不同场所暗娼的高危行为和HIV/STI感染状况调查

目的了解不同场所中暗娼与艾滋病(AIDS)传播有关的行为,以及艾滋病病毒/性传播感染(HIV/STI)的感染状况,为开展有针对性的行为干预提供依据。方法对贵阳市云岩区宾馆、酒店、卡拉OK歌厅等娱乐场所的暗娼进行两阶段概率抽样,发廊和街头的暗娼在知情同意后全部纳入调查。收集人口学和高危行为信息,并采集静脉血检测HIV、梅毒、乙型肝炎病毒(HBV)、丙型肝炎病毒(HCV)。结果432名暗娼中,来自宾馆、酒店及娱乐场所占50.9%,发廊占25.5%,街头占23.6%。与前两组相比,街头暗娼平均年龄较大(30.6岁),文化程度较低(小学和文盲占54.9%),首次性交年龄(18.7岁)和首次从事性交易年龄(27.9岁)较大,从事性交易时间较长(4年及以上者占21.6%)。调查对象最近一次与客人发生性关系时使用安全套的比例为81.3%,最近1个月与客人发生性关系时,每次都使用安全套的比例为44.9%,从未使用的占8.1%。17.6%的街头暗娼有吸毒行为。HIV感染率为0.2%,HBV感染率为4.6%,HCV感染率为4.9%,梅毒感染率为13.0%。结论街头暗娼高危行为的危险性最高,STI的感染率也高于其他场所的暗娼,应作为监测和干预的重点亚人群。

2010-2016年十堰市羁押场所在押人员HIV/STI感染及相关知信行调查

目的:掌握在押在教人员艾滋病性病感染及艾滋病知识知晓状况,为确定今后干预策略提供依据。方法:对十堰市近7年在押在教人员艾滋病性病监测和问卷调查资料进行统计分析。结果:共调查的18 364人,HIV感染率为0.09%(17/18 364),性病患病率为3.13%(574/18 364);其中吸毒人群HIV感染率8.62%(15/174),性乱人群HIV感染率0.03%(2/7 294),其它高危人群和无高危行为人员均未检出HIV-抗体阳性者。在吸毒人群中,共用注射器占注射吸毒的97.89%(139/142),性乱人群中,使用过安全套的比例占98.00%(7 148/7 294),而经常使用的占70.59%(5 149/7 294);艾滋病知识回答正确率在7.11%-93.84%之间,对艾滋病病毒感染者和病人态度正向回答率分别为30.33%、40.76%。结论:"知行分离"现象较严重。应将注射吸毒和性乱人群作为十堰市艾滋病防治的重点人群,加大其预防艾滋病基本知识和技能的宣传教育力度,开发科学、适宜的与目标人群行为改变密切的核心知识,采用生动与互动的宣传方式,强化健康是人的第一财富观念,消除目标人群认识上的误区,促进其高危行为改变,同时积极营造全社会关心爱护艾滋病感染者/病人的良好氛围,从根本上消除社会歧视。

男性性工作者的STI/HIV高危行为研究

目的 监测男性性工作者 (MSW )的性传播感染 (STI) /艾滋病病毒 (HIV)感染的高危行为。方法 以定向抽样获取的男男性接触者 (MSM)中从事 (过 )性工作的男性为样本 ,将之与年龄相匹配的一般的MSM进行比较。结果 相对年轻、未婚、低教育水平、原来在农村地区从事体力劳动、低收入或无收入阶层的男性 ,更倾向于从事性工作。MSW组的首次性交年龄早于对照组 ,其累计男性伴侣数、累计肛交男性伴侣数、累计口交男性伴侣数、近 1年内男性伴侣数、近 1年内陌生男性伴侣数和近 1年内口交男性伴侣数均大于对照组 ;近 1年内曾接受同性性服务和近 1年内曾群交的比例均高于对照组。结论 MSW较一般的MSM有更多的高危性行为 ,应加大对这一亚人群的STI/HIV干预力度。

浙江省台州地区男男性行为人群HIV/STIs感染状况调查

目的:了解浙江省台州市男男性行为者(MSM)艾滋病病毒(HIV)、性传播疾病感染(STIs)状况。方法:以现场为基础的方便抽样法展开横断面调查。对愿意接受HIV/STIs检测的MSM采集5 ml静脉血,并以ELISA法进行HIV抗体筛查,对HIV抗体筛查阳性者以Western Blot法进行确证试验;以TPPA法进行梅毒特异性抗体检测。结果:共有251名MSM参加了本项研究,其中完成调查问卷并参加血液检验者169人,仅回答问卷不参加检测者37人,仅参加检测而不愿意回答问卷者45人。共收集有效问卷206份,血样214份。其中HIV抗体确证阳性率7.0%(15/214),梅毒(TPPA法)阳性率23.1%(49/212)。结论:台州地区MSM人群HIV/STIs感染水平较高,危险行为较普遍,需要尽快开展综合性的干预。

男男性接触者多重STIs/HIV感染1例

患者男,18岁,同性恋史8个月。面部、躯干、四肢、掌跖部泛发斑丘疹,肛周见数个斑块状增生物,阴茎系带旁有两个糜烂面,肛门灼痛、有脓性分泌物。TRUST1∶16(+),TPPA(+),肛周皮损组织液暗视野显微镜查螺旋体(+),直肠分泌物涂片见细胞内革兰阴性双球菌,淋球菌培养(+),CT-PCR(+),UU-PCR(-),HSV-2-PCR(+)。结合临床、组织病理及血清学等实验室检查诊断为二期梅毒、生殖器疱疹、淋菌性直肠炎等多种性传播性疾病(STDs)和HIV感染。该患者免疫功能正常,治疗方法的选择及其疗效与一般STDs患者无异。

开远市CSW人群HIV/AIDS/STI监测结果分析

[目的]了解开远市暗娼人群HIV/AIDS/STI流行状况及相关知识知晓现状,为进一部宣传教育和行为干预活动方案的制定,提供科学依据。[方法]使用标准问卷进行一对一调查,实验室HIV和梅毒检测用项目统一方法,调查结果全部输入计算机用SPSS统计软件包进行分析。[结果]共调查366人,合格问卷363份,问卷合格率为99.18%,其中梅毒阳性率为11.82%,HIV阳性率为16.16%。[结论]暗娼人群、HIV/STIS流行形势较为严竣。目标人群相关知识、知晓率有待进一步提高。

Gender Sensitive STIs/HIV/AIDS Prevention Policies: A Qualitative Study

Background: The global incidence of STIs is rising. It is estimated that 499 million new cases of curable STIs occur every year. The existence of more than one million reported cases of STIs annually in Iran shows that addressing this issue must be a priority for Iranian health authorities. While recognition of the importance of gender issues to reproductive health (RH) programs has grown significantly in the past several years, major challenges remain in implementing gender-sensitive programs. Gender mainstreaming in Iranian reproductive health program is a relatively new issue, so this study aims to explore gender sensitive STIs/HIV/AIDS prevention policies. Method: This study employed a qualitative research design. Participants were health managers, health policy makers and reproductive health providers. They were selected purposefully and then continued by snowball sampling method. 43 semi-structured in-depth interviews with 37 key informants were done. All the interviews were recorded and transcribed. The data were analyzed by content analysis method. Trustworthiness of the data was achieved by using credibility, trans-ferability and conformability. Results: Key informants clearly explained the gender sensitive STIs/ HIV/AIDS prevention policies in three main categories: 1) advocacy, 2) collaboration between different sectors and 3) community empowerment to gender sensitive STIs/HIV/AIDS prevention programs. Conclusion: Changing gender neural STIs/HIV/AIDS prevention policy to more complete gender sensitive policy needs advocacy, collaboration of sectors and community empowerment.

Cognitive and Behavioral Effects of Participatory Sex Education on the Dual Prevention of STI/HIV/AIDS and Unwanted Pregnancies among Adolescents in Kinshasa High Schools, DR Congo

Context: With the view to reorient both STI/HIV/AIDS prevention and adolescents pregnancies, this research study aims at evaluating cognitive and behavioral acquisitions, as well as the process of interactive sex education participatory approach among adolescents in Kinshasa high schools. Methods: Based on a “pre and post” virtually experimental design, two crosswise surveys were conducted in Kinshasa, for six months in 2011-2012 on 484 high school students (pre-survey) and on 441 high school students (post-survey), whose age range from 14 - 19 years including both sexes. Two participatory educational talks (PET) “A” and “B”, covered weekly in two different schools, were compared to a control group school. The PET “A” consisted of interactive interpersonal communication sessions given by an external expert as a substitute for the life education course in one school. The PET “B” carried out in another school, included more educational talk sessions, led by the external expert and supplemented by a close follow-up of teenagers divided into small groups of 10 participants. The subjects’ assessment was based on their knowledge, attitudes and practices relating to STI/HIV/AIDS dual prevention as well as to unwanted pregnancies. Results: The subjects involved in the PET “B” displayed a better/higher performance based on their knowledge, attitudes and practices related to STI/HIV/AIDS dual prevention and unwanted pregnancies. Broadly speaking, knowledge has been improved 6 times with the PET “B” (OR = 6, 10, IC 95%) (3.24 - 11.9), and 3 times with the PET “A” (OR = 3, 45, IC 95%) (1.79 - 6.81), compared to control school. Similarly, findings on subjects’ attitudes show an improvement rated 12 times with the PET”B” (OR = 11, 99, IC 95%) (5.67 - 27.38) and 5 times for the PET “A” (OR = 5.51, IC 95%) (2.54 - 12.87). As far as the subjects’ practices are concerned, an improvement of 6 more times of protected sexual intercourses with the PET “B” compared with the control school group (OR = 6, 52, IC 95%) (3.60 - 12.0). The process assessment records a spontaneous involvement of schools enhanced by the positive contribution of Life Education and Biology teachers;add a massive participation of adolescents who requested permanent PET program. Conclusion: The results of this study suggest that school sexual education programs can be improved to increase the quality of apprenticeship. The use of interactive methods and the consideration of the adolescents’ specific needs that take into account the gender approach may bring about beneficial advantages on both educational outcomes and reproductive health of adolescents.

Mandatory Testing for HIV and Sexually Transmissible Infections among Sex Workers in Australia: A Barrier to HIV and STI Prevention

Australia is an apt landscape upon which to measure the success of mandatory testing of HIV and sexually transmissible infections (STIs) among sex workers. Mandatory testing is implemented in some Australian jurisdictions and not others, allowing for a comprehensive comparison of the outcomes. It is apparent that mandatory testing of HIV and STIs among sex workers in Australia has proven to be a barrier to otherwise successful HIV and STI peer education, prevention and free and anonymous testing and treatment. The outcomes of mandatory testing are counterproductive to reducing HIV and STI rates, do not reach the intended target group, are costly and inefficient, and mandatory testing has proven to be a very difficult policy to repeal once in place. Scarlet Alliance, the Australian Sex Workers Association, as well as numerous academics and policy leaders in Australia recommend against mandatory testing of HIV and STIs among sex workers.

男性性病患者HIV感染风险意识及相关知识调查

目的了解性病门诊男性性病患者艾滋病的感染情况,分析该人群感染艾滋病的风险意识和艾滋病相关知识的掌握情况及其影响因素,为制定防治策略和措施提供参考依据。方法采用横断面研究设计,用统一设计的标准化问卷对云南省某省级医院皮肤性病科就诊的258名男性患者进行调查,并进行相关指标检测。结果男性高危人群人类免疫缺陷病毒(HIV)阳性的检测率为2.0%(2/100)。男性性病患者感染HIV的风险与非固定性伴的情况和艾滋病自愿咨询检测的意愿等因素的联系差异有统计学意义。艾滋病相关的知识总得分>12分(共21分)以上者有169人,比例为65.5%;文化程度、年龄和职业等因素与艾滋病相关的知识得分差异有统计学意义。结论性病门诊男性性病患者艾滋病的感染率较高,不安全性行为比较普遍,自愿咨询检测的比例低,应加强该人群艾滋病预防的教育干预工作。

贵阳市男男同性恋人群HIV感染状况及有关艾滋病的KABP调查研究

目的掌握贵阳市男男同性恋(MSM)人群艾滋病病毒(HIV)等感染状况,以及有关艾滋病知识、态度、信念及行为(KABP)的情况,为采取相应的健康教育及行为干预提供科学的依据。方法通过自愿咨询与检测、利用MSM志愿者“滚雪球”等方式,调查检测贵阳市MSM人群HIV等感染率,并在抽取血样时进行KABP问卷调查,了解该人群有关预防艾滋病性病中存在问题。结果共对276名MSM进行检测,首次发现HIV感染者6例,HIV感染率为2．17％,HBV、HCV及梅毒感染率分别为12．32％、4．34％及0．72％。共对170名MSM人群进行KABP调查,其中年龄以20- 24岁组为最多,占39．41％,其次为15-19岁组,占21．18％。文化程度以高中／中专为多占40．59％, 其次为大学占25．88％;职业以学生为最多占32．94％;性取向男男同性恋占63．53％,双性恋占 25．29％,未确定占4．71％,拒答6．47％。该人群有关艾滋病性病知识回答正确率较低,只达 75．10％,在高危性行为时每次都用安全套率只为11．18％。结论贵阳市MSM人群HIV感染率较高,为2．17％,已居贵阳市高危人群HIV感染率首位,该人群年龄偏小,在学生中占一定人数,预防艾滋病性病知识缺乏,高危性行为普遍存在,安全套使用率低,极易造成艾滋病性病的传播与流行,应及时采取相应的防控措施。

沈阳市西塔地区娱乐场所服务员预防AIDS/STI行为干预研究

目的 使目标人群预防艾滋病 /性传播感染 (AIDS/STI)相关知识水平提高 30 %以上 ,增强自我保护意识 ,进而改变高危行为 ,推广使用安全套 ,降低和减少AIDS/STI的危害。方法 按教育对象的年龄、教育程度、来源 ,随机分为教育组和对照组 ,教育组的干预方法采取同伴教育形式。干预前后通过问卷形式对各组进行干预效果评估。结果 教育组预防AIDS/STI知识知晓率提高 36 5 % ,而对照组无明显提高 ,安全套使用在干预前后未见差异。结论 同伴教育可以提高高危人群预防AIDS/STI知识的知晓率 ,但行为干预工作应在不同人群、从不同层面开展 ,以保证行为干预成果的持续性。

Utilization of HIV and Sexually Transmitted Infections Prevention Services, and Associated Factors among the Long-Distance Truck Drivers along the Northern Corridor Highway, Kenya

Background: Often, long-distance truck drivers’ (LDTDs’) work predisposes them to sexually transmitted infections (STIs) whose outcomes are influenced by access and behavior of seeking sexual health care. Methodology: In this study, we assessed the utilization of HIV/STI preventive services and associated factors among 296 LDTDs operating along the northern corridor highway using an interviewer-administered questionnaire for data collection at Mlolongo stopover in Machakos, Kenya. Responses for the investigated variables, including condom use, history of HIV testing, frequency of HIV testing, antiretroviral therapy (ART) use and follow-up for the HIV positive and STI treatment, were assigned a score of either 1 or 0 depending on the question’s dimension. Following summing up for each participant, we computed a weighted score ranging between 0 and 1 by dividing the summed responses by the number of eligible variables. We arbitrarily multiplied these scores by 8 to generate endpoint scores ranging from one to eight for each participant to help create a dichotomized outcome variable for utilization levels: limited utilization (1 to 4) and good utilization (5 to 8). Association between certain independent variables and the outcome variable (level of utilization of H.I.V./STIs preventive services) was analyzed using binomial logistic regression analysis in R statistical software. Results: The mean age of the LDTDs was 38.4 years, ranging from 24 - 57 years. The majority (n = 287, 97%) of the LDTDs had been tested on HIV at least once since the beginning of their career. Only 4.9% of the LDTDs had been tested on HIV within the previous three months. Of the 175 LDTDs who reported a history of STI, most (n = 173, 98.9%) of them had sought treatment. Condom use rates were higher (97.1%) among the LDTDs who had sexual interactions with casual sexual partners compared to 47.2% among regular sexual partners. Analyses classed most of the respondents (n = 231, 78.0%) as having good utilization, while the rest (22%) had limited utilization. History of STI was independently associated with utilizing HIV/STI preventive services (OR 8.4;95% CI;4.5, 16.7;P < 0.001). Conclusion: Although most of the LDTDs were classed to have good utilization of HIV/STI preventive services, the uptake of subsequent HIV testing services among them was low at only 4.9%. The association of STI history with utilization levels that we determined supports policies of integrating HIV and STI services in the delivery of sexual healthcare provision among LDTDs.

Multiple partnerships and risk for HIV among the Garífuna minority population in Belize

Belize has the highest rates of HIV infection in Central America and is experiencing a generalized epidemic. The Garífuna, a minority ethnic population, is at risk for HIV. This study uses survey data from Garífuna men and women to examine the frequency of multiple partnerships as well as sociodemographic characteristics and behavioral constructs correlated with having multiple partners. A high proportion of respondents reported having multiple partners, but rates were significantly higher for men, and men had a higher mean number of partners than women. A high proportion of respondents reported having a sexually transmitted infection (STI) in the last year, with more men reporting a history of STIs than women. Regression results show the importance of improving men and women’s perceived susceptibility for HIV and encouraging them to know their HIV status. Reinforcing a social norm for partner reduction would also benefit men. Study findings support the need for HIV counseling and testing in Garífuna communities as well as STI prevention, diagnosis and treatment. This study demonstrates that reducing multiple partnerships among Garífuna men and women is critical for reducing the spread of HIV in Belize.

HIV and Other Sexual Transmitted Infections—Challenges for Liberal Prevention Strategies

Many countries use similar strategies in prevention campaigns, but despite that the spread of HIV is unabated. The basic messages of the current liberal prevention strategies aim to promote changes in individual behaviour so as to prevent HIV transmission. The strategies avoid any kind of regulation, prescription and controls, and trust solely on the readiness of the sexually active part of the general population, and in particular the “at-risk populations” to cooperate with those messages. However, only a small number of people have cooperated. The increase in the incidence of HIV over the past decade in the countries listed discloses the failures of the current prevention strategies. With respect to the goal of trying to influence those people prone to high-risk sexual lifestyles, and the injecting drug users, the prevention strategies have not had a meaningful effect in the long term. This is also reflected in the increase of other STIs such as hepatitis C, syphilis, and the human papilloma virus, which are worse when there is co-infection with HIV. The liberal prevention strategies turned out to be inadequate for the goal, and must be adjusted to real life situations to counteract their misuse. Meanwhile there are ample evidence-based measures which must be implemented into concerted efforts by complementing the current strategies with respect to a person-to-person bound infection. Medical care policies have to consider the non-adherence behaviour of those in need.

Syphilis and HIV Infection among Pregnant Women Previously Screened Negative during Their First Antenetal Care Visit (ANC) at Some Selected Health Facilities in the Buea Health District, Cameroon

Syphilis and HIV are amongst the world’s most widespread diseases, particularly in low-income countries. Syphilis and HIV infections during pregnancy have been associated with numerous adverse pregnancy outcomes. Of concern now are the rising rates of congenital syphilis and HIV in Cameroon. Cameroon only mandates testing pregnant women for syphilis and HIV during their first ANC visit. This study was aimed at determining the incidence of new syphilis and HIV infections and factors associated with pregnant women who previously tested negative during their first ANC visit. A cohort design was used, where 335 pregnant women were followed up for a period from December 2019 to August 2020. A blood sample was drawn and the serum was analyzed using the WANTAI ELISA and AIDTM HIV 1 + 2 Ag/Ab ELISAPlus test methods for syphilis and HIV respectively at three intervals. A questionnaire was used to identify risk factors. Data was analyzed using SPSS 23.0. Out of the 335 pregnant women who were followed up during this study, 49 (14.6%) were later diagnosed with syphilis (32 in 2nd trimester and 17 in 3rd trimester). 54 (16.1%) were diagnosed with HIV infection (13 at two months post-1st-trimester visit, 23 in the 2nd trimester and 18 in the 3rd trimester). Lastly, 10 (2%) were co-infected with syphilis and HIV of which 8 occurred during 2nd trimester and 2 in the 3rd trimester. The factors associated with contracting new syphilis infections include;younger age group aOR (1.302, 95% CI), leaving in an urban area aOR (3.158, 95% CI), lower level of education (Primary and no formal) with aOR of (9.055, 95% CI) (P = 0.001) and (6.764, 95% CI) (P = 0.006) respectively, inadequate knowledge on the diseases aOR (2.176, 95% CI), women unaware of their partner status aOR (3.190, 95% CI). Most factors associated with contracting new HIV infections were similar to the factors associated with contracting new syphilis infections post 1st ANC visit aOR (1.174, 95% CI) and pregnant women with more than one sexual partner aOR (7.342, 95% CI) were observed for HIV infection.. There is an increased incidence of new infection of syphilis and HIV post first ANC screening in the Buea Health District, Cameroon. The need for constant education on the identifiable factors and these diseases, and screening during every ANC visit irrespective of their previous laboratory results is warranted.

Impact of Intervention Program on Sexual Behavior, HIV and Sexually Transmitted Infections among Self-Identified Men Who Have Sex with Men in Select Districts of Andhra Pradesh, India

The study aimed to assess the impact of Avahan intervention program on risk behaviors. Knowledge of HIV/STIs and their prevalence among self-identified men who have sex with men (MSM) in four select districts of Andhra Pradesh, India, covers about 1600 respondents in each of the two rounds. The response rates of MSM in R1 and R2 were about 70%. Higher numbers of MSM in R2 had literacy level of ≥10th class, were either students, self-employed/business men and belonged to 20 - 24 years. Higher proportion of MSM in R2 reportedly had knowledge of HIV and its prevention, at least two signs/symptoms of STIs in men. Significantly higher numbers of MSM in R2 were exposed to programme interventions and consistent condom users. HIV prevalence declined significantly in one district, increased in one and remained similar in two districts. The prevalence of STIs decreased significantly in two districts, while remained similar in the other.

The Power of Partners: A Qualitative Study of the Dissonance between African-American Females’ Interest in Practicing Secondary Abstinence and Continued Sexual Activity

Reducing disparities in STI/HIV rates for young heterosexual African-American women in the US is a public health priority. Although several strategies can reduce risk, some sexually experienced young women are choosing to abstain from sex for various reasons and periods of time following sexual debut, a practice known as secondary abstinence. However, others who desire to practice secondary abstinence find it difficult to do so. This qualitative study explored barriers that explained the dissonance between interest in secondary abstinence and continued sexual activity. In-depth interviews were conducted with 20 sexually-experienced African-American adolescent females, ages 18 - 23, who expressed interest in secondary abstinence. Partner-related barriers that created power imbalances presented the greatest challenges to becoming or remaining abstinent. Findings suggest that teaching young women how to recognize characteristics of healthy and unhealthy relationships, identify power imbalances, communicate assertively and develop positive coping skills can empower young women to build healthier relationships with their partners.

An Online Library of Science-Based HIV Prevention Resources

This paper introduces the online Sociometrics Social, Behavioral, and Health Sciences Library, an exciting new science-based resource for HIV/AIDS researchers, health educators, and clinicians. The over 400 products in the Sociometrics Library supplement the online publications—journal articles, books, reports, monographs—that have been the focus of scientific research libraries and publishers to date, both printed and online. Examples of the innovative science-based products that serve as the library’s content include: Evidence-based interventions and programs (EBIs/EBPs) that evaluation research has shown to be effective in preventing HIV or its risky social and behavioral antecedents;primary research data and survey instruments;and interactive, multimedia training tools and courses to build HIV professionals’ capacity to implement EBPs with fidelity and to cooperate with evaluators in the assessment of their effectiveness. A Scientist Expert Panel has guided and will continue to guide product selection and acquisition, ensuring the collection’s continuing technical merit, research utility, and relevance for practice and policy. The Sociometrics Library aims to become the dominant online source of behavioral and social science-based HIV research by-products, operationally sustainable and able to stay up-to-date both from a technological and scientific perspective.

Sexually Transmitted Infections (STIs) Knowledge Assessment of Adults in a US South Eastern Texas Region

The purpose of this cross-sectional descriptive study was to assess knowledge level regarding signs and symptoms, prevention, treatment of STIs among a sample of residents from Southeastern Texas. One hundred and fifty-seven participants age 18 and over responded to the 23 questionnaire items. Questionnaires were distributed to mostly public places such as hair salons, fitness centers, health centers, gas stations, apartments, and stores. Results indicated that 50.3% of participants reported syphilis was not curable;while over 61% reported gonorrhea was incurable. Over 64% of respondents reported they did know the symptoms for syphilis and over 70% believed that syphilis was vaccine preventable. The data collected from this study indicated that some residents from Southeast Texas lack basic information concerning Syphilis, Gonorrhea, and Chlamydia with regard to prevention, signs and symptoms, and treatment. The cost and effort to increase educational programs and educational messages appear to be justified. Implications for practice include increasing funding and efforts to provide more educational programs focusing on sexually transmitted disease prevention, health literary education to dispel the myths and stigma related to STIs and community wide collaboration efforts to increase awareness.