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1.
Investig Clin Urol ; 65(2): 108-114, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38454819

RESUMO

The Korean Association of Urogenital Tract Infection and Inflammation (KAUTII) and the Korea Disease Control and Prevention Agency updated the guidelines for human papillomavirus (HPV) vaccine against sexually transmitted HPV infections in Korea to respond to changing epidemiologic trends, evolving scientific evidence, and advances in laboratory diagnostics and research. Main purpose and recommendation of vaccination against HPV are as follows: (1) the purpose of HPV vaccine is to reduce the risk of genital warts and HPV-related cancers including cervical and vulvar cancer, head and neck cancer, anal cancer, and penile cancer; (2) in Korea, bivalent (16, 18) vaccines, quadrivalent vaccines (6, 11, 16, 18), and 9-valent vaccines (6, 11, 16, 18, 31, 33, 45, 52, 58) are used depending on the type of HPV; (3) bivalent and quadrivalent vaccines are national immunizations targeting girls aged 11-12 years and low-income young females aged 18-26 years (age and range of inoculation: routinely administered at 11 or 12 years of age, 2 doses at 0 and 6 months for 12-14 years of age; for females aged 15-26 years, 3 doses depending on the type of vaccine; vaccination can be given to those aged up to 45 years through consultation with a clinician); (4) in the case of administering 2 doses, at least 5 months apart; in the case of administering 3 doses, it is recommended to keep 4 weeks between the 1st and 2nd doses, 12 weeks between the 2nd and 3rd doses, and 5 months between the 1st and 3rd doses; (5) immunocompromised patients such as those with HIV, malignant neoplasms, and autoimmune diseases, and those undergoing transplantation or immunosuppressive therapy should receive 3 doses. HPV vaccine is not recommended during pregnancy.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Infecções Sexualmente Transmissíveis , Neoplasias do Colo do Útero , Masculino , Gravidez , Feminino , Humanos , Pré-Escolar , Lactente , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/prevenção & controle , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/complicações , Infecções Sexualmente Transmissíveis/prevenção & controle , Vacinação , Inflamação , Papillomavirus Humano , República da Coreia/epidemiologia
2.
Investig Clin Urol ; 65(2): 115-123, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38454820

RESUMO

Non-gonococcal sexually transmitted infections (STIs) include chlamydia, syphilis, and chancroids. Chlamydia is the most common STI caused by Chlamydia trachomatis and is mainly transmitted through sexual intercourse or vertical transmission at birth. Although symptoms are mostly absent or mild, untreated chlamydial infections in females can lead to pelvic inflammatory disease, chronic pelvic pain, and infertility due to the narrowing of fallopian tubes. Syphilis is caused by Treponema pallidum and is divided into phase I, phase II, latent syphilis, and phase III. The incidence of syphilis, including congenital syphilis, has significantly increased in the United States in recent years. The chronic status of this disease can significantly increase morbidity and potentially affect almost all body organs, which, in rare cases, can lead to death. Additionally, untreated maternal syphilis can lead to fetal death and fatal congenital infections in newborns. Chancroid is an STI caused by Haemophilus ducreyi, and its prevalence is gradually decreasing in Korea and worldwide. The symptoms include shallow genital ulcers with suppurative granulomatous inflammation and tender inguinal lymphadenopathy. Chancroids can be differentiated from syphilitic chancres based on their appearance. In contrast to painless chancres, chancroids are painful. Ureaplasma urealyticum, Ureaplasma parvum, and Mycoplasma hominis are considered symbiotic bacteria. Infections caused by these bacteria are usually not considered STIs and do not require treatment unless they are suspected of being associated with infertility. This article presents the 2023 Korean STI guidelines for non-gonococcal bacterial infections.


Assuntos
Infecções Bacterianas , Infertilidade , Infecções Sexualmente Transmissíveis , Sífilis , Recém-Nascido , Feminino , Humanos , Sífilis/complicações , Infecções Sexualmente Transmissíveis/complicações , Infecções Sexualmente Transmissíveis/epidemiologia , Chlamydia trachomatis , Inflamação , República da Coreia
3.
Clin Lab ; 70(3)2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38469784

RESUMO

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are major health concerns worldwide. Recent data indicate a decline in prevalence in the Saudi population; however, there are no data on the prevalence in prisoners. This study is the first to investigate the prevalence of viral hepatitis in female inmates in Jeddah, Saudi Arabia. This study aimed to explore the prevalence of HBV and HCV infections and to assess the knowledge and attitudes related to these infections among inmates. METHODS: Inmates were interviewed using a pre-designed questionnaire, and their blood samples were tested for HBV and HCV infections using serology, PCR, and phylogenetic analysis. RESULTS: The overall prevalence of HBV infection in the study population was 4.4%. The age group > 25 years was predominantly affected; 11.1% of the infected cases were Saudi nationals, and 88.9% were non-Saudis. The prevalence of HCV infection was 2.4%. Among the studied variables, age and previous employment were significantly associated with positive HBV PCR, while conviction, knowledge about protection from sexually transmitted infections (STIs), knowledge about condom use for protection against STIs, and condom use for protection against STIs were significantly associated with HCV infection. CONCLUSIONS: This study shows higher HBV and HCV prevalence in the female prisoners in Briman prison compared to the general population. Uneducated prisoners, over 25 years old, and convicted of prostitution are more associated with both HBV and HCV infection. Future preventive plans should include screening new prisoners with these risk factors for HBV and HCV at the time of entry.


Assuntos
Infecções por HIV , Hepatite B , Hepatite C , Prisioneiros , Infecções Sexualmente Transmissíveis , Humanos , Feminino , Adulto , Prisões , Arábia Saudita/epidemiologia , Filogenia , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Hepatite B/complicações , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Hepatite C/complicações , Fatores de Risco , Infecções Sexualmente Transmissíveis/complicações , Vírus da Hepatite B , Hepacivirus , Prevalência , Infecções por HIV/complicações
4.
Rev Esp Salud Publica ; 982024 Mar 08.
Artigo em Espanhol | MEDLINE | ID: mdl-38477553

RESUMO

OBJECTIVE: Sexually Transmitted Infections (STI), as their name suggests, are infections caused by more than thirty different bacteria, viruses, and parasites and are transmitted through sexual contact, including vaginal, anal, or oral intercourse, although some sexually transmitted infections can also transmitted from mother to child during pregnancy, childbirth and lactation. According to World Health Organization, one of the main populations at risk for acquiring these diseases are sex workers and their clients. Due to the high prevalence, the characteristics and behaviors that favor the development of these diseases are analyzed. The main objective of this paper was to analyze the risk factors in the acquisition of sexually transmitted diseases in the population of sex workers. METHODS: A literature search was conducted in Scopus, Pubmed, CINAHL, Medline, LILACS and IBECS, of observational, longitudinal and mixed methods studies conducted in sex workers and published between January 2011 and March 2021, with a final sample of fourty-three articles. The mixed methods assessment tool (MMAT) was used to assess the methodological quality of the papers. RESULTS: After analyzing the literature, eleven groups of risk factors related to the acquisition of sexually transmitted diseases were obtained, these being economic factors, factors related to sexual practices, drug use, sex work, education, health problems, country of origin and mobility, partner, age, violence and other factors not belonging to the previous categories. CONCLUSIONS: Sex workers have numerous characteristics and behaviors that make them vulnerable to sexually transmitted infections. Of note are years of prostitution, drug use, number of partners and condom use, which are key factors for future prevention and intervention strategies, as well as research.


OBJETIVO: Las Infecciones de Transmisión Sexual (ITS) son infecciones causadas por más de treinta bacterias, virus y parásitos diferentes, que se transmiten por contacto sexual, incluido el coito vaginal, anal o bucal, aunque algunas infecciones también pueden transmitirse de la madre al hijo durante el embarazo, el parto y la lactancia. Según la Organización Mundial de la Salud, una de las principales poblaciones de riesgo para la adquisición de estas infecciones son los/las trabajadores/as del sexo y sus clientes. El objetivo de este trabajo fue analizar los factores de riesgo en la adquisición de infecciones de transmisión sexual en la población de trabajadores/as del sexo. METODOS: Se realizó una revisión sistemática mediante búsqueda en Scopus, Pubmed, CINAHL, Medline, LILACS e IBECS, de estudios observacionales, longitudinales y mixtos realizados en trabajadores/as del sexo que fueron publicados entre enero de 2011 y marzo de 2021, obteniendo una muestra final de cuarenta y tres artículos. La herramienta de evaluación de métodos mixtos (mixed methods assessment tool) fue utilizada para evaluar la calidad metodológica de los trabajos. RESULTADOS: Después de analizar la bibliografía se obtuvieron once grupos de factores de riesgo relacionados con la adquisición de ITS, siendo estos factores económicos, relacionados con las prácticas sexuales, consumo de drogas, trabajo sexual, educación, problemas de salud, país de origen y movilidad, pareja, edad, violencia y otros factores no pertenecientes a las anteriores categorías. CONCLUSIONES: Las/os profesionales del sexo tienen numerosas características y comportamientos que les convierten en una población vulnerable a las ITS. Destacan los años ejerciendo la prostitución, el consumo de drogas, el número de parejas y el uso del preservativo, siendo estos factores clave para futuras estrategias de prevención e intervención, así como de investigación.


Assuntos
Infecções por HIV , Profissionais do Sexo , Infecções Sexualmente Transmissíveis , Gravidez , Criança , Feminino , Humanos , Preservativos , Transmissão Vertical de Doenças Infecciosas , Espanha , Infecções Sexualmente Transmissíveis/epidemiologia , Comportamento Sexual , Fatores de Risco , Infecções por HIV/epidemiologia
5.
Actas Dermosifiliogr ; 2024 Mar 11.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38479688

RESUMO

Sexually transmitted infections are communicable diseases where the pathogen is transmitted through sexual contact. The Sexually Transmitted Infections Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) is engaged in the drafting of documents to guide dermatologists and health care personnel who treat Spanish patients with these infections. This document analyzes the epidemiological, clinical, therapeutic, and control characteristics of 2 sexually transmitted parasitosis: scabies due to Sarcoptes scabiei var. hominis, and pubic pediculosis due to Phthirus pubis. Both parasitoses share a sort of mixed spread through sexual and community transmission regardless of the route through which the infection was initially acquired. This specific feature creates particularities in the management and control of the infestation.

6.
BMC Womens Health ; 24(1): 171, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38468306

RESUMO

BACKGROUND: Pubic hair grooming involves the partial or complete removal of pubic hair, and it is a common practice among men and women. Grooming is more prevalent in women, who employ various methods such as shaving, waxing and laser removal. However, it is associated with variable rates of post-grooming adverse outcomes including lacerations and sexually transmitted infections (STIs). To the best of our knowledge, this is the first systematic review and meta-analysis comparing women's sexual health outcomes between those who groom and those who don't. METHODS: We followed the MOOSE guidelines and conducted a computerized-based search using (PubMed, Web of Science, Scopus, and Ovid Medline), till June 20th, 2022, for eligible studies using the relevant keywords; (pubic hair grooming) OR (pubic hair removal OR Genital hairless OR Bikini hair removal OR pubic hair depilation). Cross-sectional studies included which compared grooming practices among women in terms of motivation and health outcomes. Women's satisfaction and incidence of STIs were pooled as standardized mean difference (SMD) and odds ratio (OR) respectively. RESULTS: Twenty-Two cross-sectional studies were included in our review with 73,091 participant.The odds of having gram-negative gonorrheal and chlamydial infection in Pubic hair groomers were found to be statistically significant (OR = 1.55, 95% CI [1.31, 1.84], P < 0.001) (OR = 1.56, 95% CI [1.32, 1.85], P < 0.001] respectively. There was no difference between groomer and non-groomer women regarding viral infections such as genital herpes (OR = 1.40, 95% CI [0.56, 3.50], P = 0.47) and Condyloma acuminata (OR = 1.75, 95% CI [0.51, 6.01], P = 0.37). The most common grooming side effect is genital itching (prevalence = 26.9%, P < 0.001). Non-electrical razor (prevalence = 69.3%, P < 0.001) is the most common grooming method. White women (prevalence = 80.2%, P < 0.001) remove pubic hair more frequently compared to black women (prevalence = 12.2%, P < 0.001). Women practice complete grooming (50.3%, P < 0.001) of the pubic hair more frequently than partial grooming (33.1%, P < 0.001). There are no differences in women's satisfaction between the two groups (SMD = 0.12, 95% CI [-0.16, 0.40], P = 0.39). CONCLUSION: This review aligns with previous observational studies regarding sexual health outcomes of pubic hair grooming. There is a need to raise awareness among women regarding the safe practice of pubic hair grooming, emphasizing the clarification of hazards and benefits.


Assuntos
Remoção de Cabelo , Saúde Sexual , Infecções Sexualmente Transmissíveis , Masculino , Animais , Humanos , Feminino , Estudos Transversais , Asseio Animal , Remoção de Cabelo/efeitos adversos , Cabelo , Infecções Sexualmente Transmissíveis/epidemiologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-38492988

RESUMO

INTRODUCTION: There is discussion about the frequency of STI screening among pre-exposure prophylaxis (PrEP) users. The aim of this study was to analyse the incidence of STIs and to evaluate different screening models in order to optimise the follow-up. METHODOLOGY: A prospective study was conducted between 2017 and 2023, including 138 PrEP users in a STI clinic. Participants were tested for STIs every three months. Unscheduled visits were performed for those with STI-related symptoms or for people who were notified for an STI by a sexual partner. We performed a survival analysis of repeated events, estimating the cumulative incidence (CI) and incidence rate (IR). RESULTS: The overall CI by quarterly screening was 8.3 (95% CI: 7.6-9.1) infections per person over six years, with a decreasing trend. The most frequently diagnosed pathogen was Neisseria gonorrhoeae, with a IR of 0.76 (95% CI: 0.68-0.84). If the frequency of screening is reduced to every six months, the IR of STIs is reduced by (95% CI: 0.5-0.66) infections per user per year, and at 12 months by 0.82 (95% CI: 0.73-0.89). In the case of no pharyngeal or urethral screening, IR is reduced by 0.37 (95% CI: 0.32-0.42) infections per person per year and in those over 35 years of age by 0.33 (95% CI: 0.25-0.4). Eliminating unscheduled visits, the reduction in IR is 0.33 (95% CI: 0.24-0.42). CONCLUSIONS: The incidence of STIs among PrEP users is high, especially in the rectum, but it does not increase over time. STI screening could be optimised reducing the frequency of pharyngeal and urethral testing, particularly in those over 35 years of age. It is essential to redistribute health resources for unscheduled visits, which have been shown to be the most cost-effective screening.

8.
Afr J Prim Health Care Fam Med ; 16(1): e1-e7, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38426781

RESUMO

BACKGROUND:  South African female students' consistent condom use is low, possibly due to personal factors, such as knowledge about sexual reproductive health, attitudes towards safe sex, risk perceptions and condom use, self-efficacy. AIM:  This study aimed to investigate the personal factors that influence condom utilisation among female students. SETTING:  This study was conducted at a higher education institution in the Northern Cape province in South Africa. METHODS:  A quantitative, descriptive survey design was used. Three hundred and eighty five participants were selected using convenience sampling. The research instrument was a self-administered questionnaire, and the data were analysed using the Statistical Package for the Social Sciences, version 28. RESULTS:  Almost two-thirds (250, 64.9%) of participants used condoms to prevent pregnancy, sexually transmitted infections (STIs), and human immunodeficiency virus (HIV). Although attitudes towards safe sex were generally positive, low risk perceptions were reported. Consistent use of condoms was found in 32.2% (124) of participants, while 45.3% (174) participants used condoms inconsistently or never. A significant finding was that consistent use increased the likelihood of negotiating for a condom with partners by 9.14 times and confidence in putting one on for a partner by 8.05 times. CONCLUSION:  The findings depict average levels of the use of condoms among female students. Prevention efforts should concentrate on educating female students to strengthen condom use and self-efficacy.Contribution: This study, supporting existing literature, suggests that preventative efforts should focus on educating young women about condom use, self-efficacy and encouraging STI conversations with sexual partners.


Assuntos
Preservativos , Infecções Sexualmente Transmissíveis , Gravidez , Humanos , Feminino , Comportamento Sexual , Parceiros Sexuais , Infecções Sexualmente Transmissíveis/prevenção & controle , Estudantes , Conhecimentos, Atitudes e Prática em Saúde
9.
J Am Pharm Assoc (2003) ; 64(1): 186-196.e2, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38453662

RESUMO

BACKGROUND: Rates of sexually transmitted infections (STIs) are rising despite significant management efforts in traditional healthcare settings. The growing number of individuals affected by STIs demonstrates a gap in care. Pharmacy-based STI clinical services are a potential solution to improve care. OBJECTIVE: To identify and summarize research about the implementation of pharmacy-based STI services, focusing on program characteristics, barriers, facilitators, and pharmacist and patient experiences. METHODS: A search of PubMed, Embase, and Cochrane Database of Systematic Reviews was conducted for papers evaluating STI expanded-scope clinical services performed by regulated pharmacists in an outpatient/community pharmacy setting. Study setting, design, data collection method, outcomes, target infection, services offered, patient population, and barriers and facilitators are reported. RESULTS: Twelve studies, 11 cross-sectional and 1 randomized control trial, were identified in this review. All studies focused on chlamydia, and two included gonorrhea and trichomoniasis or syphilis. Eleven services investigated STI screening, with four also offering treatment, and two offering partner treatment. Overall, patients reported positive experiences, found the services accessible, and trusted pharmacists. Pharmacists recognized the importance of STI services, were keen, and felt comfortable performing clinical tasks. Patients described convenience as a key facilitator, and concerns about privacy, particularly at the pharmacy counter, and the stigma and fear of judgement associated with STIs as primary barriers. For facilitators, pharmacists reported increased job satisfaction and a sense of relieving the burden on traditional STI services; for barriers, pharmacists highlighted patient recruitment, communication challenges, and lack of remuneration. CONCLUSION: Research on pharmacy-based STI services includes predominately small-scale, cross-sectional studies, and focuses on chlamydia screening. Both patients and pharmacists perceive these services to be acceptable and feasible, though strategies addressing patient privacy and recruitment, pharmacist competency, training, and remuneration must be considered to support the success of pharmacy-based STI services.


Assuntos
Farmácias , Farmácia , Infecções Sexualmente Transmissíveis , Humanos , Estudos Transversais , Revisões Sistemáticas como Assunto , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Farmacêuticos , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Eur J Med Res ; 29(1): 157, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454476

RESUMO

The vaginal microbiota plays an important role in the health of the female reproductive tract and is closely associated with various pregnancy outcomes and sexually transmitted diseases. Plenty of internal and external factors have strong influence on the changes in a woman's vaginal microbiome. However, the effect of a high-altitude on female vaginal microbiota has not been described. In this study, we characterized the vaginal bacteriome and virome of 13 and 34 healthy women living in high-altitude and sea-level areas, using whole-metagenome shotgun sequencing of their vaginal mucus samples. The results revealed that the vaginal bacteriomes of high-altitude individuals are featured by a significant increase of species diversity, depletion of Lactobacillus crispatus, and more abundant of some anaerobic bacteria, such as Chlamydia trachomatis, Mageeibacillus indolicus, Dialister micraerophilus, and Sneathia amnii). In addition, the vagina samples of sea-level subjects harbor more Lactobacillus strains, whereas the anaerobic bacteroidetes strains mostly appeared in high-altitude subjects. Identified and assembled 191 virus operational taxonomic units (vOTUs), there were significant differences in the abundance of 107 vOTUs between the two groups. Together, the results of this study raised the understanding of bacteriome and virome in the vagina of women at different elevations, and demonstrated that the vaginal microbiome is related to the high-altitude geographic adaptation.


Assuntos
Microbiota , Infecções Sexualmente Transmissíveis , Vírus , Gravidez , Feminino , Humanos , Viroma/genética , Altitude , Vagina/microbiologia
12.
PLoS One ; 19(3): e0290574, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38489281

RESUMO

OBJECTIVE: High prevalence of sexually transmitted infections (STIs) combined with poor antimicrobial stewardship are drivers of STI antimicrobial resistance (AMR) especially in resource-limited settings where syndromic case management (SCM) is the norm. We characterized patterns of antibiotic use prior to clinic attendance and study enrollment in Ugandan men with urethral discharge syndrome (UDS), evaluated in-clinic prescribing, and the performance characteristics of SCM. METHODS: Participants were recruited from government clinics participating in an existing gonococcal surveillance program in Kampala, Uganda. Questionnaires including antimicrobial use prior to attendance, prior episodes of UDS, penile swabs, and blood samples were collected. Bivariable and multivariable logistic regression models were used to estimate odds ratios (OR) for preselected factors likely to be associated with antibiotic use. In-clinic antibiotic treatment data were extracted from clinical notes, and the performance of SCM against laboratory-based STI diagnoses was evaluated. FINDINGS: Between October 2019 and November 2020, 100(40%) of 250 men with UDS reported taking antibiotics in the 14days prior to attending the clinic. Of these 210(84%) had at least one curable STI and 20% had a reactive point-of-care HIV test. Multivariable analysis demonstrated significant associations between recent antimicrobial use and duration of UDS symptoms <6 days (OR 2.98(95%CI 1.07,8.36), p = 0.038), and sex with women only (OR 0.08(95%CI 0.01,0.82),p = 0.038). The sensitivity of SCM ranged from 80.0% to 94.4%; specificity was low between 5.6% and 33.1%. The positive predictive value of SCM ranged from 2.4(95%CI 0.7,6.0) for trichomoniasis to 63.4(95%CI 56.5,69.9) for gonorrhea. CONCLUSION: Pre-enrollment antibiotic use was common in this population at high risk of STI and HIV. Combined with the poor specificity of SCM for male UDS, extensive antibiotic use is a likely driver of STI-AMR in Ugandan men. Interventions to improve antimicrobial stewardship and deliver affordable diagnostics to augment SCM and decrease overtreatment of STI syndromes are required.


Assuntos
Gestão de Antimicrobianos , Gonorreia , Infecções por HIV , Infecções Sexualmente Transmissíveis , Doenças Uretrais , Humanos , Masculino , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/diagnóstico , Uganda/epidemiologia , Antibacterianos/uso terapêutico , Administração de Caso , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Infecções Sexualmente Transmissíveis/epidemiologia , Gonorreia/diagnóstico , Gonorreia/tratamento farmacológico , Gonorreia/epidemiologia , Prevalência
13.
EBioMedicine ; 101: 105037, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38428259

RESUMO

BACKGROUND: Clinical trials showed a single oral dose of doxycycline taken after sex protects against STIs among men who have sex with men (MSM) but not women. Pharmacokinetic data at vaginal, rectal and penile sites of STI exposure are lacking. We examined vaginal, rectal and urethral doxycycline concentrations in men and women to better inform STI prevention. METHODS: Doxycycline pharmacokinetics in male and female participants 18-59 years of age were evaluated in blood and urine and on rectal and vaginal swabs collected at 1, 2, 4, 8, 24, 48, 72, 96 and 168 h after receiving a 200 mg oral doxycycline dose in a non-randomised single dose open label single centre study in Atlanta, Georgia. Rectal, vaginal, and cervical biopsies and male urethral swabs were collected 24 h after dosing (Trial registration: NCT04860505). Doxycycline was measured by liquid chromatography-mass spectrometry. FINDINGS: Eleven male and nine female participants participated in the study. Doxycycline concentrations on rectal and vaginal swabs collected up to 96 h after dosing were approximately twice those of plasma and remained above minimum inhibitory concentrations (MICs) for at least four, three, and two days for Chlamydia trachomatis, Treponema pallidum, and tetracycline-sensitive Neisseria gonorrhoeae, respectively. Geometric mean doxycycline concentrations in male urethral secretions (1.166 µg/mL; 95% CI 0.568-2.394 µg/mL), male rectal (0.596 µg/g; 0.442-0.803 µg/g), vaginal (0.261 µg/g; 0.098-0.696 µg/g) and cervical tissue (0.410 µg/g; 0.193-0.870 µg/g) in biopsies collected 24 h after dosing exceeded MICs. Plasma and urine doxycycline levels defined adherence markers up to four and seven days postdosing, respectively. No adverse events were reported in this study. INTERPRETATION: Doxycycline efficiently distributes to the rectum, vagina and urethra. Findings can help explain efficacy of STI prevention by doxycycline. FUNDING: Funded by CDC intramural funds, CDC contract HCVJCG-2020-45044 (to CFK).


Assuntos
Infecções por Chlamydia , Infecções por HIV , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Masculino , Feminino , Humanos , Doxiciclina/efeitos adversos , Reto , Homossexualidade Masculina , Uretra , Infecções por Chlamydia/microbiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Infecções Sexualmente Transmissíveis/tratamento farmacológico , Infecções Sexualmente Transmissíveis/microbiologia , Vagina , Infecções por HIV/tratamento farmacológico
14.
PLoS One ; 19(3): e0297965, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38483925

RESUMO

When a contagious disease spreads, people wonder about who to blame for transmission. Herein, we document a novel bias, the "First-To-Test" bias, that emerges when individuals assign responsibility for contagion within a dyad. People tend to believe that the member of the dyad who tested positive first is more likely to have given the disease to the other member, even when all other relevant factors are held constant. That is, while using testing order as a basis for assigning responsibility for a dyad's contraction of a contagious disease may be rational in cases where all other relevant factors are not held constant, we show that individuals are more likely to allocate responsibility to whoever tested positive first even when these relevant factors are held constant. This overgeneralization bias emerges regardless of whether the evaluator is an outside observer or the member of the dyad who tested positive first. While we explore this bias with COVID-19 and strep throat, it has implications for other contagious diseases such as sexually transmitted infections (STIs) and illnesses often spread among school children (e.g., influenza, whooping cough). We conclude by discussing its implications for patients and organizations.


Assuntos
COVID-19 , Infecções Sexualmente Transmissíveis , Criança , Humanos , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia , Comportamento Social , COVID-19/epidemiologia , Viés , Cognição
15.
Clin Geriatr Med ; 40(2): 223-237, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38521594

RESUMO

Sexual health is an important but often overlooked health concern of LGBTQ + older adults. Multiple factors influence sexual health including intersecting identities; adverse life events; coping mechanisms; and psychological, social, and physical health domains. Thus, the use of a culturally competent and comprehensive person-centered approach to sexual health is warranted. In this review, we discuss approaches to engaging LGBTQ + older adults to ensure they are able to achieve their sexual health priorities and prevent new human immunodeficiency virus infections. We also discuss doxycycline postexposure prophylaxis to prevent other sexually transmitted infections and the impact of chemsex.


Assuntos
Infecções por HIV , Saúde Sexual , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Humanos , Idoso , Infecções Sexualmente Transmissíveis/prevenção & controle , Comportamento Sexual/psicologia
16.
BMC Infect Dis ; 24(1): 347, 2024 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-38521947

RESUMO

BACKGROUND: Men who have sex with men (MSM) are a key population group disproportionately affected by HIV and other sexually transmitted infections (STIs) worldwide. In Rwanda, the HIV epidemic remains a significant public health concern, and understanding the burden of HIV and hepatitis B and C coinfections among MSM is crucial for designing effective prevention and control strategies. This study aims to determine the prevalence of HIV, hepatitis B, and hepatitis C infections among MSM in Rwanda and identify correlates associated with HIV infection within this population. METHODS: We used respondent-driven sampling (RDS) to recruit participants between November and December 2021. A face-to-face, structured questionnaire was administered. Testing for HIV infection followed the national algorithm using two rapid tests: Alere Combo and STAT PAK as the first and second screening tests, respectively. Hepatitis B surface antigen (HBsAg) and anti-HCV tests were performed. All statistics were adjusted for RDS design, and a multivariable logistic regression model was constructed to identify factors associated with HIV infection. RESULTS: The prevalence of HIV among MSM was 6·9% (95% CI: 5·5-8·6), and among HIV-positive MSM, 12·9% (95% CI: 5·5-27·3) were recently infected. The prevalence of hepatitis B and C was 4·2% (95% CI: 3·0-5·7) and 0·7% (95% CI: 0·4-1·2), respectively. HIV and hepatitis B virus coinfection was 0·5% (95% CI: 0·2-1·1), whereas HIV and hepatitis C coinfection was 0·1% (95% CI: 0·0-0·5), and no coinfection for all three viruses was observed. MSM groups with an increased risk of HIV infection included those who ever suffered violence or abuse because of having sex with other men (AOR: 3·42; 95% CI: 1·87-6·25), those who refused to answer the question asking about 'ever been paid money, goods, or services for sex' (AOR: 10·4; 95% CI: 3·30-32·84), and those not consistently using condoms (AOR: 3·15; 95% CI: 1·31-7·60). CONCLUSION: The findings suggest more targeted prevention and treatment approaches and underscore the importance of addressing structural and behavioral factors contributing to HIV vulnerability, setting interventions to reduce violence and abuse against MSM, promoting safe and consensual sexual practices, and expanding access to HIV prevention tools such as condoms and preexposure prophylaxis (PrEP).


Assuntos
Coinfecção , Infecções por HIV , Hepatite B , Hepatite C , Minorias Sexuais e de Gênero , Masculino , Humanos , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/diagnóstico , Homossexualidade Masculina , Coinfecção/epidemiologia , Estudos Transversais , Ruanda/epidemiologia , Fatores de Risco , Hepatite B/epidemiologia , Hepatite C/epidemiologia , Inquéritos e Questionários , Prevalência
17.
PLoS One ; 19(3): e0298398, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38512825

RESUMO

Sexually transmitted infections (STIs) have seen a considerable increase in the last years and given the health burden they may represent from both a personal and community perspective, they require surveillance and prevention programmes based on a timely and decentralized diagnosis. In this context, user-friendly rapid molecular tests may represent a good trade-off between diagnostic accuracy, accessibility and affordability. In this study we evaluated the diagnostic performance of a new real-time LAMP (Loop Mediated Isothermal Amplification) method for the rapid detection and differentiation of 7 major sexually transmissible pathogens by analysing real clinical samples (genital and extra-genital matrices) from individuals with suspected STIs. The assay showed good overall diagnostic performances in terms of sensitivity, specificity and concordance with a gold-standard PCR-based molecular method. This assay, not requiring specialised laboratory technicians or expensive instrumentation, but nonetheless capable of guaranteeing accurate results, is within the reach of outpatient settings, obstetrics, and gynaecology clinic, hence ensuring on-field access to early diagnosis.


Assuntos
Técnicas de Laboratório Clínico , Infecções Sexualmente Transmissíveis , Feminino , Gravidez , Humanos , Sensibilidade e Especificidade , Técnicas de Laboratório Clínico/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Técnicas de Diagnóstico Molecular/métodos , Infecções Sexualmente Transmissíveis/diagnóstico
18.
PLoS One ; 19(3): e0299629, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38512837

RESUMO

BACKGROUND: Sexually transmitted infection is a common public health issue, and it is characteristically transmitted through sexual intercourse. Around the globe, particularly in less developed countries, delayed treatment of this infection could lead to a health and economic burden. Even though the health and economic burden of sexually transmitted infections is high, studies to identify the pooled proportion and the possible factor of delayed treatment seeking are rare in sub-Saharan African countries. OBJECTIVE: To assess the prevalence of delayed treatment for STIs and its determinants in sub-Saharan African countries. METHOD: Articles searched on search engines like Medline via PubMed, HINARI, Embase, Scopus, Cochrane Library, Science Direct, and websites like Google Scholar. The searching mechanism was using keywords and medical subject heading terms by combining the key terms of the title. To assure the quality of the included articles, Joana Brigg's Institute critical appraisal checklist was used. To assess the heterogeneity of the studies, a sensitivity analysis was conducted. The PRISMA checklist was used, and to estimate the pooled odds ratio, a random effect model was considered. The pooled odds ratio of 95% CL was used to identify the factors. RESULTS: About 13 studies with 46,722 participants were incorporated. Despite considerable heterogeneity, the pooled prevalence of delayed treatment for STI in Sub-Saharan Africa was 47% (95% CI: 42%-51%, I2 = 98.42, p<0.001). Geographically, the higher pooled prevalence of delayed treatment for STI was in the eastern part of Africa (50%) (95% CI: 41%-59%, I2 = 98.42, p<0.001). Rural residence (OR = 1.44, 95% CI: 1.03-2.01, I2 = 39.3%, p-value = 0.19), poor knowledge about STI (OR = 1.49, 95% CI: 1.04-2.13, I2 = 93.1%, p-value = <0.001), perceived as STIs not serious (OR = 2.1, 95% CI: 1.86-2.36, I2 = 73.7%, p-value = 0.022), misconception for STD cause (OR = 1.39, 95% CI: 1.12-1.72), no education (OR = 4.1, 95% CI: 3.4-5.1), primary education (OR = 3.17, 95% CI: 2.23-4.2), and secondary education (OR = 1.57, 95% CI: 1.1-2.76) as compared to secondary and above education were factors associated with delayed treatment for STIs. CONCLUSION: The pooled prevalence of delayed treatment for STIs in Sub-Saharan African countries was high. Poor knowledge, attitude, and educational status affect the treatment delay for STIs. Thus, improving knowledge, educational status, and attitude are highly recommended to reduce the delayed treatment of STIs.


Assuntos
Infecções por HIV , Infecções Sexualmente Transmissíveis , Humanos , Infecções por HIV/epidemiologia , Prevalência , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/terapia , África Subsaariana/epidemiologia
19.
BMC Womens Health ; 24(1): 190, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38515067

RESUMO

BACKGROUND: Although Zika virus infection is rarely reported now, continuous prevention is needed to achieve sustained eradication. This study aimed to explore the knowledge gaps, risk perception and preventive measures against Zika virus infection (ZIKV) in pregnant women in Malaysia. METHODS: We conducted in-depth virtual interviews with pregnant women between February and April 2022. The interviews were recorded and transcribed, and data were analyzed by content analysis. RESULTS: The majority of the participants demonstrated a commendable level of awareness regarding the signs and symptoms associated with ZIKV infection. They also exhibited a clear understanding of preventive measures, particularly emphasizing the importance of avoiding mosquito bites to minimize the risk of ZIKV transmission. However, a noteworthy gap in knowledge surfaced as a subset of participants remained uninformed about the potential for sexual transmission of ZIKV, which could lead to congenital ZIKV in pregnant women. Even among women who were cognizant of ZIKV and its potential negative health outcomes, associated with the infection, many of them did not perceive themselves to be at risk, mainly because ZIKV infection is infrequently discussed or heard of, leading to a sense of infections' rarity. While the adoption of preventive measures such as mosquito bite prevention during pregnancy was a common practice, however, prevention of sexually transmitted infections (STIs) including mosquito-borne diseases such as Zika is low. A minority of women express concerns about the sensitivity surrounding discussions and prevention of STIs within the context of marriage. Most of the participants were supportive of the provision of awareness of ZIKV infection in women during pregnancy and the involvement of men, especially in initiatives aimed at preventing transmission through sexual contact. CONCLUSION: This study uncovered gaps in both knowledge and practices pertaining ZIKV infection among pregnant women in the aftermath of the ZIKV pandemic. The insights gleaned from our research are valuable for shaping future interventions geared towards preventing the resurgence or facilitating the sustainable eradication of ZIKV.


Assuntos
Complicações Infecciosas na Gravidez , Infecções Sexualmente Transmissíveis , Infecção por Zika virus , Zika virus , Masculino , Animais , Feminino , Gravidez , Humanos , Infecção por Zika virus/prevenção & controle , Gestantes , Malásia , Complicações Infecciosas na Gravidez/prevenção & controle , Infecções Sexualmente Transmissíveis/prevenção & controle
20.
BMC Public Health ; 24(1): 872, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38515116

RESUMO

BACKGROUND: Hazardous drinking and drug consumption are associated with an increased risk of HIV due to the complex interplay of factors influencing decision-making capability, stigma and social marginalization. In this study, we explore the patterns of hazardous alcohol and drug use and correlates of risk factors among female sex workers (FSW) and men who as sex with men (MSM) in Mozambique. METHODS: We conducted a secondary data analysis of bio-behavioral surveys (BBS) among FSW and MSM using a respondent-driven sampling methodology conducted in five main urban areas of Mozambique from 2019 to 20. The survey included a standardized questionnaire, where hazardous drinking was assessed (using AUDIT-C scores ≥ 4 for men, ≥ 3 for women) and drug use in the last year (FSW). Chi-squared test was used to analyze the association between socio-demographic and behavioral variables, and multivariate logistic regression measured the impact of the associated factors. RESULTS: The prevalence of hazardous alcohol drinking was 47.1% (95% CI:44.8-49.5) for FSW and 46.5 (95% CI: 44.0-49.0) for MSM. Current drug use was reported in 13.3% of FSW. FSW engaging in hazardous alcohol drinking reported more sexual partners in the last month than those no reporting hazardous alcohol use (55.3% vs. 47,1%, p < 0.001), higher rates of self-reported STIs in the last year (62,5% vs. 48,2%, p < 0.001), physical (53.5% vs. 46.7%, p < 0.0001) and sexual violence (54.7% vs. 44.2%, p < 0.001), and HIV prevalence (55.2% vs. 44.2 p < 0.001). Among MSM with hazardous alcohol drinking, there was a higher prevalence of self-reported STIs (52.8% vs. 45.4%, p < 0.001), experiences of sexual violence (18.0% vs. 8.3%, p < 0.001), and HIV prevalence (53.0% vs. 46.3%, p < 0.001). In addition, FSW who reported illicit drug use were more likely to self-reported HIV own risk (14.2% vs. 9.7%), early start sexual activity (15.4% vs. 5.3%), self-reported STIs (17.9% vs. 10.2%), and experiences of both physical (17.4% vs. 7.0%) and sexual violence (18.6% vs. 8.9%). CONCLUSION: There is an immediate need for the introduction and integration of comprehensive substance use harm mitigation and mental health interventions into HIV prevention programs, particularly those targeting key populations in Mozambique.


Assuntos
Infecções por HIV , Profissionais do Sexo , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Transtornos Relacionados ao Uso de Substâncias , Masculino , Feminino , Humanos , Homossexualidade Masculina , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Prevalência , Moçambique/epidemiologia , Comportamento Sexual , Infecções Sexualmente Transmissíveis/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia
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