Higher Number Of Sexual Partners Research Articles

The sexual behaviors of young Polish women and their knowledge about contraception

Introduction. With the increasing trend of early sexual activity among adolescents, contraception has become a crucial topic. Poland ranks last in the Contraceptive Atlas, as the country with the poorest access to contraception methods and information. This results in a low level of contraceptive knowledge among young people, leading to unintended pregnancies and sexually transmitted infections. Adequate sexual education is a key element in promoting sexual health, enabling informed contraceptive choices based on medical knowledge. The responsibility for sexual education lies not only with parents but also with educators, pedagogues, doctors, and governmental bodies. Aim. To assess knowledge about contraception and investigate the sexual behaviors of women aged 15-25, comparing the results with available literature and indicating possible preventive actions in the studied area. Material and methods. An anonymous electronic survey was conducted among women aged 15-25 from across Poland. The survey was distributed on various internet groups, primarily comprising students. It included closed-ended questions verifying knowledge of the topic under study and a demographic section. Statistical analysis of the data was performed using Statistica and Microsoft Excel. Results. The average age of sexual initiation among respondents was 17.84±1.96 years, with one-third of them yet to engage in sexual activity. The majority of respondents (58%) had 1 to 3 sexual partners, and with increasing age and education level, the percentage of those with a higher number of sexual partners increased. The most popular contraceptive methods among respondents were barrier methods, combined oral contraceptive pills, and a combination of barrier and hormonal methods. The main sources of contraceptive information for the respondents were the internet, gynecologists, and scientific literature. Almost all respondents were aware of the definition of contraception, but only half were aware of the Pearl Index. Less than half of the respondents could identify the most effective contraceptive method, while almost all correctly identified the least effective method. The knowledge of the majority of respondents was assessed as moderate, good, or very good. Conclusions. Despite the generally good knowledge of contraception among the majority of respondents, there are still gaps that need to be filled. Due to the progressively decreasing age of sexual initiation, education on contraception is a priority that will help reduce the number of unintended pregnancies and sexually transmitted diseases in the future.

HIV epidemic among key populations in Nigeria: results of the integrated biological and behavioural surveillance survey (IBBSS), 2020–2021

IntroductionNigeria has the fastest-growing HIV epidemic in West and Central Africa and key populations (KPs) bear a higher burden of HIV. This integrated biological and behavioural surveillance survey was conducted...

The Roles of Affective Lability, Boredom, and Mindfulness in Predicting Number of Sex Partners within Women

Affective lability, a trait related to borderline personality disorder, bipolar disorder, eating disorders, and post-traumatic stress disorder, is associated with a higher number of lifetime sex partners. Among individuals who are affectively labile, boredom proneness, which has been linked to impulsive and risky sexual behaviors, might increase the likelihood of having more sex partners. Conversely, mindfulness has been found to be associated with healthy emotion regulation and lower impulsivity, and may enable a greater tolerance of affective lability and boredom, and, in turn, lower the sense of urgency to engage in sex to cope. Thus, the present study investigated the links between affective lability, boredom proneness, mindfulness, and number of sex partners in the last year. We predicted that affective lability would be positively associated with number of sex partners, and that this association would be moderated by boredom proneness and mindfulness in a three-way interaction. Adult women (N = 469, Mage = 25.15 years) were recruited from online communities and completed measures of affective lability, boredom proneness, trait mindfulness, and number of sex partners in the last year. None of the preregistered three-way interactions were supported; however, exploratory analyses revealed that, among women who reported rapid changes between depression and elation, those who were less likely to observe thoughts and sensations had more sex partners in the last year. Clinicians and researchers should further investigate which facets of mindfulness may protect against a higher number of sex partners in affectively labile individuals.

Youth-friendly health service in Ethiopia: Assessment of care friendliness and user's satisfaction.

Health facilities' level of readiness to provide adolescent and youth-friendly health services (AYFHS) is crucial for preventing and reducing teenage pregnancies and maternal mortality. This study examined friendliness and satisfaction with AYFHS among users. A cross-sectional study was conducted among 419 adolescents and youths recruited from six health institutions in the East Shewa Zone, Oromia region, and Addis Ababa, Ethiopia from August 1 to October 28, 2022. Based on the WHO Quality Assessment Guidebook, the friendliness of AYFHS was evaluated as a proxy for the quality of care. Descriptive measures were computed to summarize the participants' socio-demographic characteristics. Bivariate and multivariable logistic regression analysis was used to evaluate the potential association between each independent variable and client satisfaction. The type, magnitude, and precision of association were presented using an adjusted odds ratio (AOR) with 95% Confidence Intervals (CI) and a p-value of < 0.05 ascertained statistical significance. The overall friendliness was 69%: Specifically, 82% of the participants stated the service was accessible, 72% said it was acceptable, and 90% thought it was effective. However, only 33% and 34% of respondents reported the services were equitable and appropriate respectively. The overall satisfaction with AYFHS was 25.3%. Increased age (AOR = 0.70, 95% CI: 0.57-0.86), being female (AOR = 0.11, 95%CI: 0.04-0.33), no prior information about AYFHS (AOR = 0.20, 95%CI: 0.10-0.44), and higher number of sexual partners (AOR = 0.3, 95%CI: 0.21-0.65) were factors statistically associated with client satisfaction with AYFHS. The overall quality of AYFHS was sub-optimal and did not meet the four components of WHO's good quality standards; equity, appropriateness, acceptability, and accessibility must be improved. Female and older adolescents and youths and those with a higher number of sexual partners should be targeted for intervention.

Patterns of Sexual Risk Behaviors and Sexuality-Related Risk Factors among Young Adults in Germany: Implications for Prevention and Therapy

Sexual risk behavior (SRB) includes behavioral (sex without contraception, sexualized substance use, sex work, sexual partner violence, other sexual activities that harm oneself or others) and affective subtypes (sexuality-related feelings of shame/guilt, relationship impairments) and leads to psychosocial and health-related consequences. Young adults comprise a vulnerable group regarding the development of SRB. The study aimed to identify SRB patterns among young adults and their relation to sexuality-related risk factors. A cross-sectional online survey measured behavioral and affective aspects of SRB with nine items. Latent class analysis was conducted to identify patterns of SRB. Gender, sexual orientation, age of first intercourse, number of sexual partners, hypersexuality, and sexual dysfunction were captured as risk factors via multinomial logistic regression. Within this convenience sample (n = 609; nfemale = 365; nmale = 245; Mage = 23.1 years), the SRB patterns unremarkable (67%; low values in all SRB subtypes), shame-ridden (17%; high values in sexual feelings of shame/guilt) and risky sexual behavior (16%; high values in all subtypes of SRB, especially sexualized drug use) were identified. The shame-ridden and risky patterns were strongly associated with higher hypersexuality values, the risky pattern moreover with being non-heterosexual, of younger age at first sexual experience, and a higher number of sexual partners. Male and sexual minority participants demonstrated SRB more often than females and heterosexuals. Within prevention and treatment of SRB, it seems beneficial to address sexuality-related feelings of shame/guilt and addictive patterns (concerning sexual behaviors/substances) via gender- and diversity-sensitive measurements.

Prevalence of sexually transmitted infections in women of the Czech Republic Armed Forces: a cross-sectional pilot study

IntroductionSexually transmitted infections (STIs) are an everlasting health issue globally. The military environment is recognised as a high-risk setting. Human papillomavirus (HPV), Chlamydia trachomatis and Neisseria gonorrhoeae are the most...

Cost-effectiveness of 4CMenB vaccination against gonorrhea: importance of dosing schedule, vaccine sentiment, targeting strategy, and duration of protection.

Observational evidence suggests the 4CMenB meningococcal vaccine may partially protect against gonorrhea, with one dose being two-thirds as protective as two. We examined the cost-effectiveness of vaccinating men-who-have-sex-with-men (MSM) in England, with one- or two-dose primary vaccination. Integrated transmission-dynamic health-economic modeling explored the effects of targeting strategy, first- and second-dose uptake levels, and duration of vaccine protection, using observational estimates of vaccine protection. Vaccination with one or two primary doses is always cost-saving, irrespective of uptake, although vaccine sentiment is an important determinant of impact and cost-effectiveness. The most impactful and cost-effective targeting is offering "Vaccination-according-to-Risk" (VaR), to all patients with gonorrhea plus those reporting high numbers of sexual partners. If VaR is not feasible to implement then the more-restrictive strategy of "Vaccination-on-Diagnosis" (VoD) with gonorrhea is cost-effective, but much less impactful. Under conservative assumptions, VaR(2-dose) saves £7.62M(95%CrI:1.15-17.52) and gains 81.41(28.67-164.23) QALYs over 10 years; VoD(2-dose) saves £3.40M(0.48-7.71) and gains 41.26(17.52-78.25) QALYs versus no vaccination. Optimistic versus pessimistic vaccine-sentiment assumptions increase net benefits by ∼30%(VoD) or ∼60%(VaR). At UK costs, targeted 4CMenB vaccination of MSM gains QALYs and is cost-saving at any uptake level. Promoting uptake maximizes benefits and is an important role for behavioral science.

Sexual history of patients with human papillomavirus positive and negative oropharyngeal cancer: A systematic review and meta-analysis.

Increased sexual activity is associated with higher human papillomavirus (HPV) rates; however, there is a lack of analysis comparing the sexual history of patients with HPV positive and HPV negative oropharyngeal cancer (OPC). In this meta-analysis, PubMed, Scopus, and CINAHL were searched for articles that included patients with OPC and reported information regarding HPV status and either history of oral sex, number of sexual partners, or sexually transmitted infections (STI). A total of 11 studies were included with 3296 patients with OPC. Patients with HPV positive OPC were more likely than patients with HPV negative OPC to report a history of oral sex (92%, 95% CI: 87.0-97.0 vs. 74.5%, 95% CI: 50.6-98.4, p < 0.0001), higher mean number of sexual partners (18.4 partners, 95% CI: 1.5-35.4 vs. 7.2 partners, 95% CI: 1.0-13.4, p < 0.0001), and more frequent history of STI (23.7%, 95% CI: 18.4-29.0 vs. 8.8%, 95% CI: 4.7-12.8, p = 0.0001). Compared to patients with HPV negative OPC, our analysis shows a larger proportion of patients with HPV positive OPC had participated in oral sex, had a higher number of sexual partners, and had a higher proportion of STI history.

Impact of enacted stigma on mental health, substance use, and HIV-related behaviors among sexual minority men in Zambia

Sexual minority men (SMM) in Zambia face significant challenges including stigma, discrimination, and mental health issues, which further impact their HIV-related risk behaviors. This study aimed to investigate the associations between enacted stigma, substance abuse, HIV-related behaviors, and mental health (i.e., depression, anxiety, and post-traumatic stress disorder [PTSD] symptoms) among SMM in Zambia. SMM aged 18–35 years who reported having multiple and/or concurrent sexual partners or low and/or inconsistent condom use in the past three months were recruited from four districts in Zambia between February and November 2021. Participants completed an anonymous interviewer-administered survey. Key variables of interest were compared between participants with higher vs. lower levels of enacted stigma. Independent samples t-tests were used for continuous variables, and chi-squared tests were used for categorical variables. A total of 197 eligible SMM participated in the study (mean age = 24.41 years). Participants with a higher level of enacted stigma showed a higher level of anxiety symptoms (χ2 = 12.91, p ≤ .001), PTSD symptoms (χ2 = 7.13, p < .01), tobacco use (χ2 = 10.47, p < .01), cannabis use (χ2 = 5.90, p < .05), and a higher number of sexual partners (t = 1.99, p < .05) in the past three months. Stigma reduction interventions may help mitigate substance abuse, HIV-related behaviors, and adverse mental health outcomes among SMM in Zambia. Health care providers, especially psychiatric-mental health nurses, can incorporate strategies for recognizing and addressing stigma into their practice through training and integrate multiple resources to create an inclusive and non-judgmental environment for SMM to improve their well-being.

Moderating Effect of Gender on the Relationship Between Sexual Knowledge and Sexual Activity Among Adolescents

IntroductionAdolescent sexual activity is an important topic for public health policies and can be shaped by them. This study examines the relationship between sexual knowledge and sexual activity and tests the moderating effect of gender.MethodsThis study uses a random sample of 1246 Polish adolescents aged 18−19 years. The methods of partial least squares path modeling and bootstrap testing are utilized.ResultsAmong boys, unlike among girls, a low level of sexual knowledge was associated with early and intense sexual activity represented by an early age of sexual initiation, a high number of sexual partners, and a short time since last sexual intercourse. Additionally, the average level of sexual knowledge was lower among boys than among girls. More specifically, the difference in knowledge of every element of the male reproductive system between boys and girls was not significant; however, girls were more aware of the female reproductive system than boys.ConclusionsGender differentiated the relationship between sexual knowledge and sexual activity. The revealed moderating effect could reflect gender differences in the motives of sexual activity of adolescent men and women. The early and intense sexual activity exhibited by boys with limited sexual knowledge exposed them to sexually transmitted diseases and unintended parenthood.Policy ImplicationsThe self-selection of boys with low sexual knowledge levels into early and intense sexual activity may be of interest to public health.

Patterns of sexual risk behaviour among young adults

Abstract Background Sexual risk behaviour (SRB), including the subtypes sex without contraception, sexualized substance use, sex work, and intimate partner violence, leads to health-related consequences for one-self or intimate partners. Especially young adults comprise a vulnerable group for SRB as they tend to use risk behaviour as maladaptive coping strategies to face developmental challenges. We aim to identify SRB patterns by analysing the relation between SRB-subtypes and to previous found risk factors, and to derive adequate treatment and prevention strategies. Methods A cross-sectional study was conducted via an online-questionnaire. SRB was measured via nine items. Latent class analysis was used to identify patterns of SRB, multinomial logistic regression to capture related risk factors. Included risk factors were gender, sexual orientation, younger age of first intercourse, higher number of sexual partners, and hypersexual behaviour (HB; measured via HB-inventory). Results Within the sample (n = 609) three classes of SRB patterns were identified: unremarkable (67%; low values in all SRB facets), and the therapeutic-relevant classes shame-ridden (17%; esp. high values in sexual feelings of shame/ guilt), and risky (16%; high values in all SRB facets, esp. sexualized use of illegal drugs, inadequate contraception use, and impairments in important relationships). Both pathological patterns are strongly associated to higher HB-values. Male and queer participants tend to demonstrate pathological SRB-patterns more often than females and heterosexuals. Conclusions To implement adequate gender- and diversity sensitive prevention and treatment addressing SRB it is necessary to understand the complexity of its expression. Based on the results, shame-ridden clients could be addressed by focusing on their feelings of shame/ guilt, while it seems helpful to address substance use and compulsive sexual behaviour of clients belonging to the risky group primarily. Key messages • Three patterns of sexual risk behaviour could be identified, two of them are theraptuic-relevant. • To implement adequate SRB prevention and treatment it is necessary to understand its complexity, thus respective differentiated strategies should address specific needs of young adults.

The sins of the church: The long-term impacts of Christian missionary praxis on HIV and sexual behaviour in Zambia

ABSTRACT This study examines the long-term effect of Christian missionary exposure on HIV infection and related sexual behaviour in Zambia. I use distance to a historical missionary church and health facility as proxies for missionary exposure. I constructed a geocoded data set combining information on the historical locations of churches and missionary health centres with contemporary individual-level data. I find that individuals who live close to a historical missionary church have a higher likelihood of being infected with HIV. I find no significant effect of proximity to a missionary health centre on HIV. Considering that heterosexual transmission is the main channel of HIV transmission in Zambia, I analyse the effect of missionary exposure on sexual behaviour. The following patterns emerge: individuals who live close to a Protestant church are less likely to engage in premarital sexual abstinence; they also have their first sexual encounter at an earlier age, with the effect being stronger for men than women. Living near a Catholic church is associated with having a higher number of sexual partners.

Risk Factors for Patients with Hepatitis B and C in Hemodialysis Unit

Background: Risk factors for HCV, HBV transmission are blood transfusions and surgeries before 1992, intravenous drug use, contaminated parenteral drugs and other invasive non-medical procedures (tattooing, piercing). Based on these risk factors, high-risk groups are: multiramified patients (i.e., hemophiliacs), health personnel, intravenous drug users, inmates, individuals with high-risk sexual behaviors (early sex life, high number of sexual partners and prostitution). Other populations at risk are patients on extracorporeal circulation system, such as end-stage kidney disease patients on hemodialysis program. Study aim: To determine risk factors for patients with hepatitis B and C in hemodialysis unit. Methodology: A descriptive study design was conducted at Al-Najaf city in the southern region of Iraq in Al-Sadder Medical City and Al-Hakim General Hospital from February 20th, 2023, to May 23th, 2023, in order to assess risk factors for patients with hepatitis B and C in hemodialysis unit. The methodological strategies for data collection used an assessment questionnaire survey. Results: As the study shows, that the risk factors that cause the most infection are hemodialysis sessions, contact with infected persons, and injected medication, while the lowest risk factors to spread infection are children born with infected hepatitis and unprotected sexual contacted. Conclusion: The study concludes that the first leading risk factor for infection is the hemodialysis session, while the contact with infected persons and contaminated injections of medication comes in the second place. Recommendations: Careful monitoring and strict adherence to infection control procedures among patients undergoing hemodialysis treatment, including commitment to sterilization of hemodialysis devices and the use of all preventive measures when starting the hemodialysis procedure.

Prevalence, Risk factors, and Shedding of Human Herpes Virus-8 among Men Having Sex With Men Enrolled in a Pre-exposure Prophylaxis Study.

Seroprevalence and risk factors for Human Herpesvirus-8 (HHV-8) infection among HIV-negative men who have sex with men (MSM) on pre-exposure prophylaxis (PrEP) have not been well characterized. Our objectives were to assess the prevalence and incidence of HHV-8 infection in MSM enrolled on PrEP and assess viral shedding in seropositive participants. The ANRS IPERGAY study enrolled 429 participants in France and Canada to evaluate oral PrEP for HIV-1 prevention. Stored sera samples at day 0 (D0) and last visit were tested for the detection of HHV-8 antibodies using an indirect immunofluorescence assay. Baseline characteristics were analyzed to identify risk factors associated with HHV-8 seropositivity. Among seropositive participants, HHV-8 DNA was quantified on available oral and anal swabs, and ORF-K1 typing performed on HHV-8 positive samples. One hundred participants were seropositive at D0 (prevalence of 24%, 95% Confidence Interval (95%CI): 20·0-28·4) and 18/329 seroconverted during the study (incidence rate of 2·66 per 100 person-years, 95%CI: 1·57-4·20). Risk factors independently associated with baseline HHV-8 seropositivity included older age, high number of sexual partners, chemsex use and HSV-2 seropositivity. Among HHV-8 seropositive participants with available swab(s) for virological analysis, 37/115 (32%) displayed HHV-8 oral shedding, and 5/113 (4.4%) anal shedding at least once. Four patients had positive viral load before seroconversion. Prevalence and incidence of HHV-8 infection were high in HIV-negative PrEP users. Among seropositive participants, HHV-8 DNA is mainly detected in saliva, which may play a major role in viral transmission in this population.

Non-Consensual Sex and Help-Seeking Behavior Among PrEP Users in Belgium: Findings from an Online Survey

ABSTRACT Non-consensual sex poses a threat not only to sexual health but also to mental and physical health in general. HIV pre-exposure prophylaxis (PrEP) users might be particularly vulnerable to non-consensual sex because of interplaying factors such as mental health disorders, a high number of sex partners, engagement in chemsex, and the widespread use of dating apps. The objectives of this study were to assess the occurrence of non-consensual sex, its associated factors, and related help-seeking behavior among PrEP users. We analyzed data from an online survey among PrEP users in Belgium (09/2020-02/2022). Almost one in five participants (34/187, 18.2%) reported having ever experienced non-consensual sex. The most reported form was having sex against one’s will, followed by having been given drugs against one’s will, and having had sex without a condom against one’s will. The vast majority of those who had experienced non-consensual sex (29/34, 85.3%) did not seek help afterward, mostly due to a lack of perceived need (21/29, 72.4%). Reported barriers to seeking help were shame (6/29, 20.7%) and lack of awareness of help services (3/29, 10.3%). Having experienced non-consensual sex in the past five years was associated with younger age and suicidal ideation in a multivariable logistic regression model. We conclude that addressing barriers to non-consensual sex help services is crucial to maximize their use and minimize the consequences of non-consensual sex experiences. PrEP consultations also represent an opportunity to offer such help given PrEP users are already familiar with these PrEP services and engaged in care.

The Use of Daily and On-Demand Oral Pre-Exposure Prophylaxis Dosing Strategies Among Young Adult Gay, Bisexual and Other Men who have Sex with Men Enrolled in an mHealth Adherence Intervention.

Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention option for gay, bisexual and other men who have sex with men (GBMSM). However, with newer PrEP options, a greater understanding of whether and why GBMSM switch dosing strategies is needed to inform clinical practice and research. We assessed the dosing strategies (daily or on-demand) of GBMSM enrolled in an mHealth PrEP adherence pilot intervention at four timepoints over approximately 10 months. Among GBMSM with complete data (n = 66), a consistent daily dosing strategy was used by most (73%) participants across all time points, while on-demand PrEP was used at least once during the study period by 27% of participants. A higher percentage of on-demand PrEP users self-reported as Asian/Pacific Islander and had less positive attitudes toward PrEP, adjusting for key sociodemographic variables and intervention arm. Daily PrEP users reported high numbers of sexual partners, and the primary reason that they would switch to on-demand PrEP is reduced sexual activity. At the final assessment, 75% of participants were taking daily PrEP, of whom 27% reported that they would like to switch to another option, including on-demand and long-acting injectable PrEP. While findings were largely descriptive, they showed that switches in PrEP dosing strategies are relatively common and PrEP strategy choice may vary across racial and ethnic groups.

Sexual Risk Behavior of Children and Adolescents With a History of Sexual Violence

Abstract: Theoretical Background: Experiencing sexual violence (SV) at a young age can impede sexual development and lead to sexual risk behavior. Objective: This meta-analysis aims to provide a systematic overview regarding the development of sexual risk behavior in sexually violated children and adolescents. Method: A systematic literature search was carried out (PubMed, ERIC, Cochrane, and PubPsych). Meta-analyses were conducted, investigating the link between child SV and sexual behaviors (teenage pregnancy, safer sex, substance use during intercourse, transactional sex, and number of sex partners). Results: A total of 19 studies were identified. Survivors of SV are more likely to have higher numbers of sex partners, be involved in teenage pregnancy, and participate in transactional sex. Discussion: Early identification of sexually violated youth is important in order to intervene at an early stage and reduce the effects of sexual violence preventively. PROSPERO registration number CRD42020145139.

The Correlation of Papanicolaou Smears and Clinical Features to Identify the Common Risk Factors for Cervical Cancer: A Retrospective and Descriptive Study from a Tertiary Care Hospital in Trinidad.

Background: Cervical cancer, the fourth most frequent cancer in women, is associated with the human papillomavirus (HPV). This study identifies risk factors and clinical findings for abnormal cervical cytology and histopathology in the Trinidad and Tobago populations. Some risk factors include early age of first coitus, a high number of sexual partners, high parity, smoking, and using certain medications, such as oral contraception. This study aims to identify the significance of Papanicolaou (pap) smears and the common risk factors that contribute to the development of premalignant and malignant cervical lesions. Method: A three-year retrospective, descriptive study of cervical cancer was conducted at the Eric Williams Medical Sciences Complex. The subject population included 215 female patients aged 18 years and older with the following documented abnormal cervical cytology: (ASCUS), ASC-H, LSIL, HSIL, Atypical Glandular cells, HPV, Adenocarcinoma, and Invasive Squamous Cell Carcinoma. Histopathology records were analysed for thirty-three of these patients. Patients' information was recorded on data collection sheets adapted from the North Central Regional Health Authority's cytology laboratory standardised reporting format request form. Results and Findings: The data were analysed via Statistical Package for Social Sciences (SPSS) software edition 23 using frequency tables and descriptive analysis. The mean sample age of the population was 36.7 years, the first age of coitus was 18.1 years, the number of sexual partners was 3.8, and the number of live births was 2. LSIL was the most popular abnormal finding, 32.6%, followed by HSIL, 28.8%, and ASCUS, 27.4%. Most histopathological reports resulted in CIN I and II. Conclusions: The significant risk factors observed for cytology abnormalities and premalignant lesions were early age of coitus, a high number of sexual partners, and no use of contraception. Patients mostly presented as asymptomatic despite obtaining abnormal cytology results. Hence, regular pap smear screening should continue to be highly encouraged.

Psychiatric symptoms in people living with HIV: prevalences, interactions and consequences

IntroductionPeople living with HIV (PLHIV) experience higher levels of mental health issues compared to the general population. Especially depression, anxiety, impulsivity and substance use occur frequently in PLHIV. This is thought to have important consequences for quality of life, sexual risk behaviour and antiretroviral treatment (ART) adherence. Both in PLHIV as well as in the general population, divergent psychiatric symptoms often co-occur, and influence one another.ObjectivesTo assess the interrelatedness of psychiatric symptoms and their potential consequences in PLHIV.MethodsData from 1615 outpatient PLHIV using suppressive ART from the 2000HIV study (NCT03994835) were analysed. Participants reported on the severity of substance use (MATE-Q), depression and anxiety (HADS), impulsivity (BIS-11), quality of life (EQ-5D-5L), ART adherence (MASS-8) and sexual risk behaviour. For these variables, prevalence rates and mean scores were calculated. After binarizing the data, an Ising network model was constructed. Using this network, interrelations between psychiatric symptoms were assessed, the centrality of symptoms was estimated and connections with clinical consequences were explored.ResultsIn our cohort of PLHIV, the increased prevalence of substance use was most pronounced, as shown by a prevalence rate of 28.7% for smoking, 13.6% for cannabis use, 11.1% for heavy alcohol drinking and 9.2% for ecstasy use in the past month. The network analysis revealed that symptoms of depression and anxiety were most strongly interrelated. The depressive symptom “feeling slowed down” was one of the most central symptoms, and was most strongly connected with quality of life. Substance use was associated with a higher occurrence of sexually transmitted diseases, and this relationship was mediated by a higher number of sexual partners. Notably, ART adherence did not display any connections with depression, anxiety, impulsivity or substance use.Image:ConclusionsThe high occurrence of substance use and its link with sexual risk behaviour, emphasizes it’s role as a potential target for prevention of HIV transmission. Contrary to general assumption, psychiatric symptoms are not associated with lower levels of ART adherence in our cohort. Treatment of depression in PLHIV might be improved by focussing on the symptom of feeling slowed down, since this symptom was most strongly connected with quality of life.Disclosure of InterestE. Meeder Grant / Research support from: ViiV Healthcare, M. Blaauw: None Declared, L. van Eekeren: None Declared, A. Groenendijk: None Declared, W. Vos: None Declared, Q. de Mast: None Declared, W. Blok: None Declared, A. Verbon: None Declared, M. Berrevoets: None Declared, J. van Lunzen Employee of: ViiV Healthcare, L. Joosten: None Declared, M. Netea: None Declared, V. Matzaraki: None Declared, A. van der Ven: None Declared, A. Schellekens: None Declared

Determinants and prediction of Chlamydia trachomatis re-testing and re-infection within 1 year among heterosexuals with chlamydia attending a sexual health clinic.

Chlamydia trachomatis (chlamydia) is one of the most common sexually transmitted infections (STI) globally, and re-infections are common. Current Australian guidelines recommend re-testing for chlamydia 3 months after treatment to identify possible re-infection. Patient-delivered partner therapy (PDPT) has been proposed to control chlamydia re-infection among heterosexuals. We aimed to identify determinants and the prediction of chlamydia re-testing and re-infection within 1 year among heterosexuals with chlamydia to identify potential PDPT candidates. Our baseline data included 5,806 heterosexuals with chlamydia aged ≥18 years and 2,070 re-tested for chlamydia within 1 year of their chlamydia diagnosis at the Melbourne Sexual Health Center from January 2, 2015, to May 15, 2020. We used routinely collected electronic health record (EHR) variables and machine-learning models to predict chlamydia re-testing and re-infection events. We also used logistic regression to investigate factors associated with chlamydia re-testing and re-infection. About 2,070 (36%) of 5,806 heterosexuals with chlamydia were re-tested for chlamydia within 1 year. Among those retested, 307 (15%) were re-infected. Multivariable logistic regression analysis showed that older age (≥35 years old), female, living with HIV, being a current sex worker, patient-delivered partner therapy users, and higher numbers of sex partners were associated with an increased chlamydia re-testing within 1 year. Multivariable logistic regression analysis also showed that younger age (18-24 years), male gender, and living with HIV were associated with an increased chlamydia re-infection within 1 year. The XGBoost model was the best model for predicting chlamydia re-testing and re-infection within 1 year among heterosexuals with chlamydia; however, machine learning approaches and these self-reported answers from clients did not provide a good predictive value (AUC < 60.0%). The low rate of chlamydia re-testing and high rate of chlamydia re-infection among heterosexuals with chlamydia highlights the need for further interventions. Better targeting of individuals more likely to be re-infected is needed to optimize the provision of PDPT and encourage the test of re-infection at 3 months.