Sexually Transmitted Diseases Screening Research Articles

1516. High Incidence of Newly Infected Syphilis, Hepatitis B and C Virus among People Living with HIV Who Have Reached U=U

Abstract Background The concept of “Undetectable equals Untransmittable (U=U)” has been widely accepted. However the risk of acquiring other sexually transmitted diseases (STDs) such as syphilis (TP), hepatitis B virus (HBV) and hepatitis C virus (HCV) in people living with HIV (PLWH) in the context of “U=U” remains unclear. This study evaluated the incidence of newly STDs in PLWH in Shenzhen, China. Methods 128 virally suppressed PLWH were investigated from March 21 to April 7 2023 at the Third People’s Hospital of Shenzhen. Information on sexual behavior, the awareness rate of U=U and clinical records were collected. Results of HBSAg, HCV RNA, TP antibody before ART(calculating baseline prevalence) and in follow-up(calculating incidence) were collected. The STD incidences among various subgroups were compared. Results At baseline, the prevalence of TP, HBV and HCV were 29.7%(38/128), 15.6%(20/128), and 1.56%(2/128). 78(60.9%) PLWH were not coinfected with any STDs, of which were male with a median age of 36.8 years (IQR 29, 42) and median duration of ART 4.9 years (IQR 2.3, 7), 75(96.2%) were men who have sex with men(MSM). Twelve TP, six HBV and five HCV new infections occurred over 382.9 person-years; the corresponding incidences were 3.13/100 person-years, 1.57/100 person-years and 1.31/100 person-years, respectively. One participant had TP/HBV co-infection, one had HBV/HCV, and one had TP/HCV. Surprisingly, all six newly HBV-infected PWLH received a TDF/TAF+XTC-based regimen. Among the 45 participants who had reached the awareness of U=U and 33 who had not, the new TP incidence were 2.35/100 and 4.11/100 person-years, the new HBV incidence were 1.88/100 and 1.76/100 person-yearsand, the new HCV incidence were 1.88/100 and 1.17/100 person-years(p > 0.05), respectively. Conclusion The high incidence of newly acquired TP, HBV and HCV infection after reaching U=U highlights the necessity of STD screening and prevention in viral suppression population in PWLH. Disclosures All Authors: No reported disclosures

Pay-it-forward gonorrhea and chlamydia testing among men who have sex with men and male STD patients in China: the PIONEER pragmatic, cluster randomized controlled trial protocol

BackgroundGonorrhea and chlamydia are the most common sexually transmitted diseases (STDs) among men who have sex with men (MSM) in China. Previous studies have shown pay-it-forward (PIF) interventions to be associated with a substantial increase in gonorrhea and chlamydia test uptake compared to standard-of-care. We propose a 'pay-it-forward' gonorrhea and chlamydia testing randomized controlled trial (PIONEER). The trial would evaluate the effectiveness of two pay-it-forward strategies in promoting testing uptake compared to the standard of care (in which men pay for their tests out-of-pocket) among MSM and male STD patients in China.MethodsPIONEER will be a three-armed, pragmatic cluster randomized controlled trial (RCT), conducted across 12 clinics (six MSM-led and six public STD clinics) to compare the effectiveness of three implementation strategies. Each facility will be randomized to a standard pay-it-forward intervention of gonorrhea/ chlamydia testing with minimal encouragement for testing, a community-engaged pay-it-forward arm, or a control arm where men pay for their tests out-of-pockets. The primary outcome will be dual gonorrhea/chlamydia test uptake. Secondary outcomes will include syphilis testing, amount donated in pay-it-forward, number of positive gonorrhea and chlamydia tests, and measures of antimicrobial resistance. A sequential transformative mixed methods design will be used to evaluate the implementation process in type 2 effectiveness-implementation hybrid design. Data sources will include survey on acceptability, and feelings and attitudes towards the interventions among participants; testing and treatment uptake data from clinic records, WeChat records, and qualitative data to gain insights into men's perceptions and attitudes towards the pay-it-forward, mechanisms driving uptake, and donating behaviors. Implementers and organizers will be interviewed about fidelity and adherence to protocol, sustainability of pay-it-forward intervention, and barriers and facilitators of implementing the intervention.DiscussionPIONEER will substantially increase gonorrhea/chlamydia testing among MSM in China, providing an innovative and new financial mechanism to sustain STD screening among sexual minorities in low- and middle-income countries. This study will answer compelling scientific questions about how best to implement pay-it-forward and the individual and organizational characteristics that moderate it.Trial registration: The study with identification number NCT05723263 has been registered on clinicaltrials.gov/.

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.

The effect of screening on the health burden of chlamydia: An evaluation of compartmental models based on person-days of infection.

Sexually transmitted diseases (STDs) are detrimental to the health and economic well-being of society. Consequently, predicting outbreaks and identifying effective disease interventions through epidemiological tools, such as compartmental models, is of the utmost importance. Unfortunately, the ordinary differential equation compartmental models attributed to the work of Kermack and McKendrick require a duration of infection that follows the exponential or Erlang distribution, despite the biological invalidity of such assumptions. As these assumptions negatively impact the quality of predictions, alternative approaches are required that capture how the variability in the duration of infection affects the trajectory of disease and the evaluation of disease interventions. So, we apply a new family of ordinary differential equation compartmental models based on the quantity person-days of infection to predict the trajectory of disease. Importantly, this new family of models features non-exponential and non-Erlang duration of infection distributions without requiring more complex integral and integrodifferential equation compartmental model formulations. As proof of concept, we calibrate our model to recent trends of chlamydia incidence in the U.S. and utilize a novel duration of infection distribution that features periodic hazard rates. We then evaluate how increasing STD screening rates alter predictions of incidence and disability adjusted life-years over a five-year horizon. Our findings illustrate that our family of compartmental models provides a better fit to chlamydia incidence trends than traditional compartmental models, based on Akaike information criterion. They also show new asymptomatic and symptomatic infections of chlamydia peak over drastically different time frames and that increasing the annual STD screening rates from 35% to 40%-70% would annually avert 6.1-40.3 incidence while saving 1.68-11.14 disability adjusted life-years per 1000 people. This suggests increasing the STD screening rate in the U.S. would greatly aid in ongoing public health efforts to curtail the rising trends in preventable STDs.

2070. Risk Factors Affecting PrEP Offering and Uptake Among At-Risk Youth in an Area of High HIV Prevalence

Abstract Background New HIV cases are steadily reported in our community among at-risk youth despite the availability of highly effective pre-exposure prophylaxis (PrEP). Although providers regularly offer PrEP during sexually transmitted disease (STD) screening visits, PrEP utilization rates remain low among those patients. The primary outcomes of this study are determining the rates of PrEP offering and uptake in high-risk individuals seeking care for STD screening at local youth clinics and whether these rates differ by demographic factors. Methods A retrospective chart review was conducted on 218 charts of patients ages 18 - 24 years with risk factors for HIV infection who sought care at a youth clinic in Tampa, FL between 2018 and 2020. PrEP offering and utilization rates were compared across demographic and risk factor variables using Chi-square tests for categorical variables and Mann-Whitney U tests for continuous variables. Results Of 218 patients, 86 (39.4%) were offered or had a documented discussion of PrEP at their visit but uptake occurred only in 22 (10.1%). Factors associated with offerings are depicted in table 1. Factors associated with uptake are depicted in table 2. Age at first visit, insurance type, level of education, and employment did not significantly impact PrEP offering or uptake. Additionally, there was no significant difference in PrEP uptake associated with race or ethnicity. PrEP Offerings Demographic characteristics associated with offering and uptake of PrEP among young people screened for STD in a high prevalence of HIV area PrEP Uptake Demographic characteristics associated with uptake of PrEP among young people screened for STD in a high prevalence of HIV area Conclusion This study highlights differences in offering and uptake of PrEP among young adults with a high risk of acquiring HIV living in a high prevalence of HIV area. Males and MSM are offered more PrEP and also use it more. Black patients are less likely to be offered PrEP. These differences emphasize the need for interventions to improve the rate of PrEP discussions among female and black patients at risk for HIV and to improve adherence to PrEP among young individuals at risk of HIV infection. Interventions targeting these demographics may lessen disparities and incidence of HIV in the community. Moving forward we will continue to investigate additional data collected on PrEP compliance at 6mo and at 12mo follow-ups among our patient population. Future studies with qualitative data identifying barriers to use PrEP will provide important information on this topic. Disclosures All Authors: No reported disclosures.

Screening for Monkeypox Infection in Asymptomatic High-Risk-Behaviour Men Having Sex with Men (MSM).

Background: Since the outbreak of monkeypox in formerly non-endemic countries, we have included a screening for monkeypox in our sexually transmitted diseases (STD) routine in patients with high-risk behavior, as it is mainly transmitted through close skin to mucous membrane contact with infected individuals. Methods: Between 16 June 2022 and 14 July 2022, we screened 53 MSM with high-risk behavior for monkeypox acquisition in an observational prospective cohort trial. We complemented the throat and anal swabs for chlamydia and gonococci with monkeypox using polymerase chain reaction (PCR). In addition, all patients participated in a questionnaire survey about their risk behavior and previous STD in their medical history. Results: None of the 53 participants had tested positive for the monkeypox virus. One patient was diagnosed with syphilis and one with an oral and anorectal chlamydia infection. Conclusions: STD screening in high-risk populations is a valuable tool to detect asymptomatic patients for chlamydia, gonococci, HIV, hepatitis B and C and syphilis. Based on our small cohort, monkeypox screening in asymptomatic MSM patients in areas of low prevalence does not seem to be an appropriate approach to deal with the ongoing outbreak. Therefore, we recommend to focus more on vaccinations, targeted nonstigmatizing information and behavior recommendation for risk populations, and to engage further investigations.

A pilot clinical validation study of a self-collected vaginal swab device for the detection of chlamydia trachomatis in women.

Chlamydia trachomatis (C. trachomatis) is one of the most prevalent preventable sexually transmitted diseases (STDs) in the world. In women, C. trachomatis infection can lead to long-term complications such as pelvic inflammatory disease (PID), and other related conditions such as ectopic pregnancies and even tubal factor infertility. These complications are preventable given early detection and clinical intervention, but these efforts are often hampered by asymptomatic silent infections, and non-compliance to screenings for STDs. Some women do not get tested out of concerns for violation of privacy, and fear of discomfort. Clinicians often use a multitude of tests to determine if a patient is infected by C. trachomatis, including a Polymerase Chain Reaction (PCR) test of First catch urine (FCU) samples. However, these tend to be inconvenient to store and transport, as they carry risk of spillage and have stringent refrigeration requirements. Moreover, given the gold-standard recommendations set forth by the Centres for Disease Control (CDC), the current technique can be inconvenient in remote areas where refrigeration and transport may not always be reliable. The current study therefore looks at the potential of a self-collected vaginal swab device that relies on Nucleic Acid Amplification Tests (NAATs), is dry-stored, and does not require refrigeration, to detect the presence of C. trachomatis in women. The study found evidence to suggest that the self-collection device has the potential to aid clinicians in the diagnosis of C. trachomatis in women when compared to doctor-collected vaginal discharge samples as the designated standard, FCU, and blood serology. Moreover, as a self-collection device it has the potential to break down some of the barriers to STD screening especially in young women, such as violation of privacy. The device therefore has a potential to encourage screening and therefore a potentially effective tool in the fight against the spread of preventable sexually transmitted diseases.

Prevalence of Chlamydia trachomatis, Ureaplasma urealyticum, and Neisseria gonorrhoeae in Asymptomatic Women from Urban-Peripheral and Rural Populations of Cuenca, Ecuador.

Background: Sexually transmitted diseases (STDs) are a serious public health issue due to their high prevalence and a substantial percentage of women being asymptomatic. The present study aimed to determine the prevalence of three STD-causative pathogens in asymptomatic women from Southern Ecuador, with the ultimate purpose of updating the epidemiological data and obtaining a timely diagnosis, which can prevent further complications. Methods: This cross-sectional study included 102 asymptomatic women from Cuenca, Ecuador, who underwent a cervical cytology examination. They met all the inclusion criteria and signed the consent form. Nucleic acids were extracted from each sample, and PCR and flow-through hybridization were performed to detect the pathogens responsible for three STDs. Descriptive and inferential statistics were used to define and describe the study population, obtain the frequency data, and measure central tendencies to determine possible associations among the variables. Results: We found that 49.02% of the participants were infected with at least one of the three microorganisms, with 48.04% and 2.94% carrying Ureaplasma urealyticum (UU) and Chlamydia trachomatis (CT), respectively. Neisseria gonorrhoeae (NG) infection was not observed. Among the participants, 1.96% presented co-infections with CT and UU. Approximately half of the participants presented with asymptomatic infections caused by at least one microorganism. Conclusions: This study demonstrates the importance of conducting regular STD screening programs for high-risk asymptomatic women.

Rise of syphilis surge amidst COVID-19 pandemic in the USA: A neglected concern

IntroductionSyphilis is a treatable but highly contagious sexually transmitted disease (STI) that has a long history of infecting millions of people from diverse ethnicities and is mainly considered promiscuity. An uprise in syphilis cases is noted in the Coronavirus pandemic. This short communication discerns salient factors precipitating the syphilis upsurge, implications, current efforts, and recommendations. DiscussionA decrease in funds and investments for public health clinics during COVID-19 because the funds have been diverted for treating COVID-19 has resulted in a dramatic rise in syphilis. The main determinants of the increased spread of syphilis during the COVID-19 pandemic include unsafe sexual activities, reduced STI screening, lack of sufficient staff during the pandemic, and abandoning of STI programs and services. RecommendationsWe recommend high-risk screening clinics and effective telehealth programs to combat against rising STI burden in the US.

The effect of combat exposure on sexually transmitted diseases

Traumatic exposures can affect beliefs and behaviors related to the spread of sexually transmitted diseases (STDs), a persistent public health problem. I leverage a natural experiment created by variation in US military deployment location assignments to estimate how combat exposure changes a surviving deployed male veteran’s probability of acquiring a sexually transmitted disease. I analyze longitudinal data from 1994 to 2008 on 485 deployed veterans with information theoretic methods to reduce the sensitivity of estimates to small samples, an infrequently observed outcome, and highly correlated covariates. For veterans assigned to a combat zone, I estimate combat exposure results in a 5.4 percentage point increase in the probability of acquiring an STD. Additional estimations provide evidence suggesting risky behaviors involving substance use or multiple sexual partners may serve as pathways from combat exposure to STDs. My results are relevant to discussions regarding STD screening and care needs for trauma exposed individuals.

Demographic, Behavioral, and Clinical Characteristics of Persons Seeking Care at Sexually Transmitted Disease Clinics - 14 Sites, STD Surveillance Network, United States, 2010-2018.

Demographic, Behavioral, and Clinical Characteristics of Persons Seeking Care at Sexually Transmitted Disease Clinics - 14 Sites, STD Surveillance Network, United States, 2010-2018.

Utilizing a Community Dance to Hold STD Testing for Chlamydia and Gonorrhea in High-Risk Adolescents.

Sexually transmitted diseases (STDs) in adolescents are a major public health concern, particularly in underserved communities. While STD screening is recommended by the United States Preventive Services Task Force, limited access remains one of a number of barriers. Community-based approaches may provide greater access and enhance screening rates. This study occured in a nationally recognized hot spot for STDs. We used a unique approach of hosting supervised dances at a community venue, during which free STD screening was offered at an attached health care clinic. A series of six Friday night dances was held at one community center sponsored by a nonprofit, girl-focused organization from 2018 to 2019. Dance participants could access an on-site health clinic for self-collected screening for chlamydia and gonorrhea. Treatment was provided for detected STDs. STD screening was also available to area youth at the on-site clinic during regular daytime clinic hours. A total of 118 adolescents were screened during the school year, and were predominantly female (88.13%) and African American (85.6%). More than half of the total STD screenings (51.7%) were administered during the dances, doubling the total number of STD screenings when compared to those administered during regular clinic hours. A significantly younger cohort were screened at the dances (mean age 14.8 years) compared to those screened at the regular clinic (mean age of 18.9 years). A youth-centric event utilizing community resources can be used to facilitate and enhance screening rates for STDs in youth in an underserved, high-risk community.

Cost-Effectiveness Analysis of Michigan’s School-Wide Sexually Transmitted Disease Screening Program in Four Detroit High Schools

PurposeThe Michigan Department of Health and Human Services, in collaboration with St. John Providence Health System, initiated voluntary school-wide sexually transmitted disease (STD) screenings in four Detroit public high schools. We sought to assess the cost-effectiveness of the STD screening program from 2010 to 2015, with a focus on chlamydia. MethodsThe costs and effectiveness of the school-based screening were compared with those of a “no school screening” scenario using a healthcare system perspective. A decision tree model was constructed to project cases of chlamydia, epididymitis, and pelvic inflammatory disease (PID) in each of the two scenarios among students tested positive and their partners. Health effects were measured as cases of PID prevented, and quality-adjusted life-years (QALYs) gained. Cost estimates included program costs, chlamydia testing/treatment costs in the absence of school screening, and treatment costs for epididymitis, PID, and PID sequelae. The incremental cost-effectiveness ratio (ICER) was measured as cost/QALY gained. Multivariate sensitivity analyses were conducted on key parameter estimates and assumptions used. ResultsUnder base-case assumptions, at a total program cost of $333,848 over 5 years, the program prevented an estimated 1.9 cases of epididymitis and 17.3 cases of PID, resulting in an ICER of $38,235/QALY gained (yearly ICER ranging from $27,417 to $50,945/QALY). Of 10,000 Monte Carlo simulation runs, the yearly ICER remained ≤$50,000/QALY in 64%–98% of the simulation runs. ConclusionsWe found favorable cost-effectiveness ratios for Michigan's school-wide STD screening program in Detroit. School-based STD screening programs of this type warrant careful considerations by policy makers and program planners.

Infectious diseases screening approach among refugees: results from a single-center study.

Our aim was to evaluate a screening program, with active case-finding and treatment for active tuberculosis (TB), latent tuberculosis infection (LTBI), blood-borne viruses (BBV), and sexually transmitted diseases (STDs) among refugees living in facility centers. We collected data on refugees arriving to our attention in migrant centers in Sardinia, Italy. Socio-demographical data, anamnesis, and clinical features were collected. TST Mantoux was conducted, and X-ray chest (XRC) was performed if TST was positive. Blood-borne virus screening was proposed to all patients. Screening for STDs was offered according to guidelines, anamnesis, and physical examination. Eighty-one patients were included. Seventy (86.4%) were male, and the mean age was 24.8±5.7 years. Thirty-three (40.7%) had scabies. Overall, 40/81 (49.4%) had a positive TST Mantoux. One (2.5%) was hospitalized and died for multi-drug-resistant TB. One (2.5%) patient had intestinal-TB. 52/81 (64.2%) refused HIV screening, whereas no positivity was found among tested migrants. Sixty-two (76.5%) accepted HCV screening, and one (1.6%) had a positive test. Fifty-eight (71.6%%) accepted HBV testing, and 29 (50%) of them had positive serology. Ten (12.3%) patients had anal or genital lesions due to syphilis, Molluscum contagiosum, and HPV in 7 (70%), 2 (20%), and one (10%) case, respectively. Infectious diseases control and prevention are a key strategy among refugees. The stay in a migrant center is an extraordinary occasion for healthcare provision. This condition could allow a broad screening program in which quick BBV screening tests could be a good method to implement uptake. More information and educational programs would allow a higher understanding and acceptance of HIV screening.

620 Syphilis infection during pregnancy: an essential contributor to adverse pregnancy and neonatal outcomes

To determine whether syphilis infection in pregnancy is associated with adverse pregnancy and neonatal outcomes. Retrospective analysis of the Centers for Disease Control and Prevention, Natality Live Birth database (2016-2018). Adverse pregnancy and neonatal outcomes were compared between births diagnosed with syphilis during pregnancy (syphilis group) and those without syphilis (no syphilis group), using Pearson’s Chi-square test with Bonferroni adjustments. Multivariate logistic regression was used to adjust outcomes for potential confounders such as maternal age, body mass index, race/ethnicity, and prior preterm birth (PTB). Results were presented as adjusted Odds Ratios (aOR) with 95% confidence intervals (CI). Statistical significance was set as a P value < 0.05. Infection with syphilis complicated 0.1% (10,215 of 10,426,235) of US live births in 2016-1028. The rates of adverse pregnancy and neonatal outcomes in both groups are displayed in table 1. Syphilis was associated with several adverse pregnancy and neonatal outcomes, including a significantly increased risk for PTB (<37 weeks and<32 weeks), low birthweight, congenital malformations, low 5 minute APGAR scores, NICU admissions, antibiotic treatment of the neonate, immediate ventilation, as well as prolonged ventilation (Table 2). Based on this large US population cohort, syphilis infection during pregnancy is associated with a significant risk for several adverse pregnancy and neonatal outcomes, as well as congenital malformations. Improved strategies for infection prevention, access to timely screening and treatment are essential in order to reduce these adverse pregnancy and neonatal outcomes. The CDC reported recently on the rise in sexually transmitted diseases (STD) during the COVID-19 pandemic. Recent changes in prenatal care related to COVID-19, including fewer prenatal visits, and replacements with telemedicine further challenge the implementation of STD screening and treatment strategies to improve prenatal outcome.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

621 Gonorrhea infection during pregnancy is associated with adverse pregnancy and neonatal outcomes

To determine whether gonorrhea infection in pregnancy is associated with adverse pregnancy and neonatal outcomes. Retrospective analysis of the Centers for Disease Control and Prevention, Natality Live Birth database (2016-2018). The study group included women with gonorrheal infection in pregnancy, while all births with no gonorrheal infection served as controls. The rates of several adverse pregnancy and neonatal outcomes were compared between the two groups using Pearson’s Chi-squared test with Bonferoni adjustments. Multivariate logistic regression was used to adjust outcomes for potential confounders such as maternal age, body mass index, race/ethnicity, and prior preterm birth (PTB). Results were presented as adjusted Odds Ratios (aOR) with 95% confidence intervals (CI). Statistical significance was defined as a P value < 0.05. Infection with gonorrhea complicated 0.28% (29,071 of 10,426,235) of US live births in 2016-2018. The rates of adverse pregnancy and neonatal outcomes in both groups are displayed in Table 1. Gonorrhea was associated with several adverse pregnancy and neonatal outcomes, including a significantly increased risk for PTB (<37 weeks and <32 weeks), low birthweight, congenital malformations, low 5 minute APGAR scores, NICU admissions, antibiotic treatment of the neonate, immediate ventilation, as well as prolonged ventilation (Table 2). Based on this large US population cohort, gonorrheal infection during pregnancy is associated with a significant adverse pregnancy outcomes, neonatal complications, and congenital malformations. Strategies for infection prevention are needed to reduce the likelihood of these associated adverse outcomes. The CDC reported recently on the rise in sexually transmitted diseases (STD) during the COVID-19 pandemic. Recent changes in prenatal care related to COVID-19, including fewer prenatal visits and replacements with telemedicine, further challenge the implementation of STD screening and treatment strategies to improve prenatal outcome.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

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 &lt; 0.001; rENG = 0.595, p &lt; 0.001; rECON= 0.595, p &lt; 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 &lt; 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.

Human Immunodeficiency Virus (HIV) and Treponema pallidum (Syphilis) Co-infection in Uyo, Nigeria

Aim: HIV/AIDS remains a leading cause of death and disability in Sub Saharan Africa and this accounts for almost half of the world’s HIV related deaths. On the other hand, bacterial sexually transmitted diseases (STDs) such as syphilis contributes to the morbidity and mortality obtained in developing countries. Co-infection of syphilis and HIV may increase the risk of HIV transmission and adversely affect reproductive health. Prompt diagnosis and treatment of STDs in HIV positive individuals can help prevent spread to their partners. There is also very little information about incidence and prevalence of HIV/Syphilis co-infection and their determinants. The aim of this study is to evaluate the HIV/Syphilis co-infection among HIV-infected individuals in Uyo, Nigeria.&#x0D; Methods: A total of 176 individuals living with HIV participated in this study. The average age of the study participants was 39.1 years from a range of 6-67 years. Plasma samples obtained from the human subjects were analysed for presence of HIV and Syphilis antibodies using enzyme-Linked immunosorbent Assay.&#x0D; Results: Our findings showed that the overall prevalence of HIV/Syphilis co-infection in Uyo was 1.7%. Analysis of the results revealed that the variables—sex and educational background—significantly influenced the rate of syphilis sero-positivity among the population under study. While variables- age, marital status and occupational skills non-significantly influenced the rate of syphilis sero-positivity among the population under study.&#x0D; Conclusion: This study confirmed the co-infection of HIV and Syphilis in Uyo, Nigeria. Early screening of Syphilis and other STDs contributes to the control of infection and reduces the spread of HIV to partners. A number of primary preventive interventions for HIV and syphilis need to be adopted including use of condoms and medical male circumcision in order to improve sexual and reproductive health amongst individuals.

Recommendations for Intervention Content to Enhance HIV Pre-Exposure Prophylaxis Uptake among Men Who have Sex with Men Receiving Care at Sexually Transmitted Disease Clinics

Background and objective Pre-exposure prophylaxis (PrEP) uptake has been suboptimal. Sexually transmitted disease (STD) clinics provide important opportunities to scale PrEP uptake. Material and methods To inform the development of a brief intervention to enhance PrEP uptake in STD clinics, we conducted 32 qualitative interviews to explore barriers and facilitators of PrEP uptake among PrEP eligible, PrEP naïve, and men who have sex with men (MSM) presenting for STD screening services. We also solicited input for intervention components to enhance PrEP uptake at STD clinics. Results Most participants’ self-perceived HIV risks were low despite reporting unprotected anal intercourse. Many were reluctant to take any medications, expressed apprehension about perceived side effects of PrEP, and were unaware of how to obtain PrEP. Participants recommended that interventions focusing on enhancing PrEP uptake in STD clinics should include: culturally tailored educational materials about PrEP, informational graphics indicating PrEP’s relative efficacy in reducing HIV transmission risks, and comprehensive PrEP navigation. Most participants did not feel strongly about gender, race or ethnicity of providers; however, nearly all preferred gay affirming providers. Brief interventions to enhance PrEP uptake among MSM in STD clinics should include efforts to raise self-awareness of HIV risk, provide information about PrEP’s efficacy relative to other interventions, underscore PrEP’s relatively few side effects, and provide culturally tailored messaging.

Critical Elements of Community Engagement to Address Disparities and Related Social Determinants of Health: The Centers of Disease Control and Prevention Community Approaches to Reducing Sexually Transmitted Disease Initiative.

Community Approaches to Reducing Sexually Transmitted Disease (CARS), a unique initiative of the US Centers for Disease Control and Prevention, promotes the use of community engagement to increase sexually transmitted disease (STD) prevention, screening, and treatment and to address locally prioritized STD-related social determinants of health within communities experiencing STD disparities, including youth, persons of color, and sexual and gender minorities. We sought to identify elements of community engagement as applied within CARS. Between 2011 and 2018, we collected and analyzed archival and in-depth interview data to identify and explore community engagement across 8 CARS sites. Five to 13 interview participants (mean, 7) at each site were interviewed annually. Participants included project staff and leadership, community members, and representatives from local community organizations (e.g., health departments; lesbian, gay, bisexual, transgender, and queer-serving organizations; faith organizations; businesses; and HIV-service organizations) and universities. Data were analyzed using constant comparison, an approach to grounded theory development. Twelve critical elements of community engagement emerged, including commitment to engagement, partner flexibility, talented and trusted leadership, participation of diverse sectors, establishment of vision and mission, open communication, reducing power differentials, working through conflict, identifying and leveraging resources, and building a shared history. This study expands the community engagement literature within STD prevention, screening, and treatment by elucidating some of the critical elements of the approach and provides guidance for practitioners, researchers, and their partners as they develop, implement, and evaluate strategies to reduce STD disparities.