Abstract

Sexually transmitted infections (STIs) are a serious global health problem. In Italy, data describing the vulnerability to STIs of specific sexual minorities and the influence of sociodemographic and behavioral determinants are limited, as most infections are not subject to mandatory notification. This retrospective study describes the sociodemographic profile and main sexual behaviors of patients attending a hospital in Palermo (Sicily, Italy) from January 2018 to March 2019 as predictors of STI risk. Patients were divided in subgroups: men-who-have-sex-with-men (MSM), men-who-have-sex-with-women (MSW), bisexual men and females. Data were obtained through an anonymous questionnaire. Patients were tested for chlamydia, syphilis, Mycoplasma genitalium infection, genital herpes and HPV infection. A total of 294 subjects with STIs (male/female ratio about 2:1) were screened. Of the total sample, 79.6% of patients were Italian. MSM accounted for 34.3%, MSW for 29.6%, bisexual men for 5.8% and females for 30.3%. A total of 44.5% of patients had a high education level, 42.5% reported irregular use of condoms, 20.7% reported having had 5–10 partners in the six months prior to the visit and 32.9% were HIV-positive. HPV infection and syphilis were the most prevalent STIs. Conclusions: The most common profile of patients attending our clinic was that of an adult, Italian man with a high level of education, poor use of condoms and a high number of partners. MSM had the highest sex-behavior-related risk for STIs. In addition, our results suggest that all STD teams need to implement counselling topics and recommendations to share with patients, as well as tips on how to approach sexual health education/counselling, thereby promoting patient-centered approaches and educational programs.

Highlights

  • Transmitted infections (STIs) are among the most important global public health problems both in high-income and low-income countries [1]

  • We suggest implementation of the primary health care system and completion of risk assessments in order to identify those patients for whom sexual health or STI-related education may be indicated

  • All STD staff need to implement counselling topics and recommendations to share with patients, as well as tips on how to approach sexual health education/counselling, thereby promoting patient-centered approaches and educational programs

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Summary

Introduction

Transmitted infections (STIs) are among the most important global public health problems both in high-income and low-income countries [1]. STI increase worldwide is mostly due to changes in sexual behaviors, such as contact with a significant number of sexual partners, the lower average age of people engaging in sexual intercourse and inconsistent condom use [2]. In 2016, the World Health Organization (WHO) estimated 376 million new cases (more than 1 million per day) of curable STIs (i.e., chlamydia, gonorrhea, syphilis and trichomoniasis). The burden of viral STIs is similar, with an estimated 417 million prevalent cases of herpes simplex virus infection (HSV) and about 291 million women infected with human papillomavirus (HPV) [1]. Regarding the STI scenario in Italy, this is mainly.

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