Past Sexually Transmitted Infections Research Articles

Knowledge on sexually transmitted infections and dedicated healthcare centers among Italian adults: insights from a nationwide cross-sectional study.

Sexually transmitted infections (STI) are a global concern. In Italy, despite the presence of publicly funded STI diagnostic centers, limited attention has been given to the knowledge of these services among the adult population. This study primarily aimed to evaluate Italian adults' knowledge about STI and dedicated healthcare centers. Secondarily, it explored condom usage behaviors. Conducted nationwide, this cross-sectional study employed an online questionnaire. The primary outcomes included knowledge of dedicated STI centers and scores on the Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ); secondary outcomes included inconsistent condom usage rates during various forms of intercourse. With a participant count of 1036, results indicated that only 36% were aware of dedicated STI centers. The median STD-KQ score was 11 (IQR = 6-15). Multivariable regression models unveiled factors significantly associated with knowledge. LGBTQ individuals, healthcare workers, and those with higher STD-KQ scores exhibited greater STI centers' awareness. Better STD-KQ scores correlated with higher education levels, substance use, past STI diagnosis, and healthcare employment. Around 80% of the sample reported inconsistent condom use during different forms of intercourse. While enhanced knowledge correlated with increased condom use, certain groups exhibited discrepancies between knowledge of STI and actual condom use. These findings emphasize the need for targeted awareness campaigns to enhance accessibility to STI centers, underscoring the necessity for multifaceted interventions beyond information dissemination to address suboptimal condom usage. In providing insights into STI knowledge and behaviors among Italian adults, this research informs interventions and policy adjustments to combat STI.

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 <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 <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.

Using Machine Learning to Identify Predictors of Sexually Transmitted Infections Over Time among Young People Living with or At Risk for HIV Who Participated in ATN Protocols 147, 148, and 149.

Sexually transmitted infections (STI) among youth aged 12-24 years old have doubled in the last 13 years, accounting for 50% of STI nationally. We need to identify predictors of STI among youth in urban HIV epicenters. Sexual and gender minority (SGM; gay, bisexual, transgender, gender-diverse) and other youth with multiple life stressors (homelessness, incarceration, substance use, mental health disorders) were recruited from 13 sites in Los Angeles and New Orleans (N = 1482). Self-reports and rapid diagnostic tests for STI, HIV, and drug use were conducted at 4-month intervals for up to 24 months. Machine learning was used to identify predictors of time until new STI (including a new HIV diagnosis). At recruitment, 23.9% of youth had a current or past STI. Over 24 months, 19.3% tested positive for a new STI. Heterosexual males had the lowest STI rate (12%); African-American youth were 23% more likely to acquire an STI compared to peers of other ethnicities. Time to STI was best predicted by attending group sex venues or parties, moderate but not high dating app use, and past STI and HIV seropositive status. STI are concentrated among a subset of young people at highest risk. The best predictors of youth's risk are their sexual environments and networks. Machine learning will allow the next generation of research on predictive patterns of risk to be more robust.

Psychological Distress as a Primer for Sexual Risk Taking Among Emerging Adults

Emerging adults experience increased morbidity as a result of psychological distress and risky sexual behavior. This study examines how sexual behaviors (e.g., condom use inconsistency and past year STI history) differ among emerging adults with low, moderate, and high psychological distress. Participants are 251,254 emerging adults attending colleges and universities in the United States who participated in the National College Health Assessment (NCHA). Findings suggest a dose-response relationship between psychological distress, condom use inconsistency, and past STI history, such that an association between greater psychological distress and condom use inconsistency and/or past year history of sexually transmitted infections (STIs).

Hepatitis B prevalence association with sexually transmitted infections: a systematic review and meta-analysis.

We conducted a systematic review and meta-analysis. PubMed, Embase, and Web of Science from 1982 to 2018 were searched using medical subject headings (MeSH) terms for HBV, STIs and epidemiology. We included studies conducted in Organisation for Economic Cooperation and Development countries or Latin America that permit the calculation of prevalence ratios (PRs) for HBV and STIs and extracted PRs and counts by HBV and STI status. Of 3144 identified studies, 43 met inclusion requirements, yielding 72 PRs. We stratified outcomes by HBV sero-markers [surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), combined], STI pathogen (syphilis, gonorrhoea/chlamydia, unspecified), and STI history (current, past) resulting in 18 potential outcome groups, for which results were available for 14. For the four outcome groups related to HBsAg, PR point estimates ranged from 1.65 to 6.76. For the five outcome groups related to anti-HBc, PRs ranged from 1.30 to 1.82; and for the five outcome groups related to combined HBV markers, PRs ranged from 1.15 to 1.89). The median HBsAg prevalence among people with a current or past STI was 4.17; not all studies reported HBsAg. Study settings and populations varied. This review found evidence of association between HBV infection and current or past STIs.

Sexual behaviour patterns and STI risk: results of a cluster analysis among men who have sex with men in Portugal

ObjectivesPortugal has the highest HIV incidence rate in Western Europe. The proportion assigned to sexual contact between men recently increased to more than 30% of all HIV infections. Men who...

1541. Prevalence of Asymptomatic Sexually Transmitted Infections (STIs) in a Philadelphia Ryan White HIV population

BackgroundIn 2018, Philadelphia County ranked 7th, 8th and 16th for chlamydia (CT), gonorrhea (GC), and syphilis cases, respectively, in the Centers for Disease Control (CDC) STI Surveillance Report. Asymptomatic presentations and lack of routine screening, especially at extragenital (i.e., pharyngeal and rectal) sites, increase the challenge of timely diagnosis and treatment. We determined extent of screening, reported symptoms, and asymptomatic infections.MethodsWe analyzed records of 372 patients receiving care at an urban, university-based Ryan White HIV clinic from 2016-2018. Outcomes included: positive GC/CT nucleic acid amplification tests from genital, pharyngeal, and rectal sites as well as new diagnoses of syphilis. We collected demographic data, risk factors for HIV transmission, time from HIV diagnosis, number of clinic visits, multiple sex partners, partner with STI, and injection drug use. We used logistic regression to model factors associated with STIs and determined prevalence of asymptomatic STIs.ResultsOf 372 participants, 234 (63%) were men, 262 (70%) were Black, 245 (66%) were over 40 years old, 148 (40%) identified as MSM, 140 (38%) reported inconsistent condom use, 89 (24%) reported multiple sex partners, 35 (9%) reported injection drug use, 141 (38%) had past STI, and 26 (7%) had partner with past STI. Mean time from HIV diagnosis was 12.3 years (SD, 8.8) and mean number of clinic visits was 2/year. Testing included 720 GC/CT urine, 176 GC/CT pharyngeal, 143 GC/CT rectal swabs and 887 syphilis blood tests. Asymptomatic GC/CT infections were seen in urine 6/22 (27%), pharyngeal 12/14 (86%) and rectal 28/31 (90%) swabs. And, of 39 new diagnoses of syphilis, 23 (59%) were asymptomatic. In multivariate analysis, men (aOR, 12.2, 95%CI, 2.7-55.3), < 40 years (3.2, 1.7-6.1), with clinic visit in 2018 (1.4, 1.2-1.8), and partner with STI (1.7, 0.9-2.8) were more likely to have a positive GC/CT test. Patients with positive syphilis test were more likely men (4.6, 1.1-20.2), with multiple sex partners (3.7, 1.7-8.0), and more recent HIV diagnosis (1.1, 1.0-1.1).Prevalence of Asymptomatic STIs ConclusionResults indicate the importance of routine, site-specific STI screening among patients living with HIV. Our findings can inform screening strategies among urban HIV populations.Disclosures All Authors: No reported disclosures

Correlates of HIV, STI and TB among sub-Saharan African migrants in Lisbon: a biobehavioral study

Abstract Sub-Saharan African migrants (SAMs) have been disproportionately affected by infectious diseases such as HIV, other sexually transmitted infections (STIs) and Tuberculosis infection (TB). Research on infectious diseases and related factors among migrant populations is critical to further understand these populations' health needs and inform prevention strategies. However, migrants are often underrepresented in national statistics and research. This study aimed to examine correlates of HIV, past STI and past TB among SAMs. A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Uni- and multivariable logistic regression analyses were performed to examine factors associated with HIV, past STI and past TB. Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive increased by age (OR 1.07, 95%CI 1.03-1.11) and were higher among those who experienced violence from a partner (OR 2.77, 95%CI 1.08-7.10). Increased odds of having a past STI were found among migrants with low income (OR 2.86, 95%CI 1.48-5.56), long-term migrants (&amp;gt;25 years residing in Portugal: OR 2.16, 95%CI 1.06-4.38) and those who reported sexual risk behaviors (≥3 sexual partners: OR 2.06, 95%CI 1.14-3.70; inconsistent condom use: OR 2.61, 95%CI 1.32-5.17). In total, 4.1% of participants had TB in the past; these were more likely male (OR 3.42, 95%CI 1.29-9.06) and HIV positive (OR 11.48, 95%CI 4.55-28.94). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past. Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases. Key messages High levels of HIV, STI and TB infection among SAMs were found to be strongly associated with socioeconomic disadvantage and poor living conditions in the host country. Social inequalities are persistently a major factor affecting risk for HIV, STIs and TB, and thus addressing social determinants of infectious diseases must remain a public health priority.

Serologic markers of Chlamydia trachomatis and other sexually transmitted infections and subsequent ovarian cancer risk: Results from the EPIC cohort.

A substantial proportion of epithelial ovarian cancer (EOC) arises in the fallopian tube and other epithelia of the upper genital tract; these epithelia may incur damage and neoplastic transformation after sexually transmitted infections (STI) and pelvic inflammatory disease. We investigated the hypothesis that past STI infection, particularly Chlamydia trachomatis, is associated with higher EOC risk in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort including 791 cases and 1669 matched controls. Serum antibodies against C. trachomatis, Mycoplasma genitalium, herpes simplex virus type 2 (HSV-2) and human papillomavirus (HPV) 16, 18 and 45 were assessed using multiplex fluorescent bead-based serology. Conditional logistic regression was used to estimate relative risks (RR) and 95% confidence intervals (CI) comparing women with positive vs. negative serology. A total of 40% of the study population was seropositive to at least one STI. Positive serology to C. trachomatis Pgp3 antibodies was not associated with EOC risk overall, but with higher risk of the mucinous histotype (RR = 2.30 [95% CI = 1.22-4.32]). Positive serology for chlamydia heat shock protein 60 (cHSP60-1) was associated with higher risk of EOC overall (1.36 [1.13-1.64]) and with the serous subtype (1.44 [1.12-1.85]). None of the other evaluated STIs were associated with EOC risk overall; however, HSV-2 was associated with higher risk of endometrioid EOC (2.35 [1.24-4.43]). The findings of our study suggest a potential role of C. trachomatis in the carcinogenesis of serous and mucinous EOC, while HSV-2 might promote the development of endometrioid disease.

Predictors of Sexually Transmitted Infection Positivity Among Substance-Using Native American Adults.

Sexually transmitted infections (STIs) are a public health crisis with Native Americans suffering a high burden of disease. Studies across gender and racial/ethnic groups have found varying risk factors associated with STI positivity. Understanding how risk factors are associated with STI positivity can help design interventions for those most at risk. Participants were Native American binge substance using adults enrolled in a randomized controlled trial evaluating a brief intervention to increase STI screening and reduce sexual risk-taking behaviors. Participants completed a self-report assessment at baseline that included questions about sexual risk factors and STI testing behaviors and diagnosis. This analysis includes those who had ever completed an STI test at baseline. Bivariate and multivariate analyses using logistical regression were utilized to identify associations between risk factors and past STI diagnosis. A total of 193 people were included in the analysis. Over half (50.6%) of the participants had ever been diagnosed with an STI. Risk behaviors varied by gender. More women with a self-reported history of STI reported having sex with someone they thought had an STI, past experience of physical/sexual violence, and having passed out from drinking. Men with a self-reported history of STI were more likely to report past marijuana and other drug use. Among women with a self-reported history of STI, having sex with someone they thought had an STI was associated with STI positivity, whereas other drug use was associated with STI positivity among men with a self-reported history of STI. Findings provide information for those working to reduce STIs in Native Communities to better identify and design programs for those at highest risk for STIs. Additional studies examining gender dynamics and sexual risk taking among native adults are warranted.

Are Opportunities Being Missed? Burden of HIV, STI and TB, and Unawareness of HIV among African Migrants.

Sub-Saharan African migrants (SSAMs) have been disproportionately affected by infectious disease burden. We aimed to identify correlates of HIV, past sexually transmitted infection (STI) and past Tuberculosis infection (TB), as well as examine HIV seropositivity unawareness and testing history among SSAMs. A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive or having a past STI were higher among participants with low socioeconomic status and who experienced violence from a partner. Increased odds of having a past STI were also found among long-term migrants and those who reported sexual risk behaviors. In total, 4.1% of participants had TB in the past; these were more likely male and HIV positive. Unawareness of HIV-positive status was notably high (35%). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past. Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases.

The Sexual Health Needs of Adolescent Boys Involved in a Pregnancy

PurposeLittle is known about fatherhood in middle adolescence. To better understand their sexual health needs, we describe relationship characteristics, perception of masculinity, and associated sexually transmitted infection (STI) risk behaviors in a community-based sample of urban middle adolescent boys who have fathered a child or been involved with a pregnancy. MethodsWe used venue-based sampling to recruit 339 boys (aged 14–17 years) in neighborhoods with high STI prevalence. We administered a brief survey on sexual relationship and pregnancy history, STI risk, juvenile justice involvement, and masculinity. ResultsFifteen percent had either fathered a child or been involved with a pregnancy. In multivariate analysis, controlling for age and ethnicity, adolescent fathers were more likely to be involved with juvenile justice and engage in STI risk behaviors. These included condom nonuse and partner checking a cell phone. Although of borderline significance, older partners, past STI testing, and drug or alcohol use at last sex improved model fit. ConclusionAdolescent fathers have distinct relational and sexual health needs. Their specific needs should be targeted by prevention programs.

CCR5 HIV-1 receptor predominance in adult male prepuce; the major entry route for HIV-1 in indigenous black males in zambia?

HIV-1 entry requires not only CD4 molecule but also CCR5 (CD 195) and CXCR4 (CD 184) coreceptors. A number of randomised controlled trials in Africa have reported that male circumcision (MC) reduces the risk of HIV-1 acquisition by up to 60%. Other studies have reported that sexually transmitted infections (STIs) increase the risk of infection by HIV via an inflammatory recruitment of more HIV target cells to the foreskin. Our aim was to compare the density of HIV-1 co-receptors (CCR5 and CXCR4) in naïve penile prepuce of neonates and penile prepuce of adults with and without history of ulcerative STIs at Male Circumcision Centres in Lusaka, Zambia. Twenty (20) fresh foreskin samples were included: five (5) from neonates, ten (10) from adult males without history of ulcerative STIs and five (5) from adult males with a history of ulcerative STIs. Immediately following MC, fresh foreskin specimens were fixed using 10% normal buffered formalin and transported to University Teaching Hospital (UTH) where tissues were processed and stained with anti-CD 195 and anti-CD 184 antibodies. Neonatal penile foreskin co-receptor mean density for CCR5 and CXCR4 was 13±5.148/mm2 and 7±1.581/mm2 respectively. CCR5 mean density of adults without past history of ulcerative STIs was 42.1±11.874/mm2 while those with history of ulcerative STIs was 78.6±13.520/mm2. Densities of CCR5 were all statistically significant with both having Pvalue of 0.000. CXCR4 mean density was 18.6±4.812/mm2 in adults without past history ofulcerative STIs and 23.4±4.393/mm2 in those with history of ulcerative STIs giving an insignificant P-value of 0.084. It could be concluded that CCR5 co-receptors provide major entry route for HIV-1 in male adults and that CCR5 seemed to be mobilized more than CXCR4 to the prepuce during inflammation. This supports evidence that MC reduces CCR5 co-receptors for acquisition and transmission of R5 strains of HIV-1.Key words: HIV, CCR5, CD 195, CD 184.

Exploring psychosocial predictors of STI testing in University students

BackgroundTo explore university students’ Sexually Transmitted Infection (STI) testing knowledge, psychosocial and demographic predictors of past STI testing behaviour, intentions to have an STI test, and high risk sexual behaviour, to inform interventions promoting STI testing in this population.MethodsA cross-sectional, quantitative online survey was conducted in March 2016, recruiting university students from North East Scotland via an all-student email. The anonymous questionnaire assessed student demographics (e.g. sex, ethnicity, age), STI testing behaviours, sexual risk behaviours, knowledge and five psychological constructs thought to be predictive of STI testing from theory and past research: attitudes, perceived susceptibility to STIs, social norms, social fear and self-efficacy.ResultsThe sample contained 1294 sexually active students (response rate 10%) aged 18–63, mean age = 23.61 (SD 6.39), 888 (69%) were female. Amongst participants, knowledge of STIs and testing was relatively high, and students held generally favourable attitudes. 52% reported ever having an STI test, 13% intended to have one in the next month; 16% reported unprotected sex with more than one ‘casual’ partner in the last six months. Being female, older, a postgraduate, longer UK residence, STI knowledge, perceived susceptibility, subjective norms, attitudes and self-efficacy all positively predicted past STI testing behaviour (p < 0.01). Perceived susceptibility to STIs and social norms positively predicted intentions to have an STI test in the next month (p < 0.05); perceived susceptibility also predicted past high-risk sexual behaviour (p < 0.01).ConclusionsSeveral psychosocial predictors of past STI testing, of high-risk sexual behaviour and future STI intentions were identified. Health promotion STI testing interventions could focus on male students and target knowledge, attitude change, and increasing perceived susceptibility to STIs, social norms and self-efficacy towards STI-testing.

The role of venues in structuring HIV, sexually transmitted infections, and risk networks among men who have sex with men

BackgroundVenues form part of the sampling frame for time-location sampling, an approach often used for HIV surveillance. While sampling location is often regarded as a nuisance factor, venues may play a central role in structuring risk networks. We investigated individual reports of risk behaviors and infections among men who have sex with men (MSM) attending different venues to examine structuring of HIV risk behaviors. However, teasing apart ‘risky people’ from ‘risky places’ is difficult, as individuals cannot be randomized to attend different venues. However, we can emulate this statistically using marginal structural models, which inversely weight individuals according to their estimated probability of attending the venue.MethodsWe conducted a cross-sectional survey of 609 MSM patrons of 14 bars in San Diego, California, recruited using the Priorities for Local AIDS Control Efforts (PLACE) methodology, which consists of a multi-level identification and assessment of venues for HIV risk through population surveys.Results and discussionVenues differed by many factors, including participants’ reported age, ethnicity, number of lifetime male partners, past sexually transmitted infection (STI), and HIV status. In multivariable marginal structural models, venues demonstrated structuring of HIV+ status, past STI, and methamphetamine use, independently of individual-level characteristics.ConclusionsStudies using time-location sampling should consider venue as an important covariate, and the use of marginal structural models may help to identify risky venues. This may assist in widespread, economically feasible and sustainable targeted surveillance and prevention. A more mechanistic understanding of how ‘risky venues’ emerge and structure risk is needed.

Temporal Trends in Population Level Impacts of Risk Factors for Sexually Transmitted Infections Among Men Who Have Sex with Men, Heterosexual Men, and Women: Disparities by Sexual Identity (1998-2013).

Sexually transmitted infections (STIs) remain a significant public health problem worldwide. We aimed to describe the temporal trends and relative contributions of established risk factors to STIs among sexual health center attendees. This retrospective study included more than 90,000 individuals who attended a sexual health center in Sydney, Australia, during the period 1998-2013. Multivariable logistic regression models were used to identify the correlates of STI diagnoses for three groups: men who have sex with men (MSM), heterosexual men, and women separately. Trends in population attributable risk percentages (PAR%) were estimated to assess the relative contributions of the risk factors on STI diagnosis. STI diagnosis rates among sexual health clinic attendees increased by 75% from 16 to 28% among MSM and more than doubled among heterosexual men and women (7-15 and 5-12%, respectively). Inconsistent condom use, three or more sex partners, sex overseas, past STI diagnosis, and contact with an STI case collectively contributed 61, 74 and 55% of the STI diagnoses among MSM, heterosexual men and women, respectively. Increase in STI diagnosis associated with temporal trends in combined risk factors including condomless sex, multiple sex partners, past STI diagnosis, and contact with an STI case. Although the majority of the factors considered in this study have been significantly associated with STI positivity in all three groups, their overall population level contributions to the epidemic have changed substantially. Our results indicated significant disparities between the MSM and heterosexual men and women as well as sex-specific differences in terms of sexual behaviors.

Characteristics of pelvic inflammatory disease where no sexually transmitted infection is identified: a cross-sectional analysis of routinely collected sexual health clinic data

ObjectivesPelvic inflammatory disease (PID) occurs when pathogens, often sexually transmitted, ascend to the upper genital tract, yet a causative pathogen is not detected in a substantial proportion of diagnosed PID....

Continence Care Literature Review 2012

Continence Care Literature Review 2012

Women's preferences for testing and management of sexually transmitted infections among low-income New York City family planning clients

High prevalence of chlamydia in the USA persists despite efforts to annually screen women under the age of 26. Tailoring sexually transmitted infection (STI) services to client preferences may strengthen existing programmes. We report women's preferences for STI services from a family planning clinic in New York City serving low-income women. Seventy-eight percent (995/1275) of eligible women participated, with a mean age of 26 (SD±7). Ninety-one percent self-identified as Latina. Nineteen percent reported a past STI. Women preferred self-collection (65%) for testing to a speculum exam (20%); 15% had no preference. Women with a previous STI were more likely to prefer a pelvic exam to women with no previous STI (50% versus 32%, P < 0.01). Nearly all women (94%) preferred informing a sex partner about a positive STI test themselves, but 88% were willing to bring expedited partner therapy to a partner. Women were more likely to prefer third party partner notification if their last partner was casual rather than a main partner (14% versus 3%, respectively, P < 0.01). Forty-four percent of participants worried about physical violence after partner notification. Self-collecting specimens for screening was widely acceptable. Partner notification strategies should be based on understanding partnership status, including fears of violence.

Associations between partner violence perpetration and history of STI among HIV-infected substance using men in Russia

Studies document a significant association between victimization from intimate partner violence (IPV) and sexually transmitted infections (STIs) and HIV among substance using women in Russia and elsewhere, but no study has examined IPV perpetration and STI among Russian men or HIV-infected men in Eastern Europe. This study was designed to assess the association between lifetime history of IPV perpetration and STI (lifetime and current) among substance using HIV-infected men in Russia. Cross-sectional analyses were conducted with baseline data from 415 male participants enrolled in a randomized HIV intervention clinical trial [the HERMITAGE Study]. Participants were HIV-infected men reporting recent heavy alcohol use and unprotected sex in St. Petersburg, Russia. Baseline surveys assessed demographics, IPV perpetration, risk behaviors, and STI history. Current STI was assessed via blood testing for syphilis and urine testing for gonorrhea, Chlamydia and Trichomonas. Multiple logistic regression analyses were used to assess the association between history of IPV with lifetime and current STI. Participants were aged 20–57 years. Almost half of participants (46%) reported a history of IPV perpetration; 81% reported past 30-day binge alcohol use, and 43% reported past 30-day injection drug use. Past and current STI was 41% and 12%, respectively. Men reporting a history of IPV perpetration had significantly higher odds of reporting ever having an STI (AOR=1.6, 95% CI=1.1, 2.4) but lower odds of testing positive for a current STI (AOR=0.50, 95% CI=0.26, 0.96). These findings demonstrate that a history of male IPV perpetration is common in HIV-infected Russian men and associated with a history of STI. Programmatic work toward IPV prevention is needed in Russia and may be beneficial in mitigating STIs, but more research is needed to understand how and why the association between IPV and STI changes over time in this population.