STI Infection Research Articles

Assessment of Stigma, Violence and Coping Mechanisms Among HIV Infected People Who Inject Drugs in Akwa-Ibom State, Nigeria

People who inject drugs (PWIDs) living with HIV face high levels of stigma, violence, and rape due to their risky lifestyles, potentially facilitating the spread of HIV. This study assessed the level and type of stigma and violence among PWIDs attending Heartland Alliance in Akwa Ibom State and their coping mechanisms. This descriptive cross-sectional study of 442 PWIDs receiving care at four one-stop shops in the state was conducted using mixed methods. Quantitative data were collected through pretested structured questionnaires and an adopted stigma scale, administered by trained research assistants using Computer Assisted Personal Interviewer (CAPI). For qualitative data, one focus group discussion (FGD) was held at each site with 8-10 purposively selected PWIDs, and transcripts were analyzed thematically. The study findings reveals that most respondents were male (78%) with a mean age of 32.7±7 years. Pentazocine use was common (52%), and 18% shared needles, with 15% sharing blood after injections among friends. More than half (58%) missed more than one dose of ARVs in the past week. Perceived stigma (59%) was more common than internal stigma (18%), with predictors being student status, non-disclosure of HIV status, and non-adherence to treatment. PWIDs Physical violence (47.5%) and verbal abuse (37.1%) were prevalent among PWIDs. Female PWIDs had a ninefold higher risk of rape. Coping mechanisms included isolation, increased substance use, battle readiness, and positive reframing. <i>Conclusion</i>: PWIDs face significant levels of stigma, violence, and non-adherence, jeopardizing treatment outcomes and perpetuating STI, HIV, and blood-borne infection transmission. Establishing harm-reduction programs is essential to address these vulnerabilities and the consequences associated with drug use.

Prevalence and associated risk factors of chlamydia and gonorrhoea infections among men who have sex with men in Durban, South Africa.

Despite significant research on the prevalence of STIs in South African men who have sex with men (MSM), recent data on the prevalence and risk factors for curable STI infections among this key populations are limited. This study determined the prevalence of and risk factors associated with Neisseria gonorrhoeae and Chlamydia trachomatis infections among MSM. The sample consisted of 200 MSM resident in Durban. Data were collected using a self-administered questionnaire, and urine samples were collected and tested for N. gonorrhoeae and C. trachomatis. The prevalence of N. gonorrhoeae and C. trachomatis were 3.0% and 6.0%, respectively. Younger age was significantly associated with testing positive for C. trachomatis (p=0.037). Being between the ages of 30-39 years old reduced the risk of acquiring C. trachomatis infection (OR: 0.10, 95% CI: 0.0120-0.7564, p=0.026). In addition, being circumcised reduced the risk of contracting C. trachomatis (adjusted OR: 0.01, 95% CI: 0.0005-0.3516, p=0.01). However, having between 2-4 sex partners increased the risk of testing positive for C. trachomatis (adjusted OR: 107.45, 95% CI: 1.3467-8573.3130, p=0.036). The following factors were significantly associated (p<0.05) with testing positive for N. gonorrhoeae infection: cohabiting with sex partner, engaging in group sex, and drug use. Fear and stigma were the main barriers to accessing health care in the studied population. This study provided evidence of high rates of C. trachomatis infection among MSM resident in Durban. Based on the results, South African MSM, especially the young MSM population, should be given priority when delivering intervention programs to prevent STIs.

Status of reproductive health knowledge amongst High School girls in selected secondary schools, Limpopo Province, South Africa.

Among all age groups, knowledge of reproductive health can prevent unplanned pregnancy and STIs. The study assessed the status of reproductive health knowledge among secondary school girls in Limpopo Province, South Africa. A cross-sectional descriptive study design was conducted among secondary school girls between the ages of 14 and 19. A total of three hundred and forty (N=340) eligible learners were selected using stratified random sampling method. A self-administered questionnaire was used for data collection and data was analysed using Statistical Package for Social Sciences (SPSS) version 25. All ethical considerations were ensured throughout the study. About 184(56%) of the respondents were aged between 14 and 16 years, and 59% were grade nine and ten. The majority (72%; n=239) of the respondents stayed in rural areas and attended public schools (83%;n=274). Half (51%) of the study respondents had no idea about menstruation. Nine percent (24) of the respondents mentioned ICUD as a method of contraception. HIV/AIDS was the most common STI infection known by respondents at 52%. Oral and injectable contraceptives 72(35%) were cited as the most known methods to prevent unplanned pregnancies. The study found that respondents exposed little or lack of knowledge about reproductive health. Therefore, the Department of Education must carry out reproductive education among girls to promote reproductive health. Parents should be encouraged to explain reproductive health issues to their girl child.

Suicidal behaviour and intravenous drug use in chemsex context

IntroductionSeveral studies have called atention to the mental health disorders associated with chemsex --the intentional use of drugs before or during sexual intercourse GBMSM (gay, bisexual and men who have sex with men) population-. Sexualized intravenous drug use is also known as slam or slamsex. There are few studies that analyze the mental health differences between intravenous drug users compared to non-intravenous drug users in chemsex context.ObjectivesTo describe the suicidal behaviour in a sample of users with sexualized drug use (chemsex) attended by the non-governmental organization Apoyo Positivo in the program “Sex, Drugs and You” and to compare the suicidal behaviour between intravenous drug users compared to non-intravenous drug users.MethodsA cross-sectional descriptive analysis of a sample of users attended by the non-governmental organization Apoyo Positivo in the program “Sex, Drugs and You” between 2016-2019 was performed.ResultsWe included 217 participants. 37 had attempted suicide at least once. The percentage of chemsex users who have attempted suicide were significantly higher in the intravenous drug use group compared to the non-intravenous drug use group (p&lt;0.05).ConclusionsPossible risk factors for suicidal behaviour among chemsex users include slamsex. Other possible risk factors previously described in other studies include adversities experienced due to one’s sexual orientation and an increased risk for HIV and other STI infections. Further studies analyzing the relationship between chemsex, slamsex and suicidal behaviour are needed.Disclosure of InterestNone Declared

Роль нутритивной поддержки при планировании беременности

Aim. The review is devoted to the causes and consequences of nutritional deficiency in the diet of a pregnant woman, as well as the possibilities of its replenishment. It has been proven that insufficient intake of vitamins and minerals during pregnancy is accompanied by a lack of nutrients to the fetus, which can cause obstetric and perinatal complications (such as gestational diabetes mellitus, preeclampsia, FGRS, etc.). In the conditions of the unfavorable demographic situation that currently exists in Russia, the birth of a healthy child is becoming one of the pressing problems. This is due to the entry into the childbearing period of a generation with low health indicators. The portrait of a modern young woman is 2 or more chronic extragenital diseases (arterial hypertension, chronic pyelonephritis, cystitis, anemia), early onset of sexual activity, frequent change of sexual partners (STI infection), refusal to use contraceptives (abortion), underweight, bad habits. The importance of the role of vitamin-mineral complex as an integral part of pre-gravid preparation becomes obvious. Material and methods. To write this review, a search was carried out for domestic and foreign publications in Russian and international search systems (PubMed, eLibrary, etc.) over the past 25 years. The review included articles from the peer-reviewed literature. Results. The review presents research data on the importance of using micronutrient support drugs before, during and after pregnancy. Conclusion. Thus, at the present stage, prenatal preparation is distinguished by an integrated approach and promotes the onset of pregnancy with optimal indicators, prevents the development of gestational complications, improves perinatal outcomes, and, accordingly, improves the health of the offspring as a whole.

Influence of Migration on the Situation with Syphilis in the Russian Federation

Syphilis is a socially significant disease, and the relevance of monitoring its incidence rates remains constant. The spread and level of syphilis morbidity in the Russian Federation is strongly influenced by migration processes. Over the last 7 years the migration flow in the country has increased by 17.5% and the number of migrant workers, them has increased 3 times. It is contingent of people, that being a “vulnerable group”, and most off all exposed to risky sexual behavior and STI infection. In 2021 and 2022 there was a significant increase in the incidence of syphilis in the Russian Federation, compared to 2020 — by 69.7%. The increase in the incidence of syphilis is largely due to the growth of this indicator among foreign citizens (from 2801 cases in 2020 to 12 748 cases in 2022). The proportion of registered cases of syphilis among foreign citizens in 2022 was 45.9% of all detected cases, while 80% of syphilis patients were citizens of one of 3 countries — Kyrgyz Republic (30%), Republic of Uzbekistan (27%), Republic of Tajikistan (23%). In the structure of clinical forms of syphilis detected in foreign citizens 98% are hidden and unspecified forms of the disease, only 13% of migrants with syphilis were treated and 87% have no information about the fact of treatment. Thus, latent forms of the disease and low percentage of treated foreign citizens with diagnosed syphilis have a negative impact on the epidemiological situation of syphilis incidence. These facts testify to the formation of risks of epidemiological danger of syphilis among foreigners entering the territory of the country, which poses a direct threat to biological security of the Russian Federation and requires the development of a set of measures to prevent the spread of the disease.

The Burden and Predictors of Early Sexual Initiation among School-Going Adolescents in Rural Settlements in Rivers State, Nigeria

Introduction. Early sexual initiation is the art of initiating sexual activity before age 15. This study aimed to identify the burden and predictors of early sexual initiation among school-­going adolescents in rural settlements in Rivers State, Nigeria. Materials and Methods. A cross-­sectional study was conducted among 420 school-­going senior secondary school adolescents of coeducational schools aged 15–19 from May 2023 to September 2023. A multi-­stage sampling procedure was used to select respondents from four senior secondary coeducational schools. Data were collected using a semi-structured interviewer-­assisted questionnaire. Frequency tables were generated and Logistic regression analysis was used to determine predictors of early sexual initiation at a 5% level of significance. Results. The mean age of respondents was 15.7 ± 0.8 years. The mean age at early sexual initiation was 12.2 ± 1.2 years. The burden of early sexual initiation and ever-had sex among the respondents was 46% and 54.8% respectively with poor academic performance, school dropout, STI infection, pregnancy, and HIV infection experienced as outcomes of first sexual initiation among the respondents. The statistically significant predictors of early sexual initiation were adolescents having worked for pay, currently working for pay, and adolescents’ age at first sexual partner (OR = 4.6; 95% CI = 1.6–12.7; P = 0.004, OR = 6.6; 95% CI = 1.9–23.7; P = 0.003 and OR = 3.1; 95% CI = 1.3–7.2; P = 0.009). Conclusion. Sexuality education and programmes aimed at encouraging school-­going adolescents to delay first-sex initiation should be encouraged.

Substance use, economic vulnerability, and HIV/STI risk among female sex workers in Mexico.

Economic hardship (e.g., difficulty to pay for basic needs) has been associated with increased HIV/STI risk among female sex workers (FSW), and may be exacerbated by high levels of substance use. Few studies have assessed the intersection of economic hardship, substance use, and HIV/STI risk among FSW. Quantitative data were collected via questionnaires among 469 FSW residing in Tijuana and Ciudad Juarez, Mexico. Using logistic regression, we assessed the role of economic hardship on the association between substance use (past 30-days alcohol use, drug use, or injection drugs use with clients, and past 6-months drug use) and testing positive for an STI (also an indicator of HIV risk). Drug use in the preceding six months was significantly associated with testing positive for an STI (AOR = 1.8, CI: 1.1 = 2.9, p = .02); no difference in this association was found by whether women reported economic hardship. Past 30-day drug use with clients was associated with STI infection, but only among those who did not report economic hardship (AOR = 1.5, 95% CI: 1.1-1.9, p < .01). Findings suggest that economic hardship influences the association between substance use and increased risk for HIV/STI among FSW; however, these associations may be more complex than previously hypothesized.

Fabaceae: South African Medicinal Plant Species Used in the Treatment and Management of Sexually Transmitted and Related Opportunistic Infections Associated with HIV-AIDS

The use of medicinal plants, particularly in the treatment of sexually transmitted and related infections, is ancient. These plants may well be used as alternative and complementary medicine to a variety of antibiotics that may possess limitations mainly due to an emerging enormous antimicrobial resistance. Several computerized database literature sources such as ScienceDirect, Scopus, Scielo, PubMed, and Google Scholar were used to retrieve information on Fabaceae species used in the treatment and management of sexually transmitted and related infections in South Africa. The other information was sourced from various academic dissertations, theses, and botanical books. A total of 42 medicinal plant species belonging to the Fabaceae family, used in the treatment of sexually transmitted and related opportunistic infections associated with HIV-AIDS, have been documented. Trees were the most reported life form, yielding 47.62%, while Senna and Vachellia were the frequently cited genera yielding six and three species, respectively. Peltophorum africanum Sond. was the most preferred medicinal plant, yielding a frequency of citation of 14, while Vachellia karoo (Hayne) Banfi and Glasso as well as Elephantorrhiza burkei Benth. yielded 12 citations each. The most frequently used plant parts were roots, yielding 57.14%, while most of the plant species were administered orally after boiling (51.16%) until the infection subsided. Amazingly, many of the medicinal plant species are recommended for use to treat impotence (29.87%), while most common STI infections such as chlamydia (7.79%), gonorrhea (6.49%), syphilis (5.19%), genital warts (2.60%), and many other unidentified STIs that may include “Makgoma” and “Divhu” were less cited. Although there are widespread data on the in vitro evidence of the use of the Fabaceae species in the treatment of sexually transmitted and related infections, there is a need to explore the in vivo studies to further ascertain the use of species as a possible complementary and alternative medicine to the currently used antibiotics in both developing and underdeveloped countries. Furthermore, the toxicological profiles of many of these studies need to be further explored. The safety and efficacy of over-the-counter pharmaceutical products developed using these species also need to be explored.

Changes in HIV Prevention and Sexual Experiences During the COVID-19 Pandemic: A Mixed-Methods Study.

STI and HIV services and infection rates were affected during the COVID-19 pandemic, because of changes in access to health care and individual behavior. Understanding how individuals made decisions around prevention and sexual activities during different phases of the pandemic is useful to addressing the rising rates of STIs and HIV. Federally-qualified health center focused on sexual and gender minority health, Chicago IL, 2021. Patients with a history of PrEP use who were contacted by the PrEP retention team as part of standard care were invited to complete an online survey. A subset of survey participants were then contacted to complete one-on-one interviews. Participants were asked about two distinct periods: November 2020 to January 2021 and February to June 2021. From the 356 survey participants (mostly young, insured, and experienced with PrEP), more than half maintained their number of sex partners during the early pandemic and most also maintained PrEP use; during the later pandemic; most reported more or the same number of sex partners and almost all maintained PrEP use. From interviews, we identified diverse and changing experiences regarding sexual practices throughout the pandemic; whereas many participants changed PrEP use in accordance with sexual practices, many others maintained PrEP use as a habit. COVID-19 prevention was also a factor in sexual activities, particularly prevaccination. Many PrEP users try to align their HIV prevention with their sexual exposures and establish PrEP as a long-term habit. Removing financial and access barriers is important to improve PrEP use and STI testing.

Association of sexual relationship power with PrEP persistence and other sexual health outcomes among adolescent and young women in Kenya and South Africa.

Gendered power inequalities impact adolescent girls' and young women's (AGYW) sexual and reproductive health (SRH) outcomes. We investigated the influence of sexual relationship power on AGYW's SRH outcomes, including HIV pre-exposure prophylaxis (PrEP) persistence. The POWER study in Kisumu, Kenya, and Cape Town and Johannesburg, South Africa provided PrEP to 2,550 AGYW (aged 16-25). AGYW's perceived power in their primary sexual relationship was measured among the first 596 participants enrolled using the Sexual Relationship Power Scale's (SRPS) relationship control sub-scale. Multivariable regression was used to test for (1) key sociodemographic and relationship characteristics associated with relationship power; and (2) the association of relationship power with SRH outcomes including PrEP persistence. In this cohort, the mean SRPS score was 2.56 (0.49), 542 (90.9%) initiated PrEP; 192 (35.4%) persisted with PrEP at 1 month of which 46 (24.0% of 192) persisted at 6 months. SRPS were significantly lower among AGYW who cohabited with their sex partner (-0.14, 95% CI: -0.24 to -0.04, p = 0.01), or had ≥1 sex partner (-0.10, 95% CI: -0.19 to -0.00, p = 0.05). AGYW with lower SRPS were more likely to not know their partner's HIV status (aOR 2.05, 95% CI: 1.27 to 3.33, p < 0.01), but SRPS was not associated with PrEP persistence, STI infection, condom, or hormonal contraception use. AGYW's reasons for initiating PrEP and reasons for continuously using PrEP may be different. While low relationship power was associated with perceived HIV vulnerability, AGYW's PrEP persistence may be influenced by more than relationship power.

Partnership types and coital frequency as predictors of gonorrhea and chlamydia among young MSM and young transgender women.

Sexually transmitted infections pose a major public health challenge in the United States and this burden is especially acute in subpopulations like young men who have sex with men (YMSM) and young transgender women (YTW). Yet, the direct behavioral antecedents of these infections are not well understood making it difficult to identify the cause of recent increases in incidence. This study examines how variations in partnership rates and the number of condomless sex acts are associated with STI infections among YMSM-YTW. This study leveraged 3years of data from a large longitudinal cohort of YMSM-YTW. A series of generalized linear mixed models examined the association between the number of condomless anal sex acts, number of one-time partners, number of casual partners, and number of main partners and chlamydia, gonorrhea, or any STI. Results indicated the number of casual partners was associated with gonorrhea [aOR = 1.17 (95% CI: 1.08, 1.26)], chlamydia [aOR = 1.12 (95% CI: 1.05, 1.20)], and any STI [aOR = 1.14 (95% CI: 1.08, 1.21)] while the number of one-time partners was only associated with gonorrhea [aOR = 1.13 (95% CI: 1.02, 1.26)]. The number of condomless anal sex acts was not associated with any outcome. These findings suggest the number of casual partners is a consistent predictor of STI infection among YMSM-YTW. This may reflect the quick saturation of risk within partnerships making the number of partners, rather than the number of acts, the more relevant factor for STI risk.

Spatial variations in STIs among women enrolled in HIV prevention clinical trials in Durban, KwaZulu-Natal, South Africa

ABSTRACT South Africa is faced with a high HIV and STI prevalence and incidence, respectively, with pockets of high burden areas driving these diseases. Localised monitoring of the HIV epidemic and STI endemic would enable more effective targeted prevention strategies. We assessed spatial variations in curable STI incidence among a cohort of women enrolled in HIV prevention clinical trials between 2002 and 2012. STI incidence rates from 7557 South African women enrolled in five HIV prevention trials were geo-mapped using participant household GPS coordinates. Age and period standardised incidence rates were calculated for 43 recruitment areas and Bayesian conditional autoregressive areal spatial regression (CAR) was used to identify significant patterns and spatial patterns of STI infections in recruitment communities. Overall age and period standardised STI incidence rate were estimated as 15 per 100 PY and ranged from 6 to 24 per 100 PY. We identified five significant STI high risk areas with higher-than-expected incidence of STIs located centrally (three-locations) and southern neighbouring areas of Durban (two-locations). Younger age (<25), not married/cohabitating, parity <3 and poor education were all significant correlates of high STI communities. Findings demonstrate sustained STI incidence rates across the greater Durban area. The role of STI incidence in HIV acquisition in high HIV endemic areas need to be revisited as current highly effective PrEP interventions do not protect from STI acquisition. In these settings there is an urgent need for integrative HIV and STI prevention and treatment services.

Abstinence-Only Sex Education in Public Schools: A Special Commentary

Abstinence Only Until Marriage (AOUM) programs, also known as Sexual Risk Avoidance (SRA) programs, are non-comprehensive, religion and values-based programs that are still widely used, and supported by government funding, in schools around the United States of America. Content of these programs include messages of misogyny, heteronormativity, and racism, among others. Existing research has indicated that sex education programs lack efficacy in prevention or reduction in teen pregnancy and STI infection. However, little research has investigated the potentially harmful impact of biased messaging to long term sexual and mental health and well-being. In this commentary, I highlight some of the messaging included in AOUM and SRA programs and suggest future research into the impact on sexual development, intimate relationships, and mental health and wellness.

Self-start HIV postexposure prophylaxis (PEPSE), to reduce time to first dose and increase efficacy

BackgroundEffectiveness of HIV postexposure prophylaxis (PEPSE) correlates with speed of uptake following HIV exposure. Time to first dose has not improved in the UK for over 10 years. On-demand pre-exposure...

Co-infection of COVID-19 and Monkeypox: A Case Report from Florida, USA, 2022

Monkeypox is a re-emerging zoonotic disease of the orthopoxvirus genus presenting with myocutaneous symptoms similar to those caused by smallpox. Patients infected with monkeypox may experience a prodromal period with flulike symptoms lasting between 1-4 days, an asymptomatic incubation period lasting 7-17 days and a symptomatic rash period lasting 14-28 days between the appearance of widespread vesiculopapular lesions and desquamation. Specific risk factors for the current monkeypox outbreak include HIV infection, prior STI infection, male sex, young-adult age (specifically being in the 20’s-30’s age group), engaging in risky behaviors (such as unprotected sex) and men having sex with other men. We report the case of a 38-year old HIV+ patient testing positive for monkeypox, COVID-19 and herpes who presented to the emergency department with widespread vesiculopapular lesions. One week prior to ED presentation, the patient experienced flu-like symptoms including fever and, two days later, developed a vesiculopapular rash beginning on his face and spreading downwards to his extremities, trunk and genitalia. The flu-like symptoms developed twelve days after attending an event where the patient reported having sex with multiple other men. The patient was treated with intravenous fluids and supportive care alongside his HIV medications. Nine days after initial ED presentation, all skin lesions were desquamated and the patient was discharged from the hospital. To our knowledge, this is one of the first reported cases of co-infection with COVID-19 and monkeypox in Florida and the United States more broadly. Despite our patient’s several risk factors for monkeypox infection, and immunosuppressed status, he experienced an uncomplicated clinical course. As vaccination and antiviral treatments become more available for monkeypox patients, our case suggests supportive care with airborne and contact precautions may be adequate in the treatment of future monkeypox patients where these treatments are unavailable.

KORUNMASIZ CİNSEL İLİŞKİ SONUCU ÜRETRİT TANISI ALAN SÜNNETLİ HASTALARDA ASEMPTOMATİK HIV, HEPATİT B, HEPATİT C VE SİFİLİZ GÖRÜLME SIKLIĞI

Aim: In this study, it was aimed to determine the frequency of asymptomatic Human Immunodeficiency Virus (HIV), Hepatitis B, Hepatitis C, and syphilis in circumcised patients diagnosed with urethritis transmitted by sexual intercourse because of unprotected sexual contact. Material and Methods: We retrospectively investigated the serological results of HIV, Hepatitis B, Hepatitis C, and Syphilis diseases in 364 male patients diagnosed with urethritis, all of them were circumcised during childhood. The study included patients who applied to the urology outpatient clinic of secondary state hospital between January 2017 and December 2019 with symptoms or signs of urethritis. In the examination, only urethral discharge could be seen without symptoms. After the patients were examined, first void urine samples were taken. Also at the first examination, peripheral blood samples were tested for HIV, Hepatitis B, Hepatitis C, and syphilis antibodies. Results: As a result of retrospective screening of the serological results of 364 male patients diagnosed with urethritis, Hepatitis B positivity was 1.09% with 4 cases, Hepatitis C positivity was found as 0.27% in 1 case and the Syphilis positivity rate was 1.92% with 7 cases in 364 patients. None of the patients had HIV positivity. Conclusions: The fact that there was not any encounter of HIV-positive patients in patients diagnosed with urethritis because of unprotected sexual contact led to the thought that circumcision had a protective contribution in these patients with urethritis, who were all circumcised. Also, screening tests, especially syphilis, should be performed on all patients diagnosed with STI infection.

Assessing the Impacts of HIV/AIDS Programmes on Sexual Health among the Youths of Obiyebe Community in Ogba/Ebgema/Ndoni Local Government Area of Rivers State

This study assessed the impacts of HIV/AIDS programmes on sexual health among youths of Obiyebe community in Ogba/Egbema/Ndoni LGA of Rivers State. The purpose of the study was to identify HIV/AIDS programmes on sexual health, to assess the knowledge of HIV/AIDS programmes on sexual health among the youths and to examine the impacts of HIV/AIDS programmes on sexual health among youths. The study adopted a descriptive survey study design with a sample size of 83 participants which are selected through a simple random sampling technique. A structured questionnaire was used as the instrument for data collection, while a frequency table and simple percentage were used as the instrument for data analysis. The findings of the study revealed that HIV/AIDS programmes on sexual health are; HIV/AIDS testing programmes, HIV/AIDS treatment programmes, HIV/AIDS prevention programmes, and United Nations Programmes on HIV/AIDS (UNAIDS). Another finding of the study showed that sexuality, condoms, sexual anatomy and sex, and adolescence sexual features and puberty are the knowledge of sexual health among the youths that enhance their good sexual health and prevention of HIV/AIDS. Again the study revealed that the impacts of HIV/AIDS programmes on the sexual health of the youths were that their understanding of sexuality is increased, they understand the importance of using condoms if sexually active, there is a reduction in unwanted teenage pregnancies, they are informed of their normal sexual features development, puberty, reproductive anatomy and physiology, they are informed of the option to delay sexual activity until they are ready (matured), and there is a reduction of new HIV/AIDS/ other STI infections. The study made some recommendations and suggestions.

An individually randomized controlled trial of a mother-daughter HIV/STI prevention program for adolescent girls and young women in South Africa: IMARA-SA study protocol

BackgroundSouth Africa has the world’s largest HIV epidemic, but South African adolescent girls and young women (AGYW) acquire HIV at twice the rate of and seroconvert on average 5–7 years earlier than their male peers. Female caregivers (FC) are an untapped resource for HIV/STI prevention in South Africa and offer a novel opportunity to strengthen AGYW prevention efforts. This study will evaluate the effectiveness and cost-effectiveness of an evidence-based mother-daughter HIV/STI prevention program tested in the United States and adapted for South Africa, Informed Motivated Aware and Responsible Adolescents and Adults (IMARA), to decrease STI incident infections and increase HIV testing and counseling (HTC) and PrEP uptake in AGYW.MethodsThis is a 2-arm individually randomized controlled trial comparing IMARA to a family-based control program matched in time and intensity with 525 15–19-year-old Black South African AGYW and their FC-dyads in Cape Town’s informal communities. AGYW will complete baseline, 6-, and 12-month assessments. Following randomization, AGYW-FC dyads will participate in a 2-day group workshop (total 10 h) that includes joint and separate mother and daughter activities. Primary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 6 months. Secondary outcomes are AGYW STI incidence, HTC uptake, and PrEP uptake at 12 months, sexual behavior (e.g., condom use, number of partners), HIV incidence, and ART/PrEP adherence and intervention cost-effectiveness. AGYW who test positive for a STI will receive free treatment at the study site. HIV positive participants will be referred to ART clinics.DiscussionPrimary prevention remains the most viable strategy to stem new STI and HIV transmissions. HIV and STI disparities go beyond individual level factors, and prevention packages that include supportive relationships (e.g., FC) may produce greater reductions in HIV-risk, improve HTC and PrEP uptake, and increase linkage, retention, and adherence to care. Reducing new HIV and STI infections among South African AGYW is global public health priority.Trial registrationClinicalTrials.gov Number NCT04758390, accepted 02/16/2021.

The Intersection of Intimate Partner Violence Perpetration and Sexual Risk Behavior Among Young Men in Tanzania: A Latent Class Analysis of Patterns and Outcomes.

Few studies of intimate partner violence (IPV) perpetration and sexual risk behavior among men have examined how multiple dimensions of these behaviors intersect in ways that may uniquely elevate health risks. The current study used latent class analysis to: (1) identify distinct patterns of IPV and sexual risk behavior in a sample of Tanzanian men (n = 985) and (2) examine associations between identified patterns and health outcomes. Four classes were identified: normative (64% of the sample), IPV only (14%), sexual risk only (13%), and comorbid IPV/sexual risk (5%). Compared to men in the normative subgroup, men in the comorbid group had significantly higher odds of STI infection, higher perceived HIV risk, and greater odds of substance use. Findings provide evidence that engaging in IPV and multiple sexual partnerships (i.e., a comorbid pattern) denotes elevated health risks across a range of indicators, suggesting the importance of targeted treatment and prevention efforts for men in this subgroup.