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 a...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.展开更多
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...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.展开更多
<b><span>Background</span></b><span><span>: Often, long-distance truck drivers’ (LDTDs’) work predisposes them to sexually transmitted infections (STIs) whose outcomes are influen...<b><span>Background</span></b><span><span>: 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. </span><b></b></span><b><b><span>Methodology</span></b><span>:</span></b><span> 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) w</span><span>as</span><span style="font-family:;" "=""><span><span> analyzed using binomial logistic regression analysis in R statistical software. </span><b></b></span><b><b><span>Results</span></b><span>:</span></b><span> 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,</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span><span>16.7;P < 0.001). </span><b></b></span><b><b><span>Conclusion</span></b><span>:</span></b> </span><span>Although most of the LDTDs were </span><span>classed to have good utilization of HIV/STI preventive services, the uptake of subsequent HIV testing services among </span><span>them</span><span style="font-family:;" "=""><span> was low at only 4.9%. </span><span>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.</span></span>展开更多
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 record...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.展开更多
<strong>Background:</strong> 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.<strong> Pu...<strong>Background:</strong> 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.<strong> Purpose:</strong> The purpose is to evaluate the relationship between menstrual and sanitary hygiene and sexually transmitted diseases (STD) based on syndromic diagnosis<strong> Methods:</strong> 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. <strong>Results:</strong> 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.<strong> Conclusion:</strong> 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.展开更多
The prevalence of human immunodeficiency virus (AIDS) and hepatitis B virus among heavy truck drivers and their assistants has been well documented globally in correlation with their behavioral characteristics. The pr...The prevalence of human immunodeficiency virus (AIDS) and hepatitis B virus among heavy truck drivers and their assistants has been well documented globally in correlation with their behavioral characteristics. The present study aimed to screen for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and behavioral characteristics among heavy truck drivers in Port Sudan. A cross-sectional study was conducted on 274 heavy truck drivers and their assistants who used the highway Port Sudan-Khartoum in Port Sudan city during 2019-2021. Data on behavioral characteristics and substance use habits were collected using a structured questionnaire, and an ELISA test was used to screen for HIV and HBV infections in the study participants. The chi-square test, odds ratio, and confidence intervals were used to find the association between behavioral characteristics and seropositive HIV/HBV. Of the 274 enrolled participants, the seroprevalence rates of HIV were 2.7% and HBV was 23.7%. Ninety-four (34.3%) of them had a history of high-risk sexual behavior outside of marriage;only two (0.7%) used condoms;14.2% of participants reported alcohol use;and 1.1% reported drug use. Univariate analysis revealed that having a sex history outside of marriage with ≥1 sex partner and never using a condom with a spouse or casual partner were significant risk factors for HIV and HBV among drivers. Fortunately, we found that most of the drivers reported low alcohol and drug use. Concerning this study, the seroprevalence of HIV and HBV is highly associated with a history of having sex outside of marriage and sexual behavior among truck drivers and assistances. Additional studies are needed to further investigate other STIs and behavioral characteristics associated with factors in truck drivers/assistance in different truck stop regions in Sudan.展开更多
BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific r...BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific region.Examining the HCV care cascade can identify barriers to the completion of HCV treatment and facilitate achievement of HCV micro-elimination in PLWH.AIM To investigate the care cascade of incident HCV infections among PLWH in Taiwan.METHODS PLWH with incident HCV infections,defined as HCV seroconversion,were retrospectively identified by sequential anti-HCV testing of all archived blood samples at National Taiwan University Hospital between 2011 and 2018.All PLWH with incident HCV infections were followed until December 31,2019.The care cascade of HCV examined included all incident HCV-infected patients,the percentages of anti-HCV antibodies detected by HIV-treating physicians in clinical care,plasma HCV RNA load tested,HCV RNA positivity diagnosed,referral to treatment assessment made,anti-HCV treatment initiated,and sustained virologic response achieved.Those who had HCV seroconversion during the interferon(IFN)era(2011–2016)and the direct-acting antiviral(DAA)era(2017–2018)were analyzed separately.The duration of HCV viremia—from the date of seroconversion to viral clearance by treatments or until the end of observation—and the incidence of sexually transmitted infections(STIs)during the HCV viremic period were estimated.RESULTS During the study period,287 of 3495(8.2%)PLWH(92.3%being men who have sex with men)who were HCV-seronegative at baseline developed HCV seroconversion by retrospective testing of all archived blood samples.Of the 287 incident HCV infections,277(96.5%)had anti-HCV antibodies detected by HIV-treating physicians,270(94.1%)had plasma HCV RNA determined and 251(87.5%)tested positive for HCV RNA.Of those with HCV viremia,226(78.7%)were referred to treatment assessment,215(74.9%)initiated anti-HCV treatment,and 202(70.4%)achieved viral clearance.Compared with that in the IFN era,the median interval from HCV seroconversion by retrospective testing to detection of HCV seropositivity by HIV-treating physicians was significantly shorter in the DAA era{179 d[interquartile range(IQR)87-434]vs 92 d(IQR 57-173);P<0.001}.The incidence rate of STIs in the DAA vs the IFN era was 50.5 per 100 person-years of follow-up(PYFU)and 38.5 per 100 PYFU,respectively,with an incidence rate ratio of 1.31(95%confidence interval 0.96-1.77),while the duration of HCV viremia was 380 d(IQR 274-554)and 735 d(IQR 391-1447)(P<0.001),respectively.CONCLUSION While anti-HCV therapies are effective in achieving viral clearance,our study suggests more efforts are needed to expedite the linkage of PLWH diagnosed with incident HCV infections to HCV treatment.展开更多
Objective:To identify the prevalence,determinants of reproductive tract infection,and healthcare seeking behavior among ever married women of reproductive age residing in an urban slum of Faridabad,Haryana,North India...Objective:To identify the prevalence,determinants of reproductive tract infection,and healthcare seeking behavior among ever married women of reproductive age residing in an urban slum of Faridabad,Haryana,North India.Methods:This community based cross-sectional study was conducted among ever married women aged between 15 and 49 years insured under employees state insurance scheme and residing in an urban slum of Faridabad.Simple random sampling technique was used to interview 149 eligible women using a predesigned structured questionnaire.Study variables included sociodemographic profile,family planning methods,menstrual absorbent usage,and symptoms of reproductive tract infection.Binary logistic regression was used to investigate the determinants of reproductive tract infection.Results:Of the women,46.3%had at least one reproductive tract infection or sexually transmitted infection symptom and 28.9%among them sought treatment for the symptom.Vaginal discharge,itching(14.1%)and lower abdominal pain(30.2%)were the major symptoms reported.Non-usage of condoms as contraceptive was significantly associated with a higher rate of symptoms(50.4%vs.20.0%).Abortion had a significantly high odds of having reproductive tract infection symptoms(aOR 3.71,95%CI 1.59-8.62;P<0.01).Less frequent change in absorbent during menstruation was also reported to have a higher rate of symptoms.The majority of those who took treatment sought it from government or employees state insurance dispensary.2%also went to faith healers.Conclusions:Nearly half of the study population have reproductive tract infection symptom.Abortions and non-usage of condom increase the risk of reproductive tract infection.Menstrual hygiene and condom usage are the significant interventions,which may reduce the prevalence of these symptoms.展开更多
Background: Commercial female sex workers (CFSWs) are considered a high-risk group for HIV/AIDs. The prevalence of HIV/AIDs trends to increase among those groups also in Thailand. An adequate perception of the degree ...Background: Commercial female sex workers (CFSWs) are considered a high-risk group for HIV/AIDs. The prevalence of HIV/AIDs trends to increase among those groups also in Thailand. An adequate perception of the degree to which one is at risk of having HIV is necessary for behavioral change and of safe behaviors. HIV/AIDs risk perception among CFSWs was needed to reduce HIV/AIDs infection. Methods: A cross-sectional study was conducted among 141 CFSWs in Bangkok, Thailand. Participants were selected using convenient and purposive sampling methods for January to October 2019. Self-access questionnaire was used for collecting data with the reliability testing of 0.82. Logistic regression employed to identify adjusted odd ratio between demographic data, sexual behaviors and HIV/AIDs risk perception, p-value less than 0.05 was considered statistically significant. Results: 51.77% of CFSWs perceived themselves at high risk for HIV/AIDs infection. Most CFSWs reported that they did not consistently use condom (57.45%), factors associated with perception risk of HIV/AIDs including education level (adjusted OR = 2.23, 95% CI = 1.07 - 4.54), knowledge of HIV and STDs (adjusted OR = 3.65 and 3.22. 95% CI = 1.89 - 3.91), Condom use (adjusted OR = 2.56, 95% CI = 1.05 - 2.90) years engaged in sex work, age of initiating in sex work, frequency of sex work in the last month and unplanned sex work were significant with risk perception of HIV/AIDs (adjusted OR = 3.33, 2.71, 2.67, 2.56 and 95% CI = 1.99 - 3.84, 1.72 - 3.32, 1.29 - 3.12, 1.05 - 2.78 respectively), and had HIV/STDs test (adjusted OR = 3.22, 95% CI = 2.11 - 3.95). Other used illicit drugs by injection, smoking and alcohol consumption had a strong association with the high perception of HIV/AIDs among CFSWs. Conclusion: Majority of CFSWs with risky sexual behaviors had a high HIV/AIDs risk perception. Effective educational programmes are necessary to enable CFSWs to correctly assess their own HIV/AIDs risk and change risk behaviors based on self-assessment of actual risk.展开更多
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...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.展开更多
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 f...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.展开更多
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 wom...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.展开更多
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...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.展开更多
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...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.展开更多
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 challen...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.展开更多
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 fro...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.展开更多
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 newbo...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.展开更多
Aim: To determine the most common risk factors of male infertility in Mongolian men attending an infertility clinic. Methods: A prospective, case-control study was conducted in which 430 men were enrolled. All the men...Aim: To determine the most common risk factors of male infertility in Mongolian men attending an infertility clinic. Methods: A prospective, case-control study was conducted in which 430 men were enrolled. All the men had sought their first infertility evaluation between 1998-2002 in the State Research Center on Maternal Child Health, Ulaanbaatar, Mongolia. They were divided into two groups depending on the results of their semen analysis: 191 with abnormal semen and 239 with normal semen profile. Univariate and multivariate analyses were performed to determine any association between risk factors and semen abnormality. Results: Logistic regression analysis demonstrated that the testicular volume, a history of sexually transmitted infections (STI), epididymitis and testicular damage all have statistically significant associations with semen abnormality, when controlled for multiple risk factors. Adjusted odds ratios of 3.4 for mumps orchitis, 2.3 for other orchitis and 3.9 for testicular injury were found. Gonorrhoea, the most commonly reported STIs in this study, gave an adjusted odds ratio of 1.0 for having one or more sperm abnormality. An adjusted odds ratio for subjects with a history of other STIs was 2.7. However, as a predictor of azoospermia, STIs had very high odds ratio, being 5.6 in patients with gonorrhoea and 7.6 in patients with other STIs. Conclusion: A history of pathology involving testicular damage appeared to have the strongest impact on male infertility in Mongolia. STIs have less impact on semen quality except when complicated by orchitis, epididymitis and vasal obstruction.展开更多
Background: Adolescents are disproportionally affected by sexually transmitted infections (STI). Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) are the most frequent curable STI in adolescents, causing seri...Background: Adolescents are disproportionally affected by sexually transmitted infections (STI). Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) are the most frequent curable STI in adolescents, causing serious consequences for their reproductive health. Therefore, we aimed to determine the prevalence and incidence of CT and TV, as well as their risk factors in pregnant adolescents from Belém, northern Brazilian Amazon. Methods: This prospective study enrolled 199 adolescents up to 20 weeks of pregnancy. They were scheduled for follow-up visit between 28 and 29 weeks of pregnancy. Sociodemographic and behavioral data were obtained by interview. Cervicovaginal samples were taken to test for TV, CT, Neisseria gonorrhoeae and bacterial vaginosis. Univariate and multivariate analyses were performed to test the association of prevalent/incident CT and TV with the variables. Results: Prevalence of cervical CT infection was 33.7% (n = 67/ 199), and for trichomoniasis it was 4.0% (n = 8/199). Cervical ectopy increased the risk for prevalent CT (OR, 1.93;95% CI, 1.01 - 3.70), while having treated vaginal discharge in the past (OR, 0.51;95% CI, 0.26 - 0.98) and being married (OR, 0.10;95% CI, 0.01 - 0.83) were protective against current CT and TV, respectively. Among the 95 (47.7%) adolescents who completed follow-up, 15 cases of incident CT were identified. Incident CT was associated with having a formal or informal job (OR, 28.4;95% CI, 2.1 - 391.6) and bacterial vaginosis treatment at the baseline (OR, 0.08;95% CI, 0.01 - 0.69). Conclusion: Prevalence and incidence rates of TV and CT are high in this population devoid of STI routine screening. Treatment of bacterial vaginosis may benefit this population by reducing risk for CT acquisition.展开更多
Syphilitic periostitis is not a common manifestation of bone involvement in congenital and acquired late syphilis, and it’s rarely seen in secondary syphilis. Syphilis should be considered as a differential diagnosis...Syphilitic periostitis is not a common manifestation of bone involvement in congenital and acquired late syphilis, and it’s rarely seen in secondary syphilis. Syphilis should be considered as a differential diagnosis in patient with deep bony pain that worsens at night. We report a case of secondary syphilis presented with multiple bony swelling of both tibiae (sabre-like) and other long bones.展开更多
文摘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.
文摘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.
文摘<b><span>Background</span></b><span><span>: 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. </span><b></b></span><b><b><span>Methodology</span></b><span>:</span></b><span> 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) w</span><span>as</span><span style="font-family:;" "=""><span><span> analyzed using binomial logistic regression analysis in R statistical software. </span><b></b></span><b><b><span>Results</span></b><span>:</span></b><span> 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,</span></span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span><span>16.7;P < 0.001). </span><b></b></span><b><b><span>Conclusion</span></b><span>:</span></b> </span><span>Although most of the LDTDs were </span><span>classed to have good utilization of HIV/STI preventive services, the uptake of subsequent HIV testing services among </span><span>them</span><span style="font-family:;" "=""><span> was low at only 4.9%. </span><span>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.</span></span>
文摘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.
文摘<strong>Background:</strong> 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.<strong> Purpose:</strong> The purpose is to evaluate the relationship between menstrual and sanitary hygiene and sexually transmitted diseases (STD) based on syndromic diagnosis<strong> Methods:</strong> 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. <strong>Results:</strong> 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.<strong> Conclusion:</strong> 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.
文摘The prevalence of human immunodeficiency virus (AIDS) and hepatitis B virus among heavy truck drivers and their assistants has been well documented globally in correlation with their behavioral characteristics. The present study aimed to screen for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and behavioral characteristics among heavy truck drivers in Port Sudan. A cross-sectional study was conducted on 274 heavy truck drivers and their assistants who used the highway Port Sudan-Khartoum in Port Sudan city during 2019-2021. Data on behavioral characteristics and substance use habits were collected using a structured questionnaire, and an ELISA test was used to screen for HIV and HBV infections in the study participants. The chi-square test, odds ratio, and confidence intervals were used to find the association between behavioral characteristics and seropositive HIV/HBV. Of the 274 enrolled participants, the seroprevalence rates of HIV were 2.7% and HBV was 23.7%. Ninety-four (34.3%) of them had a history of high-risk sexual behavior outside of marriage;only two (0.7%) used condoms;14.2% of participants reported alcohol use;and 1.1% reported drug use. Univariate analysis revealed that having a sex history outside of marriage with ≥1 sex partner and never using a condom with a spouse or casual partner were significant risk factors for HIV and HBV among drivers. Fortunately, we found that most of the drivers reported low alcohol and drug use. Concerning this study, the seroprevalence of HIV and HBV is highly associated with a history of having sex outside of marriage and sexual behavior among truck drivers and assistances. Additional studies are needed to further investigate other STIs and behavioral characteristics associated with factors in truck drivers/assistance in different truck stop regions in Sudan.
基金Supported by National Taiwan University Hospital,Taipei,Taiwan,No.NTUH106-003347(to Sun HY).
文摘BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific region.Examining the HCV care cascade can identify barriers to the completion of HCV treatment and facilitate achievement of HCV micro-elimination in PLWH.AIM To investigate the care cascade of incident HCV infections among PLWH in Taiwan.METHODS PLWH with incident HCV infections,defined as HCV seroconversion,were retrospectively identified by sequential anti-HCV testing of all archived blood samples at National Taiwan University Hospital between 2011 and 2018.All PLWH with incident HCV infections were followed until December 31,2019.The care cascade of HCV examined included all incident HCV-infected patients,the percentages of anti-HCV antibodies detected by HIV-treating physicians in clinical care,plasma HCV RNA load tested,HCV RNA positivity diagnosed,referral to treatment assessment made,anti-HCV treatment initiated,and sustained virologic response achieved.Those who had HCV seroconversion during the interferon(IFN)era(2011–2016)and the direct-acting antiviral(DAA)era(2017–2018)were analyzed separately.The duration of HCV viremia—from the date of seroconversion to viral clearance by treatments or until the end of observation—and the incidence of sexually transmitted infections(STIs)during the HCV viremic period were estimated.RESULTS During the study period,287 of 3495(8.2%)PLWH(92.3%being men who have sex with men)who were HCV-seronegative at baseline developed HCV seroconversion by retrospective testing of all archived blood samples.Of the 287 incident HCV infections,277(96.5%)had anti-HCV antibodies detected by HIV-treating physicians,270(94.1%)had plasma HCV RNA determined and 251(87.5%)tested positive for HCV RNA.Of those with HCV viremia,226(78.7%)were referred to treatment assessment,215(74.9%)initiated anti-HCV treatment,and 202(70.4%)achieved viral clearance.Compared with that in the IFN era,the median interval from HCV seroconversion by retrospective testing to detection of HCV seropositivity by HIV-treating physicians was significantly shorter in the DAA era{179 d[interquartile range(IQR)87-434]vs 92 d(IQR 57-173);P<0.001}.The incidence rate of STIs in the DAA vs the IFN era was 50.5 per 100 person-years of follow-up(PYFU)and 38.5 per 100 PYFU,respectively,with an incidence rate ratio of 1.31(95%confidence interval 0.96-1.77),while the duration of HCV viremia was 380 d(IQR 274-554)and 735 d(IQR 391-1447)(P<0.001),respectively.CONCLUSION While anti-HCV therapies are effective in achieving viral clearance,our study suggests more efforts are needed to expedite the linkage of PLWH diagnosed with incident HCV infections to HCV treatment.
文摘Objective:To identify the prevalence,determinants of reproductive tract infection,and healthcare seeking behavior among ever married women of reproductive age residing in an urban slum of Faridabad,Haryana,North India.Methods:This community based cross-sectional study was conducted among ever married women aged between 15 and 49 years insured under employees state insurance scheme and residing in an urban slum of Faridabad.Simple random sampling technique was used to interview 149 eligible women using a predesigned structured questionnaire.Study variables included sociodemographic profile,family planning methods,menstrual absorbent usage,and symptoms of reproductive tract infection.Binary logistic regression was used to investigate the determinants of reproductive tract infection.Results:Of the women,46.3%had at least one reproductive tract infection or sexually transmitted infection symptom and 28.9%among them sought treatment for the symptom.Vaginal discharge,itching(14.1%)and lower abdominal pain(30.2%)were the major symptoms reported.Non-usage of condoms as contraceptive was significantly associated with a higher rate of symptoms(50.4%vs.20.0%).Abortion had a significantly high odds of having reproductive tract infection symptoms(aOR 3.71,95%CI 1.59-8.62;P<0.01).Less frequent change in absorbent during menstruation was also reported to have a higher rate of symptoms.The majority of those who took treatment sought it from government or employees state insurance dispensary.2%also went to faith healers.Conclusions:Nearly half of the study population have reproductive tract infection symptom.Abortions and non-usage of condom increase the risk of reproductive tract infection.Menstrual hygiene and condom usage are the significant interventions,which may reduce the prevalence of these symptoms.
文摘Background: Commercial female sex workers (CFSWs) are considered a high-risk group for HIV/AIDs. The prevalence of HIV/AIDs trends to increase among those groups also in Thailand. An adequate perception of the degree to which one is at risk of having HIV is necessary for behavioral change and of safe behaviors. HIV/AIDs risk perception among CFSWs was needed to reduce HIV/AIDs infection. Methods: A cross-sectional study was conducted among 141 CFSWs in Bangkok, Thailand. Participants were selected using convenient and purposive sampling methods for January to October 2019. Self-access questionnaire was used for collecting data with the reliability testing of 0.82. Logistic regression employed to identify adjusted odd ratio between demographic data, sexual behaviors and HIV/AIDs risk perception, p-value less than 0.05 was considered statistically significant. Results: 51.77% of CFSWs perceived themselves at high risk for HIV/AIDs infection. Most CFSWs reported that they did not consistently use condom (57.45%), factors associated with perception risk of HIV/AIDs including education level (adjusted OR = 2.23, 95% CI = 1.07 - 4.54), knowledge of HIV and STDs (adjusted OR = 3.65 and 3.22. 95% CI = 1.89 - 3.91), Condom use (adjusted OR = 2.56, 95% CI = 1.05 - 2.90) years engaged in sex work, age of initiating in sex work, frequency of sex work in the last month and unplanned sex work were significant with risk perception of HIV/AIDs (adjusted OR = 3.33, 2.71, 2.67, 2.56 and 95% CI = 1.99 - 3.84, 1.72 - 3.32, 1.29 - 3.12, 1.05 - 2.78 respectively), and had HIV/STDs test (adjusted OR = 3.22, 95% CI = 2.11 - 3.95). Other used illicit drugs by injection, smoking and alcohol consumption had a strong association with the high perception of HIV/AIDs among CFSWs. Conclusion: Majority of CFSWs with risky sexual behaviors had a high HIV/AIDs risk perception. Effective educational programmes are necessary to enable CFSWs to correctly assess their own HIV/AIDs risk and change risk behaviors based on self-assessment of actual risk.
文摘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.
基金supported by the National Key Research and Development Project(2019YFA0802600)the National Natural Science Foundation of China(No.81901543,81901545,81971333,82001495,32002354)+2 种基金the Fundamental Research Funds for the Central Universities(WK9110000063)the State Key Laboratory of Reproductive Medicine(SKLRM-K201904)the Natural Science Foundation of Anhui Provincial of China(1908085QH315).
文摘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.
文摘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.
文摘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.
基金US National Institutes of Health(R21-HD065525"Conditional economic incentives to reduce HIV risk:A pilot in Mexico"and R34-MH114664"PrEP Seguro:Antiretrovial-Based HIV Prevention Among Men at High Risk in Mexico",PI:Galarraga)Additional support was provided to A.Zullo by the Agency for Healthcare Research and Quality(K12-HS022998)+4 种基金B.Marshall is supported by the National Institute on Drug Abuse(DP2-DA040236)by a Henry Merrit Wriston Fellowship from Brown UniversityM.Lurie is supported in part by US NIH National Institute of Child Health and Development grant(R24-HD077976)1R01 MH 106600-01 from the National Institute of Mental Health.This research was facilitated by the Providence/Boston Center for AIDS Research(P30AI042853)it also benefited from support to the Population Studies and Training Center(PSTC)at Brown University,which receives core support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development(P2C-HD041020).
文摘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.
基金This project has been partially supported by National Institute of Child Health and Human Development of the National Institutes of Health under award number R01HD086794by grants from the National Science Foundation(DMS1263374)the Office of the President of ASU,and the Office of the Provost at ASU.The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
文摘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.
文摘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.
文摘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.
文摘Aim: To determine the most common risk factors of male infertility in Mongolian men attending an infertility clinic. Methods: A prospective, case-control study was conducted in which 430 men were enrolled. All the men had sought their first infertility evaluation between 1998-2002 in the State Research Center on Maternal Child Health, Ulaanbaatar, Mongolia. They were divided into two groups depending on the results of their semen analysis: 191 with abnormal semen and 239 with normal semen profile. Univariate and multivariate analyses were performed to determine any association between risk factors and semen abnormality. Results: Logistic regression analysis demonstrated that the testicular volume, a history of sexually transmitted infections (STI), epididymitis and testicular damage all have statistically significant associations with semen abnormality, when controlled for multiple risk factors. Adjusted odds ratios of 3.4 for mumps orchitis, 2.3 for other orchitis and 3.9 for testicular injury were found. Gonorrhoea, the most commonly reported STIs in this study, gave an adjusted odds ratio of 1.0 for having one or more sperm abnormality. An adjusted odds ratio for subjects with a history of other STIs was 2.7. However, as a predictor of azoospermia, STIs had very high odds ratio, being 5.6 in patients with gonorrhoea and 7.6 in patients with other STIs. Conclusion: A history of pathology involving testicular damage appeared to have the strongest impact on male infertility in Mongolia. STIs have less impact on semen quality except when complicated by orchitis, epididymitis and vasal obstruction.
基金This study was supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq),Grant#551245/2007-7.
文摘Background: Adolescents are disproportionally affected by sexually transmitted infections (STI). Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) are the most frequent curable STI in adolescents, causing serious consequences for their reproductive health. Therefore, we aimed to determine the prevalence and incidence of CT and TV, as well as their risk factors in pregnant adolescents from Belém, northern Brazilian Amazon. Methods: This prospective study enrolled 199 adolescents up to 20 weeks of pregnancy. They were scheduled for follow-up visit between 28 and 29 weeks of pregnancy. Sociodemographic and behavioral data were obtained by interview. Cervicovaginal samples were taken to test for TV, CT, Neisseria gonorrhoeae and bacterial vaginosis. Univariate and multivariate analyses were performed to test the association of prevalent/incident CT and TV with the variables. Results: Prevalence of cervical CT infection was 33.7% (n = 67/ 199), and for trichomoniasis it was 4.0% (n = 8/199). Cervical ectopy increased the risk for prevalent CT (OR, 1.93;95% CI, 1.01 - 3.70), while having treated vaginal discharge in the past (OR, 0.51;95% CI, 0.26 - 0.98) and being married (OR, 0.10;95% CI, 0.01 - 0.83) were protective against current CT and TV, respectively. Among the 95 (47.7%) adolescents who completed follow-up, 15 cases of incident CT were identified. Incident CT was associated with having a formal or informal job (OR, 28.4;95% CI, 2.1 - 391.6) and bacterial vaginosis treatment at the baseline (OR, 0.08;95% CI, 0.01 - 0.69). Conclusion: Prevalence and incidence rates of TV and CT are high in this population devoid of STI routine screening. Treatment of bacterial vaginosis may benefit this population by reducing risk for CT acquisition.
文摘Syphilitic periostitis is not a common manifestation of bone involvement in congenital and acquired late syphilis, and it’s rarely seen in secondary syphilis. Syphilis should be considered as a differential diagnosis in patient with deep bony pain that worsens at night. We report a case of secondary syphilis presented with multiple bony swelling of both tibiae (sabre-like) and other long bones.