Chlamydia Infection Between Men and Women: A Cross-Sectional Study of Heterosexual Partnerships

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae in the homeless population of Medellín, Colombia: a cross-sectional study

OBJECTIVE

To determine the prevalence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in the homeless population in Medellín, Colombia, using molecular diagnostic methods. It also intended to develop a demographic profile, exploring associated factors and the dynamics of the social and sexual interactions of this community.

DESIGN

Cross-sectional study.

SETTING

Two homeless care centres in Medellín, Colombia.

PARTICIPANTS

Homeless individuals that assisted to the main homeless care centres of Medellín, Colombia from 2017 to 2019.

PRIMARY AND SECONDARY OUTCOME MEASURES

The prevalence of CT and NG in this population using qPCR detection, factors associated with CT and NG infection, and the sociodemographic profile of the community.

RESULTS

The prevalence of CT infection was 19.2%, while that of NG was 22.6%. Furthermore, being a female was significantly correlated to CT infection p<0.05 (adjusted OR, AOR 2.42, 95% CI 1.31 to 4.47). NG infection was significantly associated with factors such as: sexual intercourse while having a sexually transmitted infection p<0.05 (AOR 3.19, 95% CI 1.48 to 6.85), having more than 11 sexual partners in the last 6 months p=0.04 (AOR 2.91, 95% CI 1.04 to 8.09) and having daily intercourse p=0.05 (AOR 3.15, 95% CI 1.02 to 9.74).

CONCLUSIONS

The prevalence of CT and NG was higher than that reported in the general population. Additionally, females had a higher percentage of infection compared with males.

Facilitators and Barriers to Expedited Partner Therapy: Results From a Survey of Family Physicians

BACKGROUND

Expedited partner therapy (EPT) can prevent transmission of sexually transmitted infections (STIs) and reinfection of the index patient. We surveyed family physicians (FPs) in British Columbia to understand their perceptions of barriers and facilitators to EPT use and explored how perceptions varied by demographic and practice characteristics.

METHODS

Survey participants were recruited through the Divisions of Family Practice, which include greater than 90% of FPs in British Columbia. Common barriers and facilitators for EPT were identified using descriptive statistics. The association between each EPT barrier and facilitator and demographic and practice characteristics were tested using χ test.

RESULTS

One hundred eighty-one FPs started the survey, of which 146 (80.7%) answered 10 questions or more and were analyzed. Overall, inaccurate information about sex partners (88 [60.3%] of 146) and medicolegal concerns (87 [59.6%] of 146) were the most common barriers reported. Family physicians in nonurban settings were more likely to identify insufficient time as a barrier compared with FPs in urban settings (P < 0.01). The most common facilitators were having a health care professional for follow-up after prescribing EPT (110 [75.3%] of 146), improved remuneration (93 [63.7%] of 146), clear clinical guidelines around EPT (87/146, 59.6%), and having a legal framework (92 [63.0%] of 146). Family physicians practicing for less than 9 years (the median) were more likely to identify the latter as facilitating EPT compared with FPs practicing for 9 years or longer (P < 0.05).

CONCLUSIONS

Ensuring patients have access to a health care professional for follow-up, improved remuneration, and development of clinical guidelines and a legal framework can support the implementation of EPT. Tools catered to different practice types and contexts may help increase EPT use.

Considerations for Research on Sexually Transmitted Infections (STIs): Reflections of an STI Clinician-Researcher

Sexually transmitted infections (STIs) have been explored in various sexual subgroups. While excellent, these analyses have primarily occurred from uniquely biologic, epidemiologic, or sociologic perspectives. Missing from these discussions has been in-depth presentations of the dynamics of STI transmission from all three viewpoints simultaneously. In this paper, I present information about STI transmission for each STI, including considerations of prevalence, and then review the STI research and of the concept of risk. I then apply these three considerations to a fictitious case study to show their importance and utility. I close by arguing that this information could strengthen future sociologic reviews of STIs and sexual health by helping such researchers include more nuanced understandings about STIs.

Prevalence, concordance and reproductive sequelae after Chlamydia trachomatis infection in Mexican infertile couples

There are few concordance studies on the Chlamydia trachomatis (infection among infertile couples. The objective of this research was to know the prevalence, concordance and reproductive sequelae that couples may develop when both partners show a C. trachomatis infection. A cross-sectional study among 688 infertile couples using the C. trachomatis detection by real-time PCR was performed. The infertility causes were obtained from their medical records. The prevalence of infection was 8.68%. The percentage of concordance was 22.4% (13 couples). A presence of tubal occlusion was only associated with infected-discordant women [RR = 3.46, 95% CI (1.54-7.74), p < .003]. Seminal values were not associated with discordant men. The concordant couples showed association with the infection and tubal occlusion [RR = 3.19, 95% CI (1.09-9.34), p < .05], and oligozoospermia [RR = 12.17, 95% CI (4.29-34.54), p < .001], hypospermia [RR = 14.13, 95% CI (4.78-41.84), p < .001]. An alteration in semen quality was shown particularly in men whose sexual partners show a tubal pathology. This could occur due to a C. trachomatis infection in the testis, which underlines the need to carry out effective and efficient strategies to identify and treat all sexual partners exposed to C. trachomatis.

High Willingness to Participate in Partner Notification among Women Attending Reproductive Health and STI Clinics in Shenzhen, China: A Cross-Sectional Study

Genital Chlamydia trachomatis (CT) is one of the most common sexually transmitted infections (STI) worldwide. We explored the factors associated with willingness to participate in partner notification (PN) among women attending reproductive health and STI clinics in Shenzhen, China. An anonymous questionnaire was used to collect the sociodemographic characteristics, STI histories, and willingness to participate in routine CT screening and partner notification. In total, 87.31% (n = 10,780) of participants were willing to notify their sex partner(s) if they were diagnosed with a CT infection. Willingness to complete PN was significantly associated with: being married, residing in Shenzhen ≥1 year, having completed junior college or higher, not currently reporting STI-related symptoms, willing to have routine CT screening, and having a correct understanding of the health sequelae of CT infection. Nearly all women surveyed at reproductive health and STI clinics in Shenzhen reported willingness to complete PN. Promoting PN in these settings could help detect a large number of additional CT cases. Our findings provide evidence and implications for public health interventions on PN and suggest that targeted interventions are urgently needed for particular subpopulations including those not currently married, with shorter residency, lower education, and less awareness about the dangers of CT infection.

Chlamydiae from Down Under: The Curious Cases of Chlamydial Infections in Australia

In Australia, the most researched and perhaps the most successful chlamydial species are the human pathogen Chlamydia trachomatis, animal pathogens Chlamydia pecorum and Chlamydia psittaci. C. trachomatis remains the leading cause of sexually transmitted infections in Australians and trachoma in Australian Indigenous populations. C. pecorum is globally recognised as the infamous koala and widespread livestock pathogen, whilst the avian C. psittaci is emerging as a horse pathogen posing zoonotic risks to humans. Certainly not innocuous, the human infections with Chlamydia pneumoniae seem to be less prevalent that other human chlamydial pathogens (namely C. trachomatis). Interestingly, the complete host range for C. pecorum and C. psittaci remains unknown, and infections by other chlamydial organisms in Australian domesticated and wildlife animals are understudied. Considering that chlamydial organisms can be encountered by either host at the human/animal interface, I review the most recent findings of chlamydial organisms infecting Australians, domesticated animals and native wildlife. Furthermore, I also provide commentary from leading Australian Chlamydia experts on challenges and future directions in the Chlamydia research field.