Aetiological molecular identification of sexually transmitted infections that cause urethral discharge syndrome and genital ulcer disease in Brazilian men: a nationwide study.

BACKGROUND: Little is known about the aetiology of urethral discharge syndrome (UDS) and genital ulcer disease (GUD) in Brazil due to limited access to laboratory tests and treatment based mainly on the syndromic approach. OBJECTIVES: To update Brazilian treatment guidelines according to the current scenario, the first nationwide aetiological study for UDS and GUD was performed. METHODS: Male participants with urethral discharge (UD) and/or genital ulcer (GU) reports were enrolled. Sample collection was performed by 12 sentinel sites located in the five Brazilian regions. Between 2018 and 2020, 1141 UD and 208 GU samples were collected in a Universal Transport Medium-RT (Copan). A multiplex quantitative PCR kit (Seegene) was used to detect UD: Chlamydia trachomatis (CT), Mycoplasma genitalium (MG), M. hominis (MH), Neisseria gonorrhoeae (NG), Trichomonas vaginalis (TV), Ureaplasma parvum (UP), U. urealyticum (UU) and another kit to detect GU: cytomegalovirus (CMV), Haemophilus ducreyi (HD), herpes simplex virus type 1 (HSV1), herpes simplex virus type 2 (HSV2), lymphogranuloma venereum (LGV), Treponema pallidum (TP) and varicella-zoster virus (VZV). RESULTS: In UD samples, the frequency of pathogen detection was NG: 78.38%, CT: 25.6%, MG: 8.3%, UU: 10.4%, UP: 3.5%, MH: 3.5% and TV: 0.9%. Coinfection was assessed in 30.9% of samples, with 14.3% of NG/CT coinfection. The most frequent pathogen identified in GU was HSV2, present in 40.8% of the samples, followed by TP at 24.8%, LGV and CMV at 1%, and HSV1 at 0.4%. Coinfection of TP/HSV2 was detected in 4.4% of samples. VZV and HD were not detected. In 27.7% of the GU samples, no pathogen was detected. CONCLUSION: This study provided the acquisition of unprecedented data on the aetiology of UDS and GUD in Brazil, demonstrated the presence of a variety of pathogens in both sample types and reaffirmed the aetiologies known to be most prevalent globally.

Impact of COVID-19 on income, prevention attitudes, and access to healthcare among male clients in a Sexually Transmitted Infections clinic.

BACKGROUND: Mobility restrictions and overloaded health services during the COVID-19 pandemic compromised services dedicated to the prevention and care of HIV and other sexually transmitted infections (STI). In this study, we present client's responses to standardized questionnaires applied during the COVID-19 pandemic period as part of the strategy to measure impacts on social and sexual vulnerability, access to STI prevention services, and access to STI care. METHODS: The questionnaires included variables on sociodemographics, behavior, risk perception, prevention attitudes, barriers to service-based HIV rapid test, reasons for taking an HIV self-test, and access to health services for STI diagnosis and treatment. We explored demographic variables associated with income reduction, reduced access to HIV/STI testing/treatment and increased vulnerability to HIV/STI. RESULTS: 847 participants responded to the study questionnaire between May 2020 and January 2021. Most were young, cisgender male, and 63% self-reported as men who have sex with men. Income reductions were reported by 50%, with 30% reporting a decline over 50% of total income. An increase in heavy episodic drinking (>5 doses) was reported by 18%; 7% reported more sexual partners and 6% reported using condoms less often. Difficulties in obtaining HIV tests, tests for other STI and treatment for STI were reported by 5%, 6% and 6%, respectively. Lower schooling was significantly associated with income reduction (p = 0.004) and with reduced access to HIV/STI testing or STI treatment (p = 0.024); employment status was associated with income reduction (p < 0.001) and increased vulnerability to HIV/STI (p = 0.027). Having access to an expedite test result, avoiding physical attendance in health units during the pandemic, and undertaking the test with privacy with a trusted person were reported as motivators for HIV self-test. CONCLUSIONS: Our findings are relevant to promote service improvements tailored to subgroups more likely to struggle with detrimental effects during and after the COVID-19 pandemic.

Prevalence and risk factors of syphilis and human immunodeficiency virus co-infection at a university hospital in Brazil.

INTRODUCTION: The incidence of syphilis has increased since the 1970s. METHODS: This was a descriptive and analytical cross-sectional study with a non-probabilistic sample. RESULTS: Of 973 patients with human immunodeficiency virus, 179 (18.4%) tested positive for both human immunodeficiency virus and syphilis, 84.8% were men, 50.9% were aged between 36 and 50 years, 47.8% with syphilis were diagnosed with human immunodeficiency virus for 10-20 years, and 40.3% received antiretroviral therapy for 10-20 years. CONCLUSIONS: The prevalence of syphilis in patients with human immunodeficiency virus is higher than expected, making it urgent to adopt efficient public health measures.

Prevalence and risk factors of syphilis and human immunodeficiency virus co-infection at a university hospital in Brazil

Abstract INTRODUCTION The incidence of syphilis has increased since the 1970s. METHODS This was a descriptive and analytical cross-sectional study with a non-probabilistic sample. RESULTS: Of 973 patients with human immunodeficiency virus, 179 (18.4%) tested positive for both human immunodeficiency virus and syphilis, 84.8% were men, 50.9% were aged between 36 and 50 years, 47.8% with syphilis were diagnosed with human immunodeficiency virus for 10-20 years, and 40.3% received antiretroviral therapy for 10-20 years. CONCLUSIONS The prevalence of syphilis in patients with human immunodeficiency virus is higher than expected, making it urgent to adopt efficient public health measures.

Procedimentos operacionais para a vigilância epidemiológica da Aids em mulheres e crianças em Pernambuco / Operational procedures for epidemiological surveillance of AIDS in women and children in Pernambuco

Divulgar os procedimentos e rotinas operacionais da vigilância epidemiológica da Aids em mulheres e crianças no Estado de Pernambuco, promovendo sua maior utilização com vistas à melhoria da qualidade da atenção à saúde. MÉTODOS: revisão normativa e da literatura, padronização e sistematização de informações essenciais nas categorias operacionais - definição de casos, notificação, investigação, medidas de prevenção, controle e coleta de amostras. RESULTADOS: procedimentos operacionais padronizados para a vigilância epidemiológica da Aids em mulheres e crianças. CONCLUSÕES: a padronização e sistematização associada à uma adequada divulgação e disseminação entre os profissionais e serviços de saúde contribui para intervenções em tempo oportuno e com qualidade das ações normatizadas...

To divulge procedures and operational routines of epidemiological surveillance of AIDS in women and children in the state of Pernambuco in order to promote its use towards the improvement of the quality of health care. METHODS: normative and literature review, standardization and systematization of essential information on operational categories - case definition, notification, investigation, measurements of prevention, control and sampling collection. RESULTS: standardized operational procedures for the epidemiological surveillance of AIDS in women and children. CONCLUSIONS: standardization and systematization associated with adequate publicizing and dissemination among health professionals and health services contributes to interventions on time and to the quality of standardized actions...