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1.
Curr Opin HIV AIDS ; 16(2): 115-120, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33625042

RESUMEN

PURPOSE OF REVIEW: This review considers the potential and demonstrated impacts of SARS-CoV-2 on the sexually transmissible infection (STI)/HIV transmission. RECENT FINDINGS: COVID-19 increases the vulnerability of those at highest risk of acquiring STI/HIV. Altered health-seeking behaviour, reductions in STI/HIV clinic capacity, service disruptions and redeployment of human resources to assist COVID-19 control efforts have impacted on STI/HIV control programmes. Reports of reduced STI incidence are emerging, but it is hard to determine whether this is real or due to decreased testing during COVID-19 lockdown periods. Fear of COVID-19 and implemented control measures have altered STI/HIV transmission dynamics. Sexual health services adapted to the pandemic by reducing face-to-face patient encounters in favour of telehealth and mail-based initiatives as well as more stringent triage practice. Many sexual health and HIV treatment services now operate at reduced capacity and experience ongoing service disruptions, which necessarily translates into poorer outcomes for patients and their communities. SUMMARY: In the short-term, COVID-19 related sexual behaviour change is driving STI/HIV transmission downwards. However, the impacts of the global COVID-19 response on sexual health-seeking behaviour and STI/HIV services threaten to drive STI/HIV transmission upwards. Ultimately, the expected rebound in STI/HIV incidence will require an appropriate and timely public health response. VIDEO ABSTRACT: http://links.lww.com/COID/A31.


Asunto(s)
/epidemiología , Infecciones por VIH/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Infecciones por VIH/transmisión , Humanos , Incidencia , Conducta Sexual , Parejas Sexuales , Enfermedades de Transmisión Sexual/transmisión
2.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33431534

RESUMEN

A man in his late 30s presented with a several-day history of rectal pain, discharge and bleeding associated with systemic upset. Sexual history revealed receptive anal sex with several male partners in the 2 weeks preceding his clinic visit. Examination of the perianal area was unremarkable. Proctoscopy showed evidence of non-ulcerative proctitis. Microscopy for Gram stain showed pus cells plus extracellular Gram-negative diplococci. The patient was treated for presumptive gonorrhoea and chlamydial infection with ceftriaxone, azithromycin and doxycycline. The patient failed to improve with this treatment regimen. Rectal swab results at 48 hours confirmed the causative agent to be herpes simplex virus (HSV) type 2. The patient was recalled and treated successfully with valaciclovir. This case serves as a useful reminder to clinicians to consider HSV in the differential diagnosis of sexually transmitted proctitis, in the absence of perianal or anorectal ulceration.


Asunto(s)
Herpes Simple/diagnóstico , Herpesvirus Humano 2/aislamiento & purificación , Proctitis/diagnóstico , Enfermedades de Transmisión Sexual/diagnóstico , Adulto , Antivirales/uso terapéutico , ADN Viral/aislamiento & purificación , Diagnóstico Diferencial , Gonorrea/diagnóstico , Herpes Simple/tratamiento farmacológico , Herpes Simple/transmisión , Herpes Simple/virología , Herpesvirus Humano 2/genética , Humanos , Enfermedades Inflamatorias del Intestino/diagnóstico , Mucosa Intestinal/virología , Masculino , Proctitis/tratamiento farmacológico , Proctitis/virología , Recto/virología , Conducta Sexual , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/transmisión , Enfermedades de Transmisión Sexual/virología , Valaciclovir/uso terapéutico
3.
BMC Infect Dis ; 21(1): 95, 2021 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-33478403

RESUMEN

BACKGROUND: Recommendations for sexually transmitted infection (STI) screening vary significantly across countries. This study evaluated the prevalence of urogenital and extragenital infections with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Mycoplasma genitalium (MG) in patients visiting a French STI clinic in the Indian Ocean region to determine whether current STI screening practices should be updated. METHODS: This cross-sectional study examined all patients who visited the STI clinic between 2014 and 2015. Triplex polymerase chain reaction screening for CT, NG, and MG was performed on urine, vaginal, pharyngeal, and anal specimens (FTD Urethritis Basic Kit, Fast Track Diagnostics, Luxembourg). RESULTS: Of the 851 patients enrolled in the study, 367 were women (367/851, 43.2%) and 484 were men (484/851, 56.0%). Overall, 826 urogenital specimens (826/851, 97.1%), 606 pharyngeal specimens (606/851, 71.2%), and 127 anal specimens (127/851, 14.9%) were taken from enrolled patients. The prevalence of urogenital CT and MG was high in women ≤25 years (19/186, 10.21%; 5/186, 2.69%) and in men who have sex with women ≤30 years (16/212, 7.54%; 5/212, 2.36%). Among patients with urogenital CT infection, 13.7% (7/51) had urethritis. All patients with urogenital MG infection were asymptomatic. Men who have sex with men had a high prevalence of pharyngeal CT (2/45, 4.44%) and NG (3/44, 6.81%) and a high prevalence of anal CT (2/27, 7.41%), NG (2/27, 7.40%), and MG (1/27, 3.70%). After excluding patients with concomitant urogenital infection, extragenital infections with at least 1 of the 3 pathogens were found in 20 swabs (20/91, 21.9%) taken from 16 patients (16/81, 19.7%), all of them asymptomatic. CONCLUSIONS: Routine multisite screening for CT, NG, and MG should be performed to mitigate the transmission of STIs in high-risk sexually active populations.


Asunto(s)
Chlamydia trachomatis/aislamiento & purificación , Mycoplasma genitalium/aislamiento & purificación , Neisseria gonorrhoeae/aislamiento & purificación , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/microbiología , Adolescente , Adulto , Anciano , Canal Anal/microbiología , Estudios Transversales , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Faringe/microbiología , Prevalencia , Reunión/epidemiología , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/transmisión , Sistema Urogenital/microbiología , Adulto Joven
4.
Curr Opin Infect Dis ; 34(1): 56-61, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33315752

RESUMEN

PURPOSE OF REVIEW: This review considers the potential and demonstrated impacts of SARS-CoV-2 on the sexually transmissible infection (STI)/HIV transmission. RECENT FINDINGS: COVID-19 increases the vulnerability of those at highest risk of acquiring STI/HIV. Altered health-seeking behaviour, reductions in STI/HIV clinic capacity, service disruptions and redeployment of human resources to assist COVID-19 control efforts have impacted on STI/HIV control programmes. Reports of reduced STI incidence are emerging, but it is hard to determine whether this is real or due to decreased testing during COVID-19 lockdown periods. Fear of COVID-19 and implemented control measures have altered STI/HIV transmission dynamics. Sexual health services adapted to the pandemic by reducing face-to-face patient encounters in favour of telehealth and mail-based initiatives as well as more stringent triage practice. Many sexual health and HIV treatment services now operate at reduced capacity and experience ongoing service disruptions, which necessarily translates into poorer outcomes for patients and their communities. SUMMARY: In the short-term, COVID-19 related sexual behaviour change is driving STI/HIV transmission downwards. However, the impacts of the global COVID-19 response on sexual health-seeking behaviour and STI/HIV services threaten to drive STI/HIV transmission upwards. Ultimately, the expected rebound in STI/HIV incidence will require an appropriate and timely public health response. VIDEO ABSTRACT: http://links.lww.com/COID/A31.


Asunto(s)
/epidemiología , Infecciones por VIH/epidemiología , Enfermedades de Transmisión Sexual/epidemiología , Infecciones por VIH/transmisión , Humanos , Incidencia , Conducta Sexual , Salud Sexual , Parejas Sexuales , Enfermedades de Transmisión Sexual/transmisión
5.
Rev. enferm. UERJ ; 28: e44520, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1123445

RESUMEN

Objetivo: analisar condições clínicas e comportamentos de risco à saúde de pessoas em situação de rua. Método: estudo transversal, realizado em duas instituições de referência para pessoas em situação de rua na região nordeste do Brasil. Aplicouse um roteiro de entrevista referente a variáveis sociodemográficas, clínicas e comportamentos vulneráveis ao adoecer para 100 participantes. Utilizou-se o teste Qui Quadrado e ANOVA. Resultados: o tipo de parceiro sexual influência na presença de sintomas de infecção sexualmente transmissível, a presença de sintomatologia relacionada à infecção sexualmente transmissível do parceiro influência na sintomatologia do próprio indivíduo, o etilismo influência na prática de sexo com usuário de drogas, a prática de sexo em troca de dinheiro apresenta correlação com a violência física, o sexo oral influência na presença de sintoma de infecção sexualmente transmissível. Conclusão: pessoas em situação de rua apresentam condições e comportamentos que potencializam o adoecimento.


Objective: to examine the clinical conditions and health risk behavior of homeless people. Method: this cross-sectional study was conducted at two referral centers for homeless people in northeast Brazil. Information on sociodemographic and clinical variables, and vulnerable behaviors when falling ill was elicited from 100 participants by scripted interviews. Chi-Square and Anova tests were used. Results: type of sexual partner influenced the presence of symptoms of sexually-transmitted infection; the presence of symptoms related to the partner's sexually-transmitted infections influenced the participant's symptomatology; alcoholism influenced the practice of sex with drug users; sex in exchange for money correlated with physical violence; and oral sex influenced the presence of a sexually-transmitted infection symptom. Conclusion: people on the street display conditions and behaviors that potentiate illness.


Objetivo: examinar las condiciones clínicas y el comportamiento de riesgo para la salud de las personas sin hogar. Método: este estudio transversal se realizó en dos centros de referencia para personas sin hogar en el noreste de Brasil. La información sobre las variables sociodemográficas y clínicas, y los comportamientos vulnerables cuando se enferma se obtuvo de 100 participantes mediante entrevistas con guión. Se utilizaron pruebas de Chi-Cuadrado y Anova. Resultados: el tipo de pareja sexual influyó en la presencia de síntomas de infección de transmisión sexual; la presencia de síntomas relacionados con las infecciones de transmisión sexual de la pareja influyó en la sintomatología del participante; el alcoholismo influyó en la práctica del sexo con consumidores de drogas; sexo a cambio de dinero correlacionado con violencia física; y el sexo oral influyó en la presencia de un síntoma de infección de transmisión sexual. Conclusión: las personas en la calle exhiben condiciones y comportamientos que potencian la enfermedad.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Personas sin Hogar , Estado de Salud , Vulnerabilidad en Salud , Conductas de Riesgo para la Salud , Conducta Sexual , Brasil , Enfermedades de Transmisión Sexual/transmisión , Estudios Transversales , Trastornos Relacionados con Alcohol , Abuso Físico
6.
Nurs Clin North Am ; 55(3): 325-335, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32762853

RESUMEN

Sexually transmitted infections (STIs) are diseases that are transmitted from one person to another person through acts of vaginal, anal, or oral intercourse. The increased presence of STIs among men who have sex with men (MSM) results in a higher rate of STI-related diagnoses, such as proctitis. Proctitis is a common, but often misdiagnosed condition experienced by MSM who present to primary care, urgent care, and emergency settings. It is important that health care providers be knowledgeable of the pathophysiology, risk factors, and clinical presentation of proctitis among MSM for accurate and timely management.


Asunto(s)
Homosexualidad Masculina , Proctitis/complicaciones , Proctitis/diagnóstico , Enfermedades de Transmisión Sexual , Adulto , Cólico/etiología , Diarrea/etiología , Humanos , Masculino , Proctitis/fisiopatología , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/transmisión
7.
Nurs Clin North Am ; 55(3): 403-416, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32762859

RESUMEN

This article provides an overview of the incidence and prevalence of sexually transmitted infections in pregnant women in the United States. It discusses screening guidelines and best practices related to treatments. Safety, pharmacology, and monitoring of both the woman and her fetus are detailed.


Asunto(s)
Tamizaje Masivo , Atención Prenatal , Atención Primaria de Salud , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Femenino , Humanos , Incidencia , Embarazo , Prevalencia , Enfermedades de Transmisión Sexual/transmisión , Adulto Joven
9.
PLoS One ; 15(6): e0235286, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32598394

RESUMEN

Bacterial vaginosis (BV) is a common vaginal infection among women of reproductive age. Increasing evidence suggests BV may be sexually transmitted indicating a potential role for the treatment of sexual partners. If partner treatment reduces BV recurrence in women, real-world success will depend on sexual partners' willingness to accept it. However, a lack of data exists on the acceptability of partner treatment among sexual partners, and no data exists on male partners' experience of BV specifically. The aim of this study was to explore male partners' views and experience of BV and their attitudes toward associated partner treatment. A social constructionist approach informed the framework of this study. Semi structured interviews were conducted with eleven men who participated in a BV partner treatment trial. Interviews were transcribed verbatim and analysed thematically. In the absence of symptoms in themselves, BV had little impact on men beyond their concerns for their partner's health and self-esteem. Acceptance of treatment was largely a demonstration of care and support. While all participants had accepted treatment, men surmised the primary reasons other men may reject treatment as being: if they felt BV had "nothing to do with them", which was related to not wanting to be viewed as having a 'problem' and exacerbated by norms of masculinity and STI-related stigma; lack of a diagnostic test to indicate if a male "had BV"; and a casual or less established relationship. Men's attitudes to BV and partner treatment were primarily influenced by the nature of their relationships. The ambiguous aetiology of BV appears to attenuate STI related stigma and questions of infidelity.


Asunto(s)
Aceptación de la Atención de Salud , Conducta Sexual/psicología , Parejas Sexuales/psicología , Enfermedades de Transmisión Sexual/transmisión , Vagina/microbiología , Vaginosis Bacteriana/tratamiento farmacológico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de Transmisión Sexual/diagnóstico , Vaginosis Bacteriana/etiología , Vaginosis Bacteriana/psicología , Adulto Joven
10.
J Virol ; 94(12)2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32269129

RESUMEN

Concurrent sexually transmitted infections (STI) can increase the probability of HIV-1 transmission primarily by increasing the viral load present in semen. In this study, we explored the relationship of HIV-1 in blood and seminal plasma in the presence and absence of urethritis and after treatment of the concurrent STI. Primer ID deep sequencing of the V1/V3 region of the HIV-1 env gene was done for paired blood and semen samples from antiretroviral therapy (ART)-naive men living in Malawi with (n = 19) and without (n = 5) STI-associated urethritis; for a subset of samples, full-length env genes were generated for sequence analysis and to test entry phenotype. Cytokine concentrations in the blood and semen were also measured, and a reduction in the levels of proinflammatory cytokines was observed following STI treatment. We observed no difference in the prevalence of diverse compartmentalized semen-derived lineages in men with or without STI-associated urethritis, and these viral populations were largely stable during STI treatment. Clonal amplification of one or a few viral sequences accounted for nearly 50% of the viral population, indicating a recent bottleneck followed by limited viral replication. We conclude that the male genital tract is a site where virus can be brought in from the blood, where localized sustained replication can occur, and where specific genotypes can be amplified, perhaps initially by cellular proliferation but further by limited viral replication.IMPORTANCE HIV-1 infection is a sexually transmitted infection that coexists with other STI. Here, we examined the impact of a concurrent STI resulting in urethritis on the HIV-1 population within the male genital tract. We found that viral populations remain largely stable even with treatment of the STI. These results show that viral populations within the male genital tract are defined by factors beyond transient inflammation associated with a concurrent STI.


Asunto(s)
Infecciones por VIH/virología , VIH-1/genética , Semen/virología , Enfermedades de Transmisión Sexual/virología , Uretritis/virología , Productos del Gen env del Virus de la Inmunodeficiencia Humana/genética , Adulto , Secuencia de Bases , Recuento de Linfocito CD4 , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD4-Positivos/virología , Estudios de Cohortes , Citocinas/genética , Citocinas/inmunología , Infecciones por VIH/epidemiología , Infecciones por VIH/inmunología , Infecciones por VIH/transmisión , VIH-1/clasificación , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Malaui/epidemiología , Masculino , Persona de Mediana Edad , Filogenia , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/inmunología , Enfermedades de Transmisión Sexual/transmisión , Uretritis/epidemiología , Replicación Viral , Productos del Gen env del Virus de la Inmunodeficiencia Humana/sangre , Productos del Gen env del Virus de la Inmunodeficiencia Humana/clasificación
11.
Sex Transm Infect ; 96(5): 342-347, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32241905

RESUMEN

OBJECTIVES: In 2016, WHO estimated 376 million new cases of the four main curable STIs: gonorrhoea, chlamydia, trichomoniasis and syphilis. Further, an estimated 290 million women are infected with human papillomavirus. STIs may lead to severe reproductive health sequelae. Low-income and middle-income countries carry the highest global burden of STIs. A large proportion of urogenital and the vast majority of extragenital non-viral STI cases are asymptomatic. Screening key populations and early and accurate diagnosis are important to provide correct treatment and to control the spread of STIs. This article paints a picture of the state of technology of STI point-of-care testing (POCT) and its implications for health system integration. METHODS: The material for the STI POCT landscape was gathered from publicly available information, published and unpublished reports and prospectuses, and interviews with developers and manufacturers. RESULTS: The development of STI POCT is moving rapidly, and there are much more tests in the pipeline than in 2014, when the first STI POCT landscape analysis was published on the website of WHO. Several of the available tests need to be evaluated independently both in the laboratory and, of particular importance, in different points of care. CONCLUSION: This article reiterates the importance of accurate, rapid and affordable POCT to reach universal health coverage. While highlighting the rapid technical advances in this area, we argue that insufficient attention is being paid to health systems capacity and conditions to ensure the swift and rapid integration of current and future STI POCT. Unless the complexity of health systems, including context, institutions, adoption systems and problem perception, are recognised and mapped, simplistic approaches to policy design and programme implementation will result in poor realisation of intended outcomes and impact.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Pruebas en el Punto de Atención/organización & administración , Enfermedades de Transmisión Sexual/diagnóstico , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/prevención & control , Infecciones por Chlamydia/transmisión , Femenino , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/prevención & control , Gonorrea/transmisión , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Humanos , Ciencia de la Implementación , Masculino , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/tratamiento farmacológico , Infecciones por Mycoplasma/prevención & control , Infecciones por Mycoplasma/transmisión , Mycoplasma genitalium , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/transmisión , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/transmisión , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Sífilis/prevención & control , Sífilis/transmisión , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/tratamiento farmacológico , Vaginitis por Trichomonas/prevención & control , Vaginitis por Trichomonas/transmisión
12.
Sci Rep ; 10(1): 3846, 2020 03 02.
Artículo en Inglés | MEDLINE | ID: mdl-32123251

RESUMEN

Sexually transmitted diseases (STD) modeling has used contact networks to study the spreading of pathogens. Recent findings have stressed the increasing role of casual partners, often enabled by online dating applications. We study the Susceptible-Infected-Susceptible (SIS) epidemic model -appropriate for STDs- over a two-layer network aimed to account for the effect of casual partners in the spreading of STDs. In this novel model, individuals have a set of steady partnerships (links in layer 1). At certain rates, every individual can switch between active and inactive states and, while active, it establishes casual partnerships with some probability with active neighbors in layer 2 (whose links can be thought as potential casual partnerships). Individuals that are not engaged in casual partnerships are classified as inactive, and the transitions between active and inactive states are independent of their infectious state. We use mean-field equations as well as stochastic simulations to derive the epidemic threshold, which decreases substantially with the addition of the second layer. Interestingly, for a given expected number of casual partnerships, which depends on the probabilities of being active, this threshold turns out to depend on the duration of casual partnerships: the longer they are, the lower the threshold.


Asunto(s)
Modelos Estadísticos , Parejas Sexuales , Enfermedades de Transmisión Sexual/transmisión , Femenino , Humanos , Masculino , Factores de Riesgo , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología
14.
Reprod Health ; 17(1): 20, 2020 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-32005263

RESUMEN

BACKGROUND: Zimbabwe has the highest teenage pregnancy rate in Sub Saharan Africa. Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) prevalence in adolescents that are from tribes that perform cultural initiations and subscribe to certain norms are higher than the national prevalence which is estimated at 12% (18 and 13.6% respectively) in Zimbabwe. Indigenous Health Systems (IHSs) and Modern Health Systems (MHSs) in Zimbabwe run parallel thereby introducing challenges in the management of adolescent sexual health due to conflicts. This study seeks to develop strategies that will facilitate the integration of IHSs and MHS in Mberengwa and Umguza districts. METHODS: This research will be conducted in two phases. The first phase would utilise a concurrent triangulation mixed methods design with both qualitative and quantitative approaches. The findings from the qualitative and quantitative approaches would be merged through a comparison of findings side by side. The second phase would focus on the development and validation of strategies that would facilitate the integration of IHSs and MHSs. The Strength, Weakness, Opportunity and Threat (SWOT) analysis would be applied on interfaced findings from phase one. The Basic Logic and the Build, Overcome, Explore and Minimise (BOEM) models would then be used to develop strategies based on the SWOT findings. The developed strategies would be validated through the application of Delphi technique and administration of checklist to selected key stakeholders through organised workshops. DISCUSSION: There have been no known studies found in the literature that explores the possibility and developed strategies of integrating IHSs and MHSs so as to promote safe sexual practices in adolescents. Most programs on sexual health have ignored the role of IHSs and MHSs in influencing safe sexual practices leading to them failing to attain desired goals. A lot of emphases has been targeted at minimising the spread of Sexually Transmitted Infections (STIs) through advocating for utilisation MHSs rather than focussing on an integrating systems that are meant to manage Adolescent Sexual Health (ASH) related issues. The study protocol was approved by the University of Venda Ethics Committee Registration (SHS/19/PH/17/2608) on the 26th of August 2019.


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/prevención & control , Salud del Adolescente/normas , Prestación Integrada de Atención de Salud/normas , Embarazo en Adolescencia/prevención & control , Proyectos de Investigación/normas , Educación Sexual , Enfermedades de Transmisión Sexual/prevención & control , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/transmisión , Adolescente , Adulto , África del Sur del Sahara , Niño , Preescolar , Femenino , Humanos , Masculino , Embarazo , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/transmisión , Adulto Joven
15.
Sex Transm Infect ; 96(4): 238-245, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32041738

RESUMEN

OBJECTIVE: Despite increases in STIs among those over 40, little is known about the social context of STI transmission among people experiencing relationship transition in midlife, and few sexual health promotion initiatives are targeted at this group. This study sought to identify factors shaping STI risk perceptions and practices among midlife individuals either contemplating or having sex with new partners following the end of a long-term relationship. METHODS: Participants were purposively selected from respondents to Britain's third National Survey of Sexual Attitudes and Lifestyles, using three eligibility criteria: aged 40-59, reported experience of the end of a marital or cohabiting relationship with an opposite-sex partner in the past 5 years, and willingness to participate in a qualitative interview. Qualitative data were generated via face-to-face interviews with 10 women and 9 men and analysed inductively using thematic analysis, with themes then organised using a socioecological framework. RESULTS: Participants' accounts of new sexual partnerships in midlife indicate that STI risk perceptions and practices are shaped by factors operating at multiple levels across the socioecological arena (individual, partnership, peers and communities, societal). Constraints on, and resources for, the navigation of sexual safety include self-perceived STI risk rooted in past rather than present circumstances; legacies of mistrust within former relationships; intersecting gender-age dynamics in negotiation of risk prevention strategies with new partners; peers and younger relatives' influences on understandings of sexual risk and safety; postrelationship change in social networks that increase or mitigate vulnerability to sexual risk; age-related barriers to accessing condoms; and disconnection from safer sex messaging and services culturally coded as for the young. CONCLUSIONS: Improving sexual health among midlife adults requires age-sensitive interventions designed to address multilevel constraints, and harness positive influences, on the navigation of sexual safety at this stage of life.


Asunto(s)
Transmisión de Enfermedad Infecciosa , Conocimientos, Actitudes y Práctica en Salud , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/transmisión , Adulto , Inglaterra/epidemiología , Femenino , Humanos , Entrevistas como Asunto , Estilo de Vida , Masculino , Persona de Mediana Edad , Medición de Riesgo
16.
Rev. Rol enferm ; 43(2): 124-126, feb. 2020.
Artículo en Español | IBECS | ID: ibc-198917

RESUMEN

El término Chemsex hace referencia al uso intencionado de drogas psicoactivas para mantener relaciones sexuales (antes o durante la actividad sexual), generalmente entre hombres que tienen sexo con hombres, y durante largos períodos de tiempo, desde varias horas a varios días, denominados sesiones. La práctica del Chemsex se asocia a un aumento del riesgo de infección por VIH y otras infecciones de transmisión sexual, así como a un incremento de los problemas de salud mental y de drogodependencia. Los usuarios de drogas recreativas presentan a menudo un funcionamiento y ajuste en su entorno socio-familiar y laboral aparentemente normal. Por tanto, ni el usuario de Chemsex ni su entorno afectivo tienen una demanda clara de ayuda profesional. Muchas de las personas que lo practican no tienen contacto con los servicios de salud, excepto en situaciones puntuales. Este fenómeno ha despertado preocupación por parte de los profesionales de la salud. En nuestro medio sanitario, actualmente, se tratan por separado a pacientes con enfermedades de transmisión sexual y a pacientes con drogodependencias. Para su cobertura resulta imprescindible un abordaje multidisciplinar


The term Chemsex refers to the intentional use of psychoactive drugs for sexual intercourse (before or during sexual activity), usually between men who have sex with men, and for long periods of time, from several hours to several days, called sessions. The practice of Chemsex is associated with an increased risk of HIV infection and other sexually transmitted infections, as well as an increase in mental health and drug dependence problems. Recreational drug users often have functioning and adjustment in their apparently normal socio-family and work environment. Therefore, neither the Chemsex user nor their emotional environment have a clear demand for professional help. Many of the people who practice it do not have contact with the health services, except in specific situations. This phenomenon has aroused concern on the part of health professionals. In our healthcare environment, currently, patients with sexually transmitted diseases and patients with drug dependence are treated separately. A multidisciplinary approach is essential for its coverage


Asunto(s)
Humanos , Masculino , Psicotrópicos/efectos adversos , Conducta Sexual/efectos de los fármacos , Enfermedades de Transmisión Sexual/transmisión , Drogas Ilícitas/efectos adversos , Homosexualidad Masculina , Infecciones por VIH/transmisión , Conductas de Riesgo para la Salud/efectos de los fármacos
17.
J Acquir Immune Defic Syndr ; 83(3): 223-229, 2020 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-31913994

RESUMEN

BACKGROUND: HIV status disclosure to sex partners potentially reduces the risk of sexually transmitting HIV. However, there is limited information on the associations between HIV status disclosure in types of sexual partnerships and ensuing sexual practices. METHODS: We examined HIV status disclosure to sex partners among 205 men and women living with HIV and receiving diagnostic and treatment services for a co-occurring sexually transmitted infection (STI) in Cape Town, South Africa. Participants completed partner-by-partner sexual behavior interviews and provided permission to extract recurrent STI clinic visits over the subsequent 12 months. RESULTS: Three groups were formed on the basis of HIV status disclosure to sex partners: (1) 22% reported only HIV same-status partners, (2) 26% had HIV-negative or unknown HIV status (HIV different status) sex partners to whom they had disclosed their HIV status, and (3) 52% had at least one HIV different-status partner to whom they had not disclosed. There were no associations between HIV status disclosure and demographic characteristics, sexual practices, or recurrent STI clinic visits. Undisclosed HIV status to at least one HIV different-status sex partner was associated with greater alcohol use and less likelihood of receiving antiretroviral therapy; participants who were least likely to disclose their HIV status to partners drank more alcohol and were less likely to be taking antiretroviral therapy. CONCLUSIONS: High prevalence of partner nondisclosure and lack of significant correlates to HIV status disclosure indicate a need for further research with an eye toward identifying disclosure processes and mechanisms that may ultimately lead to effective interventions.


Asunto(s)
Infecciones por VIH/transmisión , Seropositividad para VIH/transmisión , Conducta Sexual , Enfermedades de Transmisión Sexual/transmisión , Femenino , Humanos , Masculino , Factores de Riesgo , Asunción de Riesgos , Parejas Sexuales , Sudáfrica/epidemiología , Revelación de la Verdad
18.
Sex Transm Infect ; 96(1): 68-75, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31836679

RESUMEN

OBJECTIVE: The HIV trend among female sex workers (FSWs) is understudied. We assessed the prevalence and trend of HIV and five other STIs among FSWs in Iran. METHODS: We recruited FSWs (1337 in 2015, 1005 in 2010) from 21 sites in 13 cities in two cross-sectional biobehavioural surveys. Eligible FSWs were women aged ≥18 years who reported selling sex to more than one male client in the past 12 months. Consenting FSWs were interviewed using a behavioural questionnaire and tested for HIV and five other STIs. We considered study sites as clusters in the analysis and two-sided Fisher's exact test to compare the HIV prevalence between the two survey rounds. RESULTS: HIV prevalence was 2.1% in 2015 (vs 4.0% in 2010, p=0.007). Lifetime drug injection was reported by 6.1% of participants in 2015 (vs 14.6% in 2010, p=0.003). In 2015, among FSWs with history of lifetime drug injection, HIV prevalence was 8.6% (vs 9.8% in 2010, p=0.425). The prevalence of other STIs in 2015 was 0.4% (95% CI 0.2 to 1.0) for syphilis, 1.3% (95% CI 0.8 to 2.1) for gonorrhoea, 6.0% (95% CI 4.8 to 7.4) for chlamydia, 11.9% (95% CI 8.5 to 16.5) for trichomoniasis and 41.8% (95% CI 39.2 to 44.5) for human papillomavirus. CONCLUSIONS: HIV prevalence among FSWs in Iran decreased, but remains considerably high. The decrease in HIV prevalence compared with 2010 might be explained by a decrease in drug injection. Other STIs are also high in this population. Harm reduction programmes need to be continued and scaled up among this underserved population in Iran.


Asunto(s)
Infecciones por VIH/transmisión , Trabajadores Sexuales/estadística & datos numéricos , Enfermedades de Transmisión Sexual/transmisión , Trastornos Relacionados con Sustancias/epidemiología , Adulto , Estudios Transversales , Consumidores de Drogas/psicología , Consumidores de Drogas/estadística & datos numéricos , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Humanos , Irán/epidemiología , Prevalencia , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Enfermedades de Transmisión Sexual/psicología , Adulto Joven
19.
Evolution ; 74(1): 43-56, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31732970

RESUMEN

Sexually transmitted infections (STIs) are predicted to play an important role in the evolution of host mating strategies, and vice versa, yet our understanding of host-STI coevolution is limited. Previous theoretical work has shown mate choice can evolve to prevent runaway STI virulence evolution in chronic, sterilizing infections. Here, I generalize this theory to examine how a broader range of life-history traits influence coevolution; specifically, how host preferences for healthy mates and STI virulence coevolve when infections are acute and can cause mortality or sterility, and hosts do not form long-term sexual partnerships. I show that mate choice reduces both mortality and sterility virulence, with qualitatively different outcomes depending on the mode of virulence, costs associated with mate choice, recovery rates, and host lifespan. For example, fluctuating selection-a key finding in previous work-is most likely when hosts have moderate lifespans, STIs cause sterility and long infections, and costs of mate choice are low. The results reveal new insights into the coevolution of mate choice and STI virulence as different life-history traits vary, providing increased support for parasite-mediated sexual selection as a potential driver of host mate choice, and mate choice as a constraint on the evolution of virulence.


Asunto(s)
Coevolución Biológica , Rasgos de la Historia de Vida , Preferencia en el Apareamiento Animal , Enfermedades de Transmisión Sexual/transmisión , Animales , Modelos Biológicos
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