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Ayerdi Aguirrebengoa O, Vera Garcia M, Rueda Sanchez M, D´Elia G, Chavero Méndez B, Alvargonzalez Arrancudiaga M, Bello León S, Puerta López T, Clavo Escribano P, Ballesteros Martín J, Menendez Prieto B, Fuentes ME, García Lotero M, Raposo Utrilla M, Rodríguez Martín C, Del Romero Guerrero J. Risk factors associated with sexually transmitted infections and HIV among adolescents in a reference clinic in Madrid. PLoS One 2020; 15:e0228998. [PMID: 32176884 PMCID: PMC7075699 DOI: 10.1371/journal.pone.0228998] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/27/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Adolescents have a higher incidence of sexually transmitted infections (STIs) than persons of older age groups. The WHO emphasises the need to adopt specific and comprehensive prevention programmes aimed at this age group. The objective of this work was to analyse the prevalence of HIV/STIs among adolescents and to identify the sociodemographic, clinical and behavioural markers associated with these infections, in order to promote specific preventive strategies. Methodology Retrospective descriptive study of adolescents, aged 10–19 years, who were attended to for the first consultation between 2016 and 2018 in a reference STI clinic in Madrid. All adolescents were given a structured epidemiological questionnaire where information on sociodemographic, clinical and behavioural characteristics was collected. They were screened for human inmmunodeficiency virus (HIV) and other sexually transmitted infections (STIs). The processing and analysis of the data was done using the STATA 15.0 statistical package. Results The frequency of HIV/STIs detected among all adolescents was: gonorrhoea 21.7%, chlamydia 17.1%, syphilis 4.8% and HIV 2.4%. After conducting a multivariate analysis, the independent and statistically significant variables related to the presence of an STI were having first sexual relations at a young age and having a history of STIs. Latin American origin was just below the level of statistical significance (p = 0.066). Discussion/Conclusions Adolescents who begin sexual relations at an early age or those who have a history of HIV/STIs are at higher risk of acquiring STIs. Comprehensive prevention programmes aimed specifically at adolescents should be implemented, especially before the age of 13 years.
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Affiliation(s)
| | - Mar Vera Garcia
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | | | - Giovanna D´Elia
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
| | | | | | | | - Teresa Puerta López
- Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
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Sentís A, Martin-Sanchez M, Arando M, Vall M, Barbera MJ, Ocaña I, González Cordón A, Alsina M, Martin-Ezquerra G, Knobel H, Gurguí M, Vives A, Coll J, Caylà JA, Garcia de Olalla P. Sexually transmitted infections in young people and factors associated with HIV coinfection: an observational study in a large city. BMJ Open 2019; 9:e027245. [PMID: 31061051 PMCID: PMC6502227 DOI: 10.1136/bmjopen-2018-027245] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/09/2019] [Accepted: 02/27/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Young people are a critical target group for sexually transmitted infections (STI) surveillance due to their particular behavioural and social related vulnerability. The aim of this study was to describe the epidemiological characteristics and trends in the incidence of gonorrhoea, syphilis, HIV and venereal lymphogranuloma (LGV) among 15-24-year-olds in Barcelona, and to determine factors associated with HIV coinfection. DESIGN We performed a population-based incidence study covering the 2007-2015 period. PARTICIPANTS All new cases of STI-HIV, gonorrhoea, infectious syphilis and LGV-notified to the epidemiological surveillance system in Barcelona between 2007 and 2015. 1218 cases were studied: 84.6% were men, 19.3% were 15-19 years old and 50.6% were born in Spain. Among men, 73.7% were men who have sex with men (MSM); among women, 85.6% were women that have sex with men. PRIMARY AND SECONDARY OUTCOMES Incidence of HIV, gonorrhoea, infectious syphilis and LGV. HIV coinfection. RESULTS There was an increase in the incidence of gonorrhoea, from 1.9 cases per 10 000 people in 2007 to 7.6/10 000 in 2015 (p<0.01), in MSM from 27.1 to 228.8/10 000 (p<0.01). The incidence of syphilis increased from 0.4/10 000 in 2007 to 3.1/10 000 in 2015 (significant in men only, p<0.01), in MSM from 18.1 to 116.9/10 000 (p<0.01). The incidence of HIV showed a non-significant increase in men (p=0.27), and that of LGV remained stable (p=0.59). Factors associated with increased risk of HIV coinfection included being MSM (adjusted OR[ORa]=14.14, 95% CI 3.34 to 59.91) and having >10 sexual partners (ORa=4.11, 95% CI 1.53 to 11.01) or STI diagnosis during the previous 12 months (ORa=2.06; 95% CI 1.13 to 3.77). CONCLUSIONS The incidence of gonorrhoea and syphilis among 15-24-year-olds increased, while HIV infection remained stable but with a high incidence among MSM. Being MSM, having sex with multiple partners and having a diagnosis of an STI in the previous 12 months were factors associated with HIV coinfection.
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Affiliation(s)
- Alexis Sentís
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain
| | - Mario Martin-Sanchez
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar - Pompeu Fabra University - Agència de Salut Pública de Barcelona), Barcelona, Spain
| | - Maider Arando
- Hospital de la Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | - Martí Vall
- Hospital de la Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | | | - Inma Ocaña
- Hospital de la Vall d’Hebron, Universitat Autònoma de Barcelona, Spain
| | | | - Mercè Alsina
- Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | | | - Hernando Knobel
- Hospital del Mar, Universitat Autonòma de Barcelona, Barcelona, Spain
| | - Mercè Gurguí
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alvaro Vives
- Hospital Puigvert, Universitat Autònoma de Barcelona, Spain
| | - Josep Coll
- Hospital Tries i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Joan Artur Caylà
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Foundation of Tuberculosis Research Unit of Barcelona, Spain
| | - Patricia Garcia de Olalla
- Epidemiology Service, Public Health Agency of Barcelona (ASPB), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Wendland EM, Horvath JDC, Kops NL, Bessel M, Caierão J, Hohenberger GF, Domingues CM, Maranhão AGK, de Souza FMA, Benzaken AS. Sexual behavior across the transition to adulthood and sexually transmitted infections: Findings from the national survey of human papillomavirus prevalence (POP-Brazil). Medicine (Baltimore) 2018; 97:e11758. [PMID: 30113461 PMCID: PMC6112916 DOI: 10.1097/md.0000000000011758] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 07/07/2018] [Indexed: 11/26/2022] Open
Abstract
The sexual behaviors of 15- to 24-year-olds increase the risk of this population to acquire sexually transmitted infections (STIs). The present study aimed to describe the sexual behavior in the transition to adulthood Brazilian population and its association with STI history.We analyzed cross-sectional data collected from 8562 sexually active women and men who participated in the National Survey of Human Papillomavirus Prevalence (POP-Brazil). This large-scale survey enrolled participants from 26 Brazilian capitals and the Federal District. Professionals from primary care facilities were trained to collect data utilizing a standardized questionnaire with questions on sociodemographic, sexual behavior, and drug use. We constructed a Poisson model with robust variance for both crude and adjusted analysis to investigate the associations between the variables. To adjust the distribution of the sample to the study population, we weighted the measures by the population size in each city and by gender.There were differences in several aspects from sexual behavior between genders. The majority of men reported an early sexual initiation, more sexual partners, and a different practice in sexual positions when compared with women. Women reported use of contraception more frequently than men (P < .001). The use of alcohol and drugs and the use of drugs before sexual intercourse impact in STIs equally between the genders. Exclusive for women, the presence of any STI was associated with the practice of vaginal sex and other types of intercourse (adjusted prevalence ratio [APR] 1.43, 95% CI 1.08-1.88). For men, the number of sexual partners in the last year (APR 1.02, 95% CI 1.01-1.04), not having vaginal sex (APR 3.25, 95% CI 1.78-5.92) and sexual experience with someone of the same sex (APR 4.05, 95% CI, 2.88-5.70) were associated with a higher presence of STIs.This is the first report regarding sexual behavior in a nationally representative population sample in Brazil. This study provides more valid estimates of sexual behavior and associated STIs, identifying important differences in sexual behavior and identifying predictors for referred STIs among females and males.
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Affiliation(s)
- Eliana Marcia Wendland
- Hospital Moinhos de Vento
- Federal University of Health Science of Porto Alegre, Porto Alegre, Brazil
| | | | | | | | | | | | | | | | - Flavia Moreno Alves de Souza
- Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis, Brazilian Ministry of Health, Brazil
| | - Adele Schwartz Benzaken
- Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis, Brazilian Ministry of Health, Brazil
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Seña AC, Lee JY, Schwebke J, Philip SS, Wiesenfeld HC, Rompalo AM, Cook RL, Hobbs MM. A Silent Epidemic: The Prevalence, Incidence and Persistence of Mycoplasma genitalium Among Young, Asymptomatic High-Risk Women in the United States. Clin Infect Dis 2018; 67:73-79. [PMID: 29342269 PMCID: PMC6005142 DOI: 10.1093/cid/ciy025] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 01/10/2018] [Indexed: 01/24/2023] Open
Abstract
Background Mycoplasma genitalium can result in pelvic inflammatory disease and adverse pregnancy outcomes. We analyzed data collected from a prospective study of asymptomatic bacterial vaginosis (BV) to determine the natural history of M. genitalium. Methods Women aged 15-25 years, with asymptomatic BV and ≥2 risk factors for sexually transmitted infection were recruited from 10 sites throughout the United States. Vaginal swab samples were collected at enrollment and through home-based testing every 2 months over 12 months. M. genitalium nucleic acid amplification testing was performed for M. genitalium using transcription-mediated assays (Hologic). The prevalence, incidence, and persistence of M. genitalium, defined as all positive specimens during follow-up, were estimated with 95% confidence intervals (CIs). Adjusted odds ratios (AOR) were calculated using logistic and Poisson regression to evaluate participant characteristics associated with M. genitalium infection. Results Among 1139 women, 233 were M. genitalium positive, for a prevalence of 20.5% (95% CI, 18.2%-22.9%); 42 of 204 had persistent M. genitalium (20.6%). Among 801 M. genitalium-negative women at baseline, the M. genitalium incidence was 36.6 per 100 person-years (95% CI, 32.4-41.3). Black race (AOR, 1.92; 95% CI, 1.09-3.38), age ≤21 years (1.40; 1.03-1.91), and prior pregnancy (1.36; 1.00-1.85) were associated with prevalent M. genitalium; only black race was associated with incident M. genitalium (P = .03). Conclusions We identified high rates of prevalent, incident, and persistent M. genitalium infections among young, high-risk women with asymptomatic BV, supporting the need for clinical trials to evaluate the impact of M. genitalium screening on female reproductive health outcomes.
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Affiliation(s)
- Arlene C Seña
- Department of Medicine, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill
| | - Jeannette Y Lee
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock
| | - Jane Schwebke
- Department of Medicine, University of Alabama at Birmingham
| | | | - Harold C Wiesenfeld
- Department of Obstetrics and Gynecology, Magee-Women’s Hospital of University of Pittsburgh Medical Center, Pennsylvania
| | - Anne M Rompalo
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Robert L Cook
- Departments of Epidemiology and Medicine, University of Florida, Gainesville
| | - Marcia M Hobbs
- Department of Medicine, Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill
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Prevalence and risk factors of sexually transmitted infections among French service members. PLoS One 2018; 13:e0195158. [PMID: 29608617 PMCID: PMC5880385 DOI: 10.1371/journal.pone.0195158] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/16/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Sexually Transmitted Infections (STIs) have always represented a public health concern in the military, yet most studies rely on self-reports among non-random samples of military populations. In addition, most of the studies exploring STI rates among the military focus on US service members. This paper assesses the prevalence and correlates of STIs in the French military using biomarkers and compares self-reported versus diagnosed STIs. METHODS Data are drawn from the COSEMIL study, a national sexual health survey conducted in the French military in 2014 and 2015. A random sample of 784 men and 141 women aged 18-57 years completed a self-administered questionnaire and provided biological samples for STI testing. We used logistic regression modeling to identify the correlates of STI diagnosis and self-reports. RESULTS The prevalence of diagnosed STIs was 4.7% [3.8-5.9], mostly due to Chlamydia trachomatis. This rate was four times higher than the 12 months self-reported rate of 1.1% [0.6-2.3]. Reported STI rates were similar among men and women (1.1% versus 1.8%), but diagnosed STI rates were twice as high among females versus males (10.4% versus 4.1%, p = 0.007). There were significant differences in the determinants of reported versus diagnosed STIs. In particular, age and sexual orientation were associated with reported STIs, but not with diagnosed STIs. Conversely, STI counseling and depression were associated with STI diagnosis but not with STI reports. CONCLUSION This study underlines the need to use biomarkers in population-based surveys, given the differential and substantial underreporting of STIs. Results also highlight the need for programmatic adaptation to address gender inequalities in STI rates, by developing women's health services in the French military. Addressing such needs not only benefits women but could also serve as a strategy to reduce overall STI rates as most military women have military partners, increasing the risk of internal transmission.
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Dhumale SB, Sharma S, Gulbake A. Ano-Genital Warts and HIV Status- A Clinical Study. J Clin Diagn Res 2017; 11:WC01-WC04. [PMID: 28274028 DOI: 10.7860/jcdr/2017/24610.9171] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 11/07/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Ano-Genital Warts (AGW) like other Sexually Transmitted Diseases (STD) is associated with Human Immunodeficiency Virus (HIV) infection. This study of AGW was done in HIV positive and HIV negative patients. AIM To study the risk factors and clinical presentations of ano-genital warts in HIV positive and negative patients. MATERIALS AND METHODS A comparative, cross-sectional, descriptive study of 25 HIV positive and 25 HIV negative (n=50) AGW patients between 15-60 years of both sex was conducted in Dr. D. Y. Patil Hospital and Research Centre from July 2014 to July 2016. RESULTS Significant association of HIV positivity (p<0.05) was observed between age group of 15-30 years and HIV negative status (p<0.05) in age group of 31-45 years. HIV positive status significantly higher in patients with self-admitted multiple sexual partners (p<0.01), homosexuality (p<0.05) and presentation with anal warts (p<0.01). HIV negative status correlated significantly with single sexual partner admission (p<0.01) and hetero-sexuality (p<0.05). Gender did not show significant association with number of sexual partners or HIV positivity. Extra-genital or only genital warts had no association with HIV status. Co-STDs though more in number in ser-positive group, did not show any significant association with HIV positivity (p>0.05). No patient presented with changes of malignancy. Four were adolescents below 19 years. Two patients had atypical presentations of giant condylomata i.e., Buschke-Lowenstein Tumour (BLT). CONCLUSION HIV positivity was significantly associated with the risk factors of age below 30 years, homo sexuality and multiple sexual partners. Anal warts were significantly common in HIV positive patients. Four adolescents with AGW underline the need for high risk behaviour counselling. No patient had malignant ano-genital warts. Follow up of these patients with Human Papilloma Virus (HPV) sub-typing is necessary.
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Affiliation(s)
| | - Shimpa Sharma
- Professor, Department of Medicine, D.Y. Patil Medical College , Kolhapur, Maharastra, India
| | - Arvind Gulbake
- Assistant Professor, Center for Interdisciplinary Research, D.Y. Patil University , Kolhapur, Maharastra, India
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