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1.
Stud Health Technol Inform ; 264: 940-944, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438062

RESUMO

Current approaches to gathering sexually transmitted infection (STI) case information for surveillance efforts are inefficient and lead to underreporting of disease burden. Electronic health information systems offer an opportunity to improve how STI case information can be gathered and reported to public health authorities. To test the feasibility of a standards-based application designed to automate STI case information collection and reporting, we conducted a pilot study where electronic laboratory messages triggered a FHIR-based application to query a patient's electronic health record for details needed for an electronic case report (eCR). Out of 214 cases observed during a one week period, 181 (84.6%) could be successfully confirmed automatically using the FHIR-based application. Data quality and information representation challenges were identified that will require collaborative efforts to improve the structure of electronic clinical messages as well as the robustness of the FHIR application.


Assuntos
Registros Eletrônicos de Saúde , Registros de Saúde Pessoal , Humanos , Projetos Piloto , Saúde Pública , Doenças Sexualmente Transmissíveis
2.
Medicine (Baltimore) ; 98(32): e16401, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393348

RESUMO

Viral hepatitis is caused by different etiological agents with distinct epidemiological, clinical, and laboratory characteristics accounting for significant worldwide morbidity and mortality. Since 1996, the Brazilian Department of Sexually Transmitted Infections (STIs), Acquired Immune Deficiency Syndrome (AIDS) and Viral Hepatitis (DIAHV) in collaboration with the Ministry of Defense has been conducting periodic serosurveys of conscripts enlisted for the Brazilian army to assess STI prevalence and obtain data on knowledge and risk factors pertaining to STIs. This article aims to present the hepatitis B (hepatitis B surface antigen - HBsAg) and C (anti-HCV) seroprevalence estimates and risk factors as per the 8th edition of the Conscript Survey performed in 2016.This cross-sectional study was conducted among conscripts across Brazil aged 17 to 22 years from August to December 2016. It included a self-reported questionnaire and blood testing for syphilis, human immunodeficiency virus (HIV), and hepatitis B and C.In total 38,247 conscripts were enrolled; after applying exclusion criteria, 37,282 conscripts were included. The estimated HBsAg and anti-HCV prevalence rates were 0.22% and 0.28%, respectively. Higher HBsAg and anti-HCV prevalence rates were observed in the North Region (0.49%) and in the Central-west Region (0.65%), respectively. Regarding hepatitis B vaccination, 23.5% (n = 8412) of the individuals reported being unvaccinated and 47.4% (n = 16,970) did not know if they had been vaccinated. Among the anti-HCV positive conscripts, 53% (n = 51, 0.56%, P = .049) reported that they had never had sexual intercourse. Regarding self-reported STI status, most of the positive anti-HCV (n = 100, 0.29%, P < .01) and positive HBsAg (n = 76, 0.22%, P = .205) conscripts reported not having a STI. From those who tested positive for HBsAg, 89% (n = 42, 0.28%, P = .005) reported not making consistent use of condoms with steady partners.Our data suggest a low prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among Brazilian young men, and relatively low rates of self-reported HBV immunization. History of STIs, higher number of partners, inconsistent use of condoms, and lack of awareness of routes of transmission were significantly associated with HBV and HCV infections. To achieve the World Health Organization's goal of viral hepatitis elimination, access to hepatitis information, testing, and surveillance need to be improved.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Adolescente , Fatores Etários , Brasil/epidemiologia , Preservativos/estatística & dados numéricos , Estudos Transversais , Escolaridade , Conhecimentos, Atitudes e Prática em Saúde , Hepatite B/imunologia , Hepatite B/prevenção & controle , Antígenos de Superfície da Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Hepatite C/imunologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Masculino , Militares/estatística & dados numéricos , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Doenças Sexualmente Transmissíveis/epidemiologia , Adulto Jovem
3.
Rev Assoc Med Bras (1992) ; 65(6): 745-754, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340297

RESUMO

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.


Assuntos
Técnicas de Laboratório Clínico/normas , Doenças Sexualmente Transmissíveis/diagnóstico , Brasil , Tomada de Decisão Clínica , Técnicas de Laboratório Clínico/métodos , Humanos , Fatores de Risco , Sensibilidade e Especificidade
4.
Rev. enferm. UFSM ; 9: 7, jul. 15, 2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1009341

RESUMO

"\"\\\"[{\\\\\\\"text\\\\\\\": \\\\\\\"Objetivo: identificar as práticas sexuais e os cuidados com a saúde sexual de graduandos de enfermagem frente às infecções sexualmente transmissíveis. Método: estudo transversal descritivo quantitativo, realizado em duas instituições de ensino superior do Rio de Janeiro, com 250 estudantes. Para a análise das variáveis empregou-se a estatística descritiva. Resultados: a maioria, 132 (52,8%) tem idades entre 18 ­ 21 anos; sendo 217 (86,8%) do sexo feminino. Entre os participantes 185 (74.0%) possuem vida sexual ativa. Desses, 113 (61,1%) utilizaram o preservativo na sexarca e 107 (57,8%) informaram fazer uso em todos os intercursos sexuais. Em relação ao cuidado com a saúde, 110 (44,0%) já fizeram teste para detectar o HIV. Entre as mulheres, 125(57,6%) fizeram o exame Papanicolau. Conclusão: pode-se inferir que os graduandos de enfermagem, são vulneráveis às infecções sexualmente transmissíveis e adotam comportamentos de risco em suas práticas sexuais.\\\\\\\", \\\\\\\"_i\\\\\\\": \\\\\\\"pt\\\\\\\"}, {\\\\\\\"text\\\\\\\": \\\\\\\"Aim: to identify the sexual practices and the sexual health care of nursing undergraduates against\\\\\\\\r\\\\\\\\nsexually transmitted infections. Method: a quantitative descriptive cross - sectional study, carried out in two higher education institutions of Rio de Janeiro, with 250 students. Descriptive statistics were used to analyze the variables. Results: a majority of 132 (52.8%) were between 18 and 21 years of age; of which 217(86.8%) were female. Among the participants, 185 (74.0%) had active sex life, 113 (61.1%) used the condom in the sexarca and 107 (57.8%) reported using it in all sexual intercourse. Regarding health care, 110 (44.0%) have already been tested for HIV. Among women, 125 (57.6%) had a Pap smear. Conclusion: it can be inferred that nursing undergraduates are vulnerable to sexually transmitted infections and adopt risky behaviors in their sexual practices.\\\\\\\", \\\\\\\"_i\\\\\\\": \\\\\\\"en\\\\\\\"}, {\\\\\\\"text\\\\\\\": \\\\\\\"Objetivo: identificar las prácticas sexuales y cuidados con la salud sexual de estudiantes de enfermería\\\\\\\\r\\\\\\\\nfrente a las infecciones sexualmente transmisibles. Método: estudio transversal, descriptivo, cuantitativo, realizado en dos instituciones de enseñanza superior de Río de Janeiro, con 250 estudiantes. Para el análisis de las variables se empleó la estadística descriptiva. Resultados: la mayoría de los estudiantes 132 (52,8%) tienen edades entre 18 - 21 años; 217 (86,8%) son del sexo femenino. Entre los participantes, 185 (74.0%) poseen vida sexual activa, de esos 113 (61,1%) utilizaron preservativo en la sexarca y 107 (57,8%) informaron hacer uso en todas las relaciones sexuales. Con relación al cuidado con la salud, 110 (44,0%) ya hicieron prueba para detectar el VIH. Entre las mujeres, 125 (57,6%) hicieron el examen Papanicolau. Conclusión: se puede inferir que los estudiantes de enfermería son vulnerables a las infecciones sexualmente transmisibles y adoptan comportamientos de riesgo en sus prácticas sexuales.\\\\\\\", \\\\\\\"_i\\\\\\\": \\\\\\\"es\\\\\\\"}]\\\"\""


Assuntos
Humanos , Doenças Sexualmente Transmissíveis , Enfermagem , Vulnerabilidade em Saúde , Adulto Jovem
5.
Rev Lat Am Enfermagem ; 27: e3163, 2019 Jul 18.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31340347

RESUMO

OBJECTIVE: to evaluate knowledge about sexual health, with blind people, before and after educational intervention. METHOD: action research conducted with 58 blind people enrolled in a philanthropic educational institution. A form with sociodemographic and knowledge variables about Sexually Transmitted Infections was used. The Chi-square and Fisher tests were performed. RESULTS: men presented higher frequency of alcoholism (p <0.001) and illicit drugs (p = 0.006). It was found that they used a male condom more frequently than women using a female condom (p = 0.003), although they had more knowledge about the prevention of Sexually Transmitted Infections (p = 0.006). Among these infections, Trichomonas vaginalis (52.4%) was more frequent. Knowledge gaps on risk factors and safe sex were identified. After the intervention, an increase in the knowledge about sexual health was detected. CONCLUSION: the educational intervention, in the light of problematizing pedagogy, (re) constructed the knowledge on sexual health, empowering the participants regarding the prevention of Sexually Transmitted Infections. Therefore, it is necessary that nurses carry out educational interventions with this clientele, aiming to soften deficits of knowledge about the thematic in screen.


Assuntos
Educação de Pessoas com Deficiência Visual , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Doenças Sexualmente Transmissíveis/prevenção & controle , Adulto , Preservativos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Assunção de Riscos , Comportamento Sexual , Saúde Sexual , Doenças Sexualmente Transmissíveis/classificação , Fatores Socioeconômicos , Pessoas com Deficiência Visual
6.
Washington, D.C.; OPS; 2019-07-12.
Não convencional em Inglês | PAHO-IRIS | ID: phr-51355

RESUMO

[Objetivos del protocol]. Este documento ha sido concebido para proporcionar un marco que respalde los estudios de prevalencia de las ITS en los niveles local y nacional. El propósito de estos estudios es conocer la carga de las infecciones por NG y CT, dos ITS prioritarias que dan lugar a resultados obstétricos y perinatales adversos. Para ello, el objetivo es describir epidemiológicamente la prevalencia de estas dos infecciones en las embarazadas y, por extensión, en la población general del país. Dada la naturaleza frecuentemente asintomática de estas infecciones, es difícil conocer la auténtica carga de enfermedad sin llevar a cabo evaluaciones de la prevalencia. Existe una carencia general de datos sobre las infecciones por NG y CT en los niveles local y nacional; a menudo no se conoce la carga en la población general. En muchos casos se utiliza al grupo de las embarazadas como sustituto de la población general. En las embarazadas, las infecciones por clamidias y por gonococos pueden dar lugar, si no se tratan, a resultados obstétricos y perinatales adversos graves, como la prematuridad y el peso bajo al nacer. Por otra parte, dado que la mayor incidencia de estas infecciones se registra en los adolescentes y adultos jóvenes, las actividades de tamizaje se han centrado en ese grupo etario. En este protocolo se describe una metodología normalizada para realizar encuestas y se usa un diseño de estudio sencillo, fiable y reproducible que puede replicarse ampliamente y aplicarse en el nivel local.


Assuntos
Cuidado Pré-Natal , Gonorreia , Gestantes , Controle de Infecções , Testes Laboratoriais , Doenças Sexualmente Transmissíveis , Chlamydia trachomatis , Neisseria gonorrhoeae
7.
J Glob Health ; 9(2): 020408, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31360448

RESUMO

Background: The epidemiology of sexually transmitted infections (STIs) and the role of commercial heterosexual sex networks in driving STI transmission in the Middle East and North Africa (MENA) region remain largely unknown. Objective: To characterize the epidemiology of Treponema pallidum (syphilis), Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and herpes simplex virus type 2 (HSV-2) among female sex workers (FSWs) in MENA using an in-depth quantitative assessment. Methods: A systematic review on ten international, regional, and country-level databases was conducted, and reported following PRISMA guidelines. Pooled prevalences of current and/or ever infection for each STI were estimated using random-effects meta-analyses. Sources of between-study heterogeneity were investigated through random-effects meta-regressions. Results: One T. pallidum incidence study and 144 STI prevalence studies were identified for 45 812 FSWs in 13 MENA countries. The pooled prevalence of current infection was 12.7% (95% confidence interval (CI) = 8.5%-17.7%) for T. pallidum, 14.4% (95% CI = 8.2%-22.0%) for C. trachomatis, 5.7% (95% CI = 3.5%-8.4%) for N. gonorrhoeae, and 7.1% (95% CI = 4.3%-10.5%) for T. vaginalis. The pooled prevalence of ever infection (seropositivity using antibody testing) was 12.8% (95% CI = 9.4%-16.6%) for T. pallidum, 80.3% (95% CI = 53.2%-97.6%) for C. trachomatis, and 23.7% (95% CI = 10.2%-40.4%) for HSV-2. The multivariable meta-regression for T. pallidum infection demonstrated strong subregional differences, with the Horn of Africa and North Africa showing, respectively 6-fold (adjusted odds ratio (AOR): 6.4; 95% CI = 2.5-16.7) and 5-fold (AOR = 5.0; 95% CI = 2.5-10.6) higher odds of infection than Eastern MENA. There was also strong evidence for declining T. pallidum odds of infection at 7% per year (AOR = 0.93; 95% CI = 0.88-0.98). Study-specific factors including diagnostic method, sample size, sampling methodology, and response rate, were not associated with syphilis infection. The multivariable model explained 48.5% of the variation in T. pallidum prevalence. Conclusions: STI infection levels among FSWs in MENA are considerable, supporting a key role for commercial heterosexual sex networks in transmission dynamics, and highlighting the health needs of this neglected and vulnerable population. Syphilis prevalence in FSWs appears to have been declining for at least three decades. Gaps in evidence persist for multiple countries.


Assuntos
Profissionais do Sexo/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , África do Norte/epidemiologia , Infecções por Chlamydia/epidemiologia , Feminino , Gonorreia/epidemiologia , Herpes Genital/epidemiologia , Humanos , Oriente Médio/epidemiologia , Sífilis/epidemiologia , Vaginite por Trichomonas/epidemiologia
8.
APMIS ; 127(9): 627-634, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31225920

RESUMO

Sexually transmitted infections (STIs) remain major public health problems globally. Appropriate laboratory diagnosis of STIs is rare in Ukraine. We investigated the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) using the US FDA-approved Aptima Combo 2 and Aptima TV assays and compared the results with the conventional routine diagnostic tests (CDTs) in Ukraine. Urogenital swabs from consecutive mostly symptomatic females (n = 296) and males (n = 159) were examined. The prevalences were as follows: 10% (n = 47) of TV, 5.3% (n = 24) of CT and 1.5% (n = 7) of NG. The specificity of some CDTs was high, for example, 100% for NG culture, TV IgG ELISA, CT IgM ELISA and CT microscopy, but lower for other CDTs, that is, from 44% to 99.8%. The sensitivity of all CDTs was suboptimal, that is, 71% (n = 5) for NG microscopy, 57% (n = 4) for NG culture, 53% (n = 8) for CT IgG ELISA, 33% (n = 1) for TV IgG ELISA, 28% (n = 13) for TV microscopy, 25% (n = 1) for CT IgA ELISA, 20% (n = 3) for CT IgM ELISA and 0% (n = 0) for CT microscopy. The prevalences of particularly TV and CT were high, but substantial also for NG, in Ternopil, Ukraine. The sensitivities of all CDTs were low, and widespread implementation of validated, quality-assured and cost-effective molecular diagnostic STI tests in Ukraine is imperative.


Assuntos
Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/epidemiologia , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Vaginite por Trichomonas/diagnóstico , Vaginite por Trichomonas/epidemiologia , Adolescente , Adulto , Chlamydia trachomatis/isolamento & purificação , Estudos Transversais , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Técnicas de Diagnóstico Molecular/métodos , Neisseria gonorrhoeae/isolamento & purificação , Prevalência , Sensibilidade e Especificidade , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/epidemiologia , Trichomonas vaginalis/isolamento & purificação , Ucrânia/epidemiologia , Estados Unidos , United States Food and Drug Administration , Adulto Jovem
9.
BMC Public Health ; 19(Suppl 4): 639, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196029

RESUMO

BACKGROUND: Previous studies show that there is a changing trend of sexual and reproductive behaviour among youth and this requires more attention and awareness especially on sexually transmitted diseases (STD). This study was carried out to evaluate the knowledge, attitude and practice of sexually transmitted diseases among selected inmates of women shelter homes. METHODS: A cross-sectional study was carried out by involving 60 participants whom aged in between 13 to 25 years old. The questionnaires were developed in 'Bahasa Melayu' and it has been anonymous guided questionnaires. RESULTS: The result showed that the mean age of the participants was 17.9 years old and most of the participants have completed secondary school (91.7%). Overall, the level of knowledge of participants on STDs were classified into three groups; 'high knowledge' (33.3%), 'medium knowledge' (35.0%) and 'low knowledge' (31.7%). The majority have heard of HIV/AIDS (95%) but with respect to other STDs was less well known. Whereas, the mean score for attitude was 23.1 out total 25. Their knowledge level was not influenced by their age (p = 0.61) and socio-economic status (p = 0.85). However, their attitude was influenced by their age (p < 0.05). CONCLUSION: Knowledge on non-HIV STDs is still lacking and risky behaviours have been practiced. Although there were high level of knowledge and attitude among them but their practice on sexuality contradicts it especially on contraceptive use and pre-marital sex.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Doenças Sexualmente Transmissíveis/psicologia , Mulheres/psicologia , Adolescente , Adulto , Comportamento Contraceptivo/psicologia , Estudos Transversais , Feminino , Humanos , Assunção de Riscos , Comportamento Sexual/psicologia , Inquéritos e Questionários , Adulto Jovem
10.
BMC Infect Dis ; 19(1): 494, 2019 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-31164096

RESUMO

BACKGROUND: A high proportion of men who have sex with men (MSM) use geosocial networking apps (Apps) to seek partners. However, the relationship of app use with HIV risk is unknown. Further, the risks of some sexually transmitted infection (STIs), including Mycoplasma genitalium, have seldom been studied among MSM. METHODS: MSM were enrolled at a community-based HIV testing site in Shenyang, China. After completing a questionnaire survey, we collected rectal swabs and venous blood specimens. We then simultaneously tested for ten STIs (Chlamydia trachomatis [CT], Neisseria gonorrhea [NG], Ureaplasma urealyticum [Uu], Ureaplasma parvum species [Up1, Up3, Up6, Up14), Mycoplasma hominis [Mh], Mycoplasma genitalium [Mg], and Herpes Simplex Virus Type 2 (HSV-2) using multiple PCR. We also performed blood tests for HIV, Syphilis, Hepatitis C antibody (HCV-Ab), Hepatitis B Surface Antigen (HBsAg), and Hepatitis A-IgM (HAV-IgM), etc. RESULTS: One hundred and eighty-three MSM participated in this study, of which 51.4% reported seeking partners through apps in the past year. The prevalence of HIV was 19.7%, Syphilis 12.0%, HAV 1.1%, rectal Mg 15.3% and Mh 7.1%. Multivariable logistic regression showed that HIV infection was independently correlated with app-using behavior (adjusted odds ratio[aOR] = 2.6), Mg infection (aOR = 3.2), Mh infection (aOR = 4.1) and Syphilis infection (aOR = 3.1) (each P < 0.05). CONCLUSIONS: App use, Mg, Mh and Syphilis infection were correlated with higher HIV Risk in MSM. Geosocial networking apps should be utilized for HIV interventions targeting MSM. There is a need for more expansive STIs screening, particularly for Mg, Mh and Syphilis in MSM.


Assuntos
Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Infecções por Mycoplasma/epidemiologia , Mycoplasma genitalium/isolamento & purificação , Mycoplasma hominis/isolamento & purificação , Minorias Sexuais e de Gênero/estatística & dados numéricos , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Adolescente , Adulto , China/epidemiologia , Estudos Transversais , HIV , Infecções por HIV/microbiologia , Humanos , Masculino , Programas de Rastreamento , Infecções por Mycoplasma/microbiologia , Prevalência , Fatores de Risco , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/classificação , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/microbiologia , Adulto Jovem
11.
BMC Infect Dis ; 19(1): 360, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31035953

RESUMO

BACKGROUND: Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. The disease affects all ages and both sexes but more prevalent among the sexually active age group of 15-49 years. The purpose of the current study was to determine the prevalence and factors associated with syphilis infection among outpatients 15-49 years in the Asikuma Odoben Brakwa District of Ghana where high levels of infection were earlier reported among antenatal women. METHODS: A descriptive cross-sectional study was carried out in 13 randomly selected health facilities. Blood samples were collected and tested for syphilis infection and a questionnaire administered to determine factors associated with the disease. RESULTS: A total 277 patients aged 15-49 years participated in the study. The overall prevalence of syphilis infection was 3.2% (9/277), with 5.7% (6/105) and 1.7% (3/172) among males and females respectively. Significant factors associated with syphilis infection included sub-district of residence, (χ2 (4) = 31.20, p < 0.001) and history of coerced sexual intercourse (χ2 (1) =7.49, p = 0.006). CONCLUSIONS: The prevalence of syphilis infection was high among male patients who lived in rural areas. Having a history of coerced sexual intercourse was a strong predictor for syphilis infection. Access to sexually transmitted infection control interventions in rural communities including health education may help control the disease.


Assuntos
Doenças Sexualmente Transmissíveis/diagnóstico , Sífilis/diagnóstico , Adolescente , Adulto , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Pacientes Ambulatoriais , Prevalência , Comportamento Sexual , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/microbiologia , Sífilis/epidemiologia , Sífilis/microbiologia , Treponema pallidum/isolamento & purificação , Adulto Jovem
12.
Maturitas ; 124: 39-42, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097177

RESUMO

OBJECTIVE: We previously conducted an audit of the care provided for survivors of sexual violence seen at our emergency department and observed that 90% of them did not receive optimal care. This study analysed whether the implementation of a new protocol and educational sessions for staff increased the proportion of such patients who received optimal medical care. METHODS: A computerized chart detailing a new care protocol was developed specifically for rape survivors. Educational sessions focusing on the use of the new protocol were organized for healthcare providers. We then conducted another audit that reviewed retrospectively the charts of all survivors of sexual violence who were cared for at a public university hospital. MAIN OUTCOME MEASURE: Optimal medical care was defined as including systematic investigations for sexually transmitted diseases, and the provision of prophylactic antibiotics, a pregnancy test, emergency contraception, and psychological and medical follow-up. RESULTS: We analysed the charts of 362 survivors of sexual violence and observed that all of the required procedures were completed for 337 patients (93%) and the required preventive measures were provided to 325 patients (90%). CONCLUSION: After the implementation of the new protocol and educational sessions, the proportion of survivors who received optimal medical care increased from 10% to 90%. Nevertheless, optimal management also implies social, psychological and legal support. We hope that the establishment of specialist sexual assault centres will further improve management.


Assuntos
Pessoal de Saúde/educação , Assistência ao Paciente/métodos , Estupro , Sobreviventes , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Protocolos Clínicos , Anticoncepção Pós-Coito , Serviço Hospitalar de Emergência , Feminino , Humanos , Pessoa de Meia-Idade , Assistência ao Paciente/normas , Testes de Gravidez , Estudos Retrospectivos , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/prevenção & controle , Adulto Jovem
13.
BMC Public Health ; 19(1): 623, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31117978

RESUMO

BACKGROUND: Biobehavioral data about men who have sex with men (MSM) and transgender women (TGW) in Papua New Guinea (PNG) are limited to those who sell sex. Information about those MSM and TGW who do not sell sex is necessary to guide HIV prevention and treatment efforts. METHODS: We conducted respondent-driven sampling (RDS) surveys among MSM and TGW in Port Moresby, Lae, and Mt. Hagen, PNG from in 2016 and 2017. Eligibility criteria was: aged > 12 years, born male, could speak English or Tok Pisin and had oral or anal sex with another person born male in the past 6 months. Participants were interviewed face-to-face and offered rapid HIV testing. Weighted data analysis was conducted using RDS-Analyst (v. 0.62). RESULTS: We enrolled 400 participants in Port Moresby, 352 in Lae, and 111 in Mt. Hagen. In the last six months, 73.2% of MSM/TGW in Port Moresby, 77.9% in Lae, and 75.9% in Mt. Hagen, had a concurrent sexual partnership. Upwards of 70% of MSM/TGW in all three cities had sex with a woman in the same period. Less than half of MSM/TGW had ever tested for HIV. HIV prevalence among MSM/TGW was 8.5% in Port Moresby and 6.9% in Lae. Among participants in Mt. Hagen it was 1.3%. HIV was associated with not having sex with a woman in the last six months and sexually transmitted disease symptoms in the last 12 months in Port Moresby and Lae. In Port Moresby, it was also associated with an uncut foreskin, and in Lae with earning income in the formal sector and being unable to rely on other MSM or TGW to accompany them to healthcare services. CONCLUSIONS: The large proportion of MSM and TGW with concurrent sexual partnerships, combined with the low testing coverage, indicates strong potential for the spread of HIV. The different correlates of HIV in Port Moresby and Lae highlight the importance of conducting surveys in multiple locations and using data to develop locally appropriate interventions even within a country.


Assuntos
Infecções por HIV/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/epidemiologia , Pessoas Transgênero/estatística & dados numéricos , Adolescente , Adulto , Cidades , Feminino , HIV , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Papua Nova Guiné/epidemiologia , Prevalência , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/virologia , Inquéritos e Questionários , Adulto Jovem
14.
BMC Public Health ; 19(Suppl 1): 604, 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31138182

RESUMO

BACKGROUND: With a human immunodeficiency virus (HIV) prevalence of 2.1% among 15-24 year olds, opportunities for further integration of sexual and reproductive health (SRH) and HIV prevention services for young people in Uganda exist. We examine a range of factors that contribute to variance in risky sexual behaviour among young Ugandans. METHODS: A cross-sectional, nationally representative household survey was conducted between February and March 2016. The questionnaire used assessed knowledge, attitudes and practices related to SRH among young people aged 10-24 years. A composite indicator was constructed to assess risky sexual behaviour, defined as being involved in sexual relations under the influence of alcohol or drugs, engaging in sexual activities without a condom, and having multiple sexual partners in the 6 months preceding the survey. Exploratory analysis was conducted to provide descriptive statistics. Logistic regression was conducted to determine the factors associated with risky sexual behaviour. This analysis focuses on the sub-category aged 15-24 years, comprised of 2725 respondents. RESULTS: Knowledge levels of family planning (FP), sexually transmitted infections (STIs) and HIV across all respondents were high (above 82%). Self-reported perceived risk of STIs and pregnancy was consistently higher among 20-24 year old respondents, with 61.5% feeling at risk of STIs compared to 46.2% of 15-19 year olds. A total of 22.7% of respondents reported having been involved in risky sexual behaviour. Factors associated with risky sexual behaviour among the 15-19 years group included gender, single orphanhood, casual work, schooling status, FP knowledge and self-perceived risk of STIs/HIV. For the 20-24 year old respondents, significantly associated factors included gender, educational level, relationship to head of household, place of residence, and self-perceived risk of pregnancy. CONCLUSIONS: Despite high general SRH/HIV knowledge and perceived risk of pregnancy and HIV, risky sexual behaviour among young Ugandans remains high. Effectiveness gaps in the integrated SRH/HIV response for young people should be addressed and targeted interventions focused on holistic prevention at individual level through information, risk awareness, and skill development should be combined with interventions targeting social structures affecting individual behaviour.


Assuntos
Infecções por HIV/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Saúde Reprodutiva/estatística & dados numéricos , Saúde Sexual/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/psicologia , Adolescente , Grupo com Ancestrais do Continente Africano , Criança , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , HIV , Infecções por HIV/prevenção & controle , Comportamentos de Risco à Saúde , Humanos , Modelos Logísticos , Masculino , Gravidez , Autorrelato , Educação Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Doenças Sexualmente Transmissíveis/virologia , Inquéritos e Questionários , Uganda , Adulto Jovem
15.
BMC Public Health ; 19(Suppl 1): 606, 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31138228

RESUMO

BACKGROUND: Partner notification is an essential component of sexually transmitted infection (STI) management. The process involves identifying exposed sex partner(s), notifying these partner(s) about their exposure to a curable STI, and offering counselling and treatment for the STI as a part of syndromic management or after results from an STI test. When implemented effectively, partner notification services can prevent the index patient from being reinfected with a curable STI from an untreated partner, reduce the community burden of curable STIs, and prevent adverse health outcomes in both the index patient and his or her sex partner(s). However, partner notification and treatment rates are often low. This study seeks to explore experiences and preferences related to partner notification and treatment for curable STIs among pregnant women receiving care in an antenatal clinic with integrated HIV and curable STI testing. Results are intended to inform efforts to improve partner notification and treatment rates in Southern Africa. METHODS: We conducted qualitative interviews among women diagnosed with Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and/or Trichomonas vaginalis (TV) infection while seeking antenatal care in Gaborone, Botswana. Semi-structured interviews were used to obtain women's knowledge about STIs and their experiences and preferences regarding partner notification. RESULTS: Fifteen women agreed to participate in the study. The majority of women had never heard of CT, NG, or TV infections prior to testing. Thirteen out of 15 participants had notified partners about the STI diagnosis. The majority of notified partners received some treatment; however, partner treatment was often delayed. Most women expressed a preference for accompanying partners to the clinic for treatment. Experiences and preferences did not differ by HIV infection status. CONCLUSIONS: The integration of STI, HIV, and antenatal care services may have contributed to most women's willingness to notify partners. However, logistical barriers to partner treatment remained. More research is needed to identify effective and appropriate strategies for scaling-up partner notification services in order to improve rates of partners successfully contacted and treated, reduce rates of STI reinfection during pregnancy, and ultimately reduce adverse maternal and infant outcomes attributable to antenatal STIs.


Assuntos
Busca de Comunicante/estatística & dados numéricos , Complicações Infecciosas na Gravidez/psicologia , Autorrevelação , Parceiros Sexuais/psicologia , Adulto , África Austral/epidemiologia , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Botsuana/epidemiologia , Chlamydia trachomatis , Busca de Comunicante/métodos , Feminino , HIV , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Humanos , Neisseria gonorrhoeae , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/microbiologia , Cuidado Pré-Natal/estatística & dados numéricos , Prevalência , Pesquisa Qualitativa , Doenças Sexualmente Transmissíveis/microbiologia , Doenças Sexualmente Transmissíveis/prevenção & controle , Trichomonas vaginalis
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(5): 527-529, 2019 May 06.
Artigo em Chinês | MEDLINE | ID: mdl-31091614

RESUMO

A survey was conducted to analyze the HIV testing status and related influencing factors of male sexually transmitted diseases(STD) patients attending 18 county-level hospitals in Shandong Province from July 2015 to August 2016. The HIV detection rate of 1 570 subjects was 77.58% (1 218/1 570), and the HIV-antibody positive rate was 0.99% (12/1 218). Compared with general hospitals patients, urinary and anorectal patients, non-sexual patients, and patients with negative attitudes toward HIV testing, patients were more likely to be tested for HIV from specialized hospitals (OR=3.74, 95%CI:2.53-5.54), the skin and venereal section (OR=1.92, 95%CI: 1.31-2.79), the STD group (OR=2.02, 95%CI: 1.34-3.03) and patients with positive attitude (OR=15.20, 95%CI:10.74-21.52).


Assuntos
Infecções por HIV/diagnóstico , Programas de Rastreamento/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/terapia , China , Pesquisas sobre Serviços de Saúde , Humanos , Masculino
17.
BMC Public Health ; 19(1): 617, 2019 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-31113398

RESUMO

BACKGROUND: Stigma differentially influences HIV and STI care among MSM, especially regarding partner notification practices. Recognizing the heterogeneous behaviors/identities within the category "MSM," we used mixed-methods to assess sexual risk behaviors among men who have sex with men only (MSMO) and behaviorally bisexual MSM (MSMW) with HIV and/or other STIs. METHODS: MSMO/MSMW recently diagnosed (< 30 days) with HIV, syphilis, urethritis, or proctitis completed a cross-sectional survey assessing sexual risk behaviors, anticipated disclosure, and sexual partnership characteristics (n = 332). Multivariable generalized estimating equation models assessed characteristics associated with female compared to male partners in the last three partnerships. Follow-up qualitative interviews (n = 30) probed partner-specific experiences (e.g., acts and disclosure). RESULTS: Among all participants, 13.9% (n = 46) described at least one of their last three sex partners as female (MSMW). MSMW (mean age of 31.8) reported a mean of 3.5 partners (SD = 4.5) in the past 3 months and MSMO (mean age 30.6) reported a mean of 4.6 partners (SD = 9.7) in the past 3 months. MSMW were more likely to report unprotected insertive anal sex (77.9%) than MSMO (43.1%; p < 0.01). Cisgender female partners were associated with condomless insertive sex in the last 3 months (aPR: 3.97, 95%CI: 1.98-8.00) and classification as a "primary" partnership (2.10, 1.34-3.31), and with lower prevalence of recent HIV diagnosis (0.26, 0.11-0.61). Planned notification of HIV/STI diagnoses was less common for female than for male partners (0.52, 0.31-0.85). Narratives illustrate internal (e.g., women as 'true' partners) and community-level processes (e.g., discrimination due to exposure of same-sex behavior) that position homosexual behavior and bisexual identity as divergent processes of deviance and generate vulnerability within sexual networks. CONCLUSIONS: MSMW recently diagnosed with HIV/STI in Peru report varying partnership characteristics, with different partner-specific risk contexts and prevention needs. Descriptions highlight how behaviorally bisexual partnerships cut across traditional risk group boundaries and suggest that HIV/STI prevention strategies must address diverse, partnership-specific risks.


Assuntos
Homofobia/psicologia , Homossexualidade Masculina/psicologia , Assunção de Riscos , Comportamento Sexual/psicologia , Minorias Sexuais e de Gênero/psicologia , Normas Sociais , Estigma Social , Adulto , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Peru/epidemiologia , Comportamento Sexual/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/prevenção & controle
18.
Infect Dis Obstet Gynecol ; 2019: 6584101, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31057323

RESUMO

Background: Sexually transmitted infections (STIs) are associated with adverse birth outcomes. Current prenatal STI screening guidelines define "risk" without explicit consideration of HIV status. Our objective was to test the hypothesis that HIV status is associated with bacterial STI in pregnant women. Methods: We designed a retrospective cohort study to identify pregnant women with HIV who delivered at our facility during 2000-2014. HIV+ women were compared to HIV- women with matching by year of delivery. Logistic regression was used to model adjusted odds of prevalent and incident STI. Prevalent STI was defined as chlamydia (CT), gonorrhea (GC), syphilis, or trichomoniasis detected on an initial prenatal screening test and incident STI as a newly positive result following a negative prenatal test. Results: The cohort included 432 women, 210 HIV+ and 222 HIV-. Most pregnant women were screened for STI (92% of HIV+ women and 74% of HIV- women). STI rates were high and particularly elevated in HIV+ women: 29% vs 18% (p=0.02), for prevalent STI and 11% vs 2% (p<0.001) for incident STI. Risk factors for prevalent STI were as follows: HIV status (aOR 3.0, CI: 1.4-6.4), Black race (aOR 2.7, 95% CI: 1.1-6.6), and more recent delivery (2007-2014 compared to 2000-2006) (aOR 2.3, CI: 1.1-4.7). HIV status was an independent risk factor for incident STI (aOR 7.2, CI: 2.1-25.0). Conclusion: Pregnant women who delivered in our center had high STI rates. Since HIV infection was independently associated with prevalent and incident STI, prenatal screening guidelines may need to incorporate HIV status as a high-risk group for repeat testing.


Assuntos
Infecções por HIV/complicações , Complicações Infecciosas na Gravidez/epidemiologia , Doenças Sexualmente Transmissíveis/epidemiologia , Adulto , Alabama/epidemiologia , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/transmissão , Estudos de Coortes , Feminino , Gonorreia/epidemiologia , Gonorreia/transmissão , Infecções por HIV/epidemiologia , Humanos , Incidência , Gravidez , Complicações Infecciosas na Gravidez/etiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Doenças Sexualmente Transmissíveis/etiologia , Sífilis/epidemiologia , Sífilis/transmissão , Tricomoníase/epidemiologia , Tricomoníase/transmissão
19.
FP Essent ; 480: 28-31, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31063343

RESUMO

In the United States, approximately 1 in 5 women will experience a sexual assault in her lifetime. In most reported cases, men are identified as perpetrators regardless of the sex of the individual assaulted. There typically is some form of relationship between the survivor and the perpetrator-whether it be an acquaintance, friend, family member, or authority figure. As such, female patients should be asked routinely about a history of sexual assault, particularly if the patient reports relevant physical symptoms and/or substance abuse. Factors that could lead to children experiencing sexual assault (particularly via domestic minor sex trafficking) include a history of abuse, substance use, mental health issues, family dysfunction, and the involvement of Child Protective Services. Short-term goals of primary care include management of physical injuries and psychological needs, evaluation for pregnancy, and prevention of sexually transmitted infections. Long-term effects may include sexual dysfunction, mental disorders (eg, depression, posttraumatic stress disorder), and medical symptoms (eg, chronic headache, infections).


Assuntos
Vítimas de Crime , Tráfico de Pessoas , Delitos Sexuais , Doenças Sexualmente Transmissíveis , Criança , Feminino , Nível de Saúde , Humanos , Masculino , Gravidez , Saúde Pública , Estados Unidos , Violência
20.
BMC Public Health ; 19(1): 594, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101045

RESUMO

BACKGROUND: Intimate partner violence (IPV), HIV and sexually transmitted infections (STI) can contribute to disparities in population health, depending on the individual, social and environmental factors characterizing a setting. To better understand the place-based determinants and patterns of these key interrelated public health problems in Uganda, we compared risk factors for IPV, HIV and STI in fishing, trading and agrarian communities in Rakai, Uganda by gender. METHOD: This study used cross-sectional data collected from 14,464 sexually active men (n = 6531) and women (n = 7933) as part of the Rakai Community Cohort Study, a population-based open cohort study of men and women aged 15-49 years. We used multilevel modified poisson regression models, which incorporated random intercepts for community and households. Factors associated with IPV, HIV and STI were assessed separately for men and women in fishing, trading and agrarian communities. RESULTS: A larger proportion of participants in the fishing communities than those in trading and agrarian communities were HIV positive, engaged in HIV risk behaviors, had STI symptoms and reported perpetration of or victimization by IPV. Female gender was a shared correlate of IPV, HIV and STI in the fishing communities. Engagement in multiple sexual relationships or partner's engagement in multiple relationships were shared correlates of IPV, and HIV in agrarian communities and IPV and STI in trading communities. CONCLUSION: Programs should target factors at multiple levels to reduce risk for syndemic conditions of HIV, STI and IPV in Rakai, Uganda particularly among men and women in fishing communities.


Assuntos
Agricultura , Infecções por HIV/epidemiologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Fatores Sexuais , Doenças Sexualmente Transmissíveis/epidemiologia , Adolescente , Adulto , Estudos de Coortes , Mercantilização , Estudos Transversais , Feminino , HIV , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Análise de Regressão , Fatores de Risco , Parceiros Sexuais , Uganda/epidemiologia , Adulto Jovem
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