Risk factors and algorithms for chlamydial and gonococcal cervical infections in women attending family planning clinics in Thailand.

AIM: To identify risk factors associated with and evaluate algorithms for predicting Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) cervical infections in women attending family planning clinics in Thailand. METHODS: Eligible women were recruited from family planning clinics from all regions in Thailand. The women were followed at 3-month intervals for 15-24 months. At each visit, the women were interviewed for interval sexually transmitted infection (STI) history in the past 3 months, recent sexual behavior, and contraceptive use. Pelvic examinations were performed and endocervical specimens were collected to test for CT and NG using polymerase chain reaction. RESULTS: Factors associated with incident CT/NG cervical infections in multivariate analyses included region of country other than the north, age

Psychosocial burden of women with abnormal Pap smears.

This cross-sectional study aimed to describe the psychosocial burden of women with abnormal Pap-smear results during the 3 months after recruitment into the study. Seventy-five women negative for intraepithelial lesions and 76 women with epithelial cell abnormalities were recruited. The two study groups did not differ in baseline demographic characteristics or gynecological history. However, the mean Health Impact Profile (HIP) scores were higher for the women negative for intraepithelial lesions [68.18 +/- 14.22 and 57.74 +/- 16.29, respectively (p < 0.001)], who were mostly concerned about getting cancer, pain during the visit to the gynecologist, and that having sex with their partner may give them an infection (p < 0.001). There were no statistically significant differences in mean scores for Sheehan Disability Scale (SDS), Work Productivity and Activity Impairement Questionnaire (WPAI), Health Utilities Index (HUI), Health State Score (HSS), and Hospital Anxiety and Depression (HADS), between the two study groups. However, there was a significant difference in mean scores for HSS within the younger age group (18-28 years) [(75.00 +/- 13.64, n = 19 and 59.72 +/- 19.13, n = 18, respectively)] (p = 0.008). The provision of information, counseling, and advice, support services and clinician consultation times, need strengthening, to help alleviate women's concerns about infection, and their worries, anxiety or depression, following an abnormal Pap result.

Risk factors for bacterial vaginosis incidence in young adult Thai women.

OBJECTIVE: To determine risk factors for incident bacterial vaginosis (BV) in young Thai women. STUDY DESIGN: Prospective data from a cohort of 1522 women aged 18 to 35 years, who were enrolled in a study of hormonal contraception and HIV acquisition, were used to evaluate potential risk factors for BV, as diagnosed by Amsel criteria. RESULTS: The median prevalence of BV from 3 to 24 months of follow-up visits was 2.5%. The BV incidence was 10.0 per 100-woman years. Statistically significant factors in multivariable analysis were sex during menstruation [hazard ratio (HR), 1.80; 95% CI, 1.11-2.92], male partners having sex with other women (HR, 2.3; 95% CI, 1.45-2.98), cigarette smoking (HR, 1.79; 95% CI, 1.08-2.98), and trichomoniasis (HR, 15.68; 95% CI, 4.95-49.68). Intravaginal practices were not associated with incident BV in unadjusted or adjusted analysis. CONCLUSIONS: This study supports the association between sexual behaviors and the incident BV. Failure to detect an association between intravaginal practices and incident BV warrants further studies in high-risk populations or in women with a higher prevalence of intravaginal practices.