History Of Sexually Transmitted Infections Research Articles

Mpox across countries from Central and Eastern Europe - 2022 outbreak

BackgroundThe aim of the study was to assess socio-demographical characteristics, clinical presentation, and outcomes in patients diagnosed with mpox. MethodsA survey on patients diagnosed with mpox was performed in 14 countries from Central and Eastern Europe. Data was compared according to HIV status and country of origin (EU vs. non-EU). Mpox diagnosis was confirmed by RT-PCR from oropharyngeal swabs, skin lesions, and other body fluids. ResultsOut of 154 patients confirmed with mpox in 2022, 99.3% were males, with a median age (years) of 35 (IQR 30–39), 90.2% MSM and 48.7% PLWH. Compared to HIV-negative subjects, PLWH had more frequent high-risk behaviours:chemsex (p = 0.015), group sex (p = 0.027), and a history of sexually transmitted infections (STIs) (p = 0.004). Persons from EU were more often PLWH (p = 0.042), MSM (p < 0.0001), had multiple sexual partners (p = 0.025), practiced chemsex (p = 0.008) or group-sex (p = 0.005) and had more often history of STIs (p < 0.0001). The median CD4 cell count/mL at mpox diagnosis was 713 (IQR 486–996) and 73.5% had undetectable HIV VL. The commonest clinical features were fever (108 cases), lymphadenopathy (78), and vesiculo-pustular rash: penile (76), perianal (48), limbs (67). Fifty-one (31%) persons were hospitalized due to complications or epidemiological reasons. Three patients received tecovirimat or cidofovir. The outcome was favorable for all patients, including 4 with severe forms. ConclusionsMpox was diagnosed predominantly in young MSM, with high-risk behaviors and history of STIs. Effective contact tracing and vaccination are important strategic pillars to control mpox outbreaks.

Factors associated with hepatitis A susceptibility among men who have sex with men using HIV pre-exposure prophylaxis in Northeastern Brazil: A cross-sectional study.

Hepatitis A virus (HAV) infection has disproportionately affected more men who have sex with men (MSM), occurring in outbreaks, despite being vaccine-preventable. We determined the prevalence and factors associated with HAV susceptibility among cisgender MSM on HIV pre-exposure prophylaxis (PrEP) in Northeastern Brazil. From September 30, 2021 to June 19, 2023, 282 cisgender MSM receiving HIV PrEP were enrolled into this cross-sectional study. Sociodemographic and clinical information were collected. Blood samples were collected for screening of sexually transmitted infections (STIs) and serum samples were tested for IgM and total anti-HAV antibodies. Non-reactive results for total anti-HAV antibodies were found in 106 of 282 (37.6%) participants. Factors associated with HAV susceptibility included age <30 years (prevalence ratio [PR]: 2.02; 95% confidence interval [95% CI]: 1.61-2.53), having health insurance (PR: 1.39; 95% CI: 1.19-1.64), sex only with cisgender men (PR: 1.52; 95% CI: 1.23-1.89), non-steady partner (PR: 1.20; 95% CI: 1.01-1.43) and no lifetime history of STIs (PR: 1.25; 95% CI: 1.03-1.53). Identifying clinical correlates of HAV susceptibility in key populations is a fundamental step towards development of public policy focused on prevention, especially following the recent hepatitis A outbreak in Brazil.

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.

Analysis of Risk Factors for External Genital Health of Women of Childbearing Age in Purwakarta Regency, Indonesia

Introduction: The health of women's external genitalia is an important aspect of reproductive health. This study aims to analyze the health risk factors for the external genitalia of women of childbearing age in Purwakarta Regency, Indonesia.&#x0D; Methods: This research is an analytical observational study with a cross-sectional design. The research sample was 240 women of childbearing age in Purwakarta Regency who were selected randomly. Data was collected through questionnaires and physical examination. Data analysis was carried out univariate and bivariate.&#x0D; Results: The results of the study showed that the risk factors for the health of the external genitalia of women of childbearing age in Purwakarta Regency were age, parity, and a history of sexually transmitted infections (STIs). Women aged more than 35 years have a higher risk of external genital health than women aged less than 35 years (OR = 2.65; 95% CI: 1.22-5.83). Women with parity more than 2 have a higher risk of external genital health than women with parity 1-2 (OR = 2.32; 95% CI: 1.14-4.71). Women with a history of STIs have a higher external genital health risk than women without a history of STIs (OR = 3.52; 95% CI: 1.58-8.17).&#x0D; Conclusion: Age, parity, and history of STIs are risk factors for external genital health in women of childbearing age in Purwakarta Regency.

Factors Associated With HIV Testing in Adolescent and Young Adult Females With a History of STI.

To determine the percentage of female adolescent patients (13-26 years old) who had HIV testing ordered within 90 days of incident sexually transmitted infection (STI) diagnosis during an outpatient clinic visit. This was a retrospective chart review study evaluating 830 visits among 589 female patients 13 to 26 years who had an incident STI diagnosed in outpatient Adolescent Medicine or Pediatric Practices in an urban, nonprofit, academic, free-standing children's hospital at the main campus and a community site in the Northeast United States. Odds of HIV screening was greater at the community-based adolescent medicine practice (odds ratio [OR] = 3.17; 95% confidence interval [CI]: [1.92, 5.24]) and when seen by an adolescent medicine provider (OR = 1.44; 95% CI: [1.02, 2.03]). Only 33.5% (n = 283) of 844 clinical encounters had HIV screening obtained within 90 days of incident STI diagnosis. Overall, HIV screening rates within 90 days of STI diagnosis was low, and there is much room for improvement.

Syphilis Diagnosis After a Chlamydia, Gonorrhea, or HIV Diagnosis Among Reproductive-Aged Women in Baltimore, MD.

Syphilis incidence is increasing among reproductive-aged women, and previous sexually transmitted infections (STIs) are a risk factor for subsequent STIs. This study aimed to determine syphilis incidence after a chlamydia, gonorrhea, or HIV diagnosis, and identify characteristics associated with higher syphilis incidence rates among reproductive-aged women in 1 mid-Atlantic city. A retrospective cohort of 85,113 chlamydia, gonorrhea, and HIV diagnoses occurring between 2009 and 2021 and among women aged 13 to 50 years was constructed using public health surveillance data. Cumulative incidence curves were estimated to examine time to early syphilis (i.e., primary, secondary, or early latent) diagnosis, and multivariable analyses determined incidence rate ratios by age (<25 vs. ≥25 years) and number of prior STI diagnoses (0 vs. ≥1) during the study period, stratified by STI. There were 85,113 reportable STI diagnoses and 646 syphilis diagnoses in the cohort. Approximately 1 of 150 chlamydia, 1 of 100 gonorrhea, and 1 of 50 HIV diagnoses were followed by a syphilis diagnosis within 5 years. Cumulative incidence of syphilis differed significantly by STI diagnosis ( P < 0.001). In multivariable analysis, syphilis incidence rates were higher among women diagnosed with ≥1 (vs. 0) prior STI regardless of STI type ( P < 0.05) and among women ≥25 (vs. <25) years old diagnosed with gonorrhea ( P < 0.05). There were significant differences in syphilis incidence by prior STI type, number of STIs, and age. Our data support targeted screening for syphilis among women with a history of STIs, parwomen with ≥1 prior STI diagnosis, and older women diagnosed with gonorrhea.

Addressing Reproductive Education Among Young Adults with Sickle Cell Disease (SCD): Sickle Cell Reproductive Outreach and Education (ROE) Project

Background: As children with sickle cell disease (SCD) survive into adulthood, it is important to address emerging reproductive health concerns. This population faces unique fertility challenges, including balancing the desire for biological parenthood, risk of pregnancy-associated complications, unintended pregnancy, and fertility concerns with the use of SCD modifying therapies (DMTs) (Smith-Whitley, Blood, 2014, Pecker, Br J Haematol, 2021) . Recent research identified knowledge gaps that impact reproductive care for adults with SCD (Carrithers, Frontiers, 2023). To overcome these gaps, we need to evaluate the baseline knowledge of young adults with SCD regarding reproduction to understand the complex implications of reproductive decision-making. This study was done to gauge young adults' knowledge of reproduction, understanding of fertility, and current reproductive behaviors in order to develop educational material to support young adults' with SCD reproductive decisions. Methods: This IRB-approved, cross-sectional study included young adults living with SCD (ages 18-35) from University of Alabama-Birmingham's Lifespan Comprehensive SCD Center. Patients were recruited during routine clinic visits to complete an electronic 33-question survey to evaluate reproductive health topics adapted from the Sisters Informing Sisters About AIDS (SISTA) questionnaire (CDC, 2008), including demographics (age separated into younger age (18-25) and older age (26-35), sexual health behaviors (contraception, sexually transmitted infection (STI) prevention), family planning, patient advocacy, and attitudes towards reproductive education. Responses were recorded as “Yes, No, Don't Know”, unless questions specifically asked for participants to choose an option. Attitudes toward reproductive education were graded on 5-point Likert scale (1= strongly disagree to 5=strongly agree). Data analysis includes averages to evaluate subgroup comparisons and independent student's t-test to compare subgroups with statistical significance set at p&amp;lt;0.05. Results: We enrolled 47 participants (55% women and 51% were of older age). In this cohort, 87% completed high school and 60% were sexually active. Among those who were sexually active, 86% had previously undergone STI testing and 36% had prior history of STI (22% men vs. 77% women, 22% younger age vs. 77% older age, p&amp;lt;0.05). Thirty-eight percent identified personal or partner contraceptive use. Regarding children, 19% had birthed/fathered a child(ren) (55% men vs. 45% women, 22% younger age vs. 77% older age, p&amp;gt;0.005) among whom 11% knew their child had SCD, 55% knew their child had sickle cell trait (SCT), and 33% did not know if their child had SCD/SCT. Only 26% were aware of contraceptive options for people with SCD (17% men vs. 83% women, p&amp;lt;0.05). Importantly, 89% recognized high risk sexual activity as a risk factor for STIs but no one in the cohort recognized the risk of infertility due to STIs. When asking about their partners, 32% knew if their partner had SCD/SCT (20% men vs. 80% women, p&amp;lt;0.05). Notably, 79% desired biologic children. Among those who desired children, 41% felt that their SCD changed their decision to have children and 26% were previously told they could not have children due to SCD (12% men vs. 88% women, 25% younger age vs. 75% older age, p&amp;lt;0.05). Notably, 57% were interested in conceiving if pregnancy was planned (41% men vs. 59% women, 37% younger age vs. 63% older age, p&amp;lt;0.05). When asked if patients wanted to discuss their reproductive health, 87% wanted to discuss this with their hematologist but only 51% would discuss this with PCPs. Conclusion: In this study, we identified evaluated 4 tenets of reproductive health knowledge: contraceptive use, STI prevention, family planning, and patient advocacy. We identified gaps in knowledge in these areas that can be addressed to improve reproductive education in young adults with SCD. Young adults with SCD in our cohort have low contraceptive use and were often not aware of contraceptive options for people with SCD or their partner's SCD/SCT status. Our cohort also reported a significant history of STI but was unaware of the associated increasing risk for infertility. Importantly. young adults are especially interested in discussing reproductive health with their hematologists, which provides an opportunity to improve reproductive education within this unique population.

The impact of HIV pre-exposure prophylaxis on sexually transmitted infections incidence in Bulgaria

Abstract Background The global introduction of effective Pre-Exposure Prophylaxis (PrEP) alongside with available antiretroviral medications against HIV strongly limited the spread of infection among the high-risk population. This remarkable success predisposes to riskier sexual behaviour and has emerged as leading cause of the increased incidence of sexually transmitted infections (STIs) in sizes of new threatening pandemic. Methods Checkpoint - Sofia is a medical centre located in Sofia, Bulgaria for consultations, prevention, diagnosis and treatment of STIs and HIV. Retrospective clinical study was performed on 507 consulted HIV-negative males with monitored normal renal function (October 2020 to March 2023). Results The mean age was 32±7.8 years (18-58 years) with prevalent ages &amp;lt;30 and 30-40 years (41% and 47%, respectively). As “men having sex with men” (MSM) identified themselves 96% of the studied individuals and 131 (26%) reported past STI history. Drug substances usage monthly reported 25% and weekly 11%; vaccinated for HBV &amp;lt;55%. On demand regimen (2 + 1+1 tablets) of PrEP was preferred at 91% and 15% switched to every-day receiving before increased risk. Voluntary were tested 58% of the subjects at least once during the first year of PrEP intake. No one was positive for HIV, HBV and HCV. We observed notable increase of STIs such as syphilis, chlamydia and gonorrhoea among the PrEP users - 9% (3/4 of them in the initial phase of the disease), 6% and 4%, respectively. Mixed infection (gonorrhoea and chlamydia) was confirmed at three. Conclusions The drastic increase of unprotected sex practices in people regularly taking PrEP gradually leads to а significant raise of other STIs and potential antibiotic resistance. This trend confirms the extreme importance of sexual health centres in the application of parallel approach towards HIV/STIs including periodic screening among risk groups, confirmation of asymptomatic cases and conduction of proper prevention or therapy. Key messages • The dramatic increase of unprotected sex practices in people regularly taking PrEP as HIV prevention, gradually leads to a drastic raise of other STIs and potential antibiotic resistance. • Sexual health centres play a key role in the emergent screening among risk groups together with applying of preventive measures.

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&lt;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&lt;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&lt;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&lt;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.

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&lt;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&lt;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&lt;0.05; II half of pregnancy: 35 (68.6%) vs. 20 (44.4%) cases, p&lt;0.001), bifidobacteria (I half of pregnancy: 42 (75.0%) vs. 31 (56.4%) cases, p&lt;0.05; II half of pregnancy: 38 (74.5%) vs. 17 (37.7%) cases, p&lt;0.001), lactic acid streptococci (I half of pregnancy: 29 (51.8%) vs. 18 (32.7%) cases, p&lt;0.05; II half of pregnancy: 19 (37.2%) vs. 12 (26.6%) cases, p&lt;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&lt;0.05; II half of pregnancy: 14 (27.4%) vs. 39 (86.6%) cases, p&lt;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.