Social-, age- and gender differences in testing and positive rates for Chlamydia trachomatis urogenital infection - a register-based study

Is Regulatory Focus Related to Condom Use, STI/HIV Testing, and Sexual Satisfaction?

Regulatory focus theory contends that when making decisions people are either more inclined to focus on avoiding negative consequences (more prevention-focused) or achieving pleasurable outcomes (more promotion-focused). Some research suggests that regulatory focus is related to health behaviors, although this has not been thoroughly investigated in the sexual health domain. The purpose of this study was to examine the relationship between regulatory focus (prevention, promotion) and sexual health. In an online survey of 409 youth from the U.S. (ages = 18-25; M_age = 23.5; 57.2% women; 74.1% White, 13.4% Asian, 10.5% Black, 9.8% Hispanic), we examined the relationship between regulatory focus and three sexual health outcomes: condom use, STI/HIV testing, and sexual satisfaction. Of youth in our sample, 31.8% had a dominant prevention-focus, while 54.8% had a dominant promotion-focus. Compared to youth who were more promotion-focused, more prevention-focused youth used condoms more frequently but reported less sexual satisfaction. No differences were found in rates of STI/HIV testing. This study lays the groundwork to investigate the dynamic role that regulatory focus may play in contributing to youths' sexual health. More experimental and longitudinal studies are needed to confirm the causal nature of the association between regulatory focus and sexual health.

Associations between oil development and sexually transmitted infections: Public health nurse perspectives

BACKGROUND

Oil development (OD) has been associated with increased sexually transmitted infection (STI) rates, with limited focus on the North Dakota (ND) oil boom. Public health (PH) nurse experiences can provide context related to health challenges during OD-related population booms.

OBJECTIVE

To compare reported STI rates in ND oil-producing (OP) and non-oil-producing (NOP) counties before, during, and after the oil boom and describe PH nurse experiences during this time.

DESIGN

We conducted secondary data analysis of oil production data and reported rates for chlamydia and gonorrhea, and conducted interviews with ND PH nurses.

SAMPLE

PH nurses within ND counties geographically located in or near OD in the state.

MEASUREMENTS

ND county-level OD data trends were compared to similarly timed reported rates of chlamydia and gonorrhea in OP and NOP counties. PH nurse interviews were conducted addressing their STI-related experiences working in PH during the oil boom.

RESULTS

Significant findings include a correlation between OD and gonorrhea rates. PH nurses described a limited PH infrastructure to meet the health needs of a transient, increasing population.

CONCLUSIONS

Expanding the role of PH nurses in ND to implement STI screening and treatment would improve access to STI testing allowing for comprehensive reporting of STIs.

Primary care integration of sexual and reproductive health services for chlamydia testing across WHO-Europe: a systematic review

OBJECTIVE

To identify current uptake of chlamydia testing (UCT) as a sexual and reproductive health service (SRHS) integrated in primary care settings of the WHO European region, with the aim to shape policy and quality of care.

DESIGN

Systematic review for studies published from January 2001 to May 2018 in any European language.

DATA SOURCES

OVID Medline, EMBASE, Maternal and Infant Care and Global Health.

ELIGIBILITY CRITERIA

Published studies, which involved women or men, adolescents or adults, reporting a UCT indicator in a primary care within a WHO European region country. Study designs considered were: randomised control trials (RCTs), quasi-experimental, observational (eg, cohort, case-control, cross-sectional) and mixed-methods studies as well as case reports.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers screened the sources and validated the selection process. The BRIGGS Critical Appraisal Checklist for Analytical Cross-Sectional Studies, the Mixed Methods Appraisal Tool 2011 and Critical Appraisal Skills Programme (CASP) checklists were considered for quality and risk of bias assessment.

RESULTS

24 studies were finally included, of which 15 were cross-sectional, 4 cohort, 2 RCTs, 2 case-control studies and 1 mixed-methods study. A majority of the evidence cites the UK model, followed by the Netherlands, Denmark, Norway and Belgium only. Acceptability if offered test in primary healthcare (PHC) ranged from 55% to 81.4% in women and from 9.5% to 70.6% when both genders were reported together. Men may have a lower UCT compared with women. When both genders were reported together, the lowest acceptability was 9.5% in the Netherlands. Denmark presented the highest percentage of eligible people who tested in a PHC setting (87.3%).

CONCLUSIONS

Different health systems may influence UCT in PHC. The regional use of a common testing rate indicator is suggested to homogenise reporting. There is very little evidence on integration of SRHS such as chlamydia testing in PHC and there are gaps between European countries.

What Do Danish Youth Want to Know About Sex? Twenty Years of Telephone Counseling on Sexual and Reproductive Issues

Young people's need for sexual counseling is well documented, and both website and hotline-based services have been established as means of health promotion in this field. Such measures, however, are rarely evaluated, so this article offers data from the world's presumably oldest sexuality helpline aimed at young people. With an observation time of two decades and a total of 42,325 questions asked, the study provides a unique glance into the sexual landscapes of Danish youth. It shows an overall male predominance among callers and reveals that the counseling themes change over time and differ between both age groups and genders. The article suggests that telephone counseling-although more resource demanding than online alternatives-provides a secure, anonymous, and dialogue-based arena for discussing delicate sexual issues and therefore may constitute a viable supplement to web-based media for young people with the need to talk rather than just chat.

Risk Factors for Incident and Redetected Chlamydia trachomatis Infection in Women: Results of a Population-Based Cohort Study

OBJECTIVES

To investigate risk factors for incident and redetected Chlamydia trachomatis (CT) infection in women, including the role of high-risk human papillomavirus (HPV).

METHODS

In this population-based, prospective cohort study conducted in Copenhagen, Denmark, 10,729 women aged 20 to 29 years were tested for CT and HPV DNA and provided information on sexual and health behavior at baseline. Of these, 7998 (74.5%) participated in a follow-up visit 2 years later with identical data collection. We used logistic regression to investigate risk factors for incident and redetected CT infection at follow-up.

RESULTS

Among CT DNA negative women at baseline (n = 7529), 106 (1.4%) were CT DNA positive at follow-up (incident infection). Increasing number of sexual partners during follow-up (odds ratio [OR], 1.07 per partner; 95% confidence interval (CI), 1.02-1.11), low educational level (OR, 1.69; 95% CI, 1.11-2.56; for basic education vs. high school or higher), and high-risk HPV positivity at baseline (OR, 1.66; 95% CI, 1.06-2.58) were risk factors for incident infection, whereas older age (OR, 0.86 per year increase; 95% CI, 0.80-0.93) and condom use (OR, 0.60; 95% CI, 0.38-0.94) were associated with reduced risk. Among CT DNA positive women at baseline (n = 469), 108 (23.0%) tested positive at follow-up (redetected infection). We found no statistically significant associations between age, educational level, sexual behavior, smoking, or high-risk HPV status and the risk for redetected CT.

CONCLUSION

Young age, low educational level, high number of sexual partners, failure to use condoms, and high-risk HPV positivity are associated with increased risk for incident CT infection. These findings may guide the development of targeted CT prevention strategies, including screening and information campaigns.