Factors Associated With Willingness to Use Daily Antibiotics as Sexually Transmitted Infection Prophylaxis Among HIV Preexposure Prophylaxis-Experienced Gay and Bisexual Men in Australia.

BACKGROUND: Gay and bisexual men (GBM) who use HIV preexposure prophylaxis (HIV-PrEP) have high rates of bacterial sexually transmitted infections (STIs). The use of daily antibiotics as STI preexposure prophylaxis (STI-PrEP) may be appealing to GBM who are using or have previously used HIV-PrEP (HIV-PrEP-experienced) for the prevention of bacterial STIs. METHODS: We examined willingness to use daily STI-PrEP among a cross-sectional sample of HIV-PrEP-experienced GBM in Australia who participated in an observational online cohort study from August 2018 to March 2020. Factors associated with willingness to use daily STI-PrEP were determined using bivariate and multivariate logistic regression. RESULTS: Of the 1347 participants, half (54.3%) were willing to use daily STI-PrEP. Factors independently associated with greater willingness to use daily STI-PrEP included having >10 sexual partners in the last 6 months, using methamphetamine in the last 6 months, being more conscious about avoiding STIs, having a greater number of STIs since commencing HIV-PrEP, being willing to take HIV-PrEP for as long as they were at risk of acquiring HIV, and only using condoms when a sexual partner requested them. Conversely, factors associated with less willingness to use daily STI-PrEP included being university educated, using nondaily dosing regimens of HIV-PrEP, preferring event-driven HIV-PrEP, and being concerned about long-term HIV-PrEP adverse effects. CONCLUSIONS: Sexually transmitted infection PrEP is likely to be appealing to many HIV-PrEP-experienced GBM, especially those who engage in activities associated with a higher risk of STI transmission. However, they are less likely to be willing to use STI-PrEP unless it aligns with their HIV-PrEP dosing regimen, suggesting that research into the safety and efficacy of alternative STI prophylaxis dosing options should be prioritized.

Pre-exposure prophylaxis and bacterial sexually transmitted infections (STIs) among gay and bisexual men.

OBJECTIVES: While pre-exposure prophylaxis (PrEP) prevents HIV acquisition among gay, bisexual and other men who have sex with men (GBM), PrEP-using GBM may be more likely to engage in sexual behaviours associated with bacterial STIs. We examined associations between PrEP use, condomless anal sex (CAS), number of anal sex partners, oral sex and bacterial STI diagnoses among GBM living in Canada's three largest cities. METHODS: Among HIV-negative/unknown-status GBM in the baseline of the Engage cohort study, we fit a structural equation model of the associations between any PrEP use, sexual behaviours and bacterial STI diagnosis. We estimated direct and indirect paths between PrEP use and STI via CAS, number of anal sex partners and oral sex. RESULTS: The sample included 2007 HIV-negative/unknown status GBM in Montreal, Toronto and Vancouver. There was a significant direct association between PrEP use and current STI diagnosis (ß=0.181; 95% CI: 0.112 to 0.247; p<0.001), CAS (ß=0.275; 95% CI: 0.189 to 0.361; p<0.001) and number of anal sex partners (ß=0.193; 95% CI: 0.161 to 0.225; p<0.001). In the mediated model, the direct association between PrEP use and STIs was non-significant. However, the indirect paths from PrEP to CAS to STIs (ß=0.064; 95% CI: 0.025 to 0.120; p=0.008), and from PrEP to greater number of anal sex partners to CAS to STIs were significant (ß=0.059; 95% CI: 0.024 to 0.108; p=0.007). CONCLUSIONS: Our study adds to the growing awareness that PrEP use among GBM may be associated with bacterial STIs because PrEP users have more anal sex partners and are more likely to engage in CAS. The results underscore the importance of providing effective STI counselling and regular testing to PrEP users, adapting PrEP care and related STI testing to individual needs, and the need for effective prevention strategies for bacterial STIs.

Differing Correlates of Incident Bacterial Sexually Transmitted Infections Among a Cohort of Black Cisgender Men Who Have Sex With Men and Transgender Women Recruited in 6 US Cities (HIV Prevention Trials Network 061).

ABSTRACT: Compared with Black cisgender men who have sex with men (MSM), Black transgender women had a higher incidence of bacterial sexually transmitted infections (25.9 [11.1-46.3] vs. 9.6 [8.10-11.3] per 100 person-years), higher rates of income and housing insecurity, and condomless receptive anal intercourse. Further investigation of unique risk pathways among transgender women is critical.

Bacterial Sexually Transmitted Infection Incidence Among Southern Men Who Have Sex With Men With Human Immunodeficiency Virus in the Treatment as Prevention Era, 2014-2019.

In this retrospective analysis of men who have sex with men with human immunodeficiency virus (HIV) in the South from 2014 through 2019, incident bacterial sexually transmitted infections (STIs) increased regardless of virologic control. Clinicians should prioritize STI screening and management in primary HIV care.

EVO100 prevents chlamydia and gonorrhea in women at high risk of infection.

BACKGROUND: According to the Centers for Disease Control and Prevention, rates of infection for Chlamydia trachomatis and Neisseria gonorrhoeae are increasing in the United States. EVO100 is an investigational antimicrobial, pH-modulating, vaginal gel with active ingredients L-lactic acid, citric acid, and potassium bitartrate that is being evaluated for the prevention of sexually transmitted infections. OBJECTIVE: The objective of this phase 2B/3 study was to assess the efficacy and safety of EVO100 for the prevention of chlamydia and gonorrhea. STUDY DESIGN: AMPREVENCE was a double-blinded, placebo-controlled, multicenter study based in the United States conducted over approximately 16 weeks in women at the age of 18 to 45 years who were at risk of urogenital chlamydia and gonorrhea infection. Enrolled women had been diagnosed as having and treated for chlamydia or gonorrhea ≤16 weeks before enrollment. Women received either EVO100 or placebo vaginal gel and were instructed to apply the study drug immediately before or up to 1 hour before each act of vaginal sexual intercourse. The primary and secondary endpoints were the prevention of urogenital chlamydia and gonorrhea, respectively. Exploratory outcomes include women's overall satisfaction with EVO100. RESULTS: In total, 860 women were randomized 1:1 to receive EVO100 (n=426) or placebo (n=434), and 764 women (EVO100, n=376; placebo, n=388) were documented as using the study drug at least once. Baseline characteristics were similar between treatment arms. Overall, women had a mean age of 27.7 years (standard deviation, 6.9) and body mass index of 28.9 kg/m2 (standard deviation, 8.0). Most women were of White (54.3% [467 of 860]) or African American (41.6% [358 of 860]) race and of non-Hispanic/Latina ethnicity (67.1% [577 of 860]). The chlamydia infection rate in EVO100 users was 4.8% (14 of 289) compared with 9.7% (28 of 290) among placebo users (P=.0256), representing a relative risk reduction of 50%. For gonorrhea, the infection rate was 0.7% (2 of 280) in the EVO100 arm compared with 3.2% (9 of 277) in the placebo arm (P=.0316), representing a relative risk reduction of 78%. Increased efficacy was observed with increased adherence, and chlamydia infection rates were significantly reduced with increased adherence in the EVO100 group compared with placebo. Across both arms, there were similar rates of all-cause adverse events (EVO100, 21.3% [80 of 376]; placebo, 20.4% [79 of 388]) and treatment-related adverse events (EVO100, 7.2% [27 of 376]; placebo, 7.5% [29 of 388]). The most common adverse events in the EVO100 arm were vulvovaginal candidiasis (5.1% [19 of 376]), vaginal discharge (3.2% [12 of 376]), and urinary tract infection (3.2% [12 of 376]) and, in the placebo arm, bacterial vaginosis (4.6% [18 of 388]), urinary tract infection (2.6% [10 of 388]), and vaginal discharge (2.6% [10 of 388]). Few women discontinued owing to adverse events in either arm (EVO100, 1.1% [4 of 376]; placebo, 1.5% [6 of 388]). No treatment-related serious adverse events were reported. Most EVO100 users (88%) were satisfied or very satisfied with EVO100 after 16 weeks of use. CONCLUSION: EVO100 significantly reduced the risk of chlamydia and gonorrhea infections in women at high risk of Chlamydia trachomatis and Neisseria gonorrhoeae infection and was well tolerated, with observed adverse events consistent with its known safety profile.

Conference report: 34th IUSTI Europe Congress.

The 34th IUSTI European Conference was held from the 3rd to the 5th of October 2020. There were presentations on STIs in Europe, many centred on Romania. A full session was devoted to syphilis, including global efforts in syphilis vaccine development. A workshop on Pre-Exposure Prophylaxis (PrEP) implementation in Europe reviewed the 'PrEP gap' and the East/West divide with an additional presentation on upcoming PrEP technologies. The conference featured symposia from WHO: STIs are still increasing and with no Euro universal surveillance systems. Other symposia focused on health inequalities amongst gender and sexual minorities and the recently published changes in IUSTI guidelines on gonorrhoea, syphilis and Lymphogranuloma Venereum. SARS-CoV-2 was a focus for several plenary sessions and its possibly lasting impact on service delivery. New challenges were discussed, particularly the loss of azithromycin as a useful antimicrobial. The symposia covered latest research and work into genomics of STIs. Whole-genome sequencing has revolutionised infectious disease study, particularly infection transmission and control. There was a debate on whether 'screening and treatment of bacterial Sexually Transmitted Infection is associated with Antimicrobial Resistance and should be reconsidered', emphasising limited damage of asymptomatic infection and the possibility of emergence of rapid antibiotic resistance. The conference closed with several IUSTI awards.

Meningococcal disease and sexual transmission: urogenital and anorectal infections and invasive disease due to Neisseria meningitidis.

Neisseria meningitidis is an obligate human commensal bacterium that frequently colonises the upper respiratory tract. Person-to-person transmission occurs via direct contact or through dispersion of respiratory droplets from a carrier of the bacteria, and can lead to invasive meningococcal disease. Rare sporadic cases of meningococcal urogenital and anorectal infections, including urethritis, proctitis, and cervicitis, have been reported, typically following orogenital contact with an oropharyngeal meningococcal carrier. The resulting infections were clinically indistinguishable from infections caused by Neisseria gonorrhoeae. Over the past two decades, there have also been multiple outbreaks across North America and Europe of invasive meningococcal disease among men who have sex with men (MSM). The responsible meningococci belong to a highly virulent and predominantly serogroup C lineage, including strains that are able to express nitrite reductase and grow in anaerobic environments, such as the urogenital and anorectal tracts. More recently, a distinct clade within this lineage has expanded to cause urethritis predominantly among men who have sex with women. Evolutionary events giving rise to this clade included the loss of the ability to express a capsule, and acquisition of several gonococcal alleles, including one allele encoding a highly efficient gonococcal nitrite reductase. Members of the clade continue to acquire gonococcal alleles, including one allele associated with decreased antibiotic susceptibility. This evolution has implications for the clinical and public health management of those who are infected and their close contacts, in terms of both antibiotic treatment, and prevention through vaccination.

Factors associated with interest in bacterial sexually transmitted infection vaccines at two large sexually transmitted infection clinics in British Columbia, Canada.

OBJECTIVE: To explore sexually transmitted infection (STI) clinic client attitudes and preferences towards STI vaccines and STI vaccine programming in an urban clinic setting. METHODS: A 31-item questionnaire was administered during check-in by clinic clerical staff at two STI clinics in Vancouver, Canada. Demographic characteristics and preferences were summarised descriptively. Multivariable logistic regression models to assess factors associated with STI vaccine interest (reported as ORs) were constructed using a priori clinically relevant variables and factors significant at p≤0.05 in bivariate analysis. RESULTS: 293 surveys were included in analysis. 71.3% of respondents identified as male, 80.5% had college level education or higher and 52.9% identified as white/of European descent. The median age was 33. 86.5% of respondents reported they would be interested in receiving an STI vaccine, with a primary motivator to protect oneself. Bivariate analysis indicated several factors associated with vaccine interest, with differences for each infection. After adjusting for other variables, willingness to pay for an STI vaccine (OR=3.83, 95% CI 1.29 to 11.38, p=0.02) remained a significant factor for syphilis vaccine interest and intent to engage in future positive health behaviours remained a significant factor for chlamydia (OR=5.94, 95% CI 1.56 to 22.60, p=0.01) and gonorrhoea (OR=5.13, 95% CI 1.45 to 18.07, p=0.01) vaccine interest. CONCLUSION: Respondents expressed a strong willingness to receive STI vaccines. These valuable findings will inform for eventual STI vaccine programme planning and implementation.

Reducing time to treatment of bacterial sexually transmitted infections in an HIV cohort.

Sexually transmitted infections (STIs) are known to increase the risk of transmission of HIV and care of sexual health needs should form part of routine HIV care. Delayed treatment of STIs can lead to complications and avoidable onward transmission. Management of acute STIs in UK specialist sexual health services usually involves a multidisciplinary approach to ensure patient recall, antimicrobial treatment and partner notification. While this works well in dedicated sexual health clinics, we found this was less optimal in our hospital-based HIV care unit. We describe a quality improvement project to improve interdisciplinary pathways by using electronic shared worklists that reduced time to treatment for chlamydia and gonorrhoea infections. Use of electronic shared worklists could be applied to other settings where rapid treatment is required or has transmission implications.

Rapid point of care test for detecting urogenital Chlamydia trachomatis infection in nonpregnant women and men at reproductive age.

BACKGROUND: Chlamydia trachomatis (C trachomatis) is one of the most frequent sexually transmitted infections and a source of deleterious effects on the reproductive health of men and women. Because this infection is likely asymptomatic and is associated with subfertility, ectopic pregnancy, and chronic pain, its presence needs to be confirmed. Technologies available for the diagnosis of C trachomatis infection can be classified into tests performed in a laboratory and rapid tests at the point of care (POC tests). Laboratory-based tests include culture, nucleic acid amplification tests, enzyme immunoassays (EIA), direct fluorescent antibody, nucleic acid hybridization, and transformation tests. Rapid tests include solid-phase EIA and solid-phase optical immunoassay. POC tests can be performed within 30 minutes without the need for expensive or sophisticated equipment. The principal advantage of this technology is the immediate presentation of results with the subsequent possibility to start the treatment of infected patients immediately. OBJECTIVES: To determine the diagnostic accuracy of rapid point-of-care (POC) testing for detecting urogenital C trachomatis infection in nonpregnant women and men of reproductive age, as verified with nucleic acid amplification tests (NAATs) as the reference standard. SEARCH METHODS: In November 2019 we searched CENTRAL, MEDLINE, Embase and LILACS. We also searched Web of Science, two trials registries and an abstract database. We screened reference lists of included studies for additional references. SELECTION CRITERIA: We included diagnostic accuracy studies of symptomatic or asymptomatic nonpregnant women and men reproductive age. Included trials should have prospectively enrolled participants without previous diagnostic testing, co-infections or complications and consecutively or through random sampling at primary or secondary care facilities. Only studies reporting that all participants received the index test and the reference standard and presenting 2 x 2 data were eligible for inclusion. We excluded diagnostic case-control studies. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles and abstracts for relevance. Two review authors independently, and in duplicate, assessed eligibility, extracted data, and carried out quality assessment. We resolved differences through consensus or by involving a third review author. We assessed studies for methodological quality using QUADAS-2 and used meta-analysis to combine the results of studies using the bivariate approach to estimate the expected sensitivity and specificity values. We assessed the quality of the evidence using GRADE criteria and explored sources of heterogeneity. MAIN RESULTS: We included a total of 19 studies, with 13,676 participants, that assessed the diagnostic accuracy of POC tests for C trachomatis infection in nonpregnant women and men of reproductive age, as verified with NAATs as the reference standard. Rapid tests were provided by the distributors in nine studies. Seven studies recruited a predominantly high risk or symptomatic population; the studies were conducted in America, Asia, Africa, Europe and Oceania, with a median prevalence of 10% (range 8% to 28%); nine different brands were assessed. The mean sensitivity for rapid tests for detecting urogenital infection was 0.48 (95% confidence interval (CI) 0.39 to 0.58; low-quality evidence) with a mean specificity of 0.98 (95% CI 0.97 to 0.99; moderate-quality evidence). We explored sources of heterogeneity by looking into differences in diagnostic accuracy according to the specimen (endocervical versus urine or vaginal), symptoms among participants (symptomatic versus asymptomatic), and setting (low/middle-income versus high-income countries). Likelihood ratio tests were not significantly different in terms of sensitivity or specificity by specimen (P = 0.27) or setting (P = 0.28); for this reason, these covariates do not appear to explain the observed variability. Included studies did not provide enough information to assess the 'presence of symptoms' covariate. We downgraded the quality of evidence because of some limitations in applicability and heterogeneity. AUTHORS' CONCLUSIONS: Based on the results of this systematic review, the POC test based on antigen detection has suboptimal sensitivity but good specificity. Performance of this test translates, on average, to a 52% chance of mistakenly indicating absence of infection and a 2% chance of mistakenly pointing to the presence of this condition. Because of its deleterious consequences for reproductive health, and considering the current availability of safe and effective interventions to treat C trachomatis infection, the POC screening strategy should not be based on a rapid diagnostic test for antigen detection. Research in this topic should focus on different technologies.

Alcohol and drug use, partner PrEP use and STI prevalence among people with HIV.

OBJECTIVES: People with HIV (PWH) have a high burden of bacterial sexually transmitted infections (STIs). We examined the relationship of alcohol and drug use and partner pre-exposure prophylaxis (PrEP) use to STI prevalence in a cohort of PWH with a history of unhealthy alcohol use. METHODS: We analysed data from a primary care-based alcohol intervention study at Kaiser Permanente Northern California (KPNC). Participants were recruited between April 2013 and May 2015 and were followed for up to 24 months. We linked participant responses to questions from the 24 month follow-up interview, including alcohol and drug use and partner PrEP use, with STI test results (ie, syphilis, chlamydia, gonorrhoea) in the KPNC electronic health record. Prevalence ratios (PR) were estimated using Poisson models fitted with robust variance estimators to evaluate the association of substance use and partner use of PrEP with STIs. RESULTS: In the analytic sample (n=465), the median age was 52 years (IQR 45-59); 67% were white; 95% were men who have sex with men. Thirty-two per cent of participants had HIV-positive partners only; 31% had HIV-negative partners with at least one on PrEP in the previous year and 37% had HIV-negative partners without any on PrEP. Twenty-three per cent reported alcohol and drug use prior to sex in the last 6 months. Eight per cent of participants had an STI. Partner PrEP use (adjusted PR (aPR) 2.99 (95% CI 1.11 to 8.08)) was independently associated with higher STI prevalence. Participants who reported use of alcohol (aPR 1.53 (0.61 to 3.83)), drugs (aPR 1.97 (0.71 to 5.51)) or both (aPR 1.93 (0.75 to 4.97)) prior to sex had a higher STI prevalence. CONCLUSIONS: The higher prevalence of STIs among PWH with unhealthy alcohol use who have partners on PrEP suggests that this subgroup may be a high-yield focus for targeted outreach, STI screening and sexual health counselling.

Vulnerabilidade de homens jovens e suas necessidades de saúde / Vulnerabilidad de hombres jóvenes y sus necesidades de salud / Vulnerability of young men and their health needs

RESUMO Objetivos Identificar as condutas de saúde dos homens jovens universitários; conhecer a percepção dos homens jovens universitários sobre o cuidar de sua saúde; e descrever as práticas adotadas para a prevenção das infecções sexualmente transmissíveis. Método Estudo descritivo e exploratório, com abordagem qualitativa, desenvolvido com 25 jovens universitários entre 18-29 anos numa universidade pública do Rio de Janeiro. Para análise dos dados, utilizou-se a técnica de análise de conteúdo. Resultados Os homens jovens universitários percebem o cuidar como feminino, desconhecendo suas próprias particularidades, com a percepção de que não adoecem e, com isso, só procuram o serviço de saúde em situações de emergência. Conclusão e Implicações para a prática Existem desafios a serem vencidos na prática da assistência, como a visão de invulnerabilidade desses homens, a ausência na busca pelos serviços de saúde, o despreparo dos serviços de saúde para atender às necessidades desses jovens, com base em estratégias que contemplem, de forma singular e holística, essa população. As brechas identificadas no estudo permitem levantar futuras questões e provocar mudanças de atitudes voltadas a situações do contexto masculino, a fim de reverter vulnerabilidades ainda existentes e, também, as consequências dessas atitudes na saúde desses homens.

RESUMEN Objetivos Identificar las conductas de salud de hombres jóvenes universitarios; conocer la percepción de ellos sobre el cuidado de su salud; y describir las prácticas adoptadas para la prevención de las infecciones de transmisión sexual. Método Estudio descriptivo y exploratorio, de enfoque cualitativo, desarrollado con 25 universitarios entre 18-29 años en una universidad pública en Rio de Janeiro. Se utilizó la técnica de análisis de contenido. Resultados Los jóvenes perciben el cuidado como algo femenino, sin darse cuenta de sus propias peculiaridades, con la percepción de que no se enferman y, con esto, solo buscan el servicio de salud en situaciones de emergencia. Conclusión e Implicaciones para la práctica Hay desafíos que superar en la práctica de la atención, como la visión de la invulnerabilidad masculina, la ausencia en la búsqueda de servicios de salud, servicios de salud no preparados para satisfacer las necesidades de estos jóvenes a través de estrategias que contemplan de manera única y holística esa población. Las lagunas identificadas nos permiten plantear preguntas futuras y provocar cambios en las actitudes relacionadas con situaciones del contexto masculino, a fin de revertir las vulnerabilidades existentes y también las consecuencias de estas actitudes en la salud de estos hombres.

ABSTRACT Objectives To identify the health behaviors of university students, young men, to know the perception of them about caring for their health, and to describe practices adopted for the prevention of sexually transmitted infections. Method Descriptive and exploratory study, with a qualitative approach, developed with 25 students aged 18-29 at a public university in Rio de Janeiro. To the data analyzed, the content analysis technique was applied. Results Those university students perceived caring as a female practice. They were unaware of their health peculiarities, with the perception that they do not get sick. Because of that, they only seek health services in emergency health conditions. Conclusion and Implications for practice There are challenges to overcome in the practice of men's care. As the vision of the invulnerability of these men, there is an absence in the search for health services.Furthermore, a sort of unprepared health services does not meet the needs of these young people through strategies that contemplate them uniquely and holistically. The gaps identified allow us to raise inevitable questions and bring about changes in attitudes toward situations in the male context. It is necessary to reverse existing vulnerabilities and consequences on the men's health of these men.

Práticas de prevenção de Infecções Sexualmente Transmissíveis adotadas por jovens universitárias / Sexually Transmitted Infections prevention practices adopted by college girls

Estudo descritivo, quanti-qualitativo, realizado no Rio de Janeiro, em uma universidade pública, que teve o objetivo de analisar as práticas de prevenção de Infecções Sexualmente Transmissíveis adotadas por jovens universitárias. Os dados quantitativos foram aplicados a uma amostra de 276 estudantes que responderam a um questionário, em 2017. Os qualitativos foram coletados com 27 estudantes que participaram de grupos focais. As informações foram armazenadas com auxílio dos softwares Excel 2007 e Word 2010. Os achados quantitativos foram analisados com emprego da estatística descritiva e os discursivos com emprego da técnica de análise de conteúdo temático categorial. Todos os procedimentos éticos de pesquisa envolvendo seres humanos, recomendados pelo Conselho Nacional de Saúde, foram respeitados. Resultados: Na análise qualitativa, emergiram duas categorias: A informação como recurso para a prevenção de IST e Práticas de cuidado com a saúde adotada pelas jovens; e uma subcategoria: Aspectos influenciadores no uso do preservativo. Na análise dos achados verificou-se que a maioria das participantes têm idades entre 18-24 anos; são heterossexuais; tiveram a primeira relação sexual na faixa etária de 15 a 18 anos; usaram preservativos na primeira relação sexual, mas não utilizam esse recurso em todas as relações. As estudantes não utilizam preservativos nos relacionamentos afetivos com parceiros fixos, contudo empregam-no em relacionamentos com parcerias eventuais. Pode-se notar que o uso de preservativos nas relações sexuais tem associação direta com o tipo de parceria, sendo mais empregado quando não existe confiança no parceiro sexual. Quanto ao preservativo feminino, a maioria das estudantes não adota em função da falta de conhecimento, pela dificuldade de acesso e pelo desconforto. A negociação do uso de preservativos não é uma prática habitual das mulheres, e na maioria das situações essa é uma decisão dos parceiros sexuais, já que muitas não verbalizam a sua opinião. O álcool é outro fator que influencia diretamente no uso de preservativos. As participantes informaram fazer uso de álcool de forma esporádica, porém não utilizaram antes do último intercurso sexual. As jovens buscaram atendimento de saúde no último ano, fizeram exame ginecológico e de Papanicolau. Conclusão: As participantes do estudo relacionam a prática de cuidado com a saúde sexual com o uso de preservativos, embora nem sempre usem esse recurso. O uso de preservativos sofre influencia de diversos fatores que afetam diretamente a adoção desse recurso pelas jovens. As universitárias destacaram a importância da educação em saúde para oferecer informações de qualidade aos jovens sendo uma importante ferramenta para dirimir duvidas e prevenir agravos para a saúde sexual.

Descriptive, quantitative and qualitative study, carried out in Rio de Janeiro, at a public university, which aimed to analyze the prevention practices of Sexually Transmitted Infections adopted by young university students. Quantitative data were applied to a sample of 276 students who answered a questionnaire in 2017. Qualitative data were collected from 27 students who participated in focus groups. The information was stored with the help of Excel 2007 and Word 2010 software. The quantitative findings were analyzed using descriptive statistics and the discursive ones using the categorical thematic content analysis technique. All ethical research procedures involving human beings, recommended by the National Health Council, were respected. Results: In the qualitative analysis, two categories emerged: Information as a resource for STI prevention and Health care practices adopted by young women; and a subcategory: Aspects that influence condom use. In the analysis of the findings, it was found that most participants are aged between 18-24 years; they are heterosexual; had their first sexual intercourse in the 15 to 18 age group; used condoms in the first sexual intercourse, but do not use this resource in all relationships. Students do not use condoms in affective relationships with fixed partners, however they do use them in relationships with occasional partners. It can be noted that the use of condoms during sexual intercourse is directly associated with the type of partnership, being more used when there is no trust in the sexual partner. As for the female condom, most students do not adopt due to the lack of knowledge, the difficulty of access and the discomfort. Negotiating the use of condoms is not a common practice for women, and in most situations this is a decision of sexual partners, as many do not verbalize their opinion. Alcohol is another factor that directly influences the use of condoms. The participants reported making sporadic use of alcohol, but did not use it before the last sexual intercourse. The young women sought health care in the last year, underwent gynecological and Pap tests. Conclusion: Study participants relate the practice of caring for sexual health with the use of condoms, although they do not always use this resource. Condom use is influenced by several factors that directly affect the adoption of this resource by young women. The university students highlighted the importance of health education to offer quality information to young people, being an important tool to resolve doubts and prevent injuries to sexual health.

Vaccination with MIP or Pgp3 induces cross-serovar protection against chlamydial genital tract infection in mice.

Previously we reported that recombinant Chlamydia muridarum macrophage infectivity potentiator (MIP) provided partial protection against C. muridarum genital tract infection in mice. On the other hand, Chlamydia trachomatis plasmid encoded Pgp3could induce the protection against C. muridarum air way infection. This study aimed to evaluate the immunogenicity of MIP and Pgp3 from C. trachomatis serovar D and further investigate whether MIP and Pgp3 provide cross-serovar protection against C. muridarum genital tract infection in mice. Our results showed that vaccination by any regimen, including MIP alone, Pgp3 alone or MIP plus Pgp3, induced specific serum antibody production and Th1-dominant cellular responses in mice. Live chlamydial shedding from the vaginal and inflammatory pathologies in the oviduct markedly reduced. However, MIP + Pgp3 vaccination did not provide better protection than the single immunization. In conclusion, this study demonstrated that both MIP and Pgp3 can induce cross-serovar protective against chlamydial genital tract infection, and provided the guide for the development of optimal multisubunit vaccines against C. trachomatis infection.

Action Needed on Chlamydia Vaccines.

Chlamydia trachomatis is the most common infectious disease in the USA for which the Centers for Disease Control (CDC) collects case reports. Its prevalence in young women is a public health crisis given the threat to their reproductive health. Consequently, development of a vaccine to prevent infection should be prioritized.