Prevention and treatment of sexually transmitted infections in high-risk individuals, including patients with HIV infection

Sexually transmitted infections and associated risk factors among the transgender population of Pakistan

BACKGROUND

Transgender (TG) people are key drivers for sexually transmitted infections (STIs) all over the world. There is substantial evidence that STIs are associated with an increased likelihood of risky sexual behavior however little is known about the prevalence of STIs (HIV, HBV, HCV, and Syphilis) among HIV infected transgender population in Pakistan.

METHODS

The current study investigated the seroprevalence of four STIs and associated socio-demographic risk factors among TGs of Punjab, Pakistan from July 2019 to June 2021. The samples were tested serologically and final confirmation was done through PCR for HIV, HBV, and HCV.

RESULTS

A total of 1,562 transgenders cross-sectional descriptive records of the Punjab AIDS Control Program (PACP) were reviewed during the period from July 2019 to June 2021. The serological results evidenced that 533 (34.1%) had one pathogen, 309 (19.8%) had two or more (multiple) infections. The most predominant mono-infection among the transgender population was Syphilis 324 (20.7%) followed by HCV 114 (7.3%), HIV 69 (4.4%), and HBV 26 (1.7%). The highest proportions of Infections were found in TG residing in urban areas (68.6%) as compared to rural areas (31.4%). The seropositivity of all STIs was predominantly increased in Sex worker TGs i-e 55%, 46.5%, 38.5%, and 41.8% in HIV, HBV, HCV, and Syphilis respectively. Among 280 HIV-infected Transgender, 177 (63.2%) had Syphilis co-infections. While 87 (31%) and 47 (16.8%) HIV-infected individuals had HC and HBV co-infection respectively.

CONCLUSION

Transgender is neglected population group in society. All STIs were predominantly common among sex worker transgenders, Illiterate educational groups, and TGs residing in urban areas. There is a need to spread awareness about STIs, preventive strategies, and facilitation to health care programs in this high-risk population group.

Intrahepatic cholestasis due to Treponema pallidum in an immunocompetent patient

Hepatitis due to Treponema pallidum is a rare entity and its diagnosis represents a clinical challenge. Treponema pallidum should be considered as a presumptive etiology in all patients with acute liver disease, when other frequent causes have been ruled out. We present the case of a young, immunocompetent patient with elevated values in his liver tests, a cholestatic pattern, and maculopapular lesions on his palms and soles. Given his clinical picture, diagnostic tests, and response to the antimicrobial therapy, a diagnosis of cholestasis due to secondary syphilis has been established. It is important to include secondary syphilis within the possible causes of acute liver disease.

[Discourses about condom use and non-use among gay, bisexual men, and other men who have sex with men in two colombian cities.]

OBJECTIVE

The HIV increase cases raises concern worldwide. This phenomenon is related, among other things, to sexual practices where condom use is limited. To achieve the eradication of AIDS, international organizations have been interested in analyzing and understanding the sexual practices of certain population groups, within these men who have sex with other men. In this sense, the objective of this study was to analyze the discourses on the use and non-use of condoms held by a group of gay, bisexual and other men who have sex with men (GBHSH) men from two cities in Colombia.

METHODS

A qualitative study was carried out with data analysis through the iterative process, from the interpretation of the Information, Motivation and Behavioral Skills (IMB) model. The collection of information was carried out between 2020 and 2021 through in-depth interviews, virtually and in person, with a sample of 20 GBHSH from Colombia from the cities of Cali and Medellín.

RESULTS

In the Information component, it was identified that traditional sexual education had a negative impact and was very focused on a cisheterosexual and reproductive perspective. Regarding Motivational, it was highlighted that the majority were oriented towards not using condoms and that perceiving a low risk of contracting an STI was the main motivation for not using condoms. Regarding Behavioral Skills, it was analyzed that distrust towards the sexual partner promoted its use, but the intensification of pleasure, added to the consumption of alcohol and drugs, caused its use to decrease. It was also evidenced that the use of drugs such as PreP or PEP discouraged condom use in relationships.

CONCLUSIONS

The information on condom use revolves around cisheteronormative practices, leaving aside the care related to STIs. The motivation for not using condoms revolves around misinformation, pleasure and trust in the couple, while the motivation for condom use revolves around health care. The behavior regarding the non-use of condoms is related to the previous points, while misinformation and pleasure in non-use predominate.

Condom use and non-use among transgender women in Colombia: a qualitative analysis based on the IMB model

OBJECTIVE

Review the reasons for condom use and non-use among transgender women in Colombia based on the information, motivation and behavioral skills (IMB) model.

METHOD

Qualitative study in which an iterative process analysis was carried out. A focal group participated in person, and in-depth interviews were conducted virtually.

RESULTS

First study carried out in Colombia on condom use among transgender women under the IMB model. The information component finds that traditional sexual education does not have a positive impact. Regarding motivational aspects, the importance of family support and follow-up and community-based organizations to motivate sexual health care and condom use is highlighted. Regarding behavioral skills, it was found that distrust towards sexual partners and the acquisition of condoms promote their use.

CONCLUSIONS

It is important to create spaces for sexual education delivered by and for the LGBTIQ population, followed by the medical knowledge of health centers, to have positive impacts on the sexual health of transgender women; studies with sexual partners of transgender women are encouraged in order to know the reasons why they request the non-use of condoms.

Development and validity evidence of the multidimensional scale of sexual self-concept in a Spanish-speaking context

BACKGROUND/OBJECTIVE

STIs and HIV/AIDS are an important public health problem, transmitted by risky sex behaviours. In this context, it is necessary to identify protective factors, of those behaviours, as sexual self-concept. Sexual self-concept is a multidimensional trait (i.e. sexual self-esteem; sexual self-efficacy; and sexual assertiveness), but, in an extensive review, we did not find any measure to assess this multidimensional construct in a Spanish-speaking context. The objective of this research is development a scale to assess sexual self-concept in young people and adults.

METHOD

Time-space sampling with a total size of 792 participants, coming from the two Chilean cities (i.e. Arica and Iquique) with the highest HIV rates, aged between 17 and 53 years old (ME = 23.42; SD = 6.33), with 66.2% women (N = 500), 33.6% men (N = 258).

RESULTS

Final scale has 16 items and 4 dimensions: sexual self-esteem, sexual self-efficacy, assertive sexual communication, and assertive sexual behaviour. The identified structure provides satisfactory levels of reliability (ω > .8) and presents robust evidence of validity, based on the internal structure of the test, using ESEM (RMSEA = .060; CFI = .99; TLI = .98), evidence of validity based on relationship to other variables (i.e. risky sexual behaviour) and measurement invariance between men and women.

CONCLUSIONS

The multidimensional scale of sexual self-concept has adequate psychometric properties to assess sexual self-concept in equivalent samples.