[[Translated article]]AEDV Expert Consensus Document on the Organization of a Multidisciplinary Unit for Patients With or at Risk of Venereal Infections.

Over the past few years, venereal or sexually transmitted infections (STIs) have been on the rise worldwide requiring additional specialized monographic consultations to specifically treat STIs. Therefore, the Spanish Academy of Dermatology and Venereology (AEDV) Research Working Group on STIs and HIV has drafted this document with the necessary requirements in terms of infrastructure, personnel, technology, specific materials for sample collection, and needs for current therapeutic options. Strict emphasis is placed on the protection of patient privacy. A health care circuit model is outlined too. Additionally, a section has been included on contact tracking and reporting, key elements for the effective prevention and control of STIs. These clinical practice guidelines seek to establish a clinical action framework adapted to the current challenges posed by STIs and HIV in the dermatology, venereology, and multidisciplinary settings.

Development of a Questionnaire on Knowledge, Habits, and Attitudes on Sexually Transmitted Infections in Teenagers and Young Adults / Generación de un cuestionario sobre conocimientos, hábitos y actitudes sobre infecciones de transmisión sexual en adolescentes y adultos jóvenes

Communication with teenagers who are significantly affected by sexually transmitted infections (STIs) is essential for the sake of prevention. The aim of this study is to develop a specific questionnaire for surveying the degree of knowledge, behavior, and attitudes of current teenagers and young adults on STIs to come up with the proper training tools. We conducted the study following the Delphi method, a 2-round critical assessment score (from 1 to 9) of all domains and items. Only domains and items with median scores ≥8 were selected. A total of 8 panelists were involved in this survey. After establishing a median score ≥8, a total of 14 domains and 40 items were eventually selected. This is the first questionnaire ever conducted to study the knowledge, habits, and attitudes of contemporary teenagers and young adults on STIs, and stands as a valuable tool for future training on STI prevention in teenagers and young adults. (AU)

La comunicación con los adolescentes, quienes están marcadamente afectados por las infecciones de transmisión sexual (ITS) es imprescindible para diseñar programas de prevención. El objetivo de este estudio es desarrollar un cuestionario específico para estudiar el grado de conocimiento, los hábitos y las actitudes de los adolescentes y los adultos jóvenes frente a las ITS. El estudio se desarrolló siguiendo el método Delphi con un panel de expertos. Posteriormente se realizó una evaluación crítica (puntuación de 1 a 9) de todos los dominios e ítems a través de 2 vueltas, seleccionándose dominios y elementos con una puntuación mediana ≥8. Participaron un total de 8 panelistas. Al establecerse la mediana de puntuación en ≥8, quedaron finalmente aceptados 14 dominios y 40 ítems. Este es el primer cuestionario que analiza los conocimientos, los hábitos y las actitudes de los adolescentes y los adultos jóvenes actuales sobre las ITS, y una valiosa herramienta para la formación futura sobre la prevención de las ITS en adolescentes y adultos jóvenes. (AU)

[Artículo traducido] Generación de un cuestionario sobre conocimientos, hábitos y actitudes sobre infecciones de transmisión sexual en adolescentes y adultos jóvenes / Development of a Questionnaire on Knowledge, Habits, and Attitudes on Sexually Transmitted Infections in Teenagers and Young Adults

La comunicación con los adolescentes, quienes están marcadamente afectados por las infecciones de transmisión sexual (ITS) es imprescindible para diseñar programas de prevención. El objetivo de este estudio es desarrollar un cuestionario específico para estudiar el grado de conocimiento, los hábitos y las actitudes de los adolescentes y los adultos jóvenes frente a las ITS. El estudio se desarrolló siguiendo el método Delphi con un panel de expertos. Posteriormente se realizó una evaluación crítica (puntuación de 1 a 9) de todos los dominios e ítems a través de 2 vueltas, seleccionándose dominios y elementos con una puntuación mediana ≥8. Participaron un total de 8 panelistas. Al establecerse la mediana de puntuación en ≥8, quedaron finalmente aceptados 14 dominios y 40 ítems. Este es el primer cuestionario que analiza los conocimientos, los hábitos y las actitudes de los adolescentes y los adultos jóvenes actuales sobre las ITS, y una valiosa herramienta para la formación futura sobre la prevención de las ITS en adolescentes y adultos jóvenes. (AU)

Communication with teenagers who are significantly affected by sexually transmitted infections (STIs) is essential for the sake of prevention. The aim of this study is to develop a specific questionnaire for surveying the degree of knowledge, behavior, and attitudes of current teenagers and young adults on STIs to come up with the proper training tools. We conducted the study following the Delphi method, a 2-round critical assessment score (from 1 to 9) of all domains and items. Only domains and items with median scores ≥8 were selected. A total of 8 panelists were involved in this survey. After establishing a median score ≥8, a total of 14 domains and 40 items were eventually selected. This is the first questionnaire ever conducted to study the knowledge, habits, and attitudes of contemporary teenagers and young adults on STIs, and stands as a valuable tool for future training on STI prevention in teenagers and young adults. (AU)

Incidence of sexually transmitted infections and screening models among pre-exposure prophylaxis users.

INTRODUCTION: There is discussion about the frequency of STI screening among pre-exposure prophylaxis (PrEP) users. The aim of this study was to analyse the incidence of STIs and to evaluate different screening models in order to optimise the follow-up. METHODOLOGY: A prospective study was conducted between 2017 and 2023, including 138 PrEP users in a STI clinic. Participants were tested for STIs every three months. Unscheduled visits were performed for those with STI-related symptoms or for people who were notified for an STI by a sexual partner. We performed a survival analysis of repeated events, estimating the cumulative incidence (CI) and incidence rate (IR). RESULTS: The overall CI by quarterly screening was 8.3 (95% CI: 7.6-9.1) infections per person over six years, with a decreasing trend. The most frequently diagnosed pathogen was Neisseria gonorrhoeae, with a IR of 0.76 (95% CI: 0.68-0.84). If the frequency of screening is reduced to every six months, the IR of STIs is reduced by (95% CI: 0.5-0.66) infections per user per year, and at 12 months by 0.82 (95% CI: 0.73-0.89). In the case of no pharyngeal or urethral screening, IR is reduced by 0.37 (95% CI: 0.32-0.42) infections per person per year and in those over 35 years of age by 0.33 (95% CI: 0.25-0.4). Eliminating unscheduled visits, the reduction in IR is 0.33 (95% CI: 0.24-0.42). CONCLUSIONS: The incidence of STIs among PrEP users is high, especially in the rectum, but it does not increase over time. STI screening could be optimised reducing the frequency of pharyngeal and urethral testing, particularly in those over 35 years of age. It is essential to redistribute health resources for unscheduled visits, which have been shown to be the most cost-effective screening.

AEDV Expert Document on the Management of Ulcerative Venereal Infections. / Documento de expertos de la AEDV sobre el manejo de infecciones venéreas ulcerativas.

Currently, ulcerative sexually transmitted infections, including syphilis, herpes simplex virus (HSV), lymphogranuloma venereum (LGV), chancroid, donovanosis and, more recently, monkeypox (MPOX), represent a growing challenge for health care professionals. The incidence of syphilis and LGV has increased in recent years in Spain. Additionally, HSV, syphilis and chancroid can also increase the risk of HIV acquisition and transmission. The population groups most vulnerable to these infections are young people, men who have sex with men (MSM) and commercial sex workers. It is important to make a timely differential diagnosis since genital, anal, perianal, and oral ulcerative lesions may pose differential diagnosis with other infectious and non-infectious conditions such as candidiasis vulvovaginitis, traumatic lesions, carcinoma, aphthous ulcers, Behçet's disease, fixed drug eruption, or psoriasis. For this reason, the dermatologist plays a crucial role in the diagnosis and management of sexually transmitted infections. This chapter presents the main epidemiological, clinical and therapeutic features associated with these infections.

Expert Recommendations from the AEDV on Legal Aspects Surrounding the Management of Sexually Transmitted Diseases. / Recomendaciones de expertos de la AEDV sobre los aspectos legales en el manejo de las infecciones de transmisión sexual.

The incidence of sexually transmitted diseases has been on the rise in our setting for decades. These infections represent not only an individual problem, but also a problem of public health. Therefore, the management of STDs involves reducing community incidence, which means that common issues in the clinical practice such as failure to attend may become a more complex problem, which adds to the difficult and delicate task of locating sexual contacts that would benefit from screening and the appropriate treatment. On the other hand, STDs have direct legal implications in cases of underage patients, or suspected sexual assault. Therefore, the correct handling of these scenarios requires knowledge of the legal framework that regulates them. Dermatologists are clinically trained and prepared to deal with these conditions. Nonetheless, the legal issues involved are often difficult to solve. This document stands as a simple reference guide to help solve the main legal issues we may encounter in a consultation when dealing with STDs.

Factores de riesgo para la adquisición de Infecciones de Transmisión Sexual en trabajadores/as del sexo: revisión sistemática / Risk factors for the acquisition of Sexually Transmitted Infections in sex workers: a systematic review

Fundamentos: las infecciones de transmisión sexual (its) son infecciones causadas por más de treinta bacterias, virus y pa-rásitos diferentes, que se transmiten por contacto sexual, incluido el coito vaginal, anal o bucal, aunque algunas infecciones también pueden transmitirse de la madre al hijo durante el embarazo, el parto y la lactancia. Según la organización mundial de la salud, una de las principales poblaciones de riesgo para la adquisición de estas infecciones son los/las trabajadores/as del sexo y sus clientes. El objetivo de este trabajo fue analizar los factores de riesgo en la adquisición de infecciones de transmisión sexual en la población de trabajadores/as del sexo.métodos: se realizó una revisión sistemática mediante búsqueda en scopus, pubmed, cinahl, medline, lilacs e ibecs, de estudios observacionales, longitudinales y mixtos realizados en trabajadores/as del sexo que fueron publicados entre enero de 2011 y marzo de 2021, obteniendo una muestra final de cuarenta y tres artículos. La herramienta de evaluación de métodos mixtos (mixed methods assessment tool) fue utilizada para evaluar la calidad metodológica de los trabajos. Resultados: después de analizar la bibliografía se obtuvieron once grupos de factores de riesgo relacionados con la adquisición de its, siendo estos factores económicos, relacionados con las prácticas sexuales, consumo de drogas, trabajo sexual, educación, problemas de salud, país de origen y movilidad, pareja, edad, violencia y otros factores no pertenecientes a las anteriores categorías.conclusiones: las/os profesionales del sexo tienen numerosas características y comportamientos que les convierten en una población vulnerable a las its. Destacan los años ejerciendo la prostitución, el consumo de drogas, el número de parejas y el uso del preservativo, siendo estos factores clave para futuras estrategias de prevención e intervención, así como de investigación.(AU)

Background: sexually transmitted infections (sti), as their name suggests, are infections caused by more than thirty different bacteria, viruses, and parasites and are transmitted through sexual contact, including vaginal, anal, or oral intercourse, although some sexually transmitted infections can also transmitted from mother to child during pregnancy, childbirth and lactation. According to world health organization, one of the main populations at risk for acquiring these diseases are sex workers and their clients. Due to the high prevalence, the characteristics and behaviors that favor the development of these diseases are analyzed. The main objective of this paper was to analyze the risk factors in the acquisition of sexually transmitted diseases in the population of sex workers. Methods: a literature search was conducted in scopus, pubmed, cinahl, medline, lilacs and ibecs, of observational, longitudinal and mixed methods studies conducted in sex workers and published between january 2011 and march 2021, with a final sample of four-ty-three articles. The mixed methods assessment tool (mmat) was used to assess the methodological quality of the papers.results: after analyzing the literature, eleven groups of risk factors related to the acquisition of sexually transmitted diseases were obtained, these being economic factors, factors related to sexual practices, drug use, sex work, education, health problems, country of origin and mobility, partner, age, violence and other factors not belonging to the previous categories.conclusions: sex workers have numerous characteristics and behaviors that make them vulnerable to sexually transmitted in-fections. Of note are years of prostitution, drug use, number of partners and condom use, which are key factors for future prevention and intervention strategies, as well as research.(AU)

[Translated article] Spanish Academy of Dermatology and Venereology (AEDV) expert recommendations for the management of sexual transmitted parasitosis. Scabies, and pediculosis pubis.

Sexually transmitted infections are communicable diseases where the pathogen is transmitted through sexual contact. The Sexually Transmitted Infections Working Group of the Spanish Academy of Dermatology and Venereology (AEDV) is engaged in the drafting of documents to guide dermatologists and health care personnel who treat Spanish patients with these infections. This document analyzes the epidemiological, clinical, therapeutic, and control characteristics of 2 sexually transmitted parasitosis: scabies due to Sarcoptes scabiei var. hominis, and pubic pediculosis due to Phthirus pubis. Both parasitoses share a sort of mixed spread through sexual and community transmission regardless of the route through which the infection was initially acquired. This specific feature creates particularities in the management and control of the infestation.

Development of a Questionnaire on Knowledge, Habits, and Attitudes on Sexually Transmitted Infections in Teenagers and Young Adults. / [Artículo traducido] Generación de un cuestionario sobre conocimientos, hábitos y actitudes sobre infecciones de transmisión sexual en adolescentes y adultos jóvenes.

Communication with teenagers who are significantly affected by sexually transmitted infections (STIs) is essential for the sake of prevention. The aim of this study is to develop a specific questionnaire for surveying the degree of knowledge, behavior, and attitudes of current teenagers and young adults on STIs to come up with the proper training tools. We conducted the study following the Delphi method, a 2-round critical assessment score (from 1 to 9) of all domains and items. Only domains and items with median scores ≥8 were selected. A total of 8 panelists were involved in this survey. After establishing a median score ≥8, a total of 14 domains and 40 items were eventually selected. This is the first questionnaire ever conducted to study the knowledge, habits, and attitudes of contemporary teenagers and young adults on STIs, and stands as a valuable tool for future training on STI prevention in teenagers and young adults.

Encuesta para conocer la percepción sobre la educación sexual en adolescentes / Survey to know the perception of sexual education in adolescents

Fundamentos: la educación sexual es un pilar fundamental para un correcto enfoque de la sexualidad en los adolescentes, siendo más efectiva si se realiza en edades tempranas. El objetivo de este trabajo se fundamentó en estimar los conocimientos de salud sexual y la información percibida por los adolescentes, así como de dónde provenía. Métodos: se realizó un estudio observacional transversal en estudiantes de dos centros educativos públicos de castilla-la mancha a los que se les realizó una encuesta sobre conocimientos de sexualidad. Se hicieron comparaciones mediante t de student o u de mann whitney, o test de chi-cuadrado (o test exacto de fisher), según variables. Resultados: se incluyeron 248 encuestados/as (68,1% de madridejos y 31,9% de herencia) con una edad media de 14,67±1,1 años. El 47,2% fueron mujeres. Solo un 4,8% de los/as encuestados/as afirmaron hablar sobre sexualidad con sus progenitores. Un 56% afirmaron haber consumido contenido pornográfico, siendo la edad media de la primera visualización de 12,8±1 años. Se encontraron diferencias estadísticamente significativas entre la información recibida en los centros educativos y el ámbito familiar, tratándose más frecuentemente el consumo de alcohol y drogas, las infecciones de transmisión sexual (its) y los métodos anticonceptivos en los centros. Un cuarto de los/as encuestados/as que afirmaron haber tenido relaciones sexuales no habían utilizado preservativo. Aproximadamente, la mitad de los/as participantes no percibieron un riesgo alto de contraer its (vih, herpes y clamidia) en el caso de mantener relaciones sexuales sin preservativo. Conclusiones: existe una falta de educación sexual en los/as adolescentes, percibiendo gran heterogeneidad en los conocimientos ofrecidos en los centros educativos y el ámbito familiar.(AU)

Background: sex education is essential for an accurate approach of sexuality in adolescents, being more effective when it is carried out at early ages. This study aimed to estimate the sexual health knowledge and the information in this regard perceived by adolescents, as well as where it came from.methods: a cross-sectional observational study was performed in students from two public high schools in castilla-la mancha who were surveyed about sexual knowledge. Comparisons were made by using the student’s t test or mann whitney u test, the chi-square test (or fisher’s exact test) depending on the variables.results: 248 students were included (68.1% from madridejos and 31.9% from herencia) with a mean age of 14.67±1.1 years. The 47.2% were women. Only 4.8% of the participants affirm to talk about sexuality with their parents. The 56% declared had consumed pornographic content, with a mean first access age of 12.8±1 years. Significant statistically differences were found between the information received in schools and in the familiar surroundings, being alcohol and drug intake, sexually transmitted infections (sti), and contraceptive methods more frequently treated at the educational centers. A 25% of the surveyed students who reported having performed sexual relations stated not having used condom. Approximately, half of the participants did not perceive a high risk of getting stis (hiv, herpes and chlamydia) in the case of having sex without condom.conclusions: there is a lack of sexual knowledge in adolescents, perceiving a noteworthy heterogeneity in the offered informa-tion depending on it is received in high school or in familiar surroundings.(AU)

AEDV Expert Consensus Document on the Organization of a Multidisciplinary Unit for Patients With or at Risk of Venereal Infections. / Documento de expertos de la Academia Española de Dermatología y Venereología sobre la organización de una unidad multidisciplinar de atención a pacientes con o en riesgo de infecciones venéreas.

Over the past few years, venereal or sexually transmitted infections (STIs) have been on the rise worldwide requiring additional specialized monographic consultations to specifically treat STIs. Therefore, the Spanish Academy of Dermatology and Venereology (AEDV) Research Working Group on STIs and HIV has drafted this document with the necessary requirements in terms of infrastructure, personnel, technology, specific materials for sample collection, and needs for current therapeutic options. Strict emphasis is placed on the protection of patient privacy. A health care circuit model is outlined too. Additionally, a section has been included on contact tracking and reporting, key elements for the effective prevention and control of STIs. These clinical practice guidelines seek to establish a clinical action framework adapted to the current challenges posed by STIs and HIV in the dermatology, venereology, and multidisciplinary settings.

Evaluation of health status of transgender sex workers in Turkey: A qualitative study.

OBJECTIVE: Sex workers can be disadvantaged in terms of overall health due to challenging living and working conditions. This research aimed to evaluate the health status and experiences related to sexually transmitted infections (STDs) of unregistered transgender sex workers in Turkey. DESIGN: It employed a phenomenological qualitative research design. SITE: Data were collected in Istanbul between March 2021 and November 2021. PARTICIPANTS: Data were collected through in-depth interviews involving 24 people (19 sex workers and 5 physicians). METHODS: Key statements were listed during data analysis, and clusters of meanings were formed based on these statements. The participants' statements were used for contextual and structural descriptions. RESULTS: Sex workers suffer from chronic illnesses such as asthma, chronic obstructive pulmonary disease (COPD), diabetes, allergic diseases, and neurological disorders. Among the health issues affecting them, the most notable ones are STDs, psychological problems, and the risk of suicide. Sex workers also face a dilemma between choosing public hospitals and private hospitals. Majority of sex workers undergo regular testing for STDs, with the frequency varying from person to person. Reasons for not undergoing regular testing include lack of social security coverage, financial constraints, lack of information, and feeling undervalued. Some individuals are being subjected to mandatory testing. CONCLUSIONS: It is recommended that sex workers who seek and request healthcare services should be provided with detailed information and education, particularly regarding psychological problems and STDs.

La Transmisión Transgeneracional de Situaciones Traumáticas: Papel de la Psicología en el Proceso de Recuperación de la Memoria Colectiva de la Dictadura Franquista en España / The Transgenerational Transmission of Traumatic Situations: The Role of Psychology in the Process of Recovery of the Collective Memory of the Franco Dictatorship in Spain

En este trabajo se hacen algunas consideraciones sobre la memoria y el olvido, se describen complejos procesos emocionales individuales y familiares que dan lugar a determinados estados psicológicos colectivos que suelen configurarse bajo las dictaduras y los estados totalitarios. Reflexiones que se enmarcan en el contexto de la reciente historia de España y que ayudarán a comprender, al menos en parte, el enorme retraso que la recuperación de la memoria ha tenido en nuestro país. Estas aportaciones están apoyadas en fuentes históricas, sociológicas, literarias y basadas en la teoría y la práctica clínica psicológica aplicada a tratamientos individuales, de familia y de grupos. (AU)

In this work, some considerations are made about memory and forgetting, complex individual and family emotional processes that give rise to certain collective psychological states that are usually configured under dictatorships and totalitarian states are described. These reflections are framed in the context of Spain’s recent history and will help to understand, at least in part, the enormous delay that the recovery of memory has had in our country. These contributions are supported by historical, sociological, and literary sources and based on psychological theory and clinical practice applied to individual, family, and group treatments. (AU)

La Transmisión Transgeneracional de Situaciones Traumáticas: Papel de la Psicología en el Proceso de Recuperación de la Memoria Colectiva de la Dictadura Franquista en España / The Transgenerational Transmission of Traumatic Situations: The Role of Psychology in the Process of Recovery of the Collective Memory of the Franco Dictatorship in Spain

En este trabajo se hacen algunas consideraciones sobre la memoria y el olvido, se describen complejos procesos emocionales individuales y familiares que dan lugar a determinados estados psicológicos colectivos que suelen configurarse bajo las dictaduras y los estados totalitarios. Reflexiones que se enmarcan en el contexto de la reciente historia de España y que ayudarán a comprender, al menos en parte, el enorme retraso que la recuperación de la memoria ha tenido en nuestro país. Estas aportaciones están apoyadas en fuentes históricas, sociológicas, literarias y basadas en la teoría y la práctica clínica psicológica aplicada a tratamientos individuales, de familia y de grupos. (AU)

In this work, some considerations are made about memory and forgetting, complex individual and family emotional processes that give rise to certain collective psychological states that are usually configured under dictatorships and totalitarian states are described. These reflections are framed in the context of Spain’s recent history and will help to understand, at least in part, the enormous delay that the recovery of memory has had in our country. These contributions are supported by historical, sociological, and literary sources and based on psychological theory and clinical practice applied to individual, family, and group treatments. (AU)

Manejo en atención primaria de las infecciones de transmisión sexual (II). Lesión ulcerada genital. Vulvovaginitis. Virus del papiloma humano / Management of sexually transmitted diseases in primary care (II). Genital ulcers. Vulvovaginitis. Human papilloma virus

En el presente artículo abordamos tres síndromes clínicos infecciosos con diferentes gérmenes como causantes, pero tienen en común que las manifestaciones que presentan son a nivel genital. Algunos son estrictamente originados por gérmenes de transmisión sexual, pero otros no. Hablaremos en este capítulo de las vulvovaginitis, de la lesión ulcerada genital y del virus del papiloma humano, tres grandes entidades que presentan una tasa no menospreciable de consulta en atención primaria, en aumento en los últimos años, y que como profesionales de salud debemos saber abordar por completo, desde su manejo diagnóstico, pasando por su correcto tratamiento y finalizando con los posteriores controles. En estas entidades es tan importante el correcto abordaje como el saber recomendar la prevención, el estudio de contactos y los cribados de otras infecciones que pueden presentarse concomitantemente.(AU)

In this paper we approach three clinical syndromes with different microbial agents that cause sexually transmitted diseases (STD) with a common condition: the symptomatology is in the genital area. Some of these microbial agents are transmitted strictly sexually, but not all. In this section we will discuss about vulvovaginitis, genital ulcers and human papilloma virus, three syndromes which have increased their incidence in recent years and primary care must know its management: diagnosis, correct treatment, controls, and study of sexual contacts. The optimal approach is as important as knowing how to recommend prevention of STD, contact study and screening for other infections that can be present at the same time although asymptomatically.(AU)

MPOX, o que sabemos sobre propagação e controle: uma revisão integrativa / MPOX, what we know about propagation and control: an integrative review / Viruela del mono, qué sabemos sobre la propagación y el control: una revisión integradora

Esta é uma revisão integrativa que busca compreender os fatores associados à propagação e controle de mpox, seguindo as recomendações estabelecidas pela declaração Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A consulta foi feita nas bases de dados PubMed, Lilacs e Cochrane Library. Foram selecionados quinze artigos, com amostra majoritária de homens que fazem sexo sem proteção com homens e homens que viajaram para locais com surto da doença ou tiveram contato com pessoas infectadas. Os principais fatores associados à infecção e à propagação da doença foram históricos de viagem, sexo desprotegido, ingestão de carne possivelmente contaminada, aglomerados e contato próximo com pessoa sintomática. Quanto aos fatores relacionados à prevenção, estão principalmente associados à triagem de casos suspeitos, hábitos de higiene pessoal, uso de equipamentos de proteção individual e isolamento do doente.

This integrative review examines the factors associated with mpox spread and control, following the recommendations established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Bibliographic search was conducted on the PubMed, Lilacs and Cochrane Library databases. The final sample included 15 articles, mostly composed of men who have unprotected sex with men and men who traveled to places with a mpox outbreak or had contact with infected people. Travel history, unprotected sex, eating potentially contaminated meat, crowding and close contact with a symptomatic person were the main factors associated with mpox infection and spread. Prevention is mainly associated with the screening of suspected cases, personal hygiene habits, use of personal protective equipment and patient isolation.

Este estudio realiza una revisión integradora para comprender los factores asociados con la propagación y el control de la viruela del mono, siguiendo las recomendaciones establecidas por Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Se consultaron las bases de datos PubMed, Lilacs y Cochrane Library. Se seleccionaron quince artículos, con una muestra mayoritaria de hombres que tienen sexo con hombres sin protección y hombres que viajaron a lugares con brote de la enfermedad o que tuvieron contacto con personas infectadas. Los principales factores asociados con la infección y la propagación de la enfermedad fueron el historial de viajes, las relaciones sexuales sin protección, el consumo de carne potencialmente contaminada, el hacinamiento y el contacto cercano con una persona sintomática. Los factores relacionados con la prevención están asociados principalmente con el tamizaje de casos sospechosos, los hábitos de higiene personal, el uso de equipos de protección personal y el aislamiento del paciente.

Complex posttraumatic stress disorder in intergenerational trauma transmission among Eritrean asylum-seeking mother-child dyads.

Background: Traumatic stress among forcibly displaced people has a variety of adverse consequences beyond individual mental health, including implications for poor socioemotional developmental outcomes for their children post-displacement.Objective: This study explored the intergenerational transmission of maternal ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) and depression among asylum-seeking mothers for their children's internalizing and externalizing difficulties.Method: Participants were 127 trauma-affected Eritrean mothers of preschool-aged children in Israel. The severity of child difficulties was compared between mothers with probable ICD-11 CPTSD (94.5% comorbid depression), ICD-11 PTSD (48.5% comorbid depression), unimorbid depression, and healthy mothers, using multivariate analyses of variance, while controlling for children's direct exposure to adverse life experiences.Results: Probable ICD-11 CPTSD and PTSD were present in 23.6% and 26.0% of mothers, respectively. Relative to maternal PTSD, CPTSD was significantly and strongly associated with elevated child internalizing symptoms (d = 2.44) and marginally significantly, although strongly, associated with child externalizing symptoms (d = 1.30). Post-hoc exploratory analyses documented that, relative to maternal PTSD and depression, CPTSD and depression comorbidity was marginally significantly but strongly associated with child internalizing (SMD = .67), but not externalizing symptoms (SMD = .35).Conclusions: Findings implicate maternal CPTSD and comorbid depression in child socio-emotional development and inform clinical assessment, prevention, and intervention to attenuate poor development among children in unstable post-displacement settings.

Trauma among forcibly displaced people has a variety of aversive multisystemic consequences, compromising the socioemotional development of non-exposed children.ICD-11 complex posttraumatic stress disorder (CPTSD) and comorbid depression may be functionally important to elevated risk for maternal intergenerational trauma transmission, even relative to ICD-11 posttraumatic stress disorder (PTSD).To effectively attenuate intergenerational transmission of trauma post-displacement, efforts and resources should be invested in maternal mental health care as well as socio-culturally adapted, trauma-sensitive parenting training.

[Management of sexually transmitted diseases in primary care (II). Genital ulcers. Vulvovaginitis. Human papilloma virus]. / Manejo en atención primaria de las infecciones de transmisión sexual (II). Lesión ulcerada genital. Vulvovaginitis. Virus del papiloma humano.

In this paper we approach three clinical syndromes with different microbial agents that cause sexually transmitted diseases (STD) with a common condition: the symptomatology is in the genital area. Some of these microbial agents are transmitted strictly sexually, but not all. In this section we will discuss about vulvovaginitis, genital ulcers and human papilloma virus, three syndromes which have increased their incidence in recent years and primary care must know its management: diagnosis, correct treatment, controls, and study of sexual contacts. The optimal approach is as important as knowing how to recommend prevention of STD, contact study and screening for other infections that can be present at the same time although asymptomatically.

Trends in vasectomy and sexually transmitted diseases in Chile: findings from robust national databases / Tendencias de la vasectomía y las enfermedades de transmisión sexual en Chile: resultados de bases de datos robustas / Tendências em vasectomia e doenças sexualmente transmissíveis no Chile: resultados de bases de dados robustas

Abstract: A controversy about the increase or decline of vasectomy is emerging; however, the evidence is still scarce in Latin America. This ecological study analyzed the vasectomy and sexual transmitted diseases (STD) trends over a period of 10 years in Chile and determined if there is any relationship between them. We conducted a mixed ecological study using secondary and representative data on the number of vasectomies and STD cases from 2008 to 2017. Vasectomy rates were calculated for age-specific groups of men aged 20-59 years, and specific STD (HIV, chlamydia, gonorrhea, trichomoniasis, and syphilis) for the same period. Multivariate negative binomial regression models were fitted to evaluate rate trends and relationships. The mean vasectomy age was 40.3 years, with no significant differences between the years of the study (p = 0.058). The overall vasectomy rate significantly increased from 2008 to 2017 (p < 0.001), with differences between age groups (p < 0.001). The most significant increase was observed in men aged 30-49 (p < 0.001). The STD rates significantly increased (p < 0.05) during the study period. A significant positive correlation was found between vasectomy and gonorrhea incidence rates (p = 0.008) and an inverse correlation was found with hepatitis B incidence rates (p = 0.002). Vasectomy trends and STD rates significantly increased from 2018 to 2017 in Chile. especially among men aged 30-49 years. The relationship between vasectomy and STD increments suggests a new risk factor for reproductive and sexual health policies to aid controlling the HIV and STD epidemic.

Resumen: Se viene surgiendo una controversia sobre el aumento o la disminución de la vasectomía; sin embargo, la evidencia aún es escasa en América Latina. Este estudio ecológico analizó las tendencias de la vasectomía y las enfermedades de transmisión sexual (ETS) durante un período de 10 años en Chile y determinó si existe alguna relación entre ellas. Este es un estudio ecológico mixto que utiliza datos secundarios representativos sobre el número de vasectomías y casos de ETS de 2008 a 2017. Las tasas de vasectomía se calcularon por grupos de edad teniendo en cuenta a hombres entre 20-59 años de edad y ETS específicas (VIH, clamidia, gonorrea, tricomoniasis y sífilis) para el mismo período. Los modelos de regresión binomial negativa multivariante se ajustaron para evaluar las tendencias y las relaciones entre las tasas. La edad media de la vasectomía fue de 40,3 años, sin diferencias significativas entre el período del estudio (p = 0,058). La tasa general de vasectomía tuvo un incremento significativo para el período de 2008 a 2017 (p < 0,001), con diferencias entre los grupos de edad (p < 0,001). El incremento más significativo se observó en hombres de entre 30-49 años (p < 0,001). Las tasas de ETS tuvieron una alza significativa (p < 0,05) durante el período de estudio. Hubo una correlación positiva significativa entre las tasas de vasectomía y las tasas de incidencia de gonorrea (p = 0,008) y una correlación inversa con las tasas de incidencia de hepatitis B (p = 0,002). Se concluye que las tendencias de la vasectomía y las tasas de ETS presentaron un incremento significativo en período de 2008 a 2017 en Chile, especialmente entre los hombres de entre 30-49 años. La relación entre la vasectomía y el incremento de las ETS puede ser un nuevo factor de riesgo para las políticas de salud sexual y reproductiva que puede ayudar a controlar la epidemia del VIH y las ETS.

Resumo: Uma controvérsia sobre o aumento ou declínio da vasectomia está surgindo; no entanto, as evidências ainda são escassas na América Latina. Este estudo ecológico analisou as tendências de vasectomia e doenças sexualmente transmissíveis (DST) em um período de dez anos no Chile e determinou se há alguma relação entre elas. Este é um estudo ecológico misto utilizando dados secundários e representativos sobre o número de vasectomias e casos de DSTs de 2008 a 2017. As taxas de vasectomia foram calculadas por grupos etários, considerando homens de 20-59 anos de idade e DSTs específicas (HIV, clamídia, gonorreia, tricomoníase e sífilis) para o mesmo período. Modelos de regressão binomial negativa multivariada foram ajustados para avaliar tendências e relações entre taxas. A média de idade da vasectomia foi de 40,3 anos, sem diferenças significativas entre os anos do estudo (p = 0,058). A taxa geral de vasectomia aumentou significativamente de 2008 a 2017 (p < 0,001), com diferenças entre grupos etários (p < 0,001). O aumento mais significativo foi observado em homens de 30-49 anos (p < 0,001). As taxas de DST aumentaram significativamente (p < 0,05) durante o período de estudo. Houve correlação positiva significativa entre as taxas de vasectomia e as taxas de incidência de gonorreia (p = 0,008) e uma correlação inversa com as taxas de incidência de hepatite B (p = 0,002). As tendências de vasectomia e as taxas de DST aumentaram significativamente de 2008 para 2017 no Chile, especialmente entre homens de 30-49 anos. A relação entre vasectomia e incrementos de DST sugere um novo fator de risco para políticas de saúde sexual e reprodutiva para auxiliar no controle da epidemia de HIV e DST.

Validação do conteúdo de um recurso audiovisual para pessoas vivendo com HIV / Validación del contenido de un recurso audiovisual para personas que viven con el VIH / Content validation of an audiovisual resource for people living with HIV

Resumo Objetivo Validar o conteúdo do roteiro de um recurso audiovisual para pessoas vivendo com HIV. Métodos Estudo metodológico com abordagem quantitativa, norteado pelo referencial teórico metodológico da psicometria. A validação de conteúdo foi realizada por juízes especialistas na área temática usando a técnica Delphi. A amostra foi composta por 22 juízes na primeira análise de validação e sete juízes na segunda análise. Resultados Todos domínios analisados apresentaram coeficiente de validade de conteúdo (CVC) >0,80, com CVC total (CVCt) de 0,96, consistência interna quase perfeita, Alfa de Cronbach de 0,988, ICC de 0,982 [IC95% 0,969-0,991] e p<0,005 significativo na primeira rodada de avaliação dos especialistas. Na segunda análise, os critérios usados para validação de conteúdo apresentaram CVCt de 0,97, com os critérios de objetividade, simplicidade, clareza, relevância, precisão, variedade, credibilidade e equilíbrio, atingindo 100% de aprovação. Conclusão O roteiro foi validado quanto ao conteúdo, mostrando ser um instrumento representativo e pertinente para construção do recurso audiovisual. Ele contribui para o avanço do conhecimento científico pois apresenta resultados com rigor metodológico, com inovações no campo da educação em saúde para pessoas vivendo com HIV.

Resumen Objetivo Validar el contenido del guion de un recurso audiovisual para personas que viven con el VIH Métodos Estudio metodológico con enfoque cuantitativo, norteado por el marco referencial teórico metodológico de la psicometría. La validación de contenido fue realizada por jueces especialistas en el área temática mediante el uso del método Delphi. La muestra estuvo compuesta por 22 jueces en el primer análisis de validación y siete jueces en el segundo análisis. Resultados Todos los dominios analizados presentaron coeficiente de validez de contenido (CVC) >0,80, con un CVC total (CVCt) de 0,96, consistencia interna casi perfecta, Alfa de Cronbach de 0,988, ICC de 0,982 [IC95 % 0,969-0,991] y p<0,005 significativo en la primera ronda de evaluación de los especialistas. En el segundo análisis, los criterios usados para la validación de contenido presentaron un CVCt de 0,97, con los criterios de objetividad, simplicidad, claridad, relevancia, precisión, variedad, credibilidad y equilibrio, con un 100 % de aprobación. Conclusión Se validó el guion en cuanto al contenido, lo que demuestra que es un instrumento representativo y pertinente para la elaboración del recurso audiovisual. Contribuye al avance del conocimiento científico ya que presenta resultados con rigor metodológico, con innovaciones en el campo de la educación para la salud para personas que viven con el VIH.

Abstract Objective The study aimed to validate the script content of an audiovisual resource for people living with HIV. Methods This methodological study had a quantitative approach and was guided by the methodological theoretical framework of psychometrics. Content validation was performed by expert judges in the thematic area using the Delphi technique. The sample consisted of 22 judges in the first validation analysis and seven judges in the second analysis. Results All domains analyzed had a content validity coefficient (CVC) >0.80, with a total CVC (CVCt) of 0.96, almost perfect internal consistency, Cronbach's alpha of 0.988, ICC of 0.982 [95%CI 0.969-0.991], and p<0.005 which was significant in the first round of expert evaluation. In the second analysis, the criteria used for content validation showed a CVCt of 0.97, with the criteria of objectivity, simplicity, clarity, relevance, accuracy, variety, credibility, and balance achieving 100% approval. Conclusion The script was validated in terms of content, showing to be a representative and relevant instrument for building the audiovisual resource. It contributes to the advancement of scientific knowledge as it presents results with methodological accuracy and innovations in the field of health education for people living with HIV.