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1.
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
2.
Public Health Rep ; 135(1_suppl): 82S-89S, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32735186

RESUMEN

OBJECTIVES: Correctional settings (prisons, jails, detention facilities) provide a unique opportunity to screen for sexually transmitted infections (STIs) among correctional populations with a high prevalence of infection. Immigrant detainees are a distinct and poorly described correctional population. The main objective of this study was to determine the feasibility of a national STI screening program for immigrant detainees. METHODS AND MATERIALS: We developed an opt-out STI testing program that included electronic health record integration, patient education, and staff member training. We piloted this program from June 22 through August 19, 2018, at 2 detention facilities with different operational requirements and detainee demographic characteristics. We assessed STI test positivity rates, treatment outcomes, estimated cost to conduct testing and counseling, and staff member perceptions of program value and challenges to implementation. RESULTS: Of 1041 immigrant detainees approached for testing, 526 (50.5%) declined. Of 494 detainees who were tested, 42 (8.5%) tested positive for at least 1 STI; the percentage positivity rates were 6.7% (n = 33) for chlamydia, 0.8% (n = 4) for syphilis, 0.8% (n = 4) for gonorrhea, 0.6% (n = 3) for hepatitis B, and 0.2% (n = 1) for HIV. The estimated cost to detect any STI ranged from $500 to $961; the estimated cost to identify 1 person infected with HIV ranged from $22 497 to $43 244. Forty of 42 persons who tested positive began treatment before release from custody. Medical staff members had positive views of the program but had concerns about workload. PRACTICE IMPLICATIONS: STIs are prevalent among immigrant detainees. A routine screening program is feasible if operational aspects are carefully considered and would provide counseling, education, and treatment for this vulnerable population.


Asunto(s)
Emigrantes e Inmigrantes/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Enfermedades de Transmisión Sexual/diagnóstico , Negativa del Paciente al Tratamiento/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Estado de Salud , Humanos , Masculino , Tamizaje Masivo/economía , Persona de Mediana Edad , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/etnología , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/etnología , Adulto Joven
3.
Nurs Clin North Am ; 55(3): 307-323, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32762852

RESUMEN

Sexually transmitted infections (STIs) are a prevalent global health care problem. Incidence rates are rising yearly. STI incidence is highest for adolescents and young adults ages 15 to 24, who are diagnosed with half of all new STIs. Chlamydia trachomatis and Neisseria gonorrhea are common STIs caused by bacteria. Treatment guidelines change frequently as a result of antimicrobial resistance and public health trends. It is important for primary care providers to remain up to date with new guidelines. This article provides updates on pharmacologic treatment as well as patient education and follow-up specific to the primary care setting.


Asunto(s)
Guías como Asunto/normas , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , Farmacorresistencia Microbiana , Salud Global , Humanos , Incidencia , Enfermedades de Transmisión Sexual/clasificación , Estados Unidos/epidemiología
4.
Lancet Infect Dis ; 20(8): e181-e191, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32569625

RESUMEN

Progressive antimicrobial resistance in Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis has created a pressing need for treatment optimisations for sexually transmitted infections (STIs). In this Review, we aim to highlight urgent needs in global STI management, including: (1) improved surveillance to monitor antimicrobial resistance and clinical outcomes; (2) systematic pharmacokinetic and pharmacodynamic evaluations to ensure resistance suppression and bacterial eradication at all sites of infection; (3) development of novel, affordable antimicrobials; and (4) advancements in new molecular and point-of-care tests to detect antimicrobial resistance determinants. Antimicrobial resistance among STIs is a global public health crisis. Continuous efforts to develop novel antimicrobials will be essential, in addition to other public health interventions to reduce the global STI burden. Apart from prevention through safer sexual practices, the development of STI vaccines to prevent transmission is a crucial research priority.


Asunto(s)
Antiinfecciosos/farmacocinética , Antiinfecciosos/uso terapéutico , Resistencia a Medicamentos , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Humanos , Vigilancia de la Población , Enfermedades de Transmisión Sexual/microbiología , Enfermedades de Transmisión Sexual/parasitología
8.
Am J Health Syst Pharm ; 77(Supplement_2): S54-S58, 2020 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-32426834

RESUMEN

PURPOSE: To streamline workflow of the culture review process in the emergency department (ED), a transition from a nurse-driven to a pharmacist-initiated process was implemented. METHODS: This was a single-center retrospective study conducted at an adult urban level 1 trauma academic medical center. The pharmacist-initiated culture review process was compared to the previous nurse-initiated process. The primary objective was time from final culture result to patient contact by an advanced practice provider. Secondary objectives included incidence of treatment failure and hospital admission within 30 days of ED visit. RESULTS: A total of 283 patients met inclusion criteria: 144 patients in the pre-intervention group and 139 patients in the postintervention group. Patients were contacted a median time of 15.7 hours (95% confidence interval [CI], 9.88-18.83) earlier for definitive urinary tract infection antibiotic therapy and 46.7 hours (95% CI, 33.34-61.62) earlier for definitive sexually transmitted infection therapy in the pharmacist-initiated workflow compared to the nurse-initiated workflow (P < 0.001). Treatment failure occurred in 0.01% of patients in the postintervention group and 6.3% in the pre-intervention group (P = 0.01). Hospital admission within 30 days of the ED visit occurred in 0% of patients in the postintervention group and 4.2% in the pre-intervention group (P = 0.03). CONCLUSION: Pharmacist-initiated culture review in the ED at an academic medical center reduced time from final culture to patient contact for optimal antibiotic therapy and decreased hospital admission and treatment failure rates. A change in the culture review workflow involving pharmacists appears to have a positive impact on clinical outcomes.


Asunto(s)
Servicio de Urgencia en Hospital , Farmacéuticos/organización & administración , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Infecciones Urinarias/tratamiento farmacológico , Centros Médicos Académicos , Adolescente , Adulto , Antibacterianos/administración & dosificación , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Servicio de Farmacia en Hospital/organización & administración , Rol Profesional , Estudios Retrospectivos , Enfermedades de Transmisión Sexual/diagnóstico , Factores de Tiempo , Insuficiencia del Tratamiento , Infecciones Urinarias/diagnóstico , Adulto Joven
9.
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
11.
Am J Obstet Gynecol ; 223(3): 417.e1-417.e8, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32135143

RESUMEN

BACKGROUND: The rising incidence rates of sexually transmitted infections in the United States highlight the need for concurrent treatment of patients and their sexual partners. Expedited partner therapy allows healthcare providers to offer antibiotic prescriptions or medications to an index patient for distribution to their sexual partner(s) without evaluating the partner. We hypothesized that there was a gap between expedited partner therapy policy at the state level and its downstream implementation by community pharmacists. OBJECTIVE: The objectives of our study were to evaluate pharmacists' expedited partner therapy knowledge and practices in 41 expedited partner therapy-permissible US states, to determine whether there were differences in practice based on the length of time expedited partner therapy was permissible in the state and chlamydia incidence rates, and to measure the cost of expedited partner therapy treatment. STUDY DESIGN: A randomized cohort of pharmacists (n=335) was invited to complete a telephone interview from November 2017 through January 2018. Descriptive statistics were calculated and stratified by early, mid, and late expedited partner therapy-adopter status based on the year of the state's expedited partner therapy enactment and the state's chlamydia incidence rate. Fisher's exact test and 1-way analyses of variance were used to compare measures across strata. RESULTS: We had 143 pharmacists (42.7%) agree to complete the survey. Among our respondents, 40.6% (n=58/143) indicated that they were aware of expedited partner therapy; 14.7% (n=21/143) reported that they had ever received an expedited partner therapy prescription, and 97% (n=139/143) reported that they would dispense an expedited partner therapy prescription if they received 1 in the future. These findings were stable across the 6 strata defined by early, mid, or late expedited partner therapy-adopter and high or low incidence rates of chlamydia status. Mean cost of azithromycin 1000 mg and cefixime 400 mg for treatment of chlamydia and gonorrhea was $22.17 (95% confidence interval, 20.29-24.05) and $30.46 (95% confidence interval, 28.65-32.26), respectively. CONCLUSION: Fewer than one-half of the pharmacists were aware of expedited partner therapy. A small minority of pharmacists reported ever having received an expedited partner therapy prescription, regardless of the length of time expedited partner therapy had been legal in their states and the incidence of chlamydia. However, almost all pharmacists reported that they would dispense an expedited partner therapy prescription if they received 1. Additionally, costs were high for expedited partner therapy for self-pay patients. These data suggest that there are opportunities to increase expedited partner therapy utilization by healthcare providers, patients, and pharmacists.


Asunto(s)
Infecciones por Chlamydia/epidemiología , Personal de Salud , Farmacéuticos , Parejas Sexuales , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Antibacterianos/economía , Antibacterianos/uso terapéutico , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/prevención & control , Estudios de Cohortes , Femenino , Humanos , Entrevistas como Asunto , Masculino , Distribución Aleatoria , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/prevención & control , Estados Unidos/epidemiología , Adulto Joven
12.
Gastroenterology ; 158(6): 1546-1547, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32017908

Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/complicaciones , Coinfección/diagnóstico , Granuloma/diagnóstico , Proctitis/diagnóstico , Enfermedades de Transmisión Sexual/diagnóstico , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/inmunología , Antibacterianos/administración & dosificación , Antivirales/administración & dosificación , Ceftriaxona/administración & dosificación , Chlamydia trachomatis/genética , Chlamydia trachomatis/aislamiento & purificación , Coinfección/tratamiento farmacológico , Coinfección/inmunología , Coinfección/microbiología , Colonoscopía , Citomegalovirus/aislamiento & purificación , ADN Bacteriano/aislamiento & purificación , Doxiciclina/administración & dosificación , Quimioterapia Combinada/métodos , Granuloma/tratamiento farmacológico , Granuloma/inmunología , Granuloma/microbiología , Humanos , Mucosa Intestinal/diagnóstico por imagen , Mucosa Intestinal/microbiología , Mucosa Intestinal/patología , Masculino , Persona de Mediana Edad , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/aislamiento & purificación , Proctitis/tratamiento farmacológico , Proctitis/inmunología , Proctitis/microbiología , Recto/diagnóstico por imagen , Recto/microbiología , Recto/patología , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/inmunología , Enfermedades de Transmisión Sexual/microbiología , Resultado del Tratamiento , Valganciclovir/administración & dosificación
13.
Praxis (Bern 1994) ; 109(2): 79-85, 2020 Feb.
Artículo en Alemán | MEDLINE | ID: mdl-32019451

RESUMEN

Recurrent Urogynecological Infections Abstract. Changes in the urogenital microbiome of the bladder, urethra, vagina and cervix can cause recurrent infections. We distinguish between obligate and facultative pathogens. In the case of facultative pathogens, treatment with antibiotic, antiviral or antifungal drugs should only be considered in cases with attributable symptoms. Sexually transmitted diseases (STD) manifest either urogenitally alone or in association with an ascending infection of the adnexa as a pelvic inflammatory disease. STD may be asymptomatic, as in cases of chlamydia, or may cause a high burden of symptoms, impairment of quality of life or infertility. The aim of this minireview is to give an overview of the pathogenicity of the different germs and their treatment.


Asunto(s)
Infecciones por Chlamydia , Enfermedad Inflamatoria Pélvica , Enfermedades de Transmisión Sexual , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/tratamiento farmacológico , Chlamydia trachomatis , Femenino , Humanos , Enfermedad Inflamatoria Pélvica/microbiología , Calidad de Vida , Recurrencia , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/tratamiento farmacológico
15.
Eur J Clin Microbiol Infect Dis ; 39(2): 229-234, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31522281

RESUMEN

Mycoplasma genitalium was first isolated from the urethral swabs of two symptomatic men with urethritis in 1980. It is a sexually transmitted bacterium associated with a number of urogenital conditions in women like cervicitis, endometritis, pelvic inflammatory disease, infertility, and susceptibility to human immunodeficiency virus (HIV). However, M. genitalium may also act like a stealth pathogen at female reproductive tract, giving no symptoms. Its prevalence varies between different groups, with the average being 0.5-10% in the general population and 20-40% in women with sexually transmitted infections. The recommended treatment of this infection is azithromycin as a single 1-g dose. However, in recent years, macrolide resistance has increased which is significantly lowering the cure rate, being less than 50% in some studies. New treatment regimens need to be investigated due to increasing drug resistance. The discussion and suggestion of an algorithm for management of this infection is the highlight of this paper.


Asunto(s)
Farmacorresistencia Bacteriana , Infecciones por Mycoplasma/diagnóstico , Mycoplasma genitalium/patogenicidad , Infecciones del Sistema Genital/microbiología , Enfermedades de Transmisión Sexual/microbiología , Antibacterianos/uso terapéutico , Infecciones Asintomáticas , Azitromicina/uso terapéutico , Femenino , Humanos , Macrólidos/uso terapéutico , Infecciones por Mycoplasma/tratamiento farmacológico , Mycoplasma genitalium/aislamiento & purificación , Enfermedad Inflamatoria Pélvica/microbiología , Prevalencia , Infecciones del Sistema Genital/tratamiento farmacológico , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Uretritis/microbiología
16.
J Am Acad Dermatol ; 82(1): 17-28, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30986474

RESUMEN

The methods used for the laboratory diagnosis of syphilis include direct detection of Treponema pallidum subspecies pallidum and serologic testing. Serologic testing relies on both nontreponemal and treponemal tests. In newly developed reverse-sequence screening algorithms, treponemal tests are performed before nontreponemal tests. The management of syphilis requires appropriate staging, treatment, and follow-up of patients along with the prompt reporting of infections to public health authorities to assist with prevention and control efforts. Benzathine penicillin G remains the treatment of choice for all stages of syphilis. Screening of populations at higher risk for syphilis is recommended by the US Centers for Disease Control and Prevention, the US Preventive Services Task Force, and the World Health Organization. The second article in this continuing medical education series reviews the testing for and the management of sexually acquired syphilis.


Asunto(s)
Penicilina G/administración & dosificación , Enfermedades de Transmisión Sexual/diagnóstico , Serodiagnóstico de la Sífilis/métodos , Sífilis/diagnóstico , Sífilis/epidemiología , Treponema pallidum/patogenicidad , Técnicas de Laboratorio Clínico , Diagnóstico Precoz , Educación Médica Continua , Humanos , Incidencia , Masculino , Prevención Primaria/organización & administración , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/epidemiología , Sífilis/tratamiento farmacológico , Estados Unidos/epidemiología
17.
J Pharm Pract ; 33(1): 63-73, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29558852

RESUMEN

PURPOSE: Review selected sexually transmitted infections (STIs) and treatment recommendations for pharmacists and providers practicing in the acute care setting. SUMMARY: In 2015, the Centers for Disease Control and Prevention (CDC) published an updated guideline on the treatment of STIs with an emphasis on prevention and new diagnostic strategies to combat the growing problem of STIs in the United States. Despite this guidance, the incidence of infection has continued to grow. In October 2016, an in-depth analysis reported that 20 million new infections occur annually in the United States. With this growing burden of disease, it is pertinent that health-care providers optimize their treatment strategies to improve upon the management of STIs. Focusing on identification of asymptomatic- and symptomatic-infected persons, treatment, education, effective follow-up, and counseling for patients and sexual partners, emergency medicine pharmacists and providers can help minimize the negative long-term health consequences of STIs. CONCLUSION: In the emergency department setting, clinical pharmacists and providers can play a crucial role in preventing and treating STIs and should continue to expand and keep current their knowledge of this topic.


Asunto(s)
Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/epidemiología , Chlamydia , Consejo , Servicio de Urgencia en Hospital , Epididimitis , Femenino , Gonorrea , Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Humanos , Masculino , Enfermedad Inflamatoria Pélvica , Farmacéuticos , Profilaxis Posexposición , Embarazo , Parejas Sexuales , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/prevención & control , Simplexvirus , Sífilis , Tricomoniasis , Estados Unidos , Vaginosis Bacteriana
18.
Sex Transm Dis ; 47(1): 19-23, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31688719

RESUMEN

BACKGROUND: Gay, bisexual, transgender, and homeless youth are at risk of sexually transmitted infections. As part of an adolescent human immunodeficiency virus prevention study, we provided same-day Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) testing and treatment. We aimed to evaluate the feasibility and effectiveness of same-day CT and NG treatment on the proportion of participants receiving timely treatment. METHODS: We recruited adolescents with high sexual risk behaviors aged 12 to 24 years from homeless shelters, lesbian, gay, bisexual, and transgender organizations, and community health centers in Los Angeles, California, and New Orleans, Louisiana from May 2017 to June 2019. Initially, participants were offered point-of-care pharyngeal, rectal, and urethral/vaginal CT and NG testing and referral to another clinic for treatment. After March 2018 in Los Angeles and November 2018 in New Orleans, we provided same-day treatment (and partner treatment packs) for study participants. We measured the proportion of participants who received same-day treatment and the median time to treatment. We collected frequency of partner treatment and any reported adverse treatment-related events. RESULTS: The proportion of participants receiving same-day CT and NG treatment increased from 3.6% (5/140) to 21.1% (20/95; Δ17.5%; 95% confidence interval, 9.2%-26.9%) after implementation of same-day testing and treatment. The median time to treatment decreased from 18.5 to 3 days. Overall, 36 participants took a total of 48 partner treatment packs. There were no reported treatment-related adverse events. CONCLUSIONS: Providing sexually transmitted infection treatment to adolescents at the same visit as testing is feasible and safe, and can increase the proportion of individuals receiving timely treatment.


Asunto(s)
Infecciones por Chlamydia/diagnóstico , Prestación de Atención de Salud , Gonorrea/diagnóstico , Tamizaje Masivo , Pruebas en el Punto de Atención , Enfermedades de Transmisión Sexual/prevención & control , Adolescente , Instituciones de Atención Ambulatoria , Niño , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/prevención & control , Chlamydia trachomatis , Femenino , Gonorrea/tratamiento farmacológico , Gonorrea/prevención & control , Jóvenes sin Hogar/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Los Angeles , Masculino , Neisseria gonorrhoeae , Nueva Orleans , Minorías Sexuales y de Género/estadística & datos numéricos , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/microbiología , Factores de Tiempo , Personas Transgénero/estadística & datos numéricos , Adulto Joven
19.
Sex Transm Dis ; 47(1): 28-33, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31651711

RESUMEN

BACKGROUND: Data are scarce on sexually transmitted infection (STI) treatment-seeking behavior among men who have sex with men (MSM) in China. The purpose of the study was to characterize the first response to STI symptoms, treatment-seeking behavior, and its associated factors among MSM in China. METHODS: A cross-sectional study with convenience sampling design was conducted in 13 cities from April to July 2017. Face-to-face interviews were conducted to collect information on demographics, STI symptoms, and treatment-seeking behavior. Logistic regression analysis was conducted to evaluate variables associated with not seeking treatment. RESULTS: Among 3925 recruited participants, 628 (16.0%) reported STI symptoms in the past 12 months and were included in the analysis. Upon or after being notified of the symptoms, MSM sought help from various sources or self-tested using rapid testing kits. Only 322(51.3%) went to see a doctor in clinic. In multiple logistic regression analyses, younger age, lower income, less STI knowledge (adjusted odds ratio [AOR], 1.8; 95% confidence interval [CI], 1.2-2.5), not knowing own STI risk (AOR, 1.8; 95% CI, 1.2-2.7), no symptoms of anogenital ulcers (AOR, 2.3; 95% CI, 1.3-3.8) or anogenital warts (AOR, 2.4; 95% CI, 1.6-3.7), no syphilis testing in the past 12 months (AOR, 2.1; 95% CI, 1.5-3.0) were associated with higher probability of not seeking treatment in clinics. CONCLUSIONS: We found a high prevalence of STI symptoms among MSM and only half sought treatment. Prevention efforts should promote STI education, testing, and adequate treatment-seeking behavior.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Servicios de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Adulto , China/epidemiología , Ciudades/epidemiología , Estudios Transversales , Conductas Relacionadas con la Salud , Homosexualidad Masculina , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Análisis de Regresión , Asunción de Riesgos , Conducta Sexual , Parejas Sexuales , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Encuestas y Cuestionarios , Adulto Joven
20.
Georgian Med News ; (309): 81-85, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33526734

RESUMEN

Objective - studying species belonging to the causative agents of trichomoniasis of the genitourinary system in patients with sexually transmitted infections and immunodeficiency, assessing efficiency of their treatment. 77 patients with sexually transmitted infections and immunodeficiency were examined using the method of polymerase chain reaction in order to detect trichomonas species. 32 patients were given treatment and immune system indicators dynamics were determined. Trichomonas tenax was detected in 15.5%, Pentatrichomonas hominis - in 22%, Trichomonas vaginalis - in 4.1% of 77 examined patients. The method of combine treatment, providing for consecutive application of anti-protist substances of ornidazole and nifurotel with PROPES® taking smiltaniosly was effective to manage chronic trichomoniasis in 96.9% cases. Normalization of immune system took place. Trichomonias is a widespread disease in patients with sexually transmitted infections and immunodeficiency at the same time (41.6%). Application of the suggested original method allows us to achieve effective cure of chronic genital trichomoniasis caused by its various trichomonas species. Administration of PROPES® could be recommended as combined treatment of trichomoniasis on the background of immunodeficiency.


Asunto(s)
Enfermedades de Transmisión Sexual , Tricomoniasis , Trichomonas vaginalis , Trichomonas , Genitales , Humanos , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Tricomoniasis/diagnóstico , Tricomoniasis/tratamiento farmacológico
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