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1.
Brasília, D.F.; OPAS; 2023-01-11. (OPAS-W/BRA/PHE/Monkeypox/22-0043).
em Português | PAHO-IRIS | ID: phr2-56993

RESUMO

Este Plano Estratégico de Preparação, Prontidão e Resposta (SPRP) foi elaborado para ajudar a guiar uma ação coordenada de saúde pública para deter o surto de varíola símia (monkeypox). A varíola símia pode infectar qualquer pessoa, mas causa especial preocupação em grupos vulneráveis com maior risco de doenças graves, o que inclui pessoas imunossuprimidas, gestantes e crianças pequenas. Além disso, a transmissão não controlada cria mais oportunidades de adaptação para o vírus, potencialmente gerando linhagens mais difíceis de controlar ou tratar. A médio prazo, existe o risco de que a varíola símia se estabeleça em diversos ambientes, especialmente porque poderia explorar o nicho ecológico deixado pela erradicação da varíola humana (smallpox). A OMS elaborou este SPRP com a contribuição de parceiros e especialistas em saúde pública. Ele se baseia na avaliação de risco mundial atual da OMS e será ajustado à medida que a situação evolui. Além disso, o SPRP será complementado pelo documento Operational Planning Guidelines and a Monitoring and Evaluation Framework [Orientações de Planejamento Operacional e Estrutura de Monitoramento e Avaliação], a ser publicado no futuro próximo.


Assuntos
Doenças não Transmissíveis , Infecções Sexualmente Transmissíveis , Emergências
2.
Int J Infect Dis ; 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36690140

RESUMO

BACKGROUND: Although the World Health Organization (WHO) recommends 'frequent' screening of sexually transmitted infections (STI) for people who use pre-exposure prophylaxis (PrEP) for HIV, there is no evidence for optimal frequency. METHODS: We searched five databases and used random-effects meta-analysis to calculate pooled estimates of STI test positivity. We narratively synthesized data on secondary outcomes, including adherence to recommended STI screening frequency and changes in STI epidemiology. FINDINGS: Of 7477 studies, we included 38 for the meta-analysis and 11 for secondary outcomes. With 2-3 monthly STI screening, the pooled positivity was 0·20 (95% confidence interval (CI):0·15-0·25) for chlamydia, 0·17 (95% CI:0·12-0·22) for gonorrhoea and 0·07 (95% CI:0·05-0·08) for syphilis. For chlamydia and gonorrhoea, the positivity was approximately 50% and 75% lower, respectively, in studies that screened 4-6 monthly versus 2-3 monthly. There was no significant difference in the positivity for syphilis in studies that screened 4-6 monthly compared to 2-3 monthly. Adherence of clients to recommended screening frequency varied significantly (39-94%) depending on population and country. Modelling studies suggest more frequent STI screening could reduce incidence. INTERPRETATION: Though more frequent STI screening could reduce delayed diagnoses and incidence, there remain significant knowledge gaps regarding the optimal STI screening frequency.

3.
J Adolesc Health ; 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36690549

RESUMO

PURPOSE: The aim of this study is to evaluate the efficacy and mediation of a culturally appropriate, theory-based HIV/STI (sexually transmitted infection) risk-reduction intervention delivered in barbershops by barbers via iPads to African-American young men in reducing sexual risk behaviors. METHODS: In a cluster randomized controlled trial, 24 matched pairs of barbershops serving African-American men ages 18-24 in the 10 Philadelphia, PA zip codes with the highest HIV/AIDS prevalence were randomized to implement via iPads one of 2 interventions: "Shape Up! Barbers Building Better Brothers," an HIV/STI risk-reduction intervention based on the theory of planned behavior and formative research or an attention-matched violence-prevention control intervention. The primary outcome was self-reported consistent condom use 3, 6, and 12 months postintervention, controlling for baseline consistent condom use. RESULTS: Participants were 618 men, 319 in the HIV/STI intervention and 299 in the control intervention. Generalized estimating equation analysis indicated that the direct effect of the HIV/STI intervention in increasing consistent condom use postintervention was nonsignificant (odds ratio = 1.13, 95% confidence interval: 0.73-1.75), adjusting for clustering among participants in barbershops and baseline condom use. However, mediation analysis using the product-of-coefficients approach revealed indirect effects of the intervention. Consistent with the theory of planned behavior, the intervention increased behavioral beliefs and self-efficacy regarding using condoms, which raised condom use intention, which, in turn, boosted consistent condom use. DISCUSSION: Sexual risks among young African-American men can be reduced by barber-led theory-based, culturally appropriate HIV/STI risk-reduction interventions in barbershops in high HIV prevalence neighborhoods that increase behavioral beliefs and self-efficacy.

4.
NASN Sch Nurse ; : 1942602X221151134, 2023 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-36691362

RESUMO

The human papillomavirus (HPV) is the most common sexually transmitted infection in the United States despite most cases being preventable by vaccination. HPV vaccine efficacy varies in relationship to when the vaccine is administered, with greater efficacy obtained if administered prior to sexual debut. Historically, this vaccine was created to protect women from cervical cancer. As scientific knowledge of HPV-related cancers has advanced, it has become evident that HPV vaccination is a priority for both genders. HPV is known to contribute to male cancers of the mouth, throat, anus, and penis, as well as causing genital warts. This article aims to explain the benefits of HPV immunization for the gender the farthest from meeting vaccination goals, boys, and young men. This article expounds on the school nurses' role in promoting vaccination to prevent HPV infection and the sequela of related cancers.

5.
Pathogens ; 12(1)2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36678425

RESUMO

A point-of-care (POC) diagnostic is needed for both women and men to establish universal screening and surveillance for the number one, non-viral sexually transmitted infection (STI) caused by Trichomonas vaginalis. We developed a POC diagnostic for this STI using the MedMira Rapid Vertical Flow (RVF®) Technology test cartridge with a membrane that includes a Vertical procedural/reagent control line (referred to as CVL) and spotted with 1 µg of a 72.4-kDa truncated version of α-actinin called ACT::SOE3. This protein is a specific diagnostic target for antibody in sera of individuals with trichomoniasis. Serum antibody to ACT::SOE3 is a positive reaction with the test spot. Specificity of ACT::SOE3 was revealed with monoclonal antibodies (MAbs) generated to ACT::SOE3. Addition of negative control serum with MAb 67B reactive to ACT::SOE3 shows detection of both ACT::SOE3 and the CVL. Only positive sera of individuals had antibody reactive with ACT::SOE3 and detected the presence of the spot and the CVL. Negative control sera were unreactive with ACT::SOE3 and only showed the presence of the CVL. Importantly, to show proof-of-principle for POC application, ACT::SOE3 was detected with the positive patient sera spiked with whole blood. Finally, packaged cartridges stored with desiccant packs at 37 °C for one year gave identical results with the positive and negative human sera. Our results show the validity of this new POC serodiagnostic for this STI.

6.
Vaccines (Basel) ; 11(1)2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36679984

RESUMO

Cervical cancer is the second most common cancer in low-income countries and the third most common cancer in Malaysia among women aged 15 to 44. This is a huge concern because of the high mortality rate compared to other countries. Cervical cancer is caused by a common sexually transmitted human papillomavirus (HPV). Of cervical cancer cases, 80% are attributed to serotypes 16 and 18; therefore, early detection of premalignant lesions and infections from these viruses is important. Diagnosis can be carried out by polymerase chain reaction (PCR)-based HPV DNA analysis and Pap smear, which act as a viable preventive strategy. (1) Background: This study determined the adoption of the human papillomavirus (HPV) vaccine and the willingness to get vaccinated in Malaysian women. (2) Methods: An online survey was conducted with women from across Malaysia to gather their views on the barriers that prevent them from accessing HPV services. Sentiment analysis was performed to detect and classify the comments into three groups (positive, neutral, and negative). (3) Results: A total of 449 opinions were received, and the findings revealed that 41.3% were not afraid to be diagnosed early, and were prepared to accept positive or negative screening results. In addition, 18.6% of those surveyed indicated that they feared a Pap smear and were very concerned that they would not get good results. Of the respondents, 36% believed in vaccination and preferred to know more about it; 43.24% claimed that their family members were very supportive towards screening and vaccination; and 21.3% felt embarrassed and were afraid to undergo the screening procedure, as they had no prior experience and were unsure of how the procedure was conducted. In addition, 40.5% indicated that they had no concerns about HPV testing and related procedures, as this information is widely available. Only a few respondents (8.1%) talked about the time constraints and busy work schedules that prevented them from going to medical appointments. The survey also revealed that women are prevented from participating in cervical cancer screening and vaccination programs due to a lack of knowledge, shyness, personal rumors, privacy issues, financial issues, a lack of access to medical services, and ignorance and beliefs about rumors spreading online. (4) Conclusion: Results indicate that awareness of HPV and related prevention measures among women is vague and that negative perceptions continue to exist. It is strongly advised to develop a well-designed and knowledge-based application on the efficacy of screening and vaccination among Malaysian women.

7.
J Adolesc Health ; 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36623966

RESUMO

PURPOSE: Supporting adolescents in developing healthy relationships and promoting sexual and reproductive health (SRH) is an important responsibility of pediatric primary care providers. Less is known about evidence-based interventions in pediatric settings focused on healthy relationships and SRH. METHODS: We conducted a systematic review to describe SRH and healthy relationship/adolescent relationship abuse (ARA) interventions for pediatric primary care over the past 20 years. Eligible articles were original research on an SRH-focused or ARA-focused intervention, conducted in-person within pediatric primary care or school-based health centers specifically for middle or high school-aged adolescents. Data abstracted from included articles included intervention description, content, delivery, evaluation design, and effectiveness of primary outcomes. Heterogeneous outcomes and evidence levels made conducting a meta-analysis infeasible. RESULTS: Nineteen studies described 17 interventions targeting a variety of SRH and ARA topics (e.g., sexually transmitted infections, contraception, ARA). Interventions largely focused on screening/counseling adolescents (89%). Interventions generally were reported as being effective in changing adolescent health or practice-level outcomes. DISCUSSION: This review provides preliminary evidence that SRH and ARA interventions in pediatric primary care settings can be effective in promoting adolescent health. Future work should consider ARA-specific prevention interventions, including parents in interventions, and strategies for implementation, dissemination, and scaling.

8.
PLoS One ; 18(1): e0280447, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36649337

RESUMO

INTRODUCTION: Dual contraception is a method used to prevent sexually transmitted infections (STIs) including Human Immunodeficiency Virus (HIV) and unintended pregnancies. Prevention of unintended pregnancy in people living with HIV (PLHIV) and ART given to pregnant women to suppress viral load prevent transmission of HIV to children. Counseling and provision of dual contraceptive methods is a very cost-effective method to tackle this double burden among women living with HIV. However, little has been known about utilization of dual methods among HIV positive women in Bishoftu town and its surroundings. OBJECTIVE: The aim of this study was to assess dual contraception method utilization and associated factors among reproductive age women who were on antiretroviral therapy in public health facilities of Bishoftu town. METHODS: A facility based cross- sectional study was conducted from November 01 to December 30, 2020. The study participants were selected by using simple random sampling technique. Data were collected using a pretested and structured questionnaire through a face to face interview. Data were processed and analyzed using SPSS version 20. Frequencies and percentages were used to describe characteristics of participants. Bivariable and multivariable logistic regression analyses were used to identify variables which had an independent association with the dependent variable. The degree of association between dependent and independent variables were measured using odds ratio with 95% confidence interval. Level of significance was set at a p-value less than 0.05. RESULTS: The Magnitude of dual contraceptive utilization of women living with HIV in Bishoftu town was 56.9% (95% Cl (51.6, 62.1). Being married (AOR = 4.33; 95% Cl (1.67, 11.27), not getting pregnant since the start of chronic care follow up (AOR = 2.19; 95% Cl (2.90, 3.70), having a partner positive for HIV (AOR = 2.67; 95% Cl (1.34, 5.32) and having a partner negative for HIV (AOR = 2.38; 95% Cl (1.09, 5.20) were factors independently associated with dual method contraceptive use. CONCLUSION: The study showed that use of dual contraceptive methods was low; factors like marital status, partner HIV status, and pregnancy after chronic HIV care follow up were found to be significantly associated with dual contraceptive method use. In addition to ART, use of dual contraceptive methods utilization may play a role in prevention of HIV infection in children and is important in the prevention of unintended pregnancy.


Assuntos
Infecções por HIV , Criança , Humanos , Feminino , Gravidez , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Serviços de Planejamento Familiar , Etiópia/epidemiologia , Logradouros Públicos , Anticoncepção , Anticoncepcionais , HIV , Comportamento Contraceptivo
9.
AIDS ; 2023 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-36625252

RESUMO

OBJECTIVE: Sexually transmitted infections (STIs) increase mucosal HIV infection risk and have the potential to reduce preexposure prophylaxis efficacy. Clinical trials of a broadly neutralizing antibody (bNAb) provided proof-of-concept that passive immunization against HIV can be efficacious in people. We sought to evaluate preclinically the protective efficacy of passive bNAb immunization against simian-human immunodeficiency virus (SHIV) infection in the context of concurrent vaginal STIs. DESIGN: Using a macaque model of combined ulcerative and nonulcerative vaginal STIs caused by Treponema pallidum , Chlamydia trachomatis , and Trichomonas vaginalis , we determined the protection that passively administered bNAb 10-1074 conferred against repeated vaginal SHIV challenges and compared correlates of protection to contemporaneous and historical controls without STIs. METHODS: Plasma viremia was monitored via RT-qPCR assay. Concentrations of 10-1074 were determined longitudinally in plasma samples via TZM-bl pseudovirus neutralization assay. RESULTS: Among macaques with vaginal STIs, a single subcutaneous injection of 10-1074 durably protected against vaginal SHIV acquisition, as compared with untreated controls. Interestingly, the median plasma concentration of 10-1074 at the time of SHIV breakthrough among macaques with STIs was significantly higher (10-fold) than that previously observed among 10-1074-treated macaques in the absence of STIs. CONCLUSION: Passive immunization with 10-1074 conferred significant protection against repeated vaginal SHIV challenges among macaques harboring vaginal STIs. However, our findings suggest that higher bNAb concentrations may be required for prophylaxis when STIs are present. Our findings potentially impact dose selection for the clinical development of bNAbs and highlight the importance of additional preclinical efficacy testing in STI models.

10.
CMAJ Open ; 11(1): E33-E39, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36649980

RESUMO

BACKGROUND: Although prophylaxis for ophthalmia neonatorum at birth is required by law in Ontario, declining prevalence of disease and efficacy of prophylaxis have called this practice into question. The objective of this modelling study was to assess the cost-effectiveness of universal prophylaxis for ophthalmia neonatorum to inform decision-makers on the potential impact of a change in this policy. METHODS: We compared the cost-effectiveness of prophylaxis for ophthalmia neonatorum with no prophylaxis through cost-utility analysis with a lifetime time horizon, considering a provincial government payer, for a hypothetical population of newborns in Ontario. We assessed both the mean incremental costs of prophylaxis and its mean incremental effectiveness using a hybrid (part decision tree, part Markov) model. We used a scenario analysis to evaluate alternative time horizons and discount rates. We conducted a threshold analysis to evaluate the impact of variations in the cost of prophylaxis and in the prevalence of sexually transmitted infections (gonorrhea and chlamydia). RESULTS: In our model, prophylaxis for ophthalmia neonatorum did not meet a willingness-to-pay threshold of Can$50 000 per quality-adjusted life-year (QALY). Although prophylaxis was effective in reducing morbidity associated with ophthalmia neonatorum, the number needed to treat to prevent 1 case of ophthalmia neonatorum blindness was 500 000, with an associated cost of more than Can$4 000 000. When compared with no prophylaxis, prophylaxis had an incremental cost of Can$355 798 per long-term QALY gained (incremental cost-effectiveness ratio). INTERPRETATION: We found that prophylaxis for ophthalmia neonatorum, although individually inexpensive, leads to very high costs on a population level. These findings contribute to the discussion on mandatory prophylaxis currently underway in several jurisdictions.


Assuntos
Gonorreia , Oftalmia Neonatal , Humanos , Recém-Nascido , Oftalmia Neonatal/epidemiologia , Oftalmia Neonatal/prevenção & controle , Oftalmia Neonatal/tratamento farmacológico , Ontário/epidemiologia , Gonorreia/epidemiologia , Gonorreia/prevenção & controle , Análise Custo-Benefício
11.
Nat Rev Urol ; 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36627487

RESUMO

Since 2006, five penis transplants have been performed worldwide. Mixed outcomes have been reported, and two of the five penile transplants have required explantation. However, the long-term outcomes have been encouraging when compliance is implemented, whether standard induction and triple therapy maintenance, or single therapy maintenance. Follow-up monitoring of transplant recipients has enabled a synthesis of technical considerations for surgical success and has shown stable leukocyte counts and renal function after a donor bone-marrow-based immunomodulatory regimen followed by tacrolimus monotherapy as long as 3 years post-transplant, as well as continuous nerve regeneration of penile allografts 3 years post-transplant. Areas of uncertainty include the ethics of donor-recipient colour mismatch, surveillance for sexually transmitted infections and how to optimize patient compliance. Questions also remain with respect to the long-term immunological sequelae of penile tissue, functional outcomes, psychosocial implications and patient selection. Patient counselling should be modified to mention the possibility of long-term improvement in nerve regeneration and sufficient renal function with single-therapy maintenance, and to build a longitudinal dialogue and partnership between the patient and the multidisciplinary care team regarding the risks of sexually transmitted infection instead of surveillance.

12.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 41(1): 24-28, Ene. 2023. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-214212

RESUMO

Introducción: La profilaxis preexposición (PrEP) es una intervención biomédica dirigida a prevenir la infección por el VIH en personas seronegativas con alto riesgo de contraer la infección. Esta estrategia fue aprobada por el Ministerio de Salud de España en octubre de 2019. Objetivo: Presentar la experiencia inicial de la PrEP en la Unidad de VIH del Hospital Clínic de Barcelona, poniendo especial atención en el análisis de los factores de vulnerabilidad de la cohorte. Materiales y métodos: Estudio retrospectivo, descriptivo. Se analizan las características epidemiológicas, sociodemográficas y clínicas basales de los usuarios incluidos en el programa durante el primer año de funcionamiento, prestando particular atención a las infecciones, las prácticas de riesgo y el consumo de sustancias. Resultados: Se incluyeron 190 individuos, 177 hombres y 12 mujeres transexuales con una edad media de 35 años (8DE). El 70% tenía estudios superiores y la mitad nacionalidad española. Informaron de tener 10 parejas de media al trimestre y el 60% de practicar sexo anal desprotegido. El 31% presentó al menos una PCR positiva para ITS, siendo la N. gonorrhoeae el germen más prevalente (51%) y la muestra rectal la más afectada (21%). El 63% reportó el uso de chemsex, el 19% policonsumo y el 8% slamming. La mitad expresó su preocupación por el consumo y/o prácticas sexuales y un 25% la necesidad de ayuda. Conclusiones: El perfil del usuario de PrEP visitado en nuestra unidad hospitalaria justifica la creación de equipos multidisciplinares que permitan prestar una atención holística de la vida sexual de estas personas.(AU)


Introduction: Pre-Exposure Prophylaxis (PrEP) is a biomedical intervention to prevent HIV infection in seronegative people at high risk of becoming infected. This strategy was endorsed in October 2019 by the Spanish Ministry of Health. Objective: To present the PrEP initial experience in the HIV Unit of the Hospital Clínic of Barcelona, paying special attention to the analysis of the vulnerability factors in the cohort. Materials and methods: Retrospective, descriptive study. The epidemiological, sociodemographic, and clinical characteristics of the users included in the program during the first year are analyzed, paying particular attention to Infections, risky practices, and substance use. Results: 190 individuals were included, 177 men and 12 trans women with a mean age of 35 years (8 SD). 70% had higher education, and half had Spanish nationality. An average of 10 couples per trimester and 60% reported unprotected anal sex. 31% had at least one positive PCR for STIs, with N. gonorrhoeae being the most prevalent microorganism (51%) and the rectal sample the most affected (21%). 63% reported chemsex use, 19% polydrug use, and 8% “slamming”. Half expressed concern about consumption and/or sexual practices and 25% the need for help. Conclusions: The PrEP user profile attended in our Hospital Unit justifies the creation of multidisciplinary teams that allow us to provide holistic attention to the sexual life of these people.(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , HIV , Profilaxia Pré-Exposição , Infecções Sexualmente Transmissíveis , Doenças Transmissíveis , Espanha
16.
Enferm. glob ; 22(69): 499-510, ene. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-EMG-507

RESUMO

Objetivo: Validar el contenido y la apariencia de una aplicación para adolescentes sobre la prevención y el control de la sífilis. Método: Estudio metodológico realizado de enero a junio de 2020. Participaron 22 jueces con experiencia en el área de la sífilis con énfasis en la promoción de la salud de los adolescentes, las tecnologías educativas y la validación de instrumentos. Se utilizó un instrumento que tiene variables relacionadas con el contenido, la estructura, la funcionalidad y la relevancia. Se utilizaron el Índice de Validez de Contenido, la Prueba Alfa de Cronbach y el Índice de Legibilidad de Flesch. Resultados: En las tres dimensiones, la media del Índice de Validez de Contenido fue superior a 0,80, lo que valida los contenidos de la aplicación. El Índice de Validez de Conocimiento global de la aplicación fue de 0,86, resultando satisfactorio y permitiendo considerar la aplicación como validada en cuanto a conocimiento y apariencia. En relación con el Alfa de Cronbach total de la aplicación, se obtuvo un valor de 0,94, lo que demuestra una excelente homogeneidad entre las respuestas de los participantes. La prueba de legibilidad reveló que la tecnología se considera de fácil comprensión para el lector. Conclusión: La aplicación móvil se presenta válida en cuanto al contenido y la apariencia, demostrando que es una herramienta tecnológica fiable para ser utilizada por los adolescentes en la educación para la salud sobre la prevención y el control de la sífilis. (AU)


Objetivo: Validar o conteúdo e a aparência de um aplicativo sobre prevenção e controle da sífilis para adolescentes. Método: Estudo metodológico realizado de janeiro a junho de 2020. Participaram 22 juízes com experiência na área de sífilis, com ênfase em promoção da saúde do adolescente, tecnologias educativas e validação de instrumentos. Foi usado instrumento que possui variáveis relacionadas ao conteúdo, estrutura, funcionalidade e relevância. Utilizou-se o Índice de Validade de Conteúdo, Teste Alpha de Cronbach e Índice de Legibilidade de Flesch. Resultados: Nas três dimensões, a média do Índice de Validade de Conteúdo foi superior a 0,80, o que valida os conteúdos do aplicativo. O Índice de Validade de Conteúdo global do aplicativo foi de 0,86, sendo satisfatório e possibilitando considerar aplicativo validado quanto ao conteúdo e aparência. Em relação ao Alfa de Cronbach total do aplicativo, obteve-se um valor de 0,94, demonstrando uma excelente homogeneidade entre as respostas dos participantes. O teste de legibilidade revelou que a tecnologia é considerada de fácil compreensão para o leitor. Conclusão: O aplicativo móvel se apresentou válido quanto ao conteúdo e a aparência, demonstrando que é uma ferramenta tecnológica confiável para ser utilizada por adolescentes na educação em saúde acerca da prevenção e controle da sífilis. (AU)


Objective: To validate the appearance and content of an application for the prevention and control of syphilis in adolescents. Method: Amethodological study was carried out from January to June 2020. Twenty-two judges with experience in syphilis control participated, with an emphasis on adolescent health promotion, educational technologies, and instrument validation. An instrument with variables related to content, structure, functionality, and relevance was used. The Content Validity Index, Cronbach's Alpha Test, and Flesch's Readability Index were used. Results: In the three dimensions, the average Content Validity Index was greater than 0.80, which validates the contents of the application. The overall Content Validity Index of the application was 0.86, which is satisfactory and makes it possible to consider the application valid in terms of content and appearance. Concerning the total Cronbach's Alpha of the application, a value of 0.94 was obtained, demonstrating excellent homogeneity between the participants' responses. The readability test revealed that the technology is easy for the user to understand. Conclusion: The mobile application proved valid in terms of content and appearance, demonstrating that this is a reliable technological tool that adolescents can use as a health education strategy for syphilis prevention and control. (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Aplicativos Móveis , Infecções Sexualmente Transmissíveis , Sífilis/prevenção & controle , Tecnologia da Informação , Brasil
17.
Int J STD AIDS ; : 9564624221149770, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36626249

RESUMO

BACKGROUND: Increases in life expectancy, the availability of sexual performance enhancing medication, and changes in sexual partnering suggest that sexually transmitted infections (STIs) among older persons could be on the rise, yet there have been relatively few studies examining STIs in this demographic. Our systematic review aimed to further characterize the incidence and prevalence of chlamydia, gonorrhea, and syphilis, along with associated risk factors among older adults (45 years or older) in the United States. METHODS: We searched five electronic databases (PubMed, Embase, Cinahl, Web of Science, and Global Health) for data published from inception to January 2021. The retrieved articles were screened based on eligibility criteria, and subsequent review of relevant article bibliographies was conducted. RESULTS: Of 4748 articles identified, 23 studies met our inclusion criteria and one additional article was identified through bibliography review. Of the 23 included articles, only 3 (11.5%) were focused exclusively on evaluating STIs in an older population. We found prevalence to be the following ranges: syphilis (0-18%), chlamydia (0-14.2%) and gonorrhea (0-15%). Few studies specifically investigated risk factors in this demographic. CONCLUSIONS: The understudied burden of STIs in the older adult population substantiates the need to recognize issues surrounding sexuality in this demographic.

18.
Infection ; 2023 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-36641506

RESUMO

PURPOSE: To analyze sensitivity and specificity of the rapid point-of-care (POC) eazyplex testing platform for bacterial sexually transmitted infections (STI) among men who have sex with men (MSM). METHODS: 272 anal, urethral, and pharyngeal swabs collected from 153 MSM were tested by both the eazyplex platform and an in-house PCR or culture in the university microbiology reference laboratory. RESULTS: Compared to the reference diagnostic method, the overall sensitivity/specificity of eazyplex was 88%/98% for N. gonorrhoeae, 82%/100% for C. trachomatis, 70%/ > 99% for U. urealyticum, and 85%/98% for M. hominis, respectively. Sensitivity for N. gonorrhoeae and U. urealyticum in urethral samples was 100%. CONCLUSION: With good to very good sensitivity depending on the sampling site and pathogen as well as very good specificity overall the eazyplex platform is a useful rapid diagnostic method for POC bacterial STI-testing especially for N. gonorrhoeae and C. trachomatis, allowing for almost immediate treatment initiation.

19.
Rev Esp Quimioter ; 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36651283

RESUMO

The present outbreak of Human Monkeypox (HMPX) that has begun in May 2022 and has spread across all continents in less than two months has qualitative and quantitative characteristics that make it different from the pattern of human disease previously caused by this virus. It has spread with enormous ease, affects almost exclusively adults, behaves as a sexually transmitted disease and focuses on very specific groups and transmission conditions. The high incidence in the city of Madrid in males that have sex with males (MSM) has allowed us to observe and report the experience with the first 30 cases diagnosed in our institution. Patients presented with febrile symptoms, genital and paragenital skin lesions reminiscent of smallpox, but less extensive and severe. The disease may also cause proctitis, pharyngitis and perioral lesions. The PCR test for diagnostic confirmation has been shown to be very sensitive and effective, not only in skin lesions but also in blood and other fluids such as pharyngeal, rectal exudates and blood. A very high proportion of patients with HMPX also have other sexually transmitted diseases that must be actively detected in this context. The spontaneous evolution of our patients has been good and hospitalization has been practically unnecessary. Transmission to non-sexual cohabitants and health personnel has been nonexistent and the lesions have disappeared in less than 30 days without leaving sequelae and no need for specific antiviral treatment.

20.
Microbiol Spectr ; : e0261422, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36651786

RESUMO

Chlamydia trachomatis is the leading cause of sexually transmitted bacterial disease and a global health burden. As an obligate intracellular pathogen, Chlamydia has evolved many strategies to manipulate its host and establish its intracellular niche called the inclusion. C. trachomatis reorganizes the host actin cytoskeleton to form scaffolds around the inclusion and reinforce the growing inclusion membrane. To control the kinetics and formation of actin scaffolds, Chlamydia expresses the effector InaC/CT813, which activates the host GTPase RhoA. Here, we have discovered that InaC stabilizes actin scaffolds through the host actin cross-linking proteins α-actinins 1 and 4. We demonstrate that α-actinins are recruited to the inclusion membrane in an InaC-dependent manner and associate with actin scaffolds that envelop the inclusion. Small interfering RNA (siRNA)-mediated knockdown of α-actinins differentially regulate the frequency of actin scaffolds and impair inclusion stability, leaving them susceptible to rupture and to nonionic detergent extraction. Overall, our data identify new host effectors that are subverted by InaC to stabilize actin scaffolds, highlighting the versatility of InaC as a key regulator of the host cytoskeletal network during Chlamydia infection. IMPORTANCE Despite antibiotics, recurrent C. trachomatis infections cause significant damage to the genital tract in men and women. Without a preventative vaccine, it is paramount to understand the virulence mechanisms that Chlamydia employs to cause disease. In this context, manipulation of the host cytoskeleton is a critical component of Chlamydia development. Actin scaffolds reinforce the integrity of Chlamydia's infectious vacuole, which is a critical barrier between Chlamydia and the host environment. Having previously established that InaC co-opts RhoA to promote the formation of actin scaffolds around the inclusion, we now show that Chlamydia hijacks a new class of host effectors, α-actinins, to cross-link these scaffolds and further stabilize the inclusion. We also establish that a core function of the chlamydial effector InaC is the regulation of cytoskeletal stability during Chlamydia infection. Ultimately, this work expands our understanding of how bacterial pathogens subvert the actin cytoskeleton by targeting fundamental host effector proteins.

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