Impacts of Sexually Transmitted Disease/HIV Outreach Sites on the Effectiveness of Detecting New Infections in Baltimore City, 2015 to 2018.

BACKGROUND: Effectiveness of sexually transmitted disease (STD)/HIV mobile van outreach programs has been shown to assist in identifying new cases of syphilis and HIV among high-risk populations. However, specific types of mobile outreach testing and their varying abilities to assist in STD/HIV case identification have not been thoroughly explored. METHODS: We analyzed data from the Baltimore City Health Department syphilis and HIV testing intake interviews and subsequent laboratory results for clients at any of the 6 different Baltimore City Health Department mobile outreach testing setting types between 2015 and 2018. A total of 8098 syphilis and 7946 HIV testing encounters were included. Cross-tabulation and proportion estimates were used to obtain the volume of new syphilis and HIV diagnoses across the different mobile outreach testing setting types. Multivariable firth logistic regressions for rare events were used to obtain odds ratios for new syphilis diagnoses across the different mobile outreach setting categories. RESULTS: Testing at street corners yielded the highest proportion of new syphilis cases (0.83%), whereas at community centers, it produced the highest proportion of new HIV cases (0.48%). The adjusted odds for new syphilis were 2.14 among street corners compared with community centers. CONCLUSIONS: The findings indicated that street corners were the most successful at detecting new syphilis cases, whereas community centers were the most successful at detecting new HIV cases. However, because of the small number of new cases detected and low uptake per testing event between 2015 and 2018, STD/HIV mobile testing does not seem to be effective overall.

Management of Chronic Bacterial Prostatitis.

PURPOSE OF REVIEW: We conducted a review of the literature describing the most up-to-date diagnosis and treatment options of chronic bacterial prostatitis. RECENT FINDINGS: Recurrence after oral antimicrobial therapy is common, due in part to the rising rates of antimicrobial resistance and inability to completely clear the offending bacteria from the prostate following prostatitis. Recent literature has described various treatment options for chronic bacterial prostatitis refractory to conventional antimicrobial agents, including the use of alternative agents such as fosfomycin, direct antimicrobial injections into the prostate, surgical removal of infected prostatic tissue, chronic oral antibiotic suppression, and an emerging novel therapy utilizing bacteriophages to target antibiotic resistant bacteria. Management of chronic bacterial prostatitis, especially recurrence after oral antimicrobial treatment, remains challenging. This review highlights an urgent need for further evidence assessing the efficacy and safety of treatment modalities for chronic bacterial prostatitis refractory to conventional oral antimicrobials.