Incidence Of Sexually Transmitted Diseases Research Articles

АНАЛИЗ РОССИЙСКОГО РЫНКА ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ, ПРИМЕНЯЕМЫХ ДЛЯ ЛЕЧЕНИЯ ЗАБОЛЕВАНИЙ, ПЕРЕДАЮЩИХСЯ ПОЛОВЫМ ПУТЕМ

Sexually transmitted diseases (STDs) are the category of diseases that infected during sexual intercourse. Today, unfortunately, despite the decrease in the level of general morbidity, the structure of the incidence of STDs is changing, which forces us to return to solving this problem again. Diseases of this group not only spread very easily, but also cause harm to both the genitals and the body as a whole. As a result, human health deteriorates, the function of the reproductive system suffers, which also affects the health of future offspring. To minimize the above consequences, the Russian pharmaceutical market (RPhM) has a large assortment portfolio of medicines with various groups. So, in particular, many medicines are included in the List of vital and essential medicines(VEM) and in the minimum assortment list, according to the decree of the Government of the Russian Federation dated 12.10.2019 No. 2406-r "On approved The list of vital VEM for 2023, as well as lists of medicines for medical use and the minimum range of medicines necessary for the provision of medical care". A similar study was conducted in order to analyze the range of RPhM drugs used for the treatment of STDs. During the research, various official information sources on medicines registered in the territory of the Russian Federation used for the treatment of STDs were reviewed and studied: the Register of Medicines of Russian Federation "RADAR" (2023), the State Register of Medicines and Medical Devices (2023), the Vidal handbook of medicines "Medicines in Russian Federation" (2023), orders of the Government of the Russian Federation, Internet sources. Research methods: structural, graphical, comparative, content analysis, segmentation.

Profile of Sexually Transmitted Infections in Quarantine Blood at the Indonesian Red Cross Blood Transfusion Unit, Depok City

Sexually Transmitted Disease (STDs) is a group of infection which is responsible for morbidity and mortality in developing country. This group of infections plays its role in the transmission of the Human Immunodeficiency Virus (HIV). DKI Jakarta, Papua, and East Java are the provinces responsible for 90% of the STD incidence. STDs are caused by 30 types of bacteria, viruses, parasites, and fungi, which are transmitted by sexual contact and are asymptomatic. This study used a cross-sectional approach and a univariate test. The result is Hepatitis B was most found in 2017, as many as 30,7%; Hepatitis C in 2017, as many as 24,7%; Syphilis in 2017, as many as 25,9%; and HIV in 2018, as many as 27,2%. Keywords: STD, blood screening, HIV

Sexualized drug use and STD and HIV incidence among men who have sex with men in Amsterdam, the Netherlands.

We assessed the association between sexualized drug use (SDU), and incident sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV) infections among men who have sex with men (MSM). We used data from the MS2 cohort study, conducted at the STI Outpatient Clinic of the Public Health Service of Amsterdam, the Netherlands, in 2014-2019. Eligible participants were adult HIV-negative MSM with ≥2 STDs in the preceding year and MSM living with HIV and ≥1 STD. Participation encompassed 3-monthly visits including STD screening and questionnaires on drug use. Primary outcomes were incident HIV, anal chlamydia/gonorrhoea, and syphilis. We studied the association between SDU of individual drugs and incident HIV and STDs, using Poisson regression. Analyses were adjusted for age and HIV-status. 131 HIV-negative MSM and 173 MSM living with HIV were included for analysis. SDU with GHB/GBL (aIRR = 7.2, 95% CI = 1.4-35.5) in the 3months before testing was associated with incident HIV. SDU with GHB/GBL (aIRR = 1.2, 95% CI = 1.0-1.4), ketamine (aIRR = 1.3, 95% CI = 1.0-1.6) or methamphetamine (aIRR = 1.3, 95% CI = 1.0-1.6) was associated with incident anal chlamydia/gonorrhoea. We found no association between SDU with specific drug types and syphilis incidence. SDU with GHB/GBL, ketamine and methamphetamine among MSM was associated with incident HIV and anal chlamydia/gonorrhoea. HIV-negative MSM engaging in SDU should be advised to use HIV pre-exposure prophylaxis, and all MSM engaging in SDU should be advised to have STD screening regularly. We suggest counselling on STDs among MSM engaging in SDU.

Evaluation of the Approach, Awareness and Practices on Sexually Transmitted Diseases among Medical Students at KIU Western Campus, Ishaka Town Bushenyi District, Uganda.

Sexually transmitted diseases (STDs) still remain a great public health problem of major significance in most parts of the world. The incidence of acute STD is believed to be high among sexually active adolescents worldwide due to changes and development in their lives. The study aims at establishing the attitude, knowledge and practices on STDS among students studying at Kampala International University Western Campus in Ishaka town. The study aims at establishing the attitude, knowledge and practices on STDS among students studying at Kampala International University Western Campus in Ishaka town. A great percentage of anticipated respondents participated in this study making the response rate 96%. Among these respondents (65%) were males and (35%) were females. The age distribution of the respondents showed that most of the respondents (50%) were between 20- 25 years old. Respondents (50%) were followers of the Catholic faith and followed other religions. The majority (76%) of the respondents were living near campus and (24%) of them are from rural areas. The majority of (60%) of respondents were single, and others were in a relationship. During the study period (70.9%) of the respondents were living in a hostel, (15.6%) were living in a rented house, and (13.5%) were living in another relative house. Most of the respondents have knowledge about STIs, but there are still misconceptions and their practice remained quite low. Keywords: STDs, Sexually active adolescents, Females, Sexual transmission infection, Health institutes.

Development and comparison of predictive models for sexually transmitted diseases-AIDS, gonorrhea, and syphilis in China, 2011-2021.

BackgroundAccurate incidence prediction of sexually transmitted diseases (STDs) is critical for early prevention and better government strategic planning. In this paper, four different forecasting models were presented to predict the incidence of AIDS, gonorrhea, and syphilis.MethodsThe annual percentage changes in the incidence of AIDS, gonorrhea, and syphilis were estimated by using joinpoint regression. The performance of four methods, namely, the autoregressive integrated moving average (ARIMA) model, Elman neural network (ERNN) model, ARIMA-ERNN hybrid model and long short-term memory (LSTM) model, were assessed and compared. For 1-year prediction, the collected data from 2011 to 2020 were used for modeling to predict the incidence in 2021. For 5-year prediction, the collected data from 2011 to 2016 were used for modeling to predict the incidence from 2017 to 2021. The performance was evaluated based on four indices: mean square error (MSE), mean absolute error (MAE), and mean absolute percentage error (MAPE).ResultsThe morbidities of AIDS and syphilis are on the rise, and the morbidity of gonorrhea has declined in recent years. The optimal ARIMA models were determined: ARIMA(2,1,2)(0,1,1)12, ARIMA(1,1,2)(0,1,2)12, and ARIMA(3,1,2)(1,1,2)12 for AIDS, gonorrhea, and syphilis 1-year prediction, respectively; ARIMA (2,1,2)(0,1,1)12, ARIMA(1,1,2)(0,1,2)12, and ARIMA(2,1,1)(0,1,0)12 for AIDS, gonorrhea and syphilis 5-year prediction, respectively. For 1-year prediction, the MAPEs of ARIMA, ERNN, ARIMA-ERNN, and LSTM for AIDS are 23.26, 20.24, 18.34, and 18.63, respectively; For gonorrhea, the MAPEs are 19.44, 18.03, 17.77, and 5.09, respectively; For syphilis, the MAPEs are 9.80, 9.55, 8.67, and 5.79, respectively. For 5-year prediction, the MAPEs of ARIMA, ERNN, ARIMA-ERNN, and LSTM for AIDS are 12.86, 23.54, 14.74, and 25.43, respectively; For gonorrhea, the MAPEs are 17.07, 17.95, 16.46, and 15.13, respectively; For syphilis, the MAPEs are 21.88, 24.00, 20.18 and 11.20, respectively. In general, the performance ranking of the four models from high to low is LSTM, ARIMA-ERNN, ERNN, and ARIMA.ConclusionThe time series predictive models show their powerful performance in forecasting STDs incidence and can be applied by relevant authorities in the prevention and control of STDs.

Impact of COVID-19 pandemic on the epidemiology of STDs in China: based on the GM (1,1) model

BackgroundCOVID-19 and Sexually Transmitted Diseases (STDs) are two very important diseases. However, relevant researches about how COVID-19 pandemic has impacted on the epidemiological trend of STDs are limited in China. This study aimed to analyze the impact of COVID-19 on STDs in China and proposed relevant recommendations to be used in bettering health.MethodsThe incidence of HIV infection, syphilis and gonorrhea in China from 2008 to 2020 were collected. Grey Model (1,1) were established to predict the incidence of STDs with the incidence data of these three STDs from 2013 to 2018 considering the impact of policies in China, respectively. We then calculated the predictive incidence of each STD in 2019, 2020 and 2021 by the established Model. And we estimated the extent of the impact of COVID-19 on the epidemiological changes of STDs by analyzing the difference between the absolute percentage error (APE) of the predictive incidence and actual rate in 2019 and 2020.ResultsThe incidence of HIV infection and syphilis showed a trend of increase from 2008 to 2019 in China, but that for gonorrhea was fluctuant. Of note, the incidence of these three STDs decreased significantly in 2020 compared with that in 2019. The APE of HIV infection, syphilis and gonorrhea in 2020 (20.54%, 15.45% and 60.88%) were about 7 times, 4 times and 2 times of that in 2019 (2.94%, 4.07% and 30.41%). The incidence of HIV infection, syphilis and gonorrhea would be 5.77/100,000, 39.64/100,000 and 13.19/100,000 in 2021 based on our model.ConclusionsThe epidemiological trend of STDs in China was significant influenced by COVID-19 pandemic. It is important to balance the control of COVID-19 and timely management of STDs during the COVID-19 epidemic to prevent or reduce the poor outcome among COVID-19 patients with STDs. New management strategies on STDs, such as leveraging social media, online medical care, rapid self-testing, timely diagnosis and treatment guarantee and balance of medical resources for STDs management should be adapted in the context of the long-term effects of COVID-19.

Analytic approaches to assess the impact of local spending on sexually transmitted diseases.

To compare the estimated associations between annual sexually transmitted diseases (STD) expenditures per capita and STD incidence rates among Florida and Washington local health departments (LHDs) from 2001 to 2017, using two approaches-a longitudinal regression model with lagged STD spending and a regression model with the Arellano-Bond panel estimator. Secondary data for LHDs were obtained from Florida and Washington state government offices and combined with county sociodemographic and health system data from the federal government. We examined LHDs in Florida and Washington using a longitudinal panel study design to estimate ecological relationships between annual STD expenditures per capita and annual STD incidence rates from 2001 to 2017, with LHDs as the unit of analysis. We compared two regression models: generalized estimating equations (GEE) and the Arellano-Bond panel estimator (an instrumental variable approach). The secondary data were combined to build a longitudinal panel database for LHDs in Florida and Washington from 2001 to 2017. In the GEE model with both states, greater STD spending in a prior year was associated unexpectedly with greater STD incidence rates in succeeding years. The Arellano-Bond models for both states had the expected inverse associations but were not significant. In the Arellano-Bond models for Florida, a $1 increase in STD spending in previous years was followed by decreases in STD incidence rates ranging between 29 and 58 points in succeeding years (0.09 ≥ p ≥ 0.04). In longitudinal panel data for LHDs in two states, the Arellano-Bond estimator, or other instrumental variable approach, is preferred over conventional regression models to obtain unbiased estimates of the relationship between annual STD spending rates and annual STD rates. Future studies will require accurate, standardized, and detailed longitudinal data and rigorous analytic approaches, such as those illustrated in our study.

Bacterial sexually transmitted infections

Sexually transmitted diseases (STD) are among the most frequent infectious diseases worldwide, representing an important public health issue. Sexually transmitted di­­sea­ses comprise a large range of infections caused by bac­te­­ria, viruses and parasites, transmitted during sexual in­ter­course (vaginal, oral or anal) with an infected person. In the last 30 years, STD incidence has increased globally, in the context of financial reduction in this domain and of concurrent priorities in public healthcare systems, the ac­cess to the supervision and prevention of this type of in­­fec­­tions being restricted. Among the bacterial sexually trans­­mitted infections, the most frequent are chlamydiosis, caused by Chlamydia trachomatis, gonorrhea, caused by Neisseria gonorrhoeae, and syphilis, caused by Treponema pallidum. Left untreated, these infections can have serious health consequences on the long term for those affected and for their partners, even life-threatening. In this con­text, the development of new innovative strategies for tes­ting and supervision of STD, along with increasing aware­ness regarding the way these diseases influence our life are essential for the prevention and treatment of these in­fec­tions.

Prevalence of Sexually Transmitted Diseases in Men of 25 - 60 Years in Iran

Background: Sexually transmitted diseases (STDs), especially in men, can lead to multiple morbidities and facilitate the transmission of serious pathogens, such as the human immunodeficiency virus. The present study used the data from a nationwide survey on male morbidities to estimate the prevalence of STDs among men in Iran. Methods: This cross-sectional study used the data from a nationwide project on male reproductive morbidities in 2007. A total of 2296 men within the age range of 25 - 60 years were recruited by systematic cluster sampling from four provinces (i.e., Golestan, Hormozgan, Kermanshah, and Isfahan, Iran). The data on the symptoms of STDs, including genital secretion, pushing out, itching or genital ulcers, and lymphadenopathy of the inguinal area after sexual contact, were collected by trained urologists. Data analysis was carried out using SPSS software (version18.0, Chicago, IL, USA). The independent samples t-test and chi-square test were used for data analysis. Results: A total of 2296 men with a mean age value of 39.95 ± 10.3 years were interviewed in this study. Two-thirds of all the subjects (75%) were aware of using condoms in suspected sexual relationships; however, only 69% of the aforementioned subjects used condoms in those circumstances. Overall, 14 subjects (0.6%) had one type of STDs at the study time. Moreover, 110 subjects (4.7%) answered “yes” to the question of whether they were referred to a physician for sexual problems. Conclusions: The prevalence of STDs is still low among the male population in Iran. Careful and well-designed surveillance systems to monitor the incidence of STDs and proper preventive measures to restrict the spread of sexually transmitted pathogens are among the proposed recommendations.

The impact of the coronavirus disease 2019 epidemic on notifiable infectious diseases in Taiwan: A database analysis

IntroductionThe impact of the COVID-19 pandemic on the incidence of notifiable infectious diseases (NIDs) in Taiwan remains unclear. Materials and methodsThe number of cases of NID (n = 42) between January and September 2019 and 2020 were obtained from the open database from Taiwan Centers for Disease Control. ResultsThe number of NID cases was 21,895 between January and September 2020, which was lower than the number of cases during the same period in 2019 (n = 24,469), with a decline in incidence from 102.9 to 91.7 per 100,000 people in 2019 and 2020, respectively. Fourteen airborne/droplet, 11 fecal-oral, seven vector-borne, and four direct-contact transmitted NID had an overall reduction of 2700 (−28.1%), 156 (−23.0%), 557 (−54.8%), and 73 (−45.9%) cases, respectively, from 2019 to 2020. Similar trends were observed for the changes in incidence, which were 11.5 (−28.4%), 6.7 (−23.4%), 2.4 (−55.0%), and 0.3 (−46.2%) per 100,000 people for airborne/droplet, fecal-oral, vector-borne, and direct-contact transmitted NID, respectively. In addition, all the 38 imported NID showed a reduction of 632 (−73.5%) cases from 2019 to 2020. In contrast, 4 sexually transmitted diseases (STDs) showed an increase of 903 (+7.2%) cases from 2019 to 2020, which was attributed to the increase in gonorrhea (from 3220 to 5028). The overall incidence of STDs increased from 52.5 to 56.0 per 100,000 people, with a percentage change of +6.7%. ConclusionThis study demonstrated a collateral benefit of COVID-19 prevention measures for various infectious diseases, except STDs, in Taiwan, during the COVID-19 epidemic.

Knowledges, attitudes and behaviors related to sexually transmitted diseases of male undergraduate students from three faculties of Chiang Mai University

Objectives To study differences in knowledge, risky behavior and attitudes related to sexually transmitted diseases in male undergraduate students from three faculties of Chiang Mai University. Methods This cross-sectional study surveyed 652 male undergraduate students from three faculties including 85 from Associated Medical Science (AMS), 480 from Engineering (ENG) and 87 from Economics (ECON) as representative of health sciences, science/technology, and social sciences/humanities, respectively. An online questionnaire was used to evaluate the students’ knowledge, risky behavior and attitudes related to sexually transmitted diseases (STDs). Descriptive statistics included one-way ANOVA and Spearman’s rank correlation coefficient. Results AMS male students had a higher average score for knowledge related to STDS than the other groups. There were, however, significant differences among AMS students to the questions, “Should parents teach appropriate sex education to their young children?” and “Do you think early STD screening is good?” (both p = 0.001). Positive correlations were found between self-reported alcohol drinking and visiting of entertainment places in all the groups (rAMS = 0.673, p < 0.001; rENG = 0.595, p < 0.001; rECON= 0.595, p < 0.001). Self-reported risky behavior was positively correlated with frequency of having sex during the past 2 months and alcoholic drinking (rAMS = 0.510 and = 0.409; rENG = 0.562 and = 0.345; rECON = 0.655 and = 0.259, respectively. All were p < 0.001) Conclusions Male health sciences students possessed higher knowledge, reported lower risk behaviors, and expressed more positive attitudes toward individuals with STDs than the other groups. Providing knowledge about STDs and encouraging abstinence from alcohol should be used to reduce the incidence of risky behavior and the incidence of STDs among male university undergraduates.

Trend Analysis of the Profiles of 12 Sexually Transmitted Disease Pathogens in the Republic of Korea in 2019.

Background: Sexually transmitted diseases (STDs) are common infectious diseases in humans transmitted through unprotected sexual activities. In South Korea, despite the high annual incidence of STDs, detailed examinations of pathogen-specific factors and causes for delays in diagnosis and treatment are still lacking. Furthermore, STD prevalence patterns and important pathogen-specific factors remain unclear. Herein, we retrospectively analyzed the epidemiology of STDs in South Korea in 2019 by analyzing the association of pathogen-specific infection patterns with factors such as sex, age, region, and month. Methods: We obtained the STD test results of 172,973 individuals from the Seoul Clinic Laboratory in 2019, most of whom had multiple infections; hence, 275,296 STD-positive cases were included in this analysis. Through deoxyribonucleic acid (DNA) amplification, they were categorized by pathogen type. Subsequently, they were further classified by month, region, and age while concurrently being stratified according to sex. Results: Among the 12 pathogens detected in this study, Gardnerella vaginalis had the highest prevalence, with 92,490 cases in both sex groups; moreover, many of them were concurrently infected by two or more pathogens. The prevalence of STDs did not differ according to month or region. Conversely, the pathogen-specific prevalence rates significantly differed according to age. Older adults had higher prevalence rates of Chlamydia trachomatis, Trichomonas vaginalis, Candida albicans, and herpes simplex virus type 1 infections than younger adults. Conclusion: These pathogen-specific prevalence patterns provide information that helps to understand population vulnerability according to region and age and helps develop STD prevention and treatment strategies in South Korea.

KNOWLEDGE, ATTITUDES, RISK BEHAVIOURS AND PREVENTIVE PRACTICES ON SEXUALLY TRANSMITTED DISEASES AMONG STUDENTS IN A PUBLIC UNIVERSITY IN MALAYSIA

Increased rates of sexually transmitted diseases (STDs) among young adults between the ages of 15 and 24 years old had been one of the major concerns of the world. For each of the 20 million new recorded STDs cases, people within those age group were responsible for more than 50% of them. This cross-sectional study was done to determine the knowledge, attitudes, risky behaviours and preventive practices related to sexually-transmitted diseases (STDs) among undergraduate students in a public university in Malaysia. A total of 1327 university students aged between 19 and 27 years were surveyed by using a self-administered questionnaire. The majority (75.1%) had good knowledge on STDs, and a significant number of students (53.8%) had acceptable preventive practice. Marital status was associated not only to the students’ level of knowledge but also with their preventive practices. Despite having a good knowledge of STDs, students in Science and Technology academic cluster perceived unacceptable preventive practices. This study highlighted some misconceptions about STDs, preventive practices and risky behaviours, raising concerns about a likely future rise in STD incidence. Therefore, interventions to implement strengthened health education on STD-related issues were required to bring change in practices, along with knowledge and attitudes.

The Impact of the Coronavirus Disease 2019 Epidemic on the Status of Notifiable Infectious Diseases in Taiwan

Background: The impact of the COVID-19 pandemic on the incidence of notifiable infectious diseases (NID) in Taiwan remains unclear. Methods: The number of cases of NID between January and September 2019 and 2020 were obtained from the open database established by the Taiwan Centers for Disease Control for comparison. Percentage change was defined as the difference in the number of cases between 2020 and 2019, divided by the number in 2019 and multiplied by 100. Findings: Overall, 42 NID were included in this study. The number of cases was 21,895 between January and September 2020, which was lower than the number of cases during the same period in 2019 (n = 24,469), with a decline in incidence from 102.9 to 91.7 per 100,000 people in 2019 and 2020, respectively. Among these diseases, 30 infectious diseases showed a lower incidence in 2020 than in 2019. In contrast, an increase in the number of cases of 10 diseases was observed in 2020 in comparison with 2019, and 2 diseases had the same number of cases in both 2019 and 2020. Fourteen airborne/droplet, 11 fecal-oral, seven vector-borne, and four direct-contact transmitted NID had an overall reduction of 2,700 (-28.1%), 156 (-23.0%), 557 (-54.8%), and 73 (-45.9%) cases, respectively, from 2019 to 2020. Similar trends were observed for the changes in incidence, which were 11.5 (-28.4%), 6.7 (-23.4%), 2.4 (-55.0%), and 0.3 (-46.2%) per 100,000 people for airborne/droplet, fecal-oral, vector-borne, and direct-contact transmitted NID, respectively. In addition, all the 38 imported NID showed a reduction of 632 (-73.5%) cases from 2019 to 2020. In contrast, 4 sexually transmitted diseases (STDs) showed an increase of 903 (+7.2%) cases from 2019 to 2020, which was attributed to the increase in gonorrhea (from 3,220 to 5,028). The overall incidence of STDs increased from 52.5 to 56.0 per 100,000 people, with a percentage change of +6.7%. Interpretation: This study demonstrated a collateral benefit of COVID-19 prevention measures for various infectious diseases, except STDs, in Taiwan, during the COVID-19 epidemic.Funding Statement: This study did not receive any specific funding from agencies in the public, commercial, or not-for-profit sectors.Declaration of Interests: The authors have no competing interests.

Analysis on Neisseria gonorrhoeae infection status and related factors in outpatients of sexually transmitted diseases in Shenzhen

Objective: To understand the prevalence of Neisseria gonorrhoeae (NG) infection and related factors in outpatients of sexually transmitted disease (STD) in Shenzhen and provide scientific evidence for targeted intervention. Methods: A cross-sectional study was conducted in STD outpatients who were aged 18-49 years, had had sexual intercourse, had not received antibiotics in the last 2 weeks and sought medical cares in 22 medical institutions in 6 districts of Shenzhen from 15 April, 2018 to 16 May, 2018, their basic information and urine samples were collected, and NG in urine sample was detected by nucleic acid amplification test. Logistic regression analysis was conducted to identify the related factors for NG infection. Results: The information collection and sample collection were completed for 8 324 STD outpatients, among these STD outpatients, 196 were NG positive, with a positive rate of 2.4% (196/8 324). The positive rate of NG in men (5.8%, 148/2 567) was higher than that in women (0.8%, 47/5 742) (χ(2)=189.43, P<0.05). Aged 24 years or below (OR=2.11, 95%CI: 1.44-3.09), single/divorced/widowed (OR=1.98, 95%CI:1.38-2.84), having casual sex in the last 3 months (OR=1.77, 95%CI:1.29-2.43) were the related factors for NG infection. Conclusions: We found that NG infection rate was high in STD outpatients in Shenzhen. The infection rates in men and in women differed obviously. It is necessary to conduct gonorrhea screening and intervention in STD outpatients with high-risk behaviors, such as extramarital and casual sex behaviors, and standardize the treatment to reduce the incidence and spread of gonorrhea and other STDs.

1285. PrEP Acceptability, Uptake, and Adherence Among Young Men Who Have Sex with Men and Transgender Women in PrEP Demonstration Project, Chiang Mai, Thailand

BackgroundYoung men who have sex with men (YMSM) and transgender women (YTGW) are at high risk for HIV acquisition. In attempt to end the HIV epidemic, the comprehensive HIV prevention packages should be offered. However, the PrEP persistent among this population in western studies was low. The acceptability, uptake and persistent among Thai YMSM/YTGW PrEP clients were explored.MethodsThis is a sub-study of PrEP implementation project in Chiang Mai Thailand which was conducted during December 2015–February 2017. In the main study, PrEP@PIMAN, 105 participants who were 18 years and older, able to read and write in Thai, creatinine clearance ≥60 mL/minute, negative urine protein, and HBs-Ag-negative YMSM/YTGW were enrolled. Twelve months of PrEP along with quarterly visit and comprehensive HIV prevention package were offered. The data were collected through interview and computer-assisted self-interview. Each participant voluntary made their own decision about PrEP uptake.ResultsSixty participants (57% of the main study) were youth, aged 16–24 years old. Of those, 82% were gay men and 12% were TGW (self-identified). Mean age was 21 years old and 80% were university/college students. At baseline, median partner in past 3 month was 3 (range 0–52). Approximately one-fourth of the participants reported history of sexually transmitted diseases (STDs) and 8% has positive TPHA at baseline. Majority (72%) initiated PrEP with 70% at the enrollment 2% during the study. PrEP was discontinued in 25% (10/42) due to nonserious side effects, participant preference or lost to follow-up (see Figure 1). The retention rate at 12 month were 70%. PrEP use was not consistent (see Figure 2). Only 30% reported adherence ≥60% (or equivalent to ≥4 pills/ week) throughout the study period. There was no seroconversion during 49 person-year of follow-up with 5 confirmed new STDs (incidence of 10/100 person-year).ConclusionThis project demonstrated a good uptake with varying PrEP adherence rate among Thai YMSM and YTGW. The PrEP persistent was persistence could be improved. Further interventions and strategies should be explored to enhance PrEP adherence among this population. Disclosures All authors: No reported disclosures.

430. Impact of a Pharmacist-Managed Sexually Transmitted Disease (STD) Test Result Review Service at a Veterans Affairs Medical Center

BackgroundThe CDC recommends annual STD screenings in all sexually active women ³25 years old and men who have sex with men. Given the increased incidence of STDs and the need to improve their management, in September 2018 infectious diseases clinical pharmacists implemented a pharmacist-managed STD quality improvement project (QI) that reviewed positive STD test results with feedback to providers. We present the results of this QI project below.MethodsThe QI project consisted of prospective, daily reviews of all positive chlamydia, gonorrhea or syphilis tests (post-implementation period: 9/2018 to 2/2019). Patient electronic medical records were reviewed and assessed for the need for additional laboratory tests and to determine whether appropriate treatment was received, with feedback provided to the primary provider. In addition, risk factors were assessed to determine the appropriateness of human immunodeficiency virus (HIV) Pre-Exposure Prophylaxis (PrEP). A retrospective review of positive STD results from 9/2017 to 2/2018 was also conducted (pre-implementation period) for comparison. The purpose of this project was to evaluate the impact of pharmacist test result review on the appropriate testing, review appropriateness of prescribed treatments of patients diagnosed with any STD according to accepted clinical guidelines, and to inform the need for and the areas of focus for educating providers in the emergency room and primary care clinics on the management of these patients. Descriptive statistics, Chi square, and Fisher’s exacts tests were used to analyze the outcomes of the project.ResultsA total of 144 patients were included in the project (pre-implementation, n = 47; post-implementation n = 74). Please refer to the table for other results.ConclusionThe implementation of a pharmacist-managed STD test review service decreased time to treatment and time to STD test result review. More patients in the post-implementation period received appropriate therapy compared with patients in the pre-intervention period. These findings indicate that there is a role for a pharmacist-managed STD test review service in assisting providers with quickly and appropriately connecting patients to care. Disclosures All authors: No reported disclosures.

Trends in the Epidemiology of Sexually Transmitted Disease, Acquired Immune Deficiency Syndrome (AIDS), Gonorrhea, and Syphilis, in the 31 Provinces of Mainland China.

BackgroundThis study aimed to investigate trends in the epidemiology of the leading sexually transmitted diseases (STDs), acquired immune deficiency syndrome (AIDS), gonorrhea, and syphilis, in the 31 provinces of mainland China.Material/MethodsThis retrospective study analyzed the incidence data of STDs from official reports in China between 2004 and 2016. The grey model first order one variable, or GM (1,1), time series forecasting model for epidemiological studies predicted the incidence of STDs based on the annual incidence reports from 31 Chinese mainland provinces. Hierarchical cluster analysis was used to group the prevalence of STDs within each province.ResultsThe prediction accuracy of the GM (1,1) model was high, based on data during the 13 years between 2004 and 2016. The model predicted that the incidence rates of AIDS and syphilis would continue to increase over the next two years. Cluster analysis showed that 31 provinces could be classified into four clusters according to similarities in the incidence of STDs. Group A (Sinkiang Province) had the highest reported prevalence of syphilis. Group B included provinces with a higher incidence of gonorrhea, mainly in the southeast coast of China. Group C consisted of southwest provinces with a higher incidence of AIDS.ConclusionsThe GM (1,1) model was predictive for the incidence of STDs in 31 provinces in China. The predicted incidence rates of AIDS and syphilis showed an upward trend. Regional distribution of the major STDs highlights the need for targeted prevention and control programs.

Analysis of Sexually Transmitted Diseases Within the Patient Population at a Student-Run Free Clinic.

Uninsured patients living in rural areas of North Carolina have been inordinately affected by the increasing prevalence of sexually transmitted diseases (STDs) in the midst of severe budget cuts to treatment programs and a shortage of rural primary care physicians. The Campbell University Community Care Clinic, a self-funded, student-run clinic, provides free health care to uninsured residents of rural Harnett County. As a relatively new clinic serving a unique population, epidemiologic research is paramount to the clinic's continued efficacy. To determine which STDs are present in this patient population and to identify demographic groups at higher risk of contracting STDs. This study was a retrospective analysis of patient medical records from March 1, 2015, to March 6, 2018. Records were evaluated to identify STD cases based on diagnostic information, such as primary diagnoses, positive laboratory results, and clinical indicators. A total of 449 patient records were analyzed, revealing an STD incidence rate of 5.3%, which represents a higher STD frequency than the national average of 2%. Our results identified human papillomavirus infection and gonorrhea as the most frequent STDs (n=7 [29.2%] and n=6 [25%], respectively), followed by chlamydia (n=4 [16.7%]), herpes simplex virus (n=4 [16.7%]), syphilis (n=2 [8.3%]), hepatitis C virus (n=2 [4.2%]), trichomoniasis (n=1 [4.2%]), and HIV (n=1 [4.2%]) infections. Among racial/ethnic groups, Hispanics had a slightly higher relative risk (RR) for STDs by a factor of 1.3 when normalized to the average frequency. Patients aged 26 to 29 and 30 to 39 years had a significantly higher RR for STDs: 2.1 and 2.0, respectively. Furthermore, female patients had an STD frequency 3 times that of male patients. This study reveals noteworthy health risks in a rural uninsured population, including a higher rate of gonorrhea compared with national rates and a higher RR for STDs in certain demographic groups. These findings form a foundation for improvements in care through earlier STD diagnoses, effective treatment, and enhanced patient education.

Methods for Sexually Transmitted Disease Prevention Programs to Estimate the Health and Medical Cost Impact of Changes in Their Budget.

The purpose of this article was to describe methods that sexually transmitted disease (STD) programs can use to estimate the potential effects of changes in their budgets in terms of disease burden and direct medical costs. We proposed 2 distinct approaches to estimate the potential effect of changes in funding on subsequent STD burden, one based on an analysis of state-level STD prevention funding and gonorrhea case rates and one based on analyses of the effect of Disease Intervention Specialist (DIS) activities on gonorrhea case rates. We also illustrated how programs can estimate the impact of budget changes on intermediate outcomes, such as partner services. Finally, we provided an example of the application of these methods for a hypothetical state STD prevention program. The methods we proposed can provide general approximations of how a change in STD prevention funding might affect the level of STD prevention services provided, STD incidence rates, and the direct medical cost burden of STDs. In applying these methods to a hypothetical state, a reduction in annual funding of US $200,000 was estimated to lead to subsequent increases in STDs of 1.6% to 3.6%. Over 10 years, the reduction in funding totaled US $2.0 million, whereas the cumulative, additional direct medical costs of the increase in STDs totaled US $3.7 to US $8.4 million. The methods we proposed, though subject to important limitations, can allow STD prevention personnel to calculate evidence-based estimates of the effects of changes in their budget.