Prevalence and risk factors of Sexually Transmitted Infections (STI) among persons living with HIV attending the STI Clinic in Trinidad

Objective: To determine the prevalence and risk factors for sexually transmitted infections (STIs) among persons living with HIV (PLHIV) attending the STI Clinic in Trinidad. Design and Methodology: A cross-sectional study of STI prevalence among PLHIV attending the STI Clinic in Trinidad was conducted during the period April-September 2014. A questionnaire was administered to obtain socio-demographic data and risk factors for STI infections, a physical examination was carried out and patients were screened for STIs. Data were analysed using SPSS Version 22. Results: A total of 210 HIV infected patients (138 males [65.7%] and 72 females [34.3%]) were enrolled; age range 17-68 years, mean age 36.4 years. Of these, 68 (32.4%) were newly HIV diagnosed and 142 (67.6%) had a known history of HIV infection. Seventy-eight (37.1%) of the 210 patients were concurrently diagnosed with a STI. Homosexual/ bisexual study patients were more likely to be diagnosed with a STI (OR, 3.56; 95% CI, 1.94- 6.51) and more likely to be diagnosed with syphilis (OR, 4.84; 95% CI, 2.40-9.77). Multivariate analysis using binary multiple regression showed that risk factors for STIs included male sex (OR, 2.46; 95% CI, 1.06-5.73), homosexual/bisexual sexual orientation (OR, 2.26; 95% CI, 1.06-4.80) and multiple sex partners within the past 12 months (OR, 1.99; 95% CI, 1.03-3.86). Conclusion: There is a high prevalence of STIs among PLHIV in this study, especially among homosexual/ bisexual sexual males in whom the most commonly diagnosed STI was syphilis. Hence targeted HIV/STI prevention efforts are urgently needed in these patients.

National communicable diseases digest: Epidemiological week 16

This communicable diseases digest offers a summary of incidence rates for the Ministry of Health's epidemiological week 16. It draws on weekly data retrieved through the Belize Health Information System (BHIS) which seeks to improve individual health outcomes and public health performance as well as to optimize resource utilization. Using graphics, national, seasonal and weekly trends are compared for the following: Acute Respiratory Infections (ARIs), a leading cause of death among children under the age of five; Severe Acute Respiratory Infections (SARIs), which have the potential for large scale epidemics; Gastrointestinal Diseases; Vector Borne Diseases; Sexually Transmitted Infections (STIs); and Other Communicable Diseases/Outbreaks/Public Health related incidents.

National communicable diseases digest: Epidemiological week 17

This communicable diseases digest offers a summary of incidence rates for the Ministry of Health's epidemiological week 17. It draws on weekly data retrieved through the Belize Health Information System (BHIS) which seeks to improve individual health outcomes and public health performance as well as to optimize resource utilization. Using graphics, national, seasonal and weekly trends are compared for the following: Acute Respiratory Infections (ARIs), a leading cause of death among children under the age of five; Severe Acute Respiratory Infections (SARIs), which have the potential for large scale epidemics; Gastrointestinal Diseases; Vector Borne Diseases; Sexually Transmitted Infections (STIs); and Other Communicable Diseases/Outbreaks/Public Health related incidents.

National communicable diseases digest: Epidemiological week 19

This communicable diseases digest offers a summary of incidence rates for the Ministry of Health's epidemiological week 19. It draws on weekly data retrieved through the Belize Health Information System (BHIS) which seeks to improve individual health outcomes and public health performance as well as to optimize resource utilization. Using graphics, national, seasonal and weekly trends are compared for the following: Acute Respiratory Infections (ARIs), a leading cause of death among children under the age of five; Severe Acute Respiratory Infections (SARIs), which have the potential for large scale epidemics; Gastrointestinal Diseases; Vector Borne Diseases; Sexually Transmitted Infections (STIs); and other Communicable Diseases/Outbreaks/Public Health related incidents.

National communicable diseases digest: Epidemiological week 20

This communicable diseases digest offers a summary of incidence rates for the Ministry of Health's epidemiological week 20. It draws on weekly data retrieved through the Belize Health Information System (BHIS) which seeks to improve individual health outcomes and public health performance as well as to optimize resource utilization. Using graphics, national, seasonal and weekly trends are compared for the following: Acute Respiratory Infections (ARIs), a leading cause of death among children under the age of five; Severe Acute Respiratory Infections (SARIs), which have the potential for large scale epidemics; Gastrointestinal Diseases; Vector Borne Diseases; Sexually Transmitted Infections (STIs); and other Communicable Diseases/Outbreaks/Public Health related incidents.

Sexually transmitted infections among PLHIV attending the STI clinic in Trinidad

OBJECTIVE: The purpose of this study was to determine the sexually transmitted infection (STI) prevalence in HIV infected patients, so as to better understand the common trends in HIV/STI transmission in this population, so that appropriate HIV/STI prevention strategies may be designed. SUBJECTS AND METHODS: A chart review study of STI prevalence among people living with HIV (PLHIV) attending an STI clinic in Trinidad was conducted during the period January–December 2012. Data were abstracted from client records and laboratory log books to obtain the clinical and the laboratory diagnoses of STIs and analysed using SPSS version 22. RESULTS: A total of 385 PLHIV (168 males [43.6%] and 217 females [56.4%]) were seen during this period; age range 16–77 years, mean age 36.5 years. Of these, 104(27.0%) were newly HIV diagnosed and 281 (73.0%) had a known history of HIV infection. An STI was concurrently diagnosed in 135 (35.1%) of the 385 PLHIV and 18 (4.7%) had two concurrent STIs. In patients with known HIV infection, 117 (48.6%) patients were diagnosed with an STI compared to 18 (17.6%) patients newly diagnosed with HIV infection (p < 0.001). The most common STIs included syphilis = 51 (13.2%), genitalwarts = 46 (11.9%), non-gonococcal urethritis/cervicitis =27 (7.0%), genital herpes = 17 (4.4%), gonorrhoea = 6(1.6%) and trichomoniasis = 6 (1.6%). CONCLUSION: The STI prevalence is high among patients with known HIV infection in Trinidad, identifying them as a critical target group for efforts to prevent the spread of HIV and STIs.

There's no easy way to say this... STD partner-notification via an e-card

This chapter explores the online sexually transmitted disease (STD) partner-notification service, InSPOT, found at www.InSPOT.org. This chapter seeks to understand the interpersonal issue of low partner self-disclosure rates and offers a critical view of the online notification method through a rhetorical perspective. Tetradic analysis of the health campaign exploits the technological power of this new disclosure strategy. It also reveals both positive and negative enhancements, obsolescences, retrievals, and reversals that are brought about by online partner notifications via e-card. As society turns more technological, this study is essential to understanding how the Internet can be channeled by health organizations and individuals infected with STDs. Given STD rates in the Caribbean and worldwide, the research suggests that InSPOT has great potential for increasing communication and slowing the spread of disease; yet if left unaltered, InSPOT has great potentials for furthering the silence surrounding STDs and consequently increasing the spread of disease. Conclusions and recommendations for improving the partner notification service are highlighted. These conclusions are valuable for not only students of communication but health practitioners and individuals infected with communicable diseases.

Changes in HIV needs identified by theNational AIDS Hotline of Trinidad and Tobago

OBJECTIVES: To examine utilization of the National AIDS Hotline of Trinidad and Tobago (AIDSLINE), evaluate its validity as a reliable data source for monitoring national HIV-related needs, and identify changes in caller requests between two different time periods. METHODS: A total of 7 046 anonymous hotline calls in 1998–2002 (T1) and 2 338 calls in 2007 (T2) were analyzed for associations between caller characteristics and call content. A subsample of the data was also analyzed qualitatively. T1 findings were compared with HIV-related data collected by national policy-makers during that period, to evaluate the hotline's validity as a data source, and findings from T2, to reveal changes in call content over time. RESULTS: In T1, the hotline was well utilized for information and counseling by both the general population and those living with HIV/AIDS. Call content from T2 indicated an increase versus T1 in 1) general awareness of HIV and other sexually transmitted diseases; 2) HIV testing; and 3) knowledge of HIV symptoms and transmission. HIV-related mental health needs, and the relationship between HIV and both child sexual abuse (CSA) and intimate partner violence (IPV), were identified as emerging issues. CONCLUSIONS: AIDSLINE is a well-utilized tool for providing information and counseling on national HIV-related issues, and a valid, cost-effective, easily accessed information source for planners and policy-makers involved in HIV management. Over the two study periods, there was an increase in HIV awareness and testing and in requests related to mental health, CSA, and IPV, but no change in sexual behaviors.

Caribbean Epidemiology Centre: annual report 2006

This report summarises the health situation, issues of unit management and perspectives for the way foward. Several emerging diseases pose a threat to the health of the Caribbean people. These include avian influenza and chickungunya, a disease spread by the Aedes aegypti. Measures have been put in place at CAREC and in countries to address the possibility of pandemic influenza. Many of the leading causes of morbidity and mortality have behavioural determinants such as diet and physical activity; alcohol, tobacco and drug use; sexual behaviour; road use behaviour; conflict resolution behaviour; personal and environmental hygiene and health care seeking behaviour. Strategies to reduce morbidity and mortality include personal commitment to a health lifestyle, intersectoral collaboration and policy initiatives of governments. The annual report for the most part describes the work undertaken by the Centre's Divisions. Technical cooperation was provided using several modalities including surveilance, advocacy, policy and norms, dissemination of information,resource mobilization and capacity building.

Clinical profile of patients newly diagnosed with human immunodeficiency virus [abstract]

OBJECTIVE: Comprehensive medical examination of newly presenting patients infected with the human immunodeficiency virus (HIV) is important to establish health status and stage disease progession. This study was conducted to determine the clinical and epidemiological characteristics of persons newly diagnosed with HIV presenting a primary care clinic for sexually transmitted infections (STIs). METHODS: A retrospective analysis of the medical records of 125 patients (aged 13 years and over) was undertaken over a 12-month period. All patients were serologically confirmed positive for HIV. Information abstracted included socio-demographic factors, presenting complaints and medical examination findings. The EPI Info 6 software was used for data entry and analysis. RESULTS: Most patients (64 percent) were between 20 and 39 years old (range 14-68 years; M:F= 1:1.4). Five percent were homosexuals/bisexuals. Sixty-five per cent used a condom less than half the time and 10 percent never used condoms. Males were more likely than females to have had multiple sex partners during the last three months (p= 0.01). Initial assessment revealed that 53 percent were asymptomatic, 24 percent symptomatic and 21 percent had AIDS at time of presentation. The most common presentation was generalised by lymphadenopathy (67 percent), which was significantly higher than skin rash (27 percent), oral candidiasis (24 percent), cough (24 percent), weight loss (24 percent), and pallor of mucous membranes (19 percent. p< 0.001). Co-infection with syphilis occurred in five percent of patients. CONCLUSIONS: This study confirms that young people continue to account for the majority of cases of newly diagnosed HIV infection. Heterosexual mode of transmission predominates and women are disapropriately affected. HIV infection should be considered as a differential in patients who have persistent generalized lymphadenopathy and other risk factors. (AU)

Sexually transmitted disease symptoms. A comparative analysis of male and female youth in Jamaica

Data from Reproductive Health Survey 1997 were used to examine symptoms of (STD) and sex behaviour of adolescents and young adults in Jamaica. Overall, nine per cent of the sample reported symptoms of STD in the year prior to the survey. Rates of high-risk sexual behaviours were high with one-fifth of the sample reporting multiple sex partners in the last three months. Slightly more than half reported condom use at coitus. Logistical regression analyses indicated that being older, having multiple sex partners, using condoms inconsistently with steady partners, and having cultural attitudes conducive to high-risk sexual activity were all associated with having symptoms of STD. These findings indicate that certain sub-populations are more likely to have symptoms of STD. STD prevention programmes should recognize the various risk groups at increased risk of STD and, ultimately, HIV. Interventions should be targeted to those who continue to have unprotected sex with multiple sex partners. In addition, cultural factors should be considered in the development of such prevention programes. (AU)

Risky behaviour in Jamaican adolescent patients attending a sexually transmitted disease clinic

The prevalence of sexually transmitted diseases (STD) and risky behaviour patterns were studied in 165 adolescents attending a STD clinic in Jamaica. A standardised structured questionnaire, clinical algorithms for STD and serological tests for HIV and syphilitic infection were applied. High prevalences of risky behaviour including young age at onset of sexual activity, especially in boys, (mean age 12.5 ñ 2.5 years); unprotected sexual intercourse (only 4 percent used condoms consistently); multiple sexual partners (mean 3.8 ñ 2.4 and 1.8 ñ 1.2 for boys and girls, respectively were found. Marijuana, used by 60 percent of the boys, was an independent risk factor for dysuria (adjusted Odds Ratio (OR), 2.0; 95 prcent CI, 1.6 - 3.4). Repeated episodes of STD (33 percent), coinfection with HIV (1.2 percent), syphilis (1.2 percent) and teenage pregnancy (13 percent) were prominent findings. Educational strategies which promote behaviour intervention at an early age, frequent and consistent use of condoms, abstinence or delayed onset of sexual activity are essential to reducing the HIV/AIDS and STD risk in adolescents in Jamaica.(Au)

El VIH y el sida en las Americas: una epidemia con muchas caras / HIV and AIDS in the Americas: an epidemic with many faces

This document presents data that was analyzed at a joint meeting of the Monitoring the AIDS Pandemic Network and the LAtin America and Caribbean Epidemiological Network for HIV/AIDS, held in Rio de Janiero from 4 to 5 November 2000, along with the final recommendations of that meeting. The report focuses on the diversity of the global HIV/AIDS pandemic, a diversity that is particularly evident in Latin America and the Caribbean. After providing an overall perspective on the epidemic in the Americas, the report describes the epidemic in different areas of the Americas: the Andean Subregion, Brazil, the Caribbean, Central America, Mexico, the Southern Cone, and North America. The problem of infections associated with HIV/AIDS is also addressed, especially tuberculosis, as well as other sexually transmitted infections. Also analyzed are achievements and challenges in preventing HIV infection, both in groups that are considered low risk (heterosexual adults) and those of high risk (men who have sex with men, intravenous drug users, young people, and marginalized populations). Other aspects analyzed are efforts to improve HIV surveillance, new antiretroviral agents and their impact, and the prevention of vertical transmission of HIV (AU)

Risk factors for sexually transmitted diseases among females adolescents

OJBECTIVE: To explore the risk factors involved in the occurence of sexually transmitted diseases (STDs) among female adolescents. METHODS: A 38-item pretested questionnaire was administered to a purposive sample of 28 female adolescents, aged 16-19.9 years, diagnosed with more than one sexually transmitted disease, attending the Comprehensive Health Centre, Kingston, Jamaica. Information regarding their socio-demographic characteristics, sex education, sexual behaviour and knowledge of safer sex practices was analysed using SPSS Version 6.13. RESULTS: The median age of their first sexual experience, initiation of alcohol consumption and smoking was 15 years. Sixty-one per cent had one or two children and/or were pregnant. Their reports behaviour was inconsistent with the high scores obtained in the knowledge of safer sex practices. Four of them had HIV. Fifty-seven per cent were unable to say what were their STD diagnosis. Fifty-four per cent had three or more partners, 62 percent consumed alcoholic drinks and 25 smoked cigarettes/marijuana. They seldom used condoms. There was an inverse association between their age at first sexual experience and their number of reported partners (p<.05). CONCLUSION: The early initiation of unprotected sexual activity and substance use in this group of adolescents, the low rate of condom use and the history of multiple partners are a cause for concern. Their apparent knowledge of safer sex practices did not appear to influence their risky behaviour.(Au)

Retrospective audit of blood donation at a Hospital-based blood centre: Implications for blood product supply and safety

An audit of blood donation at the University Hospital of the West Indies (UHWI) was performed between January 1995 and December 1998. During these four years, 21,733 persons attended the blood collection centre and 6,711 (30.8 percent) were rejected as donors. Females accounted for 3, 054 (45.6 percent) of rejected donors while 3,647 (54.4 percent) were males. Females were rejected primarily because of low haemoglobin levels, while rejection was most frequently attributed to symptoms of the common cold and recent drug use. One hunderd and two rejected donors (1.5 percent) admitted to recent treatment of a sexually transmitted disease, and 138 (2.0 percent) presented within 16 weeks of a prior donation. Of 15,022 units donated, altruistic voluntary donations accounted for 307 (2 percent) and 53 (0.3 percent) were autologous donations. Seven hundred and four units (4.6 percent) were discarded because of positivity on initial testing for a marker of transmissible infection. Overall prevalence for markers of infection was 2.5 eprcent for HTLV-1, 0.9 percent for Hepatitis B and 0.4 percent for HIV I/II. Donations at the University Hospital of the West Indies (UHWI) collection centre contributed 15.8 percent of the national blood supply for the period under study.(Au)

Differences in HIV-risk behaviours among recidivists and persons with their first episode of an STD in Guyana

OBJECTIVE: To ascertain differences in HIV-risk behaviour patterns between recidivists and persons having their first episode of an STD. DESIGN AND METHODS: A cross-sectional survey was conducted among 300 consecutive persons who complained of a new STD. RESULTS: 164/300 (55 percent) persons were recidivists while 136 (45 percent) were persons with their first STD episode. Recidivists were more likely to be males odds ratio (OR=1.89; 95 percent CI: 1.16-3.09) and Afro-Guyanese (OR=3.8; 95 percent CI: 1.96-5.50). As compared to recidivists, persons with their first STD episode were more likely to be younger, <20 years old, (23.4 percent vs. 8.8 percent; p=0.009). No significant differences were found between recidivists and first-timers with respect to educational attainment and marital status. As compared to the first-timers, recidivists were significantly less likely to report condom use (OR=0.56; 95 percent CI: 0.31-0.99) and two times more likely to report having had sex for money (OR=2.22; 95 percent CI: 1.23-5.32). No significant differences were found between recidivists and first-timers with respect to mean age of first sexual intercourse and mean number of partners during the past 12 months. Recidivists were more likely to report alcohol use (76.2 percent vs. 58. percent; p=0.003) and use of marijuana (23.2 percent vs. 16.3 percent; p=0.176). CONCLUSIONS: Recidivists were more likely to engage in high-risk sexual behaviour patterns, indicating that they should be targeted by HIV-prevention programmes that focus on the reduction of high-risk sexual practices.(Au)