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1.
BMC Infect Dis ; 20(1): 684, 2020 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-32948128

RESUMEN

BACKGROUND: Untreated male partners are a critical source of maternal re-infection. Contact tracing is a good way to identify infection among partners and reduce risk of mother-to-child transmission related to maternal re-infection. This study aimed to analyze the current situation and related factors of contact tracing of syphilis-seropositive pregnant women and syphilis-infection among their male partners. METHOD: Data of syphilis-seropositive pregnant women and their male partners attending clinic for syphilis-screening were obtained from the Shenzhen Program for Prevention of Congenital Syphilis. Contact tracing rate of syphilis-seropositive pregnant women and syphilis prevalence among male partners were counted, and related factors were also analyzed using a random-effects logistic regression model. RESULT: Of the 1299 syphilis-seropositive pregnant women, 74.1% (963/1299) had their male partners receiving syphilis-screening and 19.1% (184/963) of male partners were syphilis-infected. For pregnant women, being divorced (adjusted odds ratio [AOR] =0.39; 95%CI: 0.17-0.87), seeking for emergency services at their first antenatal clinics visits (AOR = 0.58; 95%CI: 0.44-0.77), reporting willingness to notify partner(AOR = 7.65; 95%CI: 4.69-12.49), multi-partners (AOR = 1.38; 95%CI:1.03-1.86) and having a history of drug abuse (AOR = 0.37; 95%CI: 0.14-1.00)were independently associated with successful contact tracing. For male partners, of minority ethnicity (AOR = 4.15; 95%CI: 1.66-10.34), age at first sex>20(AOR = 0.57; 95%CI: 0.37-0.87), reporting multi-partners (AOR = 1.60; 95%CI: 1.04-2.46), having a history of drug abuse (AOR = 4.07; 95%CI: 1.31-12.64) were independently associated with syphilis-infection. In addition, pregnant women with TRUST titer ≥1:8 (AOR = 2.81; 95%CI: 1.87-4.21), having a history of adverse pregnancy outcomes (AOR = 1.70; 95%CI: 1.14-2.53), reporting multi-partners (AOR = 0.43; 95%CI: 0.29-0.64) and reporting the current partner as the source of syphilis (AOR = 5.05; 95%CI: 2.82-9.03) were independently associated with partners' syphilis-infection. CONCLUSION: Contact tracing is feasible and effective in identifying syphilis-infected partners among syphilis-seropositive pregnant women. Contact tracing is associated with many factors such as women's marital status, services at their first antenatal clinics visit and willingness of partner notification. Partners' ethnicity, age at first sex, multi-partners and history of drug abuse as well as women's levels of TRUST titer were associated with partners' syphilis-infection.


Asunto(s)
Trazado de Contacto , Complicaciones Infecciosas del Embarazo/epidemiología , Sífilis/transmisión , Adolescente , Adulto , Instituciones de Atención Ambulatoria , China/epidemiología , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Modelos Logísticos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Oportunidad Relativa , Embarazo , Resultado del Embarazo , Mujeres Embarazadas , Prevalencia , Parejas Sexuales , Sífilis/epidemiología , Sífilis Congénita/prevención & control , Sífilis Congénita/transmisión , Adulto Joven
2.
PLoS Negl Trop Dis ; 14(5): e0008078, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32463835
3.
Artículo en Inglés | MEDLINE | ID: mdl-32236386

RESUMEN

The aim of study was to assess the prevalence of Treponema pallidum and HIV infection in Amerindian people (Mbya Guarani) over the age of 11 in Puerto Iguazu (Argentina) and to describe the contact tracking of cases. The method was a cross-sectional study in the Mbya Guarani people living in three villages of Puerto Iguazu (community A, pop. 1,146; community B, pop. 369; and community C, pop. 149). Participants were randomly invited to participate in the survey and in blood testing. Of the 551 participants, 48 were infected by T. pallidum (8.71%; 95% confidence interval [CI] 7.38-10.04). The infection prevalence decreased with age, standing at 9.66% in the 11-19 age group, 8.42% in 20-39 age group and 4.54% in people aged 40 and older. We tracked 130 contacts for the 48 T. pallidum cases; 39/40 (97.5%) sexual contacts tested positive for syphilis. Among the 90 children born to infected mothers, 76 aged 18 months or older tested negative, while 8/14 younger children were still at risk for congenital syphilis. There were four cases of HIV infection (0.72%, 95% CI 0.31-1.13). Prevalence of T. pallidum infection and HIV infection are relevant in this indigenous community of Argentina, representing a public health concern.


Asunto(s)
Trazado de Contacto/estadística & datos numéricos , Infecciones por VIH/epidemiología , Indios Sudamericanos/estadística & datos numéricos , Sífilis/epidemiología , Adolescente , Adulto , Argentina/epidemiología , Niño , Estudios Transversales , Femenino , Estudios de Seguimiento , Infecciones por VIH/diagnóstico , Infecciones por VIH/transmisión , Humanos , Lactante , Masculino , Prevalencia , Estudios Seroepidemiológicos , Sífilis/diagnóstico , Sífilis/transmisión , Adulto Joven
4.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(3): 337-342, 2020 Mar 10.
Artículo en Chino | MEDLINE | ID: mdl-32294831

RESUMEN

Objective: To assess the health status and health service utilization of children born to syphilis infected mothers during pregnancy, in order to prevent mother-to-child transmission of syphilis to the newborns. Methods: Women with maternal syphilis were studied by trained researchers via phone calls, in Shanghai during 2014-2015. Data related to demographics, status of infection and health care, utilization by both mothers and their children were collected through specifically designed questionnaires. Non-parametric tests including chi-square were used to assess the health status and health service utilization of children born to mothers with different demographic and socioeconomic characteristics. Results: A total of 495 children born to mothers with maternal syphilis were recruited from 1 000 syphilis infected parturient women. A total of 61 out of the 495 children were diagnosed as having congenital syphilis (57 children were diagnosed at birth and another 4 were diagnosed during the follow-up period). Children born to women who received syphilis treatment during pregnancy were at lower risk on congenital syphilis (χ(2)=7.214, P=0.027). 37.8% of the children were reported to have had different illnesses in the past three months, mainly involving upper respiratory infections (32.3%) or diarrhea (3.6%). Children diagnosed with congenital syphilis showed a higher prevalence of different kinds of diseases, compared to those without congenital syphilis (47.5% vs. 36.6%). 81.6% of the children had received regular child health care services. Subjects with the following factors as: being immigrant, with lower education, unemployed, unmarried and multipara, were related to the less use of regular child healthcare services. Only 39.7% of the parents would inform the care-takers about the risk of congenital syphilis infection of their own children at the child health care centers. Mothers with residency of Shanghai, having higher education level and employed, were less willing to inform doctors about the risk of congenital syphilis infection of their children. Conclusions: Loss to follow-up among children born to syphilis infected pregnant women remained a serious problem. Few parents would be willing to inform the healthcare takers that their children are at risk of syphilis, when receiving child health care services at the centers. It was necessary to integrate the congenital syphilis follow-up programs into the routine child care services so as to timely diagnose and treat the patients with congenital syphilis.


Asunto(s)
Servicios de Salud del Niño/estadística & datos numéricos , Salud del Niño/estadística & datos numéricos , Complicaciones Infecciosas del Embarazo/epidemiología , Sífilis/epidemiología , Niño , China/epidemiología , Femenino , Humanos , Recién Nacido , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Embarazo , Complicaciones Infecciosas del Embarazo/terapia , Sífilis/terapia , Sífilis/transmisión , Sífilis Congénita/diagnóstico
5.
AIDS Behav ; 24(10): 2895-2905, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32239359

RESUMEN

Syphilis and HIV among gay, bisexual and other men who have sex with men (MSM) are syndemic suggesting current prevention strategies are not effective. Sex partner meeting places and their networks may yield effective and optimal interventions. From 2009 to 2017, 57 unique venues were reported by > 1 MSM and 7.0% (n = 4), 21.1% (n = 12) and 71.9% (n = 41) were classified as syphilis, HIV or co-diagnosed venues, respectively. Forty-nine venues were connected in one main network component with four online, co-diagnosis venues representing 51.6% of reports and the highest degree and eigenvector centralities. In a sub-analysis during a local syphilis epidemic, the proportion of venues connected in the main component increased 38.7% (61.5% to 86.4%); suggesting increasing overlap in syphilis and HIV transmission and density of the venue network structure over time. This network analysis may identify the optimal set of venues for tailored interventions. It also suggests increasing difficulty of interrupting network transmission through fragmentation.


Asunto(s)
Bisexualidad , Infecciones por VIH/diagnóstico , Homosexualidad Masculina , Parejas Sexuales , Minorías Sexuales y de Género/psicología , Red Social , Sífilis/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Humanos , Masculino , Instalaciones Públicas , Salud Pública , Factores de Riesgo , Conducta Sexual , Medio Social , Sífilis/epidemiología , Sífilis/transmisión
6.
AIDS Behav ; 24(10): 2918-2926, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32297067

RESUMEN

Despite the high HIV incidence among men who have sex with men (MSM) in China, over half of MSM have never been tested for HIV before (MSMNT). Through a serial cross-sectional study from 2012 to 2016 in Shenyang, China, we studied 1036 MSMNT, and diagnosed 16.2% (168/1036) with HIV. The percentage of MSMNT who had condomless anal intercourse (CAI) in the past year increased from 42.1% (130/309) in 2012 to 63.4% (102/161) in 2016 (P < 0.001). 61.9% (104/168) of HIV-positive MSMNT had CAI and this percentage remained constant for the study period (P = 0.593). 53.3% (463/868) of HIV-negative MSMNT had CAI and this percentage significantly increased over the study period (P < 0.001). Encouraging HIV testing in this key subset through online HIV risk self-evaluation tools and HIV self-testing kits may help mitigate the overall MSM HIV incidence.


Asunto(s)
Condones/estadística & datos numéricos , Homosexualidad Masculina/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Sexo Inseguro/estadística & datos numéricos , Adulto , China/epidemiología , Estudios Transversales , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Infecciones por VIH/transmisión , Homosexualidad Masculina/etnología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Medición de Riesgo , Asunción de Riesgos , Parejas Sexuales , Minorías Sexuales y de Género , Factores Socioeconómicos , Sífilis/epidemiología , Sífilis/transmisión
7.
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
8.
Artículo en Inglés | MEDLINE | ID: mdl-32033272

RESUMEN

Syphilis is a disease that is found all over the world that causes damaging effects to the fetus through vertical transmission. This study aimed to analyze the processes that trigger the vertical transmission of syphilis through gestational and congenital syphilis notifications. It is a cross-sectional study. The sample totaled 129 notifications of syphilis in pregnant women and 132 notifications of congenital syphilis in the city of Natal, from 2011 to 2015. Data were obtained from the Information System for Disease Notification. The Chi-square, Student's and Fisher's tests were used to verify associations of interest. Diagnosis of maternal syphilis was predominant in the third trimester of pregnancy. Only 1.6% of the pregnant women were registered with an adequate treatment regimen, of these 16.3% had the concomitant treatment with their partners. Of the affected children, 78.8% were registered as asymptomatic. The factors that trigger vertical transmission are related to the late diagnosis of the pregnant woman and sexual partner(s) and the deficiencies in clinical/therapeutic management in relation to the phase of the disease. Strategies of professional training should be adopted to notify and expand the provision of information for epidemiological surveillance, aiming to strengthen care, reduce vertical transmission and enable the continuous analysis of this problem.


Asunto(s)
Notificación de Enfermedades , Feto/microbiología , Transmisión Vertical de Enfermedad Infecciosa , Tercer Trimestre del Embarazo , Sífilis/transmisión , Adulto , Niño , Estudios Transversales , Diagnóstico Tardío , Femenino , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Atención Prenatal , Vigilancia en Salud Pública , Parejas Sexuales , Sífilis/diagnóstico
9.
Ann Dermatol Venereol ; 147(2): 127-130, 2020 Feb.
Artículo en Francés | MEDLINE | ID: mdl-31955971

RESUMEN

INTRODUCTION: Syphilis mainly affects men who have sex with men (MSM) between the ages of 20 and 49. Herein we report a case in a teenager illustrating extension of the epidemic to other populations. PATIENTS AND METHODS: A 15-year-old boy consulted in May 2018 for an anal fissure and painful oral erosions. He reported having had unprotected anal sex with another male teenager of the same age three months earlier. Syphilis serology was positive, with a positive treponemal test (TT) and non-treponemal test (VDRL) at 1/128. A treponemal bacterial DNA PCR assay was also positive for swabs obtained from the oral erosions and anal fissure. Due to a history of allergy to penicillin the patient was treated with doxycycline 200mg daily for 14 days. One month later, the mucosal lesions had subsided, and 3 months later the VDRL titer had decreased by 2 dilutions. CONCLUSION: This case of "early" syphilis illustrates a change in the French epidemiology of sexually transmitted diseases (STIs). STIs currently affect very young and previously unexposed metropolitan French populations. These infections are increasing in teenagers due to an increase in high-risk sexual behavior associated with a lack of knowledge of STIs. This case is a reminder of the current decline in the level of knowledge about STIs among teenagers as compared to young people of the same age in the 1990s.


Asunto(s)
Minorías Sexuales y de Género , Sífilis/transmisión , Adolescente , Factores de Edad , Antibacterianos/uso terapéutico , Doxiciclina/uso terapéutico , Fisura Anal/diagnóstico , Fisura Anal/tratamiento farmacológico , Humanos , Masculino , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/tratamiento farmacológico , Conducta Sexual , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Serodiagnóstico de la Sífilis
10.
Sci Rep ; 9(1): 19547, 2019 12 20.
Artículo en Inglés | MEDLINE | ID: mdl-31862938

RESUMEN

The aim of this study was to evaluate the effectiveness of preventing mother to child syphilis transmission to improve pregnancy outcomes. We performed a retrospective analysis of municipal databases of mother-to-child syphilis transmission. Pregnant women with syphilis were included. Group specific pregnancy outcomes were analyzed according to treatment. A total of 28 pregnant women were diagnosed with syphilis in 2012; 321 were diagnosed with syphilis in 2018. A prevalence of 0.14% was observed amongst pregnant women in Suzhou city from 2012-2018. Primary treatments included benzathine penicillin, ceftriaxone sodium or erythromycin when patients were allergic to Benzathine penicillin. The treatment coverage was 81.57%, and only 52.86% of pregnant women were adequately treated. Adverse pregnant outcomes were higher amongst untreated women. Expanding early screening coverage and promoting treatment were key to improving pregnancy outcomes amongst women with syphilis.


Asunto(s)
Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Sífilis/prevención & control , Sífilis/transmisión , Adulto , Antibacterianos/uso terapéutico , Ceftriaxona/uso terapéutico , Eritromicina/uso terapéutico , Femenino , Humanos , Persona de Mediana Edad , Penicilina G Benzatina/uso terapéutico , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Resultado del Embarazo , Atención Prenatal , Estudios Retrospectivos , Adulto Joven
11.
Acta Med Port ; 32(12): 776-781, 2019 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-31851887

RESUMEN

Over the last few decades, behavioral changes in sexual practices have made oral transmission of traditional sexually transmissible infections increasingly recognized. Patients harboring a sexually transmissible infection may first present lesions on the oral cavity, as these may be visible and interfere with basic functions such as speech or swallowing. Moreover, the oral cavity may function as a reservoir for future spread of these infections. In order to successfully control this problem, a greater focus on oral sex should be persued, along with promotion of the use of condom and education on safe oral sex practices. Furthermore, examination of the oral cavity should is essential when evaluating any patient suspected of harboring a sexually transmissible infection. In this article, oral transmission of several viral and bacterial infections is reviewed, including human papillomavirus infection, genital herpes, syphilis and gonorrhea, among others.


Asunto(s)
Enfermedades de la Boca/complicaciones , Sexo Seguro , Conducta Sexual , Enfermedades de Transmisión Sexual/transmisión , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/transmisión , Chlamydia trachomatis , Gonorrea/diagnóstico , Gonorrea/transmisión , Infecciones por VIH/diagnóstico , Infecciones por VIH/patología , Infecciones por VIH/transmisión , Herpes Simple/diagnóstico , Herpes Simple/transmisión , Humanos , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/patología , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/patología , Infecciones por Papillomavirus/transmisión , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/patología , Sífilis/diagnóstico , Sífilis/patología , Sífilis/transmisión
12.
BMC Pregnancy Childbirth ; 19(1): 439, 2019 Nov 27.
Artículo en Inglés | MEDLINE | ID: mdl-31771540

RESUMEN

BACKGROUND: Partner infection is a significant factor in preventing mother-to-child syphilis transmission. We compared pregnancy outcomes between syphilis discordant and syphilis concordant couples. METHODS: We conducted a retrospective study among 3076 syphilis-positive women who received syphilis screening together with their partners during pregnancy. Multivariate analysis was used to explore risks for abnormal outcomes in objects correcting for the major covariate factors. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated to compare pregnancy outcomes between syphilis concordant and syphilis discordant couples. RESULTS: Overall, 657 of the 3076 women were diagnosed with gestational syphilis and had a syphilis-positive partner, giving a partner concordance prevalence of 21.36%. Women in concordant couples were more likely to have higher parity, more children, late antenatal care and syphilis screening, a lower proportion of latent syphilis, and elevated serologic titers than women in discordant couples (P < 0.01 for all). Totally, 10.08% of women had adverse pregnancy outcomes. Multivariate analysis showed partners' syphilis infection (ORadj = 1.44, 95% CI: 1.10-1.89), untreated pregnancy syphilis (ORadj = 1.67, 95% CI: 1.15-2.43), and higher maternal serum titers (> 1:8) (ORadj = 1.53, 95% CI: 1.17-2.00) increased the risks of adverse pregnancy outcomes. Concordance was associated with increased risk for stillbirth (ORadj = 2.86, 95%CI:1.36-6.00), preterm birth (PTB) (ORadj = 1.38,95%CI:1.02-1.87) and low birth weight (LBW) (ORadj = 1.55, 95%CI:1.13-2.11) compared with discordance. Even among treated women, concordance was associated with increased risk for stillbirth (ORadj = 3.26, 95%CI:1.45-7.31) and LBW (ORadj = 1.52, 95%CI:1.08-2.14). Among women with one treatment course, the risks for PTB(ORadj = 1.81, 95%CI:1.14-2.88) and LBW(ORadj = 2.08, 95%CI:1.28-3.38)were also higher among concordant couples than discordant couples. Nevertheless, there were no significant differences between concordant and discordant couples in risks of stillbirth (ORadj = 2.64, 95% CI: 0.98-7.05),PTB (ORadj = 1.15, 95% CI: 0.76-1.74), and LBW(ORadj = 1.21, 95% CI: 0.78-2.02) among women with two treatment courses. CONCLUSION: Male partner coinfection increased the risks for stillbirth, PTB and LBW, particularly when gestational syphilis treatment was suboptimal. However, this risk could be reduced by adequate treatment.


Asunto(s)
Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Complicaciones Infecciosas del Embarazo/microbiología , Parejas Sexuales , Sífilis/transmisión , Adulto , Femenino , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Masculino , Oportunidad Relativa , Embarazo , Resultado del Embarazo , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/microbiología , Estudios Retrospectivos , Factores de Riesgo , Mortinato/epidemiología
13.
Sex Health ; 16(6): 580-586, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31699208

RESUMEN

Background Amidst an increase in STI rates among men who have sex with men (MSM) and transgender women (TGW), there is little research on STI knowledge, risk perception and concern about infection in these populations. METHODS: This mixed-methods study explored these constructs among 60 racially and ethnically diverse MSM and TGW who regularly engage in condomless anal intercourse with multiple partners. RESULTS: Participants had a mean age of 40.63 years. Most (95%) identified as a man and as gay or homosexual (73%); 55% were college graduates. Almost half the respondents reported a prior STI. Participants correctly answered a mean of 55.36% and 76.90% STI and HIV knowledge items respectively. STI knowledge was positively correlated with education and prior HIV tests, and was higher among those with a prior STI. During in-depth interviews, some participants expressed concerns about limited knowledge of STIs and syphilis. Half reported low concern about syphilis infection, due to prior treatment that was perceived as relatively simple, lack of STI infection in the past, erroneous information about transmission routes or simply not thinking about it. CONCLUSIONS: Among this high-risk sample who perceived themselves to be at low risk of infection, knowledge was primarily gained through being diagnosed and treated for an STI rather than from acquiring knowledge to prevent STI infection. Participants expressed interest in increasing their STI knowledge and recognised the importance of regular STI testing. Dissemination of targeted information about STI prevention, routinising of STI testing and STI self-testing might contribute to decreasing STI infection rates among this population.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Homosexualidad Masculina/psicología , Enfermedades de Transmisión Sexual/psicología , Personas Transgénero/psicología , Adulto , Femenino , Infecciones por VIH/psicología , Infecciones por VIH/transmisión , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Entrevistas como Asunto , Masculino , Factores de Riesgo , Enfermedades de Transmisión Sexual/transmisión , Sífilis/psicología , Sífilis/transmisión , Personas Transgénero/estadística & datos numéricos , Sexo Inseguro/psicología , Sexo Inseguro/estadística & datos numéricos
14.
PLoS One ; 14(10): e0223377, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31581277

RESUMEN

The aim of this study is to assess the HIV/syphilis epidemic among men who have sex with men (MSM) aged <50 years and ≥50 years in Shenzhen, and explore the associated factors of HIV/syphilis co-infections among MSM in Shenzhen, in order to help prevention and intervention programs determine their target sub-group. A serial cross-sectional study was conducted on MSM in Shenzhen city, China from 2009 to 2017. A questionnaire was used to collect demographic characteristics, history of HIV testing, history of blood donation and sexual behaviors. 5 ml of venous blood were collected for syphilis and HIV tests. The overall prevalence of HIV, syphilis, HIV/syphilis co-infection was 9.40%, 18.97%, and 4.91%, respectively. The prevalence of HIV (15.26%), syphilis (27.71%), HIV/syphilis co-infection (9.24%) in aged ≥50 years MSM was significantly higher than aged <50 years MSM (9.15%, 18.59% and 4.72%, respectively). The following factors were found to be significantly associated with HIV/syphilis co-infections (P<0.05): age≥50 years (OR = 1.78, 95% CI = 1.10-2.87), high school or lower (OR = 1.49, 95% CI = 1.10-2.01), monthly income ≤436.2 USD (OR = 1.74, 95% CI = 1.25-2.42), monthly income 436.4-727.2 USD (OR = 1.46, 95% CI = 1.05-2.03), ≥2 anal sex partners in the past 6 months (OR = 1.59, 95% CI = 1.02-2.49), ≥2 oral sex partners in the past 6 months (OR = 1.60, 95% CI = 1.08-2.36), inconsistent condom use during anal sex in the past 6 months (OR = 1.50, 95% CI = 1.11-2.03). We found that aged <50 years and ≥50 years MSM in Shenzhen had a high prevalence of HIV/syphilis infection in a period from 2009 to 2017. Age-specific sexually transmitted diseases education, prevention, and intervention programs for aged ≥50 years MSM should be implemented urgently and integrated interventions of both HIV and syphilis infections on MSM are needed in the future.


Asunto(s)
Coinfección , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Sífilis/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , China/epidemiología , Estudios Transversales , Femenino , Infecciones por VIH/historia , Infecciones por VIH/transmisión , Historia del Siglo XXI , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Vigilancia en Salud Pública , Factores de Riesgo , Parejas Sexuales , Enfermedades de Transmisión Sexual/epidemiología , Sífilis/historia , Sífilis/transmisión , Adulto Joven
15.
Sex Transm Dis ; 46(11): 716-721, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31644499

RESUMEN

BACKGROUND: Home-based human immunodeficiency virus (HIV) testing and education has increased HIV test uptake and access to health services among men. We studied how a home-based antenatal intervention influenced male partner utilization of clinic-based HIV and sexually transmitted infection (STI) services, linkage to HIV care and medical circumcision. METHODS: We conducted a secondary analysis within a randomized controlled trial of pregnant women attending antenatal care in Kenya. Women and their male partners received either a home-based couple intervention or an invitation letter for clinic-based couple HIV testing. The home-based intervention included education on STI symptoms, STI and HIV treatment and male circumcision for HIV prevention. Male self-reported outcomes were compared using relative risks at 6 months postpartum. RESULTS: Among 525 women, we reached 487 (93%) of their male partners; 247 men in the intervention arm and 240 men in the control arm. Men who received the intervention were more likely to report an STI consultation (n = 47 vs. 16; relative risk, 1.59; 95% confidence interval, 1.33-1.89). Among 23 men with newly diagnosed HIV, linkage to HIV care was reported by 4 of 15 in the intervention (3 men had missing linkage data) and 3 of 5 men in the control arms (relative risk, 0.66; 95% confidence interval, 0.34-1.29). Although the intervention identified 3 times more men with new HIV infection, the study lacked power to find significant differences in linkage to HIV care. Few eligible men sought medical circumcision (4 of 72 intervention and 2 of 88 control). CONCLUSIONS: Home-based couple education and testing increased STI consultations among male partners of pregnant women, but appeared insufficient to overcome the barriers involved in linkage to HIV care and medical circumcision.


Asunto(s)
Infecciones por VIH/prevención & control , Educación en Salud/métodos , Parejas Sexuales , Enfermedades de Transmisión Sexual/prevención & control , Sífilis/prevención & control , Adulto , Circuncisión Masculina , Femenino , VIH/efectos de los fármacos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Educación en Salud/estadística & datos numéricos , Humanos , Kenia/epidemiología , Masculino , Embarazo , Mujeres Embarazadas/educación , Atención Prenatal , Prevalencia , Enfermedades de Transmisión Sexual/microbiología , Enfermedades de Transmisión Sexual/virología , Sífilis/tratamiento farmacológico , Sífilis/epidemiología , Sífilis/transmisión
16.
Med Hist ; 63(4): 494-511, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31571698

RESUMEN

This article considers the social function of contagious disease as moderator of class relationships in England during the first half of the eighteenth century and takes into account the ways in which the 'communicability' of the plague, great pox (syphilis) and smallpox (variola) was used by authors to crystallise social interaction and tension along class lines. The essay begins by examining the representation of the plague, syphilis and smallpox in the medical tradition, before shifting its attention to the practice of maritime quarantine, as laid out by Richard Mead in his Short Discourse Concerning Pestilential Contagion (1720). By foregrounding medical writing on contagion through skin contact, I suggest that pornographic texts such as John Cleland's The Memoirs of a Woman of Pleasure (Fanny Hill) (1748) had an interventionist function. Cleland is often charged with sanitising the true horrors of sex work in this period. This article proposes that if we take the time to appreciate the way infectious cutaneous diseases were believed to operate and spread we can recognise the moments in which he not only alludes to disease but invokes it for structural and thematic purposes. In proposing this, I am challenging the dominant interpretation that the problematic realities of eighteenth-century prostitution, especially disease, are subordinated to the narrative's greater interest in erotic pleasure.


Asunto(s)
Literatura Moderna/historia , Medicina en la Literatura/historia , Peste/historia , Cuarentena/historia , Trabajo Sexual/historia , Viruela/historia , Sífilis/historia , Distinciones y Premios , Transmisión de Enfermedad Infecciosa/historia , Historiografía , Historia del Siglo XVII , Historia del Siglo XVIII , Humanos , Londres , Peste/transmisión , Navíos/historia , Viruela/transmisión , Sífilis/transmisión , Libros de Texto como Asunto/historia
17.
Enferm. glob ; 18(56): 198-208, oct. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-188270

RESUMEN

Objetivo: Analizar el perfil epidemiológico de Sífilis Congénita en 18 municipios en el interior del estado de Bahía entre 2007 y 2017. Método: Estudio descriptivo, transversal y cuantitativo de los casos confirmados de Sífilis Congénita en la microrregión registrados en el Sistema de Información de Agravios y Notificación. Resultados: En el período estudiado se confirmaron 39 casos, donde el 30,8% de las madres tiene entre 20 a 24 años, el 59% son pardas, el 46,2% tienen enseñanza fundamental incompleta, el 33,3% amas de casa, el 74,4% en el momento del parto / curetaje, el 41% recibió tratamiento inadecuado y el 38,5% de los socios no fueron tratados. Con respecto a los recién nacidos, el 69,2% fue diagnosticado con 0 días de vida, 74,4% con Sífilis Congénita reciente y 46,2% asintomáticos. Conclusión: Los datos revelan un serio problema de salud pública en la microrregión analizada apuntando también fallas en el sistema de notificación, observadas en el elevado índice de ignorados en las variables estudiadas


Objective: To analyze the epidemiological profile of Congenital Syphilis in 18 municipalities in the state of Bahia between 2007 and 2017. Method: A descriptive, cross-sectional and quantitative study of the confirmed cases of Congenital Syphilis in the micro-region registered in the Aggravation and Notification Information System. Results: In the study period, 39 cases were confirmed, with 30.8% of the mothers being between 20 and 24 years of age, 59% were brown, 46.2% had incomplete primary education, 33.3% were housewives, 74.4% 94.9% underwent prenatal care, 53.8% were diagnosed at the time of delivery / curettage, 41% received inadequate treatment and 38.5% of the partners were not treated. With regard to newborns, 69.2% were diagnosed with 0 day of life, 74.4% with recent Congenital Syphilis and 46.2% asymptomatic. Conclusion: The data reveal a serious public health problem in the micro-region analyzed, also pointing out failures in the notification system, observed in the high ignored index in the studied variables


Objetivo: Analisar o perfil epidemiológico de Sífilis Congênita em 18 municípios no interior do estado da Bahia entre 2007 e 2017. Método: Estudo descritivo, transversal e quantitativo dos casos confirmados de Sífilis Congênita na microrregião registrados no Sistema de Informação de Agravos e Notificação. Resultados: No período estudado foram confirmados 39 casos, onde 30,8% das mães tem entre 20 a 24 anos, 59% são pardas, 46,2% possuem ensino fundamental incompleto, 33,3% donas de casa, 74,4% residentes na zona urbana, 94,9% realizou o pré-natal, 53,8% foram diagnosticadas no momento do parto/curetagem, 41% receberam tratamento inadequado e 38,5% dos parceiros não foram tratados. Com relação aos recém-nascidos, 69,2% foram diagnosticados com 0 dia de vida, 74,4% com Sífilis Congênita recente e 46,2% assintomáticos. Conclusão: Os dados revelam um sério problema de saúde pública na microrregião analisada apontando também falhas no sistema de notificação, observadas no elevado índice de ignorados nas variáveis estudadas


Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Recién Nacido , Lactante , Adolescente , Adulto Joven , Adulto , Sífilis Congénita/epidemiología , Serodiagnóstico de la Sífilis/métodos , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Brasil/epidemiología , Sífilis Latente/epidemiología , Infecciones Asintomáticas/epidemiología , Diagnóstico Prenatal/métodos , Notificación de Enfermedades/estadística & datos numéricos , Sífilis/transmisión , Mujeres Embarazadas , Complicaciones Infecciosas del Embarazo/epidemiología
18.
Transfus Clin Biol ; 26(3): 155-159, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31255509

RESUMEN

INTRODUCTION: Different evaluations conducted on blood safety between 2004 and 2013 in Africa showed some progress in most countries. This paper describes the current status of the availability and access to safe blood in the Region. METHODS: A cross-sectional survey was conducted from January to December 2018. Data were collected through a questionnaire prepared using key indicators of blood safety and analysis was done using Excel 2010 and results were compared to those of the 2013. RESULTS: A total of 2,678 blood centres were reported including 244 (9%) stand-alone and 2,434 (91%) hospital based. Amongst these countries, 90.2% had a blood policy, 60.1% participated in an External Quality Assessment Scheme for Transfusion Transmissible Infections screening, 12% had accredited blood services, 73.2% had national guidelines on clinical use of blood and 78% had a government budget. The total number of blood units collected was 4,899,913 and the average proportion of voluntary blood donations was 71%. Plasma-derived medicinal products were included in the national essential medicines list in 52.6% of countries. The average proportion of units of blood tested for infections was 99.5% for HIV, 92.3% for HBV, 98.9% for HCV, 98.8% for syphilis. The percentage of whole blood separated into blood components was 63.4%. CONCLUSION: Countries in the region continue to improve availability and access to safe blood, but challenges still remain and call for concrete actions required to reach universal access to quality and safe blood for transfusion throughout the region.


Asunto(s)
Seguridad de la Sangre , Transfusión Sanguínea/estadística & datos numéricos , África/epidemiología , Bancos de Sangre/normas , Bancos de Sangre/estadística & datos numéricos , Donantes de Sangre/estadística & datos numéricos , Seguridad de la Sangre/normas , Seguridad de la Sangre/estadística & datos numéricos , Transfusión Sanguínea/normas , Estudios Transversales , Encuestas de Atención de la Salud , Humanos , Utilización de Procedimientos y Técnicas/estadística & datos numéricos , Sífilis/prevención & control , Sífilis/transmisión , Reacción a la Transfusión/epidemiología , Reacción a la Transfusión/prevención & control , Viremia/diagnóstico , Viremia/epidemiología , Virosis/prevención & control , Virosis/transmisión , Organización Mundial de la Salud
19.
Sex Transm Dis ; 46(10): 629-636, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31356529

RESUMEN

The syphilis epidemic among men who have sex with men (MSM) has been increasing steadily. Many syphilis control programs focus on assuring treatment of all persons diagnosed with early syphilis without prioritizing acute primary syphilis or specific subgroups. Acute primary syphilis is highly infectious and contributes to a high proportion of new cases. Surveillance data show that among MSM with incident syphilis (primary or secondary) only about 35% are identified in the primary stage, indicating that most primary cases are missed and untreated. Patients with primary syphilis and large numbers of sex partners may play a major role in maintaining syphilis transmission. Considering those issues, sexually transmitted disease (STD) programs should consider increasing their focus on primary syphilis by assigning primary cases the highest priority, expanding client and clinician health education, and increasing the detection of primary syphilis through increased serologic screening frequency among high-risk MSM. Furthermore, syphilis control programs should implement steps to identify asymptomatic high-probable occult primary cases based on low titer (≤1:8) and recent seroconversion. Finally, to address core transmission groups, programs should implement periodic risk assessment to identify persons with a high number of sex partners and offer these individuals risk-reduction counseling, case management, and selective syphilis preexposure or postexposure doxycycline chemoprophylaxis. Although reprioritizing prevention efforts might be challenging, the Centers for Disease Control and Prevention, community advocacy groups, university STD research centers, and national STD prevention training centers can assist by providing support for consensus discussions and direction in developing operational guidance, some of which may be best delivered through STD and human immunodeficiency virus program partnerships.


Asunto(s)
Homosexualidad Masculina , Sífilis/prevención & control , Sífilis/transmisión , Enfermedad Aguda , Humanos , Masculino , Tamizaje Masivo , Pruebas Serológicas , Parejas Sexuales , Sífilis/diagnóstico
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