The Social Determinants of Health in Relation to Sexually Transmitted Infections in Maricopa County Arizona

Based on the information that was collected on the County Health Rankings website [1], one of the top health concerns for Maricopa County was sexually transmitted infections or STIs. A big concern with STIs is this is not a common subject explored in educational settings or addressed socially. There are many organizations, including the CDC, that have access to materials, there is limited distribution of the educational content. Therefore, the public is not well informed and lacks the information to make educated decisions. The areas with insufficiencies are knowledge of the disease processes, prevention, and treatment.

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.

Impact of sexually transmitted infections on women health

Sexually transmitted infections (STIs) are the infections that can be transmitted from one sex partner, who already has such infection, to another. The causes of STIs in human are very well elucidated and their causative agents are identified as bacteria, parasites and viruses. The worldwide epidemiology of more than 20 types of STIs has been established, which includes diseases like Chlamydia, Gonorrhea, Genital herpes, HIV/ AIDS, HPV, Syphilis and Trichomoniasis. Though STIs affect both men and women indiscriminately, however, the pathophysiology of disease is more obvious among women. Other than abstinence, the most effective way to prevent the transmission or acquisition of STIs is to use a condom during sexual intercourse. Condoms are effective in decreasing the transmission of HIV. However, once contacted, STIs caused by bacteria or parasites can be treated with antibiotics. STIs caused by a virus may not virtually have any cure though the medicines may keep the disease under control. Correct usage of preventive measures greatly reduces but does not completely eliminate the risk of catching or spreading STIs.

Perception of Sexually Transmitted Infection-Preventive Measures among Senior Secondary School Students in Nnewi-North Local Government Area, Anambra State, Nigeria

Background: Sexually transmitted infections-preventive measures are effective methods employed in the prevention of sexually transmitted infections [STIs]. Sexually transmitted infections are among the most common infections in the world and therefore a major public health problem as they cause devastating long term consequences if untreated, especially in adolescents. Sexually transmitted infection-preventive measures, if correctly and consistently used, have been proven to be efficacious. Methodology: This was a cross-sectional descriptive study carried out among SS2 and SS3 students in Nnewi North Local Government Area of Anambra state, Nigeria. A structured, self administered questionnaire was administered to consenting senior secondary students to gather relevant information about socio-demogaraphic characteristics, knowledge about STIs, sexual behaviours. Three hundred and thirty four students participated in the study. Multi stage sampling technique was used. SPSS version 20 was used to analyze the data. Results were represented in tables and graphs. Results: Three hundred and thirty four students participated in the study, of which females and males are 167 each. 89% understood the meaning of STI. The majority of the respondents got the knowledge from TV/radio (34.4%), teachers (28.1%) and mother (27.0%). The majority of respondents knew that HIV/AIDS (89.8%), syphilis (58.1%) and Gonorrhoea (56.9%) were STIs. Good numbers of respondents knew the symptoms of STIs and risk factors of STI with unprotected sex and multiple sexual partners (57.5%) and (42.2%) respectively, as the highest risk factors. About 75.7% of respondents knew that HIV/AIDS cannot be cured. The Majority knew that avoiding sexual intercourse, being faithful to one partner and use of condom are preventive measures respectively. The majority of respondents (71%) felt they cannot be infected with an STI. 92.8% believed that STIs can be prevented. Age range for first sexual intercourse was 13 - 18 years for females and 8 - 19 years for males. Of the 86 that have had sexual intercourse, 48.8% had experienced one or more of the symptoms of STIs and the majority (80.9%) went to a hospital for treatment. Males (31.4%) are more likely to have multiple sexual partners than females (4.7%). Conclusion: The majority of the students had an objective knowledge on STIs transmission and prevention. Their overall attitude was positive but their practices were not satisfactory, especially for the males. Females were more careful and health conscious than their male counterpart.

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.

Women and Sexually Transmitted Infections in Africa

Despite efforts to control the spread of sexually transmitted infections (STIs), these infections are still highly prevalent in the developing world, especially in Africa where the prevalence and incidence of Human immunodeficiency virus (HIV) is also very high. Unfortunately, women bear the disproportionate burden of both STIs and HIV in this region. Early diagnosis, treatment and prevention of STIs is therefore crucial in this population given the strong evidence that some STIs have been shown to facilitate the transmission of HIV. This review summarizes the epidemiology, and management of the common STIs affecting African women, and the health complications associated with these infections in the era of emerging antimicrobial resistance.

Sexually Transmitted Infections among African-American Population of the Midwest United States

Background: Sexually transmitted infections (STIs) such as chlamydia and gonorrhea are commonly reported infections in the United States. Greater Omaha has had continually higher reported rates of chlamydia and gonorrhea for more than a decade compared to the rest of the state rates. Minority and young adults have been disproportionately affected. Purpose: The objectives of our study were to estimate the prevalence and to identify risk factors for chlamydia and gonorrhea among young adults. Methods: We conducted a cross-sectional survey with 310 young adults aged 19 -25 years between June 2011 and June 2012. The study collected socio-demographic, behavioral and other risk factors for STIs utilizing a pre-design standardized questionnaire. Gonorrhea and chlamydia status of the participants were established by testing urine samples using PCR-based diagnostic technique. Descriptive and multivariable regression analyses were used to examine risk factors for STIs. Results: About 12.6% survey participants had at least one STI test positive. Lower education was associated with STIs but was not statistically significant (Odd Ratio for no schooling was 8.24, 95% CI 0.93 -72.86, Odd Ratio for high school education was 2.05, 95% CI 0.25 -16.63 compared to associate or college level education). No other predictors were associated with STIs. The average age of the first sexual intercourse was lower, and the number of sexual partners was higher compared to their national counterparts. Conclusion: We found a higher percentage of STI-positive individuals compared to previously reported county-level estimates. Education was the single and most important predictor of positive STI status.

Knowledge of sexually transmitted infections among senior high school adolescents in the Wa Municipality of Ghana

Background:Sexually transmitted infections(STIs)are responsible for a high burden of morbidity and mortality in many developing countries especially among adolescents.Adolescents are predisposed to STIs because they are more likely to engage in unhealthy lifestyles.However,these adolescents have limited knowledge of the use and barriers to sexual and reproductive health information and care services.This study explored the knowledge of STIs among Senior High School Adolescents in the Wa Municipality of Ghana.Method:The study designed as a descriptive cross-sectional research.A multistage sampling technique was used to recruit these adolescents for the study.Totally 355 adolescents were selected from senior high schools in the Wa Municipality.Descriptive statistics and Chi-square test were used to analyze the data,at a significance level ofP<0.05.Results:The majority of respondents had good knowledge of STIs,with the most common examples of STIs identified as HIV/AIDS(80.8%,287/355)and gonorrhea(73.8%,262/355).The main known signs and symptoms identified were discharges from the penis/vagina(72.4%,257/355),painful urination(71.5%,254/355),and itching,and sores around the genital area(72.7%,258/355).The main sources of information/education of STIs for these adolescents were the school,hospital,internet and mother.Whom respondent lived with was found to be significantly associated with knowledge of STI(P<0.001).Conclusion:Many of the respondents had good knowledge of STI,and the school was the most common source of information on STL It is,therefore,important for the Ghana Education Service and the Ghana Health Service to strengthen the School Health Education Programme in second cycle institutions in the Wa Municipality.Parents,especially mothers,should be actively involved in the sexual health education of adolescents.

Rapid Determination of Sexually Transmitted Infections by Real-time Polymerase Chain Reaction Using Microchip Analyzer

Development of non expensive and time-saving techniques based on the polymerase chain reaction (PCR) is of great importance for modern diagnostics. We considered a new approach for PCR determination of a variety of sexually transmitted infections using microchip analyzer “AriaDNA”, which had been tested using clinical samples in several medical institutions of St. Petersburg (Russia). The use of microchips containing lyophilized PCR reagents allows reducing significantly time of analysis and the number of manipulations thus preventing possible sample contamination.

Facilitating the Implementation of Sexually Transmitted Infection Syndromic Management in China

Objective: To introduce the current status ofimplementing sexually transmitted infection (STIs)syndromic management in China. Methods: Data were collected and analyzed from the literature. Possiblesolutions were suggested for the obstacles encountered inthe implementation process. Results: Validation of revised flowcharts for themanagement of three syndromes (urethritis, vaginaldischarge, and genital ulcers) has been conducted in China.The feasibility, effectiveness and acceptance of using asyndromic STI approach were investigated in a large studyin Hainan, Zhejiang and Hubei Provinces. Chief obstaclesto implementation included the following: lack of supportfrom government authorities; negative reaction by hospitals;lack of critical thinking and innovation; perceivedover-emphasis on treatment at the expense of prevention;and lack of coverage for several important pathogens withintreatment algorithms. Possible solutions may include policyadvocacy, adopting syndromic management into a Chinesecontext, dissemination and promotion, training of providers,encouraging use of syndromic approach, and conductingoperational research. Conclusions: Syndromic STI management provides afeasible approach for the diagnosis and treatment of STIs inChina. Further efforts should be made for scaling up itsapplication in clinical settings.

Health-related attitudes and risk factors for sexually transmitted infections of Chinese women who have sex with women

Background Previous studies have shown evidence of health-related risk behaviors among women who have sex with women （WSW）, such as sex with men, multiple bisexual partners, and drug use. Women who have sex with women have also been known to avoid routine physical examinations and conceal their same-sex history from physicians, which can affect their ability to receive an accurate diagnosis and treatment. No previous research has targeted women who have sex with women in China. We sought to describe women who have sex with women in China and explore risk factors for their reproductive tract infections （RTI）/sexually transmitted infections （STI）. Methods Participants were recruited through outreach in venues and online for a cross-sectional study. Data were collected using interviews and laboratory tests. Results We recruited 224 women who have sex with women. In the year preceding their participation in the study, 92% （206/224） of women reported sexual relations with women. The RTI rates were： gonorrhea （15.8%）, chlamydia （3.5%）, syphilis （0.5%）, bacterial vaginosis （14.4%）, hepatitis B virus （HBV） （0.9%）, hepatitis C virus （HCV） （0.5%）, and candidiasis （6.9%）. No HIV or herpes simplex virus （HSV） positive cases were detected. Factors associated with gonorrhea infection were non-Beijing local residency （odds ratio （OR）=2.1, 95% confidence interval （C/）： 1.2-3.8） and genital-genital contact （OR=3.1, 95% CI： 1.3-7.2）; factors associated with curable STI （excluding bacterial vaginosis, candidiasis, HBV and HCV） were non-Beijing local residency （OR=1.9; 95% CI： 1.2-3.0） and bleeding during or after sex （OR=18.1; 95% CI： 5.2-62.6）; and the factor associated with RTI （including all the infections tested） was bleeding during or after sex （OR=37.8, 95% CI： 11.2-127.4）. Conclusions Behaviors that may cause RTI/STI exist among Chinese women who have sex with women. Researchers should consider these behaviors when planninq correspondin.q prevention and interventions.

Association of sexually transmitted infection with semen quality in men from couples with primary and secondary infertility

This study aims to compare the prevalence of sexually transmitted infections(STIs)with semen quality in men from couples with primary and secondary infertility.Semen samples were collected from 133 men who requested fertility evaluation.Seminal tract infection with Ureaplasma spp.(UU),Mycoplasma hominis(MH),Mycoplasma genitalium(MG),Chlamydia trachomatis(CT),Neisseria gonorrhoeae(NG),and herpes simplex virus-2(HSV-2)was assessed by PCR-based diagnostic assays.Among all patients,the prevalence of STIs was higher in men from couples with primary infertility than that in men from couples with secondary infertility(39.7%vs 21.7%,P=0.03).The prevalence of UU was 28.8%and 13.3%in men from couples with primary and secondary infertility,respectively.Men from couples with primary infertility were more likely to be positive for UU than men from couples with secondary infertility(P=0.04).Regarding the UU subtype,the prevalence of Ureaplasma urealyticum(Uuu)and Ureaplasma parvum(Uup;including Uup1,Uup3,Uup6,and Uup14)did not differ between the two groups.No associations between the prevalence rates of MH,MG,and CT were found in men from either infertility group.A lower sperm concentration was associated with STI pathogen positivity in men with primary infertility according to the crude model(P=0.04).The crude and adjusted models showed that semen volume(both P=0.03)and semen leukocyte count(both P=0.02)were independently associated with secondary infertility.These findings suggest the importance of classifying the type of infertility during routine diagnosis of seminal tract infections.

Impact of HIV/sexually transmitted infection testing on risky sexual behaviors among men who have sex with men in Langfang, China

Background Men who have sex with men （MSM） in China remain at high risk for HIV infection, the proportion of reported HIV/AIDS cases that occurred among MSM rose greatly from 2005 to 2011. HIV testing and counseling is a critical HIV prevention strategy among HIV related high-risk population, including MSM in China. This article aimed to assess the association between receiving HIV testing and high-risk sexual behaviors among MSM in Langfang, Hebei Province, China. Methods Between September and November 2007, 233 MSM were recruited to receive an HIV testing intervention. Face-to-face interviews were conducted before HIV testing and 3 months later HIV-related risk behaviors were assessed. Serological testing for HIV and other sexually transmitted infections （STIs） was performed. Results Of the recruited 233 MSM, 200 completed follow-up. Baseline prevalence was 7.8% for HIV, 21.0% for syphilis, 15.8% for gonorrhea, and 5.0% for chlamydia. Multivariate analysis indicated that inconsistent condom use （OR=7.9, 95% CI： 0.9-66.7, P=0.059） and bleeding during anal sex （OR=5.9, 95% Cl： 1.3-26.2, P=0.019） were risk factors for HIV infection, and group sex （OR=6.6, 95% Cl： 2.2-19.7, P=0.001） was a risk factor for syphilis infection at baseline. At 3 months follow-up, among STI-positive MSM, self-reported anal sex fell from 73.1% to 38.5% （P 〈0.001）; group sex fell from 19.2% to 5.8% （P 〈0.001）; and bleeding during anal sex fell from 23.1% to 5.8% （P 〈0.001）. Among STI-negative MSM, the frequency of one-night stands fell from 32.5% to 17.2% （P 〈0.001）, and oral sex rose from 57% to 78.5% （P 〈0.001）. STI-positive MSM were less likely to engage in anal sex compared to STI-negative MSM （X^2=5.189, P=0.023）. Conclusions HIV testing is an important intervention strategy among MSM. HIV testing services among MSM need to be scaled up, along with comprehensive, tailored interventions including condom promotion and STI treatment.

Incidenee and time-varying predictors of HIV and sexually transmitted infections among male sex workers in Mexico City

Background:Male sex workers are at high-risk for acquisition of sexually transmitted infections(STIs),including human immunodeficiency virus(HIV).We quantified incidence rates of STIs and identified their time-varying predictors among male sex workers in Mexico City.Methods:From January 2012 to May 2014,male sex workers recruited from the largest HIV clinic and community sites in Mexico City were tested for chlamydia,gonorrhea,syphilis,hepatitis,and HIV at baseline,6-months,and 12-months.Incide nee rates with 95%bootstrapped confide nee limits were calculated.We examined potential timevarying predictors using generalized estimating equations for a population averaged model.Results:Among 227 male sex workers,median age was 24 and baseline HIV prevalence was 32%.Incidence rates(per 100 person-years)were as follows:HIV[5.23;95%confidence interval(CI):2.15-10.31],chlamydia(5.15;95%CI:2.58-9.34),gonorrhea(3.93;95%CI:1.88-7.83),syphilis(13.04;95%CI:8.24-19.94),hepatitis B(2.11;95%CI:0.53-4.89),hepatitis C(0.95;95%CI:0.00-3.16),any STI except HIV(30.99;95%CI:21.73-40.26),and any STI including HIV(50.08;95%CI:37.6062.55).In the multivariable-adjusted model,incident STI(excluding HIV)were lower among those who reported consistently using condoms during anal and vaginal intercourse(odds ratio=0.03,95%CI:0.00-0.68)compared to those who reported inconsistently using condoms during anal and vaginal intercourse.Conclusions:Incidence of STIs is high among male sex workers in Mexico City.Consistent condom use is an important protective factor for STIs,and should be an important comp on ent of interventions to prevent incide nt infect i ons.

A risk-based model for predicting the impact of using condoms on the spread of sexually transmitted infections

We create and analyze a mathematical model to understand the impact of condom-use and sexual behavior on the prevalence and spread of Sexually Transmitted Infections(STIs).STIs remain significant public health challenges globally with a high burden of some Sexually Transmitted Diseases(STDs)in both developed and undeveloped countries.Although condom-use is known to reduce the transmission of STIs,there are a few quantitative population-based studies on the protective role of condom-use in reducing the incidence of STIs.The number of concurrent partners is correlated with their risk of being infectious by an STI such as chlamydia,gonorrhea,or syphilis.We develop a Susceptible-Infectious-Susceptible(SIS)model that stratifies the population based on the number of concurrent partners.The model captures the multi-level heterogeneous mixing through a combination of biased(preferential)and random(proportional)mixing processes between individuals with distinct risk levels,and accounts for differences in condom-use in the low-and high-risk populations.We use sensitivity analysis to assess the relative impact of high-risk people using condom as a prophylactic intervention to reduce their chance of being infectious,or infecting others.The model predicts the STI prevalence as a function of the number of partners of an individual,and quantifies how this distribution of effective partners changes as a function of condom-use.Our results show that when the mixing is random,then increasing the condom-use in the high-risk population is more effective in reducing the prevalence than when many of the partners of high-risk people have high risk.The model quantifies how the risk of being infected increases for people who have more partners,and the need for high-risk people to consistently use condoms to reduce their risk of infection.

Pair formation models for sexually transmitted infections:A primer

Formodelling sexually transmitted infections,duration of partnerships can strongly influence the transmission dynamics of the infection.If partnerships are monogamous,pairs of susceptible individuals are protected from becoming infected,while pairs of infected individuals delay onward transmission of the infection as long as they persist.In addition,for curable infections re-infection froman infected partnermay occur.Furthermore,interventions based on contact tracing rely on the possibility of identifying and treating partners of infected individuals.To reflect these features in a mathematical model,pair formation models were introduced tomathematical epidemiology in the 1980's.They have since been developed into a widely used tool in modelling sexually transmitted infections and the impact of interventions.Here we give a basic introduction to the concepts of pair formation models for a susceptibleinfected-susceptible(SIS)epidemic.We review some results and applications of pair formation models mainly in the context of chlamydia infection.

Utility of syndromic approach in management of sexually transmitted infections:public health perspective

Sexually transmitted infections(STIs)are infections that are mainly transmitted from person-to-person through sexual contact.Untreated or inadequately treated STIs can have significant impact on the maternal and newborn health.An extensive search of all materials related to the topic was made using library sources including PubMed,Medline and World Health Organization website for a period of one month.Relevant documents,technical publication series,systematic reviews,research articles focusing on the practice of syndromic management in treatment of STIs published in the period 1995-2013 were included in the review.The identified articles were then re-grouped into different sections for better understanding.Keywords used in the search include syndromic management,sexually transmitted infections,women,reproductive age-group and pregnancy.There is an immense need for implementation of prevention and control of STIs because of the associated morbidity/mortality,association with HIV and adverse outcomes of pregnancy and burdening of the health system.Multiple socio-demographic determinants have been identified,which usually precipitates STIs.In addition,some of the barriers have been recognized which is hampering with the expected utilization of the health care services.To counter the high prevalence of reproductive tract infection/STI,especially in countries with limited resources,syndromic diagnostic approach has been adopted by countries for the standardized management of sexually transmitted disease cases.The aim of syndromic management is to identify a syndrome and treat it accordingly with combination therapy which will cover the main pathogens that cause it.Strategies have been suggested to overcome the limitations of the syndromic approach and bring the problem under control.To conclude,syndromic management is a rapid and cost-effective approach in reducing the transmission of STIs.

Risk factors of sexually transmitted infections among female sex workers in Republic of Korea

Background:Female sex workers(FSW)who live in urban areas in Republic of Korea have a particularly high risk of sexually transmitted diseases(STD).We investigated the prevalence of s STDs in FSWs in order to determine the factors associated with sexually transmitted infections in Korea.Methods:Study data were collected from 832 FSWs through a 2014 survey on the prevalence of STDs in high risk populations in Republic of Korea.We assessed the associations between sexually transmitted infections and demographic and risk behaviour variables through logistic regression analysis.Results:The risk probability of sexually transmitted infection was higher for those who drank alcohol often as well as those who had their first sexual experience at an early age.However,the effects of these factors were attenuated by working conditions.The risk probability of sexually transmitted infections was higher for those who engaged in sex with several customers per day as well as for those who did not practice regular condom use.Conclusions:The risk factors for sexually transmitted infections among FSWs in Republic of Korea are related to and affected by working conditions.Thus,multifaceted health interventions to protect FSWs and their sexual health are deemed necessary.

Sexually Transmitted Diseases at Monkey Bay Community Hospital in Mangochi, Malawi;an Analysis of Characteristics of Common Sexually Transmitted Diseases

We present the characteristics of the commonly diagnosed sexually transmitted infections (STI) at a clinic of Monkey Bay community hospital by a retrospective study. We conducted an audit of patients’ hospital records from a STIs clinic at Monkey Bay community hospital in Mangochi District (Malawi) covering a period from January 2019 to June 2019 (18 months). Data was tabulated in excel and analyses were made based on sex, age, male circumcision status, pregnancy and the pattern of STIs diagnosed within the chosen study period. A total number of 659 clients presented at STI clinic of Monkey Bay community hospital between January 2018 and June 2019. Out these clients, 409 (62%) were females and 250 (38%) were males. Most of the patients were in the age range of 25 years or above (447, 68%). Majority of the patients were HIV negative (523, 79%). Out of the 250 males, 113 (45%) were circumcised. Among female patients 56 of the 409 (14%) were pregnant. The most common presentations for all cases put together were lower abdominal pain (253, 38%), then urethral discharge (189, 29%), abnormal vaginal discharge (141, 21%), genital ulcer disease (64, 10%), in that order. Syphilis, genital warts, inguinal bubo and scrotal swelling were less common. The most common presentation in males was urethral discharge (178, 71%), while in females it was lower abdominal pain (214, 52%). Our audit showed that in Mangochi (Malawi) sexually transmitted diseases of various types are more common among young adults, females and uncircumcised men. There was no much difference in the percentage of STI’s between HIV positive and HIV negative people. These results point to an alarmingly high level of risky sexual behaviors among sexually active age groups in this part of Malawi, a country which still has one of the highest HIV prevalence in sub-Saharan Africa. This calls for continued and better research and control for transmission of STIs in the district.

Socio-Demographic, Clinical, and Hygiene Profile of Syndromically Managed Sexually Transmitted Diseases: A Cross Sectional Study in a Tertiary Care Center in India

Background: Sexually transmitted diseases are one of the several major public health concerns, the burden of which is borne by low- and middle-income countries like India. Purpose: The purpose is to evaluate the relationship between menstrual and sanitary hygiene and sexually transmitted diseases (STD) based on syndromic diagnosis Methods: An out-patient department (OPD) based cross sectional survey to determine these associations, if any exist, which would help critically analyze syndromic management. STD was reported by the presence of vaginal/cervical/urethral discharge with or without irritation and itching, lower abdominal pain and ulcer. Results: The prevalence of STD was 66.84% with the most commonly reported symptoms being discharged (31.18%), followed by abdominal pain (17.92%) and itching/irritation (12.90%), with ulcer (4.83%) being the least reported symptom. Perimenopausal age ((AOR: 0.420 [CI: 0.189 - 0.915];p = 0.030), higher grades of education ((AOR: 0.228 [CI: 0.119 - 0.424];p < 0.001) for secondary), urban residency (AOR: 0.435 [CI: 0.686 - 2.733];p < 0.001), and contraception use (AOR: 0.531 [CI: 0.308 - 0.887];p = 0.018) were associated with lesser odds of presenting with an STD symptom. Belonging to a minority religious community (AOR: 7.20 [CI: 1.866 - 48.251];p < 0.012) or backward castes (AOR: 3.753 [CI: 1.587 - 10.144];p < 0.001), having similar illness (AOR: 4.205 [CI: 2.795 - 6.439];p < 0.001) or having an invasive gynecological procedure done in the past one year (AOR: 1.953 [CI: 1.184 - 3.295];p = 0.010) and washing the reusable sanitary material only with water (AOR: 4.900 [CI: 2.701 - 9.116];p < 0.001) as compared to washing it with water and soap, had a higher association with presenting with STD symptoms. Stratified analysis also showed that women presenting discharge (AOR: 2.049 [CI: 1.343 - 3.146] for vaginal and cervical;AOR: 1.426 [CI: 0.826 - 2.482] for urethral) were more likely to not have a toilet facility in an accessible condition. Women with sanitary napkin use had lesser odds (AOR: 0.780 [CI: 0.516 - 1.180];p = 0.293) of presentation for STD in OPD than women who used other material. Conclusion: To better manage the group of diseases that may present with symptoms of STD under syndromic approach, we propose interventions such as menstrual hygiene education and promotion of the use of sanitary napkins among women especially those belonging to lower socio-economic sections of the society.