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Background: Sexually transmitted infections (STIs) promote Human immunodeficiency virus (HIV) transmission by augmenting HIV infectiousness and susceptibility. In our society, especially in rural areas, males are common visitors t...
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Background: Sexually transmitted infections (STIs) promote Human immunodeficiency virus (HIV) transmission by augmenting HIV infectiousness and susceptibility. In our society, especially in rural areas, males are common visitors to STI clinic than females who are generally traced as a contact. This difference may be due to the asymptomatic nature of infections in females, lower awareness among women of need for availing medical facilities, or their frequent consultation in gynecological clinics instead of STI clinics. Aim: To determine the prevalence, clinical profile, and the pattern of STIs in males and the prevalence of HIV infection in them at a rural-based tertiary care center. Materials and Methods: A retrospective study of male cases attending STI clinic between January 2008 and December 2009 was carried out. Diseases were diagnosed on the basis of clinical morphology of the lesion, and HIV and Venereal disease research laboratory (VDRL) testing was done in all cases. Results: Of 23 433 male patients presenting at the Skin/ VD department, 201 were diagnosed to have STI. Most common age group affected was 25 to 44 years (59.7%). Incidence of STI was high among married individuals (77.2%). Herpes genitalis was most common STI in 49 (24.37%) cases. Viral infections (herpes genitalis, genital warts, and molluscum contagiosum) accounted for 62.2% of cases. Prevalence of HIV in STI was 2.48%. Conclusions: The persistent and recurrent nature of viral infections is responsible for their increasing trend in the current STI scenario. HIV and STIs are perfect examples of epidemiologic synergy as they are core transmitters of each other. STI being higher in married individuals further underlines the importance of contact tracing, counseling, and prompt management of the partners.
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The aim of this study was to investigate the incidence of reinfection with sexually transmitted infection (STI) and its possible predicting factors among patients reattending a department of genitourinary (GU) medicine. The method...
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The aim of this study was to investigate the incidence of reinfection with sexually transmitted infection (STI) and its possible predicting factors among patients reattending a department of genitourinary (GU) medicine. The method included a retrospective study on consecutive patients re-screened for STI in a busy department of GU medicine between January 1996 and April 2005. Cox regression model was used to investigate the association of age, gender, sex group, previous STI, counselling for an STI on the last attendance, number of sexual partners in the previous attendance episode, condom use and the number for partners with whom they had unprotected sex, with STI at current screening. The results show that 302 consecutive patients with more than two attendance episodes were included in the study. Patients were mostly women (92%), younger than 35 years (80%) and heterosexual (98%). At baseline, 70 (23%) patients had STI. The incidence density of STI at the end of follow-up period was 15.69/100 person-years. Testing positive for an STI was associated with age younger than 25 years (hazard ratio 2.70 [95% confidence interval 1.70–4.57]; P = 0.000). In conclusion, our study confirmed the improvement in access to GU medicine services, encouragement of patients with an STI for re-screening on regular basis and use of novel STI counselling strategies, especially for younger patients may reduce the incidence of subsequent STI.
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An isocratic online-enrichment HPLC-assay was developed allowing for the simple and fast separation and quantitation of STI-571 and its main metabolite N-desmethyl-STI (N-DesM-STI) in plasma, urine, cerebrospinal fluid (CSF), cult...
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An isocratic online-enrichment HPLC-assay was developed allowing for the simple and fast separation and quantitation of STI-571 and its main metabolite N-desmethyl-STI (N-DesM-STI) in plasma, urine, cerebrospinal fluid (CSF), culture media and cell preparations in various concentrations using UV-detection at 260 nm. The analytical procedure consists of an online concentration of STI-571 and N-DesM-STI in the HPLC system followed by the elution on a ZirChrom-PBD analytical column. Time of analysis is 40 min including the enrichment time of 5 min. The detection limit is 10 ng/ml in plasma, CSF, culture medium (RPMI) and 25 ng/ml in urine for both STI-571 and N-DesM-STI. The intra-day precision, as expressed by the coefficient of variation (CV), in plasma samples ranges between 1.74 and 8.60% for STI-571 and 1.45 and 8.87% for N-DesM-STI. The corresponding values for urine measurements are 2.17–7.54% (STI-571) and 1.31–9.51% (N-DesM-STI). The inter-day precision analyzed over a 7-month time period was 8.31% (STI-571) or 6.88% (N-DesM-STI) and 16.45% (STI-571) or 14.83% (N-DesM-STI) for a concentration of 1000 ng/ml in plasma and 750 ng/ml in urine, respectively. Moreover, we demonstrate that with an alternative, but more time and labor consuming sample preparation and the implementation of electrochemical detection, a detection limit <10 ng/ml can be achieved. The method described was used to perform pharmacokinetic measurements of STI-571 and N-desmethyl-STI in patient samples and for kinetic measurements of intracellular STI-571 and N-DesM-STI following in vitro incubation.
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Background. In 2018, the municipal Sexual Health Clinic in Seattle, implemented trans-inclusive questions about sexual behavior, anatomy, gender-affirming surgeries, and sexually transmitted infection (STI) symptoms in the clinic'...
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Background. In 2018, the municipal Sexual Health Clinic in Seattle, implemented trans-inclusive questions about sexual behavior, anatomy, gender-affirming surgeries, and sexually transmitted infection (STI) symptoms in the clinic's computer-assisted self-interview (CASI) to improve care for transgender and nonbinary (TNB) patients. Methods. We calculated test positivity, the proportion of TNB patient visits that received testing for human immunodeficiency virus (HIV); syphilis; pharyngeal, rectal, and urogenital gonorrhea (GC); and chlamydia (CT) before (5/2016-12/2018) and after (12/2018-2/2020) implementation of new CASI questions, and the proportion of asymptomatic patients who received anatomic site-specific screening based on reported exposures.
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Taking the pioneer efforts made in Nigeria as a case, this paper discusses the challenges associated with undertaking R&D surveys in a developing country. The 2006/2007 survey of R&D activities in Nigeria was carried out in both the higher education and government sectors, using the Frascati Manual as guide. In all, 75 universities and 62 research institutes were surveyed with an overall response rate of 73.8%. Among several, the adaptation of definitions and methodologies prescribed in the Manual -designed with developed economies in mind - was a major challenge. We conclude that for R&D indicators to become more relevant for economic policy in developing countries survey methods and indicators should be adapted or new ones developed to reflect the local realities of STI systems. Agriculture, informal economy and indigenous knowledge are three important aspects of African system that S&T indicators, to date, do not cover....
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Taking the pioneer efforts made in Nigeria as a case, this paper discusses the challenges associated with undertaking R&D surveys in a developing country. The 2006/2007 survey of R&D activities in Nigeria was carried out in both the higher education and government sectors, using the Frascati Manual as guide. In all, 75 universities and 62 research institutes were surveyed with an overall response rate of 73.8%. Among several, the adaptation of definitions and methodologies prescribed in the Manual -designed with developed economies in mind - was a major challenge. We conclude that for R&D indicators to become more relevant for economic policy in developing countries survey methods and indicators should be adapted or new ones developed to reflect the local realities of STI systems. Agriculture, informal economy and indigenous knowledge are three important aspects of African system that S&T indicators, to date, do not cover.
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Abstract Purpose Annual screening for asymptomatic infections with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) is recommended by international guidelines in people living with HIV but uptake in routine care remains p...
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Abstract Purpose Annual screening for asymptomatic infections with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) is recommended by international guidelines in people living with HIV but uptake in routine care remains poor. This study analyzed the effects of the implementation of a CT/NG screening program in a primary HIV treatment center.Methods In this single-center cohort study, we included men having sex with men (MSM) living with HIV during the study period from January 2016 to December 2019. From January 2018 on, annual sexual health counseling including CT/NG screening was proactively offered to all MSM presenting at the center. CT/NG screening rates, test positivity rates and case detection rates in the years 2018 and 2019 were compared to those in the years 2016 and 2017.Results A total of 234 patients were enrolled in the study contributing to 798.7 patient years (py) during the four-year study period. Screening rates increased from 3.1% and 3.9% in 2016 and 2017 to 51.1% in 2018 and decrease to 35.4% in 2019. Over the study period, 19.7% (46/234) had at least one positive CT/NG result. After the intervention, case detection per 100 py increased for CT (2016: 2.6, 2017: 3.7, 2018: 7.7, 2019: 7.1) and NG (2016: 3.2, 2017: 3.1, 2018: 5.3, 2019: 7.6). The number needed to test was 8.9 for CT and 10.4 for NG.Conclusion Regular CT/NG screening is feasible in a primary care setting, leads to an increase in case detection and may contribute to decrease transmission and complications of CT/NG.Trial registration The trial is registered in ClinicalTrials.gov (NCT02149004).
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Background Guidelines recommend annual screening for gonorrhea/chlamydia in sexually active people with HIV at multiple sites (urogenital, oropharyngeal, rectal). In the first year of multisite screening at our Ryan White HIV/AIDS...
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Background Guidelines recommend annual screening for gonorrhea/chlamydia in sexually active people with HIV at multiple sites (urogenital, oropharyngeal, rectal). In the first year of multisite screening at our Ryan White HIV/AIDS Program clinic, we studied (1) sexual history documentation rate, (2) sexually transmitted infection (STI) screening rate, (3) characteristics associated with STIs, and (4) the percentage of extragenital STIs that would have been missed without multisite screening. Methods Participants were ≥14 years old with ≥1 in-person medical visit at our clinic in 2019. Descriptive analyses were performed, and adjusting for number of sites tested, a log-binomial model was used to estimate the association between characteristics and STI diagnosis in men. Results In this cohort (n?=?857), 21% had no sexual history recorded. Almost all STI diagnoses were among males (99.3%). Sixty-eight percent (253/375) received appropriate urogenital testing, 63% (85/134) received appropriate oropharyngeal testing, and 69% (72/105) received appropriate rectal testing. In male participants with ≥1 STI test (n?=?347), Hispanic ethnicity and having a detectable HIV viral load were associated with an STI diagnosis. Of those diagnosed with an STI who had multisite testing, 96% (n?=?25/26) were positive only at an extragenital site. Conclusions Screening rates were similar across all anatomical sites, indicating no obvious bias against extragenital testing. In males, STIs were more frequently diagnosed in people who identify as Hispanic and those with detectable viral loads, which may indicate more condomless sex in these populations. Based on infections detected exclusively at extragenital sites, our clinic likely underdiagnosed STIs before implementation of multisite screening.
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Objective:To determine whether patients attending an urban STI clinic can accurately identify the STIs for which they were tested.Methods:Participants completed a self-administered survey assessing demographics, reason for visit, ...
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Objective:To determine whether patients attending an urban STI clinic can accurately identify the STIs for which they were tested.Methods:Participants completed a self-administered survey assessing demographics, reason for visit, perceived STI testing performed, and patient satisfaction. Chart review was conducted for verification of STI testing.Results:40.7% of participants were able to correctly identify the STIs for which they had been tested. Education level greater than a high school diploma was significantly associated with a patient's ability to correctly identify tests performed.Conclusions:Patients presenting to STI clinics are generally unaware of which STI tests were done. Providers performing STI testing should inform patients of all tests performed, as well as common STIs for which they have not been tested.
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Objective: This research sought to delineate the pathways that link experiences of abuse in women's lives to heightened risk for sexually transmitted infections (STIs), including HIV/AIDS. It was hypothesized that ethnically diver...
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Objective: This research sought to delineate the pathways that link experiences of abuse in women's lives to heightened risk for sexually transmitted infections (STIs), including HIV/AIDS. It was hypothesized that ethnically diverse abused women would not only be at greater risk for STI/HIV than their nonabused counterparts but would also experience unique, abuse-related risks.
Methods: In order to bridge the findings of previous studies examining abuse-generated sexual risk, this study employed a mixed-method approach that elicited data from both life-history interviews of 28 abused women and structured interviews with 215 abused and nonabused women. In the first stage of analysis, multiple coders used a combination of inductive/open and deductive/precoded text analysis to delineate patterns of sexual risks in transcripts of abused women's life histories. Next, correspondence analysis, a tool that graphically illustrates the degree of similarity or difference between variables and participants, was performed on structured interview data in order to ascertain the relationship between specific risk factors and participants' levels of abuse/affection. Logistic regression of structured data tested for the effects of ethnicity.
Results: Both life-history and structured interview data revealed that a history of violence heightens STI/HIV risk in multiple interrelated ways, which include depression, substance abuse, exchange sex, first sex at an early age, high numbers of lifetime and current sexual partners, unfaithful partners, and inability to negotiate safe sex. As the severity/frequency of lifetime abuse increased, so too did sexual risk regardless of standard sociodemographic factors or ethnicity of participants.
Conclusions: The domestic violence literature indicates an association between violence and STI/HIV risk. Findings from this mixed-method research provide a detailed account of the pathways that link the two.
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