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Keisham C, Guite Z, Kulabidhu H. Sexual behavior pattern in the young attending sexually transmitted infection clinic in a tertiary health-care center. Indian J Sex Transm Dis AIDS 2020; 41:97-99. [PMID: 33062991 PMCID: PMC7529170 DOI: 10.4103/ijstd.ijstd_117_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 07/01/2018] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Half of all new HIV infections occur in young people(15-24years). Unfortunately, the study on the sexual behaviour pattern in these age group is lacking. MATERIALS AND METHODS It is retrospective, cross sectional study assessing adolescent and youth between 10 to 24 years presenting to STD clinic in a tertiary health care centre as a part of their risk assessment. RESULTS Adolescent and youth were a total of 17.13%(165) amongst 963 STD clinic attendees. The male to female ratio was 84:81. The mean age for male±1SD was 21.17±2.26 years and for female±1SD was 20.54±2.37 years. Around 47.27% (78) were students at various levels of education. Earliest onset of sexual activity was at 14 years. Risky sexual behaviour was reported in 75.75% clients. Onset of sexual activity was earlier in females with 24.6% having sex before the age of 18 years as compared to 15.4% in males. Condom use was poor. Around 63% had heard of HIV or AIDS. CONCLUSION The young being a vulnerable age group, education on safe sex, condom use and other protective measures should be strengthened.
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Affiliation(s)
- Chitralekha Keisham
- Department of Dermatology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India,Address for correspondence: Dr. Chitralekha Keisham, Keishamthong Thangjam Leirak, Imphal - 795 001, Manipur, India. E-mail:
| | - Zamzachin Guite
- Department of Dermatology, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
| | - Heisnam Kulabidhu
- Department of Community Medicine, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India
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Chawada BL, Kosambiya JK, Chaudhari VP, Wells KJ. Development of the Sexually Transmitted Infection Service Evaluation Tool: Use of Delphi Approach. Indian J Community Med 2018; 43:260-265. [PMID: 30662176 PMCID: PMC6319279 DOI: 10.4103/ijcm.ijcm_20_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND With the wide variation in sexually transmitted infection (STI) services, it is a challenge to devise strategies for ensuring effective service delivery. The objectives of this study were to develop a standard tool for STI services evaluation and use the Delphi method to derive a weighted factor for each parameter of the tool. METHODS A review of existing guidelines for quality care STI services were conducted, and parameters were selected to form the content of the measurement tool. Delphi technique was used to derive weighted factor for each STI service delivery parameter by using the Likert scale of 0-7. A heterogeneous group of 18 anonymous experts was invited to rate the parameters. All the responses were collected online. Cronbach's alpha level ≥0.8 was selected to define consensus the experts. RESULTS The STI service evaluation tool (SSET) was created including ten parameters to evaluate the performance of clinic with the help of standard National guidelines. The SSET was standardized by deriving weighted factor for each evaluation parameter. Three rounds of Delphi were required to achieve consistency. Response rates for each Delphi round were 77.78%, 100%, and 78.57%, respectively. Each parameter, such as workforce, materials, consumables, consultation, counseling, coverage, referral, records, information education and communication, and supervision, was assigned weighted factor derived by converting the final score into the total standard score of 100. CONCLUSION The Delphi method represents a novel approach to develop standardized tools to evaluate the performance of service delivery.
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Affiliation(s)
- Bansari L. Chawada
- Department of Community Medicine, Medical College, Baroda, Vadodara, Gujarat, India
| | - Jayendrakumar K. Kosambiya
- Department of Community Medicine, Government Medical College, Surat, Gujarat, India,Address for correspondence: Dr. Jayendrakumar K. Kosambiya, Department of Community Medicine, Government Medical College, Majura Gate, Surat - 395 001, Gujarat, India. E-mail:
| | - Vipul P. Chaudhari
- Department of Community Medicine, Government Medical College, Surat, Gujarat, India
| | - Kristen J. Wells
- Department of Psychology, San Diego State University, San Diego, California, USA
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Pandhi D, Bisherwal K, Singal A, Guleria K, Mishra K. p16 immunostaining as a predictor of anal and cervical dysplasia in women attending a sexually transmitted infection clinic. Indian J Sex Transm Dis AIDS 2016; 37:151-156. [PMID: 27890949 DOI: 10.4103/0253-7184.192125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Carcinogenesis caused by human papillomavirus (HPV) leads to over-expression of p16 protein. p16 may act as a marker of HPV integration with host genome and serve as a surrogate marker of HPV oncogenesis. MATERIALS AND METHODS A single center study of 75 women (35 HIV-positive and 40 HIV-negative women) was conducted. Anal and cervical specimens were obtained for cytology and p16 immunostaining. RESULTS The sensitivity of p16 to diagnose anal and cervical dysplasia was 50% and 58.8%, respectively, whereas specificity was 98.6% and 100%, respectively. Positive predictive value for anal and cervical was 75% and 100%, whereas negative predictive value was 95.8% and 89.2%, respectively. A strong relationship between the grade of dysplasia and intensity of p16 immunoscore was observed (Pearson correlation r = 0.666, P < 0.0001 and r = 0.496, P < 0.0001 for anal and cervical, respectively). CONCLUSION p16 immunostaining with greater specificity for high-grade lesions may improve the diagnostic accuracy, especially for high-grade lesions which have a high risk of progression to malignancy and thereby necessitate treatment.
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Affiliation(s)
- Deepika Pandhi
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Kavita Bisherwal
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Kiran Guleria
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Kiran Mishra
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
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Tuddenham SA, Page KR, Chaulk P, Lobe EB, Ghanem KG. Patients fifty years and older attending two sexually transmitted disease clinics in Baltimore, Maryland. Int J STD AIDS 2016; 28:330-344. [PMID: 27101993 DOI: 10.1177/0956462416646687] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many individuals remain sexually active into their eighth decade. Surveillance data suggest that rates of sexually transmitted infections in older patients are increasing. We compared demographics, risk behaviors, and predictors of acute infections in patients 50 years and older versus younger patients attending sexually transmitted disease clinics in Baltimore, Maryland. This was a retrospective study from a large electronic database of visits to two urban sexually transmitted disease clinics between 2005 and 2010. Proportions were compared using the Chi square test. Logistic regression was used to assess predictors of acute sexually transmitted infections in older versus younger groups. It was found that patients over 50 were more likely than younger patients to report never using condoms (32.6% [CI 0.31-0.34] versus 24.1% [CI 0.23-0.25]). The overall prevalence of acute sexually transmitted infections was 18.1% (CI 0.17-0.19) in older and 25.8% (CI 0.25-0.27) in younger patients. Older women were more likely to be diagnosed with trichomoniasis (21.5% [CI 18.6-24.5] versus 13.1% [CI 11.5-14.8]). Black race was predictive of having an acute sexually transmitted infections in younger men (OR 2.2 [CI 1.47-3.35]) and women (OR 2.7 [CI 1.34-5.30]) but not in older men (OR 1.2 [CI 0.79-1.73]) or women (OR 1.2 [CI 0.43-3.15]). Older age was associated with a decreased risk of acute STI diagnosis in younger men and older women only, while having had sex for money or drugs in the past month was predictive only in younger women. Reporting symptoms and increasing numbers of sexual partners in the last six months was predictive of acute sexually transmitted infection diagnosis in all age groups. Older patients seeking care at sexually transmitted disease clinics engage in important risk behaviors. Race, a factor predictive of acute sexually transmitted infections in younger patients is not a significant predictor of sexually transmitted infections in older persons.
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Affiliation(s)
| | - Kathleen R Page
- 1 Johns Hopkins University School of Medicine, Baltimore, MD, USA.,2 Baltimore City Health Department, Baltimore, MD, USA
| | - Patrick Chaulk
- 1 Johns Hopkins University School of Medicine, Baltimore, MD, USA.,2 Baltimore City Health Department, Baltimore, MD, USA.,3 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Erika B Lobe
- 3 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Khalil G Ghanem
- 1 Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Pandhi D, Bisherwal K, Singal A, Guleria K, Mishra K. p16 immunostaining as a predictor of anal and cervical dysplasia in women attending a sexually transmitted infection clinic. Indian J Sex Transm Dis AIDS 2016. [PMID: 27890949 PMCID: PMC5111300 DOI: 10.4103/2589-0557.192125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Carcinogenesis caused by human papillomavirus (HPV) leads to over-expression of p16 protein. p16 may act as a marker of HPV integration with host genome and serve as a surrogate marker of HPV oncogenesis. MATERIALS AND METHODS A single center study of 75 women (35 HIV-positive and 40 HIV-negative women) was conducted. Anal and cervical specimens were obtained for cytology and p16 immunostaining. RESULTS The sensitivity of p16 to diagnose anal and cervical dysplasia was 50% and 58.8%, respectively, whereas specificity was 98.6% and 100%, respectively. Positive predictive value for anal and cervical was 75% and 100%, whereas negative predictive value was 95.8% and 89.2%, respectively. A strong relationship between the grade of dysplasia and intensity of p16 immunoscore was observed (Pearson correlation r = 0.666, P < 0.0001 and r = 0.496, P < 0.0001 for anal and cervical, respectively). CONCLUSION p16 immunostaining with greater specificity for high-grade lesions may improve the diagnostic accuracy, especially for high-grade lesions which have a high risk of progression to malignancy and thereby necessitate treatment.
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Affiliation(s)
- Deepika Pandhi
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India,Address for correspondence: Dr. Deepika Pandhi, Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi - 110 095, India. E-mail:
| | - Kavita Bisherwal
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Kiran Guleria
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
| | - Kiran Mishra
- Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
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Suvirya S, Singh R, Senthamizh P, Sharma V. Treatment seeking behaviour of STI clients in a tertiary care centre of North India: A cross sectional study. Indian J Sex Transm Dis AIDS 2016. [PMID: 27190405 PMCID: PMC4857687 DOI: 10.4103/2589-0557.180284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE (1) To determine the treatment seeking behaviour of STI clients. (2) To ascertain the relationship of socio-demographic factors and sexual behaviours with the treatment seeking component in STI clients. METHODS This cross-sectional study was conducted in Department of Dermatology, Faculty of Medical Sciences, King George's Medical University, Lucknow, Uttar Pradesh. After obtaining approval from the Institutional Ethical Committee, the data collected daily from master register, STI/RTI patient wise register and counsellor's patient diary during the study period August 2013 to July 2015 was processed by Microsoft Excel program. The counsellor also recorded the source of information regarding STI Clinic. The information collected regarding bio-social characteristics, high risk sexual behaviours and source of knowledge about Suraksha clinic was analysed. RESULTS Our results showed that literacy, male sex, urban residence and employment were some of the parameters which significantly improved the health seeking behaviour of STI clients. These variables were associated with higher odds for seeking treatment when adjusted for other variables. Similarly group with bisexual and homosexual behaviour had significantly lower odds for seeking treatment when adjusted for other variables. CONCLUSION/KEY MESSAGE The optimal use of information, education and communication (IEC) techniques needs to be strengthened to further improve the utilization of STI clinic services at tertiary care teaching hospitals.
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Affiliation(s)
- Swastika Suvirya
- Department of Dermatology, KG Medical University, Lucknow, India,Address for correspondence: Dr. Swastika Suvirya, Department of Dermatology, KG Medical University, Lucknow, Uttar Pradesh, India. E-mail:
| | - Rohit Singh
- Department of Dermatology, KG Medical University, Lucknow, India
| | - Prasad Senthamizh
- Department of Community Medicine, KG Medical University, Lucknow, India
| | - Vishal Sharma
- Department of Dermatology, Udhampur Command Hospital (NC), Jammu and Kashmir, India
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van Aar F, van Weert Y, Spijker R, Götz H, Op de Coul E. Partner notification among men who have sex with men and heterosexuals with STI/HIV: different outcomes and challenges. Int J STD AIDS 2014; 26:565-73. [PMID: 25141854 DOI: 10.1177/0956462414547398] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 07/17/2014] [Indexed: 11/17/2022]
Abstract
Partner notification effectiveness among index clients diagnosed with HIV, syphilis and/or gonorrhoea at sexually transmitted infection (STI) clinics was evaluated between 2010 and 2012. We explored percentages of identifiable, notified and tested partners by sexual preference and gender. Partner notification trends were studied using the national STI database. Men who have sex with men (n = 304), heterosexual men (n = 33) and women (n = 35) reported, respectively, 6.7, 3.8 and 2.3 partners per index. Percentages of identifiable partners differed between groups (men who have sex with men: 46%, heterosexual men: 63%, women: 87%, p < 0.001). The percentage of notified partners (of those identifiable) was lowest for heterosexual men (76%; men who have sex with men: 92%; women: 83%; p < 0.001). STI positivity rates among notified partners were high: 33%-50% depending on sexual preference. Among men who have sex with men, having HIV was associated with not notifying all identifiable partners. Percentages of notified clients at STI clinics increased between 2010 and 2012: from 13% to 19% among men who have sex with men, from 13% to 18% among heterosexual men and from 8% to 11% among women (p < 0.001 for all groups). The percentage of STI/HIV detected through partner notification increased among men who have sex with men (from 22% to 30%) and women (from 25% to 29%; p < 0.001). Unidentifiable partners among men who have sex with men, lower partner notification effectiveness for HIV and the relative large proportion of heterosexual men not notifying their partners appear to be important partner notification challenges.
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Affiliation(s)
- Fleur van Aar
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Yolanda van Weert
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | | | - Hannelore Götz
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands Department Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands
| | - Eline Op de Coul
- Epidemiology and Surveillance, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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