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Bala R, Maharaj RG, Boppana LKT, Teelucksingh S. The preconception health status of nongravid women aged 18 to 45 years in Arima, Trinidad: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:720. [PMID: 37817065 PMCID: PMC10566166 DOI: 10.1186/s12884-023-06017-2] [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] [Received: 01/11/2022] [Accepted: 09/21/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Preconception care (PCC) is the term used for activities and interventions designed to address and prevent problems related to pregnancy, the neonatal period and childhood. This study assessed maternal health status prior to conception in Trinidad by means of a screening tool, physical measurements, and laboratory samples. METHODS A cross-sectional study was conducted among women aged 18-45 years at a primary care centre in Arima, Trinidad. A de novo PCC screening tool was used to assess 13 domains of high-risk pregnancy in participants. These domains included dietary details, gynaecological and obstetric histories, and genetic and vaccination histories, among others. Blood pressure, weight, height, and waist circumference were recorded, and a capillary blood sample was used to determine random blood glucose and HbA1c levels. All data were coded and entered into SPSS ver. 21. RESULTS A total of 400 nongravid participants were recruited, of whom 366 were included in the final analysis. Most (96.7%) had one or more risk factors for adverse pregnancy outcomes. These included overweight (27%), obesity (35%), central obesity (69.4%), and impaired glucose tolerance/diabetes mellitus (IGT/DM) (26.2%). Additionally, a sedentary lifestyle and diet high in processed food/fats were self-reported by 74.9% and 88.8% of participants, respectively. Only 13.1% had planned to conceive, and of those who had no immediate plans to conceive, 76.4% were currently sexually active, and many (60.7%) did not use birth control techniques. More than half (57.1%) had never had a pap smear. On the other hand, 86.3% knew their HIV status. Self-reported percentages for vaccination were as follows: MMR (100%), tetanus (17.5%), hepatitis B (11.5%) and influenza (2.7%). The majority (82.8%) of participants had not visited the dentist in the past year, with 35.9% of these individuals reporting symptoms of periodontitis. Segments of the population had multiple risk factors; for example, 23.7% of participants were overweight or obese and had an elevated HbA1c level. CONCLUSIONS Unexpectedly, most participants had a risk factor for an adverse pregnancy outcome, and many had multiple risk factors. There is a strong case for enhanced preconception care for women in Trinidad.
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Affiliation(s)
- Ria Bala
- Unit of Public Health and Primary Care, Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Trinidad
| | - Rohan G Maharaj
- Unit of Public Health and Primary Care, Department of Paraclinical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Trinidad.
| | - Leela Krishna Teja Boppana
- Unit of Internal Medicine, Department of Medicine, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Trinidad
| | - Surujpal Teelucksingh
- Unit of Internal Medicine, Department of Medicine, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Trinidad
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Raccagni AR, Poli A, Galli L, Spagnuolo V, Bruzzesi E, Muccini C, Gianotti N, Canetti D, Mainardi I, Castagna A, Nozza S. Association of high-risk sexual behaviours with sexually transmitted infections among men who have sex with men living with HIV. Sex Transm Infect 2023; 99:120-123. [PMID: 35523576 DOI: 10.1136/sextrans-2021-055365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 04/15/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore different sexual behaviours as risk factors for STI among men who have sex with men (MSM) living with HIV. METHODS This is a cross-sectional study on MSM living with HIV followed at the Infectious Diseases Unit of San Raffaele Hospital, Milan, with at least one diagnosis of gonorrhoea, syphilis, chlamydia or anal human papilloma virus (HPV), between July 2016 and February 2021. We conducted a survey on high-risk sexual behaviours with regard to (1) mean number of partners per month, (2) estimated percentage of condom use and (3) most frequent type of sexual intercourse during 2016-2021. Data on these variables were grouped as follows: (1a) ≤5 vs >5, (1b) >10 vs ≤10, (2a) 0% vs >0%, (2b) ≤50% vs >50%, (2c) 100% vs <100%, (3a) ≥50% vs <50% receptive, (3b) 100% vs <100% insertive, and (3c) 100% vs <100% receptive. A high-risk group was defined as >5 partners, <100% use of condom and ≥50% receptive intercourse. Univariate logistic regressions were applied to assess the association between sexual behaviours and the risk of each STI. RESULTS Out of 1051 MSM with at least one STI diagnosis, 580 (55%) answered the survey. The risk of chlamydia was lower among individuals with ≤5 partners (≤5 partners vs >5 partners: OR=0.43, 95% CI 0.28 to 0.66, p=0.001) and among those using condoms more frequently (≤50% use of condom vs >50% use of condom: OR=1.55, 95% CI 1.06 to 2.27, p=0.025; 100% vs <100%: OR=0.35, 95% CI 0.20 to 0.59, p=0.001). Individuals using condoms more frequently also had lower risk of gonorrhoea (100% use of condom vs <100% use of condom: OR=0.37, 95% CI 0.17 to 0.79, p=0.011). The risks of chlamydia (OR=3.07, 95% CI 1.92 to 4.90, p<0.001) and gonorrhoea (OR=2.05, 95% CI 1.12 to 3.75, p=0.020) were higher among individuals belonging to the high-risk group. CONCLUSIONS Chlamydia and gonorrhoea are more likely associated with high-risk sexual behaviours than syphilis and anal HPV among MSM living with HIV.
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Affiliation(s)
| | - Andrea Poli
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Laura Galli
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | | | - Elena Bruzzesi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Camilla Muccini
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Nicola Gianotti
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Diana Canetti
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
| | - Ilaria Mainardi
- Infectious Diseases Unit, Vita-Salute San Raffaele University, Milano, Italy
| | - Antonella Castagna
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy.,Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy
| | - Silvia Nozza
- Infectious Diseases Unit, San Raffaele Hospital, Milano, Italy
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Patterns of sexual behaviour associated with repeated chlamydia testing and infection in men and women: a latent class analysis. BMC Public Health 2022; 22:652. [PMID: 35382799 PMCID: PMC8981706 DOI: 10.1186/s12889-021-12394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents and young adults are at higher risk of acquiring Chlamydia trachomatis infection (chlamydia), so testing is promoted in these populations. Studies have shown that re-testing for chlamydia is common amongst them. We investigated how sexual risk behaviour profiles are associated with repeated testing for chlamydia. METHODS We used baseline data from a cohort of 2814 individuals recruited at an urban STI -clinic. We applied latent class (LC) analysis using 9 manifest variables on sexual behaviour and substance use self-reported by the study participants. We fitted ordered logistic regression to investigate the association of LC membership with the outcomes repeated testing during the past 12 months and lifetime repeated testing for chlamydia. Models were fit separately for men and women. RESULTS We identified four LCs for men and three LCs for women with increasing gradient of risky sexual behaviour. The two classes with the highest risk among men were associated with lifetime repeated testing for chlamydia: adjOR = 2.26 (95%CI: 1.50-3.40) and adjOR = 3.03 (95%CI: 1.93-4.74) as compared with the class with lowest risk. In women, the class with the highest risk was associated with increased odds of repeated lifetime testing (adjOR =1.85 (95%CI: 1.24-2.76)) and repeated testing during past 12 months (adjOR = 1.72 (95%CI: 1.16-2.54)). An association with chlamydia positive test at the time of the study and during the participant's lifetime was only found in the male highest risk classes. CONCLUSION Prevention messages with regard to testing for chlamydia after unprotected sexual contact with new/casual partners seem to reach individuals in highest risk behaviour classes who are more likely to test repeatedly. Further prevention efforts should involve potentially more tailored sex-specific interventions taking into consideration risk behaviour patterns.
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Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, Reno H, Zenilman JM, Bolan GA. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1-187. [PMID: 34292926 PMCID: PMC8344968 DOI: 10.15585/mmwr.rr7004a1] [Citation(s) in RCA: 762] [Impact Index Per Article: 254.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
These guidelines for the treatment of persons who have or are at risk for
sexually transmitted infections (STIs) were updated by CDC after consultation
with professionals knowledgeable in the field of STIs who met in Atlanta,
Georgia, June 11–14, 2019. The information in this report updates the
2015 guidelines. These guidelines discuss 1) updated recommendations for
treatment of Neisseria gonorrhoeae, Chlamydia trachomatis,
and Trichomonas vaginalis; 2) addition of
metronidazole to the recommended treatment regimen for pelvic inflammatory
disease; 3) alternative treatment options for bacterial vaginosis; 4) management
of Mycoplasma genitalium; 5) human papillomavirus vaccine
recommendations and counseling messages; 6) expanded risk factors for syphilis
testing among pregnant women; 7) one-time testing for hepatitis C infection; 8)
evaluation of men who have sex with men after sexual assault; and 9) two-step
testing for serologic diagnosis of genital herpes simplex virus. Physicians and
other health care providers can use these guidelines to assist in prevention and
treatment of STIs.
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Groves AK, Niccolai LM, Keene DE, Rosenberg A, Schlesinger P, Blankenship KM. Housing Instability and HIV Risk: Expanding our Understanding of the Impact of Eviction and Other Landlord-Related Forced Moves. AIDS Behav 2021; 25:1913-1922. [PMID: 33389317 PMCID: PMC7778418 DOI: 10.1007/s10461-020-03121-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 10/26/2022]
Abstract
The study purpose is to comprehensively measure landlord-related forced moves (inclusive of, but not restricted to, legal eviction), and to examine whether landlord-related forced moves is associated with HIV risk. Baseline survey data was collected between 2017 and 2018 among 360 low-income participants in New Haven, Connecticut. We used multivariable logistic regression analyses to examine associations between landlord-related forced moves and HIV sexual risk outcomes. Seventy seven out of three hundred and sixty participants reported a landlord-related forced move in the past 2 years, of whom 19% reported formal eviction, 56% reported informal eviction and 25% reported both. Landlord-related forced moves were associated with higher odds of unprotected sex (AOR 1.98), concurrent sex (AOR 1.94), selling sex for money or drugs (AOR 3.28), exchange of sex for a place to live (AOR 3.29), and an HIV sexual risk composite (ARR 1.46) (p < .05 for all). We found robust associations between landlord-related forced moves and HIV sexual risk. Findings suggest that the social and economic consequences of landlord-related forced moves may impact sexual vulnerability.
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Ferrand JL, Blashill AJ, Corliss HL, Walsh-Buhi ER. Condom application skills and self-efficacy in youth: A systematic review and meta-analysis. PLoS One 2021; 16:e0249753. [PMID: 33831080 PMCID: PMC8032349 DOI: 10.1371/journal.pone.0249753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 03/24/2021] [Indexed: 01/22/2023] Open
Abstract
Globally, and in the United States (U.S.) specifically, rates of reported sexually transmitted infections (STIs) have been steadily increasing and are especially high among youth aged 13-25 years. Using condoms correctly and consistently is an effective STI prevention measure for sexually active youth, yet public health endeavors tend to focus only on condom use consistency. Directly measuring condom application is challenging and expensive. Alternative tools evaluate this behaviour, but little evidence exists on the appropriateness of these instruments in measuring application skills. This systematic review and meta-analysis examined the association between condom application skills and self-efficacy. We conducted a search of several databases as well as unpublished works. Studies were included if they were in English, examined youth aged 13-25 years, and were available between 1992 and 2019. The authors screened 630 titles and abstracts for initial inclusion criteria. A full-text review of 30 studies was conducted. The authors included 19 studies in the systematic review and 5 studies were included in the meta-analysis. Both a fixed- and random-effects model (Q = .2321, I2 = 0%) yielded a medium-sized statistically non-significant association (r = 0.217) between skills and self-efficacy. Despite the small sample size, findings suggest that skills and self-efficacy may not be as interchangeable as previously assumed when assessing condom application. Implications for future research are discussed.
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Affiliation(s)
- John L. Ferrand
- Department of Applied Health Science, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States of America
| | - Aaron J. Blashill
- Department of Psychology, San Diego State University, San Diego, CA, United States of America
- San Diego State University/University of California Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, CA, United States of America
| | - Heather L. Corliss
- School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Eric R. Walsh-Buhi
- Department of Applied Health Science, School of Public Health, Indiana University Bloomington, Bloomington, IN, United States of America
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Marcus U, Mirandola M, Schink SB, Gios L, Schmidt AJ. Changes in the prevalence of self-reported sexually transmitted bacterial infections from 2010 and 2017 in two large European samples of men having sex with men-is it time to re-evaluate STI-screening as a control strategy? PLoS One 2021; 16:e0248582. [PMID: 33720969 PMCID: PMC7959389 DOI: 10.1371/journal.pone.0248582] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/02/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND/OBJECTIVES Many European countries reported increased numbers of syphilis, gonorrhoea and chlamydia diagnoses among men who have sex with men (MSM) in recent years. Behaviour changes and increased testing are thought to drive these increases. METHODS In 2010 and 2017, two large online surveys for MSM in Europe (EMIS-2010, EMIS-2017) collected self-reported data on STI diagnoses in the previous 12 months, diagnostic procedures, STI symptoms when testing, number of sexual partners, and sexual behaviours such as condom use during the last intercourse with a non-steady partner in 46 European countries. Multivariate regression models were used to analyse factors associated with diagnoses of syphilis, gonorrhoea/chlamydia, and respective diagnoses classified as symptomatic and asymptomatic. If applicable, they included country-level screening rates. RESULTS Questions on STI diagnoses and sexual behaviours were answered by 156,018 (2010) and 125,837 (2017) participants. Between 2010 and 2017, overall diagnoses with gonorrhoea/chlamydia and syphilis increased by 76% and 83% across countries. Increases were more pronounced for asymptomatic compared to symptomatic infections. The proportion of respondents screened and the frequency of screening grew considerably. Condomless anal intercourse with the last non-steady partner rose by 62%; self-reported partner numbers grew. Increased syphilis diagnoses were largely explained by behavioural changes (including more frequent screening). Gonorrhoea/chlamydia increases were mainly explained by more screening and a change in testing performance. A country variable representing the proportion of men screened for asymptomatic infection was positively associated with reporting symptomatic gonorrhoea/chlamydia, but not syphilis. DISCUSSION/CONCLUSION The positive association of country-level screening rates with the proportion of symptomatic infections with gonorrhoea/chlamydia may indicate a paradoxical effect of screening on incidence of symptomatic infections. Treatment of asymptomatic men might render them more susceptible to new infections, while spontaneous clearance may result in reduced susceptibility. Before expanding screening programmes, evidence of the effects of screening and treatment is warranted.
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Affiliation(s)
- Ulrich Marcus
- Department for Infectious Diseases Epidemiology, Robert Koch Institute, Berlin, Germany
- * E-mail:
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy
| | - Susanne B. Schink
- Department for Infectious Diseases Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Lorenzo Gios
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy
| | - Axel J. Schmidt
- Sigma Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
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8
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Serier KN, Venner KL, Hernandez-Vallant A. The Condom Use Self-Efficacy Scale in Substance Use Disorder Treatment-Seeking American Indian Adults. Subst Use Misuse 2021; 56:2066-2073. [PMID: 34590538 DOI: 10.1080/10826084.2021.1963988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
American Indians (AIs) experience substance use disorder and sexual risk related inequities with elevated rates of sexually transmitted infections, unintended pregnancy, and fetal alcohol spectrum disorders. Substance misuse is associated with risky sexual behaviors including condomless sex. Objectives: The current study aimed to test the validity of the Condom Use Self-Efficacy Scale (CUSES) and the relationship between self-efficacy and condom use behaviors in AI individuals with substance use disorders (SUDs). Exploratory analyses also examined changes in condom use self-efficacy across SUD treatment. Methods: As part of a larger randomized controlled trial, AI individuals (N = 79) seeking SUD treatment completed baseline measures of condom use self-efficacy and sexual risk behaviors. Results: Confirmatory factor analysis (CFA) indicated that a 3-factor, 10-item version of the CUSES was a reliable and valid measure in this population. Condom use self-efficacy was associated with condom use behavior and increased during SUD treatment. Conclusions: Overall, it appears that the CUSES is a valid measure in AI individuals, is related to condom use behavior, and increases with SUD treatment. There is a need for future research to integrate these findings into AI cultural values. Addressing sexual risk behaviors in SUD treatment may be an important target and future research is needed to understand predictors of condom use self-efficacy and determine potential intervention targets to reduce sexual risk behaviors and related health inequities.
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Affiliation(s)
- Kelsey N Serier
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Kamilla L Venner
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA.,Center on Alcohol, Substance use, & Addiction, University of New Mexico, Albuquerque, New Mexico, USA
| | - Alexandra Hernandez-Vallant
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA.,Center on Alcohol, Substance use, & Addiction, University of New Mexico, Albuquerque, New Mexico, USA
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9
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Abstract
Rates of sexual activity, pregnancies, and births among adolescents have continued to decline during the past decade to historic lows. Despite these positive trends, many adolescents remain at risk for unintended pregnancy and sexually transmitted infections (STIs). This technical report discusses the new data and trends in adolescent sexual behavior and barrier protection use. Since 2017, STI rates have increased and use of barrier methods, specifically external condom use, has declined among adolescents and young adults. Interventions that increase availability of or accessibility to barrier methods are most efficacious when combined with additional individual, small-group, or community-level activities that include messages about safer sex. Continued research informs public health interventions for adolescents that increase the consistent and correct use of barrier methods and promote dual protection of barrier methods for STI prevention together with other effective methods of contraception.
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Affiliation(s)
- Laura K Grubb
- Departments of Pediatrics and Public Health and Community Medicine, Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts
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10
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Daugherty M, Glynn K, Byler T. Prevalence of Trichomonas vaginalis Infection Among US Males, 2013-2016. Clin Infect Dis 2020; 68:460-465. [PMID: 29893808 DOI: 10.1093/cid/ciy499] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/07/2018] [Indexed: 12/20/2022] Open
Abstract
Background Trichomoniasis results from adhesion of Trichomonas vaginalis to the mucous membrane of the urethra or vagina. It has been estimated to have a higher incidence rate than both gonorrhea and chlamydia combined. Although females can experience both clinical symptoms and obstetrical complications, male infections are largely asymptomatic and often unreported. We aim to estimate the prevalence of trichomoniasis in US males using the National Health and Nutrition Examination Survey (NHANES) database. Methods The NHANES database was queried for all men aged 18-59 years during the years 2013-2016. During these years, the survey included urine testing for trichomoniasis using transcription-mediated amplification. Information was also obtained regarding patient demographics and other sexually transmitted infections. Results Overall, 0.49% of men aged 18-59 years tested positive for trichomoniasis. The highest rate was seen in black men (3.6%). There was no significant association with trichomoniasis and age. Higher rates of infection were seen in smokers, those with herpes simplex virus type 2 (HSV-2) infection, men who had sex at an early age, those with less condom usage, and those with more lifetime sexual partners. Conclusion The rates of trichomonas infection in US males are lower than in women. Infections are strongly associated with black males, HSV-2 infection, and other factors known to increase rates of sexually transmitted infection. This information may be helpful for counseling, screening, and management of patients.
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Affiliation(s)
- Michael Daugherty
- Department of Urology, SUNY Upstate Medical University, Syracuse, New York
| | - Kendall Glynn
- Department of Urology, SUNY Upstate Medical University, Syracuse, New York
| | - Timothy Byler
- Department of Urology, SUNY Upstate Medical University, Syracuse, New York
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11
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Cristaudo A, Orsini D. Neisseria gonorrhoeae Infections. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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12
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Behavioural Prevention Strategies for STI Control. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Qian S, Foster R, Bourne C, Vickers T, McIver R, McNulty A. Neisseria gonorrhoeae positivity in clients presenting as asymptomatic contacts of gonorrhoea at a sexual health centre. Sex Health 2020; 17:187-191. [DOI: 10.1071/sh19091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/25/2019] [Indexed: 11/23/2022]
Abstract
Background Previous guidelines at the Sydney Sexual Health Centre (SSHC) recommended empirical antibiotic treatment for asymptomatic contacts of Neisseria gonorrhoeae at the time of testing. With increasing concerns around gonorrhoea antibiotic resistance, it has been suggested that asymptomatic contacts should only be treated based on test results. Methods: This retrospective study of data from the SSHC electronic medical record included a total of 295 gonorrhoea contacts from 1 January 2018 to 30 June 2018. The primary outcome was the proportion of asymptomatic gonorrhoea contacts with a positive gonorrhoea result from any anatomical site. Statistically significant differences in gonorrhoea positivity according to gender, sexual preference, use of PrEP, sex worker status, country of birth, preferred language and number of partners, were calculated using Fisher’s exact test. Results: The overall proportion of asymptomatic gonorrhoea contacts with a positive gonorrhoea result was 27.1% (95% CI: 22.1–32.6%). The proportion of gonorrhoea positivity was significantly higher in females compared to males (52.0% vs 25.7%, P < 0.01), gay and bisexual men compared to heterosexual men (28.7% vs 0%, P < 0.01) and non-users of PrEP compared to PrEP users (31.2% vs 12.5%, P < 0.05). No statistically significant differences in gonorrhoea positivity were found in subgroups divided by sex worker status, country of birth, preferred language and number of partners. Conclusion: The relatively low gonorrhoea positivity rate (27.1%) in asymptomatic gonorrhoea contacts at the SSHC between January and June 2018 supports guideline changes to no longer provide empirical antibiotic treatment to asymptomatic contacts.
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Anstee S, Shepherd J, Graham CA, Stone N, Brown K, Newby K, Ingham R. Evidence for behavioural interventions addressing condom use fit and feel issues to improve condom use: a systematic review. Sex Health 2019; 16:539-547. [PMID: 31665616 DOI: 10.1071/sh19001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 06/21/2019] [Indexed: 11/23/2022]
Abstract
Continuing high rates of sexually transmissible infections (STIs) in many countries highlight the need to identify effective behavioural interventions. Consistent and correct use of male condoms is a key strategy for the prevention of STIs. However, some men report problems with condom fit (e.g. the size and shape of the condom) and feel (e.g. tightness, irritation, sensitivity), which inhibits their use. We conducted a systematic review to identify existing interventions addressing condom use fit and feel problems. We searched electronic databases for peer-reviewed articles and searched reference lists of retrieved studies. Five studies met the inclusion criteria. These were generally small-scale pilot studies evaluating behavioural interventions to promote safer sex with men aged under 30 years, addressing, among other things, barriers to condom use relating to fit and feel. There were significant increases in the reported use of condoms, including condom use with no errors and problems. Improvements in some condom use mediators were reported, such as condom use self-efficacy, knowledge, intentions and condom use experience. There were mixed findings in terms of the ability of interventions to reduce STI acquisition. Behavioural interventions addressing condom fit and feel are promising in terms of effectiveness but require further evaluation.
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Affiliation(s)
- Sydney Anstee
- Centre for Sexual Health Research, Department of Psychology, Faculty of Environmental and Life Sciences, Shackleton Building (B44) Room 3073, University of Southampton, Southampton, Hampshire SO17 1BJ, UK
| | - Jonathan Shepherd
- Southampton Health Technology Assessments Centre (SHTAC), Alpha House, Wessex Institute, Enterprise Road, University of Southampton Science Park, Southampton, Hampshire SO16 7NS, UK
| | - Cynthia A Graham
- Centre for Sexual Health Research, Department of Psychology, Faculty of Environmental and Life Sciences, Shackleton Building (B44) Room 3073, University of Southampton, Southampton, Hampshire SO17 1BJ, UK; and Corresponding author.
| | - Nicole Stone
- Centre for Sexual Health Research, Department of Psychology, Faculty of Environmental and Life Sciences, Shackleton Building (B44) Room 3073, University of Southampton, Southampton, Hampshire SO17 1BJ, UK
| | - Katherine Brown
- Centre for Advances in Behavioural Science, Faculty of Health and Life Sciences, Richard Crossman Building (4th Floor), Coventry University, Priory Street, Coventry CV1 5FB, UK
| | - Katie Newby
- Centre for Advances in Behavioural Science, Faculty of Health and Life Sciences, Richard Crossman Building (4th Floor), Coventry University, Priory Street, Coventry CV1 5FB, UK
| | - Roger Ingham
- Centre for Sexual Health Research, Department of Psychology, Faculty of Environmental and Life Sciences, Shackleton Building (B44) Room 3073, University of Southampton, Southampton, Hampshire SO17 1BJ, UK
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Kagiura F, Fujii T, Kihana N, Maruyama E, Shimoji Y, Kakehashi M. Brief HIV stigma scale for Japanese people living with HIV: validation and restructuring using questionnaire survey data. AIDS Care 2019; 32:1-9. [PMID: 31658827 DOI: 10.1080/09540121.2019.1683809] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study aimed of validating a ten-item HIV stigma scale that was originally developed in the U.S.A. and adapting it for Japanese adults with HIV. To adapt the HIV stigma scale for Japanese adults with HIV, a forward-backward translation method was employed. We assessed its validity and reliability using questionnaire survey data collected from 463 Japanese adults with HIV between August 2017 and February 2018. Although the validity was acceptable, the internal consistency in two subcategories in the Japanese version of the HIV stigma scale was low (ω: 0.63, 0.60). Therefore, we performed exploratory factor analysis, which suggested a different model consisting of two subcategories. Then, we assessed the reliability and validity of the scale. The omega values were between 0.83 and 0.89, the absolute correlations (|r|) to other psychological scales for external validity were between 0.34 and 0.51, and the non-response rates for feasibility were between 0.9 and 1.8. The Japanese version of the HIV stigma scale therefore had sufficient reliability and validity. This questionnaire may help identify individuals that need increased care, which may improve their quality of life.
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Affiliation(s)
- Fumiko Kagiura
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Japan
| | - Teruhisa Fujii
- Division of Blood Transfusion, Hiroshima University Hospital, Hiroshima City, Japan
| | - Nobuko Kihana
- AIDS Care Unit, Hiroshima University Hospital, Hiroshima City, Japan
| | - Eiko Maruyama
- AIDS Care Unit, Hiroshima University Hospital, Hiroshima City, Japan
| | - Yuka Shimoji
- Nursing Department, National Hospital Organization Osaka Medical Center, Osaka City, Japan
| | - Masayuki Kakehashi
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Japan
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16
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Harbertson J, De Vera K, Scott PT, Li Y, Shaffer RA, Michael NL, Hale BR. Longitudinal survey of condom use across a US Navy and Marine Corps shipboard deployment. BMJ Open 2019; 9:e028151. [PMID: 31230018 PMCID: PMC6596944 DOI: 10.1136/bmjopen-2018-028151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/08/2019] [Accepted: 05/29/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Condoms are highly effective in preventing sexually transmitted infections (STIs) but implementation is often inconsistent with use rarely examined across travel transition periods. We examined the prevalence of condom use among ship-assigned US military personnel across an overseas deployment cycle and identified factors associated with condom non-use. METHODS Longitudinal survey data were collected from ship-assigned US Navy/Marine Corps personnel on 11 ships before (T1), during (T2) and after (T3) an overseas deployment. The anonymous, self-completed survey included demographics, condom use at last sex, STI diagnosis, alcohol misuse and drug use with sex. Descriptive and generalised regression model analyses were conducted. RESULTS Analysis included 1900 (T1), 549 (T2) and 1168 (T3) personnel who reported age, sex and condom use/non-use at last sex. The proportion reporting condom use was significantly higher during T2 (53%, p<0.0001) than T1 (27%) or T3 (28%), with STI prevalences of 1% (T1), 7% (T2) or 2% (T3), with fewer (29%) sexually active individuals at T2. In adjusted models, condom non-use was associated with hazardous alcohol use (OR 1.44, 95% CI 1.21 to 1.71), or drug use to enhance sex (OR 1.37, 95% CI 1.06 to 1.77), but transactional sex was negatively associated (OR 0.69, 95% CI 0.50 to 0.84). CONCLUSIONS Condom use was highest during deployment, as was STI prevalence (among non-users), possibly reflecting concentration of high-risk sexual activities/individuals and/or sexual partners more likely to be infected. Higher condom use with transactional sex likely reflects awareness of higher STI risk. These data can be used to facilitate targeted interventions to reduce STI transmission and may extend to similarly aged cohorts travelling outside the US (eg, college students on spring break).
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Affiliation(s)
- Judith Harbertson
- Leidos, Inc, San Diego, California, USA
- Department of Defence HIV/AIDS Prevention Programme, Defence Health Agency, San Diego, California, USA
| | - Kimberly De Vera
- Leidos, Inc, San Diego, California, USA
- Department of Defence HIV/AIDS Prevention Programme, Defence Health Agency, San Diego, California, USA
| | - Paul T Scott
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Yuanzhang Li
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Richard A Shaffer
- Department of Defence HIV/AIDS Prevention Programme, Defence Health Agency, San Diego, California, USA
| | - Nelson L Michael
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Braden R Hale
- University of California San Diego School of Medicine, Division of Infectious Diseases, Department of Medicine, La Jolla, California, USA
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Green SM, Turner D, Baldwin JA, Walsh-Buhi ER, Vamos CA, Dagne G, Marhefka SL. Towards an Information Motivation and Behavioral Skills Model for New Sex Partners: Results of a Study of Condom Use as an HIV Prevention Method for Emerging Adults Who Met Partners on Dating and Sex-Seeking Platforms or Offline. AIDS Behav 2019; 23:1115-1134. [PMID: 30506475 DOI: 10.1007/s10461-018-2349-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The information, motivation, behavioral Skills (IMB) model was used to identify factors that affect condom use with new sex partners that were met offline or online. Mixed methods data were collected from adults between the ages of 18 and 29 years who reported a new sex partner. A model was composed of participants' IMB scale scores to determine the effect of these variables on condom use. A subset of 20 survey participants completed interviews exploring how IMB model elements may have influenced their condom use. Mixed methods results showed condom use skills were influential for condom use during the first sexual encounter between new partners. Qualitative findings suggest the information and motivation may also influence condom use with new sex partners. The IMB model for new partners may be relevant model for the development of interventions that encourage emerging adults to use condoms at first sex with new sex partners.
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Del Romero-Guerrero J, Ayerdi-Aguirrebengoa O, Rodríguez-Martín C. Jóvenes y VIH. Conocimientos y conductas de riesgo en un grupo de residentes en España. Enferm Infecc Microbiol Clin 2019; 37:149-150. [DOI: 10.1016/j.eimc.2018.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/03/2018] [Indexed: 11/16/2022]
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19
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Logie CH, Lys CL, Fujioka J, MacNeill N, Mackay K, Yasseen Iii AS. Sexual practices and condom use among a sample of Northern and Indigenous adolescents in Northern Canada: cross-sectional survey results. BMJ SEXUAL & REPRODUCTIVE HEALTH 2018; 45:bmjsrh-2018-200174. [PMID: 30591551 PMCID: PMC6579555 DOI: 10.1136/bmjsrh-2018-200174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 11/26/2018] [Accepted: 12/10/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Sexually transmitted infections (STI) prevention in the Northwest Territories (NWT), Canada is an urgent concern as STI prevalence is seven-fold the national average. The study objective was to explore factors associated with sexual activity and condom use among adolescents in the NWT. METHODS We conducted a cross-sectional survey with youth aged 13-18-years-old in 17 NWT communities. We use Poisson regression models with a robust sandwich error variance to estimate adjusted relative risks estimates of the likelihood of experiencing the primary outcomes of sexual activity (vaginal/anal/oral sex) and consistent condom use (oral/anal sex) in the past 3 months by gender. RESULTS Participants (n=607; mean age: 14.2 years; SD: 1.5) included adolescent cisgender girls (n=302; 49.5%), cisgender boys (n=298; 48.9%) and transgender persons (n=7; 1.2%). Most identified as Indigenous (n=444; 73.1%) and 14.0% (n=85) as lesbian, gay, bisexual or queer sexuality (LGBQ+). Among sexually active individuals (n=115), less than half (n=54; 47.0%) reported past 3 month consistent condom use. In adjusted analyses among girls, sexual activity was associated with age, STI knowledge, and alcohol/drug use; LGBQ+ identity and alcohol/drug use were associated with reduced likelihood of condom use. Among boys, sexual activity was associated with age and alcohol/drug use; LGBQ+ identity was associated with increased likelihood of condom use. CONCLUSIONS Findings demonstrate sexual activity among adolescents in the NWT varies by gender, age, and alcohol/drug use. Consistent condom utilisation was low, particularly for those using alcohol/drugs. Gender-tailored STI prevention strategies with Northern adolescents should address alcohol/drug use and build protective factors.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Candice L Lys
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
| | - Jamie Fujioka
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Nancy MacNeill
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
| | - Kayley Mackay
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, Northwest Territories, Canada
| | - Abdool S Yasseen Iii
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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20
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Hahn A, Schwarz NG, Meyer T, Frickmann H. PCR-based rapid diagnostic tests as a strategy for preventing infections with sexually transmitted diseases-a 'diagnostics-as-prevention' modelling approach. Lett Appl Microbiol 2018; 67:420-424. [PMID: 30074254 DOI: 10.1111/lam.13059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 07/13/2018] [Accepted: 07/31/2018] [Indexed: 12/18/2022]
Abstract
The potential was modelled of molecular rapid diagnostic tests (RDTs) that target agents of sexually transmitted diseases (STDs) to contribute to a reduction in the exposure risk for sexually active populations who prefer condom-free high-risk contacts. The biostatistical approach is exemplified by considering the use of a PCR-based RDT for Chlamydia trachomatis and Neisseria gonorrhoeae in a population of German men having sex with men. We modelled the exposure risk as risk of sexual contact with individuals infected by a STD in spite of multiple RDTs having been conducted to identify STDs that could lead to avoidance of an infectious sexual contact. The risk for a given specific disease is influenced by the diagnostic accuracy of all diagnostic tests conducted. The simulation showed a reduction in exposure risk through conducting the selected PCR-based RDT as a strategy to prevent infections with C. trachomatis and N. gonorrhoeae in comparison with unprotected sexual contact of >97% for C. trachomatis and ≥96% for N. gonorrhoeae. Reliable knowledge of the performance characteristics of the diagnostic tests applied is essential for a thorough risk assessment based on such diagnostic approaches. SIGNIFICANCE AND IMPACT OF THE STUDY A low-threshold use of molecular rapid diagnostic tests in settings where risky sexual activity is undertaken with deliberate non-use of condoms is modelled. Such an approach might contribute to a considerable reduction in the exposure risk if positively tested individuals are excluded from unprotected sexual intercourse. Protective effects are influenced by the prevalence of the disease and the performance characteristics of the applied tests. Precise knowledge of the performance characteristics of the test assays employed are prerequisites of a reliable risk assessment. The modelling approach is of particular use for preventive health experts.
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Affiliation(s)
- A Hahn
- Institute for Microbiology, Charité - University Medicine Berlin, Berlin, Germany
| | - N G Schwarz
- Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine Hamburg, Hamburg, Germany
| | - T Meyer
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Frickmann
- Department of Tropical Medicine at the Bernhard Nocht Institute, Bundeswehr Hospital Hamburg, Hamburg, Germany.,Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
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21
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Hahn A, Hinz R, Meyer T, Loderstädt U, Herchenröder O, Meyer CG, Schwarz NG, Frickmann H. Diagnostics as Prevention - A Rapid Testing-Based Strategy of Sex Workers against Sexual HIV Exposure. Eur J Microbiol Immunol (Bp) 2018; 8:47-52. [PMID: 29997911 PMCID: PMC6038536 DOI: 10.1556/1886.2018.00007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 04/06/2018] [Indexed: 01/02/2023] Open
Abstract
Introduction German sex workers have illegally established a prevention strategy, which consists of testing potential sexual partners with human immunodeficiency virus (HIV)-specific rapid diagnostic tests (RDTs) prior to engaging in unprotected sexual intercourse eventually performed in case of a negative test result. Based on a recently established modeling approach, the effectiveness of this strategy regarding the risk of HIV exposure was compared with protection provided by condom use. Methods Based on a literature search, the following assumptions were used for the calculations: an averaged 80% exposure risk reduction with a condom used during sexual intercourse, usage of a well-characterized 4th-generation HIV RDT, and a 10 day post-infection period without any measurable viral load in peripheral blood followed by a sero-conversion period of about 3 weeks with 12.3% test sensitivity (antigen-specific) and only afterwards 97.3% (antibody-specific) test sensitivity. Results In most constellations, the HIV exposure risk in case of RDT-based prevention was lower than with condom use. Conclusions: The RDT-based HIV exposure prevention as established by sex workers is effective in most situations. A notable weakness of the strategy is the RDTs' poor sensitivity in spite of a high transmission risk during the seroconversion stage.
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Affiliation(s)
- Andreas Hahn
- Institute for Microbiology, Charité - University Medicine Berlin, Berlin, Germany
| | - Rebecca Hinz
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany
| | - Thomas Meyer
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ulrike Loderstädt
- Institute for Hygiene and Environment, City of Hamburg, Hamburg, Germany
| | - Ottmar Herchenröder
- Institute for Experimental Gene Therapy and Cancer Research, University Medicine Rostock, Rostock, Germany
| | - Christian G Meyer
- Duy Tan University, Đà Nີng, Vietnam.,Institute for Tropical Medicine, Eberhard Karls University, Tübingen, Germany
| | - Norbert Georg Schwarz
- Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine Hamburg, Hamburg, Germany
| | - Hagen Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany.,Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
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22
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Hahn A, Hinz R, Meyer T, Loderstädt U, Herchenröder O, Meyer CG, Schwarz NG, Frickmann H. HIV prevention strategies and risk of infection: a model-based analysis. Epidemiol Infect 2018; 146:1015-1025. [PMID: 29655384 PMCID: PMC9184949 DOI: 10.1017/s0950268818000845] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 03/13/2018] [Accepted: 03/19/2018] [Indexed: 12/24/2022] Open
Abstract
Risk populations for HIV infections tend to neglect condom use, making alternative preventive approaches necessary. Accordingly, we modelled the risk of sexual HIV transmission for condom use vs. use of rapid diagnostic test (RDT) systems with subsequent exclusion of potential sexual partners with a correctly or falsely positive test from unprotected sex with and without the use of HIV pre-exposure prophylaxis (PrEP) in a bio-statistical approach. We combined a previously described model of transmission risk for HIV-exposed individuals with a newly suggested model of risk of HIV exposure for sexually active HIV-negative individuals. The model was adapted for several stages of infection and different strategies of HIV infection prevention.HIV prevention with RDTs can reduce the transmission risk by up to 97% compared with having sex without any prevention and up to 80% compared with condom use. Nevertheless, RDT-based prevention strategies demonstrate a lack of protection in several stages of infection; in particular, RNA-based RDT systems may fail under treatment. RDT-based pre-screening of potential sex partners prior to unprotected sexual contacts substantially reduces HIV transmission risk. Combination of different prevention strategies is advisable for high-risk groups.
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Affiliation(s)
- A. Hahn
- Institute for Microbiology, Charité – University Medicine Berlin, Berlin, Germany
| | - R. Hinz
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany
| | - T. Meyer
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - U. Loderstädt
- Institute for Hygiene and Environment, City of Hamburg, Hamburg, Germany
| | - O. Herchenröder
- Institute for Experimental Gene Therapy and Cancer Research, University Medicine Rostock, Rostock, Germany
| | - C. G. Meyer
- Duy Tan University, Đà Nẵng, Vietnam
- Institute for Tropical Medicine, Eberhard Karls University, Tübingen, Germany
| | - N. G. Schwarz
- Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine Hamburg, Hamburg, Germany
| | - H. Frickmann
- Department of Microbiology and Hospital Hygiene, Bundeswehr Hospital Hamburg, Hamburg, Germany
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Rostock, Germany
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Using Multiple Outcomes of Sexual Behavior to Provide Insights Into Chlamydia Transmission and the Effectiveness of Prevention Interventions in Adolescents. Sex Transm Dis 2018; 44:619-626. [PMID: 28876313 DOI: 10.1097/olq.0000000000000653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mathematical models are important tools for assessing prevention and management strategies for sexually transmitted infections. These models are usually developed for a single infection and require calibration to observed epidemiological trends in the infection of interest. Incorporating other outcomes of sexual behavior into the model, such as pregnancy, may better inform the calibration process. METHODS We developed a mathematical model of chlamydia transmission and pregnancy in Minnesota adolescents aged 15 to 19 years. We calibrated the model to statewide rates of reported chlamydia cases alone (chlamydia calibration) and in combination with pregnancy rates (dual calibration). We evaluated the impact of calibrating to different outcomes of sexual behavior on estimated input parameter values, predicted epidemiological outcomes, and predicted impact of chlamydia prevention interventions. RESULTS The two calibration scenarios produced different estimates of the probability of condom use, the probability of chlamydia transmission per sex act, the proportion of asymptomatic infections, and the screening rate among men. These differences resulted in the dual calibration scenario predicting lower prevalence and incidence of chlamydia compared with calibrating to chlamydia cases alone. When evaluating the impact of a 10% increase in condom use, the dual calibration scenario predicted fewer infections averted over 5 years compared with chlamydia calibration alone [111 (6.8%) vs 158 (8.5%)]. CONCLUSIONS While pregnancy and chlamydia in adolescents are often considered separately, both are outcomes of unprotected sexual activity. Incorporating both as calibration targets in a model of chlamydia transmission resulted in different parameter estimates, potentially impacting the intervention effectiveness predicted by the model.
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24
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Lemley SM, Jarmolowicz DP, Parkhurst D, Celio MA. The Effects of Condom Availability on College Women's Sexual Discounting. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:551-563. [PMID: 28913688 DOI: 10.1007/s10508-017-1040-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 06/28/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
College students commonly engage in risky sexual behaviors, such as casual sexual encounters and inconsistent condom use. Discounting paradigms that examine how individuals devalue rewards due to their delay or uncertainty have been used to improve our understanding of behavioral problems, including sexual risk. The current study assessed relations between college women's sexual partners discounting and risky sexual behavior. In this study, college women (N = 42) completed two sexual partners delay discounting tasks that assessed how choices among hypothetical sexual partners changed across a parametric range of delays in two conditions: condom availability and condom unavailability. Participants also completed two sexual partners probability discounting tasks that assessed partner choices across a parametric range of probabilities in condom availability and unavailability conditions. Additionally, participants reported risky sexual behavior on the Sexual Risk Survey (SRS). Participants discounted delayed partners more steeply in the condom availability condition, but those differences were significant only for those women with three or fewer lifetime sexual partners. There were no consistent differences in discounting rate across condom availability conditions for probability discounting. Sexual partners discounting measures correlated with risky sexual behaviors as measured by the SRS, but a greater number of significant relations were observed with the condoms-unavailable delay discounting task. These findings suggest the importance of examining the interaction of inconsistent condom use and multiple partners in examinations of sexual decision-making.
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Affiliation(s)
- Shea M Lemley
- Department of Applied Behavioral Science, University of Kansas, 4041 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA.
| | - David P Jarmolowicz
- Department of Applied Behavioral Science and Problem Gambling Research and Education Support System, University of Kansas, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA
| | - Daniel Parkhurst
- Department of Applied Behavioral Science, University of Kansas, 4050 Dole Developmental Center, 1000 Sunnyside Ave., Lawrence, KS, 66045, USA
| | - Mark A Celio
- Department of Behavioral and Social Sciences, Brown University, Box G-121-5, 121 S. Main Street, Providence, RI, 02915, USA
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25
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De Graaf H, Verbeek M, Van den Borne M, Meijer S. Offline and Online Sexual Risk Behavior among Youth in the Netherlands: Findings from "Sex under the Age of 25". Front Public Health 2018; 6:72. [PMID: 29594093 PMCID: PMC5857809 DOI: 10.3389/fpubh.2018.00072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/22/2018] [Indexed: 11/13/2022] Open
Abstract
Sexually developing adolescents and emerging adults face sexual health risks as well as potentially negative outcomes of online sexual behaviors. The goal of this study was to describe three categories of sexual risk behavior: (1) behavior related to STI/HIV, (2) behavior related to unplanned pregnancy, and (3) online sexual risk behavior. In addition, we investigated whether these behaviors are actually related to negative (health) outcomes. For this purpose, we used data from a Dutch probability survey: "Sex under the age of 25." Adolescents and emerging adults aged 12 through 24 (8,053 boys and 12,447 girls) completed a digital questionnaire, including measures of the risk of STI/HIV and pregnancy, online sexual behavior and non-consensual sex. Chi-square tests and logistic regressions were used to test for gender and age differences and compute associations between risk behavior and negative outcomes. The results showed that the risk of unplanned pregnancy is low in the Netherlands. It seems that adolescents and emerging adults are less aware of the risk of STI/HIV than of the risk of pregnancy. About 11% of the participants had had more than one partner in the last 6 months and had not used condoms consistently with their last partner, and these participants had a 3.56 times higher likelihood of ever being diagnosed with an STI. Although many young people stop using condoms with their partner after a while, most of them did not get tested for STIs. More emerging adults (aged 18-24) engage in sexting (sending personal nude pictures and sex videos to others), but the chance that these images are shared with other people than the intended recipient is higher among adolescents (aged 12-17). The results of this study can guide professionals working in sex education and sexual health services to focus their efforts on the risk behaviors in the Netherlands that deserve most attention.
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26
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Hunter LA, Nelson L, Chow JM, Holt BY, Bauer HM. Contraceptive Method Use and Chlamydia Positivity Among California Family Planning Clients: The Case for New Multipurpose Prevention Technologies. J Womens Health (Larchmt) 2018; 27:768-774. [PMID: 29377757 DOI: 10.1089/jwh.2017.6558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Adolescent girls and young women experience high rates of sexually transmitted infection (STI) with currently available contraceptive methods, yet few studies examine the burden of chlamydial infection by contraceptive method used. MATERIALS AND METHODS In this cross-sectional analysis, we linked July 2012-June 2013 claims from a publicly-funded family planning program in California to chlamydia laboratory test results. Female clients were classified by the most effective contraceptive method reported by providers during the year: tier 1 (high-efficacy permanent or long-acting reversible methods), tier 2 (shorter-acting hormonal methods), or tier 3 (barrier methods, emergency contraception, or natural family planning). In addition, we identified clients who received condoms from providers. We used log-binomial models to estimate adjusted prevalence ratios comparing chlamydia positivity by contraceptive method(s). RESULTS Of 74,636 female clients of ages 15-29 years with chlamydia test results, 5.1% had at least one positive test during the year. Chlamydia positivity was highest among tier 2 users (5.3%) compared with 4.5% and 4.9% among tiers 1 and 3 users, respectively (p < 0.001). Positivity was higher among clients who received condoms from providers than those who did not (6.3% vs. 4.3%, p < 0.001). In adjusted analyses, there were no significant differences in positivity by contraceptive tier. However, clients who received condoms had 1.32 (95% confidence interval: 1.24-1.40) times the positivity of those who did not. CONCLUSIONS We found high chlamydia positivity among young female family planning clients regardless of contraceptive method. The development and provision of additional Multipurpose Prevention Technologies that confer protection against both pregnancy and STIs may help to address unmet need for STI prevention.
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Affiliation(s)
- Lauren A Hunter
- 1 Division of Epidemiology, School of Public Health, University of California , Berkeley, Berkeley, California
| | - Lauren Nelson
- 2 Sexually Transmitted Diseases (STD) Control Branch, Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID) , California Department of Public Health (CDPH), Richmond, California
| | - Joan M Chow
- 2 Sexually Transmitted Diseases (STD) Control Branch, Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID) , California Department of Public Health (CDPH), Richmond, California
| | | | - Heidi M Bauer
- 2 Sexually Transmitted Diseases (STD) Control Branch, Division of Communicable Disease Control (DCDC), Center for Infectious Diseases (CID) , California Department of Public Health (CDPH), Richmond, California
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27
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Somayaji R, Naugler C, Guo M, Church DL. Examining sociodemographic risk factors for Chlamydia trachomatis infection: a population-based cohort study. Future Microbiol 2017; 12:1363-1370. [PMID: 29022366 DOI: 10.2217/fmb-2017-0078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection in developed nations and is an important public health concern. We aimed to assess the factors associated with testing and positivity of C. trachomatis in a large population. METHODS A retrospective study of a large Canadian health region was undertaken using 2011 census and laboratory data. Demographic and socioeconomic data from the national household survey were linked to microbiologic data for C. trachomatis. Multivariable generalized estimating equation models were constructed to examine relative risk for C. trachomatis testing and positivity. RESULTS For testing and positivity, female sex and younger age groups were associated with increased risk. University education and South Asian ethnicity were associated with lower risk of positivity. CONCLUSION Incorporating socio-demographic factors will be critical to the success of future sexually transmitted infection public health programs.
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Affiliation(s)
- Ranjani Somayaji
- Department of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Christopher Naugler
- Calgary Laboratory Services, Calgary, AB, T2L 2K8, Canada.,Department of Pathology & Laboratory Medicine & Medicine, University of Calgary, Calgary, AB, T2L 2K8, Canada.,Department of Family Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Maggie Guo
- Calgary Laboratory Services, Calgary, AB, T2L 2K8, Canada
| | - Deirdre L Church
- Department of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada.,Calgary Laboratory Services, Calgary, AB, T2L 2K8, Canada.,Department of Pathology & Laboratory Medicine & Medicine, University of Calgary, Calgary, AB, T2L 2K8, Canada
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Koff A, Goldberg C, Ogbuagu O. Condomless sex and HIV transmission among serodifferent couples: current evidence and recommendations. Ann Med 2017; 49:534-544. [PMID: 28409656 DOI: 10.1080/07853890.2017.1320423] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Human immunodeficiency virus (HIV) infection remains a global pandemic. The primary driver of HIV incidence is sexual transmission between serodifferent individuals. Condoms, when used consistently and correctly, are effective at preventing sexually transmitted HIV infections and are considered an integral component of a comprehensive approach to HIV prevention. However, the demonstrated effectiveness of antiretroviral therapy (ART) to prevent HIV transmission, known as treatment as prevention and of pre-exposure prophylaxis, have raised an intriguing dilemma on the necessity and additive preventive benefit of condom use among individuals in serodifferent relationships utilizing these prevention strategies. Recent published evidence, although of limited follow-up duration, has shown no linked HIV transmissions with condomless sex among serodifferent couples where the infected partner was on ART and virologically suppressed. This paper will review the evidence surrounding HIV transmission risk among serodifferent couples with and without the use of condoms and will highlight factors that increase or attenuate this risk. It will also address the important benefits that condomless sex offers couples. This paper aims to provide a template for providers to have personalized discussions with their patients, particularly those with an HIV-positive sexual partner, around their individual risk of HIV transmission and the role of condom use.
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Affiliation(s)
- Alan Koff
- a Department of Medicine , Norwalk Hospital , Norwalk , CT , USA
| | - Carole Goldberg
- b Department of Mental Health and Counselling , Yale School of Medicine , New Haven , CT , USA
| | - Onyema Ogbuagu
- c Section of Infectious Diseases , Yale School of Medicine , New Haven , CT , USA
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Neilson EC, Eakins DR, Davis KC, Norris J, George WH. Depressive Symptoms, Acute Alcohol Intoxication, and Risk Rationale Effects on Men's Condom Use Resistance. JOURNAL OF SEX RESEARCH 2017; 54:764-775. [PMID: 27547862 PMCID: PMC5526205 DOI: 10.1080/00224499.2016.1217500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the role of depressive symptoms, acute intoxication, and risk rationale in men's use of condom use resistance (CUR) tactics in an experimental study. Participants included 313 heterosexual male, nonproblem drinkers, ages 21 to 30. Participants were randomized to one of four beverage conditions: no alcohol, placebo, low (.04%) alcohol dose, or high (.08%) alcohol dose. They read an eroticized scenario depicting a consensual sexual encounter with a female partner who requested a condom to prevent either pregnancy or sexually transmitted infections (STIs) (risk rationale) and then indicated their intentions to use 10 different CUR tactics. Hypotheses related to the pharmacological, dosage, and expectancy effects of alcohol were tested in a generalized linear model. In intoxicated (.04% and .08%) men who were given a pregnancy risk rationale, depressive symptoms were associated with stronger intentions to use CUR tactics than in sober (control and placebo) men. Men who received a high alcohol dose (.08%) and who were given a pregnancy risk rationale reported higher intentions to use CUR tactics than those who received a lower alcohol dose (.04%). Findings suggest that the pharmacological effects of alcohol on men's likelihood to resist condoms vary by the saliency of the risk rationale and mood-related variables.
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Affiliation(s)
- Elizabeth C. Neilson
- University of Washington, Department of Psychology, Box 351525, Seattle, WA 98195
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Snead MC, Wiener J, Ewumi S, Phillips C, Flowers L, Hylton-Kong T, Medley-Singh N, Legardy-Williams J, Costenbader E, Papp J, Warner L, Black C, Kourtis AP. Prevalence and risk factors associated with STIs among women initiating contraceptive implants in Kingston, Jamaica. Sex Transm Infect 2017; 93:503-507. [PMID: 28476913 DOI: 10.1136/sextrans-2016-052963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/30/2017] [Accepted: 04/18/2017] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND There is limited information on rates of STIs in Jamaica due to syndromic management and limited aetiological surveillance. We examined the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) and characteristics associated with STIs among sexually active women who participated in a randomised trial of a progestin implant initiation in Jamaica (the Sino-Implant Study (SIS)). METHODS SIS was a randomised trial conducted in Kingston, Jamaica, from 2012 to 2014 to evaluate whether initiation of the Sino-Implant (II) led to more unprotected sex among women ages 18-44 years. Data collected included self-reported demographic, sexual behaviour information; and vaginal swabs collected at baseline, 1-month and 3-month follow-up visits for a biomarker of recent semen exposure (prostate-specific antigen (PSA)) and for STIs. We examined associations between STIs and PSA, demographics, sexual behaviour and insertion of an implant, with a repeated-measures analysis using generalised estimating equations (SAS Institute, V.9.3). RESULTS Remnant vaginal swabs from 254 of 414 study participants were tested for STIs. At baseline, 29% of participants tested for STIs (n=247) had laboratory-confirmed CT, 5% NG, 23% TV and 45% any STI. In a repeated-measures analysis adjusted for study arm (immediate vs delayed implant insertion), those with PSA detected did not have an increased prevalence of any STI (prevalence ratio (PR)=1.04 (95% CI 0.89 to 1.21)), whereas prevalence decreased for each 1-year increase in age (PR=0.98 (95% CI 0.97 to 0.99)). Immediate implant insertion was not associated with increases in any STI in subsequent visits (PR=1.09 (95% CI 0.94 to 1.27)). CONCLUSIONS Although the prevalence of laboratory-confirmed STIs was high, the immediate initiation of a contraceptive implant was not associated with higher STI prevalence rates over 3 months. TRIAL REGISTRATION NUMBER NCT01684358.
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Affiliation(s)
- Margaret Christine Snead
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jeffrey Wiener
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Christi Phillips
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lisa Flowers
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | | | - Jennifer Legardy-Williams
- Office of Science and Integrated Services, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - John Papp
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lee Warner
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Carolyn Black
- Division of Scientific Resources, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Athena P Kourtis
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Eleftheriou A, Bullock S, Graham CA, Ingham R. Using Computer Simulations for Investigating a Sex Education Intervention: An Exploratory Study. JMIR Serious Games 2017; 5:e9. [PMID: 28468747 PMCID: PMC5438447 DOI: 10.2196/games.6598] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/04/2016] [Accepted: 02/08/2017] [Indexed: 11/29/2022] Open
Abstract
Background Sexually transmitted infections (STIs) are ongoing concerns. The best method for preventing the transmission of these infections is the correct and consistent use of condoms. Few studies have explored the use of games in interventions for increasing condom use by challenging the false sense of security associated with judging the presence of an STI based on attractiveness. Objectives The primary purpose of this study was to explore the potential use of computer simulation as a serious game for sex education. Specific aims were to (1) study the influence of a newly designed serious game on self-rated confidence for assessing STI risk and (2) examine whether this varied by gender, age, and scores on sexuality-related personality trait measures. Methods This paper undertook a Web-based questionnaire study employing between and within subject analyses. A Web-based platform hosted in the United Kingdom was used to deliver male and female stimuli (facial photographs) and collect data. A convenience sample group of 66 participants (64%, 42/66) male, mean age 22.5 years) completed the Term on the Tides, a computer simulation developed for this study. Participants also completed questionnaires on demographics, sexual preferences, sexual risk evaluations, the Sexual Sensation Seeking Scale (SSS), and the Sexual Inhibition Subscale 2 (SIS2) of the Sexual Inhibition/Sexual Excitation Scales-Short Form (SIS/SES - SF). Results The overall confidence of participants to evaluate sexual risks reduced after playing the game (P<.005). Age and personality trait measures did not predict the change in confidence of evaluating risk. Women demonstrated larger shifts in confidence than did men (P=.03). Conclusions This study extends the literature by investigating the potential of computer simulations as a serious game for sex education. Engaging in the Term on the Tides game had an impact on participants’ confidence in evaluating sexual risks.
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Affiliation(s)
- Anastasia Eleftheriou
- Institute for Complex Systems Simulation, Electronics and Computer Science, University of Southampton, Southampton, United Kingdom
| | - Seth Bullock
- Department of Computer Science, University of Bristol, Bristol, United Kingdom
| | - Cynthia A Graham
- Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, United Kingdom
| | - Roger Ingham
- Centre for Sexual Health Research, Department of Psychology, University of Southampton, Southampton, United Kingdom
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Toopchian A, Kanani S, Babazadeh T, Allahverdipour H, Nadrian H. Development and Psychometric Properties of a Condom Use and Its Cognitive Determinants Questionnaire (CUCDQ). Open Access Maced J Med Sci 2017; 5:79-85. [PMID: 28293322 PMCID: PMC5320913 DOI: 10.3889/oamjms.2017.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 11/29/2016] [Accepted: 12/01/2016] [Indexed: 11/26/2022] Open
Abstract
AIM The aim of this study was to assess the psychometric properties of Condom Use and its Cognitive Determinants Questionnaire (CUCDQ) among married women in Tabriz, Iran. MATERIALS AND METHODS In this cross-sectional study, applying multistage cluster sampling 388 married women were recruited to participate in the study. A comprehensive literature review was conducted to develop CUCDQ. Face, content, and construct validity, as well as reliability, were investigated. RESULTS Principal component factor analysis with varimax rotation demonstrated a six factors structure as the best solution [Bartlett's Test of Sphericity (Approx. Chi-Square= 4193.07, df= 780, p<0.001); KMO= 0.815] which explained 43.13% of all the variance between the items. CUCDQ represented a proper validity, reliability, simplicity and functionality. CONCLUSION CUCDQ may be helpful for family health care providers and family planning decision makers in precise assessing the behavioural, psychological, and educational factors related to condom use. This scale may be useful in a various range of studies including family planning or STIs prevention studies in different communities. Future research is recommended to assess the different dimensions of the tool in different communities.
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Affiliation(s)
- Arezoo Toopchian
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Safieh Kanani
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Towhid Babazadeh
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haidar Nadrian
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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Zhao Y, Wong CKH, Miu HYH, Yuen WWY, Chin WY, Luo T, Wong WCW. Translation and Validation of a Condom Self-Efficacy Scale (CSES) Chinese Version. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:499-510. [PMID: 27925485 DOI: 10.1521/aeap.2016.28.6.499] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The English version of the Condom Self-Efficacy Scale (CSES) was translated, back-translated, and tested among a representative sample of the Hong Kong general population. It then underwent reconsolidation, confirmation, and validation following standard procedures. Construct validity was performed by exploratory factor analysis and item-scale correlation. Independent t-test and effect size were used to identify the score differences between consistent and non-consistent condom users. The factor loading scores of 14 items ranged between 0.749 and 0.884. Cronbach's alpha for the traditional Chinese version of CSES (CSES-TC) was 0.96 for the overall scale. The CSES-TC was highly correlated with self-reported condom use among the 265 participants who indicated they had been sexually active in the past 12 months. The CSES-TC demonstrated satisfactory psychometric properties in terms of validity, reliability, and sensitivity. This scale can be used as an instrument to measure condom use efficacy for condom promotion and intervention purposes.
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Affiliation(s)
- Yanping Zhao
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Heidi Yin Hai Miu
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Winnie Wing Yan Yuen
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Weng Yee Chin
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Tongyong Luo
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - William Chi Wai Wong
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
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Liu C, Mao J, Wong T, Tang W, Tso LS, Tang S, Zhang Y, Zhang W, Qin Y, Chen Z, Ma W, Kang D, Li H, Liao M, Mollan K, Hudgens M, Bayus B, Huang S, Yang B, Wei C, Tucker JD. Comparing the effectiveness of a crowdsourced video and a social marketing video in promoting condom use among Chinese men who have sex with men: a study protocol. BMJ Open 2016; 6:e010755. [PMID: 27697868 PMCID: PMC5073617 DOI: 10.1136/bmjopen-2015-010755] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Crowdsourcing has been used to spur innovation and increase community engagement in public health programmes. Crowdsourcing is the process of giving individual tasks to a large group, often involving open contests and enabled through multisectoral partnerships. Here we describe one crowdsourced video intervention in which a video promoting condom use is produced through an open contest. The aim of this study is to determine whether a crowdsourced intervention is as effective as a social marketing intervention in promoting condom use among high-risk men who have sex with men (MSM) and transgender male-to-female (TG) in China. METHOD We evaluate videos developed by crowdsourcing and social marketing. The crowdsourcing contest involved an open call for videos. Entries were judged on capacity to promote condom use, to be shareable or 'go viral' and to give value to the individual. 1170 participants will be recruited for the randomised controlled trial. Participants need to be MSM age 16 and over who have had condomless anal sex in the last 3 months. Recruitment will be through an online banner ad on a popular MSM web page and other social media platforms. After completing an initial survey, participants will be randomly assigned to view either the social marketing video or the crowdsourcing video. Follow-up surveys will be completed at 3 weeks and 3 months after initial intervention to evaluate condomless sex and related secondary outcomes. Secondary outcomes include condom social norms, condom negotiation, condom self-efficacy, HIV/syphilis testing, frequency of sex acts and incremental cost. ETHICS AND DISSEMINATION Approval was obtained from the ethical review boards of the Guangdong Provincial Center for Skin Diseases and STI Control, UNC and UCSF. The results of this trial will be made available through publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02516930.
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Affiliation(s)
- Chuncheng Liu
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Jessica Mao
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Terrence Wong
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Weiming Tang
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Lai Sze Tso
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Songyuan Tang
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Ye Zhang
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
- Guangdong Provincial Center for Skin Diseases and Sexually Transmitted Infections Control,Guangzhou, China
| | - Wei Zhang
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | - Yilu Qin
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
| | | | - Wei Ma
- Shandong University School of Public Health, Jinan, China
| | - Dianming Kang
- Shandong Center for Disease Prevention and Control, Jinan, China
| | - Haochu Li
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
- Shandong University School of Public Health, Jinan, China
| | - Meizhen Liao
- Shandong Center for Disease Prevention and Control, Jinan, China
| | - Katie Mollan
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Michael Hudgens
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Barry Bayus
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shujie Huang
- Guangdong Provincial Center for Skin Diseases and Sexually Transmitted Infections Control,Guangzhou, China
| | - Bin Yang
- Guangdong Provincial Center for Skin Diseases and Sexually Transmitted Infections Control,Guangzhou, China
| | - Chongyi Wei
- University of California, San Francisco, San Francisco, California, USA
| | - Joseph D Tucker
- University of North Carolina Chapel Hill Project-China, Guangzhou, China
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Veličko I, Ploner A, Sparén P, Marions L, Herrmann B, Kühlmann-Berenzon S. Sexual and testing behaviour associated with Chlamydia trachomatis infection: a cohort study in an STI clinic in Sweden. BMJ Open 2016; 6:e011312. [PMID: 27566631 PMCID: PMC5013445 DOI: 10.1136/bmjopen-2016-011312] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Genital chlamydia infection (chlamydia) is the most commonly reported sexually transmitted infection (STI) in Sweden. To guide prevention needs, we aimed to investigate factors associated with chlamydia. METHODS A cohort of visitors aged 20-40 years at an urban STI clinic in Sweden was recruited. Behavioural data were collected using a self-administered questionnaire. Self-sampled specimens were tested for chlamydia by a DNA amplification assay. Statistically significant (p<0.05) and epidemiologically relevant covariates were entered in a multivariate Poisson model adjusted for potential confounders (age and gender). Backward stepwise elimination produced a final model. Multiple imputation was used to account for missing values. RESULTS Out of 2814 respondents, 1436 were men with a chlamydia positivity rate of 12.6% vs 8.9% in women. Lifetime testing for chlamydia and HIV was high (82% and 60%, respectively). Factors significantly associated with chlamydia were: 20-24 years old (adjusted risk ratio (ARR)=2.10, 95% CI 1.21 to 3.65); testing reason: contact with a chlamydia case (ARR=6.55, 95% CI 4.77 to 8.98) and having symptoms (ARR=2.19, 95% CI 1.48 to 3.24); 6-10 sexual partners (ARR=1.53, 95% CI 1.06 to 2.21); last sexual activity 'vaginal sex and oral sex and anal sex and petting' (ARR=1.84, 95% CI 1.09 to 3.10); alcohol use before sex (ARR=1.98, 95% CI 1.10 to 3.57); men with symptoms (ARR=2.09, 95% CI 1.38 to 3.18); tested for chlamydia (ARR=0.72, 95% CI 0.55 to 0.94). CONCLUSIONS Risk factors associated with chlamydia were consistent with previous reports in similar settings and suggest no major changes over time. Increased risk for chlamydia infection associated with high-risk behaviour (eg, alcohol use, increased number of sexual partners) supports the need for behavioural interventions in this population such as promotion of safer sex behaviour (condom use) and testing.
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Affiliation(s)
- Inga Veličko
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Unit of Monitoring and Evaluation, Public Health Agency of Sweden, Stockholm, Sweden
| | - Alexander Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lena Marions
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
- Section of Obstetrics and Gynaecology, Stockholm South General Hospital, Stockholm, Sweden
| | - Björn Herrmann
- Section of Clinical Microbiology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
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Matteelli A, Capelli M, Sulis G, Toninelli G, Carvalho ACC, Pecorelli S, Caruso A, Bonfanti C, Gargiulo F, Donato F. Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection in adolescents in Northern Italy: an observational school-based study. BMC Public Health 2016; 16:200. [PMID: 26927226 PMCID: PMC4772514 DOI: 10.1186/s12889-016-2839-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 02/05/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We carried out a study to evaluate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae genital infections in school-based adolescents in Northern Italy. METHODS Systematic screening for C. trachomatis and N. gonorrhoeae genital infection was performed in 13th grade students in the province of Brescia, an industrialized area in Northern Italy. Student filled in a questionnaire on sexual behaviour and provided a urine sample for microbiological testing. RESULTS A total of 2,718 students (mean age: 18.4 years; 59.1% females) provided complete data (62.2% of those eligible). Overall 2,059 students (75.8%) were sexually active (i.e. had had at least one partner), and the mean age at sexual debut was 16.1 years (SD: 1.4). Only 27.5% of the sexually active students reported regular condom use during the previous 6 months, with higher frequency in males than in females (33.8% vs 24.2%). No case of N. gonorrhoeae infection was detected, while C. trachomatis was found in 36 adolescents, with a prevalence of 1.7% (95% CI: 1.2-2.4) among sexually active students, and no statistical difference between females and males (1.9 and 1.4%, respectively). Inconsistent condom use (odds ratio, OR = 5.5) and having had more than one sexual partner during the previous 6 months (OR = 6.8) were associated with an increased risk of Chlamydia infection at multivariate analysis. CONCLUSION The prevalence of C. trachomatis infection among sexually active adolescents in Northern Italy was low, despite a high proportion of students who engage in risky sexual behaviour. No cases of N. gonorrhoeae infection were identified.
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Affiliation(s)
- Alberto Matteelli
- />University Department of Infectious and TropicalDiseases, University of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Michela Capelli
- />Post-graduate school of Public Health, University of Brescia, Brescia, Italy
| | - Giorgia Sulis
- />University Department of Infectious and TropicalDiseases, University of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
| | - Giuseppe Toninelli
- />Post-graduate school of Public Health, University of Brescia, Brescia, Italy
| | - Anna Cristina C. Carvalho
- />University Department of Infectious and TropicalDiseases, University of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
- />Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
| | - Sergio Pecorelli
- />Clinic of Obstetrics and Gynaecology, University of Brescia, Brescia, Italy
| | - Arnaldo Caruso
- />Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy
| | - Carlo Bonfanti
- />Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy
| | - Franco Gargiulo
- />Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy
| | - Francesco Donato
- />Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
| | - (on behalf of the Clamigon Study Group)
- />University Department of Infectious and TropicalDiseases, University of Brescia, P.le Spedali Civili 1, 25123 Brescia, Italy
- />Post-graduate school of Public Health, University of Brescia, Brescia, Italy
- />Laboratory of Innovations in Therapies, Education and Bioproducts (LITEB), Oswaldo Cruz Institute (IOC), FioCruz, Rio de Janeiro, Brazil
- />Clinic of Obstetrics and Gynaecology, University of Brescia, Brescia, Italy
- />Laboratory of Microbiology, Spedali Civili General Hospital, Brescia, Italy
- />Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
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Kim M, McKenney J, Khosropour CM, Prater AB, Rosenberg ES, Siegler AJ, Sullivan PS. Factors Associated With Condom Breakage During Anal Intercourse: A Cross-Sectional Study of Men Who Have Sex With Men Recruited in an Online Survey. JMIR Public Health Surveill 2016; 2:e7. [PMID: 27227161 PMCID: PMC4869233 DOI: 10.2196/publichealth.5298] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 12/04/2015] [Indexed: 11/28/2022] Open
Abstract
Background Within the United States, HIV affects men who have sex with men (MSM) disproportionally compared to the general population. In 2011, MSM represented nearly two-thirds of all new HIV infections while representing less than 2% of the US male population. Condoms continue to be the foundation of many HIV prevention programs; however, the failure rate of condoms during anal intercourse among MSM is estimated to be 0.5% to 8%, and condom breakages leave those affected at high risk for HIV transmission. Objective Estimate the frequency of condom breakage and associated demographic and behavioral factors during last act of anal intercourse using data from a national online HIV prevention survey of MSM. Methods From March 19 to April 16, 2009, data were collected on 9005 MSM through an online survey of US MSM recruited through a social networking site. Using multivariable logistic regression and controlling for several demographic and sexual risk behaviors, we estimated odds ratios of the association between condom breakage and several risk factors. Results In the study, 8063 participants reported having at least one male sexual partner in the last 12 months. The median age of participants was 21 years (range 18-65). More than two-thirds (68.2%, 5498/8063) reported anal intercourse during last sex and 16.90% (927/5498) reported using a condom during last anal intercourse act. Condom breakage was reported by 4.4% (28/635) participants who engaged in receptive anal intercourse and 3.5% (16/459) participants who engaged in insertive anal intercourse, with an overall failure rate of 4.0% (95% CI 3.2%-6.0%). Age (adjusted odds ratio [aOR] per 5 years: 0.53 (95% CI 0.30-0.94), number of male sex partners (aOR per 5 sex partners: 1.03 (95% CI 1.00-1.08), and being high or buzzed during sex with a casual sex partner (aOR: 3.14, 95% CI 1.02-9.60) were associated with condom breakage. Conclusions Our results indicate condom breakage is an important problem for MSM that may be more common for younger men, for men with more partners, and during sex with casual partners after alcohol consumption or drug use. A better understanding of why condom breakage occurs more often in these groups is needed to improve educational efforts. Further, during this time of expanded interest in new condom designs, consideration should be given to how condom design might minimize breakage during anal sex.
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Affiliation(s)
- Min Kim
- Rollins School of Public HealthDepartment of EpidemiologyEmory UniversityAtlanta, GAUnited States
| | - Jennie McKenney
- Rollins School of Public HealthDepartment of EpidemiologyEmory UniversityAtlanta, GAUnited States
| | - Christine M Khosropour
- University of WashingtonDepartment of MedicineUniversity of WashintonSeattle, WAUnited States
| | - Adam B Prater
- Emory UniversityDepartment of Radiology and Imaging SciencesUniversity of EmoryAtlanta, GAUnited States
| | - Eli S Rosenberg
- Rollins School of Public HealthDepartment of EpidemiologyEmory UniversityAtlanta, GAUnited States
| | - Aaron J Siegler
- Rollins School of Public HealthDepartment of EpidemiologyEmory UniversityAtlanta, GAUnited States
| | - Patrick S Sullivan
- Rollins School of Public HealthDepartment of EpidemiologyEmory UniversityAtlanta, GAUnited States
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Molla M, Emmelin M, Berhane Y, Lindtjørn B. Readiness of youth in rural Ethiopia to seek health services for sexually transmitted infections. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2015; 8:135-46. [PMID: 25875565 DOI: 10.2989/ajar.2009.8.2.2.854] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Studies pertaining to sexually transmitted infections (STIs) among rural young adults in Ethiopia are limited. This study provides information on knowledge about common STIs, and the perceptions, preferences and use of health services for STIs, among youths and healthcare providers in predominately rural Butajira, a town in south-central Ethiopia. We performed mixed-method research, using a cross-sectional survey among 3 743 randomly selected youths aged 15-24 years, in 2004, and in-depth interviews with ten healthcare providers, in 2006. Less than 38% of the youths knew the common STIs. Among the sexually active youths (n = 802), 3.9% reported having at least one STI symptom in the past 12 months, and one-half of those who had had an STI symptom did not seek care from any source. The healthcare providers reported that the stigma associated with premarital sexual activity, the shamefulness of having an STI, and a perceived lack of confidentiality and uneasiness with the public health services were impediments to treatment-seeking in the study area. The youths in this study preferred to consult with healthcare providers of the same gender who were young, friendly and had a reputation for being empathetic. Embarrassment about having an STI and fear of being noticed by a familiar individual were perceived barriers to healthcare-seeking among the youths. The results suggest that young people are vulnerable to HIV exposure due to lack of knowledge about STIs and especially as a result of having an untreated STI. Health services that are uncoordinated and unable to handle youths' sexual and reproductive health problems, as well as judgemental health professionals and prevailing sexual taboos, were also reported as impediments to youths seeking healthcare. Reorientation of the public health services and healthcare providers could improve youths' healthcare-seeking for STIs.
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Affiliation(s)
- Mitike Molla
- a Centre for International Health , University of Bergen , PO Box 7804 , Bergen , 5020 , Norway
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Condom effectiveness for HIV prevention by consistency of use among men who have sex with men in the United States. J Acquir Immune Defic Syndr 2015; 68:337-44. [PMID: 25469526 DOI: 10.1097/qai.0000000000000461] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We derived an estimate of male condom effectiveness during anal sex among men who have sex with men (MSM) because the most widely used estimate of condom effectiveness (80%) was based on studies of persons during heterosexual sex with an HIV-positive partner. DESIGN Assessed male condom effectiveness during anal sex between MSM in 2 prospective cohort studies of HIV incidence by self-reported consistency of use. METHODS Analyzed data combined from US participants in the EXPLORE trial (1999-2001) public use data set and in the VAX 004 trial (1998-1999) data set. Initially, HIV-uninfected MSM enrolled in these trials completed baseline and semiannual interviews about their sexual behaviors with male partners and underwent HIV testing. Using a time-to-event model, effectiveness of consistent condom use in preventing HIV infection was estimated among men reporting receptive and/or insertive anal sex with an HIV-positive partner and consistency of condom use. RESULTS Among MSM reporting any anal sex with an HIV-positive male partner, we found 70% effectiveness with reported consistent condom use (compared with never use) and no significant protection when comparing sometimes use to never use. This point estimate for MSM was less than the 80% effectiveness estimate reported for heterosexuals in HIV-discordant couples reporting consistent condom use. However, the point estimates in the 2 populations are not statistically different. Only 16% of MSM reported consistent condom use during anal sex with male partners of any HIV status over the entire observation period. CONCLUSIONS These estimates are useful for counseling efforts and for modeling the impact and comparative effectiveness of condoms and other prevention methods used by MSM.
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Abstract
Introduction Infections can impact the reproductive health of women and hence may influence pregnancy related outcomes for both the mother and the child. These infections range from sexually transmitted infections (STIs) to TORCHS infections to periodontal disease to systemic infections and may be transmitted to the fetus during pregnancy, labor, delivery or breastfeeding. Methods A systematic review and meta-analysis of the evidence was conducted to ascertain the possible impact of preconception care for adolescents, women and couples of reproductive age on MNCH outcomes. A comprehensive strategy was used to search electronic reference libraries, and both observational and clinical controlled trials were included. Cross-referencing and a separate search strategy for each preconception risk and intervention ensured wider study capture. Results Preconception behavioral interventions significantly declines re-infection or new STI rates by 35% (95% CI: 20-47%). Further, condom use has been shown to be the most effective way to prevent HIV infection (85% protection in prospective studies) through sexual intercourse. Intervention trials showed that preconception vaccination against tetanus averted a significant number of neonatal deaths (including those specifically due to tetanus) when compared to placebo in women receiving more than 1 dose of the vaccine (OR 0.28; 95% CI: 0.15-0.52); (OR 0.02; 95% CI: 0.00-0.28) respectively. Conclusion Preconception counseling should be offered to women of reproductive age as soon as they test HIV-positive, and conversely women of reproductive age should be screened with their partners before pregnancy. Risk assessment, screening, and treatment for specific infections should be a component of preconception care because there is convincing evidence that treatment of these infections before pregnancy prevents neonatal infections.
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Starosta AJ, Berghoff CR, Earleywine M. Factor structure and gender stability in the multidimensional condom attitudes scale. Assessment 2014; 22:374-84. [PMID: 25139383 DOI: 10.1177/1073191114547887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sexually transmitted infections continue to trouble the United States and can be attenuated through increased condom use. Attitudes about condoms are an important multidimensional factor that can affect sexual health choices and have been successfully measured using the Multidimensional Condom Attitudes Scale (MCAS). Such attitudes have the potential to vary between men and women, yet little work has been undertaken to identify if the MCAS accurately captures attitudes without being influenced by underlying gender biases. We examined the factor structure and gender invariance on the MCAS using confirmatory factor analysis and item response theory, within-subscale differential item functioning analyses. More than 770 participants provided data via the Internet. Results of differential item functioning analyses identified three items as differentially functioning between the genders, and removal of these items is recommended. Findings confirmed the previously hypothesized multidimensional nature of condom attitudes and the five-factor structure of the MCAS even after the removal of the three problematic items. In general, comparisons across genders using the MCAS seem reasonable from a methodological standpoint. Results are discussed in terms of improving sexual health research and interventions.
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Affiliation(s)
- Amy J Starosta
- University at Albany, State University of New York, Albany, NY, USA
| | | | - Mitch Earleywine
- University at Albany, State University of New York, Albany, NY, USA
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Hua L, Zhang Y, Tu W. A spline-based semiparametric sieve likelihood method for over-dispersed panel count data. CAN J STAT 2014. [DOI: 10.1002/cjs.11208] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Lei Hua
- Vertex Pharmaceuticals, Inc.; 50 Northern Avenue Boston MA 02210 USA
| | - Ying Zhang
- Department of Biostatistics; Indiana University; 410 West 10th Street, Suite 3000 Indianapolis IN 46202 USA
| | - Wanzhu Tu
- Department of Biostatistics; Indiana University; 410 West 10th Street, Suite 3000 Indianapolis IN 46202 USA
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Fageeh W, Badawood S, Al Thagafi H, Yasir M, Azhar E, Farraj S, Alomary M, Alsaeed M, Yaghmoor S, Kumosani T. Chlamydia trachomatis infection among female inmates at Briman prison in Saudi Arabia. BMC Public Health 2014; 14:267. [PMID: 24649964 PMCID: PMC3994489 DOI: 10.1186/1471-2458-14-267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chlamydia trachomatis infection is the most common sexually transmitted infection (STI) in the western countries; its prevalence in the conservative Muslim population of Saudi Arabia is not known, but it is generally believed to be low. This study is the first to investigate the prevalence of and risk factors for C. trachomatis infection in the high-risk group of female inmates at Briman Prison in Jeddah. METHODS The inmates were interviewed using a pre-designed questionnaire, and their urine samples were tested for C. trachomatis infection by real-time PCR assay. RESULTS The overall prevalence of C. trachomatis infection was 8.7% in the study population. The ≤25 age group was predominantly affected, with an average prevalence of 16.6%. Two out of five (2/5, 40%) Yamani, (4/33 12.1%) Indonesian, (3/33, 9.1%) Somalian and (2/26, 7.7%) Ethiopian inmates were positive for infection. None of the Saudi inmates (0/14) were positive for infection. Among the studied variables, only age was significantly associated with the infection rate. The other variables (marital status, nationality, religion, employment status, education level, nature of the offense committed, knowledge about protection from STIs, and knowledge about condom use and the purpose of condom use) did not show a significant correlation with Chlamydia infection. CONCLUSIONS The overall prevalence of C. trachomatis infection was within the range published by other reports in similar prison settings in developed countries. The results indicate the need for a countrywide screening and treatment program for all inmates at the time of entry into prison.
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Affiliation(s)
- Wafa Fageeh
- Obstetrics and Gynecology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
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Matser A, Heiligenberg M, Geskus R, Heijman T, Low N, Kretzschmar M, van der Loeff MS. The importance of partnership factors and individual factors associated with absent or inconsistent condom use in heterosexuals: a cross-sectional study. Sex Transm Infect 2014; 90:325-31. [PMID: 24550539 DOI: 10.1136/sextrans-2013-051087] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Decisions to use condoms are made within partnerships. We examined the associations between inconsistent or no condom use and individual and partnership characteristics. We also examined the relative importance of individual versus partnership factors. METHODS Cross-sectional study of heterosexual individuals enrolled from the sexually transmitted infections (STI) outpatient clinic in Amsterdam, the Netherlands, from May to August 2010. Participants completed a questionnaire about sexual behaviour with the last four partners in the preceding year. Participant and partnership factors associated with inconsistent or no condom use in steady and casual partnerships were identified. RESULTS 2144 individuals were included, reporting 6401 partnerships; 54.7% were female, the median age was 25 (IQR 22-30) years and 79.9% were Dutch. Inconsistent or no condom use occurred in 86.1% of 2387 steady partnerships and in 66.5% of 4014 casual partnerships. There was statistical evidence of associations between inconsistent condom use in steady partnerships and ethnic concordance, longer duration, higher number of sex acts, practising anal sex, and sex-related drug use. In casual partnerships, associations were found with having an older partner, ethnic concordance, longer duration, higher number of sex acts, anal sex, sex-related drug use, ongoing partnerships and concurrency. In multivariable models, partnership factors explained 50.9% of the variance in steady partnerships and 70.1% in casual partnerships compared with 10.5% and 15.4% respectively for individual factors. CONCLUSIONS Among heterosexual STI clinic attendees in Amsterdam, partnership factors are more important factors related with inconsistent condom use than characteristics of the individual.
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Affiliation(s)
- Amy Matser
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands Julius Centre for Health Sciences & Primary Care, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands
| | - Marlies Heiligenberg
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
| | - Ronald Geskus
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Amsterdam, The Netherlands
| | - Titia Heijman
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Nicola Low
- Division of Clinical Epidemiology & Biostatistics, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Mirjam Kretzschmar
- Julius Centre for Health Sciences & Primary Care, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Maarten Schim van der Loeff
- Cluster of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center (AMC), Amsterdam, The Netherlands
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A partner-related risk behavior index to identify people at elevated risk for sexually transmitted infections. J Prim Prev 2014; 34:81-7. [PMID: 23355254 DOI: 10.1007/s10935-013-0290-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The purpose of this study was to develop and test a sexual-partner-related risk behavior index to identify high-risk individuals most likely to have a sexually transmitted infection (STI). Patients from five STI and adolescent medical clinics in three US cities were recruited (N = 928; M age = 29.2 years). Data were collected using audio-computer-assisted self-interviewing. Of seven sexual-partner-related variables, those that were significantly associated with the outcomes were combined into a partner-related risk behavior index. The dependent variables were laboratory-confirmed infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and/or Trichomonas vaginalis. Nearly one-fifth of the sample (169/928; 18.4%) tested positive for an STI. Three of the seven items were significantly associated with having one or more STIs: sex with a newly released prisoner, sex with a person known or suspected of having an STI, and sexual concurrency. In combined form, this three-item index was significantly associated with STI prevalence (p < .001). In the presence of three covariates (gender, race, and age), those classified as being at-risk by the index were 1.8 times more likely than those not classified as such to test positive for an STI (p < .001). Among individuals at risk for STIs, a three-item index predicted testing positive for one or more of three STIs. This index could be used to prioritize and guide intensified clinic-based counseling for high-risk patients of STI and other clinics.
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Abstract
Rates of sexual activity, pregnancies, and births among adolescents have continued to decline during the past decade to historic lows. Despite these positive trends, many adolescents remain at risk for unintended pregnancy and sexually transmitted infections (STIs). This policy statement has been developed to assist the pediatrician in understanding and supporting the use of condoms by their patients to prevent unintended pregnancies and STIs and address barriers to their use. When used consistently and correctly, male latex condoms reduce the risk of pregnancy and many STIs, including HIV. Since the last policy statement published 12 years ago, there is an increased evidence base supporting the protection provided by condoms against STIs. Rates of acquisition of STIs/HIV among adolescents remain unacceptably high. Interventions that increase availability or accessibility to condoms are most efficacious when combined with additional individual, small-group, or community-level activities that include messages about safer sex. Continued research is needed to inform public health interventions for adolescents that increase the consistent and correct use of condoms and promote dual protection of condoms for STI prevention with other effective methods of contraception.
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Kirkcaldy RD, Zaidi A, Hook EW, Holmes KK, Soge O, del Rio C, Hall G, Papp J, Bolan G, Weinstock HS, Weinstock HS. Neisseria gonorrhoeae antimicrobial resistance among men who have sex with men and men who have sex exclusively with women: the Gonococcal Isolate Surveillance Project, 2005-2010. Ann Intern Med 2013; 158:321-8. [PMID: 23460055 PMCID: PMC6697257 DOI: 10.7326/0003-4819-158-5-201303050-00004] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Gonorrhea treatment has been complicated by antimicrobial resistance in Neisseria gonorrhoeae. Gonococcal fluoroquinolone resistance emerged more rapidly among men who have sex with men (MSM) than men who have sex exclusively with women (MSW). OBJECTIVE To determine whether N. gonorrhoeae urethral isolates from MSM were more likely than isolates from MSW to exhibit resistance to or elevated minimum inhibitory concentrations (MICs) of antimicrobials used to treat gonorrhea. DESIGN 6 years of surveillance data from the Gonococcal Isolate Surveillance Project. SETTING Publicly funded sexually transmitted disease clinics in 30 U.S. cities. PATIENTS Men with a total of 34 600 episodes of symptomatic urethral gonorrhea. MEASUREMENTS Percentage of isolates exhibiting resistance or elevated MICs and adjusted odds ratios for resistance or elevated MICs among isolates from MSM compared with isolates from MSW. RESULTS In all U.S. regions except the West, isolates from MSM were significantly more likely to exhibit elevated MICs of ceftriaxone and azithromycin than isolates from MSW (P < 0.050). Isolates from MSM had a high prevalence of resistance to ciprofloxacin, penicillin, and tetracycline and were significantly more likely to exhibit antimicrobial resistance than isolates from MSW (P < 0.001). LIMITATIONS Sentinel surveillance may not be representative of all patients with gonorrhea. HIV status, travel history, and antimicrobial use data were missing for some patients. CONCLUSION Men who have sex with men are vulnerable to the emerging threat of antimicrobial-resistant N. gonorrhoeae. Because antimicrobial susceptibility testing is not routinely done in clinical practice, clinicians should monitor for treatment failures among MSM diagnosed with gonorrhea. Strengthened prevention strategies for MSM and new antimicrobial treatment options are needed.
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Affiliation(s)
- Robert D Kirkcaldy
- Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E-02, Atlanta, GA 30333, USA.
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Chen F, Griffith A, Cottrell A, Wong YL. Behavioral responses to epidemics in an online experiment: using virtual diseases to study human behavior. PLoS One 2013; 8:e52814. [PMID: 23326360 PMCID: PMC3541346 DOI: 10.1371/journal.pone.0052814] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 11/21/2012] [Indexed: 11/19/2022] Open
Abstract
We report the results of a study we conducted using a simple multiplayer online game that simulates the spread of an infectious disease through a population composed of the players. We use our virtual epidemics game to examine how people respond to epidemics. The analysis shows that people's behavior is responsive to the cost of self-protection, the reported prevalence of disease, and their experiences earlier in the epidemic. Specifically, decreasing the cost of self-protection increases the rate of safe behavior. Higher reported prevalence also raises the likelihood that individuals would engage in self-protection, where the magnitude of this effect depends on how much time has elapsed in the epidemic. Individuals' experiences in terms of how often an infection was acquired when they did not engage in self-protection are another factor that determines whether they will invest in preventive measures later on. All else being equal, individuals who were infected at a higher rate are more likely to engage in self-protective behavior compared to those with a lower rate of infection. Lastly, fixing everything else, people's willingness to engage in safe behavior waxes or wanes over time, depending on the severity of an epidemic: when prevalence is high, people are more likely to adopt self-protective measures as time goes by; when prevalence is low, a ‘self-protection fatigue’ effect sets in whereby individuals are less willing to engage in safe behavior over time.
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Affiliation(s)
- Frederick Chen
- Department of Economics, Wake Forest University, Winston-Salem, North Carolina, USA.
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