History Of Sexually Transmitted Infections Research Articles

Self-sampled multi-anatomic site testing for uncovering the community burden of undiagnosed Chlamydia trachomatis and Neisseria gonorrhoeae infection in men who have sex with men.

To detect otherwise undiagnosed asymptomatic sexually transmitted infection (STI), and for estimating prevalence among men who have sex with men (MSM). In this community-based study in Hong Kong, adult MSM were recruited. After completion of an online survey, free multi-anatomic sites self-sampling kits (urine specimens, pharyngeal and rectal swabs) for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) tests were delivered to requesting participants. Factors associated with STI positivity were analyzed in logistic regression. From September 2021 to October 2022, 712 MSM were recruited, with 86% aged 18-39, and 16% reported history of chemsex engagement. A majority (81%) had previously undergone HIV testing, 68% had ever tested for STI, and 35% previously diagnosed with STI. Totally 428 (60%) had requested self-sampling kits, and 276 (39%) returned collected samples. Among participants who returned the samples, about half had never been tested in the past and had no history of STI. Overall 21% tested positive for CT and/or NG (CT/NG)-CT positive 16% and NG positive 7%. By anatomic site, 16% of rectal swabs, 7% of pharyngeal swabs, but just 3% of urine specimens were CT/NG positive. The prevalence of CT/NG was not significantly different by history of STI diagnosis and testing. Self-sampled STI testing is a potentially useful means for enhancing uptake of screening in MSM in the community, which could uncover otherwise undiagnosed asymptomatic infections. Internet-based self-sampling for STI testing could complement the current clinic-based STI testing for supporting epidemiologic evaluation of STI control in the community.

Characteristics of Sexually Transmitted Infection (STI) Patients at the Tanggul Health Center in Jember Regency in the January-June 2023 Period

The incidence of sexually transmitted infections (STIs) can expand as the risk factors increase that increase the transmission of STIs, including having unprotected sexual contact with multiple partners, having a history of STIs, having a history of sexual violence, alcohol use, prostitution, having sexual partners who have sexual contact. additional and concomitant or have a history of previous STIs, drug use, and use of intravenous drugs. This study aimed to present the characteristics of sexually transmitted infections in Tanggul Health Center, Jember Regency, Indonesia. This study is a descriptive observational study. A total of 52 research subjects participated in this study. Analysis of variable characteristics was carried out univariately with SPSS version 25. The highest prevalence of STIs was gonorrhea, namely 20 people (38.46%), the age group with the most STIs, namely 25-49 years, as many as 36 people (69.23%), sex of STI sufferers the most were men, 37 people (71.15%) and the risk factors for experiencing STIs that were most common were customers of sex workers, 31 people (59.61%).

Potential impact of doxycycline post-exposure prophylaxis prescribing strategies on incidence of bacterial sexually transmitted infections.

Doxycycline post-exposure prophylaxis (doxyPEP) reduces bacterial sexually transmitted infection (STI) incidence in people with HIV (PWH) or using HIV preexposure prophylaxis (PrEP). Given concerns about widespread antibiotic use, we identified doxyPEP prescribing strategies to minimize use while maximizing impact on STIs. We used electronic health records of gay and bisexual men (GBM), transgender women, and non-binary people assigned male sex at birth with ≥2 STI tests (chlamydia, gonorrhea, syphilis) at an LGBTQ-focused health center during 2015-2020. We defined 10 hypothetical doxyPEP prescribing strategies based on PrEP use, HIV status, or STI history. We estimated doxyPEP use and STI diagnoses averted in counterfactual scenarios in which people meeting prescribing criteria received doxyPEP, assuming STI rates during use would have been reduced by clinical trial efficacy estimates. Among 10,546 individuals (94% GBM), rate of any STI was 35.9/100 person-years. Prescribing doxyPEP to all individuals would have averted 71% of STI diagnoses (number needed to treat for one year to avert one STI diagnosis, NNT = 3.9); prescribing to PrEP users/PWH (52%/12% of individuals) would have averted 60% of STI diagnoses (NNT = 2.9). Prescribing doxyPEP for 12 months after STI diagnosis would have reduced the proportion using doxyPEP to 38% and averted 39% of STI diagnoses (NNT = 2.4). Prescribing after concurrent or repeated STIs would have maximized efficiency (lowest NNTs) but prevented fewer STIs. Prescribing doxyPEP to individuals with STIs, particularly concurrent or repeated STIs, could avert a substantial proportion of all STI diagnoses. The most efficient prescribing strategies are based on STI history rather than HIV status or PrEP use.

Prevalence, Trends and Correlates of HIV, Syphilis and HCV Infection Among Chinese Local and Cross-border Migrant Female Sex Workers in the Sino-Vietnam Border Area of Guangxi, 2016-2021.

Female sex workers (FSWs) are considered a high-risk group for sexually transmitted infections (STIs). However, limited data exist on the prevalence and trends of HIV, syphilis and HCV among FSWs in the Sino-Vietnam border area. To determine the prevalence, trends and correlates of STIs among Chinese local FSWs (CL-FSWs) and cross-border migrant FSWs (CM-FSWs), we conducted consecutive cross-sectional surveys from 2016 to 2021, recruiting 7747 CL-FSWs and 932 CM-FSWs. The overall HIV, syphilis and HCV prevalence declined from 1.0%, 8.8% and 1.7% to 0.1%, 0.9% and 0.3%, respectively. There was no significant downward trend in the overall HIV and syphilis prevalence. However, HCV prevalence showed a decreasing trend among CL-FSWs. CM-FSWs had higher HIV prevalence (2.5% vs. 0.6%). Similarities and differences in STIs-related factors existed between CM-FSWs and CL-FSWs. For instance, receiving HIV-related services in the last year reduced the risk of HIV infection (for CM-FSWs: aOR = 0.234, 95% CI: 0.055-0.993; for CL-FSWs: aOR = 0.182, 95% CI: 0.058-0.567). Serving male clients at least 50 years old increased the risk of syphilis infection (for CM-FSWs: aOR = 4.277, 95% CI: 1.535-11.917; for CL-FSWs: aOR = 1.404, 95% CI: 1.087-1.815). Moreover, CM-FSWs with past-year STIs history had a higher risk of HIV (aOR = 34.976, 95% CI: 5.338-229.176) and HCV infection (aOR = 17.649, 95% CI: 1.846-168.846), both of which were associated with multiple factors in CL-FSWs. It is therefore necessary to develop effective, accessible, high-quality and targeted interventions for CM-FSWs and CL-FSWs.

Changes in the hemocoagulation system in pregnant women, after pre-gravid preparation before the DRT program, with a history of sexually transmitted infections

The objective: to analyze the dynamics of laboratory parameters of the functioning of the thermocoagulation system in pregnant women with a history of sexually transmitted infections(STIs) after pre-gravid preparation before cycles of assisted reproductive technologies (ART). Materials and methods. An analysis of the functioning of the thermocoagulation system was carried out in women with infertility who had a history of STIs after the DRT program: GroupI – 56 pregnant women received our proposed treatment and prevention measures in the pregravidperiod; II group – 55 pregnant women received generally accepted medical and preventive measures. The assessment of the state of the hemostasis system was determined by the following indicators: fibrinogen concentration (Fg), activated recalcification time (ACR), activated partial thromboplastin time (ATP), integrative indicator «Thrombodynamic Potential Index» (TIP), the concentration of fibrin and fibrinogen degradation products (FRP). and the level of more stable, but less biologically active metabolites of prostacyclin and thromboxane – 6-keto-PGF1α and T×B2. Statistical processing of research results was carried out using standard programs «MicrosoftExcel 5.0» and «Statistica 8.0». Results. In the period of the final formation of the placental barrier, in pregnant women of the Igroup, the APTC slowly lengthened (31.3±1.6 s in the II trimester, 34.3±2.9 s in the III trimester)with an increase in gestational age and probably differed from the indicators in the II group(27.6±3.0 s and 30.2±1.7 s respectively; p<0.05); there was a slow reduction of AChR during the II and III trimesters of pregnancy in pregnant women of the I group (63.1±2.8 s, 59.3±2.8 s); gradual decrease in the level of PDFF (5.8±0.27×10-2 g/l, 5.1±0.22×10-2 g/l) in contrast to the level of PDFF in the II group, where a gradual increase of this indicator was observed (9.4 ±0.17×10-2 g/l, 11.6±0.27×10-2 g/l) (р<0.01). The level of a stable metabolite of thromboxane (T×B2) in the trimesters decreased by 2 times and was found to be lower (p<0.05) than in the II study group; the level of a stable metabolite of prostacyclin (6-keto-PGF1α) also increased in the III trimester(p<0.05). This led to an increase in the PgI2/T×A2 balance in group I from 0.34±0.02 to 1.16±0.03, which corresponded to the physiological needs of systemic and organ hemodynamics during pregnancy. Conclusions. The development and implementation of effective pre-gravid preparation before cycles in women with a history of STIs and medication correction during pregnancy contribute to increasing the adaptive compensatory and adaptive potential of the mother’shemocoagulation homeostasis and perinatal protection of the fetus.

Клінічний перебіг вагітності та пологів після допоміжних репродуктивних технологій на тлі інфекцій, що передаються статевим шляхом

Purpose - to reveal the features of the course of the disease, childbirth, and the postpartum period in patients after assisted reproductive technologies (ART) against the background of sexually transmitted infections in the anamnesis. Materials and methods. 132 women with infertility on the background of sexually transmitted infections (STIs) in the anamnesis standard preparation for the ART program was carried out, of which 55 women completed the ART program with pregnancy and were included in the main group. The control group is 30 pregnant women without a period of infertility who became pregnant on their own. Statistical processing of research results was carried out using standard programs Microsoft Excel 5.0 and Statistica 8. Results. Pregnancy and childbirth in women after ART with a history of STIs occurs with a significantly high frequency of the following complications: threat of termination of pregnancy - 9 (16.4%); reproductive losses in the first half of pregnancy - 10 (18.2%); carrier of chronic viral and bacterial infection in the first half of pregnancy - in all women; early development of preeclampsia - 6 (13.3%); placental dysfunction - 26 (57.8%); fetal growth retardation syndrome - 17 (37.8%); fetal distress - 10 (22.2%); premature birth - 12 (26.7%); and high frequency of caesarean section - 40 (88.9%). Conclusions. The obtained results indicate that the development, implementation and application of an improved algorithm of pre-gravid preparation in women with a history of STIs before the ART program is relevant, which, in our opinion, can have a positive effect on the obstetric consequences of the delivery of these women. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Зміни в гемокоагуляційній системі після прегравідарної підготовки перед програмою ДРТ у вагітних з інфекціями, що передаються статевим шляхом, в анамнезі

Purpose - to analyze the dynamics of laboratory parameters of haemocoagulation system functioning after pregravid preparation before assisted reproductive technologies (ART) cycles in pregnant women with a history of sexually transmitted infections (STIs). Materials and methods. The functioning of the haemocoagulation system after the ART program in women with infertility and a history of STIs was analyzed: the Group 1 - 56 pregnant women received the treatment and preventive measures proposed by us in the pregravid period; the Group 2 - 55 pregnant women received conventional treatment and preventive measures. The state of the hemostasis system was assessed by the following indicators: fibrinogen concentration, activated recalcification time, activated partial thromboplastin time (APTT), integrative «index of thrombodynamic potential» (ITP), concentration of fibrin and fibrinogen degradation products (FDP) and the level of more stable but less biologically active metabolites of prostacyclin (6-keto-PGF1α) and thromboxane (T×B2). The statistical processing of the study results was performed using standard software «Microsoft Excel 5.0» and «Statistica 8.0». Results. During the period of final formation of the placental barrier in pregnant women of the Group 1, the APTT slowly lengthened (31.3±1.6 s - in the trimester ІІ; 34.3±2.9 s - in the trimester III) with increasing gestational age and significantly differed from the indicators in the Group 2 (27.6±3.0 s and 30.2±1.7 s, respectively; p<0.05); activated recalcification time slowly decreased during the trimesters II and III of gestation in pregnant women of the Group 1 (63.1±2.8 s and 59.3±2.8 s, respectively); gradually decreased the level of FDP (5.8±0.27×10-2 g/l and 5.1±0.22×10-2 g/l), in contrast to the level of FDP in the Group 2, in which this indicator gradually increased (9.4±0.17×10-2 g/l and 11.6±0.27×10-2 g/l); (p<0.01). The level of stable T×B2 in the trimester II decreased by 2 times and was lower (p<0.05) than in the Group 2; the level of stable 6-keto-PGF1α increased in the trimester III (p<0.05). This resulted in an increase in the PgI2/T×A2 balance in the Group 1 from 0.34±0.02 to 1.16±0.03, which corresponded to the physiological needs of systemic and organ hemodynamics during pregnancy. Conclusions. The development and implementation of effective pregravid preparation before ART cycles in women with a history of STIs and medical correction during pregnancy contribute to the increase of the adaptive compensatory and adaptive potential of maternal haemocoagulation homeostasis and perinatal fetal care. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Changes in the immune system in pregnant women, after pre­gravid preparation before the DRT program, with a history of sexually transmitted infections

The objective: to analyze the dynamics of laboratory indicators of the functioning of the immune system in pregnant women with a history of sexually transmitted infections (STIs) before and after pre-gravid preparation before cycles of assisted reproductive technologies (ART). Materials and methods. An analysis of the functioning of the immune system was carried out in 247 women with infertility who had a history of STIs and planned to participate in the DRT program: 115 women underwent our proposed pre-gravid training, of which 56 women in the DRT program ended in pregnancy, who entered the 1st group and received the proposed we take medical and preventive measures; 132 women underwent standard pre-gravid training, of which 55 women in the DRT program ended in pregnancy, who were included in the II group and received generally accepted medical and preventive measures. An in-depth immunological examination included: the absolute number of blood leukocytes and lymphocytes, as well as their subpopulations: CD3+ CD4+ helpers; CD3+ CD8+ cytotoxic T cells; activated CD3+DR+ T-lymphocytes; B-lymphocytes CD19+; (natural killers) of CD16+, CD56+, CD50+ cells. Statistical processing of research results was carried out using standard programs «Microsoft Excel 5.0» and «Statistica 8.0». Results. During immunological control before the start of preparation for DRT, immune maladaptation was observed in both study groups and there were no reliable changes in immunological indicators. During pregnancy, in the group of patients who received our proposed pre-gravid preparation, a probable decrease (p<0.05) of the immunoregulatory coefficient from 2.17 to 1.87 was observed, as a result of adequate correction of derived immunological disorders, compared to pregnant women of the II group (2,20–2.19). As a result of the pregravid preparation offered by us, in 84,3% of the patients of the I group, stimulation of the cellular link of immunity was observed, the phagocytic activity of neutrophils and the number of B-lymphocytes increased, the number of M-immunoglobulins decreased by 267.3±14.2 mg% versus 257.7±12, 7 mg%, p<0.05 Conclusions. The development and implementation of effective pre-gravid preparation before DRT cycles in women with a history of STIs and medical correction during pregnancy contributes to increasing the adaptive compensatory-adaptive potential in the immune homeostasis of the mother and perinatal protection of the fetus.

Prevalence of coinfections in a cross-sectional cohort of women screened for multiple pathogens in Peru

ObjectiveTo determine the prevalence and risk factors of sexually transmitted infections (STIs) including Chlamydia trachomatis, Ureaplasma urealyticum and Mycoplasma genitalium among asymptomatic women with human papillomavirus (HPV) infection. MethodsA cross-sectional study was performed in 842 asymptomatic women from Cajamarca, Peru. The pathogens were detected using polymerase chain reaction (PCR) and the results were analyzed according to the HPV status: high-risk HPV, low-risk HPV and negative for HPV. Demographical and gyneco-obstetric data was analyzed to identify risk factors. ResultsWe found that 23.99% (202/842) women were positive for HPV, of whom 79.21% (160/202) were infected with a high-risk genotype. Co-infections were evaluated and 14.38% (23/160) were positive for Ureaplasma urealyticum, 9.38% (15/160) for Chlamydia trachomatis and 1.25% (2/160) for Mycoplasma genitalium. We found a significant association between HPV genotype and the number of children, partners, and history of sexual abuse. The co-infection between high-risk HPV and Chlamydia trachomatis was associated with number of abortions, number of sexual partners and no use of condom. Finally, co-infection between high-risk HPV and Ureaplasma urealyticum was associated with no use of condom and history of STIs. ConclusionHPV infection continues to be a highly relevant problem in Peru, particularly due to the high prevalence of high-risk genotypes. In addition, we report high rates of co-infections with other STIs, such as U. urealyticum and C. trachomatis. We highlight the importance of active surveillance to promptly diagnose these infections, since they may lead to persistent HPV infections.

On Statistical Analysis of Eight Sexually Transmitted Diseases Using Categorical Analysis of Variance: A Case Study of the University of Nigeria Teaching Hospital

This paper focused on the statistical analysis of eight Sexually Transmitted Infections (STIs) reported in the University of Nigeria Teaching Hospital from 2010-2020. A population of 20,704 patients was recorded to have contracted eight (8) selected STIs. Prevalence analysis was computed to determine the most prevalent STI. Two-way CATANOVA cross-classification was computed to ascertain age group and gender that suffer more of each of these infections. Logistic regression model was fitted to predict reproductive status of patients that suffer the most prevalent STI. The prevalence analysis results showed Gonorrhea infection as the most prevalent STI. Two-way CATANOVA results for Gonorrhea and Chlamydia infections showed that there were significant difference in gender, age and interaction effects, significant difference in age and interaction effect for Trichomoniases infection, significant difference in age for Syphilis and HIV infections but no significant difference in gender, age and interaction effects for Human Papillomavirus (HPV), Hepatitis B Virus and Herpes infections. The results showed that the percentage of male that suffers STIs is more than the percentage of female, the percentage of 30-39 years that suffer STIs is more than the percentage of any other age group and the percentage of people without STIs history is more than the percentage of those that have history of them. Logistic regression results on Gonorrhea infection showed that an increase in age, body mass index, blood pressure, blood sugar, bacteria quantity, and Gonorrhea history were associated with an increased likelihood of the Gonorrhea patient being infertile.

Цитоморфологическая диагностика инфекционных заболеваний женской половой сферы с позиции персонализированной медицины

To date, the course of urogenital infections is characterized by asymptomatic or erased forms, but sexually transmitted infections (STIs) do not become less dangerous and can cause severe complications such as infertility, ectopic pregnancy, chronic diseases, intrauterine fetal damage, congenital pathology and diseases in newborn children. Taking into account the extreme urgency of the problem of timely diagnosis and adequate correction of endocervix pathology, the lack of clear cytomorphological parallels with clinical data, a very significant practical and scientific interest is the comparison of the results of cytomorphological research with diagnostic data using polymerase chain reaction. This will expand the possibilities of interpreting the cytological method as a primary study for further diagnosis and treatment. Аim: to analyze the results of cytomorphological studies of the urogenital tract of women with sexually transmitted infections of various etiologies and to assess their significance for a personal approach to treatment. Design: Prospective cohort study. Materials and methods. For a comprehensive cytomorphological study, data on 335 female patients (mean age 31.6 ± 8.2 years) with uncomplicated urogenital chlamydia (n = 18), papillomavirus (n = 97), herpetic (n = 26), mycotic (n = 41) infections, trichomoniasis (n = 12) and mixed forms were analyzed infectious lesion (n = 141). Results. If there is a history of STIs, it becomes necessary to identify concomitant genital infections and vaginal dysbiosis. It is difficult to determine which pathogen caused the "launch" of inflammatory reactions, and which one joined a second time and aggravated the course of the disease. A combination of candidiasis and chlamydial infection, candidiasis and viral lesions, chlamydial infection and viral lesions is possible, therefore, in addition to molecular genetic and serological diagnostics, cytomorphological methods are necessary for the diagnosis of STIs. Conclusion. The modern cytomorphological methods used for the diagnosis of infections of the female genital sphere allow us to quickly and reliably determine the type of pathogen and the nature of the process, which could help clinicians to choose the appropriate therapy correctly, to prevent the transition of the disease to the chronic stage, to avoid complications and the development of neoplastic processes. Keywords: cytomorphological diagnostics, sexually transmitted infections, traditional cytology, liquid cytology, personalized medicine.

Treatments and Outcomes of Patients Diagnosed With Tubal Pregnancy at Wichian Buri Hospital

Background: Treatment options of tubal pregnancy include medical and surgical treatments and the outcomes is associated with an appropriate patient selection. However, the limitation of hospital resource may influence the treatment options and also outcome. Objective: To evaluate patients diagnosed with tubal pregnancy including treatment method and outcomes of treatment at Wichian Buri Hospital. Methods: Fifty-five women diagnosed with ectopic pregnancy who were treated at Wichian Buri Hospital from January 2017 to December 2020 were included in the retrospective study. The clinical data was recorded. The treatment option and outcomes were collected. Results: The mean maternal age was 29 years (SD, 7.3 years). Most of the cases had no known risk factor such as the history of sexually-transmitted infection and no previous pelvic surgery. There were 38 patients (69.1%) presented with more than 1 symptom including pain and bleeding and the total of 48 patients (87.3%) reported symptom of pain. Most of the cases (63.6%) were diagnosed with unruptured ectopic pregnancy. Comparing ruptured and unruptured ectopic pregnancies, there was no statistical difference in clinical data except for the size of the adnexal mass, which was smaller in the ruptured group (P = .01). All ruptured tubal pregnancy underwent surgery which was salpingectomy. The majority of unruptured ectopic pregnancies also underwent surgical treatment (65.7%). Conclusions: The treatment of ectopic pregnancy in Wichian Buri Hospital was comparable to the standard treatment. The surgical management was the majority of treatment options that were selected regarding to the limitation. However, the outcomes were acceptable.

2210. Follow-up of Military Blood Donors Who Screen Positive for Syphilis

Abstract Background Most data on the transmission and outcomes of syphilis occur in community sexually transmitted infection (STI) clinics and have shown increased risk for other STIs in patients who test positive. There is limited data on outcomes in other lower risk populations that undergo universal syphilis screening, such as blood donors. This study describes the initial evaluation, follow-up, and STI risk of Air Force military basic trainees who screen-positive for syphilis at blood donation. Methods Blood donor data was gathered from the Armed Services Blood Bank Center-San Antonio for Air Force basic trainees who were screen-positive for syphilis between January 2014- September 2021. For each screen-positive case, six screen-negative controls were analyzed. Prospective donors were unable to donate if they reported male-to-male sexual encounters, HIV positive partners, or a bacterial STI in the prior year. Electronic medical records of cases and controls were examined for demographic information, STI history, and additional STI positivity within three years. Results A total of 63,375 basic military trainees donated blood at the Armed Services Blood Bank Center-San Antonio during the study period, of which 23 (0.36 per 1,000 donors) screened positive for syphilis (Table 1). At time of screening, 3 (13%) trainees who screened positive for syphilis also tested positive for an additional STI. After initial treatment and screening, donors who screened positive for syphilis had a RR: 3.8 (95% CI 1.3-10.5, p=0.01) of developing an additional STI in the three years after blood donation compared to controls. Cases of N. gonorrhoeae (Table 2) in the 3-year period following blood donation were significantly higher in those who were syphilis screen-positive compared to those who were negative. Conclusion There is limited data on follow-up of blood donors who screened positive for syphilis. This study found that in a low-risk population of military donors, those who screened positive for syphilis were at increased risk of future STIs compared to donors who were screen-negative. Syphilis screen-positive donors may be a potential target for future interventions to decrease the STIs burden in this population. Disclosures All Authors: No reported disclosures.

Зміни мікробіоценозу статевих шляхів у вагітних після прегравідарної підготовки перед програмою допоміжних репродуктивних технологій

Purpose - to investigate changes in the genital tract microbiocenosis in pregnant women with a history of sexually transmitted infections (STIs) after pre-vitro preparation before cycles of assisted reproductive technology (ART). Materials and methods. A total of 247 women with a history of STIs and who planned pregnancy under the ART program were examined: 115 women received our proposed pre-pregnancy preparation, of whom 56 ended in pregnancy (the Group 2) and they received the proposed therapeutic and preventive measures; 132 women received standard pre-pregnancy preparation, of whom 55 ended in pregnancy (the Group 2) and they received the standard therapeutic and preventive measures. The control group comprised 30 pregnant women without a period of infertility, who became pregnant on their own. Statistical processing of the study results was carried out using standard Microsoft Excel 5.0 and Statistica 8.0 software. Results. The state of the genital tract microbiocenosis in women of the Group 1 with a history of STIs, after pregravid preparation before the ART program, compared with pregnant women of the Group 2, is characterized by a significantly higher number of lactobacilli during the gestational period (I half of pregnancy: 49 (87.5%) vs. 38 (69.1%) cases, p<0.05; II half of pregnancy: 35 (68.6%) vs. 20 (44.4%) cases, p<0.001), bifidobacteria (I half of pregnancy: 42 (75.0%) vs. 31 (56.4%) cases, p<0.05; II half of pregnancy: 38 (74.5%) vs. 17 (37.7%) cases, p<0.001), lactic acid streptococci (I half of pregnancy: 29 (51.8%) vs. 18 (32.7%) cases, p<0.05; II half of pregnancy: 19 (37.2%) vs. 12 (26.6%) cases, p<0.05) against the background of a simultaneous significant decrease in the level of staphylococcus strains (I half of pregnancy: 9 (18.0%) vs. 20 (36.4%) cases, p<0.05; II half of pregnancy: 14 (27.4%) vs. 39 (86.6%) cases, p<0.05) and other microorganisms (urea and mycoplasma, chlamydia, escherichia and proteus). Conclusions. The results of these studies show that in women with a history of STIs after pre-pregnancy preparation prior to the АRT programme, the vaginal microbiocenosis during pregnancy almost matches that of a physiological pregnancy, which positively affects the obstetric and perinatal outcomes of delivery in this group of pregnant women. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the author.

Health-seeking behaviours of young women with sexually transmitted infections: Analysis of the 2014 Ghana Demographic and Health Survey.

Young people are at a disproportionately higher risk for sexually transmitted infections (STIs) due to biological factors, low awareness and limited access to sexual and reproductive health information and services. Untreated STIs can lead to major complications, including HIV, congenital infections, infertility, permanent disability and mortality. This study aimed to identify the salient factors associated with health-seeking behaviours of young women with a history of STIs in Ghana. We analysed data from the 2014 Ghana Demographic and Health Survey. In all, we analysed data from a weighted sample of 742 young women with a history of STIs. At the univariate level, frequencies and percentages were computed, while Chi-square analysis was computed at the bivariate level. Both crude and adjusted odds ratios were computed at the multivariable level using binary logistic regression. The findings showed that the majority (72%) of the participants sought treatment for STIs. Among the participants who sought treatment for STIs (n = 532), 26% sought treatment at a public hospital/polyclinic, 34% sought treatment at a chemical/drug store and 10% self-medicated. Seeking treatment for STIs was significantly associated with older age (20-24yrs), and higher socioeconomic and educational status. This study demonstrated that majority of the young women sought treatment for STIs. Seeking treatment for STIs was influenced by socio-demographic factors. These findings have implications for sexual and reproductive health policies and interventions in Ghana.

Prevalence and risk factors of bacterial enteric pathogens in men who have sex with men: A cross-sectional study at the UK's largest sexual health service

ObjectivesOutbreaks of bacterial enteric pathogens (BEPs) in men who have sex with men (MSM) associated with antimicrobial resistance are a public health concern. We investigated the prevalence and risk factors of BEPs in MSM to inform infection control. MethodsWe conducted a cross-sectional study at a London sexual health clinic between 20/12/2017 and 06/02/2018. Residual rectal swabs from MSM attending for sexually transmitted infection (STI) testing were anonymously tested for a range of BEPs using real-time PCR. A sub-set of samples were tested for the mphA gene (a marker of azithromycin resistance). Results were linked to electronic health records. ResultsBEPs were detected in 207 of 2116 participants, giving an overall prevalence of 9.8% (95% CI 8.5%-11.1%) ranging from 0.8% (0.4%-1.2%) for Shigella to 4.9% (4.0%-5.9%) for Enteroaggregative E. coli. MSM with BEPs were more likely to have a history of bacterial STIs (p = 0.010), to report more sexual partners (p<0.001), and among HIV-negative MSM, to report current HIV pre-exposure prophylaxis use (p<0.001). Gastrointestinal symptoms were rare (1.7%) and not associated with BEPs. 41.3% of MSM with BEPs and 14.1% of those without BEPs carried mphA (p<0.001). Among the former, this was associated with a history of bacterial STIs (51.5% vs 31.1%, p = 0.003). ConclusionsOne in ten MSM had a BEP detected and most did not report symptoms. MphA carriage was common, particularly among those with BEPs. Bacterial STI treatment might contribute to selection of resistant gut organisms, emphasising the need for better antimicrobial stewardship.

Increases in the Macrolide Resistance of Mycoplasma genitalium and the Emergence of the A2058T Mutation in the 23S rRNA Gene: Clonal Spread?

The management of Mycoplasma genitalium sexually transmitted infection (STI) is hindered by increasing resistance to the recommended antibiotics, macrolides and quinolones, worldwide. In Gipuzkoa (Basque Country, Spain), macrolide and quinolone resistance rates in 2014-2018 were reported as &lt;20% and &lt;10%, respectively. The aims of this study were to compare these rates with those in 2019-2021 and analyse the genetic and epidemiological features of the strains and cases associated with striking changes in the resistance trends. Resistance to macrolides (n = 1019) and quinolones (n = 958) was studied, analysing mutations in 23S rRNA and parC/gyrA genes, respectively. The rate of macrolide resistance increased from 17.3% in 2014-2018 to 32.1% in 2019-2021, as much in the more prevalent A2058/2059G mutations (16.6-27.8%) as in the emergent A2058T mutations (0.5-4.1%) but with differences in the odds ratios and the relative risk increase between A2058T and A2058/2059G mutations. MG191 adhesin and MG309 lipoprotein of the 27 emergent strains detected with A2058T mutations were amplified, sequenced, and typed using phylogenetic and variable number tandem repeat analysis, respectively. Genetic clonal spread was ruled out, but most of the A2058T cases were men who had sex with men (24/27) with a history of STI and antibiotic treatments (19/27). No changes were observed in quinolone resistance trends, but the rate of resistance to both antibiotics rose from 2.9% to 8.3%, especially in cases with A2058T mutations. The genetic characterisation of strains and epidemiological surveillance of cases are needed to detect populations at increased risk of treatment failure in this infection.

Exposure to Chlamydia trachomatis Infection in Individuals Who Are Newly Diagnosed with HIV and Antiretroviral-Naïve from Belém, Northern Brazil.

Chlamydia trachomatis is one of the most prevalent sexually transmitted bacteria worldwide and may increase the risk of other sexually transmitted infections (STIs) including the human immunodeficiency virus (HIV). This study describes the seroprevalence of C. trachomatis infection among antiretroviral-naïve patients who are newly diagnosed with HIV in the city of Belém, Pará, in the Amazon region of Brazil. A cross-sectional study was carried out between January 2018 and January 2019 in 141 people living with HIV/AIDS (PLHA) who were followed up in a specialized unit of the public health network of Pará. The investigation of IgG antibodies against C. trachomatis was performed by enzyme immunoassay. Sociodemographic and sexual behavior information were obtained through a questionnaire. The prevalence of IgG anti-C. trachomatis antibodies was 64.8% (92/141). The majority of individuals were young, heterosexual, single men who did not use condoms during sexual intercourse and had no history of STIs. No significant differences were found when comparing any clinical or demographic data between groups. Our results demonstrated a high rate of exposure to C. trachomatis in newly diagnosed HIV-infected individuals in the Amazon region of Brazil, and all PLHA should be screened for C. trachomatis to decrease transmission of the bacteria and prevent the clinical manifestations of chronic infection.

Factors Associated with Sexually Transmitted Infections among Women of Child-Bearing Age in Makululu Compound of Kabwe district, Zambia

Sexually transmitted infections (STIs) are a public health problem globally. About 376 million new infections of the four main curable STIs are reported annually. In Zambia, as well as in many countries in sub-Saharan Africa, STIs are a major public health problem. Studies conducted mostly in the urban areas of Zambia show that the majority of young people engage in risky sexual behavior despite evidence suggesting widespread awareness about STIs. Therefore, the purpose of this study was to determine factors associated with STIs among women of child-bearing age in the Kabwe district, employing a cross-sectional study design. The sample size was 405, and data was collected using structured interview questionnaires. Bivariate and multivariate logistic regression using (SPSS) version 21 was used to analyze the data. The results showed that women engaged themselves in sexual activity at a much younger age of between 16-20 years. Despite women having a high level of knowledge of STIs, some still were involved in having more than one sexual partner, and this was statistically significant. Inconsistency in condom use by women was a risk factor in influencing a history of STI, and their attitudes showed that they have misconceptions regarding condom use, as some participants felt that condoms were not safe to use to prevent STIs during a sexual encounter. The current study, therefore, revealed that knowledge of STI alone is not adequate in providing protection from STI contraction and that behavioral factors must always be taken into consideration for any effective intervention. Keywords: Condom, knowledge, STIs, Women.

Low incidence of HIV infection and decreasing incidence of sexually transmitted infections among PrEP users in 2020 in Germany

IntroductionObjectives of this study, as part of a nation-wide HIV pre-exposure prophylaxis (PrEP) evaluation project, were to determine the incidence of infections with HIV, chlamydia, gonorrhea, syphilis, hepatitis A/B/C in persons using PrEP, and to describe the health care funded PrEP use in Germany. Additionally, factors associated with chlamydia/gonorrhea and syphilis infections were assessed.MethodsAnonymous data of PrEP users were collected at 47 HIV-specialty centers from 09/2019–12/2020. Incidence rates were calculated per 100 person years (py). Using longitudinal mixed models, we analyzed risk factors associated with sexually transmitted infections (STIs).Results4620 PrEP users were included: 99.2% male, median age 38 years (IQR 32–45), 98.6% men who have sex with men (MSM). The median duration of PrEP exposure was 451 days (IQR 357–488), totaling 5132 py. Four HIV infections were diagnosed, incidence rate 0,078/100py (95% CI 0.029–0.208). For two, suboptimal adherence was reported and in the third case, suboptimal adherence and resistance to emtricitabine were observed. One infection was likely acquired before PrEP start. Incidence rates were 21.6/100py for chlamydia, 23.7/100py for gonorrhea, 10.1/100py for syphilis and 55.4/100py for any STI and decreased significantly during the observation period. 65.5% of syphilis, 55.6% of chlamydia and 50.1% of gonorrhea cases were detected by screening of asymptomatic individuals. In a multivariable analysis among MSM younger age, PrEP start before health insurance coverage and daily PrEP were associated with greater risk for chlamydia/gonorrhea. Symptom triggered testing and a history of STI were associated with a higher risk for chlamydia/gonorrhea and syphilis. A significantly lower risk for chlamydia/gonorrhea and syphilis was found for observations during the COVID-19 pandemic period.ConclusionsWe found that HIV-PrEP is almost exclusively used by MSM in Germany. A very low incidence of HIV infection and decreasing incidence rates of STIs were found in this cohort of PrEP users. The results were influenced by the SARS-CoV-2 pandemic. Rollout of PrEP covered by health insurance should be continued to prevent HIV infections. Increased PrEP availability to people at risk of HIV infection through the elimination of barriers requires further attention. Investigation and monitoring with a longer follow-up would be of value.