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Friedman JC, Cannon B, Tyson N, Kang M. Providing adolescent-friendly sexually transmitted infection screening and treatment services. Curr Opin Obstet Gynecol 2024; 36:362-371. [PMID: 39109588 DOI: 10.1097/gco.0000000000000978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
PURPOSE OF REVIEW There are high rates of sexually transmitted infections (STIs) worldwide. Adolescents and young adults (AYA) ages 15-24 years remain one of the populations that is most vulnerable to STIs. The goal of this review is to summarize recent international updates in adolescent STI screening and treatment. RECENT FINDINGS Normalizing sexual history taking and STI testing, and advocating for adolescents to receive comprehensive sexuality education improves stigma surrounding sexual health. The global rise in syphilis is pervasive and includes high rates of infection among AYA and women of reproductive age - universal screening may be indicated depending on local epidemiology. Gonococcal antimicrobial resistance remains a significant public health concern worldwide, thus judicious use of antimicrobials and reporting cases of resistance is crucial. Sexual health services are increasingly using virtual platforms, which may be an effective strategy for STI testing and treatment among AYA. SUMMARY Specific areas of focus to address the STI epidemic among AYA include reducing stigma surrounding sexual health, screening, and treatment of STIs, especially with the global rise in syphilis and high rates of gonorrhea resistance, in addition to increased use of telehealth services as effective education and intervention strategies.
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Affiliation(s)
- Julie C Friedman
- University of Colorado Department of Obstetrics and Gynecology, USA
| | - Bianca Cannon
- General Practice Clinical School, Sydney Medical School, The University of Sydney, Australia
| | - Nichole Tyson
- Stanford University Department of Obstetrics and Gynecology, USA
| | - Melissa Kang
- General Practice Clinical School, Sydney Medical School, The University of Sydney, Australia
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Ong JJ, Tucker JD. Digital technology and self-care in sexual health. Sex Health 2024; 21:SH24174. [PMID: 39270060 DOI: 10.1071/sh24174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2024] [Accepted: 09/06/2024] [Indexed: 09/15/2024]
Abstract
This Collection highlights some recent publications in Sexual Health on using technology to optimise sexual health. By leveraging innovations such as rapid diagnostic tools, mobile health (mHealth), self-testing and artificial-intelligence-powered tools, we can empower individuals to take control of their sexual health, reducing risks and enhancing accessibility.
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Affiliation(s)
- Jason J Ong
- School of Translational Medicine, Monash University, Melbourne, Vic, Australia; and Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Joseph D Tucker
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; and Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NR, USA
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DeWitt ME, Pabon V, Vasquez A, Wenner JJ, McNeil CJ. STI self-testing: ensuring representation and outreach to teens and adolescents in expanded approaches. Sex Transm Infect 2024; 100:190-191. [PMID: 38307856 PMCID: PMC11031306 DOI: 10.1136/sextrans-2023-056017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024] Open
Abstract
In our correspondence, we describe the results from a quality improvement survey in a sexual health clinic in North Carolina regarding attitudes and perceptions among adolescents and providers regarding specimen self-collection. We find that adolescents have high levels of acceptability for self-collection and confidence in their ability to self-collection; however, providers expressed hesitation regarding the ability of adolescents to self-collection. Our study shows that while self-collection may provide a way to expand testing access to difficult-to-reach populations, we must ensure that providers are confident in the corresponding results.
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Affiliation(s)
- Michael E DeWitt
- Department of Medicine, Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Biology, Wake Forest University, Winston-Salem, North Carolina, USA
- North Carolina Strengthening the United States Response to Resistant Gonorrhea (SURRG), Guilford County Department of Public Health, Greensboro, North Carolina, USA
| | - Vonda Pabon
- North Carolina Strengthening the United States Response to Resistant Gonorrhea (SURRG), Guilford County Department of Public Health, Greensboro, North Carolina, USA
| | - Andrea Vasquez
- North Carolina Strengthening the United States Response to Resistant Gonorrhea (SURRG), Guilford County Department of Public Health, Greensboro, North Carolina, USA
| | - Jennifer J Wenner
- Department of Medicine, Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- North Carolina Strengthening the United States Response to Resistant Gonorrhea (SURRG), Guilford County Department of Public Health, Greensboro, North Carolina, USA
| | - Candice J McNeil
- Department of Medicine, Section on Infectious Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- North Carolina Strengthening the United States Response to Resistant Gonorrhea (SURRG), Guilford County Department of Public Health, Greensboro, North Carolina, USA
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Gabster A, Fernández Díaz F, Zaldívar Y, Hernández M, Pascale JM, Orillac A, Moreno-Wynter S, Xavier Hall CD, Jhangimal M, Yu-Pon A, Rodríguez-Vargas C, Arjona-Miranda D, Fuentes B, Henestroza G, Araúz AB. Prevalence of syphilis among people living with HIV who attend a large urban antiretroviral therapy clinic in Panama: a cross-sectional epidemiological study. Ther Adv Infect Dis 2024; 11:20499361241256290. [PMID: 38827952 PMCID: PMC11141218 DOI: 10.1177/20499361241256290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/02/2024] [Indexed: 06/05/2024] Open
Abstract
Background Syphilis is a serious global public health challenge. Despite prior progress in syphilis control, incidence has been increasing in recent years. Syphilis is a common coinfection among people living with HIV (PLHIV). In Panama, few data describe syphilis prevalence among PLHIV. We describe syphilis antibody and high-titer (⩾1:8) active syphilis prevalence and associated factors among individuals who attended an antiretroviral clinic. Methods A cross-sectional study was undertaken during February-March 2022 and September-October 2022 for adults (⩾18 year) assigned male and female at birth, respectively. Participants provided peripheral blood samples and self-administered a questionnaire. Samples were screened using immunochromatography; antibody-positive samples were tested using rapid plasma regain to 1:512 dilutions. Logistic regression was used to identify factors associated with syphilis antibody and high-titer active syphilis. Results In all, 378 participants gave blood samples; 377 individuals participated in the questionnaire (216 self-reported male sex [males], 158 female [females], and three intersex individuals). Median age was 36 years (interquartile range: 28-45 years). Overall, syphilis antibody prevalence was 32.3% (122/378) (males, 50.7% [108/2013]; females, 5.7% [9/158]; intersex individuals, 100.0% (3/3)], p < 0.01. High-titer active syphilis was found among 24.6% (n = 30) of samples with positive antibody test (males 27.8% [n = 30], females 0.0% [0/9], intersex individuals 0.0% [0/3]). Antibody positivity was associated in the multivariable model with males (50.7%, AOR = 24.6, 95%CI: 1.57-384.53). High-titer active syphilis was associated with younger participant age (18-30 years, 13.2%, OR = 4.82, 95%CI: 1.17-19.83); 31-40 years, 7.8%, OR = 4.24, 95%CI: 1.04-17.21 versus 3.2% >40 years), homosexual identity (16.0% OR = 34.2, 95%CI: 4.50-259.27 versus 0.6% among heterosexual identity); in the multivariable model, associated with sexual identity (bisexual 19.1%, AOR = 10.89, 95%CI: 1.00-119.06) compared to heterosexual identity (0.6%) and weakly associated with concurrency (⩾1 ongoing sexual relationships, 15.9%, AOR = 3.09, 95%CI: 0.94-10.14). Conclusion This study found very high prevalence of syphilis antibodies and high-titer syphilis among PLHIV in Panama. Those most affected are males, younger in age, those who practice concurrent sexual relationships, and those who reported homosexual and bisexual identity. Targeted interventions should include repetitive testing and treatment, especially among individuals who may be at increased infection risk.
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Affiliation(s)
- Amanda Gabster
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Ave. Justo Arosemena y Calle 36, Panamá, Panamá 507-527-4952, Panama
- National Research System, National Secretariat of Science, Technology and Innovation, Panama City, Panama
- Center of Population Sciences for Health Equity, Faculty of Nursing, Florida State University, Tallahassee, FL, USA
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología, Panama City, Panama
| | | | - Yamitzel Zaldívar
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama
| | | | - Juan Miguel Pascale
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama
- Facultad de Medicina, Universidad de Panamá, Transismica, Panama City, Panama
| | - Angelique Orillac
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama
| | | | - Casey D. Xavier Hall
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, FL, USA
- College of Social Work, Florida State University, Tallahassee, FL, USA
| | - Mónica Jhangimal
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama
| | - Anyi Yu-Pon
- Instituto Conmemorativo Gorgas de Estudios de la Salud, Panamá, Panama
| | | | | | - Bárbara Fuentes
- Facultad de Medicina, Universidad Interamericana de Panamá, Panama City, Panama
| | - Germán Henestroza
- Division of Infectious Diseases, University of Alabama, Birmingham, AB, USA
| | - Ana Belén Araúz
- Hospital Santo Tomás, Panama City, Panama
- National Research System, National Secretariat of Science, Technology and Innovation, Panama City, Panama
- Facultad de Medicina, Universidad de Panamá, Transismica, Panama City, Panama
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