Transmission Of Sexually Transmitted Diseases Research Articles

Access to Justice: Protecting Spousal Health from Sexually Transmitted Diseases Transmission within Marriage

This study explores how Indonesia’s present regulatory framework navigates to protect spousal health from Sexually Transmitted Diseases (STDs) transmission within marriage. Employing a normative legal approach which combines statutory analysis and comparative methods. The analysis focuses on Indonesia’s regulatory framework. Findings reveal that the current regulations including the Constitution 1945, Health Law, Marriage Law, Elimination of Domestic Violence Law, Criminal Code, various Regional Regulations and Regulation of The Minister of Health. These regulations provide limited coverage of instances where individuals jeopardies the health of others, particularly spouses, through the transmission of STDs. Comparative analysis of Singapore, Cambodia, Brunei Darussalam, and the United Kingdom demonstrate a common emphasis on informed consent and risk mitigation, often achieved through criminalization of non-disclosure of HIV status. However, the study acknowledges the limitations of such punitive approaches in achieving sustainable public health outcomes. The conclusion proposes moving beyond the current framework. It suggests leveraging the Health Law’s framework for family health promotion and its association with disease control. This could involve establishing a regulatory system grounded in scientific research, prioritizing a consensual and holistic approach cantered on comprehensive education and prevention programs. This approach recognizes STDs as a social issue requiring collective action, contrasting with the tendency in some neighboring countries to view them solely as a medical concern. By addressing these legal gaps and fostering responsible sexual health practices within marriage, Indonesia can contribute to a healthier and more secure marital environment for its citizens.

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.

Knowledge and Attitude Towards the use of Contraceptive Methods Among Undergraduates of a Selected Higher Education Institute in Sri Lanka

Unintended pregnancies and sexually transmitted diseases are some of the major reproductive health issues commonly encountered globally. As a developing country in South Asia, Sri Lanka has a prevalence rate of 23-46% of unplanned pregnancies. Two percent (2%) of government clinic attendees are detected with sexually transmitted diseases (STDs) and it is continually increasing among the young population. Poor knowledge, awareness and undesirable attitude towards contraception usage are some of the major factors associated with unintended pregnancies and transmission of STDs. Undergraduates are a vulnerable population to unintended pregnancies and sexually transmitted diseases. Therefore, this study was conducted with the objective of assessing the knowledge and attitudes towards the use of contraceptive methods among undergraduates of KIU. A descriptive cross-sectional study was conducted enrolling 304 undergraduates of 18 to 30 years of age using the simple random sampling method. Data were collected using a pre-tested self-administered questionnaire consisting of sociodemographic details and questions to assess participants’ knowledge and attitudes. The knowledge section of the questionnaire was marked out of 34 points, ones who obtained 0-12 marks were considered to have poor knowledge 13-24 as average knowledge and above 25 as good knowledge. The likert scale was used to assess the attitude section of the questionnaire. The results of the study revealed that the majority were females 62.5% (n=190) and 76.32% (n=232) of the study participants were from the age category of 23-27 years. Eighty-four percent (84%, n=255) of the study sample possessed a satisfactory level of knowledge in contraceptive methods and females showed a higher level of knowledge than males (p=0.002). Health science students had a higher level of knowledge than non-health science students (p=0.001). In conclusion, though the study population displays an overall positive attitude towards family planning methods, knowledge in this regard is average.

A Retrospective Study on Seroprevalence and Clinical Spectrum of Syphilis from a Tertiary Care Center in South India

Objectives: Syphilis is a sexually transmitted disease (STD) and a great imitator with a varied range of clinical manifestations. Incidence of syphilis has been on the rise in the last decade. In this study, we have analyzed the seroprevalence and clinical staging of syphilis cases reported in our healthcare facility. Materials and Methods: We conducted a retrospective analysis of syphilis by reviewing data from hospital sources from January 2017 to December 2019. Out of 8827 screened patients, the clinical data from patients who were serologically positive for both rapid plasma reagin and Treponema pallidum hemagglutination tests were retrieved and statistically analyzed. Results: Of the 8827 samples screened, 35 were diagnosed as cases of syphilis. Among 35 cases, primary syphilis was diagnosed in 8, secondary syphilis in 10, and latent syphilis in 17 cases. There were 4 (11.4%) females and 31 (88.6%) males. Twenty-one (60%) were married. Of 31 males, 23 (74.2%) were men who have sex with men (MSM). Among the 35 patients, 33 (94.3%) had unprotected and 2 (5.7%) had protected sexual activity. Out of them, 3 patients were human immunodeficiency virus positive, which included 2 with secondary and 1 with latent syphilis. Conclusion: Identification and health education of MSM, especially with respect to using barrier methods of contraception, are necessary in the prevention of transmission of STDs. With epidemiological trends showing syphilis re-emerging as a major sexually transmitted infection, there is a need to conduct multicenter prospective studies with larger sample size for better understanding and effective assessment of control measures.

Knowledge levels regarding sexually transmitted diseases among individuals with visual impairment: a cross-sectional study

ABSTRACT This study aimed to discover characteristics of individuals with visually impairment (VI) that are associated with lower knowledge of sexually transmitted diseases (STDs), in Turkey. In this cross-sectional study, data were collected online from 110 individuals with VI. Data analysis was performed using descriptive statistics and chi-square test. Knowledge regarding STDs varies significantly with gender, marital status, and education status (p < .05). The study provides evidence to indicate that participants have an inadequate of information the mode of transmission, prevention, and various types of STDs. The results call for intensified STD-related education and awareness creation for individuals with VI.

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.

Awareness, Knowledge and Risky Behaviors of Sexually Transmitted Diseases among Young People in Greece.

Sexually transmitted diseases (STDs) affect mainly young individuals and cause health, social, and economic problems worldwide. The present study used a web questionnaire to assess the awareness, knowledge, sexual behaviors, and common practices regarding STDs in young Greek adults. The 1833 individuals, aged 18–30 years, who responded to the study seem to be particularly knowledgeable regarding STDs such as AIDS (97.7%), warts (97%), Chlamydia (92.2%), genital herpes (89.9%), syphilis (81.9%), and gonorrhea (72.1%), whereas lower percentages were noted for trichomoniasis (39.3%), Molluscum contagiosum (12.9%), mycoplasmosis (11.6%), and amoebiasis (7.4%). Regarding oral STD transmission, participants replied correctly for genital herpes (45%), warts (35.8%), and AIDS (HIV; 33.8%), whereas 30.2% were unfamiliar with oral sexual transmission. Of the participants, 52% were not aware that STDs might cause infertility. Only 40.4% of the respondents reported always using condoms during sexual intercourse, and 48.6% had never been tested for STDs. The majority of the young population (55%) presented a moderate knowledge STD score (41–60%) and was associated with demographic parameters such as age, gender, sexual preference, number of sexual partners, and residence (p < 0.05). These findings provide important information regarding the prevention of STDs and highlight the significance of developing more effective sex education programs for young people in Greece.

Estimation of awareness of sexually transmitted diseases among married women of Menoufia governorate, Egypt

Objective The aim of this study was to explore the awareness about common sexually transmitted diseases (STDs) among a sample of married women of Menoufia governorate and to educate those who lack information about STDs. Furthermore, it could be used to serve as a tool to prevent and minimize the problems of STDs. Background Sexually transmitted infections are a major global cause of acute illness, infertility, long-term disability, and death, with serious medical and psychological consequences to millions of men, women, and infants. Patients and methods This was a cross-sectional study by interviewing participants using a questionnaire. The study was carried out on 200 women. Cases were recruited from the outpatient clinic of Menoufia University Hospital. Results Regarding modes of transmission and complication of STDs, there was good knowledge among the participants. Overall, 85.95% of the participants, comprising 29.7% of the noneducated versus 56.25% of the educated group, knew all modes of transmission like multiple partners, infected syringe, from mother to fetus, and blood transfusion). Conclusion The knowledge and awareness about STDs in Menoufia governorate has been a topic of interest in population research because of its apparent direct relationship with the lack of health facilities and indirectly, with poverty.

2020 STD Prevention Conference: Disrupting Epidemics and Dismantling Disparities in the Time of COVID-19.

2020 STD Prevention Conference: Disrupting Epidemics and Dismantling Disparities in the Time of COVID-19.

Changing Pattern of Chemsex Drug Use Among Newly Diagnosed HIV-Positive Taiwanese from 2015 to 2020 in the Era of Treat-All Policy.

Chemsex drug use (CDU) is a frequent, yet neglected issue in the era of treat-all policy. We evaluated the temporal pattern of CDU, factors associated with CDU, and drug-drug interactions (DDIs) between chemsex drugs and initial antiretroviral therapy (ART) by surveying 621 Taiwanese individuals (mean age: 29.7 years; 99.2% men; 92.9% men who have sex with men) diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from 2015 to 2020 [2015 to 2016 (period 1), 2017 to 2018 (period 2), and 2019 to 2020 (period 3)]. CDU was defined as chemsex in the past 1 year before HIV diagnosis. CDU remained prevalent across three periods (34.3-30.5%). Among CDU, methamphetamine (43.4%) was most frequently used, followed by amphetamine (40.0%) and poppers (various alkyl nitrites) (39.5%). We identified significantly increasing amphetamine use (37.0-61.5%) and decreasing ecstasy (methylenedioxy-methamphetamine) use (32.1-17.9%) in CDU across three periods. Besides, polydrug chemsex also significantly increased in CDU across three periods (23.5-43.6%), with amphetamine plus gamma-hydroxybutyrate being the most commonly used combination. CDU was associated with multiple sexual partners and a history of sexually transmitted diseases (STDs). DDIs between chemsex drugs and initial ART remained stable across three periods (10.6-7.8%), with cobicistat/elvitegravir and methamphetamine most common combination. In summary, the magnitude of CDU remained high across 2015-2020 in Taiwan, causing DDIs with initial ART agents. Strategies to reduce the frequency of high-risk sexual practices, STD transmission, and DDIs for newly diagnosed HIV-positive patients engaging in chemsex should be implemented.

Sex Education Correlating with STI Rates Througout Counties in Florida

This study’s goal was to discover the impact that varying types of high school sex education curriculums had on the rate of which their alumni ages 19-27 in 2018 contracted bacterial sexually transmitted diseases (STDs) throughout counties in Florida. The study was able to establish results that communicated which programs were most effective in preventing the transmission of STDs in comparison to the ones that were least effective. A meta-analysis of the amount of bacterial STD cases in each of four different counties in Florida as well as their corresponding sex education curriculum was used to discover the paper’s outcome. The different curriculums analyzed in this paper include abstinence-only, abstinence-plus, and comprehensive. Abstinence-only based programs teach students that refraining from all sexual activity until marriage is the sole moral way of preventing STD transmission and generally does not go over other methods of contraceptives. Abstinence-Plus programs teach students about methods of contraception and how to prevent STDs, but still preach that remaining abstinent is the correct and moral route to go down. The results showed that Lafayette County and Martin County had the least amount of bacterial STD cases among their alumni ages 19-27 yet used the most strict program (abstinence-only), Orange County had the most amount of bacterial STD cases among their alumni and used the second most strict program(abstinence-plus), and Polk County’s amount of bacterial STD cases fell under Orange County but above Lafayette County and Martin County; however they used the least strict program (comprehensive).

Monogamy as Public Policy for STD Prevention: In Theory and in Practice

Monogamy is current public policy for preventing sexually transmitted diseases (STDs). To evaluate whether monogamy is serving its intended purposes, the Centers for Disease Control’s (CDC’s) definition of monogamy is considered. This definition does not convey to the public the fact that monogamy must be practiced very strictly to be effective and implies that serial monogamy is a safe practice. Benefits and drawbacks of employing (different versions of) monogamy to reduce STD transmission are considered. Although certain forms of monogamy are efficacious in reducing STDs, these versions of monogamy have not been adopted by the public and widely practiced forms of monogamy are not effective in practice. Finally, this review considers whether the public policy of monogamy helps society achieve its sexual health goals, explicating strengths and weaknesses of monogamy advice versus other tactics that might be utilized to curb STDs.

Protect MSM from HIV and other sexually transmitted diseases by providing mobile health services of partner notification: protocol for a pragmatic stepped wedge cluster randomized controlled trial

BackgroundRecently, more and more men who have sex with men (MSM) look for casual partners through online dating platforms in China. However, most are unable to know their partners’ HIV and other sexually transmitted diseases (STD) statuses, leading to the rapid increase in HIV infection among Chinese MSM. Effective partner notification is urgently needed to increase the risk awareness of MSM and prevent HIV and other STDs transmission. However, the traditional intervention mainly targets to the HIV-positive MSM and the effect is not promising. Our study aims to provide Internet-based partner notification, along with a series of health services for HIV-negative MSM to protect them from HIV and other STDs.MethodsA pragmatic stepped wedge cluster randomized controlled trial design is used to evaluate the effectiveness of a new intervention paradigm, which aims to reduce HIV and other STDs incidences among MSM in China. Through integrating a mobile health (mHealth) service application (app) to the current HIV and other STDs prevention and control methods, the new paradigm provides partner notification of HIV, syphilis, hepatitis B, and hepatitis C statuses. A total of 6172 MSM in 16 districts of Beijing, China will be recruited and randomized to sequentially receive partner notification intervention through the app at 6-month intervals. The primary outcomes are HIV incidence and the additional cost of the intervention. The secondary outcomes include incidences of syphilis, hepatitis B, and hepatitis C, disease transmission social networks, testing adherence, knowledge of HIV and STDs control, health self-responsibility awareness, changes of high risk behaviors and other related outcomes. The generalized linear mixed models (GLMM) will be used to analyze the differences of outcomes in the control period and in the intervention period.DiscussionWe expect that the HIV incidence will be significantly lower and the secondary outcomes will also be improved with providing health service of partner notification through mhealth intervention. The feasible and affordable public health intervention paradigm will have implications for HIV and STDs prevention and control among MSM and other key populations.Trial registrationClinicalTrials.gov, NCT04349748. Registered on 16 April 2020.

Knowledge of Adolescent Girls regarding Sexually Transmitted Diseases: A Study in a Rural Area from North-Eastern Romania

This study aimed at assessing knowledge on sexually transmitted diseases (STDs) in rural 14 to 18-year-old adolescent girls. We administered a questionnaire about STDs to 534 girls and, then, organized a health education programme that included didactic lectures. The major sources of information about STDs were: family – 45.50%, professors – 21.70%, and the family doctor – 11.80%. Girls prefer to discuss sexuality with their mothers rather than with their fathers (23.03% vs. 2.62%). 16.60% knew about at least two STDs, while 8.10% had no knowledge about STDs. 95.30% of girls questioned had heard about HIV/AIDS, while 23.20% were aware that hepatitis B can be sexually transmitted, and 33.60% had heard about vaccination. Other STDs known by the adolescents were: syphilis (55.80%), candidiasis (12.90%), and trichomoniasis (6.60%). 33.10% of adolescents did not know of any methods of preventing STDs. Condoms were reported to be the first method of protection against pregnancy, not against STDs. If they had an STD, most adolescents (58.61%) would prefer to get their treatment from the pharmacy without first consulting a doctor. 74.50% of adolescents consider it useful to receive sexual education lectures in school, whereas 41.19% would like to receive information about STDs through brochures and 85.58% would rather find information on a website. STDs in teenage girls represent a special issue both for their families and society as a whole. The health education program contributed to raising awareness about STDs prevention and transmission in adolescents from rural area

Hepatitis A outbreak in HIV-infected patients in Southeastern France: questions and responses?

During the 2017 European hepatitis A (HA) outbreak we assessed HA incidence in our cohort of 2300 HIV-infected patients, implemented preventive measures and evaluated practices and knowledge on sexually transmitted diseases (STD). HA incidence was assessed between 1 January 2017 and 31 December 2017 and included all symptomatic patients with virologically confirmed HA. Preventive measures consisted in identifying at risk and not immunised patients to propose them a free HAV vaccination, and an anonymous survey related to transmission routes of STD and to sexual behaviours. Twenty HA were diagnosed. All were homosexual men recently diagnosed with HIV and another STD. None were vaccinated against hepatitis A virus (HAV). Hospitalisation was required for 52%. We identified 250 patients at risk to acquire HAV and invited them to a free immunisation program. A total of 110 (44%) were vaccinated, of whom 74 responded to our survey. A majority of them (84%) reported recent active anal and oral sexuality with multiple (52%) male partners (81%), and ChemSex consumption (14%). Internet was the meeting link for 58%. Another STD history was found in 69%. One third of these individuals had no idea about STD transmission modes. This HA outbreak pointed the insufficient vaccine coverage against HAV and knowledge on STD, which may be improved by Internet.

G1-S4 or G2-S16 carbosilane dendrimer in combination with Platycodin D as a promising vaginal microbicide candidate with contraceptive activity.

PurposeHIV-1 and herpes simplex virus type-2 (HSV-2) represent two of the most relevant sexually transmitted diseases (STDs) worldwide. Moreover, each year there are >200 million pregnancies worldwide, and more than half are unintended. Continued high rates of unintended pregnancies and spread of HIV-1 and HSV-2 require new approaches to address these problems. G1-S4 and G2-S16 dendrimers emerge as potential candidates for the development of a topical microbicide due to their safety and effectivity against HIV-1 and HSV-2 infection, both in vitro and in vivo. Our goal is to develop a dual topical microbicide to prevent the transmission of STDs and unintended pregnancies. Platycodin D (PD) was selected for its great spermicidal activity, topical application, and biocompatibility.Materials and methodsToxicology and inhibitory profile of G1-S4/PD and G2-S16/PD were evaluated in vitro and in vivo. Spermicidal activity was assessed by a computer-assisted sperm analysis system (CASA).ResultsG1-S4/PD and G2-S16/PD presented >95% of HIV-1 inhibition in TZM-bl cells and peripheral blood mononuclear cells. CASA assessment determined that 0.25 mM of PD with therapeutic concentrations of G1-S4 or G2-S16 was able to induce 100% immobilization of the sperm in 30 seconds. To evaluate the toxicity in vivo, a vaginal toxicity assay was performed in BALB/c mice. No significant changes or damage to the vaginal epithelium after 7 consecutive days of application were observed.ConclusionOur data indicate that G1-S4/PD and G2-S16/PD combinations are promising candidates to be developed for vaginal microbicides with contraceptive activity.

Prevalence and anatomical sites of human papillomavirus, Epstein-Barr virus and herpes simplex virus infections in men who have sex with men, Khon Kaen, Thailand

BackgroundHuman papillomavirus (HPV), Epstein-Barr virus (EBV) and herpes simplex virus (HSV) cause sexually transmitted diseases (STDs) that are frequently found in men who have sex with men (MSM) with human immunodeficiency viral (HIV) infection.MethodsThis study investigated the prevalence of infection and anatomical site distribution of these viruses in asymptomatic MSM. DNA, extracted from cells collected from the anorectum, oropharynx and urethra of 346 participants, was investigated for the presence of EBV, HPV and HSV using real-time PCR. Demographic data from the participants were analyzed.ResultsAll three viruses were found in all sampled sites. EBV was the commonest virus, being detected in the anorectum (47.7% of participants), oropharynx (50.6%) and urethra (45.6%). HPV and HSV were found in 43.9% and 2.9% of anorectum samples, 13.8% and 3.8% of oropharynx samples and 25.7% and 2% of urethra samples, respectively. HPV infection of the anorectum was significantly associated with age groups 21–30 (odds = 3.043, 95% CI = 1.643–5.638 and P = 0.001) and 46–60 years (odds = 2.679, 95% CI = 1.406–5.101 and P = 0.03). EBV infection of the urethra was significantly correlated with age group 21–30 years (odds = 1.790, 95% CI = 1.010–3.173 and P = 0.046). EBV/HPV co-infection of the anorectum (odds = 3.211, 95% CI = 1.271–8.110, P = 0.014) and urethra (odds = 2.816, 95% CI = 1.024–7.740, P = 0.045) was also associated with this age group. Among HIV-positive MSM, there was a significant association between age-group (odds = 21.000, 95% CI = 1.777–248.103, P = 0.016) in HPV infection of the anorectum. A failure to use condoms was significantly associated with HPV infection of the anorectum (odds = 4.095, 95% CI = 1.404–11.943, P = 0.010) and urethra (odds = 7.187, 95% CI = 1.385–37.306, P = 0.019). Similarly, lack of condom use was significantly associated with EBV infection of the urethra (odds = 7.368, 95% CI = 1.580–34.371, P = 0.011).ConclusionThese results indicate that asymptomatic MSM in Northeast Thailand form a potential reservoir for transmission of STDs, and in particular for these viruses.

Screening wild and semi-free ranging great apes for putative sexually transmitted diseases: Evidence of Trichomonadidae infections.

Sexually transmitted diseases (STDs) can persist endemically, are known to cause sterility and infant mortality in humans, and could have similar impacts in wildlife populations. African apes (i.e., chimpanzees, bonobos, and to a lesser extent gorillas) show multi-male mating behavior that could offer opportunities for STD transmission, yet little is known about the prevalence and impact of STDs in this endangered primate group. We used serology and PCR-based detection methods to screen biological samples from wild and orphaned eastern chimpanzees and gorillas (N = 172 individuals, including adults, and juveniles) for four classes of pathogens that either commonly cause human STDs or were previously detected in captive apes: trichomonads, Chlamydia spp., Treponema pallidum (syphilis and yaws), and papillomaviruses. Based on results from prior modeling and comparative research, we expected STD prevalence to be highest in females versus males and in sexually mature versus immature individuals. All samples were negative for Chlamydia, Treponema pallidum, and papillomaviruses; however, a high percentage of wild chimpanzee urine and fecal samples showed evidence of trichomonads (protozoa). Analysis revealed that females were more likely than males to have positive urine—but not fecal—samples; however, there was no evidence of age (sexual maturity) differences in infection status. Sequence analysis of chimpanzee trichomonad samples revealed a close relationship to previously described trichomonads within the genus Tetratrichomonas. Phylogenetic comparisons to archived sequences from multiple vertebrate hosts suggests that many of the chimpanzee parasites from our study are likely transmitted via fecal-oral contact, but the transmission of some Tetratrichomonas sequence-types remains unknown and could include sexual contact. Our work emphasizes that only a fraction of infectious agents affecting wild apes are presently known to science, and that further work on great ape STDs could offer insights for the management of endangered great apes and for understanding human STD origins. Am. J. Primatol. 77:1075–1085, 2015. © 2015 Wiley Periodicals, Inc.

Changing Beliefs and Behaviors Related to Sexually Transmitted Diseases in Vulnerable Women: A Qualitative Study.

Background:The first step in health education is awareness of the people and their acceptance to change their behavior. Therefore, the aim of this study was to investigate the effects of empowerment program towards the concept of self-care and prevention of sexually transmitted diseases (STDs) in women at risk of STDs.Materials and Methods:The present study was conducted as a qualitative approach (step of action and observation of an action) by using conventional content analysis method. An empowerment program regarding STDs (Action) was performed among 32 (with convenient sample) drug user women with addicted husbands referring to the counseling center for vulnerable women (drop in enter) in Isfahan in 2015. The knowledge of quiddity, transmission, and prevention of STDs, as well as some items of life skills such as self-awareness, interpersonal communication, and assertive behavior were taught in an educational program. Teaching methods were lectures, group, and individual training and role play. The impact of the program on modified belief and behavior change regarding STDs was evaluated with structured interviews.Results:Analysis of the obtained results yielded three categories. The categories were awareness of STD, believing in being at risk, and decision and change.Conclusions:Promoting self-care and prevention through education programs based on action research can make a significant reduction in the incidence of problems and cause a behavior change in women with the disease or those at risk for STDs.

Syphilis on the rise: A prolonged syphilis outbreak among HIV-infected patients in Northern Greece.

Sexually transmitted diseases (STDs) are a major public health issue in Europe. Numerous outbreaks of syphilis have been described recently and an increased prevalence of high-risk sexual practices has raised concern about the transmission of HIV and other STDs. Similarly, an increase in sexually transmitted infections has been recorded in Northern Greece. This report describes a recent outbreak of syphilis in people living with HIV. The demographic, clinical, and serologic data of HIV patients diagnosed with syphilis were recorded and analyzed. Data on syphilis incidence from the general population was also compared to HIV patients' data. Fifty-eight HIV-patients of the Infectious Diseases Unit of a tertiary hospital (5.2%) were diagnosed with syphilis during a three-year period (2008-2010). Highly active antiretroviral therapy (HAART) and coexistence of other STDs were independent predictors of syphilis (OR: 2.4, 95CI%: 1.26, 4.63, p=0.008; OR: 9.4, 95%CI: 4.49, 19.64, p<0.001, respectively). Origin from a country other than Greece (p=0.005), and homosexual contact (p=0.003), were separate risk factors for syphilis in the general population in the same area. Diagnosis of a sexually transmitted disease in an HIV patient is a crucial clinical event that should trigger the clinician's suspicion for high-risk sexual behavior. Sexual health assessments should be a routine process for HIV patients.