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McCartney DJ, Bassichetto KC, Leal AF, Knauth D, Dourado I, Magno L, Carvalho da Silva RJ, Mayaud P, Veras MA. Acceptability and Usability of Self-Sampling for the Detection of Sexually Transmitted Infections Among Transgender Women: The TransOdara Multicentric Study in Brazil. Sex Transm Dis 2024; 51:276-282. [PMID: 38534084 DOI: 10.1097/olq.0000000000001924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
BACKGROUND The effective testing of sexually transmitted infections (STIs) requires sampling from potential infection sites. This study aimed to assess the choice, satisfaction, and performance of self-collected samples (SCS) from potential infection sites for STI testing among transgender women in Brazil. METHODS TransOdara was a multicentric, cross-sectional STI prevalence study conducted in 5 Brazilian cities. Using respondent-driven sampling, 1317 transgender women 18 years or older were recruited. Participants completed interviewer-led questionnaires and provided swab samples from multiple sites (anorectal, oropharyngeal, genital) for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and human papillomavirus (HPV) testing. Participants were given a choice of SCS or provider-collected samples (PCS) at each site. RESULTS Most participants selected SCS for anorectal (74.9%; 95% confidence interval [CI], 72.4-77.3) and genital (72.7%; 95% CI, 70.2-75.1) sites, whereas fewer chose for oropharyngeal samples (49.8%; 95% CI, 47.0-52.6). For future testing, most participants expressed a preference for SCS for genital (72.2%; 95% CI, 69.5-74.7) and anorectal (70.2%; 95% CI, 67.6-72.7) sites. There was no significant difference in the positive test results for CT and NG between SCS and PCS at anorectal and oropharyngeal sites, or for HPV at anorectal and genital (penile or neovaginal) sites. CONCLUSIONS This study demonstrated a high level of acceptability and usability of self-sampling for STI testing among transgender women. A preference for SCS was evident at the anorectal and genital sites, and the results of SCS were comparable to those of PCS. The findings suggest that multisite STI testing utilizing self-collection methods as a provided option can be effectively integrated into sexual health services for transgender women.
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Affiliation(s)
- Daniel Jason McCartney
- From the Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Daniela Knauth
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia
| | - Laio Magno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia, Salvador
| | | | - Philippe Mayaud
- From the Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Costa AF, Rocha SQ, Fonsi M, Nogueira RS, Kalichman AO, Madruga JVR, Gianna MC, Souza RDA, Rodrigues R, Tayra A, Ramos LR, da Silva RJC, Sartori AMC, Prado WDA, Abbud A, Tancredi MV. Clinical and epidemiological features of mpox in a Brazilian reference center for HIV and sexually transmitted infections: A cross-sectional study. IJID Reg 2024; 10:114-122. [PMID: 38269305 PMCID: PMC10805638 DOI: 10.1016/j.ijregi.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/18/2023] [Accepted: 11/22/2023] [Indexed: 01/26/2024]
Abstract
Background The 2022 mpox outbreak has affected disproportionately people living with HIV (PLWH) and pre-exposure prophylaxis (PrEP) users. Methods We conducted a cross-sectional study to evaluate factors associated with laboratory diagnosis of mpox among suspected cases, and access differences between PrEP users and PLWH with confirmed diagnostic. Results 394 mpox suspected cases were analyzed, 309 (78.4%) confirmed. Most patients with mpox were PLWH (54.4%) and 99 (32%) PrEP users. Mpox cases were likely to be between 25 and 39 years old (aOR=2.8; p=0.042), men who have sex with men/bisexual or transgender women (aOR=17.2; p< 0.001) and to have fever (aOR=4.7; p< 0.001), adenomegaly (aOR=7.2; p< 0.001) and multiple vesicular lesions (aOR=4.2; p< 0.001). Comparing PrEP users to PLWH with confirmed mpox, PrEP users had lesions predominantly with exclusive genital involvement (p=0.016); while PLWH had higher extragenital involvement (p=0.018). Conclusions PrEP users and PLWHA were the main epidemiological groups in our cohort. Recognizing the differences between vulnerable populations can contribute to the development public policies to control mpox in settings with reduced access to vaccines.
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Affiliation(s)
| | | | - Mylva Fonsi
- Centro de Referência e Treinamento DTS/Aids, São Paulo (SP), Brazil
| | | | | | | | | | | | | | - Angela Tayra
- Centro de Referência e Treinamento DTS/Aids, São Paulo (SP), Brazil
| | | | | | - Ana Marli Christovam Sartori
- Departamento de Moléstias Infecciosas do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil
| | - Walkiria Delnero Almeida Prado
- Centro de Informações Estratégicas em Vigilância em Saúde do Centro de Vigilância Epidemiológica de São Paulo, São Paulo (SP), Brazil
| | | | | | - Mpox-CRT working group#
- Centro de Referência e Treinamento DTS/Aids, São Paulo (SP), Brazil
- Departamento de Moléstias Infecciosas do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo (SP), Brazil
- Centro de Informações Estratégicas em Vigilância em Saúde do Centro de Vigilância Epidemiológica de São Paulo, São Paulo (SP), Brazil
- Instituto Adolfo Lutz, São Paulo (SP), Brazil
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Machado HDM, Martins JM, Schörner MA, Gaspar PC, Bigolin A, Ramos MC, Ferreira WA, Pereira GFM, Miranda AE, Unemo M, Bazzo ML, de Carvalho SVF, Costa MRR, Dias LG, Porto ER, da Fonseca Andrade L, de Castro e Caldo Lima GR, Lozano VF, Bazzo ML, de Rocco F, Barazzetti FH, Kerber G, de Melo Machado H, Martins JM, Buss K, Scheffer MC, Schörner MA, Zonta R, Ramos MC, Nicola MRC, Cecconi MC, de Noronha BSS, Santos CAD, Lopes FM, de Souza Gomes J, Saif JILPJPTC, Ferreira WA, Freire M, Ramos A, Carvalho FNM, Politano A, da Silva RJC, de Araújo; Claudio Campos do Porto S, Bocalon RAL, de Oliveira Machado de Souza U, Mialski R, da Silva Nogueira K, Bay MB, do Monte Alves M, Campos JC, Junior LFA, de Oliveira Camargo L, de Souza Neves LA, Paes APL, Barufaldi F, Reis HDO, Rocha LSD, Ribeiro MIC, da Silva P, Amaral FR, de Figueiroa FJ, Barbosa AMS, Araujo AA, Varejão MG, de França Mendes FG, Cavalcanti VO, Ribeiro PGL, Ishigami B, Caheté L, Zoccoli CM. National surveillance of Neisseria gonorrhoeae antimicrobial susceptibility and epidemiological data of gonorrhoea patients across Brazil, 2018–20. JAC Antimicrob Resist 2022; 4:dlac076. [PMID: 35795244 PMCID: PMC9252985 DOI: 10.1093/jacamr/dlac076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To (i) describe the nationwide antimicrobial susceptibility of Neisseria gonorrhoeae (NG) isolates cultured across Brazil in 2018–20 and compare it with NG antimicrobial resistance data from 2015–16, and (ii) present epidemiological data of the corresponding gonorrhoea patients in 2018–20. Methods Twelve representative sentinel sites cultured NG isolates from men with urethral discharge. Susceptibility to eight antimicrobials was examined using agar dilution method, according to WHO standards. The consenting participants were invited to provide epidemiological data. Results In total, 633 NG isolates (one isolate per participant) were analysed, and 449 (70.9%) questionnaires were answered. Heterosexual (68.2%) and homosexual (23.1%) sexual orientations were common, and most prevalent types of unprotected sexual intercourse were vaginal insertive (69.9%), oral giving (56.6%) and anal insertive (47.4%). The levels of in vitro NG resistance to ciprofloxacin, tetracycline, benzylpenicillin, azithromycin, cefixime, gentamicin, spectinomycin and ceftriaxone were 67.3%, 40.0%, 25.7%, 10.6%, 0.3%, 0%, 0% and 0%, respectively. Compliance with the recommended first-line ceftriaxone 500 mg plus azithromycin 1 g therapy was high (90.9%). Conclusions Compared with 2015–16, ciprofloxacin resistance has remained high and azithromycin and cefixime resistance rates have increased in Brazil. Resistance remained lacking to ceftriaxone, gentamicin and spectinomycin, which all are gonorrhoea treatment options. The increasing azithromycin resistance in Brazil and internationally may threaten the future use of azithromycin in dual regimens for treatment of gonorrhoea. Consequently, continued and enhanced quality-assured surveillance of gonococcal AMR, and ideally also treatment failures and including WGS, is imperative in Brazil and worldwide.
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Affiliation(s)
- Hanalydia de Melo Machado
- Molecular Biology, Microbiology and Serology Laboratory (LBMMS), Federal University of Santa Catarina , Florianópolis , Brazil
| | - Jéssica Motta Martins
- Molecular Biology, Microbiology and Serology Laboratory (LBMMS), Federal University of Santa Catarina , Florianópolis , Brazil
| | - Marcos André Schörner
- Molecular Biology, Microbiology and Serology Laboratory (LBMMS), Federal University of Santa Catarina , Florianópolis , Brazil
| | - Pamela Cristina Gaspar
- Department of Chronic Diseases and STI, Brazilian Ministry of Health , Brasília , Brazil
- Public Health Postgraduate Program, Brasilia University , Brasilia , Brazil
| | - Alisson Bigolin
- Department of Chronic Diseases and STI, Brazilian Ministry of Health , Brasília , Brazil
| | | | | | | | | | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Microbiology, Faculty of Medicine and Health, Örebro University , Örebro , Sweden
- Institute for Global Health, University College London (UCL) , London , UK
| | - Maria Luiza Bazzo
- Molecular Biology, Microbiology and Serology Laboratory (LBMMS), Federal University of Santa Catarina , Florianópolis , Brazil
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Luppi CG, Tayra A, Domingues CSB, Gomes SEC, Pinto VM, Silva MAD, Silva RJCD, Tancredi MV. Syphilis in the state of São Paulo, Brazil, 2011‒2017. Rev Bras Epidemiol 2020; 23:e200103. [PMID: 33053094 DOI: 10.1590/1980-549720200103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 04/17/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze how syphilis detection rates evolved from 2011 to 2017 according to sex, age and place of residence in the state of São Paulo. METHODS A historical series was organized with data from the Notification Disease Information System. The acquired syphilis detection rates (ASDR) per 100,000 inhabitants and the acquired syphilis detection rates including pregnant women with syphilis (PASDR) per 100,000 inhabitants were described. For a trend analysis of the rates in the studied period, the Poisson Jointpoint (inflection point) model was performed, and the annual percentage change (APC) per segment and the average annual percentage change (AAPC) were estimated, with respective 95% confidence intervals (95%CI). RESULTS A total of 205,424 cases of acquired syphilis and syphilis in pregnant women in the period were reported. The ASDR per 100,000 inhabitants ranged from 26.0 to 84.6 between 2011 and 2017 and the PASDR per 100,000 inhabitants ranged from 33.7 to 108.9; the trend was increasing in both, and an inflection point was identified dividing the ASDR and PASDR curve into two periods: 2011 to 2013 and 2013 to 2017: the AAPC found for ASDR was 21.0% (95%CI 15.5 ‒ 26.4) and the PASDR was 21.2% (95%CI 16.4 ‒ 26.1), in the age groups up to 24 years old, there was a significant growth in both sexes. A heterogeneity in the evolution of rates by region of the state was observed between 2011 and 2017. CONCLUSIONS The increasing trend in acquired syphilis detection rates can be attributed to better adherence to notification and disproportionate involvement of young people.
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Affiliation(s)
- Carla Gianna Luppi
- Centro de Referência e Treinamento de Doenças Sexualmente Transmissíveis e Aids, Programa Estadual de IST/Aids, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo - São Paulo (SP), Brasil
| | - Angela Tayra
- Centro de Referência e Treinamento de Doenças Sexualmente Transmissíveis e Aids, Programa Estadual de IST/Aids, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo - São Paulo (SP), Brasil
| | - Carmen Silvia Bruniera Domingues
- Centro de Referência e Treinamento de Doenças Sexualmente Transmissíveis e Aids, Programa Estadual de IST/Aids, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo - São Paulo (SP), Brasil
| | - Solange Eduardo Chabu Gomes
- Centro de Referência e Treinamento de Doenças Sexualmente Transmissíveis e Aids, Programa Estadual de IST/Aids, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo - São Paulo (SP), Brasil
| | - Valdir Monteiro Pinto
- Centro de Referência e Treinamento de Doenças Sexualmente Transmissíveis e Aids, Programa Estadual de IST/Aids, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo - São Paulo (SP), Brasil
| | - Maria Aparecida da Silva
- Centro de Referência e Treinamento de Doenças Sexualmente Transmissíveis e Aids, Programa Estadual de IST/Aids, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo - São Paulo (SP), Brasil
| | - Roberto José Carvalho da Silva
- Centro de Referência e Treinamento de Doenças Sexualmente Transmissíveis e Aids, Programa Estadual de IST/Aids, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo - São Paulo (SP), Brasil
| | - Mariza Vono Tancredi
- Centro de Referência e Treinamento de Doenças Sexualmente Transmissíveis e Aids, Programa Estadual de IST/Aids, Coordenadoria de Controle de Doenças, Secretaria de Estado da Saúde de São Paulo - São Paulo (SP), Brasil
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Martins RA, Cassu-Corsi D, Nodari CS, Cayô R, Natsumeda L, Streling AP, Doi AM, da Silva RJC, Bocalon RAL, Gales AC, Pignatari ACC. Temporal evolution of antimicrobial resistance among Neisseria gonorrhoeae clinical isolates in the most populated South American Metropolitan Region. Mem Inst Oswaldo Cruz 2019; 114:e190079. [PMID: 31411309 PMCID: PMC6690644 DOI: 10.1590/0074-02760190079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/17/2019] [Indexed: 11/21/2022] Open
Abstract
A total of 124 Neisseria gonorrhoeae isolates recovered during a
12-year period (2003-2015) from outpatients assisted at Centro de Referência e
Treinamento DST/AIDS-CRT of São Paulo city, Brazil, were analysed. The following
resistance rates were observed: penicillin-59.6%, ciprofloxacin-15.3%, and
azithromycin-6.7%. Although reduced susceptibility to these drugs was observed
since 2003, no ceftriaxone-resistant isolates were detected. Ciprofloxacin- and
azithromycin non-susceptible isolates were grouped in 11 clusters. Mutations
were detected in GyrA and ParC of isolates 124 and 260, and a C2611T
substitution on 23S rRNA alleles was also observed in isolate 260. Both isolates
belonged to ST1901/ST6210 (MSLT/NG-MAST schemes).
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Affiliation(s)
- Rafael Affini Martins
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - Dandara Cassu-Corsi
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - Carolina Silva Nodari
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - Rodrigo Cayô
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil.,Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Departamento de Ciências Biológicas, Laboratório de Bacteriologia e Imunologia, Diadema, SP, Brasil
| | - Larissa Natsumeda
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - Ana Paula Streling
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil
| | - André Mario Doi
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório Especial de Microbiologia Clínica, São Paulo, SP, Brasil
| | | | | | - Ana Cristina Gales
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil.,Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório Especial de Microbiologia Clínica, São Paulo, SP, Brasil
| | - Antonio Carlos Campos Pignatari
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório ALERTA, São Paulo, SP, Brasil.,Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Medicina, Laboratório Especial de Microbiologia Clínica, São Paulo, SP, Brasil
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Luppi CG, Gomes SEC, Silva RJCD, Ueno AM, Santos AMKD, Tayra Â, Takahashi RF. Factors associated with HIV co-infection in cases of acquired syphilis reported in a Reference Center for Sexually Transmitted Diseases and AIDS in the municipality of São Paulo, Brazil, 2014. Epidemiol Serv Saude 2018; 27:e20171678. [PMID: 29451611 DOI: 10.5123/s1679-49742018000100008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 09/27/2017] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to describe sociodemographic and behavioral characteristics and to identify factors associated with human immunodeficiency virus (HIV) co-infection in cases of acquired syphilis reported in a Reference Center for Sexually Transmitted Diseases (STD) and AIDS. METHODS cross-sectional study with secondary data from a Reference Center for STD and AIDS in the municipality of São Paulo, Brazil, in 2014; the Poisson regression was used to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS 648 cases of acquired syphilis were reported, and 98% were male; 88% were men who have sex with men (MSM) and 57% had HIV co-infection; male sex (PR=1.95; 95%CI 1.05;3.61) and MSM (PR=1.87; 95%CI 1.38;2.53) were factors independently associated with HIV co-infection. CONCLUSION there was a high prevalence of HIV co-infection in the service analyzed, disproportionately affecting MSM who were notified with acquired syphilis.
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Affiliation(s)
- Carla Gianna Luppi
- Centro de Referência e Treinamento em DST/Aids, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brazil
| | - Solange Eduardo Chabu Gomes
- Centro de Referência e Treinamento em DST/Aids, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Ângela Tayra
- Centro de Referência e Treinamento em DST/Aids, Secretaria de Estado da Saúde de São Paulo, São Paulo, SP, Brazil
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Abstract
INTRODUCTION Rectal douching (RD) is practised among men who have sex with men (MSM), and various products and materials are used. There have been no studies in Brazil on this practice and its risks in the transmission of sexually transmitted infections and HIV. METHOD Between June and August 2015, 401 MSM over the age of 18 were interviewed about their sexual practices associated with RD over the last 3 months. RD was associated with the reported sexual behaviour, and descriptive statistical analyses were conducted on the same. RESULTS Among the respondents, 85.6% identified themselves as men and 14.4% as transgender; 255 declared themselves to be white (63.6%) and 104 to be mixed (25.9%). From among those who had performed anal sex within the last 3 months (n=369), 197 reported having used RD (53.4%). The most commonly used material was a shower hose (84.5%) and the main product used was water (93%). Of those interviewed, 94.5% never received guidelines from health professionals on this practice and its potential risks. Receptive anal intercourse and RD were found to be associated (p<0.001). CONCLUSIONS RD is a common practice among the MSM population. Health professionals must deepen their knowledge of this. We propose studies in Brazil on the practice of RD that-from that knowledge strategies for prevention and harm reduction-can be incorporated to the vulnerable populations.
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