Previous Sexually Transmitted Infections Research Articles

Sexually transmitted infections knowledge in different populations attending a French University Hospital-A prospective observational study.

Abstract We conducted a prospective study about sexually transmitted infections (STIs) knowledge in different populations attending Lyon's University Hospitals in order to estimate awareness on STIs. Pre-exposure prophylaxis (PrEP)-users (PrEP group), persons living with HIV (PLWH group) and persons undergoing free STI screening (screening group) filled an anonymous questionnaire evaluating STI knowledge. A composite STI knowledge score was calculated and was correlated with patients’ characteristics. A total of 756 patients were enrolled in three groups: screening (n = 509), PrEP (n = 103) and PLWH (n = 144). STI transmission knowledge was better for HIV than for other STIs. The median STI knowledge score was significantly higher in PrEP-users than in the screening and PLWH groups. PrEP use and a previous STI diagnosis were independently associated with a higher score. PrEP-users have better STI knowledge than PLWH and persons undergoing free STI screening. Sexual health promotion interventions routinely reserved to PrEP-users in France seem to be effective in raising the awareness of this group for STIs. Continuous efforts are justified for PLWH and the younger layers of the population.

Sexually Transmitted Infections: Risk-Factors among Married Female Patients’ in Assiut, Egypt

Background: Sexually transmitted infections (STIs) are major concern and public health problem worldwide. Risk-factors of STIs are numerous, their determination is basic for STIs prevention and control. Aims: To determine the commonest STIs and to define the socioeconomic, gynecological, reproductive, lifestyle, and behavioral risk-factors of the studied STIs female patients. Patients and Methods: The study was conducted on one-hundred STIs married female patients attending the Obstetrics& Gynecology Clinics, Al-Azhar University Hospital, Assiut and one-hundred female as controls. A case-control study design was used. Vaginal, cervical, and urethral swabs and smears were taken from the cases and controls. Scrapes from suspicious lesions together with blood samples were taken for examinations. Results: The commonest diagnosed STIs were candidiasis (38.0%) and scabies (21.0%). Significant risk-factors for acquiring STIs were the lowest positions of education, income and social-position (ORs=2.02, 2.42, 2.29; respectively). Urban- and shared-residence were significant risk-factors (ORs=4.0, 2.1; respectively). Significant gynecologic/reproductive risk-factors were married at age ≥28years and ≥14years between menses and marriage (ORs=2.15, 2.17; respectively). Pre-marital sexual activities, practicing with symptomatic partners, and had ≥2 life-time sexual partners were significant risk-factors (OR=6.89, 4.13, 4.75; respectively). Non-religiously committed, smoking, and substance-use/alcohol-intake were significant risk-factors (ORs=7.63, 14.1, 9.33; respectively). Not using protective measures, had previous STIs, partners with previous STIs, not advising partner to seek counseling, and counseling of non-healthcare were significant risk-factors (OR=3.73, 27.59, 11.16, 7.7, 24.41; respectively). Conclusions: There are many preventable risk-factors for acquiring STIs; socioeconomic, demographic, gynecological, reproductive, sexual behavior, lifestyle, and healthcare behavior.

High Lifetime Prevalence of Syphilis in Men Who Have Sex With Men and Transgender Women Versus Low Lifetime Prevalence in Female Sex Workers in Lima, Peru.

The syphilis epidemic continues to cause substantial morbidity worldwide and is worsening despite ongoing control efforts. Syphilis remains an important public health problem among 3 key populations: men who have sex with men (MSM), transgender women, and female sex workers. We conducted a retrospective chart review of patients that received rapid point-of-care treponemal antibody tests from January 2019 to July 2019 in 4 sexually transmitted infection (STI) clinics in Lima, Peru. We assessed patient medical records for human immunodeficiency virus (HIV) infection, history of STIs, as well as sociodemographic and behavioral characteristics. Cross-sectional descriptive analyses were used to determine factors associated with treponemal positivity. We included 401 patient records in our analyses: 252 MSM, 31 transgender women, and 118 female sex workers. The overall median age of patients was 29.0 years (interquartile range, 24.0-36.0 years). Positivity on the treponemal test was 28.9% (95% confidence interval [CI], 24.3%-33.3%) overall, 37.7% (95% CI, 31.7%-44.0%) for MSM, 54.8% (95% CI, 36.0%-72.7%) for transgender women, and 3.4% (95% CI, 0.9%-8.5%) for female sex workers. In the bivariate analysis, treponemal positivity was also associated with receptive anal sex in the last 6 months in MSM (P < 0.01). Additionally, treponemal positivity increased with age (P = 0.0212) and varied by socioeconomic status (P < 0.01). Multivariate Least Absolute Shrinkage and Selection Operator logistic regression showed that treponemal positivity was highly associated with HIV coinfection (adjusted odds ratio, 5.42) and previous STI other than HIV or syphilis (adjusted odds ratio, 1.54). A review of the medical records of members of 3 key populations who had recently received a rapid point-of-care treponemal test in Lima, Peru, revealed that lifetime prevalence of syphilis was high among MSM and transgender women, but low among female sex workers. Those results may indicate a need for more frequent, regular testing among MSM and transgender women-possibly in conjunction with HIV testing, and appropriate treatment of those shown to be positive.

Trichomoniasis in a tertiary hospital of Madrid, Spain (2013-2017): prevalence and pregnancy rate, coinfections, metronidazole resistance, and endosymbiosis.

Trichomoniasis is the most prevalent curable sexually transmitted infection (STI) worldwide and a risk factor for the acquisition of other STIs and adverse pregnancy outcomes. The objectives of this study were to determine the prevalence of T. vaginalis and related coinfections in women attending a third-level hospital of Madrid (Spain). A retrospective study of 24,173 vaginal exudates from women with suspected vaginitis was conducted between 2013 and 2017. Likewise, among T. vaginalis positive samples, co-occurrence with gonorrhea, chlamydia, syphilis, VIH, Mycoplasma hominis, and Ureaplasma urealyticum was checked. Moreover, seven T. vaginalis isolates from 2017 were randomly collected for endobionts, drug resistance, and microsatellite (MS) instability determinations. The prevalence of T. vaginalis was 0.8% between 2013 and 2017. Less than 20% of patients with trichomoniasis were submitted to a complete screening for other genital pathogens. From that, two patients were coinfected with chlamydia and three with syphilis. Surprisingly, 6.4% of positive samples were diagnosed among pregnant women, showing an alarming increase from 3.2% (2014) to 10% (2017). Among the isolates randomly analyzed, five carried T. vaginalis virus, five harbored mycoplasmas, and one was metronidazole-resistant. The molecular genotyping showed a high variability in the three MS evaluated. To our knowledge, this is the first study in Spain that evaluates the prevalence of trichomoniasis in general and pregnant population and includes biomolecular determinations. These results warn about the increasing prevalence and highlight the importance of including T. vaginalis detection in routine gynecological revisions with special emphasis on childbearing age women and patients with previous STIs.

Prevalence of and risk factors for curable sexually transmitted infections on Bubaque Island, Guinea Bissau

ObjectivesComplications from sexually transmitted infections (STIs) can result in severe morbidity and mortality. To date, no STI population studies have been conducted on the Bijagos Islands, Guinea Bissau. Our objective...

HIV Testing Among Adolescents With Acute Sexually Transmitted Infections.

Rates of sexually transmitted infections (STIs) have increased over the decade. Guidelines recommend HIV testing with incident STIs. Prevalence and factors associated with HIV testing in acute STIs are unknown in adolescents. Our objective was to determine the prevalence of completed HIV testing among adolescents with incident STIs and identify patient and health care factors associated with HIV testing. Retrospective study of STI episodes (gonorrhea, Chlamydia, trichomoniasis, or syphilis) of adolescents between 13 and 24 years old from July 2014 to December 2017 in 2 urban primary care clinics. We performed mixed effects logistic regression modeling to identify patient and health care factors associated with HIV testing within 90 days of STI diagnosis. The 1313 participants contributed 1816 acute STI episodes. Mean age at STI diagnosis was 17.2 years (SD = 1.7), 75% of episodes occurred in females, and 97% occurred in African Americans. Only half (55%) of acute STI episodes had a completed HIV test. In the adjusted model, female sex, previous STIs, uninsured status, and confidential sexual health encounters were associated with decreased odds of HIV testing. Patients enrolled in primary care at the clinics, compared with those receiving sexual health care alone, and those with multipathogen STI diagnoses were more likely to have HIV testing. HIV testing rates among adolescents with acute STIs are suboptimal. Patient and health care factors were found to be associated with receipt of testing and should be considered in clinical practice.

Heterosexual men who purchase sex and attended an STI clinic in Israel: characteristics and sexual behavior

BackgroundCommercial sex shares a role in HIV and sexually transmitted infections (STI) transmission. Men who pay for sex (MPS) may transmit HIV/STI to other populations which are low-risk. This study aimed to test our hypothesis that MPS engage in high-risk sexual behaviors associated with HIV/STI transmission more so than non-MPS.MethodsThis cross-sectional study included heterosexual men who attended an STI clinic between 2003 and 2010. Demographic, clinical, behavioral and laboratory data were compared between MPS and non-MPS to identify factors associated with high-risk sexual behavior and STI-burden.ResultsOf the first visits of 6156 heterosexual men who attended the STI-clinic during the study period, 1649 (26.7%) were MPS. MPS were more commonly older, married and non-Israeli born compared with non-MPS. MPS were more likely to engage in risk-behaviors associated with HIV/STI-transmission, including a greater number of lifetime sexual partners, substance use and previous STI diagnoses.Determinants associated with STI-diagnoses at the current visit included being non-Israeli born, presenting with STI symptoms, reporting a greater number of lifetime sexual partners and having sexual encounters with non-Israeli individuals.ConclusionsApproximately 25% of all men who attended the clinic were MPS. They were more likely to engage in risk-behaviors associated with HIV/STI transmission compared to non-MPS. These findings highlight the need to establish interventions for MPS that both continue to encourage condom use and address the potential perils pertaining to risky sexual behaviors.

Integrating Pregnancy Prevention Into an HIV Counseling and Testing Program in Pediatric Primary Care

PurposeCertified health educator (CHE)-based HIV counseling and testing typically focus on HIV and sexually transmitted infection (STI) prevention only. A quality improvement initiative examined integrating assessment of reproductive life plans, counseling about pregnancy prevention, and contraception referral into a CHE-based HIV testing program. MethodsBetween February 2014 and January 2017, in one urban pediatric primary care clinic serving patients aged 0–25, CHEs assessed sexual history, HIV risk, short-term (i.e., the next 6–12 months) pregnancy desire, and current contraception method and satisfaction among patients aged 13–25 who had ever had vaginal sex, using a standardized questionnaire. Data were analyzed using a de-identified administrative dataset that also tracked referrals to initiate contraception and actual method initiation. ResultsOf 1,211 patients, most (96%) reported no short-term pregnancy or partner pregnancy desire. Use of less effective or no contraception, as well as method dissatisfaction, was common. A high proportion of female patients referred to new methods opted for more effective methods (62%) and initiated these methods (76%); a high proportion of male patients opted for receipt of condoms (67%). Patients reporting short-term pregnancy desire reported higher rates of previous pregnancy and STIs. ConclusionsProgram findings highlight the potential benefit of integrating assessment for and counseling about pregnancy prevention in a CHE-based HIV testing program. This can more effectively address the needs of patients with concomitant risks of STI/HIV and unintended pregnancy, and link patients who do not desire pregnancy to more effective methods.

RISK FACTORS OF VULVOVAGINAL CANDIDIASIS IN DERMATO-VENEREOLOGY OUTPATIENTS CLINIC OF SOETOMO GENERAL HOSPITAL, SURABAYA, INDONESIA.

Background:Vulvovaginal Candidiasis (VVC) is one-third of vaginitis case. About 75% of women will have at least one episode of VVC. Complication of VVC can be unfavorable to impact the patient’s quality of life. Knowing its risk factors can prevent someone suffering from pathological VVC and its sequelae. The purpose of this study was to identify risk factors of VVC.Materials and Methods:A descriptive retrospective study was conducted by total sampling to 213 medical records of VVC patients from 869 fluor albus patients in Sexually Transmitted Infection (STI) Division, Dermatology and Venereology Outpatient Clinic in Dr. Soetomo General Hospital, Surabaya, East-Java, Indonesia in 2011 to 2013.Results:In 2011, 69 cases (22.77%) from 303 fluor albus patients, in 2012 69 cases (22.69%) from 304 fluor albus patients, and in 2013 75 cases (28.63%) from 262 fluor albus patients. As many as 180 (84.50%) of the patients were sexually active age group, which was 15-44 years old. Mostly patients were married (69.48%). As many as 167 (78.40%) sexual partners were patient’s husband. About 95 (44.13%) patients presented with recurrent VVC. Risk factors are previous STIs 74 (34.74%), vaginal douching (27.70%), pre-martial sexual intercourse (5.63%), other STIs (3.29%), diabetes mellitus (2.34%), gestation (1.88%), other fluor albus infections (0.94%), pantyliner (0.47%), and STIs in sexual partner (0,47%).Conclusion:Avoiding and/or managing risk factors is important to prevent VVC and its complications.

Young Men's Disclosure of Same Sex Behaviors to Healthcare Providers and the Impact on Health: Results from a US National Sample of Young Men Who Have Sex with Men.

Many men who have sex with men (MSM) do not disclose their same sex behaviors to healthcare providers (HCPs). We used a series of logistic regression models to explore a conceptual framework that first identified predictors of disclosure to HCPs among young MSM (YMSM), and subsequently examined young men's disclosure of male-male sexual behaviors to HCPs as a mediator between sociodemographic and behavioral factors and three distinct health outcomes [HIV testing, sexually transmitted infection (STI) testing, and human papillomavirus (HPV) vaccination]. We determined the predictors of disclosure to HCPs among YMSM and examined the relationship between disclosure and the receipt of appropriate healthcare services. Data were collected online through a US national sample of 1750 YMSM (ages 18-29 years) using a social and sexual networking website for MSM. Sexual history, STI/HIV screening history, sexual health, and patient-provider communication were analyzed in the logistic regression models. Participants were predominantly white (75.2%) and gay/homosexual (76.7%) with at least some college education (82.7%). Young men's disclosure of male-male sexual behaviors to HCPs was associated with the receipt of all healthcare outcomes in our model. Disclosure was a stronger mediator in HPV vaccination than in HIV and STI testing. Disclosure to non-HCP friends and family, HCP visit in the past year, and previous STI diagnosis were the strongest predictors of disclosure. Young men's disclosure of male-male sexual behaviors to HCPs is integral to the receipt of appropriate healthcare services among YMSM. HPV vaccination is more dependent on provider-level interaction with patients than HIV/STI testing.

Sexual behaviours and sexual networks of men who have sex with men in Bali

Background and purpose: Transmission of HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) in Bali Province is increasing. This increased transmission is due to their sexual networks and behaviours. This study aims to examine sexual behaviours and sexual networks among MSM population in Bali Province.Methods: A descriptive cross-sectional study was conducted in Denpasar City and Badung District. A total of 130 MSM were recruited from Denpasar II Public Health Centre and Bali Medica Clinic – Badung District. Data were collected through interviews among MSM who visited both providers for STIs services from August to October 2015. Variables of this study included sociodemographic, sexual network (pattern and density), sexual activities in the last month, sexual role, condom/lubricant use, and history of previous STIs. Data were descriptively analysed.Results: As many as 53.1% respondents were aged &lt;25 years, 90.8% were senior high school or higher degree graduates, 6.2% were married, 91.5% were employed, and 59.2% were having a regular partner. In the last month, as many as 70.8% respondents reported to have sex with first sexual partner, 52.3% with second sexual partners, and 45.6% with third sexual partners. Younger respondents tended to seek for younger sexual partners. The majority of respondents had had insertive sex, as many as 40.0% with their first partner, 44.6% with their second partner, and 43.2% with their third partner. About 20% of respondents were having high density sexual network and 71.5% of respondents were having concurrent sexual partnership. The consistent condom use within six months was 67.6% with the first partner, 72.8% with the second and the third partners. As many as 23% of respondents were diagnosed to have STIs.Conclusion: MSM population in Bali Province seem to have high risk sexual behaviours with great sexual network density, high concurrent sexual partnership, and selective mixing between older and younger MSM population.

Sexual behaviours and sexual networks of men who have sex with men in Bali

Background and purpose: Transmission of HIV and other sexually transmitted infections (STIs) among men who have sex with men (MSM) in Bali Province is increasing. This increased transmission is due to their sexual networks and behaviours. This study aims to examine sexual behaviours and sexual networks among MSM population in Bali Province. Methods: A descriptive cross-sectional study was conducted in Denpasar City and Badung District. A total of 130 MSM were recruited from Denpasar II Public Health Centre and Bali Medica Clinic – Badung District. Data were collected through interviews among MSM who visited both providers for STIs services from August to October 2015. Variables of this study included sociodemographic, sexual network (pattern and density), sexual activities in the last month, sexual role, condom/lubricant use, and history of previous STIs. Data were descriptively analysed. Results: As many as 53.1% respondents were aged &lt;25 years, 90.8% were senior high school or higher degree graduates, 6.2% were married, 91.5% were employed, and 59.2% were having a regular partner. In the last month, as many as 70.8% respondents reported to have sex with first sexual partner, 52.3% with second sexual partners, and 45.6% with third sexual partners. Younger respondents tended to seek for younger sexual partners. The majority of respondents had had insertive sex, as many as 40.0% with their first partner, 44.6% with their second partner, and 43.2% with their third partner. About 20% of respondents were having high density sexual network and 71.5% of respondents were having concurrent sexual partnership. The consistent condom use within six months was 67.6% with the first partner, 72.8% with the second and the third partners. As many as 23% of respondents were diagnosed to have STIs. Conclusion: MSM population in Bali Province seem to have high risk sexual behaviours with great sexual network density, high concurrent sexual partnership, and selective mixing between older and younger MSM population.

P237 Are the over 50s being let down by sexual health clinics? – an audit of sexual history taking in over 50s

IntroductionAgeing and Human Immunodeficiency Virus (HIV) has been very topical for a long time but not much has been said of ageing and sexually transmitted infections (STI). The Public Health...

Use and acceptability of salivary hepatitis C virus testing in an English Young Offender Institution.

People held in prison are at a high risk of having hepatitis C virus (HCV) and there is a public health drive in the UK to increase HCV testing in prisons and Young Offender Institutions (YOIs), with opt-out testing. There is an oral antibody test for HCV; this project aims to determine its acceptability in an English YOI setting. This project offered HCV oral point-of-care testing (POCT) using the OraQuick® test to 107 male young offenders attending a sexual health service at an English YOI, monitoring HCV positivity and evaluating acceptability. It also investigated young offenders' histories of sexually transmitted infections (STIs) and drug use. Mean age was 19.1 years. A total of 80.4% reported lifetime drug use and 0.9% reported lifetime drug injection. A total of 19.6% reported previous STIs. One patient (0.9%) was positive for HCV on OraQuick® testing. All patients found the POCT acceptable and one stated he would have refused a fingerprick test had it been the only test available for HCV testing. Salivary rapid HCV testing is acceptable among English YOI inmates. It is not as sensitive or specific as standard HCV tests and is more expensive. In our cohort, HCV positivity was low.

Are patients in the IBD clinic at risk of proctitis secondary to sexually transmitted infections?

ObjectiveTo gauge the potential risk of sexually transmitted infection (STI) as a cause of proctitis in a cohort of patients with inflammatory bowel disease (IBD) and to gauge whether this...

HIV incidence in an open national cohort of men who have sex with men attending sexually transmitted infection clinics in England.

The aim of the study was to determine HIV incidence among men who have sex with men (MSM) who repeat test for HIV at sexually transmitted infection (STI) clinics in England, and identify associated factors. Annual HIV incidence and 95% confidence interval (CI) were calculated for a national cohort of MSM who tested HIV negative at any STI clinic in England in 2012 and had a follow-up test within 1 year using routinely collected data. Cox regression analyses were performed to identify predictors of HIV acquisition and population attributable risk for HIV infection was calculated for predictors. In 2012, 85 500 MSM not known to be HIV positive attended any STI clinic in England, and 31% tested for HIV at least twice within 1 year at the same clinic. HIV incidence was 2.0 per 100 person-years (PY; 95% CI 1.8-2.2) among repeat testers. Incidence was higher among MSM of black ethnicity (3.2 per 100 PY) and those with a bacterial STI diagnosis at the initial attendance (3.2 per 100 PY). MSM with a previous syphilis or gonorrhoea infection were at significantly greater risk of acquiring HIV in the subsequent year [adjusted hazard ratio 4.1 (95% CI 2.0-8.3) and 2.1 (95% CI 1.4-3.2), respectively]. The predictors accounted for 37% of HIV infections. Annual HIV incidence among MSM attending STI clinics in England is high. Previous STIs were predictors of HIV acquisition but only accounted for one in five infections. More discriminatory behavioural predictors of HIV acquisition could provide better triaging of HIV prevention services for MSM attending STI clinics.

Prevalence of Pelvic Inflammatory Disease in Sexually Experienced Women of Reproductive Age - United States, 2013-2014.

Pelvic inflammatory disease (PID) is a clinical syndrome of the female reproductive tract characterized by inflammation of the endometrium, fallopian tubes, or peritoneum (1). PID occurs when microorganisms ascend from the vagina or cervix to the fallopian tubes and other upper genital tract structures (1). PID can result from untreated bacterial infections, including chlamydia and gonorrhea, and can lead to infertility, ectopic pregnancy, and chronic pelvic pain (1). Because there is no single diagnostic test for PID, clinicians rely on nonspecific signs and symptoms for diagnosis. The purpose of these analyses was to assess the burden of self-reported PID in a nationally representative sample using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 cycle. Starting in 2013, NHANES female participants aged 18-44 years were asked about a lifetime history of PID diagnosis. Based on these data, the estimated prevalence of self-reported lifetime PID was 4.4% in sexually experienced women of reproductive age (18-44 years). The prevalence of self-reported lifetime PID was highest in women at increased risk, such as women reporting a previous sexually transmitted infection (STI) diagnosis. Stratified by race/ethnicity and having a previous STI diagnosis, non-Hispanic black (black) and non-Hispanic white (white) women reporting a previous STI diagnosis had nearly equal self-reported lifetime PID prevalence (10.0% versus 10.3%). However, the lifetime prevalence of PID among black women was 2.2 times that among white women if no previous STI was diagnosed (6.0% versus 2.7%). These findings suggest that PID is prevalent and associated with previous STI diagnoses; therefore, it is important for clinicians to screen female patients for chlamydia and gonorrhea to reduce the incidence of PID.

Socioeconomic status of parents and the occurrence of pelvic inflammatory disease among undergraduates attending Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria.

Pelvic inflammatory disease (PID) is a major cause of gynaecological morbidity globally. Complications from PID include infertility, ectopic pregnancy and chronic pelvic pain. Low socioeconomic status (SES) is a risk factor for the occurrence of PID. The aim of this study was to determine the association between SES of parents and the occurrence of PID among undergraduates attending Irrua Specialist Teaching Hospital, Irrua. The study was a hospital-based, descriptive cross-sectional study. Three hundred and sixty female undergraduates attending the hospital were consecutively recruited and clinically assessed for the presence of PID using the WHO and CDC MMWR 2010 criteria for the clinical assessment of PID. Their SES was determined by Oyedeji social class categorisation. Data were analysed using Epi Info 3.5.4. Descriptive statistics were used to summarise the data, and Chi-square was used to test for association. There was a significant association between SES of parents and multiple sex partners (P < 0.02), previous sexually transmitted infection (STI) (P = 0.05), unprotected sex (P < 0.001), history of induced abortion (P < 0.001) and surgical termination of pregnancy (P < 0.01). There was also association between occurrence of PID among respondents and multiple sexual partners (P < 0.001), previous history of STI (P = 0.02), non-persistent use of condom (P < 0.001), history of induced abortion (P < 0.01) and surgical termination of pregnancy (P < 0.01). There was however no significant association between SES of parents and occurrence of PID (P = 0.14) though PID was highest among respondents from low SES. Occurrence of PID among undergraduates was not associated with their SES. However, identified risk factors for PID among study population such as multiple sex partners, previous STI, unprotected sex and history of induced abortion were associated with the SES.

Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?

BackgroundPatients asking for a free anonymous HIV test may have contracted other sexually transmitted infections (STIs) such as Chlamydia trachomatis, yet Chlamydia prevalence in that population is unknown. This study aimed to assess the prevalence and factors associated with Chlamydia infection in patients seeking HIV testing at local public health authorities (LPHA) in order to evaluate whether Chlamydia testing should be routinely offered to them.MethodsWe conducted a cross-sectional study among patients (≥18 years) attending 18 LPHA in North Rhine-Westphalia from November 2012 to September 2013. LPHA collected information on participants’ socio-demographic characteristics, sexual and HIV testing behaviours, previous STI history and clinical symptoms. Self-collected vaginal swabs and urine (men) were analysed by Transcription-Mediated Amplification. We assessed overall and age-stratified Chlamydia prevalence and 95 % confidence intervals (95 % CI). Using univariate and multivariable binomial regression, we estimated adjusted prevalence ratios (aPR) to identify factors associated with Chlamydia infection.ResultsThe study population comprised 1144 (40.5 %) women, 1134 (40.1 %) heterosexual men and 549 (19.4 %) men who have sex with men (MSM); median age was 30 years. Chlamydia prevalence was 5.3 % (95 % CI: 4.1–6.8 %) among women, 3.2 % (95 % CI: 2.2–4.4) in heterosexual men and 3.5 % (95 % CI: 2.1–5.4) in MSM. Prevalence was highest among 18–24 year-old women (9 %; 95 % CI: 5.8–13) and heterosexual men (5.7 %; 95 % CI: 3.0–9.8 %), respectively. Among MSM, the prevalence was highest among 30–39 year-olds (4.4 %; 95 % CI: 1.9–8.5 %). Among those who tested positive, 76.7 % of women, 75.0 % of heterosexual men and 84.2 % of MSM were asymptomatic. Among women, factors associated with Chlamydia infection were young age (18–24 years versus ≥ 40 years, aPR: 3.0, 95 % CI: 1.2–7.8), having had more than 2 partners over the past 6 months (ref.: one partner, aPR: 2.1, 95 % CI: 1.1–4.0) and being born abroad (aPR: 1.9, 95 % CI: 1.0–3.5). Among heterosexual men, young age was associated with Chlamydia infection (18–24 years versus ≥ 40 years, aPR: 4.1, 95 % CI: 1.3–13). Among MSM, none of the variables were associated with Chlamydia infection.ConclusionsLPHA offering HIV tests should consider offering routine Chlamydia testing to women under 30 years. Women with multiple partners and those born abroad may also be considered for routine testing. Our results also suggest offering routine Chlamydia testing to heterosexual men under 25 years old. For MSM, we cannot draw specific recommendations based on our study as we estimated the prevalence of urethral Chlamydia infection, leaving out rectal and pharyngeal infections.

Trading Sex for Money or Compensation: Prevalence and Associated Characteristics from a Sexually Transmitted Infection (STI) Clinic Sample

ABSTRACTThe purpose of this study was to determine the prevalence and individual risk factors of people who trade or sell sex among sexually active individuals seeking HIV and sexually transmitted infection (STI) testing. Using electronic agency records, an analysis of the characteristics of 5,029 youth and adults who voluntarily obtained HIV and STI testing was conducted. Multiple imputation procedures for missing data from 3 variables and logistic regression were conducted. A total of 128 individuals reported having traded sex. Nine variables had statistically significant associations with trading sex. Individuals who identified as White and female had lesser odds of trading sex, whereas individuals who were transgender, were living in a shelter, had been sexually assaulted, had a previous STI, had high-risk sex, or used drugs had greater odds of trading sex. Elevated levels of high-risk behavior in addition to sexual trauma should be considered in intervention research and community health practice. Implications for service providers and researchers are discussed.