The Notijoves Project: Protocol for a Randomized Controlled Trial About New Communication Technologies and Gamification to Promote Partner Notification of Sexually Transmitted Infections Among Young People.

BACKGROUND: An increase in sexually transmitted infections (STIs) as well as an increase in the use of new information and communication technologies among young people in Catalonia is the inspiration behind the idea of designing a smartphone app to promote partner notification of STIs. OBJECTIVE: The main objective of this study is to design a Web-based tool adapted to smartphones for partner notification of STIs among youth who are 16 to 24 years old. Additionally, the objective is to evaluate the Web-based tool's role in increasing the patient referral partner notification. METHODS: This is a multicenter randomized controlled trial with a proportional stratification of the sample by center and random allocation of participants to the 3 arms of the study (simple Web-based intervention, game Web-based intervention, and control). This study is being conducted by midwives, gynecologists, and physicians in the sexual and reproductive areas of the primary health care centers. RESULTS: The primary outcome measure is the number and proportion of partner notifications. Additional outcome measures are the yield of early diagnosis and treatment of those exposed and infected, acceptability, barriers, and preferences for partner notification. Expected results include an increase in the yield of partner notification, early diagnosis and treatment among youth using Web-based interventions compared with those receiving the traditional advice to notify, and a description of sexual networks among those participating in the study. CONCLUSIONS: The Notijoves is expected to have a sustainable positive impact in the partner notification practice among youth and contribute to increasing the awareness of STI prevention. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/12896.

Discordant prevalence of Chlamydia trachomatis in asymptomatic couples screened by two screening approaches.

This study was carried out to observe the effect of screening both members of an asymptomatic couple for Chlamydia trachomatis. First void urine samples were collected from 105 women and their male sex partners. Women were recruited for screening at a sexual health clinical setting (age 16-25 years), and home sampling screening options were used for men. Using PCR we detected seven positive C. trachomatis samples in women (6.6%) and five in men (4.6%). The concordant infection rate was 33% (3/9 couples). Routine urine screening of the female partner might result in substantial underestimation of the C. trachomatis prevalence within the couple, where perhaps 56% of the couples where at least one partner tested positive would remain undiagnosed. Screening both partners compared with women- or men-only screening increased the detection rate of positive couples. Furthermore, the use of alternative screening approaches in different clinical settings increases testing in at risk populations.

[Prevalence and determining factors of acquiring C. trachomatis infection among adolescents and young adults in Catalonia]. / Prevalencia de la infección por C. trachomatis y N. gonhorroeae y determinantes para su adquisición en jóvenes y adultos-jóvenes en Cataluña.

OBJECTIVE: To determine the prevalence of Chlamydia trachomatis (C. trachomatis) and Neisseria gonorrhoeae (N. gonhorroeae) infections and the risk factors for acquiring them in individuals under 35 years-old attending sexual health clinics in Barcelona province in 2006. METHODS: Cross-sectional study of a convenience sample of 500 adolescents and young adults aged between 16 and 35 years. A total of 423 samples were analysed using real-time PCR. A standardised questionnaire was used to collect clinical, epidemiological, and behavioural data on the participants. Significant differences were analysed in the descriptive study using Pearson's ((2). The association between C. trachomatis infection and its determining factors was analysed using the Mantel-Haenszel test and a multivariate logistic regression model. RESULTS: The overall prevalence of C. trachomatis was 4%, and was significantly higher in those under 25 years of age. The overall prevalence of N. gonhorroeae was 0.2%. The independent risk factors for infection by C. trachomatis were as follows: foreign origin (OR: 3.74; CI 95%: 1.10-12.72), having had a sexual partner in the last 3 months (OR 3.91; CI 95%: 1.30-11.81), and tobacco use the last 12 months (OR: 4.99; CI 95%: 1.34-18.59). CONCLUSIONS: This is the first study performed in Catalonia that shows high prevalence of C. trachomatis in young people, thus confirming trends in the rest of Europe. Systematic monitoring of C. trachomatis infection in sentinel populations will provide valid information allowing us to assess the relevance of proposing targeted screening programs in our setting.

Prevalencia de la infección por C. trachomatis y N. gonhorroeae y determinantes para su adquisición en jóvenes y adultos-jóvenes en Cataluña / Prevalence and determining factors of acquiring C. trachomatis infection among adolescents and young adults in Catalonia

Objetivo Determinar la prevalencia de Chlamydia trachomatis (C. trachomatis) y Neisseria gonhorroeae (N. gonhorroeae) y los factores de riesgo para su adquisición en menores de 35 años, usuarios de centros de atención a la salud sexual de la provincia de Barcelona durante el año 2007.MètodosEstudio transversal de una muestra oportunista de 500 jóvenes y adultos-jóvenes de 16-35 años. Un total de 397 muestras endocervicales y 26 de orina fueron analizadas mediante PCR en tiempo real. Se utilizó un cuestionario estandarizado para recoger información clínica, epidemiológica y conductual. Se analizaron las diferencias significativas en el análisis descriptivo mediante Pearson's χ2 o Fisher's exact test. La asociación entre la infección por C. trachomatis y sus determinantes fueron examinados mediante el test Mantel-Haenszel y un modelo de regresión logística multivariante. Se calcularon las Odds ratio y los intervalos de confianza al 95%.ResultadosLa prevalencia global de C. trachomatis fue del 4%, significativamente más elevada en el grupo de menores de 25 años. La prevalencia de N. gonhorroeae fue del 0,2%. Los factores de riesgo independientes para la infección de C. trachomatis fueron: origen extranjero (OR: 3,74; IC 95%: 1,10-12,72), tener nueva pareja sexual < 3 meses (OR 3,91, IC 95%: 1,30-11,81) y el consumo de tabaco<12 meses (OR: 4,99, IC 95%: 1,34-18,59).Conclusiones Este es el primer estudio realizado en Cataluña, que muestra elevadas prevalencias de C. trachomatis en jóvenes, y que reafirma las tendencias encontradas en Europa. Sistematizar la monitorización de la infección por C. trachomatis en poblaciones centinela aportará información válida para valorar la pertinencia de proponer programas de cribado en nuestro entorno (AU)

Objective To determine the prevalence of Chlamydia trachomatis (C. trachomatis) and Neisseria gonorrhoeae (N. gonhorroeae) infections and the risk factors for acquiring them in individuals under 35 years-old attending sexual health clinics in Barcelona province in 2006.MethodsCross-sectional study of a convenience sample of 500 adolescents and young adults aged between 16 and 35 years. A total of 423 samples were analysed using real-time PCR. A standardised questionnaire was used to collect clinical, epidemiological, and behavioural data on the participants. Significant differences were analysed in the descriptive study using Pearson's (2. The association between C. trachomatis infection and its determining factors was analysed using the Mantel-Haenszel test and a multivariate logistic regression model. Results The overall prevalence of C. trachomatis was 4%, and was significantly higher in those under 25 years of age. The overall prevalence of N. gonhorroeae was 0.2%. The independent risk factors for infection by C. trachomatis were as follows: foreign origin (OR: 3.74; CI 95%: 1.10-12.72), having had a sexual partner in the last 3 months (OR 3.91; CI 95%: 1.30-11.81), and tobacco use the last 12 months (OR: 4.99; CI 95%: 1.34-18.59).Conclusions This is the first study performed in Catalonia that shows high prevalence of C. trachomatis in young people, thus confirming trends in the rest of Europe. Systematic monitoring of C. trachomatis infection in sentinel populations will provide valid information allowing us to assess the relevance of proposing targeted screening programs in our setting (AU)

Conocimiento sobre el VIH y las infecciones de transmisión sexual en inmigrantes latinoamericanos y magrebíes en Cataluña / Knowledge of HIV and sexually-transmitted diseases in Latin American and Maghrebi immigrants in Catalonia (Spain)

ObjetivoDescribir y comparar el grado de conocimiento sobre el VIH/sida con el uso del preservativo por la población inmigrante.MétodosEstudio transversal mediante encuesta semiestructurada y entrevista personal realizada en centros asistenciales de las regiones sanitarias de Barcelona y Barcelonés Norte y Maresme a 238 usuarios latinoamericanos y magrebíes en 2003. El cuestionario incluía variables sociodemográficas, de conducta sexual, de conocimientos generales sobre VIH/sida, y sobre la transmisión y la prevención. Para identificar determinantes del “conocimiento inadecuado del VIH/sida” se aplicó un modelo de regresión logística.ResultadosEl 53,8% de los encuestados tenían un conocimiento inadecuado del VIH/sida. En el análisis univariado se asociaban con este desconocimiento los magrebíes, los que no vivían en Barcelona, los que no tenían trabajo y los que no tenían estudios; en el multivariado se asociaban los magrebíes con una situación más desfavorecida respecto a los latinoamericanos [odds ratio (OR)=4,99; intervalo de confianza del 95% (IC 95%): 2,73-9,10] y los inmigrantes sin trabajo (OR=2,59; IC 95%: 1,42-4,73). El uso del preservativo fue valorado como un método de prevención eficaz, pero el 42,1% de los encuestados no lo utilizaba en sus relaciones ocasionales.ConclusionesEs necesario mejorar el conocimiento sobre los mecanismos de transmisión del VIH/sida y eliminar concepciones erróneas de la infección entre los inmigrantes latinoamericanos y magrebíes. La población inmigrante es vulnerable y prioritaria para impulsar intervenciones preventivas, adaptadas a sus especificidades lingüísticas y culturales. Monitorizar la falta de información, las concepciones erróneas y sus conductas sexuales es esencial para evaluar la efectividad de las intervenciones efectuadas(AU)

ObjectivesTo describe and compare levels of knowledge about HIV/AIDS and condom use in the immigrant population.MethodWe performed a cross-sectional study by means of a semi-structured questionnaire and face-to face interviews in 238 Latin American and Maghrebi users of medical centers in the Barcelona and North Barcelona-Maresme health areas. The questionnaire included sociodemographic variables and questions on sexual behavior and general knowledge about HIV/AIDS, transmission mechanisms, and means of prevention. A logistic regression model was used to identify the determinants of ‘inadequate knowledge of HIV/AIDS’.ResultsA total of 53.8% of interviewees had inadequate knowledge of HIV/AIDS. Univariate analysis showed inadequate knowledge to be associated with being from the Maghreb, not living in Barcelona, being without work and not having educational qualifications. Multivariate analysis revealed that the only variables significantly associated with inadequate knowledge were being from the Maghreb as opposed to being from Latin America (OR=4.99; 95% CI: 2.74-5.10) and being unemployed as opposed to being employed (OR=2.59; 95% IC: 1.42-4.73). Condoms were seen as an effective prevention method, but 42.1% of interviewees did not use them in occasional relationships.ConclusionsKnowledge of routes of HIV transmission should be improved and mistaken ideas about infection should be eliminated among Latin American and Maghrebi immigrants. The immigrant population is a vulnerable group that ought to be prioritized to promote prevention programs adapted to its linguistic and cultural specificities. Evaluating the effectiveness of the interventions performed is essential to monitor lack of information, mistaken ideas and sexual behavior in this group(AU)

[Knowledge of HIV and sexually-transmitted diseases in Latin American and Maghrebi immigrants in Catalonia (Spain)]. / Conocimiento sobre el VIH y las infecciones de transmisión sexual en inmigrantes latinoamericanos y magrebíes en Cataluña.

OBJECTIVES: To describe and compare levels of knowledge about HIV/AIDS and condom use in the immigrant population. METHOD: We performed a cross-sectional study by means of a semi-structured questionnaire and face-to face interviews in 238 Latin American and Maghrebi users of medical centers in the Barcelona and North Barcelona-Maresme health areas. The questionnaire included sociodemographic variables and questions on sexual behavior and general knowledge about HIV/AIDS, transmission mechanisms, and means of prevention. A logistic regression model was used to identify the determinants of 'inadequate knowledge of HIV/AIDS'. RESULTS: A total of 53.8% of interviewees had inadequate knowledge of HIV/AIDS. Univariate analysis showed inadequate knowledge to be associated with being from the Maghreb, not living in Barcelona, being without work and not having educational qualifications. Multivariate analysis revealed that the only variables significantly associated with inadequate knowledge were being from the Maghreb as opposed to being from Latin America (OR=4.99; 95% CI: 2.74-5.10) and being unemployed as opposed to being employed (OR=2.59; 95% IC: 1.42-4.73). Condoms were seen as an effective prevention method, but 42.1% of interviewees did not use them in occasional relationships. CONCLUSIONS: Knowledge of routes of HIV transmission should be improved and mistaken ideas about infection should be eliminated among Latin American and Maghrebi immigrants. The immigrant population is a vulnerable group that ought to be prioritized to promote prevention programs adapted to its linguistic and cultural specificities.

Combined hormonal contraception and venous thromboembolism.

This review provides an update of knowledge regarding venous thromboembolism (VTE) and combined hormonal contraceptives (CHCs) in the light of new progestins and new administration routes for CHCs. Practical recommendations are also offered. The association between the use of combined oral contraceptives (COCs) and an increased risk of VTE has been known about for many years, it being related mainly to the dose of oestrogen; however, recent research has also shown the influence of the type of progestin. When compared to COCs containing levonorgestrel or norethisterone, those containing desogestrel or gestodene present a two-fold greater risk of VTE; for COCs containing cyproterone acetate, the risk is four-fold greater, while there are no or insufficient data for those containing norgestimate, chlormadinone acetate or drospirenone. With regard to the contraceptive patch, the available data suggest that the risk of VTE is similar to that observed with COCs. There are no data concerning vaginal rings. The greatest risk of COC-associated VTE occurs during the first year of use, thus suggesting the existence of a predisposing condition, such as being a carrier of a thrombogenic mutation with which the COCs would exert a synergistic effect. Routine screening for such conditions is not justified. Changes in haemostatic variables produced by COCs, for example, acquired resistance to protein C, could be linked to VTE, although it has yet to be demonstrated that such alterations are related to a clinical risk of VTE among COC users. At present there are no laboratory tests able to detect an increased risk of VTE in asymptomatic women. The key procedures in terms of ensuring the safe use of this contraceptive method are a full clinical, personal and family history, in order to evaluate risk factors for VTE and cardiovascular disease, along with the recording of blood pressure and body mass index prior to the prescription of COCs.

Experience with GyneFIX insertions in Spain: favorable acceptance of the intrauterine contraceptive implant with some limitations.

This study evaluates the incidents associated with GyneFIX insertion and first-year expulsion and continuity rates within the usual intrauterine contraceptive practice of a working group of Spanish professionals (GESEG), formed specifically with this aim. It is a prospective, multicenter, observational study of GyneFIX insertion in 1684 women. Data were prospectively collected on a structured form and processed centrally. Interest was focused on difficulties encountered during the insertion procedure and symptoms experienced during insertion. All terms were defined by consensus. Among the total, 18.6% of the women were nulliparous. GyneFIX insertion was rated easy in 92%, with more difficulty in nulliparous women, who showed significantly more symptoms during insertion of the device. First-year expulsion and continuity rates were 5.6 and 88 per 100 women, respectively. The pregnancy rate was 0.3 per 100 women/years. The GyneFIX system is an interesting alternative to standard IUDs for intrauterine contraception with copper, particularly in women who have experienced expulsion of other types of IUDs. Experienced professionals in IUD insertion quickly acquire familiarity with the GyneFIX insertion system, but proper implantation does not completely eliminate the risk of expulsion. Thus, the insertion system should be further modified to achieve a simpler, safer technique.