Infecciones de transmisión sexual en el contexto de una agresión sexual / Sexually transmitted infections in the context of a sexual assault

La violencia sexual es un problema a nivel mundial con un impacto sobre la salud que engloba aspectos médicos, legales y psicológicos, por lo que el manejo de estos pacientes debe ser multidisciplinar siendo obligado establecer protocolos de actuación. Las personas que son víctimas de agresiones sexuales (AS) tienen un alto riesgo de adquirir infecciones de transmisión sexual (ITS), por lo que se deben prevenir, diagnosticar, tratar y realizar seguimiento postratamiento, según el protocolo de actuación establecido para evitar posibles complicaciones que se pudieran derivar si no se hiciera

Sexual violence is a worldwide problem with an impact on health that encompasses medical, legal and psychological aspects. Therefore the management of these patients must be multidisciplinary, and action protocols are compulsory. People who are victims of a sexual assault (SA) are at high risk of acquiring a sexually transmitted infection (STI), which must be prevented, diagnosed, treated and followed up post treatment, according to the established action protocol to prevent potential complications

Sexually transmitted infections in the context of a sexual assault. / Infecciones de transmisión sexual en el contexto de una agresión sexual.

Sexual violence is a worldwide problem with an impact on health that encompasses medical, legal and psychological aspects. Therefore the management of these patients must be multidisciplinary, and action protocols are compulsory. People who are victims of a sexual assault (SA) are at high risk of acquiring a sexually transmitted infection (STI), which must be prevented, diagnosed, treated and followed up post treatment, according to the established action protocol to prevent potential complications.

Chlamydia trachomatis re-infection in Spain: A STI clinic-based cohort study / Reinfección por Chlamydia trachomatis en España: un estudio de cohorte en una Unidad de ITS

BACKGROUND: Chlamydia trachomatis (C. trachomatis) is the most frequently reported sexually transmitted infection (STI) in developed countries, but there is a lack data on its incidence and population dynamics in Spain. The objectives of this study were to estimate the incidence of C. trachomatis in patients seeking medical attention in an STI clinic with a defined population catchment area, to identify factors associated with this infection, and to explore differences between factors associated with new infections and re-infections. METHODS: A retrospective study was conducted on a cohort of patients from a STI clinic who underwent chlamydia testing at least twice between 2007 and 2015. RESULTS: Of the 2633 patients who met study selection criteria, 795 (30.2%) tested positive for C. trachomatis at baseline (baseline Chlamydia). The overall incidence was 7.97/100 person-years (95% CI: 7.2-8.8): 5.9/100 person-years (95% CI: 5.2-6.7) among patients testing negative for C. trachomatis at baseline, and 18.3 person-years (95% CI: 15.6-21.5) among those testing positive at baseline. In multivariate analysis, the factors independently associated with overall incidence were a history of infection with C. trachomatis in the previous 6 months (hazard ratio=3.6; 95% CI: 2.3-5.4), younger age (HR <20 vs ≥35 years=5.5; 95% CI: 3.2-9.5), male sex, 2 or more sexual partners in the previous month and year, and inconsistent condom use. CONCLUSIONS: Guidelines should be established for C. trachomatis in Spain, including recommendations on the need for follow-up and re-testing, independently of age. Though data concerning the optimal timing of re-testing are inconclusive, our findings support the establishment of a 3-6 month interval

INTRODUCCIÓN: Chlamydia trachomatis es la infección de transmisión sexual (ITS) más frecuentemente notificada en los países desarrollados, pero en España carecemos de información sobre su incidencia y su dinámica poblacional. Nuestros objetivos han sido estimar la incidencia de C.trachomatis en los pacientes de una clínica de ITS con una población de referencia definida, identificar factores asociados con ella y evaluar diferencias entre los factores asociados con las nuevas infecciones y las reinfecciones. MÉTODOS: Cohorte retrospectiva de pacientes de una Unidad de ITS con pruebas diagnósticas para Chlamydia en más de una ocasión entre 2007 y 2015. RESULTADOS: De los 2.633 pacientes que cumplieron los criterios de inclusión en el estudio, 795 (30,2%) tuvieron un resultado positivo de C.trachomatis en el episodio basal (Chlamydia basal). La incidencia global fue de 7,97/100 años-persona (IC 95%: 7,2-8,8): 5,9/100 años-persona (IC 95%: 5,2-6,7) entre los pacientes con chlamydia basal negativa y 18,3 años-persona (IC 95%: 15,6-21,5) entre aquellos con chlamydia basal positiva. En los análisis multivariantes, los factores asociados independientemente con la incidencia global fueron haber padecido otra infección por C.trachomatis en los últimos 6meses (hazard ratio [HR] = 3,6; IC95%: 2,3-5,4), menor edad (HR < 20 vs ≥ 35 = 5,5; IC95%: 3,2-9,5), ser hombre, 2 o más parejas en el último mes o en el último año y la utilización inconsistente del preservativo. CONCLUSIÓN: Son necesarias guías de práctica clínica para C.trachomatis en España que incluyan recomendaciones sobre la necesidad de seguimiento y re-cribado, independientemente de la edad. El periodo óptimo para repetir las pruebas no está establecido, nuestros resultados apoyan la implantación de un intervalo de 3-6 meses

Chlamydia trachomatis re-infection in Spain: A STI clinic-based cohort study.

BACKGROUND: Chlamydia trachomatis (C. trachomatis) is the most frequently reported sexually transmitted infection (STI) in developed countries, but there is a lack data on its incidence and population dynamics in Spain. The objectives of this study were to estimate the incidence of C. trachomatis in patients seeking medical attention in an STI clinic with a defined population catchment area, to identify factors associated with this infection, and to explore differences between factors associated with new infections and re-infections. METHODS: A retrospective study was conducted on a cohort of patients from a STI clinic who underwent chlamydia testing at least twice between 2007 and 2015. RESULTS: Of the 2633 patients who met study selection criteria, 795 (30.2%) tested positive for C. trachomatis at baseline (baseline Chlamydia). The overall incidence was 7.97/100 person-years (95% CI: 7.2-8.8): 5.9/100 person-years (95% CI: 5.2-6.7) among patients testing negative for C. trachomatis at baseline, and 18.3 person-years (95% CI: 15.6-21.5) among those testing positive at baseline. In multivariate analysis, the factors independently associated with overall incidence were a history of infection with C. trachomatis in the previous 6 months (hazard ratio=3.6; 95% CI: 2.3-5.4), younger age (HR <20 vs ≥35 years=5.5; 95% CI: 3.2-9.5), male sex, 2 or more sexual partners in the previous month and year, and inconsistent condom use. CONCLUSIONS: Guidelines should be established for C. trachomatis in Spain, including recommendations on the need for follow-up and re-testing, independently of age. Though data concerning the optimal timing of re-testing are inconclusive, our findings support the establishment of a 3-6 month interval.