Sexually Transmitted Diseases Infection Research Articles

Recurrent Genital Herpes and Balanoposthitis Candidiasis in Men with Incomplete Circumcision: A Case Report

Background: Circumcision can reduce the risk of sexually transmitted diseases (STDs). It may reduce males acquiring HSV-2 by 30% and 68% lower prevalence of balanitis than uncircumcised males. There is no report of incomplete circumcision as a risk for STD infection.
 Case presentation: A 31-year-old male complained of multiple ulcers that covered a yellowish crust on the penile with a burning sensation since 7 days ago. Initially, it was vesicles that turned into ulcers. One month ago, he complained of moist scales on his preputium that felt itchy and smelly. The patient is married and sexually active. History of intercourse with female sex workers without condoms 2 weeks ago. The patient had incomplete circumcision when he was a child; the preputium is still persistent and seldom cleaned regularly. One year ago, there was a history of vesicles on the penis. Physical examination revealed obesity grade 2. Venereological findings showed a whitish pseudo-membrane on the preputium, glans penis, and ulcers in various sizes covered pseudo-membrane surrounded erythema oedema. Laboratory revealed positive IgG HSV1, IgM, and IgG HSV2. A fungal culture is positive candida. Diagnosis established as recurrent genital herpes, balanoposthitis candidiasis, non-specific genital infection, candidiasis intertrigo. The patient has persistent preputium as the entry of commensal pathogens through abrasions in the mucosa, which causes infection. The patient had complete resolution after being administered oral acyclovir, doxycycline, and topical miconazole.
 Conclusion: Persistent preputium in incomplete circumcision is a risk for developing candidiasis, balanoposthitis, and recurrent genital herpes.

Sexual Health Knowledge and Sexual Self-Efficacy as Predictors of Sexual Risk Behaviors in Women

According to the Center for Disease Control (CDC), the proportion of acquired immunodeficiency syndrome (AIDS) diagnoses among women in the United States has more than doubled between 1984 and 2019 and rates of sexually transmitted diseases (STDs) in all individuals increased 30% between 2015 and 2019. Further, the CDC has designated women ages 13 to 44 years as a group vulnerable to human immunodeficiency virus (HIV) and STD infection, in part due to frequency of engaging in sexual risk behaviors. Sexual self-efficacy is associated with decreased sexual risk behaviors and counters norms that emphasize passivity and compliance as traditional sexual behavior in women. In the current study, we assessed knowledge of HIV and STD transmission and risk factors, sexual self-efficacy, and frequency of sexual risk behaviors in 281 woman-identified respondents aged 18–44 years in an online survey. Knowledge of HIV and STDs was low (averages of 63.3% and 49.9%, respectively). Younger women, and women who identified as single, White, and/or LGBTQ+ reported more sexual risk behaviors. HIV knowledge and sexual self-efficacy were independently associated with fewer risk behaviors and significantly interacted to predict sexual risk behaviors. STD knowledge and sexual self-efficacy were independently associated with fewer sexual risk behaviors. These findings highlight the need for comprehensive, widespread, and identity-inclusive sexual health education.

Diagnosing Sexually Transmitted Disease from Some Symptoms Using Machine Learning Models

Sexually transmitted disease (STDs) is of serious concern, especially among the youths. Efforts to eradicate such diseases are often frustrated due to different sociodemographic elements and clinical factors that usually lead to misdiagnosis. Thus, this paper applied six (6) distinct machine learning models to accurately analyze STD infections reported by 400 patients that attended Federal Polytechnic Ilaro Medical Center, Ogun State Nigeria. Weak non-significant correlations were obtained between the 7 symptoms considered for the diagnoses and the diagnosis outcome, but no significant pattern was observed. However, the application of data mining tools revealed a hidden pattern that correctly predicted the outcome using the subjects’ symptoms, age, and sex. 4 out of the 6 machine learning models were adjudged to perform well using different performance metrics, of which Logistic regression model was found to be the best. The model feature importance chat shows that Vagina Discharge and Vagina itching have the highest and almost the same level of impact on the possibility of a diagnosed patient having STDs. Furthermore, a 100% performance of logistic regression implies that the model correctly predicted all the 309 true negatives and 101 true positives with a misclassification (misdiagnosis) of zero.

Predictors of STD Screening From the Indigenist Stress-Coping Model Among Native Adults With Binge Substance Use.

ObjectiveThe American Indian/Alaska Native (AI/AN) population in the U.S. is thriving in spite of settler colonialist efforts of erasure. AI/AN people, however, continue to experience persistent health disparities including a disproportionate burden of substance use and sexually transmitted diseases/infections (STDs/STIs), as well as a disproportionate lack of public health STD screening services and STD prevention interventions grounded in AI/AN social contexts, experiences, and epistemologies. The present study explored how stressors and protective factors based on the Indigenist Stress Coping framework predict STD screening outcomes among Native adults.MethodsWe analyzed baseline self-report data from 254 Native adults ages 18–55 years with recent binge substance use who were enrolled in an evaluation of “EMPWR,” a two-session STD risk reduction program in a rural, reservation-based community in the U.S. Southwest. Logistic regression models with robust variance were used to estimate odds ratios of lifetime STD testing for the theoretical stressors and cultural buffers.ResultsA little over half the sample were males (52.5%, n = 136), with a mean age of 33.6 years (SD = 8.8). The majority (76.7%, n = 195) reported having ever been screened for STD in their life. Discrimination score were significantly associated with lifetime STD testing: The higher discrimination was associated with lower odds of STD testing in the fully adjusted model (aOR = 0.40, 95%CI: 0.18, 0.92). The effects of AI/AN-specific cultural buffer such as participation in traditional practices on STD testing outcomes was in the expected positive direction, even though the association was not statistically significant. Household size was significantly associated with STD screening: The higher the number of people lived together in the house, the higher the odds of STD testing in the fully adjusted model (aOR = 1.19, 95%CI: 1.04, 1.38).ConclusionOur findings suggest that STD prevention programs should take into consideration AI/AN-specific historical traumatic stressors such as lifetime discrimination encounters and how these interact to drive or discourage sexual health services at local clinics. In addition, larger household size may be a protective factor functioning as a form of social support, and the extended family's role should be taken into consideration. Future research should consider improvement in measurements of AI/AN enculturation constructs.

Knowledge, awareness and prevention of sexually transmitted diseases among women in urban slums

Sexually Transmitted Diseases/ Infections (STDs/STIs) are a major public health problem and a leading cause of morbidity among women in developing countries like Bangladesh. According to WHO, 2006, STDs/STIs ranks second as a cause of healthy life loss among women in the reproductive age group. This research has been conducted on examining knowledge awareness and prevention of STDs among women. It was conducted in two selected slums (Kathalbagan’s Lakkhi slum and Moghbazar slum) of Dhaka city in Bangladesh. This study was conducted through quantitative research and convenience sampling techniques. A structured questionnaire was developed to collect data on knowledge awareness and prevention of STDs/STIs. The study shows that 68.3% of respondents have knowledge about STDs, in this research majority of respondents are not aware of risk factors associated with STDs. This study examines that, for building awareness, majority of respondents preferred “Radio and Television” as the most important media that can build awareness for STDs among slum women. Special counseling is mandatory for the victims, along with sex education. Awareness about healthy sexual behaviors, a hygienic lifestyle, and instruction about the correct use of male condoms should be promoted to reduce the risk of health complications and greatly reduce the spread of STDs not in Bangladesh but also in developing countries.

A Survey to Reduce STDs Infection in Mongolia and Big Data Virtualization Propagation

Sexually transmitted diseases refer to clinical syndromes and infections that are acquired and transmitted through sexual activity. Worldwide, more than 340 million cases of sexually transmitted disease occur each year, placing a great burden on individuals as well as communities and countries. The proportion of sexually transmitted diseases (STDs) in Mongolia is relatively high due to their inadequate treatment technologies, religious or local customs, and regional differences. It is rather difficult to grasp the exact number of patients as these diseases are considered ones that should not be disclosed to others. Therefore, this study aims to accurately identify sexually transmitted diseases in Mongolia and reduce infection through an analytic approach of big data virtualization propagation.

Treatment of chlamydia and gonorrhea infections during the COVID-19 pandemic using provisional Centers for Disease Control guidance.

The COVID-19 pandemic created new challenges in controlling the transmission of sexually transmitted diseases (STDs), forcing the Centers for Disease Control and Prevention (CDC) to temporarily modify recommendations. As rapid COVID-19 testing emerged, supplies for similar testing platforms, specifically Chlamydia trachomatis and Neisseria gonorrhoeae, became compromised. The local community was identified as having the highest rate of chlamydia infections in North Carolina. Concerns regarding disease transmission within the community were amplified as the project site began experiencing a critical shortage of chlamydia and gonorrhea testing kits. This quality improvement (QI) project, conducted in an emergency department, located in an underserved area with high STD infection rates, offered a prioritized approach to STD testing and treatment during a critical time with limited testing capabilities. Program analysis evaluated the management of 227 patients preintervention and 218 patients postintervention with confirmed or suspected infection, using a testing and treatment algorithm to identify and treat those most likely to be infected while preserving testing supplies for those at higher risk for complications from infections. Test utilization decreased by 25% (p-value = .003 via t-test), whereas a significant improvement in empiric treatment, increasing from 59% (133/227) to 73% (158/218), was also observed (p-value = .002 via chi-square analysis). Results suggest that a testing and treatment algorithm for providers can successfully guide testing and treatment decisions, reducing onward transmission and preserving supplies for those more likely to experience complications from chlamydia and gonorrhea infections.

HIV infection and related factors among men who have sex with men aged 50 and above

Objectives: To explore the HIV prevalence and related factors among MSM aged 50 and above and provide evidence on the prevention and control of HIV/AIDS. Methods: Based on an MSM social application software Blued 7.1.6, we recruited participants through online convenience sampling to collect demographic variables, behavioral and self-reported HIV infection status, etc. Univariate χ2 test and multivariate logistic regression were used to analyze the related factors of self-reported HIV infection. Results: Self-reported HIV infection rate was 17.6%(126/714) among the participants. In multivariable analysis, participants who got divorced or widowed had a 2.07(95%CI: 1.34-3.21) times greater risk of self-reported HIV-positive than those who were married. Participants unaware of HIV-related knowledge showed a 1.92(95%CI:1.21-3.04) times greater risk of self-reported HIV-positive than those with better HIV-related knowledge. Participants who have ever been diagnosed with sexually transmitted disease (STD) showed a 3.17(95%CI:2.09-4.83) times greater risk of self-reported HIV-positive than those without STD infection history. Conclusion: Our findings indicated that the self-reported HIV infection rate was high among MSM aged 50 and above. Being divorced or widowed, being unaware of HIV-related knowledge and STD infection history was proved related with self-reported HIV infection.

Individual- and Community-Level Factors in the STD Status of Justice-Involved Youth: Multi-Group, Exploratory Two-Level Analysis.

Justice-involved youth display higher prevalence rates of sexually transmitted diseases (STDs), in comparison with youth in the general population, highlighting a critical public health concern. Individual factors are important predictors of STDs, but only provide a partial understanding of this public health issue. Communities experiencing higher levels of disorder and lower levels of cohesion tend to have fewer institutional resources available, which may impact sexual risk behavior and STDs. However, few studies have examined the association between community characteristics and STD prevalence among adolescents. The current study examined community-level (n = 106) characteristics and individual-level attributes in explaining STDs among justice-involved youth (n = 1233: n = 515 female; n = 718 male). At the individual level, results showed older males and those with more drug-related problems were more likely to be STD positive, while females with more sexual partners and those with less drug-related problems were more likely to be STD positive. At the community level, females residing in areas with fewer educated residents were more likely to be STD positive. These gender differences were significant, suggesting a gendered perspective is important for understanding STD infection. The justice system represents a critical opportunity in the treatment and prevention of STDs for youth.

Prevalence and treatment of sexually transmitted diseases in gynecological practices in Germany: A retrospective study with more than 1,000,000 patients .

The aim of this study was to analyze the prevalence and treatment of sexually transmitted diseases (STDs) in gynecological practices in Germany. This study included women who were followed in gynecological practices in Germany between 2013 and 2015. The first outcome was the prevalence of women diagnosed with STDs during this time period. Eight different types of STD infections were included in the analysis: chlamydial infection, gonococcal infection, anogenital warts, anogenital herpes infection, trichomoniasis, ulcus molle, phthiriasis, and syphilis. The second outcome was the prevalence of women with STDs who received appropriate medication within 90 days of STD diagnosis. There were 1,030,968 patients available for analysis. The most frequent infection was chlamydia (0.59%), and the least frequent one was syphilis (0.01%). The prevalence of STDs was found to be the highest in women aged 21-25 years (3.42%). Mean age at diagnosis ranged from 27.3 years (chlamydia infection) to 40.6 years (syphilis). Finally, the share of women receiving medication therapy was the highest for syphilis (83.3%) and the lowest for anogenital warts (52.7%). The prevalence of STDs ranged from 0.01 to 0.59% in women followed in gynecological practices in Germany between 2013 and 2015. .

Hepatitis A outbreak in Barcelona among men who have sex with men (MSM), January-June 2017: A hospital perspective.

Acute hepatitis A is transmitted mainly via the faecal-oral route and/or contaminated aliment. Furthermore, several outbreaks in the men who have sex with men (MSM) population classified hepatitis A as a sexually transmitted disease (STD). We aimed to clarify an ongoing hepatitis A outbreak in Barcelona with respect to patients' characteristics and viral phylogenetic analysis. We prospectively analyzed 46 cases of hepatitis A infection that were registered in our hospital between January and June 2017. We evaluated demographics data, risk factors, presenting symptoms, sexual orientation, comorbidities and further STD infections. The phylogenetic correlation of the current circulating viruses among them and other hepatitis A strains was assessed by sequencing of the VP1/P2A region. Most patients were male (44, 96%) with median age 33.5years (range 28-50). Thirty-one (67%) were MSM and 18 (39%) required hospitalization. Molecular phylogenetic analyses revealed that all patients were infected by hepatitis A subgenotype IA strains. Moreover, current strains comprised 3 distinct clusters, previously reported in ongoing outbreaks in the United Kingdom, Berlin and the Netherlands. However, these strains were phylogenetically diverse to those previously reported in Barcelona metropolitan region. Ongoing hepatitis A outbreak in Barcelona affects primarily the MSM community and is phylogenetically linked to current hepatitis A outbreaks described in other European countries. As a result of the high admission rate, these outbreaks may impact the admission pattern of referral liver units. Control measures, for example vaccinations programs tailored to the MSM community, must be taken to control further spreading.

Effects of implementing the act of prohibition on sex trafficking on female sex workers' sexually transmitted infections.

This study investigated the effect of implementing the act of prohibition on sex trafficking (PST) on sexually transmitted disease (STD) infections among South Korean female sex workers (FSWs) working at prostitution blocks. Research data were collected twice through the Korean government-sanctioned survey for female sex workers (1st wave = 1,083; 2nd wave = 926). We examined the associations among health behavior, working conditions, and the effect of PST act via hierarchical logistic regression analyses using propensity score matching. After adjusted covariates, the risk probability was 0.288 times lower among FSWs who had remained in prostitute blocks after the PST act enforcement compared to FSWs who had worked before the PST. Similarly, the risk probability for a gonorrhea infection was 0.219 times lower among FSWs who had remained in prostitute blocks after the PST act compared to FSWs who had worked before the PST. Therefore, this study showed that, besides already known factors, the implementation and establishment of the PST Act was a strong factor that suppressed STD infections among FSWs.

Treatment-seeking behaviour and barriers to service access for sexually transmitted diseases among men who have sex with men in China: a multicentre cross-sectional survey

BackgroundDelayed or inappropriate treatment for sexually transmitted diseases (STDs) increases the risk of HIV acquisition and may cause other harmful outcomes. However, studies on STD treatment-seeking behaviour and correlated factors in men who have sex with men (MSM) are scarce.This information is crucial for the promotion of STD treatment-seeking behaviour and reduction of HIV transmission among Chinese MSM.MethodsDuring 2012–2013, a multicentre cross-sectional study was conducted in 7 Chinese cities. Participants completed an interview-questionnaire and gave venous blood samples, which were then tested for antibodies to HIV, syphilis, and herpes simplex virus-2 (HSV-2). MSM who tested positive for syphilis/HSV-2 or had obvious STD-related symptoms within the last 12 months were defined as suspected STD-infected MSM.ResultsOf the 4 496 eligible MSM who completed this survey, 24.4% (1 096/4 496) were categorized as suspected STD-infected MSM. 35.7% (391/1 096) of these MSM with suspected STD infections sought STD treatment in clinics within the last 12 months. Among MSM who did not attend STD clinics for treatment, the prevalence of syphilis and HSV-2 was significantly higher; the HIV prevalence and incidence within this subpopulation reached as high as 14.5% and 12.2/100 person-years, respectively. Multivariate logistic regression analysis indicated that having 7–12 years of education (vs. ≤6 years; aOR, 2.5; 95%CI, 1.0–6.1), ≥13 years of education (vs. ≤6 years: aOR, 2.8; 95%CI, 1.2–7.0), monthly income >500 USD (vs. ≤500 USD: aOR, 1.5; 95%CI, 1.1–2.1), obvious STD-related symptoms within last 12 months (aOR, 5.3; 95%CI, 3.7–7.5), being HIV infected (aOR, 1.7; 95%CI, 1.1–2.6), currently syphilis infected (aOR, 0.6; 95%CI, 0.4–0.9) and HSV-2 infected (aOR, 0.6; 95%CI, 0.5–0.9) were independent correlates with seeking STD treatment in clinics among Chinese MSM.ConclusionsThe high prevalence of STD infection coupled with a low proportion of individuals who exhibit appropriate treatment-seeking behaviour create a high risk of a growing HIV epidemic among Chinese MSM. Models that prioritize better screening for and education about STDs should be urgently implemented, especially among low-income MSM.

Impact of a Brief Intervention for Substance Use on Acquisition of Sexually Transmitted Diseases Including HIV: Findings From an Urban Sexually Transmitted Disease Clinic Population.

Unhealthy substance use is associated with increased rates of sexually transmitted diseases (STDs), including HIV. The screening, brief intervention, and referral to treatment strategy is effective at reducing substance use over time. We investigated whether STD clinic patients who received a brief intervention (BI) had lower rates of STD/HIV acquisition over time than those who did not. A retrospective sample of 7665 patients who screened positive for substance abuse or dependence between May 1, 2008, and December 31, 2010, was matched with STD and HIV surveillance registries for a 1-year follow-up period to determine incidence of STD and HIV infection. Overall, 44.6% (n = 3420) received BI; 7.0% of this population acquired a bacterial STD compared with 8.8% of persons who did not receive BI (P < 0.005). In multivariate analysis, BI had a protective effect against STD infection for men (odds ratio, 0.774; 95% confidence interval [CI], 0.63-0.96), after controlling for age, race/ethnicity, and sex of partner. There were 61 new HIV infections over the follow-up period; however, we found no significant association between BI and subsequent HIV diagnosis. Brief intervention is associated with a reduction in STD incidence among men who screen positive for substance abuse and should be considered as an STD prevention strategy. Further study is needed to identify mechanisms through which BI may impact STD outcomes.

P11.08 Knowledge of sexually transmitted disease risk among men who have sex with men

Introduction Sexually Transmitted Diseases (STDs) are the most frequent among Infectious diseases. In pathogenesis of the diseases that can be transmitted during sexual intercourse among, the most important is the problem of infected Anal secretions’ transfer. That transfer may happen directly during the Anal’s mucosa. The objective of the studies was risk awareness on STDs knowledge among men who have sex with men (MSM). Methods To describe the problem, the studies were done on 50 men of which 60% were MSMs, and 30% were Bisexual. The survey was carried out using internet, through the web page for Homosexuals. The research was based on Personal Questionnaire; concerning demographical data, question about sexuality and knowledge of STD. Results Almost half of the Men participating in the studies considered the level of their knowledge of STDs infection prevention were good. Most of them (ca.75%) reported that has never suffered an STD before. About 52% of the participants had problems to define infection risk in different sexual practices correctly, as well as to point out infection tracts. The biggest problem for them was to connect typical symptoms with particular diseases. However almost all participants assumed any STD’s symptoms appearance is an indication for immediate medical attention. Conclusions Although the prevailing parts of the participants were convinced to be well –informed about STDs, their knowledge was not deep – what can increase STDs infection risk.

Simultaneous PCR-Based Detection of Six Pathogens Inducing Sexually Transmitted Diseases

Background: Since many sexually transmitted diseases (STDs) show no noticeable symptoms immediately after the infections occur, their clinical documentation can be difficult. However, untreated infections with these pathogens may raise in time serious health problems. Conclusive identification of these pathogens is essential to limiting the spread of STD infections and other illness complications. Our study aims to test a molecular biology method based on Polymerase Chain Reaction (PCR) for the simultaneous determination in urine or vaginal samples of six pathogens that induce the most frequent STDs: Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium. Methods: Urine (men) and urine or vaginal samples (women) were collected from individuals suspected of sexually transmitted diseases. DNA was extracted, purified and amplified via PCR for simultaneous detection of the all abovementioned pathogens, and further identified in the mix using a 2% agarose gel electrophoresis, with ethidium bromide as staining agent. Results: Concentration and purity of the DNA extracted from all samples enabled proper identification of the pathogens causing STDs. Several double infections were noted. Conclusions: The method tested is accurate for simultaneous diagnosis of multiple STDs. We propose this technique to be used in population screening on the STDs incidence.

Awareness of Human Papillomavirus Vaccine Among Adolescent African American Males Who Have Sex with Males: a Pilot Study.

African American adolescent males who have sex with males (MSMs) have a high prevalence of sexually transmitted diseases (STDs) that has been directly linked to lack of access to primary care providers and reluctance to disclose their sexuality. The human papillomavirus (HPV) is the most common STD with more than 40 different serotypes and can lead to anal/genital warts as well as oral and genital cancers. The HPV vaccine if taken prior to an adolescent becoming sexually active serves a prophylactic function. The HPV vaccine is approved by the Food and Drug Administration (FDA) for girls and boys; however, HPV vaccination rates among adolescents within different minority and underserved communities have been disappointing even though these groups are disproportionately infected with the HPV virus and certain male-specific cancers. Little is known about the uptake of the vaccine among African American MSMs and thus the aim of this study. This qualitative study is based on the health belief model and assessed participants' level of awareness of HPV, the HPV vaccine, and HPV-related illnesses among 24 African American male adolescents between 16 and 18 years old who self identify as MSMs. As part of a larger study, two focus groups were conducted for African American MSMs. Participants failed to understand their potential risk for HPV given the higher rates of STD infection experienced by MSMs. They expressed very little knowledge of the HPV vaccine and are also not aware of the complications of HPV virus infection. However, they were very eager to know more about the virus and the vaccine. This study demonstrates the need for the development of health communication intervention and more research targeting African American MSMs and also the need for policy change towards making the HPV vaccine routine for males especially adolescents at no cost.

Prevalence and associated factors of mental health problems among monogamous Chinese female patients with sexually transmitted diseases in Hong Kong

Sexually transmitted disease (STD) increases risk of HIV infection and has profound psychological consequences. The present study examined the mental health problems (poor emotional well-being, insomnia, probable depression) and their associated factors among monogamous Chinese female STD patients. A total of 537 Chinese female STD patients who self-reported having had only one male sex partner in the last 12 months were recruited from a STD clinic in Hong Kong. They completed a survey including measures of mental health, STD-related history, perceptions, feelings related to STD infection, and perceptions toward condom use. Results showed that 22% had poor emotional well-being, 25.7% had insomnia, and 43% were probable cases of depression. Unemployment, worsened relationship with partners after STD diagnosis, STD history in last three months, finding STD examinations embarrassing, and feelings of helplessness were significant risk factors for poor emotional well-being and insomnia. Also, unemployment, worsened relationships with partners after STD diagnosis, and perceived high chance of STD in the coming six months were significant risk factors for probable depression. Perceived efficacy of condom use for STD prevention was a significant protective factor against poor emotional well-being and probable depression. Findings suggest that interventions are warranted to improve the mental health among this population.

Mating Competition, Promiscuity, and Life History Traits as Predictors of Sexually Transmitted Disease Risk in Primates

Competition among males influences the distribution of copulations and should therefore influence the spread of sexually transmitted diseases (STDs). We developed a model to investigate STDs in the mating and social systems found in primates, and we tested predictions using comparative methods. In the model, groups were distributed on a square lattice in which males or females disperse and males undergo characteristic dominance trajectories at maturity (challenge vs. queuing). We investigated the impact of mating rate, mating skew, migration rate of males or females, and group size on disease spread and prevalence. The model generated several predictions: 1) STD prevalence is higher in females than males; 2) STD risk increases with copulation rate; 3) high skew is negatively associated with STD risk; 4) STD risk is higher for all individuals when females disperse and 5) when mortality rates are lower; and 6) reproductive skew and later age of male dominance (queuing) produce more strongly female-biased STD prevalence. In comparative tests, we quantified STD risk as prevalence and richness of sexually transmitted organisms at the host species level. We found positive associations between host longevity and higher STD richness, and only (nonsignificant) weak trends for females to have higher STD prevalence. Mating skew showed a weakly positive association with STD richness, contrary to predictions of our model but consistent with predictions from a previous model. In some tests, we also found that female dispersal resulted in greater STD infection risk. Collectively, these results demonstrate that mating competition and demography influence patterns of STD infection, with mortality rates having the strongest effects in comparative tests.

Prevalence of HIV and sexually transmitted diseases as well as related associated risk factors among middle/low level female sex workers in a city in Guangdong province

To explore the prevalence of HIV, sexually transmitted diseases (STDs) and associated factors among medium/low level female sex workers (FSWs) in an under-developed city in Guangdong province. FSWs were reached by probability proportionate to size sampling through mapping. A cross-sectional survey was conducted to investigate data on demographic characteristics, sexual behaviors, condom use and drug use. 5 ml blood samples were collected to test for human immunodeficiency virus(HIV), syphilis and HSV-2. The prevalence rates of HIV, syphilis and HSV-2 were 0.3% (2/575), 4.9% (28/575) and 30.6% (176/575) respectively, and 32.2% (185/575)for STDs. Results from multivariate unconditional logistic regression model indicated that drug use (OR = 3.91, 95% CI:1.17-13.03) was the independent risk factor for STDs infection. Risks as ever accepted intervention program (OR = 0.14, 95% CI:0.04-0.52), with higher education level (OR = 0.40, 95% CI:0.19-0.83)and medium-fee charged FSWs(OR = 0.27, 95% CI:0.09-0.79) were protective factors for STDs. Sources of STDs and related risk factors were comprehensive among medium/low FSWs, especially for the latter, with all calling for multi-sector cooperation to explore the effective intervention program in this population.