Factors associated with inconsistent condom use among young people: systematic review.

OBJECTIVE: To identify in the literature the factors associated with the inconsistent use of conservation by the young population. METHOD: Systematic review that searched for studies in six data sources in June 2023, with no publication date or language restrictions. Materials were selected by two independent reviewers who individually screened observational studies by reading the title and abstract of the articles. The studies were assessed for methodological quality and narrative synthesis. RESULTS: Of the 15,783 publications retrieved, nine were included. It was found that anal sex, not carrying a condom, low education, shame about buying condoms, drug use, early sexual debut and difficulties in negotiating condom use were factors associated with inconsistent condom use among the young population. CONCLUSION: Multidimensional factors are associated with inconsistent condom use, permeated by sociodemographic, cultural and behavioral elements that challenge practices and policies aimed at promoting sexual and reproductive health, including the control of sexually transmitted infections.

Influence of socio-contextual factors on the link between traditional and new media use, and young people's sexual risk behaviour in Sub-Saharan Africa: a secondary data analysis.

BACKGROUND: Traditional and new media use links to young people's sexual risk behaviour. The social contexts of young people's daily lives that influence media use and sexual risk behaviour are often investigated as independent causal mechanisms. We examined the link between media use and young people's sexual risk behaviour, considering the intersecting socio-contextual factors in Sub-Saharan Africa. METHODS: Age-adjusted bivariate logistic regression models tested the association between traditional media (TV, radio, and newspapers), and new media (mobile phone and online) use and sexual risk behaviour using the Demographic and Health Surveys from six Sub-Saharan African countries among unmarried sexually active youths, aged 15-24 years. Multivariate logistic regression models ascertained the media sources that had an additional influence on young people's sexual risk behaviour, after accounting for socio-contextual factors, and knowledge about HIV and other sexually transmitted infections. RESULTS: Socio-contextual factors attenuated the association between media use and young people's sexual risk behaviour in many countries. However, those who did not have access to new and traditional media were more likely to use unreliable contraceptive methods or not use contraception. Adolescents in Nigeria who did not own phones were 89% more likely to use unreliable contraceptive methods or not use any methods [(AOR = 1.89 (1.40-2.56), p < .001)], those in Angola who did not read newspapers had higher odds of not using contraception or used unreliable methods [(aOR = 1.65 (1.26-2.15), p < .001)]. Young people in Angola (aOR = 0.68 (0.56-0.83), p < .001), Cameroon [(aOR = 0.66 (0.51-0.84), p < .001)], Nigeria [(aOR = 0.72 (0.56-0.93), p = .01)], and South Africa [(aOR = 0.69 (0.49-0.98), p = .03)] who did not own phones were less likely to have 2 or more sexual partners compared to those who owned phones. Lack of internet access in Mali was associated with lower odds of having 2 or more sexual partners (aOR = 0.45 (0.29-0.70), p < .001). Traditional media use was significantly associated with transactional sex in many countries. CONCLUSIONS: Media use is linked to sexual risk behaviour among young people in Sub-Saharan Africa. Socioeconomic inequalities, levels of globalization, as well as rural-urban disparities in access to media, underscore the need to deliver tailored and targeted sexual risk reduction interventions to young people using both traditional and new media.

In addition to television, radio, magazines, and newspapers, young people in Sub-Saharan Africa are increasingly using their phones and the Internet to connect with their peers. However, these media sources can lead to sexual risk behaviour because of access to inappropriate and inaccurate information. Social environmental factors in Sub-Saharan Africa, such as gender, place of residence, and socio-economic status influence young people's access to and use of these media sources. However, many studies that consider the influence of these social factors on the use of media among young people evaluate each of them and fail to consider that these social forces jointly influence young people's access to the internet, and ability to own phones, watch television, or read newspapers. Our study considered these combined social factors and their influence on the link between the use of media and sexual risk behaviour among young people. We found that considering these social environmental factors reduced the association between media use and young people's sexual risk behaviour but those who did not have access to these media sources were more likely to use unreliable methods to prevent pregnancy or sexually transmitted diseases. Those who listened to the radio, or read newspapers and magazines were more likely to give or receive cash or other gifts in exchange for sex. In contrast, young people who never owned phones or lacked access to the internet were less likely to have had multiple sexual partners. Our findings stress the need to consider social contexts and media use in promoting young people's sexual health.

Enhancing HIV/STI decision-making: challenges and opportunities in leveraging predictive models for individuals, healthcare providers, and policymakers.

The prevention and control of human immunodeficiency virus and sexually transmitted infections (HIV/STI) face challenges worldwide, especially in China. Prediction tools, which analyze medical data and information to make future predictions, were once mainly used in HIV/STI research to help make diagnostic or prognostic decisions, has have now extended to the public as a freely accessible tool. This article provides an overview of the different roles of prediction tools in preventing and controlling HIV/STI from the perspectives of individuals, healthcare providers, and policymakers. For individuals, prediction tools serve as a risk assessment solution that assess their risk and consciously improve risk reception or change risky behaviors. For researchers, prediction tools are powerful for assisting in identifying risk factors and predicting patients' infection risk, which can inform timely and accurate intervention planning in the future. In order to achieve the best performance, current research increasingly underscores the necessity of considering multiple levels of information, such as socio-behavioral data, in developing a robust prediction tool. In addition, it is also crucial to conduct trials in clinical settings to validate the effectiveness of prediction tools. Many studies only use theoretical parameters such as model accuracy to estimate its predictive. If these improvements are made, the application of prediction tools could be a potentially inspiring solution in the prevention and control of HIV/STI, and an opportunity for achieving the World Health Organization's agenda to end the HIV/STI epidemic by 2030.

Exploring psychosocial factors influencing sexually transmitted infection intention testing among medical students: a cross-sectional study in two universities.

Background: Despite the significant global burden of sexually transmitted infections (STI), detection rates are poor. Acceptance of these tests is influenced by several factors that have not been explored among Colombian medical students. Objectives: The aim of this study was to describe the behaviors and psychosocial factors toward STI screening among medical students of two universities in Pereira, Colombia, between March and June 2020. Methods: An observational, cross-sectional study was conducted with 284 medical students in the first 3 years of undergraduate at two universities. An online, self-administered survey was conducted between March 2020 and June 2020, using an instrument from the "STI Testing Questionnaire," to assess behaviors and psychosocial factors toward STI testing. Frequencies and percentages were used for descriptive analysis. The association between characteristics and psychosocial factors with STI testing intention was obtained using a logistic regression model. A p-value <0.05 was accepted as statistically significant for all analyses. Results: A total of 284 medical students participated in this study. The majority were female (56.7%), and 53.2% were from private universities. Eighty-four point 5% (84.5%) had risky sexual behaviors, and only 32.4% reported intentions to be tested for STIs. Among the psychosocial factors, 64.1% reported high social pressure, and 43.0% reported social fear. An association with the intention to undergo STI testing was identified in those who had been previously tested (OR = 2.486; 95% CI: 1.492-4.142) and in those who engaged in risky sexual behaviors (OR = 3.537; 95% CI: 1.437-8.704). Conclusion: Medical students exhibit a high prevalence of risky sexual behaviors but show a disturbing lack of intention to undergo STI screening. Prior experiences significantly influence screening intentions, while social pressure and fear also play a role. These insights can serve as a basis for targeted interventions to improve STI screening rates and enhance sexual health education among Colombian medical students.

Self-reported sexually transmitted infections and associated risk factors among female university students.

Background: The spread of sexually transmitted infections (STIs) is an ongoing public health challenge, and awareness of risk factors is essential for designing effective preventive interventions. This study aimed to assess self-reported STI occurrences and identify risk factors and sexual behaviors associated with STIs among female university students. Methods: This is a cross-sectional, online questionnaire study, including 384 female university students seeking contraceptive counseling at a gynecology clinic in Uppsala, Sweden, and reporting having had sex. Associated risk factors and behaviors were assessed by comparing those who reported STIs and those who did not. Results: The mean age of participants was 22.8 years. Seventy-eight (20%) had contracted at least one STI, with seven (9%) experiencing multiple infections. Seventy-three (94%) reported first-date sexual activity without a condom among STI experienced. Chlamydia trachomatis was the most common STI pathogen (68% of all infections), followed by Herpes simplex virus (18%) and Mycoplasma genitalium (13%). Behavioral factors associated with self-reported STIs were first-date sexual activity without a condom, not using condom at first intercourse, younger age at first intercourse, a higher number of sexual partners overall and in the last 12 months, experience of anal sex, dating app usage, and regretting sexual activity after substance use (P < 0.003 for all). Conclusions: Condom use was low among the respondents, and STIs were common regardless of the high level of education in this group. Contraceptive counseling needs to highlight the importance of condom use in addition to contraceptive efficacy. It is also essential to consider the specific risk factors and behaviors prevalent among young adults to reduce the spread of STIs.

The effect of teach-back method training on the prevention behaviors of reproductive age women against sexually transmitted diseases.

The aim of this research was to examine the effect of teach-back method-based training provided to reproductive-age women to protect them from sexually transmitted diseases (STDs) on their protective behaviors. Sexually transmitted diseases cause significant health problems for many women every year. The transmission of sexually transmitted diseases can be prevented through health education, which is among the preventive health services. Nurses are the leading health educators. Nurses should learn new education systems and models and use them in their practice. This study has a randomized controlled design. The teach-back method and face-to-face training were provided to women of reproductive age experimentally for protection from sexually transmitted diseases. In this research, the teach-back method in which there were 42 participants in each group, an identifying information form for women in three groups who were provided face-to-face training and not trained, the Behavioral Scale for Protection from Sexually Transmitted Diseases were applied pre-training, fifteen days and three months after the training. Participants' socio-demographic data in the intervention and control groups were compared. The mean age of the teach-back group had been 30.64 ± 5.73, the average age of the face-to-face group had been 29.83 ± 5.49, and the mean age of the non-trained group had been 28.16 ± 5.09. These groups had displayed similar characteristics. The mean score of the Behavioral Scale for Protection from Sexually Transmitted Diseases was found to be 75.57 ± 12.78 pre-training, 82.54 ± 9.59 fifteen days after the training and 81.85 ± 9.28 three months after the training in women who were trained with the teach-back method; 76.92 ± 10.03 pre-training, 80.78 ± 8.72 fifteen days after the training and 80.21 ± 8.77 three months after the training in women who received face-to-face training, while it was found in women who did not receive face-to-face training to be 75.73 ± 6.14 pre-training, 75.61 ± 6.01 fifteen days after the training and 75.54 ± 6.09 three months after the training and there was a statistically significant relationship between them (F = 6.736; p < 0.001). As a result of the research, it was found that the training provided to women with the teach-back method had a positive effect on women's behaviors and was more effective than face-to-face training.

Female transactional sex workers' experiences and health-seeking behaviour in low-middle income countries: a scoping review.

BACKGROUND: For a variety of reasons related to biology, behaviour, and environment, a subset of a population known as female sex workers (FSWs) or female transactional sex workers is at increased risk of health, depression, social stigma and access to timely and quality healthcare when needed. In low- and middle-income countries (LMICs), there was lack of understanding regarding the experiences and healthcare utilisation and behaviours, the health burden among them, their experiences, and how they access health care. Using Anderson's behavioural model of health service utilisation as a framework, this review aimed to explore the experiences of, and healthcare seeking behaviours of female sex workers in low-and middle-income countries. METHODS: Six relevant databases such as PubMed, Embase, Global Health, Scopus, Web of Science, and Google Scholar were searched for peer-reviewed research articles published between January 1990 and December 2023 that discussed female transactional sex work in low- and middle-income countries. Subject terms such as: low-and middle- incomes, sex workers (female and male), sexually transmitted infections (STIs) in the sex work industry, prostitution, commercial sex, and health-seeking behaviour were used for the databases search. Out of 6,135 articles that were retrieved for the study, 26 met the inclusion criteria. Of the total number of studies, four were reviews, eight were quantitative studies, six were qualitative studies, and two utilised mixed methods. FINDINGS: Results from a thematic analysis of studies that combined quantitative and qualitative methods yielded six overarching themes.The study found that women engaged in sex work for different reasons - to fend for themselves (i.e., livelihood), self-employment and others do it for pleasure. However, force sex or unprotected which can lead to sexually transmitted infections, sexual abuse, job insecurity, were critical risks factors in engaging in sex work. These factors make them vulnerable to predators and health risks. It was found that sex workers were aware of the importance of seeking healthcare, and do make the efforts, however, crucial factors such as difficulty accessing healthcare and maltreatment by healthcare providers and social stigma disincentivises FSW health-seeking behaviours. Sexual workers reported discomfort disclosing their occupations because of the stigma and discrimination which further affects their regular health examinations and obtaining medically approved condoms from healthcare facilities. CONCLUSION: Complex challenges rooted in economic vulnerability, social marginalisation, and limited access to healthcare afflict female sex workers in LMICs. The maltreatment and stigma can potentially affect LMICs from achieving using health facility care, with potential implications on achieving the universal health coverage goals. Comprehensive, rights-based strategies that address structural injustices and empower these women to live healthier, more secure lives are necessary to address their special needs.

Sexual behaviors and factors associated with consistent condom use among young male artisanal miners in Kassanda District, Uganda.

Artisanal and small-scale mining (ASM) is a significant source of income for tens of millions of people worldwide. Consistent condom use is pivotal in the prevention of HIV/AIDS and other STIs. This study assessed sexual behaviors and factors associated with consistent condom use among young male artisanal miners in Kassanda District, Uganda. A cross-sectional survey was conducted with 304 miners aged 15-24 years. Data -analysis included frequency distributions, chi-squared tests, and binary logistic regression. 89% had sexual intercourse in the past year, 55% had multiple partners, 11% engaged in transactional sex, and only 42% used condoms consistently. Married/cohabiting young men (OR=0.41; CI=0.19-0.87), those with a neutral attitude towards condom use (OR=0.30; CI=0.11-0.85), and those with only their mothers as parents (OR=0.37; CI=0.19-0.73) were less likely to use condoms consistently. The study highlights the need for targeted interventions promoting condom use among married young men and those raised by single mothers to reduce the risk of STI transmission.

L'exploitation minière artisanale et à petite échelle (ASM) constitue une source de revenus importante pour des dizaines de millions de personnes dans le monde. L'utilisation systématique du préservatif est essentielle à la prévention du VIH/SIDA et d'autres IST. Cette étude a évalué les comportements sexuels et les facteurs associés à l'utilisation systématique du préservatif chez les jeunes mineurs artisanaux du district de Kassanda, en Ouganda. Une enquête transversale a été menée auprès de 304 mineurs âgés de 15 à 24 ans. L'analyse des données comprenait des distributions de fréquences, des tests du chi carré et une régression logistique binaire. 89 % ont eu des rapports sexuels au cours de l'année écoulée, 55 % ont eu plusieurs partenaires, 11 % se sont livrés à des relations sexuelles transactionnelles et seulement 42 % ont utilisé des préservatifs de manière constante. Jeunes hommes mariés/cohabitants (OR=0,41 ; IC=0,19-0,87), ceux ayant une attitude neutre à l'égard de l'utilisation du préservatif (OR=0,30 ; IC=0,11-0,85) et ceux dont la mère est seule comme parent (OR=0,37 ; IC=0,19-0,73) étaient moins susceptibles d'utiliser régulièrement des préservatifs. L'étude souligne la nécessité d'interventions ciblées promouvant l'utilisation du préservatif parmi les jeunes hommes mariés et ceux élevés par des mères célibataires afin de réduire le risque de transmission des IST.

Determinants of care-seeking behavior for sexually transmitted infections among sexually active men in East Africa: A multilevel mixed effect analysis.

BACKGROUND: Addressing the global challenge of sexually transmitted infections (STIs) is crucial and demands immediate attention. Raising awareness, improving healthcare facilities, and implementing preventive measures are necessary to reduce the spread and mitigate their adverse effects. The treatment seeking behavior of individuals in relation to STIs is an important factor in STI prevention and control. Thus, this study aimed to identify factors associated with STI-related care-seeking behavior among sexually active men in East Africa. METHODS: A weighted sample of 3,302 sexually active men from recent Demographic and Health Surveys (DHSs) in East African countries were included for analysis. To accommodate the inherent clustering in DHS data and the binary nature of the dependent variable, we applied a multi-level mixed-effect logistic regression model. The deviance value was used to select the best-fitted model. The strength of the association was estimated using an adjusted odds ratio, along with a 95% confidence interval, and statistical significance was determined at a p-value < 0.05. RESULT: The pooled prevalence of STI-related care-seeking behavior among sexually active men in East Africa was 71% (95%CI: 69.76, 72.75). In the multivariable multilevel model, individuals in the age groups of 25-34 (AOR = 1.58, 95%CI: 1.22, 2.04) and 44 years and above (AOR = 1.44, 95%CI: 1.01, 2.02), those who were married (AOR = 1.62, 95%CI: 1.25, 2.11), had 1 (AOR = 1.88, 95%CI: 1.50, 2.35) and ≥2 (AOR = 2.53, 95%CI: 1.89, 3.39) sexual partners excluding their spouse, had ever been tested for HIV (AOR = 1.86, 95%CI: 1.52, 2.28), and had media exposure (AOR = 1.30, 95%CI: 1.04, 1.62) had a positive association with care-seeking behavior for STIs. CONCLUSION: Based on our findings, seven out of ten sexually active men in East Africa exhibit care-seeking behavior for STIs. It is crucial to implement policies and strategies aimed at improving the health-seeking habits of young, unmarried men. Utilizing diverse media platforms to disseminate accurate information and success stories about STI symptoms is pivotal in achieving this goal.

New evidence on adolescent sexual and reproductive health and rights from the West and Central African region.

The African Journal of Reproductive Health is pleased to publish these compendiums of original research in this special edition that document new findings in adolescent sexual and reproductive health and rights from the West and Central African region (WCA). While sub-Saharan Africa has some of the worst indicators of sexual and reproductive health and rights (SRHR) in the world, the indicators are more daunting in the WCA region. To date, the WCA is recognized to have the highest rates of unwanted pregnancy, unsafe abortion, and human immunodeficiency virus (HIV) and other sexually transmissible infections, as well as the lowest contraceptive prevalence rates among adolescents worldwide.1 Despite the high rate of adverse adolescent reproductive health outcomes in WCA, there has been limited documentations of the socio-cultural and economic circumstances that perpetuate these adverse consequences. There have also been no purposefully designed interventions that provide strong scientific evidence for developing strategies to reverse the trend.

Le Journal africain de la santé reproductive est heureux de publier ces recueils de recherches originales dans cette édition spéciale qui documentent les nouvelles découvertes sur la santé et les droits sexuels et reproductifs des adolescents de la région de l'Afrique de l'Ouest et du Centre (WCA). Alors que l'Afrique subsaharienne possède certains des pires indicateurs au monde en matière de santé et de droits sexuels et reproductifs (SDSR), les indicateurs sont plus intimidants dans la région AOC. À ce jour, l'AOC est reconnue pour avoir les taux les plus élevés de grossesses non désirées, d'avortements à risque, de virus de l'immunodéficience humaine (VIH) et d'autres infections sexuellement transmissibles, ainsi que les taux de prévalence contraceptive les plus faibles parmi les adolescents dans le monde.1 Malgré le taux élevé de En dépit des résultats négatifs en matière de santé reproductive des adolescents en AOC, il existe peu de documentation sur les circonstances socioculturelles et économiques qui perpétuent ces conséquences néfastes. Il n'y a pas non plus d'interventions spécialement conçues qui fournissent des preuves scientifiques solides pour élaborer des stratégies visant à inverser la tendance.

Positive masculinity programmes and sexual and reproductive health behaviours among boys and men in poor urban settlements in Democratic Republic of Congo, Nigeria, and Rwanda.

As Positive Masculinity (PM) Programmes continue to develop globally, it is important to examine their role in Sexual and Reproductive Health and Rights (SRHR) outcomes. This multi-country qualitative study was conducted using in-depth interviews (IDI) and focus group discussions (FGDs) with community members, beneficiaries and implementers of PM programmes. The findings show that PM programmes are designed using a gender lens to make boys and men more aware and conscious of harmful masculinity traits and their effect on SRHR. The beneficiaries of the interventions report imbibing positive SRHR behaviours by being sexually responsible - upholding sexual rights, taking precautions against sexually transmitted Infections (STIs) and learning proper communication with their partners. They also report acting as vanguards of positive gender norms to their families and peers. Although there are challenges in implementing PM programmes, the results of the study suggest that interventions targeting boys and men hold promise for improving boys' and men's health behaviours and promoting gender equality in poor urban settings.

Alors que les programmes de masculinité positive (PM) continuent de se développer à l'échelle mondiale, il est important d'examiner leur rôle dans les résultats en matière de santé et de droits sexuels et reproductifs (SDSR). Cette étude qualitative multi pays a été menée à l'aide d'entretiens approfondis (IDI) et de discussions de groupe (FGD) avec des membres de la communauté, des bénéficiaires et des responsables de la mise en œuvre des programmes PM. Les résultats montrent que les programmes PM sont conçus en utilisant une optique de genre pour rendre les garçons et les hommes plus conscients des traits de masculinité néfastes et de leurs effets sur la SDSR. Les bénéficiaires des interventions déclarent avoir adopté des comportements positifs en matière de SDSR en étant sexuellement responsables ­ en respectant leurs droits sexuels, en prenant des précautions contre les infections sexuellement transmissibles (IST) et en apprenant une bonne communication avec leurs partenaires. Ils déclarent également agir en tant qu'avant-gardes des normes de genre positives auprès de leurs familles et de leurs pairs. Bien que la mise en œuvre des programmes PM présente des difficultés, les résultats de l'étude suggèrent que les interventions ciblant les garçons et les hommes sont prometteuses pour améliorer les comportements de santé des garçons et des hommes et promouvoir l'égalité des sexes dans les milieux urbains pauvres.

Sexually transmitted infections and bacterial vaginosis among adolescent girls and young women in the early postpartum period: a cross-sectional study.

BACKGROUND: Universal antiretroviral treatment (ART) for pregnant women has reduced mother-to-child transmission risk significantly. However, not all women on ART are virally suppressed during pregnancy and lactation. In addition to poor adherence to ART, co-infections particularly other sexually transmitted infections (STIs) are known to increase the risk of HIV acquisition and HIV transmission. While the prevalence of STIs during pregnancy has been well studied, the prevalence of STIs in the postpartum period and its association with HIV viral suppression are underreported. METHODS: In this cross-sectional study, we determined the prevalence of STIs among adolescent girls and young women (AGYW) living with HIV (WLHIV) and without HIV (WNLHIV) at their 6-14 week postnatal clinic visit in a high HIV prevalence district in South Africa. All women were examined for STI-related symptoms and had vaginal swabs collected and stored for later STI testing. Vaginal swabs were tested for Trichomonas vaginalis (T.vaginalis), Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoea) and herpes simplex virus-2 (HSV-2) using PCR. All women were tested for bacterial vaginosis (BV) using the Nugent scoring criteria. WLHIV had a blood sample collected for HIV viral load, Hepatitis B and syphilis. RESULTS: Included in this analysis were 82 WLHIV and 102 WNLHIV. Between 6 and 14 weeks postpartum, 40 (21.7%) AGYW tested positive for any STI and among these 15 (37.5%) were symptomatic and received empirical treatment. C. trachomatis was most commonly detected (10.9%), followed by HSV-2 (7.7%), T. vaginalis (3.8%) and N. gonorrhoea (1.6%). WLHIV were more likely to test positive for an STI (OR 2.0; 0.96-3.96) and BV (OR 4.2; 95%CI 2.1-8.1) compared to WNLHIV. Among WLHIV on ART, 70.5% had an undetectable plasma viral load (PVL) and 20.5% had a PVL > 1000 copies/ml. Testing positive for any STI or BV at the postpartum visit was not associated with PVL > 1000 copies/ml (OR 1.33; 95%CI 0.38-4.64). CONCLUSION: We report a high prevalence of largely asymptomatic STIs and BV in the early postpartum period and STIs in WLHIV were not associated with unsuppressed PVL.The high STI positivity rate among WNLHIV has implications for HIV risk during the postpartum period, and subsequently breastfeeding transmission.

Prevalence of sexually transmitted infections (STIs) among first time visitors at STIs clinic in Hangzhou, China: Assessing the influence of the COVID-19 pandemic.

BACKGROUND: This study assesses the prevalence of sexually transmitted infections (STIs) in first time visitors to the STIs clinic in Hangzhou, China, considering different genders, ages and symptoms. And also explores howthe COVID-19 pandemic has affected on STIs. METHODS: From 2019 to 2023, 27,283 first time visitors were tested for nine distinct STIs, including Human Papillomavirus (HPV), Human Immunodeficiency Virus (HIV), syphilis, Herpes Simplex Virus type 2 (HSV-2), Ureaplasma urealyticum (UU), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), and vaginal Candida. RESULTS: Symptomatic male and female visitors showed overall STI-positive rates of 39.27% and 59.20%, respectively(p < .001). The top three pathogens in both genders were HPV (47.56% and 56.71%), UU (29.21% and 56.47%), and HSV-2 (22.41% and 52.94%). Among asymptomatic visitors, the total STI-positive rate was 36.63% in males and 52.03% in females. Age-stratified analysis revealed higher STI rates in visitors ≤ 20 or >50 years, regardless of gender and symptoms. During the COVID-19 pandemic, symptomatic visitors showed lower positive rates for HPV, HIV, syphilis, and HSV-2, while Candida, UU, CT, NG, and multiple infections increased. Among asymptomatic visitors, HPV had the lowest positive rate, while NG and multiple infections increased during the pandemic. CONCLUSION: STI prevalence is notably high, particularly in those aged ≤ 20 and >50 years. It emphasizes the need for enhanced health education, condom use, and vaccination. The COVID-19 pandemic impacting STIs through varied factors, such as reduced sexual activity and clinical service interruption.

The relationship between selected sexually transmitted pathogens, HPV and HIV infection status in women presenting with gynaecological symptoms in Maputo City, Mozambique.

Sexually transmitted infections (STIs) have a profound impact on sexual and reproductive health worldwide. Syphilis, gonorrhea, chlamydia, and trichomoniasis are four currently curable STIs. However, most STI cases are asymptomatic and not detected without laboratory diagnostics. Hepatitis B virus, herpes simplex virus, human immunodeficiency virus (HIV), and human papillomavirus (HPV) are four viral and incurable infections, but they can be mitigated by treatment. We investigated the prevalence of selected sexually transmitted pathogens and their relationship with HPV and HIV infection in women from Maputo, the capital of Mozambique. A cross-sectional study was conducted on 233 non-pregnant women seeking health care relating to gynecological symptoms in Mavalane Health facilities in Maputo, between the 1st of February 2018 and the 30th of July 2019. Cervical brush samples were collected and DNA was extracted. Selected STIs including HPV were detected using multiplex STD and HPV Direct Flow Chip Kits through a manual Hybrispot platform (Vitro, Master Diagnostica, Sevilla, Spain). HIV testing was performed using rapid tests: Determine HIV 1/2 test (Alere Abbott Laboratories, Tokyo, Japan) for screening, and UniGold HIV (Trinity Biotech, Ireland) for confirmation. All women (n = 233) were negative for Haemophilus ducreyi and Herpes Simplex Virus-1 (HSV-1). Among the 233 women, a high prevalence of STIs was found (89%), 63% of the women were positive for HPV and 24% were HIV positive. Treponema pallidum (TP), Trichomonas vaginalis (TV), Herpes Simplex Virus-2 (HSV-2), and Chlamydia trachomatis (CT) were detected in 17%, 14%, 8%, and 8% of the women, respectively. As a common phenomenon, vaginal discharge (90%) was the lower genital tract symptom reported by the majority of the women. Co-infection with any STI and HPV was detected in 56% (130/233) while 45% (59/130) of the co-infections were with high-risk HPV (hrHPV) genotypes. Among the HPV-positive participants, infection by TP was the most prevalent (27%). In total, 28% (66/233) of the participants were positive for any hrHPV genotypes. Co-infection with any STI and HIV was found in 15% (34/233) of the study participants. There was a significant association between HPV infection and TP (p = 0.039) and HSV-2 (p = 0.005). TV, TP, and CT-S1-CT-S2 positivity were significantly more prevalent in HIV-positive participants. Pathobionts Ureaplasma urealyticum/parvum and Mycoplasma hominis were detected in 84.0% (195/233) and 45% (105/233), respectively. This present study describes a high prevalence of STIs. Co-infection between HPV and STIs was found in the majority of the study subjects. The high prevalence of HPV emphasizes the need for HPV vaccination to prevent cervical cancer in this population. Management of STIs is also important in women presenting with gynecological symptoms.

A Retrospective Analysis of Four STI Pathogens in Obstetrics and Gynecological Patients in Hangzhou, China.

BACKGROUND: Among sexually transmitted infection (STI) pathogens, UU, CT, NG, and MG are very commonly detected. A retrospective study was conducted to analyze the clinical situations and laboratory data of patients in-fected with the four pathogens in Hangzhou city, Zhejiang Province, China. METHODS: For this study, 4,716 female outpatients and inpatients of the Department of Obstetrics and Gynecology of Hangzhou Third People´s Hospital were randomly selected from January 2019 to December 2023. Multiple types of specimens were collected and four STI pathogens were detected. Data collection was taken from the hospital's electronic medical records and statistical analysis was processed with SPSS 25.0 software. RESULTS: In the past five years, year by year, the positive rate presented an increasing trend. Out of 4,716 patients, 2,931 were positive, and the positive rate was 62.15%. The positive rate of single infection was significantly higher than of co-infection (p < 0.05). The highest positive rate of all STI patients was found in the  20 age group, and the rate was significantly different between each age group (p < 0.05). Single infection with UU occurred significantly more often than with the other three pathogens (p < 0.05), and co-infection with UU and CT and UU, CT, and MG were significantly dominating (p < 0.05). Only three patients had an infection with all four pathogens, and it was extremely rare. The 21 - 30 and 31 - 40 age groups had high incidences of infection, with a significant difference compared with other age groups (p < 0.05). CONCLUSIONS: The positive rate shows an increasing trend in Hangzhou in the past five years. More single infection than co-infection and more younger patients were detected. Single infection with UU was dominant in all positive patients. The publicity and more screening testing items of STI for younger people should be strengthened in Hangzhou, and the people of Hangzhou should be made more aware that information technology is helpful in aiding the control of STI diseases.

Trends of Toxoplasma gondii and common transfusable venereal infections among blood donors in Menoufia Province, Egypt.

Blood transfusion has a hazard of transmission of many pathogens, including Toxoplasma gondii (T. gondii) and other venereal infections. It is crucial to conduct epidemiological surveillance to detect the prevalence of these pathogens. The study aimed to assess the seroprevalence of T. gondii and common transfusable venereal infections among healthy blood donors in Menoufia Province, Egypt, and identify associated risk factors. Four hundred twenty individuals were recruited between January and April 2023 for cross-sectional descriptive research from the blood banks of Menoufia University medical hospitals. Collected blood samples were screened for anti-T. gondii IgM and IgG, HBsAg, anti-HCV antibodies, HIV p24 antigen and anti-HIV antibodies, and anti-Treponema pallidum antibodies. 46 (11.0%) and 22 donors (5.2%) individuals tested positive for anti-T. gondii IgG with a 95% CI (8.3-14.6) and IgM with a 95% CI (3.5-8.1), respectively, while one patient (0.2%) was positive for both antibodies. Regarding venereal infections, 12 (2.9%) were positive for HBV, 6 (1.4%) were positive for HCV, 7 (1.7%) were positive for HIV, and none of the tested population showed positivity for syphilis. Female gender, consumption of raw meat, agricultural environment, poor awareness about T. gondii, and blood group type (especially AB and O groups) were identified as independent risk factors for T. gondii infection. The study highlights the importance of testing blood donors for T. gondii and common transfusable venereal illnesses. Starting health education programs and preventative measures, such as suitable meat handling and cleanliness practices, is critical for minimizing the occurrence of these illnesses. Larger-scale additional study is advised to confirm these results and provide guidance for public health initiatives.

IST Nurse®: development and validity evidence of a mobile application as a support for the clinical management of Sexually Transmitted Infections.

OBJECTIVE: to develop and evaluate the validity evidence of a mobile application to support nurses in the clinical management of sexually transmitted infections. METHOD: methodological study conducted in four steps: analysis and definition of requirements; content definition; computational representation with system design; and coding with testing and refinement. In the first steps, nurses with expertise in the subject participated, and in the last, professionals with education in information and communication technology. Data analysis was performed by calculating the Content Validity Index (CVI), considering the minimum agreement value of 0.78. To confirm the viability of the CVI, the binomial test was used through the R software. Variables with p > 0.05 indicated agreement between the judges. RESULTS: the CVI was 0.98 for content, 1.0 for usability and 0.85 for functional performance, showing that the developed application has high validity. CONCLUSION: it is believed that the IST Nurse® application represents an important technological tool in strengthening evidence-based nursing care. Intervention studies are therefore suggested.

Peer-Delivered HIV Self-Testing, Sexually Transmitted Infection Self-Sampling, and Pre-exposure Prophylaxis for Transgender Women in Uganda: A Randomized Trial.

BACKGROUND: Peer-delivered HIV self-testing (HIVST) and sexually transmitted infection self-sampling (STISS) may promote adherence to oral pre-exposure prophylaxis (PrEP), but no studies have analyzed this approach among transgender women (TGW) in sub-Saharan Africa. SETTING: The Peer study was a cluster randomized trial in Uganda (October 2020-July 2022; NCT04328025). METHODS: Ten TGW peer groups, each with 1 TGW peer and 8 TGW, were randomized 1:1 to receive quarterly in-clinic HIV testing with PrEP refills as standard-of-care (SOC) or SOC plus monthly peer delivery of oral-fluid HIVST, STISS, and PrEP refills (intervention). Participants were followed for 12 months. The primary outcome was PrEP adherence. RESULTS: We screened 85 TGW and enrolled 82 (41 per arm). The median age was 22 years (interquartile range [IQR] 20-24). Twelve-month retention was 88% (72/82). At the 3, 6, 9, and 12-month clinic visits, 10%, 5%, 5%, and 0% of TGW in the intervention arm had TFV-DP levels ≥700 fmol/punch, versus 7%, 15%, 7%, and 2% in the SOC arm, respectively (P = 0.18). At all visits, any detectable TFV-DP levels were significantly higher in SOC than the peer delivery group (P < 0.04). PrEP adherence was associated with sex work (incidence rate ratio 6.93; 95% CI: 2.33 to 20.60) and >10 years of schooling (incidence rate ratio 2.35; 95% CI: 1.14 to 4.84). There was a strong correlation between tenofovir detection in dried blood spots and urine (P < 0.001). No HIV seroconversions occurred. CONCLUSIONS: Peer-delivered HIVST and STISS did not increase low levels of oral PrEP adherence among TGW in Uganda. Long-acting PrEP formulations should be considered for this population.

Study protocol for a pre/post study on knowledge, attitudes and behaviors regarding STIs and in particular HPV among Italian adolescents, teachers, and parents in secondary schools.

Sexually transmitted infections (STIs) are one of the most important issues related to sexual and reproductive health, as it is estimated that more than 1 million new infections are acquired every day worldwide and data on the prevalence and incidence of these infections, especially among young people, are increasing. Nevertheless, there are some knowledge and behavioral gaps, and young people need more support from their school and family network to protect themselves and their peers. Therefore, we have designed a multicenter prospective intervention study involving public lower and upper secondary school students, their parents and teachers (ESPRIT). The intervention will take place in the school year 2023-2024, where students will meet with experts and be involved in peer education, while adults (parents and teachers) will participate in distance and face-to-face trainings. All target groups will complete KAP (knowledge, attitudes, practice) questionnaires before and after participating in the intervention to measure its effectiveness. The results of this study will help to assess and improve the level of knowledge of lower and upper secondary school students, parents and teachers about STIs and HPV in particular, raise awareness of sexual and reproductive health issues, including vaccination, among lower and upper secondary school students and their families, and evaluate the effectiveness of these interventions in terms of improving knowledge and changing attitudes and behaviors. The study protocol has been approved by the Regional Unique Ethics Committee of Friuli Venezia Giulia (CEUR-2023-Sper-34). The project is being carried out with the technical and financial support of the Italian Ministry of Health-CCM.