to the vaccine or schedule a follow-up appointment. The CDC guidelines for HPV vaccinations, including the catch-up and adult guidelines, are reviewed. A clinical vignette with case scenarios and a Q&A quiz are included.
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Affiliation(s)
- Sarah A Kopp
- DNP-FNP Program, Graduate School of Nursing, University of North Florida, Jacksonville, FL, USA
| | - Dawn E Turk
- Graduate Nursing Program, University of North Florida, Jacksonville, FL, USA
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Carson JM, Barbieri S, Cunningham E, Mao E, van der Valk M, Rockstroh JK, Hellard M, Kim A, Bhagani S, Feld JJ, Gane E, Thurnheer MC, Bruneau J, Tu E, Dore GJ, Matthews GV, Martinello M. Sexual and drug use risk behaviour trajectories among people treated for recent HCV infection: the REACT study. J Int AIDS Soc 2023; 26:e26168. [PMID: 37675828 PMCID: PMC10483502 DOI: 10.1002/jia2.26168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 08/23/2023] [Indexed: 09/08/2023] Open
Abstract
INTRODUCTION Exploration of sexual and drug use behaviours following treatment for recent hepatitis C virus (HCV) is limited. This analysis modelled behavioural trajectories following treatment for recent HCV and assessed reinfection. METHODS Participants treated for recent HCV in an international trial (enrolled 2017-2019) were followed at 3-monthly intervals for up to 2 years to assess longitudinal behaviours. Population-averaged changes were assessed using generalized estimating equations. Distinct behavioural trajectories were identified using group-based trajectory modelling. HCV reinfection incidence was calculated using person-years (PY) of observation. RESULTS During the follow-up of 212 participants (84% gay and bisexual men [GBM]; 69% HIV; 26% current injecting drug use [IDU]), behavioural trajectories for IDU and stimulant use (past month) did not change. However, population-averaged decreases in the likelihood of daily IDU (adjusted odds ratio [AOR] 0.83; 95% CI 0.72, 0.95) and opioid use (AOR 0.84; 95% CI 0.75, 0.93) were observed. Among GBM, behavioural trajectories for chemsex did not change. Population-averaged decreases in condomless anal intercourse with casual male partners (CAI-CMP) (AOR 0.95; 95% CI 0.90, 0.99) and group-sex (AOR 0.86; 95% CI 0.80, 0.93) were observed, but masked distinct trajectories. While a proportion had a decreased probability of CAI-CMP (23%) and group-sex (59%) post-treatment, a substantial proportion retained a high probability of these behaviours. High HCV reinfection incidence was observed for the sustained high probability IDU (33.0/100 PY; 95% CI 17.7, 61.3) and chemsex (23.3/100 PY; 95% CI 14.5, 37.5) trajectories. CONCLUSIONS Limited sexual and drug use behavioural change was observed following treatment for recent HCV, supporting access to surveillance and (re)treatment.
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Affiliation(s)
| | - Sebastiano Barbieri
- The Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia
| | | | - Eric Mao
- Kirby InstituteUNSW SydneySydneyNew South WalesAustralia
| | - Marc van der Valk
- Division of Infectious DiseasesAmsterdam Infection and Immunity InstituteUniversity Medical CentersUniversity of AmsterdamAmsterdamThe Netherlands
- Stichting HIV MonitoringAmsterdamThe Netherlands
| | | | - Margaret Hellard
- Burnet InstituteMelbourneVictoriaAustralia
- The Alfred HospitalMelbourneVictoriaAustralia
| | - Arthur Kim
- Massachusetts General HospitalBostonMassachusettsUSA
| | | | - Jordan J. Feld
- Toronto Centre for Liver DiseasesToronto General HospitalTorontoOntarioCanada
| | - Ed Gane
- Auckland City HospitalAucklandNew Zealand
| | | | - Julie Bruneau
- Research CenterCentre Hospitalier de l'Université de MontréalMontréalQuebecCanada
| | - Elise Tu
- Kirby InstituteUNSW SydneySydneyNew South WalesAustralia
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Aravantinou M, Plagianos M, Kokogho A, Adebajo S, Nowak RG, Shoyemi E, Ekeh C, Lombardi K, Peel SA, Baral SD, Crowell TA, Derby N, Teleshova N, Martinelli E. Herpes Simplex Virus Type 2 Prevalence and Association with Inflammatory Cytokines Among Sexual and Gender Minorities Living With and Without HIV-1 from Lagos, Nigeria. AIDS Res Hum Retroviruses 2023; 39:485-494. [PMID: 36825536 PMCID: PMC10510689 DOI: 10.1089/aid.2022.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Herpes simplex virus type 2 (HSV-2) is common globally and contributes significantly to the risk of acquiring HIV-1, yet these two sexually transmitted infections have not been sufficiently characterized for sexual and gender minorities (SGM) across Sub-Saharan Africa. To help fill this gap, we performed a retrospective study using plasma and serum samples from 183 SGM enrolled at the Lagos site of the TRUST/RV368 cohort in Nigeria, assayed them for HSV-2 antibodies with the Kalon ELISA and plasma cytokines and chemokines with Luminex, and correlated the findings with HIV-1 viral loads (VLs) and CD4 counts. We found an overall HSV-2 prevalence of 36.6% (49.5% and 23.9% among SGM with and without HIV-1, respectively, p < .001). Moreover, HSV-2-positive status was associated with high circulating concentrations of CCL11 among antiretroviral therapy-treated (p = .031) and untreated (p = .015) participants, and with high concentrations of CCL2 in the untreated group (p = .004), independent of VL. Principal component analysis revealed a strong association of cytokines with HIV-1 VL independent of HSV-2 status. In conclusion, our study finds that HSV-2 prevalence among SGM with HIV-1 is twice as high than HSV-2 prevalence among SGM without HIV-1 in Lagos and suggests that this is associated with higher levels of certain systemic cytokines. Additional work is needed to further characterize the relationship between HSV-2 and HIV-1 in SGM and help develop targeted therapies for coinfected individuals.
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Affiliation(s)
- Meropi Aravantinou
- Center for Biomedical Research, Population Council, New York, New York, USA
| | - Marlena Plagianos
- Center for Biomedical Research, Population Council, New York, New York, USA
| | | | - Sylvia Adebajo
- Center for International Health Education and Biosecurity (CIHEB), University of Maryland, Baltimore, Maryland, USA
| | - Rebecca G. Nowak
- Institute of Human Virology, University of Maryland, Baltimore, Maryland, USA
| | | | | | - Kara Lombardi
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Sheila A. Peel
- Diagnostics and Countermeasures Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Stefan D. Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Trevor A. Crowell
- U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland, USA
| | - Nina Derby
- Center for Global Infectious Disease Research, Seattle Children's Research Institute, Seattle, Washington, USA
| | - Natalia Teleshova
- Center for Biomedical Research, Population Council, New York, New York, USA
| | - Elena Martinelli
- Department of Cell and Developmental Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Belcher T, Rollier CS, Dold C, Ross JDC, MacLennan CA. Immune responses to Neisseria gonorrhoeae and implications for vaccine development. Front Immunol 2023; 14:1248613. [PMID: 37662926 PMCID: PMC10470030 DOI: 10.3389/fimmu.2023.1248613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
Neisseria gonorrheoae is the causative agent of gonorrhea, a sexually transmitted infection responsible for a major burden of disease with a high global prevalence. Protective immunity to infection is often not observed in humans, possible due to high variability of key antigens, induction of blocking antibodies, or a large number of infections being relatively superficial and not inducing a strong immune response. N. gonorrhoeae is a strictly human pathogen, however, studies using mouse models provide useful insights into the immune response to gonorrhea. In mice, N. gonorrhoea appears to avoid a protective Th1 response by inducing a less protective Th17 response. In mouse models, candidate vaccines which provoke a Th1 response can accelerate the clearance of gonococcus from the mouse female genital tract. Human studies indicate that natural infection often induces a limited immune response, with modest antibody responses, which may correlate with the clinical severity of gonococcal disease. Studies of cytokine responses to gonococcal infection in humans provide conflicting evidence as to whether infection induces an IL-17 response. However, there is evidence for limited induction of protective immunity from a study of female sex workers in Kenya. A controlled human infection model (CHIM) has been used to examine the immune response to gonococcal infection in male volunteers, but has not to date demonstrated protection against re-infection. Correlates of protection for gonorrhea are lacking, which has hampered the progress towards developing a successful vaccine. However, the finding that the Neisseria meningitidis serogroup B vaccines, elicit cross-protection against gonorrhea has invigorated the gonococcal vaccine field. More studies of infection in humans, either natural infection or CHIM studies, are needed to understand better gonococcal protective immunity.
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Affiliation(s)
- Thomas Belcher
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Christina Dold
- The Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Jonathan D. C. Ross
- Sexual Health and HIV, University Hospitals Birmingham NHS Trust, Birmingham, United Kingdom
| | - Calman A. MacLennan
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
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Feng J, Janaína de Campos L, Seleem MA, Conda-Sheridan M. Synthesis and biological evaluation of sulfonylpyridine derivatives as potential anti-chlamydia agents. Bioorg Med Chem 2023; 91:117401. [PMID: 37453189 DOI: 10.1016/j.bmc.2023.117401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
Chlamydia trachomatis is the most prevalent sexually transmitted bacterial infection in the United States and the world. This pathogen can cause health problems ranging from trachoma (blindness) to damage of the fallopian tubes or ectopic pregnancy, which can be life-threatening if not treated properly. To this day, there is no chlamydia-specific drug on the market. Previously, we reported the activity and basic structure-activity relationships (SAR) of sulfonylpyridine molecules that possess antichlamydial action. Based on those results, we prepared a new series of derivatives. Our data indicate the new analogs can halt the growth of C. trachomatis. The lead compound, 22, was more active than our previous molecules and did not affect the growth of S. aureus and E. coli, suggesting bacterial selectivity. We performed docking studies on the presumed target, the cylindrical protease of Chlamydia. The in-silico studies partially explained the in vitro biological result as well as predicted a possible binding pose in the binding pocket. The top compound displayed a good cytotoxicity profile towards mammalian cell lines and was stable in both serum and stimulated gastric fluid. The presented data suggests the sulfonylpyridines are promising and selective anti-chlamydial compounds that merit further structural optimization.
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Affiliation(s)
- Jiachen Feng
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198-6125, United States
| | - Luana Janaína de Campos
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198-6125, United States
| | - Mohamed A Seleem
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198-6125, United States
| | - Martin Conda-Sheridan
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198-6125, United States.
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Zhang W, Wong CKH, Xin Y, Fong DYT, Wong JYH. A Web-Based Sexual Health Intervention to Prevent Sexually Transmitted Infections in Hong Kong: Model-Based Cost-Effectiveness Analysis. J Med Internet Res 2023; 25:e45054. [PMID: 37561571 PMCID: PMC10450529 DOI: 10.2196/45054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/30/2023] [Accepted: 06/28/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) remain a significant public health concern, particularly among young adults, and Chlamydia trachomatis (CT) infections are the most common STIs in young women. One of the most effective ways to prevent STIs is the consistent use of condoms during sexual intercourse. There has been no economic evaluation of the interactive web-based sexual health program, Smart Girlfriend, within the Chinese population. OBJECTIVE This study aimed to evaluate the long-term cost-effectiveness of Smart Girlfriend in preventing STIs in the Chinese population. The evaluation compared the program with a control intervention that used a 1-page information sheet on condom use. METHODS A decision-analytic model that included a decision tree followed by a Markov structure of CT infections was developed since CT is the most prevalent STI among young women. The model represents the long-term experience of individuals who received either the intervention or the control. One-way and probabilistic sensitivity analyses were conducted. The main outcomes were the number of CT infections and the incremental cost as per quality-adjusted life year (QALY). RESULTS A cohort of 10,000 sexually active nonpregnant young women initially entered the model in a noninfectious state (ie, "well"). In the base-case analysis, the implementation of the Smart Girlfriend program resulted in the prevention of 0.45% of CT infections, 0.3% of pelvic inflammatory disease, and 0.04% of chronic pelvic pain, leading to a gain of 70 discounted QALYs and cost savings over a 4-year time horizon, compared to the control group. With more than 4548 users, the intervention would be cost-effective, and with more than 8315 users, the intervention would be cost saving. A 99% probability of being cost-effective was detected with a willingness to pay US $17,409 per QALY. CONCLUSIONS Smart Girlfriend is a cost-effective and possibly cost-saving program over a 4-year time horizon. This result was particularly sensitive to the number of website users; launching the website would be cost-effective if more than 4548 people used it. Further work is warranted to explore if the findings could be expanded to apply to women who have sex with women and in the context of other STIs. TRIAL REGISTRATION ClinicalTrial.gov NCT03695679; https://clinicaltrials.gov/study/NCT03695679.
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Affiliation(s)
- Wen Zhang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China (Hong Kong)
| | - Carlos K H Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
- Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Yiqiao Xin
- Health Economics and Health Technology Assessment, University of Glasgow, Glasgow, United Kingdom
| | - Daniel Y T Fong
- School of Nursing, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Janet Y H Wong
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China (Hong Kong)
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Opara I, Gabriel C, Duran-Becerra B, Bond K, Hill AV, Hussett-Richardson S, Alves C, Kershaw T. Sexual Health and Drug Use Prevention for Black Girls (The Dreamer Girls Project): Protocol for an Intervention Development. JMIR Res Protoc 2023; 12:e45007. [PMID: 37556188 PMCID: PMC10448282 DOI: 10.2196/45007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 05/02/2023] [Accepted: 05/05/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Substance use among adolescent girls is associated with numerous risk characteristics, including engaging in sexual risk behaviors, which can lead to HIV and sexually transmitted infection (STI) diagnoses. This is an important phenomenon to target as there is a significant race-gendered paradox that occurs when Black girls use and misuse drugs. When misuse occurs among this group, they are more likely to face harsher consequences and worse health outcomes than boys and other ethnic-minority girls. Therefore, there is a need to understand the risk and protective factors of drug use and sexual risk behaviors among Black girls and develop a robust intervention that can cater for this group. OBJECTIVE We propose the development of a strengths-based prevention education intervention for Black girls between the ages of 13 and 18 years to promote protective factors. METHODS A sequential, mixed methods study will be conducted, and we will use the first 3 steps of the ADAPT-ITT (assessment, decision, adaptation, production, topical experts, integration, training, testing) framework to begin the development of the intervention. Three aims will be described in this protocol. First, aim 1 is to explore sociocultural risk and protective factors among Black girls between the ages 13 and 18 years in drug use and HIV/STI prevention using focus group methodology and surveys. We will conduct at least 10 focus groups to include up to 75 Black girls or until we reach saturation. Our target sample size for the quantitative portion of the study will be 200 participants. Aim 2 will focus on deciding upon an intervention based on findings from aim 1 and forming a youth advisory board to guide intervention development. Aim 3 will be to conduct a pretest of the intervention with the youth advisory board to determine if the intervention is feasible and will be accepted by Black girls. RESULTS The study is part of a 2-year research pilot study award from the National Institutes of Mental Health. Data collection for this study began in October 2021. For aim 1, data collection is 95% complete. We expect to complete all data collection for aim 1 on or before May 30, 2023. Study activities for aim 2 are occurring simultaneously as data are being collected and analyzed and will be completed in the summer of 2023. Study activities for aim 3 will begin in the fall of 2023. CONCLUSIONS This study will be one of the few interventions that address both sexual health and drug use together and cater to Black girls. We anticipate that the intervention will be beneficial for Black girls across the nation to work on building culturally appropriate prevention education and building peer social supports, resulting in reduction or delayed substance use and improved sexual health. TRIAL REGISTRATION ClinicalTrials.gov NCT05014074; https://clinicaltrials.gov/ct2/show/NCT05014074. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/45007.
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Affiliation(s)
- Ijeoma Opara
- Yale School of Public Health, New Haven, CT, United States
| | - Cora Gabriel
- Yale School of Public Health, New Haven, CT, United States
| | | | - Keosha Bond
- City University of New York School of Medicine, New York, NY, United States
| | - Ashley V Hill
- University of Pittsburgh, Pittsburgh, PA, United States
| | | | - Courtnae Alves
- Columbia University School of Public Health, New York, NY, United States
| | - Trace Kershaw
- Yale School of Public Health, New Haven, CT, United States
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Wang N, Zhang R, Ye Z, Lan G, Zhu Q, Chen H, Zhang X, Tan S, Ruan Y, Lin M. Studies on HIV/AIDS Among Students: Bibliometric Analysis. Interact J Med Res 2023; 12:e46042. [PMID: 37540553 PMCID: PMC10439465 DOI: 10.2196/46042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/08/2023] [Accepted: 05/24/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND In recent years, HIV infection in students has been an ongoing concern worldwide. A large number of articles have been published; however, statistical analysis of the data presented in these publications is lacking. OBJECTIVE This study aimed to detect and analyze emerging trends and collaborative networks in research on HIV/AIDS among students. METHODS Research publications on HIV/AIDS among students from 1985 to 2022 were collected from the Web of Science Core Collection. A topic search was used for this study, and articles in English were included. CiteSpace was used to generate visual networks of countries/regions, institutions, references, and keywords. Citation analysis was used to discover milestones in the field and trace the roots of the knowledge base. Keyword analysis was used to detect research hotspots and predict future trends. RESULTS A total of 2726 publications met the inclusion criteria. Over the past 38 years, the number of publications annually has been on the rise overall. The United States had the highest number of publications (n=1303) and the highest centrality (0.91). The University of California system was the core institution. The main target population of studies on HIV/AIDS among students were medical and university students. These studies focused on students' knowledge, attitudes, risk behaviors, and education about HIV/AIDS. The recent bursting keywords (gay, sexual health, adherence, barriers, mental health, HIV testing, stigma, and antiretroviral therapy) revealed research trends and public interest on this topic. CONCLUSIONS This study identified countries/regions and institutions contributing to the research area of HIV/AIDS among students and revealed research hotspots and emerging trends. The field of research on HIV/AIDS among students was growing rapidly. The United States was at the center, and the University of California system was the core institution. However, academic collaboration should be strengthened. Future research may focus on exploring gay students, sexual health, adherence, barriers, mental health, HIV testing, stigma, and antiretroviral therapy.
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Affiliation(s)
- Na Wang
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, School of Public Health, Guilin Medical University, Guilin, China
| | - Runxi Zhang
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, School of Public Health, Guilin Medical University, Guilin, China
| | - Zeyan Ye
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, School of Public Health, Guilin Medical University, Guilin, China
| | - Guanghua Lan
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Qiuying Zhu
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Huanhuan Chen
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Xiangjun Zhang
- Department of Clinical Pharmacy and Translational Science, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Shengkui Tan
- Guangxi Key Laboratory of Environmental Exposomics and Entire Lifecycle Health, School of Public Health, Guilin Medical University, Guilin, China
| | - Yuhua Ruan
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Mei Lin
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
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Garcia Iglesias J, Nagington M, Pickersgill M, Brady M, Dewsnap C, Highleyman L, Membrillo de Novales FJ, Nutland W, Thrasher S, Umar E, Muchamore I, Webb J. Is mpox an STI? The societal aspects and healthcare implications of a key question. Wellcome Open Res 2023; 7:252. [PMID: 37425485 PMCID: PMC10329192 DOI: 10.12688/wellcomeopenres.18436.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 07/11/2023] Open
Abstract
This letter explores the societal aspects and healthcare implications that underlie thinking about mpox (formerly known was monkeypox), in the 2022 outbreak, as a sexually transmitted infection (STI). The authors examine what underlies this question, exploring what is an STI, what is sex, and what is the role of stigma in sexual health promotion. The authors argue that, in this specific outbreak, mpox is an STI among men who have sex with men (MSM). The authors highlight the need of critically thinking about how to communicate effectively, the role of homophobia and other inequalities, and the importance of the social sciences.
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Affiliation(s)
| | | | - Martyn Pickersgill
- Centre for Biomedicine, Self and Society, University of Edinburgh, Edinburgh, UK
| | - Michael Brady
- King's College Hospital NHS Foundation Trust, London, UK
| | - Claire Dewsnap
- Sexual Health, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | | | | | | | - Steven Thrasher
- Medill School of Journalism, Media, Integrated Marketing Communications, Northwestern University, Evanston, USA
| | - Eric Umar
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Ian Muchamore
- Centre for Biomedicine, Self and Society, University of Edinburgh, Edinburgh, UK
| | - Jamie Webb
- Centre for Technomoral Futures, University of Edinburgh, Edinburgh, UK
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Garcia Iglesias J, Nagington M, Pickersgill M, Brady M, Dewsnap C, Highleyman L, Membrillo de Novales FJ, Nutland W, Thrasher S, Umar E, Muchamore I, Webb J. Is mpox an STI? The societal aspects and healthcare implications of a key question. Wellcome Open Res 2023; 7:252. [PMID: 37425485 PMCID: PMC10329192 DOI: 10.12688/wellcomeopenres.18436.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 11/19/2023] Open
Abstract
This letter explores the societal aspects and healthcare implications that underlie thinking about mpox (formerly known was monkeypox), in the 2022 outbreak, as a sexually transmitted infection (STI). The authors examine what underlies this question, exploring what is an STI, what is sex, and what is the role of stigma in sexual health promotion. The authors argue that, in this specific outbreak, mpox is an STI among men who have sex with men (MSM). The authors highlight the need of critically thinking about how to communicate effectively, the role of homophobia and other inequalities, and the importance of the social sciences.
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Affiliation(s)
| | | | - Martyn Pickersgill
- Centre for Biomedicine, Self and Society, University of Edinburgh, Edinburgh, UK
| | - Michael Brady
- King's College Hospital NHS Foundation Trust, London, UK
| | - Claire Dewsnap
- Sexual Health, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, UK
| | | | | | | | - Steven Thrasher
- Medill School of Journalism, Media, Integrated Marketing Communications, Northwestern University, Evanston, USA
| | - Eric Umar
- Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Ian Muchamore
- Centre for Biomedicine, Self and Society, University of Edinburgh, Edinburgh, UK
| | - Jamie Webb
- Centre for Technomoral Futures, University of Edinburgh, Edinburgh, UK
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65
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Recto M, Gaydos C, Perin J, Yusuf HE, Toppins J, Trent M. The Future of Sexually Transmitted Infection Research: Understanding Adolescent Perspectives for Implementation of a Chlamydia Vaccine. J Adolesc Health 2023; 73:198-200. [PMID: 37019692 PMCID: PMC10330164 DOI: 10.1016/j.jadohealth.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/20/2023] [Accepted: 01/21/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE Despite advancements in developing a vaccine for Chlamydia trachomatis (CT), vaccine hesitancy has historically limited the adoption of sexually transmitted infection immunization. This report investigates adolescent perspectives toward a potential CT vaccine and vaccine research. METHODS As part of the Technology Enhanced Community Health Nursing (TECH-N) study, conducted from 2012-2017, we surveyed 112 adolescents and young adults aged 13-25 years who presented with pelvic inflammatory disease regarding their perspectives on a CT vaccine and willingness to participate in vaccine research. Descriptive statistical analyses were conducted. RESULTS Most participants were African American (95%), on Medicaid (89%), and sexually experienced (100%). Most respondents would accept a vaccine (95%) and preferred a provider's recommendation (86%) over parents, partners, or friends. A majority (70%) would not be embarrassed to participate in research. DISCUSSION Respondents showed favorable attitudes toward CT vaccination and research in this high-risk study population.
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Affiliation(s)
- Michelle Recto
- Division of Adolescent and Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Charlotte Gaydos
- Division of Adolescent and Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jamie Perin
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Hasiya E Yusuf
- Division of Adolescent and Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jacquelyn Toppins
- Division of Adolescent and Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Maria Trent
- Division of Adolescent and Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
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Adoma PO, Yeboah Snr CA, Nantomah B, Manu E, Kushitor MK. Experiences of care-seeking behaviour for sexually transmitted infections among gay and bisexual men: A phenomenological study. Afr J Reprod Health 2023; 27:64-75. [PMID: 37742335 DOI: 10.29063/ajrh2023/v27i7.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Gay and bisexual men (GBM) are stigmatized in the Ghanaian society and that negatively affect their care-seeking behaviour. We sought to understand the experiences of care-seeking behaviour (CSB) for STIs among gay and bisexual men in Sunyani, capital of Bono Region, Ghana. A respondent-driven sampling was used to collect data from 17 gay and bisexual men in Sunyani based on phenomenological qualitative approach. The data were thematically analysed using the Atlas.ti software. Results were presented under various themes with appropriate accompanying excerpts. Two broad themes emerged from the data - personal and health system experiences of treating STIs. Personal experiences such as economic conditions, knowledge on STI, marital experiences and bisexual's partner awareness of sexual orientation had influences on CSB. Experience with cost of treatment, stigmatisation by health care workers (HCW) and perceived quality healthcare were the health system factors found to influence CSB. To help improve STIs care-seeking behaviour, government need to encourage and economically empower GBM, while at the same time, improving their knowledge on STI prevention and control. The National Health Authority should intensify and monitor the implementation of the national health insurance at the private healthcare sectors without favour and discrimination for gay and bisexual men.
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Affiliation(s)
- Prince O Adoma
- Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, Ghana
| | - Cecilia A Yeboah Snr
- Kwatire Government Hospital, Sunyani West Municipal Health Directorate, Odumase - Bono Region, Ghana
| | - Bismark Nantomah
- Department of Population and Reproductive Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Emmanuel Manu
- Department of Population and Behavioural Sciences, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Mawuli K Kushitor
- Department of Health Policy Planning and Management, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
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Higgins DM, Moore M, Alderton L, Weinberg L, Hickok AM, Yale A, Wendel KA. Evaluation of a Statewide Online, At-Home Sexually Transmitted Infection and Human Immunodeficiency Virus Screening Program. Clin Infect Dis 2023; 76:2148-2153. [PMID: 36757359 DOI: 10.1093/cid/ciad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/20/2023] [Accepted: 02/04/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Innovative approaches such as online, at-home programs may address important barriers to sexually transmitted infection (STI) and human immunodeficiency virus (HIV) screening in the United States. This study evaluated the first year of an online, at-home program offering HIV and triple-site (urogenital, rectal, and pharyngeal) gonorrhea (GC) and chlamydia (CT) testing in Colorado. METHODS Test Yourself Colorado (TYC) is an online, at-home program that provides free mailed HIV tests and/or GC/CT tests to Colorado adults. Program use and outcomes between 1 June 2021 and 31 May 2022 were analyzed. RESULTS A total of 1790 unique clients utilized TYC. Of 1709 clients who ordered HIV tests, 508 (29.7%) were men who have sex with men (MSM), and 41.3% (210/508) of these clients reported having never been tested for HIV before or were not tested in the prior year. Hispanic clients had lower STI test return rates (37.1%; 134/361) compared with non-Hispanic clients (45.9%; 518/1128) (P = .003). Positive STI tests were identified in 9.6% (68/708) of clients. Positive STI tests were more common in MSM clients (15.7%; 34/216) compared with all other sexual orientations (6.9%; 34/492) (P < .001). STI treatment was confirmed in 80.9% (55/68) of clients. CONCLUSIONS The TYC online, home testing portal is a scalable tool that reaches clients at risk of STIs and HIV and navigates those with positive STI tests to treatment. HIV/STI home testing programs need to further assess and address utilization and outcomes for disparities by race and ethnicity to assure programs equitably benefit all at-risk communities.
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Affiliation(s)
- David M Higgins
- Public Health Institute at Denver Health, Denver, Colorado, USA
- Preventive Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- Denver Prevention Training Center, Division of HIV/STI Prevention, Public Health Institute at Denver Health, Denver, Colorado, USA
| | - MaShawn Moore
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Lucy Alderton
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Laura Weinberg
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Andrew M Hickok
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Andrew Yale
- Public Health Institute at Denver Health, Denver, Colorado, USA
| | - Karen A Wendel
- Public Health Institute at Denver Health, Denver, Colorado, USA
- Denver Prevention Training Center, Division of HIV/STI Prevention, Public Health Institute at Denver Health, Denver, Colorado, USA
- Division of Infectious Disease, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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Rodrigues LLS, Pilotto JH, Martinelli KG, Nicol AF, De Paula VS, Gheit T, Oliveira NSC, Silva-de-Jesus C, Sahasrabuddhe VV, Da Silva DM, Kast WM, Hardick J, Gaydos CA, Morgado MG. Diversity of Anal HPV and Non-HPV Sexually Transmitted Infections and Concordance with Genital Infections in HIV-Infected and HIV-Uninfected Women in the Tapajós Region, Amazon, Brazil. Viruses 2023; 15:1328. [PMID: 37376627 PMCID: PMC10302924 DOI: 10.3390/v15061328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
The aim of this study was to classify the diversity of anal HPV and non-HPV sexually transmitted infections (STIs) and compare the concordance between anal and genital infections in HIV-infected and uninfected women living in the Tapajós region, Amazon, Brazil. A cross-sectional study was performed with 112 HIV-uninfected and 41 HIV-infected nonindigenous women. Anal and cervical scrapings were collected and analyzed for HPV, Chlamydia trachomatis (CT), Neisseria gonorrheae (NG), Trichomonas vaginalis (TV), Mycoplasma genitalium (MG), and Human alphaherpesvirus 2 (HSV-2). The Kappa test evaluated the concordance between anal and genital infections. The overall prevalence of anal HPV infection was 31.3% in HIV-uninfected and 97.6% in HIV-infected women. The most frequent anal high-risk HPV (hrHPV) types were HPV18 and HPV16 in HIV-uninfected women and HPV51, HPV59, HPV31, and HPV58 in HIV-infected women. Anal HPV75 Betapapillomavirus was also identified. Anal non-HPV STIs were identified in 13.0% of all participants. The concordance analysis was fair for CT, MG, and HSV-2, almost perfect agreement for NG, moderate for HPV, and variable for the most frequent anal hrHPV types. Thus, a high prevalence of anal HPV infection with moderate and fair concordance between anal and genital HPV and non-HPV STIs was observed in our study.
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Affiliation(s)
- Luana Lorena Silva Rodrigues
- Programa de Pós-Graduação em Ciências da Saúde, Instituto de Saúde Coletiva, Universidade Federal do Oeste do Pará, Santarém 68135-110, Brazil
- Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (J.H.P.); (C.S.-d.-J.)
- Programa de Pós-Graduação em Medicina Tropical, IOC-FIOCRUZ, Rio de Janeiro 21040-360, Brazil
| | - José Henrique Pilotto
- Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (J.H.P.); (C.S.-d.-J.)
| | | | - Alcina F. Nicol
- Instituto Nacional de Infectologia Evandro Chagas, INI-FIOCRUZ, Rio de Janeiro 21040-360, Brazil;
| | - Vanessa Salete De Paula
- Laboratório de Virologia Molecular e Parasitologia, IOC-FIOCRUZ, Rio de Janeiro 21040-360, Brazil;
| | - Tarik Gheit
- International Agency for Research on Cancer, 69366 Lyon, France;
| | | | - Carlos Silva-de-Jesus
- Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (J.H.P.); (C.S.-d.-J.)
| | | | - Diane M. Da Silva
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA 90033, USA; (D.M.D.S.); (W.M.K.)
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089, USA
| | - W. Martin Kast
- Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA 90033, USA; (D.M.D.S.); (W.M.K.)
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90089, USA
- Department of Molecular Microbiology and Immunology, University of Southern California, Los Angeles, CA 90089, USA
| | - Justin Hardick
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (J.H.); (C.A.G.)
| | - Charlotte A. Gaydos
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA; (J.H.); (C.A.G.)
| | - Mariza Gonçalves Morgado
- Laboratório de AIDS e Imunologia Molecular, IOC-FIOCRUZ, Rio de Janeiro 21040-360, Brazil; (J.H.P.); (C.S.-d.-J.)
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Oware K, Adiema L, Rono B, Violette LR, McClelland RS, Donnell D, Scoville CW, Odoyo J, Baeten JM, Bukusi E, Stewart J. Characteri stics of Kenyan women using HIV PrEP enrolled in a randomized trial on doxycycline postexposure prophylaxis for sexually transmitted infection prevention. BMC Womens Health 2023; 23:296. [PMID: 37270546 DOI: 10.1186/s12905-023-02413-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 05/05/2023] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION The global incidence of sexually transmitted infections (STIs) has been rapidly increasing over the past decade, with more than one million curable STIs being acquired daily. Young women in sub-Saharan Africa have a high prevalence and incidence of both curable STIs and HIV. The use of doxycycline as a prophylaxis to prevent STIs is promising; however, clinical trials, to date, have only been conducted among men who have sex with men (MSM) in high-income settings. We describe the characteristics of participants enrolled in the first trial to determine the efficacy of doxycycline post-exposure prophylaxis (PEP) to reduce STI incidence among women taking daily, oral HIV pre-exposure prophylaxis (PrEP). METHODS This is an open-label 1:1 randomized clinical trial on the efficacy of doxycycline PEP compared with standard of care (e.g., quarterly STI screening and treatment) to reduce incident bacterial STIs - Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum - among Kenyan women aged ≥18 and ≤30 years. All were also taking HIV pre-exposure prophylaxis (PrEP). We describe the baseline characteristics, STI prevalence, and STI risk perception of participants. RESULTS Between February 2020 and November 2021, 449 women were enrolled. The median age was 24 years (IQR 21-27), the majority were never married (66.1%), 370 women (82.4%) reported having a primary sex partner, and 33% had sex with new partners in the three months prior to enrolment. Two-thirds (67.5%, 268 women) did not use condoms, 36.7% reported transactional sex, and 43.2% suspected their male partners of having sex with other women. Slightly less than half (45.9%, 206 women) were recently concerned about being exposed to an STI. The prevalence of STIs was 17.9%, with C. trachomatis accounting for the majority of infections. Perceived risk of STIs was not associated with the detection of an STI. CONCLUSION Young cisgender women using HIV PrEP in Kenya and enrolled in a trial of doxycycline postexposure prophylaxis had a high prevalence of curable STIs and represent a target population for an STI prevention intervention.
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Affiliation(s)
- Kevin Oware
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
| | - Lydia Adiema
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Bernard Rono
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Lauren R Violette
- Departments of Medicine (Infectious Diseases), Seattle, United States
- Departments of Epidemiology, Seattle, United States
| | - R Scott McClelland
- Departments of Global Health, University of Washington, Seattle, United States
- Departments of Medicine (Infectious Diseases), Seattle, United States
- Departments of Epidemiology, Seattle, United States
| | - Deborah Donnell
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, United States
| | - Caitlin W Scoville
- Departments of Global Health, University of Washington, Seattle, United States
| | | | - Jared M Baeten
- Departments of Global Health, University of Washington, Seattle, United States
- Departments of Medicine (Infectious Diseases), Seattle, United States
- Departments of Epidemiology, Seattle, United States
- Gilead Sciences, Foster City, United States
| | - Elizabeth Bukusi
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
- Departments of Global Health, University of Washington, Seattle, United States
- Departments of Obstetrics and Gynaecology, Seattle, United States
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Balestrieri M, Carnovale-Scalzo C, Garbuglia AR, Chiantore MV, Accardi L, Di Bonito P. Conventional therapy for genital herpesvirus and remission of HPV-related lesions: a case series. Infect Agent Cancer 2023; 18:36. [PMID: 37269015 DOI: 10.1186/s13027-023-00511-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
This report covers the case of 7 women affected by pathologies related to genital Herpesvirus and Papillomavirus. They were referred to the gynaecology outpatient clinic for colposcopic examination, and received pharmacological antiviral treatment. The patients presented clinical signs of genital Herpesvirus infections in the cervix and vulva. Cervical lesions and condylomatosis, which are characteristic of Papillomavirus infections were also detected, and patients underwent cervical cancer screening. Patients received oral and topical treatment with Acyclovir or oral treatment with Valacyclovir. During weekly or biweekly gynaecological follow-up visits, patients showed different times of remission of genital Herpesvirus. During the antiviral treatments, the vulvar and cervical Papillomavirus lesions also showed complete resolution with restitutio ad integrum of the tissues, and no recurrence at follow-up visits. Herpesvirus and Papillomavirus infections are often associated in genital infections and, as sexual transmitted infections, share the same risk factors. In the cases presented, the observed remission of HPV-related pathologies during Acyclovir and Valaciclovir treatments may suggest that antivirals are also effective in the treatment of HPV lesions. The cases described could pave the way for further investigations and clinical studies.
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Affiliation(s)
- Maria Balestrieri
- Gynaecology and Diagnostic Colposcopy Clinic, Via Enea, 23, 00181, Rome, Italy
| | - Caterina Carnovale-Scalzo
- Histopathology Laboratory, Ospedale San Carlo di Nancy, GVM Care and Research, Via Aurelia 265, 00165, Rome, Italy
| | - Anna Rosa Garbuglia
- Laboratory of Virology, National Institute for Infectious Diseases Lazzaro Spallanzani, IRCCS, Via Portuense 292, 00149, Rome, Italy
| | - Maria Vincenza Chiantore
- Department of Infectious Diseases, EVOR Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Luisa Accardi
- Department of Infectious Diseases, EVOR Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy
| | - Paola Di Bonito
- Department of Infectious Diseases, EVOR Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161, Rome, Italy.
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Wongsomboon V, Webster GD. Delay Discounting for HIV/ STI Testing. Sex Res Social Policy 2023:1-10. [PMID: 37363350 PMCID: PMC10169202 DOI: 10.1007/s13178-023-00819-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 06/28/2023]
Abstract
Introduction Wait time in healthcare is an important barrier to HIV/STI testing. Using a delay discounting approach, the current study examined a systematic reduction in testing likelihood as a function of delay (wait time) until testing. Methods In Study 1 (N = 421; data collected in 2019), participants were randomly assigned to either a chlamydia/gonorrhea group or HIV group. A delay discounting task asked them to report how likely they would get tested for the assigned STI if they had to wait for the test (the delay durations varied within persons). In Study 2 (N = 392; data collected in 2020), we added a smaller, sooner outcome (consultation without testing) and tested whether the effect of delay was mediated by perceived severity of the STIs. Results In both studies, the subjective value of a delayed STI test was discounted. That is, people were less likely to undergo STI testing as the delay to STI testing increased. The chlamydia/gonorrhea group discounted delayed testing more than the HIV group (i.e., the effect of delay on testing decisions was stronger for the former). This effect was statistically mediated by perceived severity. Conclusions We found evidence for delay discounting for HIV/STI testing and that testing decisions were more susceptible to delay when the test was for relatively mild STIs. Policy Implications Even mild STIs can cause serious health damage if left untreated. The findings provide strong argument for policies aimed to reduce wait times in healthcare, especially for relatively mild STIs.
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Affiliation(s)
- Val Wongsomboon
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N Michigan Ave., Chicago, IL USA
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Rodrigues DL, de Visser RO, Lopes D, Prada M, Garrido MV, Balzarini RN. Prevent2Protect Project: Regulatory Focus Differences in Sexual Health Knowledge and Practices. Arch Sex Behav 2023; 52:1701-1713. [PMID: 36702994 PMCID: PMC9879562 DOI: 10.1007/s10508-023-02536-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 09/05/2022] [Accepted: 01/07/2023] [Indexed: 06/18/2023]
Abstract
The way people perceive risks and make decisions about their health is regulated by two motivational systems-prevention of harm or promotion of pleasure. People more focused on prevention strive to avoid negative outcomes and enact more health-protective behaviors. In contrast, people more focused on promotion strive to attain positive outcomes and take more risks with their health. Building upon recent evidence extending this framework to sexual behaviors and health, we conducted a pre-registered online survey ( OSF ) with Portuguese and Spanish adults (N = 742; Mage = 31.42, SD = 9.16) to examine whether self-reported STI knowledge and sexual health practices differ based on predominant regulatory focus. This study was part of the Prevent2Protect project ( OSF ). Results showed that prevention-focused participants had heard about more STIs and retrieved more of their knowledge from scientific sources but had been tested for fewer STIs in the past. In contrast, promotion-focused participants indicated they had specific knowledge about more STIs, retrieved more of their knowledge from medical and peer sources, and had been tested for more STIs in the past. They also reported more frequent STI testing, using free testing facilities or asking their family practice doctor to get tested, more routine sexual health check-ups, and more use of other contraceptive methods, such as birth control pills. These results remained unchanged after controlling for demographic differences. Overall, our findings showed that different motives in sexuality shape sexual health knowledge and sexual health practices.
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Affiliation(s)
- David L Rodrigues
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Av. das Forças Armadas, 1649-026, Lisbon, Portugal.
| | | | - Diniz Lopes
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Av. das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Marília Prada
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Av. das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Margarida V Garrido
- Iscte-Instituto Universitário de Lisboa, CIS-Iscte, Av. das Forças Armadas, 1649-026, Lisbon, Portugal
| | - Rhonda N Balzarini
- Department of Psychology, Texas State University, San Marcos, TX, USA
- The Kinsey Institute, Indiana University, Bloomington, IN, USA
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Perkins JM, Kakuhikire B, Baguma C, Jeon S, Walker SF, Dongre R, Kyokunda V, Juliet M, Satinsky EN, Comfort AB, Siedner M, Ashaba S, Tsai AC. Perceived norms about male circumcision and personal circumcision status: a cross-sectional, population-based study in rural Uganda. medRxiv 2023:2023.04.24.23288996. [PMID: 37163008 PMCID: PMC10168507 DOI: 10.1101/2023.04.24.23288996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Introduction Over the past decade, 15 high-priority countries in eastern and southern Africa have promoted voluntary medical male circucmsion for HIV and STI prevention. Despite male circumcision prevalence in Uganda nearly doubling from 26% in 2011 to 43% in 2016, it remained below the target level by 2020. Little is known about perceived norms of male circumcision and their association with circumcision uptake among men. Methods We conducted a cross-sectional study targeting all adult residents across eight villages in Rwampara District, southwestern Uganda in 2020-2022. We compared what men and women reported as the adult male circumcision prevalence within their village (perceived norm: >50% (most), 10% to <50% (some), <10%, (few), or do not know) to the aggregated prevalence of circumcision as reported by men aged <50 years. We used a modified multivariable Poisson regression model to estimate the association between perceived norms about male circumcision uptake and personal circumcision status among men. Results Overall, 167 (38%) men < 50 years old were circumcised (and 27% of all men were circumcised). Among all 1566 participants (91% response rate), 189 (27%) men and 177 (20%) women underestimated the male circumcision prevalence, thinking that few men in their own village had been circumcised. Additionally, 10% of men and 25% of women reported not knowing the prevalence. Men who underestimated the prevalence were less likely to be circumcised (aRR = 0.51, 95% CI 0.37 to 0.83) compared to those who thought that some village men were circumcised, adjusting for perceived personal risk of HIV, whether any same-household women thought most men were circumcised, and other sociodemographic factors. Conclusions Across eight villages, a quarter of the population underestimated the local prevalence of male circumcision. Men who underestimated circumcision uptake were less likely to be circumcised. Future research should evaluate norms-based approaches to promoting male circumcision uptake. Strategies may include disseminating messages about the increasing prevalence of adult male circumcision uptake in Uganda and providing personalized normative feedback to men who underestimated local rates about how uptake is greater than they thought.
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Affiliation(s)
- Jessica M. Perkins
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Charles Baguma
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Sehee Jeon
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, TN, USA
| | - Sarah F. Walker
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, TN, USA
| | - Rohit Dongre
- Department of Human and Organizational Development, Peabody College, Vanderbilt University, Nashville, TN, USA
| | - Viola Kyokunda
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Mercy Juliet
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Emily N. Satinsky
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Center for Global Health, Massachusetts General Hospital, Boston MA USA
| | - Alison B. Comfort
- Bixby Center for Global Reproductive Health, University of California, San Franciso, USA
| | - Mark Siedner
- Center for Global Health, Massachusetts General Hospital, Boston MA USA
- Harvard Medical School, Boston, MA, USA
- Mongan Institute, Massachusetts General Hospital, Boston MA USA
| | | | - Alexander C. Tsai
- Center for Global Health, Massachusetts General Hospital, Boston MA USA
- Harvard Medical School, Boston, MA, USA
- Mongan Institute, Massachusetts General Hospital, Boston MA USA
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Caza M, Charles M, Locher K, Hoang L, Tucker M, Mandy J, Jewsbury H, Wilmer A. Evaluation of the Aptima BV and CV/TV assays compared to conventional laboratory based te sting methods for the diagnosis of vaginitis. Diagn Microbiol Infect Dis 2023; 106:115953. [PMID: 37295185 DOI: 10.1016/j.diagmicrobio.2023.115953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/24/2023] [Accepted: 04/11/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Vaginitis is caused by bacterial vaginosis (BV), Candida vaginitis (CV) and Trichomonas vaginalis (TV). This retrospective study evaluates the performance of the Aptima CV/TV, and BV assays on the automated Panther system. METHODS Two hundred forty-two multitest swabs were tested on the CV/TV assay and 422 on the BV assay. Positive and negative percent agreement (PPA, NPA) of the Candida glabrata (CG), Candida species group (CSG), TV and BV targets were calculated using a modified gold standard, with review of Gram smear and the usage of the Allplex Vaginitis Screening Assay to resolve discrepancies. RESULTS The PPA and NPA were respectively 98.4% and 95.9% for BV, 100% and 95.4% for CSG, 100% and 99% for CG, and 100% and 100% for TV, and when compared to consensus results. CONCLUSION The CV/TV and BV assays surpassed the acceptance criteria threshold of 95%, and proved to be an excellent alternative to conventional testing.
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Affiliation(s)
- Mélissa Caza
- Kelowna General Hospital, Kelowna, BC, Canada; University of British Columbia, Vancouver, BC, Canada.
| | - Marthe Charles
- University of British Columbia, Vancouver, BC, Canada; Vancouver General Hospital, Vancouver, BC, Canada
| | - Kerstin Locher
- University of British Columbia, Vancouver, BC, Canada; Vancouver General Hospital, Vancouver, BC, Canada
| | - Linda Hoang
- University of British Columbia, Vancouver, BC, Canada; BCCDC Public Health Microbiology & Reference Laboratory, Vancouver, BC, Canada
| | - Morgan Tucker
- University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Jeremy Mandy
- University of British Columbia Okanagan, Kelowna, BC, Canada
| | | | - Amanda Wilmer
- Kelowna General Hospital, Kelowna, BC, Canada; University of British Columbia, Vancouver, BC, Canada
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Kamakura M, Fukuda D, Kuroishi N, Ainiwaer D, Hattori J. Exploring Current Practice, Knowledge, and Challenges of Sexually Transmitted Infection/HIV Management and Pre-Exposure Prophylaxis Among Japanese Health Care Professionals: A Cross-Sectional Web Survey. AIDS Patient Care STDS 2023; 37:253-267. [PMID: 37083443 DOI: 10.1089/apc.2023.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
We conducted a web-based survey targeting physicians in specialties of treating sexually transmitted infection (STI) and/or human immunodeficiency virus (HIV) patients to understand the current STI/HIV care practices and their acceptability of and barriers to the prescription of pre-exposure prophylaxis (PrEP) in Japan. A descriptive analysis was used to summarize survey responses. Univariate and multivariable logistic regression were performed to identify factors associated with willingness to prescribe PrEP. Of 316 survey respondents, 57 were specialized in HIV, 90 STI/Urology/Proctology, 55 Obstetrics/Gynecology, and 114 General Practice/Internal Medicine/Dermatology. Proportion of HIV-specialized physicians who interview the patients about risk behaviors tended to be higher than other physician groups (84.2% vs. 54.8%, 47.3%, and 50.9%, respectively), and 53 - 75% of non-HIV-specialized physicians reported that they were incapable of making decisions on HIV medications. Higher PrEP knowledge enhanced the willingness to recommend and prescribe PrEP drugs (odds ratio: 2.31, 95% confidence interval: 1.30-4.10, p = 0.0044), and 45.4% physicians with no PrEP knowledge raised the concern of incapability to respond and manage when an individual is infected with HIV. Educational opportunities on management and prevention measures for both STI and HIV may encourage non-HIV-specialized physicians to be involved in HIV care and to enhance initiation of HIV tests and adoption of PrEP.
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de Jesus Salgado V, de Abreu Oliveira CMP, da Silva ÁMB, de Brito HIL, de Medeiros DS, Soares F, Magno L, Dourado I, Campos GB, Marques LM. Prevalence of Mollicutes among men who have sex with men and transgender women aged 15 to 19 years in Salvador, North-eastern Brazil. BMC Infect Dis 2023; 23:244. [PMID: 37072756 PMCID: PMC10114492 DOI: 10.1186/s12879-023-08213-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 03/31/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Some species of Mollicutes have been associated with different pathologies of the urogenital tract in humans, with a high prevalence among adult men who have sex with men (MSM) and transgender women (TGW). However, few studies have been performed to investigate its prevalence among adolescents. In this study, we estimated the initial prevalence of Mycoplasma genitalium (MG), Mycoplasma hominis (MH), Ureaplasma urealyticum (UU), and Ureaplasma parvum (UP); the rate of misdiagnosis at different anatomical sites; and the associated factors with positive tests for Mollicutes among MSM and TGW aged 15 to 19 years enrolled in the PrEP1519 study. METHODS PrEP-1519 is the first study to investigate the effectiveness of pre-exposure prophylaxis for human immunodeficiency virus among adolescent MSM and TGW aged 15 to 19 in Latin America. Oral, anal, and urethral swabs were taken from 246 adolescents upon enrolment in the study to detect MG, MH, UU, and UP by quantitative polymerase chain reaction (qPCR). Bivariate and multivariate analyses were conducted by Poisson regression and 95% confidence intervals (95% CI) were estimated. RESULTS The prevalence of Mollicutes was 32.1%. UU was the most prevalent species (20.7%), followed by MH (13.4%), MG (5.7%), and UP (3.2%); 67.3% of the positive samples would have been missed if only urethral samples had been taken. Receptive anal sex (prevalence ratio [PR] = 1.79; 95% CI = 1.07-3.01) and clinical suspicion of sexually transmitted infection (PR = 1.62; 95% CI = 1.01-2.61) were factors associated with the detection of Mollicutes in general. Group sex (PR = 1.98; 95% CI = 1.12-3.50) and receptive anal sex (PR = 2.36; 95% CI = 0.95-5.86) were associated with the detection of Mycoplasma spp. No sociodemographic, clinical, or behavioural variable was significantly associated with the detection of Ureaplasma spp. CONCLUSIONS A high prevalence of Mollicutes was observed among adolescent MSM and TGW, especially at extragenital sites. Further research is required to understand the epidemiological profile of high-risk adolescents in different regions and contexts, and to investigate the pathogenesis of Mollicutes in the oral and anal mucosa before routine screening can be recommended in clinical practice.
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Affiliation(s)
- Valdiele de Jesus Salgado
- State University of Santa Cruz, Rod. Jorge Amado, Km 16, Salobrinho, Ilhéus, Bahia, 45662-900, Brazil
| | | | - Ágatha Morgana Bertoti da Silva
- Multidisciplinary Health Institute, Federal University of Bahia, Rua Hormindo Barros, 58, Candeias, Vitória da Conquista, Bahia, 45029-094, Brazil
| | - Henrique Inácio Lima de Brito
- Multidisciplinary Health Institute, Federal University of Bahia, Rua Hormindo Barros, 58, Candeias, Vitória da Conquista, Bahia, 45029-094, Brazil
| | - Danielle Souto de Medeiros
- Multidisciplinary Health Institute, Federal University of Bahia, Rua Hormindo Barros, 58, Candeias, Vitória da Conquista, Bahia, 45029-094, Brazil
| | - Fabiane Soares
- Institute of Collective Health, Federal University of Bahia, Av. Adhemar de Barros, S/nº, Ondina, Salvador, Bahia, 40170-110, Brazil
| | - Laio Magno
- Institute of Collective Health, Federal University of Bahia, Av. Adhemar de Barros, S/nº, Ondina, Salvador, Bahia, 40170-110, Brazil
- Department of Life Sciences, State University of Bahia, Rua Silveira Martins, 2555, Salvador, Bahia, 41000-150, Brazil
| | - Inês Dourado
- Institute of Collective Health, Federal University of Bahia, Av. Adhemar de Barros, S/nº, Ondina, Salvador, Bahia, 40170-110, Brazil
| | - Guilherme Barreto Campos
- Multidisciplinary Health Institute, Federal University of Bahia, Rua Hormindo Barros, 58, Candeias, Vitória da Conquista, Bahia, 45029-094, Brazil
| | - Lucas Miranda Marques
- State University of Santa Cruz, Rod. Jorge Amado, Km 16, Salobrinho, Ilhéus, Bahia, 45662-900, Brazil.
- Multidisciplinary Health Institute, Federal University of Bahia, Rua Hormindo Barros, 58, Candeias, Vitória da Conquista, Bahia, 45029-094, Brazil.
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Alam MA, Rahman MA, Rahman MM, Hasan MM, Naher S, Fahim AHF, Mottalib MA, Roy S, Islam MR, Mozumder SN, Alsuhaibani AM, Gaber A, Hossain A. Performance valuation of onion ( Allium cepa L.) genotypes under different levels of salinity for the development of cultivars suitable for saline regions. Front Plant Sci 2023; 14:1154051. [PMID: 37063224 PMCID: PMC10102481 DOI: 10.3389/fpls.2023.1154051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/13/2023] [Indexed: 06/19/2023]
Abstract
Abiotic stress, especially salt stress, is one of the major barriers to crop production worldwide. Crops like onion that belong to the glycophytic group are more sensitive to salinity stress. A huge study regarding the influence of salinity stress on the growth and development of crops has already been done and is still ongoing. One of the major targets of the research is to develop genotypes that have enhanced performance under stress environments. The world needs more of these types of genotypes to combat the ever-growing salt-stressed soils. Therefore, a number of germplasm were studied during the 2019-2020 and 2020-2021 seasons under different salt concentrations to identify tolerant genotypes as well as to study the plants' responses at different growth stages against elevated salinity levels. A 2-year study was conducted where germination potential was evaluated in the first year and carried out in petri dish culture of seeds, followed by plastic pot culture for plant establishment and bulb development evaluation during the second year. Four different saline water solutions having different salt concentrations (0, 8, 10, and 12 dS m-1) were applied to the petri dishes and pots as the source of water for plants in both seasons. Results indicated that a significant reduction in plants' performance occurs under higher salinity levels. Salt concentration had an adverse impact on germination, leaf development and growth, the height of plants, bulb size and shape, and the bulb weight of onion. All the growth phases of onion are sensitive to elevated concentrations. Variable performances were observed in the genotypes under stress conditions, and a few genotypes (Ac Bog 409, Ac Bog 414, Ac Bog 424, Ac Bog 430, Ac Bog 417, Ac Bog 419, Ac Bog 420, Ac Bog 422, and Ac Bog 425) having some sort of tolerance to salt stress were identified, which might be recommended for mass production. Tolerance indices could successfully be applied in selecting the salt-tolerant genotypes. Thus, the present findings and the identified genotypes could be further utilized in salt stress improvement research on onion.
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Affiliation(s)
- Md. Ashraful Alam
- Plant Breeding Division, Spices Research Centre, Bangladesh Agricultural Research Institute, Bogura, Bangladesh
| | - Md. Atikur Rahman
- Division of Soil Science, Spices Research Centre, Bangladesh Agricultural Research Institute, Bogura, Bangladesh
| | - Md. Marufur Rahman
- Regional Station, Bangladesh Institute of Research and Training on Applied Nutrition, Rangpur, Bangladesh
| | - Md. Mahmudul Hasan
- Division of Horticulture, Spices Research Centre, Bangladesh Agricultural Research Institute, Bogura, Bangladesh
| | - Shamsun Naher
- Division of Soil Science, Spices Research Centre, Bangladesh Agricultural Research Institute, Bogura, Bangladesh
| | - Abu Hena Faisal Fahim
- Division of Agronomy, Spices Research Centre, Bangladesh Agricultural Research Institute, Bogura, Bangladesh
| | - Md. Abdul Mottalib
- Division of Agricultural Engineering, Spices Research Centre, Bangladesh Agricultural Research Institute, Bogura, Bangladesh
| | - Srabanti Roy
- Department of Agricultural Chemistry, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Md. Rafiqul Islam
- Division of Agronomy, Regional Agricultural Research Station, Bangladesh Agricultural Research Institute (BARI), Ishwardi, Pabna, Bangladesh
| | - Shailendra Nath Mozumder
- Division of Horticulture, Spices Research Centre, Bangladesh Agricultural Research Institute, Bogura, Bangladesh
| | - Amnah Mohammed Alsuhaibani
- Department of Physical Sport Science, College of Education, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Ahmed Gaber
- Department of Biology, College of Science, Taif University, Taif, Saudi Arabia
| | - Akbar Hossain
- Division of Soil Science, Bangladesh Wheat and Maize Research Institute, Dinajpur, Bangladesh
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Isano S, Yohannes T, Igihozo G, Ndatinya GI, Wong R. A qualitative study to explore the healthcare-seeking experiences of men who have sex with men (MSM) and transgender women (TGW) in Rwanda. BMC Health Serv Res 2023; 23:291. [PMID: 36978054 PMCID: PMC10045920 DOI: 10.1186/s12913-023-09286-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Globally, men who have sex with men (MSM) and transgender women (TGW) encounter many challenging experiences when accessing health services compared to the general population. Stigma, discrimination, and punitive laws against same-sex relationships in some sub-Saharan African countries have made MSM and TGW more prone to depression, suicidal ideation, anxiety disorders, substance abuse, non-communicable diseases, and HIV. None of the prior studies in Rwanda on MSM and TGW had explored their lived experience in accessing health services. Accordingly, this study aimed at exploring the healthcare-seeking experiences of MSM and TGW in Rwanda. METHODS This study utilized a qualitative research method employing a phenomenological design. Semi-structured in-depth interviews were conducted with 16 MSM and 12 TGW. Participants were recruited via purposive and snowball sampling approaches in five districts in Rwanda." RESULTS Data were analyzed using a thematic analysis approach. Three main themes emerged from the study: (1) The healthcare experiences of MSM and TGW were generally dissatisfactory, (2) MSM and TGW hesitated to seek care unless they were severely ill, (3) MSM and TGW's perspectives on how to improve their health-seeking behavior. CONCLUSION MSM and TGW in Rwanda continue to face negative experiences within the healthcare delivery settings. These experiences include mistreatment, refusal of care, stigma, and discrimination. Provision of services for MSM and TGW and On-the-job cultural competence training in the care of MSM and TGW patients is needed. Including the same training in the medical and health sciences curriculum is recommended. Furthermore, awareness and sensitization campaigns to improve the understanding of the existence of MSM and TGW and to foster acceptance of gender and sexual diversity in society are necessary.
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Affiliation(s)
- Sandra Isano
- Department of Community Health and Social Medicine, University of Global Health Equity, Kigali, Rwanda.
| | - Tsion Yohannes
- Center of Gender Equity, University of Global Health Equity, Kigali, Rwanda
| | - Gloria Igihozo
- Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
| | - Grace Iliza Ndatinya
- Department of Community Health and Social Medicine, University of Global Health Equity, Kigali, Rwanda
| | - Rex Wong
- Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
- School of Public Health, Yale University, Yale, USA
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Reisner SL, Pletta DR, Pardee DJ, Deutsch MB, Peitzmeier SM, Hughto JM, Quint M, Potter J. Digital-Assisted Self-interview of HIV or Sexually Transmitted Infection Risk Behaviors in Transmasculine Adults: Development and Field Te sting of the Transmasculine Sexual Health Assessment. JMIR Public Health Surveill 2023; 9:e40503. [PMID: 36930204 PMCID: PMC10131935 DOI: 10.2196/40503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/29/2022] [Accepted: 01/12/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The sexual health of transmasculine (TM) people-those who identify as male, men, or nonbinary and were assigned a female sex at birth-is understudied. One barrier to conducting HIV- and sexually transmitted infection (STI)-related research with this population is how to best capture sexual risk data in an acceptable, gender-affirming, and accurate manner. OBJECTIVE This study aimed to report on the community-based process of developing, piloting, and refining a digitally deployed measure to assess self-reported sexual behaviors associated with HIV and STI transmission for research with TM adults. METHODS A multicomponent process was used to develop a digital-assisted self-interview to assess HIV and STI risk in TM people: gathering input from a Community Task Force; working with an interdisciplinary team of content experts in transgender medicine, epidemiology, and infectious diseases; conducting web-based focus groups; and iteratively refining the measure. We field-tested the measure with 141 TM people in the greater Boston, Massachusetts area to assess HIV and STI risk. Descriptive statistics characterized the distribution of sexual behaviors and HIV and STI transmission risk by the gender identity of sexual partners. RESULTS The Transmasculine Sexual Health Assessment (TM-SHA) measures the broad range of potential sexual behaviors TM people may engage in, including those which may confer risk for STIs and not just for HIV infection (ie, oral-genital contact); incorporates gender-affirming language (ie, genital or frontal vs vaginal); and asks sexual partnership characteristics (ie, partner gender). Among 141 individual participants (mean age 27, SD 5 years; range 21-29 years; n=21, 14.9% multiracial), 259 sexual partnerships and 15 sexual risk behaviors were reported. Participants engaged in a wide range of sexual behaviors, including fingering or fisting (receiving: n=170, 65.6%; performing: n=173, 66.8%), oral-genital sex (receiving: n=182, 70.3%; performing: n=216, 83.4%), anal-genital sex (receptive: n=31, 11.9%; insertive: n=9, 3.5%), frontal-genital sex (receptive: n=105, 40.5%; insertive: n=46, 17.8%), and sharing toys or prosthetics during insertive sex (n=62, 23.9%). Overall barrier use for each sexual behavior ranged from 10.9% (20/182) to 81% (25/31). Frontal receptive sex with genitals and no protective barrier was the highest (21/42, 50%) with cisgender male partners. In total, 14.9% (21/141) of participants reported a lifetime diagnosis of STI. The sexual history tool was highly acceptable to TM participants. CONCLUSIONS The TM-SHA is one of the first digital sexual health risk measures developed specifically with and exclusively for TM people. TM-SHA successfully integrates gender-affirming language and branching logic to capture a wide array of sexual behaviors. The measure elicits sexual behavior information needed to assess HIV and STI transmission risk behaviors. A strength of the tool is that detailed partner-by-partner data can be used to model partnership-level characteristics, not just individual-level participant data, to inform HIV and STI interventions.
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Affiliation(s)
- Sari L Reisner
- Brigham and Women's Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Fenway Health, Boston, MA, United States
| | - David R Pletta
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | - Madeline B Deutsch
- University of California San Francisco, San Francisco, CA, United States
| | | | - Jaclyn Mw Hughto
- Brown University School of Public Health, Providence, RI, United States
| | - Meg Quint
- Brigham and Women's Hospital, Boston, MA, United States
| | - Jennifer Potter
- Harvard Medical School, Boston, MA, United States
- Fenway Health, Boston, MA, United States
- Beth Israel Deaconess Medical Center, Boston, MA, United States
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80
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Guilamo-Ramos V, Benzekri A, Thimm-Kaiser M. Evaluating the efficacy of an online, family-based intervention to promote adolescent sexual health: a study protocol for a randomized controlled trial. Trials 2023; 24:181. [PMID: 36906589 PMCID: PMC10008101 DOI: 10.1186/s13063-023-07205-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/28/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Adolescents in the U.S. experience significant negative sexual health outcomes, representing a public health priority in the U.S. Research shows that while parents play an influential role in shaping adolescent sexual behavior, surprisingly few programs engage parents in existing programming. Moreover, most efficacious parent-based programs focus on young adolescents, and few utilize delivery mechanisms that facilitate broad reach and scale-up. To address these gaps, we propose to test the efficacy of an online-delivered, parent-based intervention adapted to address both younger and older adolescent sexual risk behavior. METHODS In this parallel, two-arm, superiority randomized controlled trial (RCT), we propose to evaluate Families Talking Together Plus (FTT+), an adaptation of an existing and efficacious FTT parent-based intervention, in shaping sexual risk behavior among adolescents aged 12-17 and delivered via a teleconferencing application (e.g., Zoom). The study population will include n=750 parent-adolescent dyads recruited from public housing developments in the Bronx, New York. Adolescents will be eligible if they are between the ages of 12 and 17 years of age, self-report as Latino and/or Black, have a parent or primary caregiver, and are South Bronx residents. Parent-adolescent dyads will complete a baseline survey, after which they will be assigned to either the FTT+ intervention condition (n=375) or the passive control condition (n=375) in a 1:1 allocation ratio. Parents and adolescents in each condition will complete follow-up assessments 3 and 9 months post-baseline. The primary outcomes will include sexual debut and ever sex, and the secondary outcomes will include the frequency of sex acts, number of lifetime sexual partners, number of unprotected sex acts, and linkage to health and educational/vocational services in the community. We will utilize intent-to-treat analyses of 9-month outcomes and single degree of freedom contrasts comparing the intervention to the control group for primary and secondary outcomes. DISCUSSION The proposed evaluation and analysis of the FTT+ intervention will address gaps in the current cadre of parent-based programs. If efficacious, FTT+ would represent a model for scale-up and adoption of parent-based approaches designed to address adolescent sexual health in the U.S. TRIAL REGISTRATION ClinicalTrials.gov NCT04731649. Registered on February 1, 2021.
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Affiliation(s)
- Vincent Guilamo-Ramos
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, Durham, NC, USA. .,School of Nursing, Duke University, 307 Trent Dr, Durham, NC, 27710, USA. .,School of Medicine, Department of Family Medicine and Community Health, Department of Infectious Diseases, Duke University, 40 Duke Medicine Circle, Durham, NC, USA. .,Presidential Advisory Council on HIV AIDS, U.S. Department of Health and Human Services, Washington, D.C., USA.
| | - Adam Benzekri
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, Durham, NC, USA.,School of Nursing, Duke University, 307 Trent Dr, Durham, NC, 27710, USA
| | - Marco Thimm-Kaiser
- Center for Latino Adolescent and Family Health, Duke University School of Nursing, Durham, NC, USA.,School of Nursing, Duke University, 307 Trent Dr, Durham, NC, 27710, USA
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81
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Maldonado-Barrueco A, Rodríguez-Ayala M, Grandioso-Vas D, García-Clemente P, Guedez-López GV, García-Rodríguez J, Quiles-Melero I. Epidemiology and prevalence of mutations associated with resistance to macrolides and fluoroquinolones in Mycoplasma genitalium in a tertiary hospital from Madrid, Spain. Rev Esp Quimioter 2023; 36:310-313. [PMID: 36896655 DOI: 10.37201/req/123.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
OBJECTIVE Mycoplasma genitalium causes persistent sexually transmitted infections. The aims of this study were to estimate the prevalence of resistances to macrolides and fluoroquinolones in M. genitalium and the sexually transmitted coinfections in patients at Hospital Universitario La Paz (Madrid, Spain). METHODS Patients attended between January and October 2021 were studied. Screening for sexually transmitted pathogens and detection of 23S rRNA and parC genes mutations were performed by real-time PCR (Allplex,SeegeneTM). RESULTS A total of 1,518 females and 1,136 males were studied. The prevalence of M. genitalium was 2.1%. The macrolides resistance rate was 51.8%. The mutations found were A2059G, A2058T and A2058G. The rate of resistance to fluoroquinolones was 17.8% being the G248T mutation (S83I) the most frequent. Seven males had some sexual transmitted coinfection. CONCLUSIONS Although the percentage of M. genitalium infections is low, the high rate of resistance to macrolides makes it necessary to revise the protocols for diagnosis and empirical treatment of sexually transmitted infections. The use of fluoroquinolones is appropriate after screening of macrolide resistance profile.
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Affiliation(s)
- A Maldonado-Barrueco
- Alfredo Maldonado-Barrueco, Clinical Microbiology and Parasitology Department. Hospital Universitario La Paz. Paseo de La Castellana 261, 28046 Madrid, Spain.
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82
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Buttram ME, Ellis MS, Kurtz SP. Young Adult Nightclub Participants Who Attend Adult Entertainment Clubs: Sexual Risk and Substance Use Behaviors. AIDS Behav 2023; 27:875-879. [PMID: 36070115 DOI: 10.1007/s10461-022-03822-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/01/2022]
Abstract
This secondary analysis of cross-sectional baseline data from an intervention trial study examines demographics, sexually transmitted infection (STI) history, substance use and sexual risk behaviors among young adult nightclub participants who do (n = 79) and do not (n = 419) frequent "strip" or adult entertainment clubs (AECs) in Miami, Florida. AEC patrons were older, and more likely to identify as Black race and report STI history. Compared to those who do not, AEC patrons also reported greater recent (past 90-day) frequencies of alcohol and ecstasy use, higher numbers of recent sex partners and were more likely to report recently being high during sex a majority of the time. Increased HIV/STI prevention efforts among young adult AEC patrons appear warranted.
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Affiliation(s)
- Mance E Buttram
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA.
| | - Matthew S Ellis
- Department of Psychiatry, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Steven P Kurtz
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, FL, USA
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83
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Pella-Saavedra P, Ramos-Vallejos F, del Valle-Mendoza J, Becerra-Goicochea L, Silva-Caso W, Pinillos-Vilca L, Cornejo-Tapia A, Martins-Luna J, Aquino-Ortega R, Carrillo-Ng H, Aguilar-Luis MA. Prevalence of coinfections in a cross-sectional cohort of women screened for multiple pathogens in Peru. Heliyon 2023; 9:e14257. [PMID: 36950601 PMCID: PMC10025105 DOI: 10.1016/j.heliyon.2023.e14257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/21/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023] Open
Abstract
Objective To determine the prevalence and risk factors of sexually transmitted infections (STIs) including Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma genitalium among asymptomatic women with human papillomavirus (HPV) infection. Methods A cross-sectional study was performed in 842 asymptomatic women from Cajamarca, Peru. The pathogens were detected using polymerase chain reaction (PCR) and the results were analyzed according to the HPV status: high-risk HPV, low-risk HPV and negative for HPV. Demographical and gyneco-obstetric data was analyzed to identify risk factors. Results We found that 23.99% (202/842) women were positive for HPV, of whom 79.21% (160/202) were infected with a high-risk genotype. Co-infections were evaluated and 14.38% (23/160) were positive for Ureaplasma urealyticum, 9.38% (15/160) for Chlamydia trachomatis and 1.25% (2/160) for Mycoplasma genitalium. We found a significant association between HPV genotype and the number of children, partners, and history of sexual abuse. The co-infection between high-risk HPV and Chlamydia trachomatis was associated with number of abortions, number of sexual partners and no use of condom. Finally, co-infection between high-risk HPV and Ureaplasma urealyticum was associated with no use of condom and history of STIs. Conclusion HPV infection continues to be a highly relevant problem in Peru, particularly due to the high prevalence of high-risk genotypes. In addition, we report high rates of co-infections with other STIs, such as U. urealyticum and C. trachomatis. We highlight the importance of active surveillance to promptly diagnose these infections, since they may lead to persistent HPV infections.
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Affiliation(s)
- Priscilla Pella-Saavedra
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Fatima Ramos-Vallejos
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Juana del Valle-Mendoza
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
- Corresponding authors. School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
| | - Lorena Becerra-Goicochea
- Hospital Regional Docente de Cajamarca, Cajamarca, Peru
- Facultad de Ciencias de la Salud. Universidad Nacional de Cajamarca, Cajamarca, Peru
| | - Wilmer Silva-Caso
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Luis Pinillos-Vilca
- Hospital Regional Docente de Cajamarca, Cajamarca, Peru
- Facultad de Medicina. Universidad Nacional de Cajamarca, Cajamarca, Peru
| | - Angela Cornejo-Tapia
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Johanna Martins-Luna
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Ronald Aquino-Ortega
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Hugo Carrillo-Ng
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
| | - Miguel Angel Aguilar-Luis
- School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
- Laboratorio de Biologia Molecular, Instituto de Investigación Nutricional, Lima, Peru
- Corresponding authors. School of Medicine, Research Center of the Faculty of Health Sciences, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
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84
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Jackman KMP, Tilchin C, Wagner J, Flinn RE, Trent M, Latkin C, Ruhs S, Fields EL, Hamill MM, Mahaffey C, Greenbaum A, Jennings JM. Desires for Individual- and Interpersonal-Level Patient Portal Use for HIV Prevention Among Urban Sexual Minority Men: Cross-sectional Study. JMIR Form Res 2023; 7:e43550. [PMID: 36826983 PMCID: PMC9994643 DOI: 10.2196/43550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Gay, bisexual, and other sexual minority men have expressed the acceptability of patient portals as tools for supporting HIV prevention behaviors, including facilitating disclosure of HIV and other sexually transmitted infection (STI/HIV) laboratory test results to sex partners. However, these studies, in which Black or African American sexual minority men were undersampled, failed to determine the relationship of reported history of discussing HIV results with sex partners and anticipated willingness to disclose web-based STI/HIV test results using a patient portal. OBJECTIVE Among a sample of predominantly Black sexual minority men, this study aimed to (1) determine preferences for patient portal use for HIV prevention and (2) test the associations between reported history of discussing HIV results and anticipated willingness to disclose web-based STI/HIV test results with most recent main and nonmain partners using patient portals. METHODS Data come from audio-computer self-assisted interview survey data collected during the 3-month visit of a longitudinal cohort study. Univariate analysis assessed patient portal preferences by measuring the valuation rankings of several portal features. Multiple Poisson regression models with robust error variance determined the associations between history of discussing HIV results and willingness to disclose those results using web-based portals by partner type, and to examine criterion validity of the enhancing dyadic communication (EDC) scale to anticipated willingness. RESULTS Of the 245 participants, 71% (n=174) were Black and 22% (n=53) were White. Most participants indicated a willingness to share web-based STI/HIV test results with their most recent main partner. Slightly fewer, nonetheless a majority, indicated a willingness to share web-based test results with their most recent nonmain partner. All but 2 patient portal features were valued as high or moderately high priority by >80% of participants. Specifically, tools to help manage HIV (n=183, 75%) and information about pre- and postexposure prophylaxis (both 71%, n=173 and n=175, respectively) were the top-valuated features to include in patient portals for HIV prevention. Discussing HIV test results was significantly associated with increased prevalence of willingness to disclose web-based test results with main (adjusted prevalence ratio [aPR] 1.46, 95% CI 1.21-1.75) and nonmain partners (aPR 1.54, 95% CI 1.23-1.93). CONCLUSIONS Our findings indicate what features Black sexual minority men envision may be included in the patient portal's design to optimize HIV prevention, further supporting the criterion validity of the EDC scale. Efforts should be made to support Black sexual minority men's willingness to disclose STI/HIV testing history and status with partners overall as it is associated significantly with a willingness to disclose testing results digitally via patient portals. Future studies should consider discussion behaviors regarding past HIV test results with partners when tailoring interventions that leverage patient portals in disclosure events.
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Affiliation(s)
- Kevon-Mark P Jackman
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Carla Tilchin
- Center for Child and Community Health Research, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jessica Wagner
- Center for Child and Community Health Research, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Ryan E Flinn
- Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Maria Trent
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Carl Latkin
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Sebastian Ruhs
- Chase Brexton Health Services, Baltimore, MD, United States
| | - Errol L Fields
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Matthew M Hamill
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, United States.,STI/HIV Program, Baltimore City Health Department, Baltimore, MD, United States
| | - Carlos Mahaffey
- Department of Public Health, College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Adena Greenbaum
- STI/HIV Program, Baltimore City Health Department, Baltimore, MD, United States
| | - Jacky M Jennings
- Center for Child and Community Health Research, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States.,Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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85
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Howard MC. Relation of Personal Characteri stics with Human Papillomavirus Vaccination Outcomes: Assessing the Mediating Role of Vaccine Hesitancy Dimensions. Int J Sex Health 2023; 35:167-180. [PMID: 38596759 PMCID: PMC10903565 DOI: 10.1080/19317611.2023.2180127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/05/2023] [Accepted: 02/08/2023] [Indexed: 04/11/2024]
Abstract
Recent findings suggest that the rate of certain cancers can be reduced by increasing human papillomavirus (HPV) vaccination coverage, resulting in considerable research interest on the antecedents of HPV vaccine receipt to identify avenues to promote vaccination. The current article continues this stream of research by (1) studying the three HPV vaccination outcomes of willingness, receipt, and word-of-mouth, (2) investigating the antecedent effects of sociodemographic characteristics, health insurance status, provider conversation, and political orientation, and (3) testing the mediating role of vaccine hesitancy dimensions using a recently developed conceptualization. We achieve these goals by conducting a cross-sectional study with 404 participants (Agemean = 37.64; AgeSD = 14.91; 57% female; 72% white; 100% located in U.S.). Our results show that provider conversations and political orientation had the most consistent and strong effects of the personal characteristics, whereas perceptions that vaccines pose health risks and perceptions that vaccines are not needed for healthy individuals produced the most consistent and strong effects of the vaccine hesitancy dimensions. Other personal characteristics and vaccine hesitancy dimensions also produced intermittent significant effects, including age, education, and race. Together, these results support that personal characteristics and vaccine hesitancy dimensions relate to a broader range of outcomes associated with HPV vaccination than previously known, and these results also support that the recently developed conceptualization of vaccine hesitancy is apt for understanding HPV vaccine perceptions. Our discussion concludes with highlighting avenues for future research and practice that can leverage our discovered relations to improve HPV vaccination outcomes.
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Affiliation(s)
- Matt C. Howard
- Mitchell College of Business, The University of South Alabama, Mobile, AL, USA
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86
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Feng R, Cao S, Zhuang J, Zhao J, Guan X, Zhang Y, Liu C, Wei H. An improved asymmetric susceptibility tensor imaging model with frequency offset correction. Magn Reson Med 2023; 89:828-844. [PMID: 36300852 DOI: 10.1002/mrm.29494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/04/2022] [Accepted: 09/28/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE To improve susceptibility tensor imaging (STI) reconstruction using the asymmetric STI model with the correction of non-bulk-magnetic-susceptibility (NBMS) effects. METHOD A frequency offset term was introduced into the asymmetric STI model to account for the bias between measured MRI frequency signals and conventional susceptibility tensor models because of NBMS contributions. Experiments were conducted to compare the proposed model with conventional STI, conventional STI with the proposed frequency offset correction, and asymmetric STI on simulation, ex vivo mouse brain, and in vivo human brain data. RESULTS In the simulation where NBMS contributions are head rotation-invariant, the proposed method achieves the lowest errors in mean magnetic susceptibility (MMS) and magnetic susceptibility anisotropy (MSA) and is more robust to noise in the estimation of principal eigenvector (PEV). When considering the head orientation dependency of NBMS contributions, the proposed method shows advantages in estimating MSA and PEV. On the mouse and human brain data, the proposed method produces more reliable MSA maps and more consistent white matter fiber directions when referring to those from DTI than the compared STI methods. CONCLUSION The proposed method can reduce the effects of NBMS-related frequency shifts on the susceptibility tensors in the brain white matter. This study inspires STI reconstruction from the perspective of better modeling the sources of frequency shifts.
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Affiliation(s)
- Ruimin Feng
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Steven Cao
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California, USA
| | - Jie Zhuang
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Jiayi Zhao
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Xiaojun Guan
- Department of Radiology, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yuyao Zhang
- School of Information and Science and Technology, ShanghaiTech University, Shanghai, China
| | - Chunlei Liu
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, California, USA.,Helen Wills Neuroscience Institute, University of California, Berkeley, California, USA
| | - Hongjiang Wei
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
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87
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Ribeiro A, Trevizol AP, Bosso RA, Gianna MC, Vieira DL, Bernardini VB, Brietzke E, Ribeiro M, Fidalgo TM. The Interactions Between Vulnerabilities for HIV and Syphilis among Cisgender and Transgender People Who Use Drugs. Arch Sex Behav 2023; 52:733-740. [PMID: 36369415 DOI: 10.1007/s10508-022-02460-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
In Brazil, transgender people are most affected by HIV, and crack cocaine addiction may contribute to social vulnerability and exposure to sexual and violence-related risks. This cross-sectional study comprised 2393 individuals seeking addiction treatment, consisting of 43 trans women, 1995 cisgender men, and 355 cisgender women. Records of rapid test results for HIV and syphilis and screening responses of trans women were compared to both cisgender groups using a logistic regression model to identify associated risk factors. HIV prevalence was higher in the transgender group (39.5%) than in cis women and men (5.9% and 3.6%, respectively). Our study showed an eightfold higher chance of a positive HIV test among transgender individuals who used drugs (OR: 8.79, p < .01, 95% CI: 3.90-19.78) compared to cisgender people who used drugs. A lifetime history of syphilis infection was more common in transgender people (60.0%) and cis women (32.8%) than in cis men (9.5%). Active syphilis was also more common in the transgender population (OR: 5.46, p < .01, 95% CI: 2.63 11.32). In our sample, 44.2% of transgender individuals had a history of at least one suicide attempt in their lifetime. Our results showed that transgender women were at higher risk of crack cocaine use (OR: 5.51, p < .01, 95% CI: 2.16-14.06) than cisgender men and women. The study showed that trans women had a higher prevalence of syphilis and HIV, and a greater chance of being homeless. The synergy of these vulnerabilities may have led to our findings of high psychotic symptoms and a history of suicide attempts in transgender individuals.
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Affiliation(s)
- Ariadne Ribeiro
- Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
- The Joint United Nations Program on HIV/AIDS, UN HOUSE Conjunto C, Quadra 802, Lote 17, Federal District, Brasília, 70800-400, Brazil.
| | - Alisson Paulino Trevizol
- CAMH - Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Maria Clara Gianna
- Reference and Training Center for STI and AIDS, Sao Paulo State Secretariat of Health, Sao Paulo, SP, Brazil
| | - Denise Leite Vieira
- Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | | | - Elisa Brietzke
- Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
- Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada
| | - Marcelo Ribeiro
- Reference Center for Alcohol, Tobacco and Other Drugs, Sao Paulo State Secretariat of Health, Sao Paulo, SP, Brazil
- Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Thiago M Fidalgo
- Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Szetela B, Łapiński Ł, Giniewicz K. Very High Incidence of Chlamydia trachomatis, Neisseria gonorrhoeae, and Treponema pallidum among Low-Risk MSM in an Outpatient Clinic in Wroclaw, Poland in 2019-2020. Int J Environ Res Public Health 2023; 20:2582. [PMID: 36767946 PMCID: PMC9915380 DOI: 10.3390/ijerph20032582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The rise in sexually transmitted infections and chemsex has led to syndemy with HIV, partly due to common routes of transmission and clustered transmissions. Despite this, barriers to STI care and PrEP still remain. We sought to determine whether MSM at low risk for HIV infection were also at low risk for other STIs. METHODS The study group was tested for HIV, HCV, and Treponema pallidum, as well as had urethral, rectal, and oropharyngeal smears performed for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) six months apart. The control group was tested once to define the background incidence. RESULTS Treponema pallidum, CT, and NG prevalence was very high at both time points and was similar to the control group. CT was especially common in the control group (20.58%) and the study group at the rectal site at the second time point (9.37%). NG dominated the oropharyngeal site (15.87%), with urethral site sparing. NG infection was associated with an increased number of partners, not condom use (OR, 1.082 [95% CI; 1.009-1.171]). Risk behavior did not change between the time points. Treponema pallidum, CT, and NG incidence was exceptionally high (12.5/100PY, 25.39/100PY, 34.92/100PY, respectively; pooled 87.5/100PY) and was comparable to other studies of high-risk MSM. CONCLUSIONS Despite a lower risk for HIV acquisition, the study group was at a very high risk for other STIs, and this risk remained high throughout the study. Patients and medical professionals should be aware of syphilis, gonorrhea, and chlamydiosis transmission risks, and screening should be performed accordingly. Prophylactic programs need to be updated to specifically include lower-risk individuals.
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Affiliation(s)
- Bartosz Szetela
- Department of Infectious Diseases, Liver Disease and Acquired Immune Deficiencies, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Łukasz Łapiński
- Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland
| | - Katarzyna Giniewicz
- Statistical Analysis Centre, Wroclaw Medical University, 50-367 Wroclaw, Poland
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89
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Eysenbach G, Zhang H, Zhao S, Tang K. Predicting Risky Sexual Behavior Among College Students Through Machine Learning Approaches: Cross-sectional Analysis of Individual Data From 1264 Universities in 31 Provinces in China. JMIR Public Health Surveill 2023; 9:e41162. [PMID: 36696166 PMCID: PMC9909517 DOI: 10.2196/41162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/10/2022] [Accepted: 11/30/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Risky sexual behavior (RSB), the most direct risk factor for sexually transmitted infections (STIs), is common among college students. Thus, identifying relevant risk factors and predicting RSB are important to intervene and prevent RSB among college students. OBJECTIVE We aim to establish a predictive model for RSB among college students to facilitate timely intervention and the prevention of RSB to help limit STI contraction. METHODS We included a total of 8794 heterosexual Chinese students who self-reported engaging in sexual intercourse from November 2019 to February 2020. We identified RSB among those students and attributed it to 4 dimensions: whether contraception was used, whether the contraceptive method was safe, whether students engaged in casual sex or sex with multiple partners, and integrated RSB (which combined the first 3 dimensions). Overall, 126 predictors were included in this study, including demographic characteristics, daily habits, physical and mental health, relationship status, sexual knowledge, sexual education, sexual attitude, and previous sexual experience. For each type of RSB, we compared 8 machine learning (ML) models: multiple logistic regression (MLR), naive Bayes (BYS), linear discriminant analysis (LDA), random forest (RF), gradient boosting machine (GBM), extreme gradient boosting (XGBoost), deep learning (DL), and the ensemble model. The optimal model for both RSB prediction and risk factor identification was selected based on a set of validation indicators. An MLR model was applied to investigate the association between RSB and identified risk factors through ML methods. RESULTS In total, 5328 (60.59%) students were found to have previously engaged in RSB. Among them, 3682 (41.87%) did not use contraception every time they had sexual intercourse, 3602 (40.96%) had previously used an ineffective or unsafe contraceptive method, and 1157 (13.16%) had engaged in casual sex or sex with multiple partners. XGBoost achieved the optimal predictive performance on all 4 types of RSB, with the area under the receiver operator characteristic curve (AUROC) reaching 0.78, 0.72, 0.94, and 0.80 for contraceptive use, safe contraceptive method use, engagement in casual sex or with multiple partners, and integrated RSB, respectively. By ensuring the stability of various validation indicators, the 12 most predictive variables were then selected using XGBoost, including the participants' relationship status, sexual knowledge, sexual attitude, and previous sexual experience. Through MLR, RSB was found to be significantly associated with less sexual knowledge, more liberal sexual attitudes, single relationship status, and increased sexual experience. CONCLUSIONS RSB is prevalent among college students. The XGBoost model is an effective approach to predict RSB and identify corresponding risk factors. This study presented an opportunity to promote sexual and reproductive health through ML models, which can help targeted interventions aimed at different subgroups and the precise surveillance and prevention of RSB among college students through risk probability prediction.
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Affiliation(s)
| | - Hanxiyue Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Shuangyu Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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90
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Maldonado-Barrueco A, Sanz-González C, Gutiérrez-Arroyo A, Grandioso-Vas D, Roces-Álvarez P, Sendagorta-Cudos E, Falces-Romero I, Mingorance J, García-Rodríguez J, Quiles-Melero I. Sexually transmitted infections and clinical features in monkeypox (mpox) patients in Madrid, Spain. Travel Med Infect Dis 2023; 52:102544. [PMID: 36669636 PMCID: PMC9846951 DOI: 10.1016/j.tmaid.2023.102544] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/02/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
Since the beginning of the monkeypox (mpox) virus outbreak in May 2022, there has been an increase in the number of cases worldwide in the setting of sexual transmission. We have tested by real-time PCR 187 mpox patients, of which 157 patients were screened for sexually transmitted infections (STI) in 245 samples. Thirty-six pathogens were detected in 30 patients: herpes simplex virus (HSV-I/II, 12/36, 33.3%), Neisseria gonorrhoeae (NG, 9/36, 25%), Chlamydia trachomatis (CT, 5/36, 13.8%), Chlamydia trachomatis-lymphogranuloma venereum (CT-LGV, 3/36, 8.3%), Treponema pallidum (TP, 4/36, 11.1%) and Mycoplasma genitalium (MG, 3/36, 8.3%). Screening of STI is recommended in mpox patients for the differential diagnosis of the main infections of sexual tract especially in patients with rectal involvement.
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Affiliation(s)
| | | | | | - David Grandioso-Vas
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Iker Falces-Romero
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Jesús Mingorance
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid, Spain; IdiPaz, Research Institute, Hospital Universitario La Paz, Madrid, Spain
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91
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Stewart J, Bartkus M, Sperring H, Ruiz-Mercado G, Johnson S, Pierre C. Monkeypox Vaccination Strategy and Missed Opportunities in STI and HIV Prevention: An Urban Sexual Health Clinic's Experience During a Public Health Emergency. Open Forum Infect Dis 2023; 10:ofad006. [PMID: 36726550 PMCID: PMC9887256 DOI: 10.1093/ofid/ofad006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
Among individuals presenting for monkeypox vaccination, transition from an opt-out protocol for sexually transmitted infection (STI) and HIV risk assessment and testing to an opt-in protocol was associated with a substantial increase in missed opportunities for HIV pre-exposure prophylaxis and STI testing at an ambulatory sexual health clinic.
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Affiliation(s)
- Jessica Stewart
- Correspondence: Jessica Stewart, Section of Infectious Diseases, Boston Medical Center, 850 Harrison Avenue, Dowling Building, 3rd Floor, Boston, MA 02118 (); or Cassandra Pierre, MD, MSc, Section of Infectious Diseases, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 ()
| | - Mary Bartkus
- Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine & Boston Medical Center, Boston, Massachusetts, USA
| | - Heather Sperring
- Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine & Boston Medical Center, Boston, Massachusetts, USA
| | - Glorimar Ruiz-Mercado
- Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine & Boston Medical Center, Boston, Massachusetts, USA
| | - Samantha Johnson
- Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine & Boston Medical Center, Boston, Massachusetts, USA
| | - Cassandra Pierre
- Correspondence: Jessica Stewart, Section of Infectious Diseases, Boston Medical Center, 850 Harrison Avenue, Dowling Building, 3rd Floor, Boston, MA 02118 (); or Cassandra Pierre, MD, MSc, Section of Infectious Diseases, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118 ()
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92
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West BS, Agah N, Roth A, Conners EE, Staines-Orozco H, Magis-Rodriguez C, Brouwer KC. Sex Work Venue Disorder and HIV/ STI Risk Among Female Sex Workers in Two México-US Border Cities: A Latent Class Analysis. AIDS Behav 2023; 27:82-95. [PMID: 35687193 PMCID: PMC10399957 DOI: 10.1007/s10461-022-03746-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 01/24/2023]
Abstract
Research increasingly recognizes the importance of social and built environments in shaping health, including risks for and outcomes related to HIV and sexually transmitted infections (STI), but research on sex work venues is limited. We use latent class analysis to identify patterns of sex work venue characteristics and factors associated with class membership in two México-US border cities. Among 603 female sex workers (FSW), three classes of sex work venues were identified: low, medium, and high disorder venues, characterized by level of violence, policing and drug activity. In multivariable analysis, risk exposures and outcomes varied by class, suggesting the need for place-based interventions that are tailored to specific venue profiles and that promote FSW health and safety in the workplace.
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Affiliation(s)
- Brooke S West
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, 10027, NY, NY, USA.
| | - Niloufar Agah
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Alexis Roth
- Department of Community Health and Prevention, Drexel University, Philadelphia, PA, USA
| | - Erin E Conners
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Hugo Staines-Orozco
- Department of Medical Sciences, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, México
| | - Carlos Magis-Rodriguez
- Centro Nacional para la Prevención y el Control del VIH y el SIDA (CENSIDA), México City, México
| | - Kimberly C Brouwer
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, USA
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93
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Silva MST, Coutinho C, Torres TS, Peixoto E, Ismério R, Lessa F, Nunes EP, Hoagland B, Echeverria Guevara AD, Bastos MO, Ferreira Tavares IC, Diniz Ribeiro MP, Meneguetti Seravalli Ramos MR, Andrade HB, Lovetro Santana AP, Santini-Oliveira M, Santos Netto JB, Reges P, Magalhães MA, Silva Rosadas LA, Nazer S, Velasque L, Cardoso SW, da Silva EE, Veloso VG, Wakimoto MD, Grinsztejn B, Trepow M, Ferreira IG, Villela L, Fraga RT, Castro de Souza Pires M, Otavio da Silva Escada R, Paiva de Sousa L, Umaña Robleda GL, Santos DV, Siqueira Camacho LR, Amparo P, Jaegger de França JV, de Oliveira Heluy Correa F, Costa de Sousa BI, Vicari do Valle B, Bortot Soares JP, Fonseca Ferreira LC, da Silva Martins P, Mesquita MB, Hildebrant Coutinho JR, de Moraes Perlingeiro R, Peixoto de Castro Oliveira P, Pedroso Barbosa HP, Accetta AF, Cunha M, Eiras RV, Martins dos Santos T, Davila da Silva W, Silveira MDV, de Souza Brum T, Calvet GA, Menezes RC, Pereira SA. Ambulatory and hospitalized patients with suspected and confirmed mpox: an observational cohort study from Brazil. Lancet Reg Health Am 2022; 17:100406. [PMID: 36776570 PMCID: PMC9904017 DOI: 10.1016/j.lana.2022.100406] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/06/2022] [Accepted: 11/11/2022] [Indexed: 12/14/2022]
Abstract
Background By October 30, 2022, 76,871 cases of mpox were reported worldwide, with 20,614 cases in Latin America. This study reports characteristics of a case series of suspected and confirmed mpox cases at a referral infectious diseases center in Rio de Janeiro, Brazil. Methods This was a single-center, prospective, observational cohort study that enrolled all patients with suspected mpox between June 12 and August 19, 2022. Mpox was confirmed by a PCR test. We compared characteristics of confirmed and non-confirmed cases, and among confirmed cases according to HIV status using distribution tests. Kernel estimation was used for exploratory spatial analysis. Findings Of 342 individuals with suspected mpox, 208 (60.8%) were confirmed cases. Compared to non-confirmed cases, confirmed cases were more frequent among individuals aged 30-39 years, cisgender men (96.2% vs. 66.4%; p < 0.0001), reporting recent sexual intercourse (95.0% vs. 69.4%; p < 0.0001) and using PrEP (31.6% vs. 10.1%; p < 0.0001). HIV (53.2% vs. 20.2%; p < 0.0001), HCV (9.8% vs. 1.1%; p = 0.0046), syphilis (21.2% vs. 16.3%; p = 0.43) and other STIs (33.0% vs. 21.6%; p = 0.042) were more frequent among confirmed mpox cases. Confirmed cases presented more genital (77.3% vs. 39.8%; p < 0.0001) and anal lesions (33.1% vs. 11.5%; p < 0.0001), proctitis (37.1% vs. 13.3%; p < 0.0001) and systemic signs and symptoms (83.2% vs. 64.5%; p = 0.0003) than non-confirmed cases. Compared to confirmed mpox HIV-negative, HIV-positive individuals were older, had more HCV coinfection (15.2% vs. 3.7%; p = 0.011), anal lesions (45.7% vs. 20.5%; p < 0.001) and clinical features of proctitis (45.2% vs. 29.3%; p = 0.058). Interpretation Mpox transmission in Rio de Janeiro, Brazil, rapidly evolved into a local epidemic, with sexual contact playing a crucial role in its dynamics and high rates of coinfections with other STI. Preventive measures must address stigma and social vulnerabilities. Funding Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz).
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Affiliation(s)
- Mayara Secco Torres Silva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Carolina Coutinho
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Thiago Silva Torres
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Eduardo Peixoto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Ronaldo Ismério
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Flavia Lessa
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Estevão Portela Nunes
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Brenda Hoagland
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | | | - Matheus Oliveira Bastos
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | | | - Maria Pia Diniz Ribeiro
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | | | - Hugo Boechat Andrade
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Ana Paula Lovetro Santana
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Marilia Santini-Oliveira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Juliana Barbosa Santos Netto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Paula Reges
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Monica Avelar Magalhães
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (ICICT-Fiocruz), Rio de Janeiro, RJ, Brazil
| | | | - Sandro Nazer
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Luciane Velasque
- Universidade Federal do Estado do Rio de Janeiro (UNIRIO), Departamento de Matemática e Estatística, Rio de Janeiro, RJ, Brazil
| | - Sandra Wagner Cardoso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Edson Elias da Silva
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz (IOC-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Valdilea Gonçalves Veloso
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Mayumi Duarte Wakimoto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (INI-Fiocruz), Rio de Janeiro, RJ, Brazil,Corresponding author. Av Brasil 4365 Manguinhos, Rio de Janeiro, RJ, Brazil.
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94
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Abstract
HIV is not exclusive to the young population. Emotional life continues with age, and 20% of new cases of infection in France are among people over 50. This is therefore a public health issue for "seniors".
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Affiliation(s)
- Richard Pougnet
- Faculté de médecine et des sciences de la santé, Université de Bretagne occidentale, 22, rue Camille Desmoulins, 29238 Brest, France.
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95
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Picchetti V, Stamatakis C, Annor FB, Massetti GM, Hegle J. Association between lifetime sexual violence victimization and selected health conditions and risk behaviors among 13-24-year-olds in Lesotho: Results from the Violence Against Children and Youth Survey (VACS), 2018. Child Abuse Negl 2022; 134:105916. [PMID: 36215756 PMCID: PMC9691579 DOI: 10.1016/j.chiabu.2022.105916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sexual violence is a serious public health concern worldwide. In Lesotho, one in seven women and one in twenty men aged 18 years and older experienced sexual violence during childhood. Sexual violence victimization may lead to long-term mental and physical health issues among victims, regardless of gender. OBJECTIVE To estimate the prevalence of lifetime sexual violence victimization (SV) among 13-24-year-olds in Lesotho and assess its association with selected health conditions and risk behaviors. PARTICIPANTS AND SETTING Data from 13 to 24-year-old participants (n = 8568) of the 2018 Lesotho Violence Against Children and Youth Survey were analyzed. METHODS SV was defined as reporting one or more types of sexual violence at any age. Logistic regression analyses measured associations between SV and selected health conditions (suicidal thoughts, self-harm behaviors, mental distress, STIs, and HIV), and risk behaviors (binge drinking in the past 30 days, drug use in the past 30 days, infrequent condom use in the past 12 months, multiple sex partners in the past 12 months, and transactional sex in the past 12 months). RESULTS After controlling for study covariates, SV was significantly associated with self-harm behaviors, suicidal thoughts, ever having an STI, binge drinking in the past 30 days, infrequent condom use in the past 12 months, and multiple sex partners in the past 12 months for both males and females; and mental distress and transactional sex in the past 12 months for females. CONCLUSIONS Preventing SV against children and youth in Lesotho may improve their health and wellbeing.
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Affiliation(s)
- Viani Picchetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
| | - Caroline Stamatakis
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Greta M Massetti
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Jennifer Hegle
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
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96
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Bonett S, Teixeira da Silva D, Lazar N, Makeneni S, Wood S. Trends in sexually transmitted infection screening during COVID-19 and missed cases among adolescents. Public Health 2022; 213:171-176. [PMID: 36423495 PMCID: PMC9576220 DOI: 10.1016/j.puhe.2022.10.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The COVID-19 pandemic disrupted sexual health services for young people, with potential consequences of decreasing preventive screening and increasing undiagnosed sexually transmitted infections (STIs). This study aimed to assess trends in asymptomatic screening among patients receiving STI testing and to estimate the number of STI cases that were missed during the early months of the pandemic. STUDY DESIGN A cross-sectional study of electronic health records for chlamydia, gonorrhea, and trichomonas testing encounters from six pediatric primary care clinics in Philadelphia, July 2014 to November 2020. METHODS A total of 35,548 testing encounters were analyzed, including 2958 during the pandemic. We assessed whether testing at each encounter was performed as asymptomatic screening, risk-based testing, or symptomatic testing. We evaluated screening trends over time and estimated the number of missed STI cases during the pandemic. RESULTS The mean monthly testing encounters decreased from 479 per month prepandemic to 329 per month during the pandemic. The percent of tests performed as asymptomatic screening dropped from 72.5% prepandemic to a nadir of 54.5% in April 2020. We estimate that this decrease in asymptomatic screening would represent 159 missed cases (23.8% of expected cases) based on patient volume from the previous year. CONCLUSIONS During the pandemic, the total volume of STI testing encounters and the proportion of tests performed as asymptomatic screening decreased, potentially resulting in missed diagnoses. Undiagnosed STIs can result in severe sequelae and contribute to community transmission of STIs. Efforts are needed to re-establish and sustain access to STI services for adolescents in response to disruptions caused by the pandemic.
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Affiliation(s)
- S. Bonett
- School of Nursing, University of Pennsylvania, USA,Corresponding author. School of Nursing, University of Pennsylvania, 418 Curie Blvd, Philadelphia, PA, 19104, USA. Tel.: +215-573-4299
| | | | - N. Lazar
- Perelman School of Medicine, University of Pennsylvania, USA,Craig-Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, USA
| | - S. Makeneni
- PolicyLab, Children's Hospital of Philadelphia, USA
| | - S.M. Wood
- Perelman School of Medicine, University of Pennsylvania, USA,Craig-Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, USA,PolicyLab, Children's Hospital of Philadelphia, USA
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97
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Niedźwiedzka-Stadnik M, Zakrzewska K. Syphilis in Poland in 2020. Przegl Epidemiol 2022; 76:391-401. [PMID: 36524901 DOI: 10.32394/pe.76.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The aim of the study was to assess the epidemiological situation of syphilis cases in Poland in 2020 in comparison to previous years. MATERIAL AND METHODS Analysis of the epidemiological situation was based on case-based data from reports of newly detected syphilis cases received from doctors and laboratories in 2020. Additionally aggregated data from MZ-56 reports on infectious diseases, infections and poisoning from 2014 to 2018 sent from Sanitary Inspections to NIPH NIH -NRI was used. Also, data about treatment patients in dermatology/venerology clinics in 2020 reported on MZ-14 forms and published in statistics bulletin on Ministry of Health on e-health system website (actually: https://e-zdrowie.gov.pl; https://cez.gov.pl) and NIPH NIH - NRI website were used. RESULTS In 2020 in Poland 686 newly diagnosed syphilis cases were reported (diagnosis rate was 1.79 per 100,000), including 18 cases among non-Polish citizens. The frequency of newly detected syphilis cases decreased by 54.6% compared to the previous year and similar decreased 52.5% compared to the median in 2014-2018 years. The syphilis cases were most often detected in the age group between 20 and 39 years (68.9%) and among men (86.2%). On the other hand, places where syphilis cases are treated, reported 1,529 cases - less by 4% than in 2019 year, including 979 cases on early stage of syphilis. CONCLUSION In 2020, the number of reported a newly detected syphilis cases decreased more than by half compared to the previous year, what is probably related to the COVID-19 pandemic and action taken to reduce it. A huge difference in some regions in Poland for diagnosis rates and not visible a significant decrease in the number of treated person, indicate on problem with reporting a newly diagnosed infections, as a main explanation about increasing observed in 2020.
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Affiliation(s)
- Marta Niedźwiedzka-Stadnik
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
| | - Karolina Zakrzewska
- National Institute of Public Health NIH - National Research Institute, Department of Epidemiology of Infectious Diseases and Surveillance
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98
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Reekie A, Gratrix J, Smyczek P, Woods D, Poshtar K, Courtney K, Ahmed R. A Cross-Sectional, Retrospective Evaluation of Opt-Out Sexually Transmitted Infection Screening at Admission in a Short-Term Correctional Facility in Alberta, Canada. J Correct Health Care 2022; 28:429-438. [PMID: 36475978 DOI: 10.1089/jchc.21.08.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Incarcerated populations experience higher rates of sexually transmitted infections (STIs) than the general population, alongside inconsistent testing strategies. In response, universal opt-out STIs (chlamydia, gonorrhea, syphilis, and HIV) screening was implemented at admission in a short-term correctional facility in Alberta, Canada, for individuals ≤35 years. A cross-sectional, retrospective evaluation of testing outcomes between March 2018 and February 2020 was completed. Descriptive statistics were used to stratify STIs by gender, age group, and date for univariate analysis. Despite low uptake (31.2%), opt-out screening resulted in high positivity rates (14.9%, 10.8%, 29.5%, and 0.3%, respectively) and treatment completion (93.7%) while capturing a high proportion (52.6%) of asymptomatic cases. Opt-out screening at admission is feasible and can improve STI testing in high-risk individuals experiencing incarceration in Canada.
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Affiliation(s)
- Alexandra Reekie
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jennifer Gratrix
- Department of STI Services, Alberta Health Services-Provincial STI Program, Edmonton, Alberta, Canada
| | - Petra Smyczek
- Department of STI Services, Alberta Health Services-Provincial STI Program, Edmonton, Alberta, Canada
| | - Dan Woods
- Department of Corrections, Alberta Health Services-Corrections Health, Edmonton, Alberta, Canada
| | - Katherine Poshtar
- Department of Corrections, Alberta Health Services-Corrections Health, Edmonton, Alberta, Canada
| | - Keith Courtney
- Department of Corrections, Alberta Health Services-Corrections Health, Edmonton, Alberta, Canada
| | - Rabia Ahmed
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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99
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Giménez-García C, Ballester-Arnal R, Ruiz-Palomino E, Castro-Calvo J, Gil-Llario MD. Exploring Self-efficacy for Condom Use in Spanish People: A Trend Analyses by Gender from 2004 to 2020. AIDS Behav 2022;:1-13. [PMID: 36441411 DOI: 10.1007/s10461-022-03937-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 11/30/2022]
Abstract
Self-efficacy seems to be one of the most important resources for the different stages underlying condom use and STI prevention. For this reason, this study evaluates trends in self-efficacy by gender, from 2004 to 2008, 2013 and 2020 in Spain. Throughout these years, 6,698 people ranging from 17 to 40 years old, participated filling the Brief scale of condom use self-efficacy. According to our findings, despite the slight improvement in the recent years, self-efficacy still maintains a risky profile for safe sex, especially among the youngest people. Moreover, most of the traditional gender differences continue over the years with women reporting lower scores for condom purchase and men for putting them. However, these differences are not relevant in other dimensions such as using condoms despite drug consumption where women reveal worse results over the years. Therefore, our findings reaffirm the need of intensifying gendered preventive efforts aimed at Spanish people and, particularly, among the youngest.
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100
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Russotto Y, Micali C, Laganà N, Marino A, Campanella E, Celesia BM, Pellicanò GF, Venanzi Rullo E, Nunnari G. Diagnosis, Treatment, and Prevention of HIV Infection among Detainees: A Review of the Literature. Healthcare (Basel) 2022; 10. [PMID: 36553904 DOI: 10.3390/healthcare10122380] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
Detainees are one of the most vulnerable populations to human immunodeficiency virus (HIV). This is mostly caused by the lack of knowledge on the topic among the inmates; the lack of prophylaxis; the high percentage of risky behaviors in jail, such as sexual abuse, unprotected sexual intercourses, and injective drug use; and the generally low perception of the risk of transmission. It has also been observed that the problem does not cease to exist at the moment of release, but it also may be aggravated by the weak support system or the total absence of programs for people living with HIV/AIDS (PLWHA) to avoid discontinuation of antiretroviral drugs. Difficulty in providing housing and jobs and, therefore, a form of stability for ex-detainees, also contributes to none adherence to antiretroviral therapy. Among the detainees, there are also categories of people more susceptible to discrimination and violence and, therefore, to risky behaviors, such as black people, Hispanics, transgender people, and men who have sex with men (MSM). We reviewed the literature in order to provide a more complete picture on the situation of PLWHA in jail and to also analyze the difficulties of ex-detainees in adhering to HIV therapy.
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