Assessing the impact of intensive programme utilisation on HIV and sexually transmitted infection prevalence among a high-risk population in urban settings of Karnataka: evidence from three cross-sectional surveys, 2005–12

The Lancet ◽  
2013 ◽  
Vol 381 ◽  
pp. S117 ◽  
Author(s):  
Ravi Prakash ◽  
Shajy Isac ◽  
Parinita Bhattacharjee ◽  
BM Ramesh ◽  
Stephen Moses
2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Martha Ali Abdulai ◽  
Frank Baiden ◽  
Samuel Afari-Asiedu ◽  
Lawrence Gyabaa-Febir ◽  
Kwame Kesse Adjei ◽  
...  

Sexually transmitted infection (STI) affects the reproductive health of both men and women worldwide. Condoms are important part of the available preventive strategies for STI control. The lack of proper risk-perception continues to impede women’s ability to negotiate condom use with their partners. This paper is the outcome of secondary analysis of data collected in a cross-sectional survey that explored the perception of risk of STI and its influence on condom use among 504 pregnant women attending antenatal clinic at two health facilities in the Kintampo North Municipality. Consecutively, three Focus Group Discussions were conducted among 22 pregnant women which was analyzed using thematic analysis technique. Multivariate logistic regression analysis was used to identify possible predictors of condom use and risk of STI. Respondents mean age was 26.0±5.9 years. 47% of respondents self-identified themselves as high risk for contracting STI, 50% of whom were married. High risk status (OR = 2.1, 95% CI: 1.1–4.4), ability to ask for condoms during sex (OR = 0.3, 95% CI: 0.1–0.73), and partner’s approval of condom use (OR = 0.2, 95% CI: 0.01–0.05) were independent predictors of condom use. Condom use (OR 2.9 (1.5–5.7); p=0.001) and marital status (engaged, OR 2.6 (1.5–4.5); p=0.001) were independent predictors of risk of STI. Women who self-identified themselves as high risk for STI successfully negotiated condom use with their partners. This is however influenced by partner’s approval and ability to convince partner to use condoms. Self-assessment of STI risk by women and the cooperation of male partners remain critical.


2018 ◽  
Vol 94 (8) ◽  
pp. 598-603 ◽  
Author(s):  
Alexis Roth ◽  
Nguyen Khai Tran ◽  
Martha Chavis ◽  
Barbara Van Der Pol

ObjectivesTo inform the development of targeted sexually transmitted infection (STI) control programmes for persons who inject drugs (PWID).MethodsWe recruited 116 PWID (aged ≥ 18 years) from a community-based syringe exchange programme (SEP) and assessed their STI knowledge and screening preferences via technology assisted self-interview. We estimated prevalence of STI transmission knowledge, attitudes and screening preferences as well as the association between reported sexual behaviours (past 6 months) and willingness to self-collect specimens.ResultsParticipants were white (77%), female (51%) and heterosexual (77%). STI knowledge regarding transmission and testing was high among the sample. More than 70% of participants were aware extragenital infections were possible and were least likely to know urine tests do not detect rectal infections (40.9%). Site-specific specimen collection was highly reflective of reported sexual behaviour. PWID who reported receptive sex (36% vs 5%, p<0.01) and insertive anal sex (31% vs 6%, p=0.01) were more likely to collect rectal specimens than those who did not. A similar trend was seen for oral sex performance on men and self-collection of oropharyngeal swabs (15% vs 3%, p=0.04). In addition, participants preferred collecting their own sample to having a clinician collect it for them (69% vs 31%, p<0.01) and testing at the SEP compared with a STI clinic (86% vs 14%, p<0.01).ConclusionOur findings suggest site-specific specimen collection may be a proxy for risk behaviour engagement in this fairly knowledgeable high-risk population. To increase case finding, STI control programmes should educate patients about site-specific screening and pair outreach with the infrastructure provided by SEPs, in settings where these programmes exist.


2017 ◽  
Vol 9 (01) ◽  
pp. 016-019 ◽  
Author(s):  
Swapna Muthusamy ◽  
Selvi Elangovan

ABSTRACT Introduction: Women with high-risk sexual behavior accounts for more than half of the sexually transmitted infection (STI) clinic attendees. The prevalence of trichomoniasis is as low as 5% in the general population to as high as 60% in high-risk population. This infection can pave the way to the acquisition of human immunodeficiency virus and other STIs, vice versa and is even associated with cancer. Objectives: To identify, isolate and study the prevalence of Trichomonas vaginalis in genital specimens of female outpatients. Materials and Methods: Total number of subjects involved in the study was 130, among them 85 belonged to high-risk group and 45 belonged to low-risk group. Two high vaginal swabs were collected from each patient. Saline wet mount, Giemsa stain, and culture in modified cysteine peptone liver infusion maltose medium were performed. Results were tabulated and analyzed. Results: Saline wet mount was positive for trichomoniasis in seven individuals, Giemsa detected trichomoniasis in five patients, and culture was positive in eight patients. Of these eight culture positive cases, one was wet mount negative and four were Giemsa stain negative. Conclusion: Culture is more sensitive than wet mount and Giemsa stain.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Maitri Kalra ◽  
Yan Tong ◽  
David R. Jones ◽  
Tom Walsh ◽  
Michael A. Danso ◽  
...  

AbstractPatients with triple-negative breast cancer (TNBC) who have residual disease after neoadjuvant therapy have a high risk of recurrence. We tested the impact of DNA-damaging chemotherapy alone or with PARP inhibition in this high-risk population. Patients with TNBC or deleterious BRCA mutation (TNBC/BRCAmut) who had >2 cm of invasive disease in the breast or persistent lymph node (LN) involvement after neoadjuvant therapy were assigned 1:1 to cisplatin alone or with rucaparib. Germline mutations were identified with BROCA analysis. The primary endpoint was 2-year disease-free survival (DFS) with 80% power to detect an HR 0.5. From Feb 2010 to May 2013, 128 patients were enrolled. Median tumor size at surgery was 1.9 cm (0–11.5 cm) with 1 (0–38) involved LN; median Residual Cancer Burden (RCB) score was 2.6. Six patients had known deleterious BRCA1 or BRCA2 mutations at study entry, but BROCA identified deleterious mutations in 22% of patients with available samples. Toxicity was similar in both arms. Despite frequent dose reductions (21% of patients) and delays (43.8% of patients), 73% of patients completed planned cisplatin. Rucaparib exposure was limited with median concentration 275 (82–4694) ng/mL post-infusion on day 3. The addition of rucaparib to cisplatin did not increase 2-year DFS (54.2% cisplatin vs. 64.1% cisplatin + rucaparib; P = 0.29). In the high-risk post preoperative TNBC/BRCAmut setting, the addition of low-dose rucaparib did not improve 2-year DFS or increase the toxicity of cisplatin. Genetic testing was underutilized in this high-risk population.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ausenda Machado ◽  
Irina Kislaya ◽  
Amparo Larrauri ◽  
Carlos Matias Dias ◽  
Baltazar Nunes

Abstract Background All aged individuals with a chronic condition and those with 65 and more years are at increased risk of severe influenza post-infection complications. There is limited research on cases averted by the yearly vaccination programs in high-risk individuals. The objective was to estimate the impact of trivalent seasonal influenza vaccination on averted hospitalizations and death among the high-risk population in Portugal. Methods The impact of trivalent seasonal influenza vaccination was estimated using vaccine coverage, vaccine effectiveness and the number of influenza-related hospitalizations and deaths. The number of averted events (NAE), prevented fraction (PF) and number needed to vaccinate (NVN) were estimated for seasons 2014/15 to 2016/17. Results The vaccination strategy averted on average approximately 1833 hospitalizations and 383 deaths per season. Highest NAE was observed in the ≥65 years population (85% of hospitalizations and 95% deaths) and in the 2016/17 season (1957 hospitalizations and 439 deaths). On average, seasonal vaccination prevented 21% of hospitalizations in the population aged 65 and more, and 18.5% in the population with chronic conditions. The vaccination also prevented 29% and 19.5% of deaths in each group of the high-risk population. It would be needed to vaccinate 3360 high-risk individuals, to prevent one hospitalization and 60,471 high-risk individuals to prevent one death. Conclusion The yearly influenza vaccination campaigns had a sustained positive benefit for the high-risk population, reducing hospitalizations and deaths. These results can support public health plans toward increased vaccine coverage in high-risk groups.


2017 ◽  
Vol 29 (4) ◽  
pp. 357-361 ◽  
Author(s):  
Ann-Marie Lobo ◽  
Yan Gao ◽  
Laura Rusie ◽  
Magda Houlberg ◽  
Supriya D Mehta

In 2015, the Centers for Disease Control and Prevention (CDC) and the American Academy of Ophthalmology (AAO) released clinical advisories on rising cases of ocular syphilis. We examined the association between eye disease and syphilis infection among primary care and sexually transmitted infection (STI) clinic patients attending an urban lesbian, gay, bisexual, transgender (LGBT) health center. We conducted a retrospective medical record review of all patients who underwent syphilis testing at Howard Brown Health between 1 January 2010 and 31 December 2015. Confirmed eye diagnosis was based on International Classification of Diseases, Ninth Revision (ICD-9) diagnosis codes for conjunctivitis, uveitis, keratitis, retinitis, and red eye. Demographic information, syphilis treatment, HIV status, and high-risk behaviors were abstracted. Syphilis diagnosis was defined by available laboratory data (enzyme immunoassay [EIA], rapid plasma reagin [RPR] titer, fluorescent treponemal antibody absorption [FTA-Abs], Treponema pallidum Ab). Multivariable logistic regression with robust variance was used to identify independent associations. During the study period, 71,299 syphilis tests were performed on 30,422 patients. There were 2288 (3.2%) positive syphilis tests. Seventy-seven patients had a confirmed eye diagnosis (0.25%). Patients with eye disease had higher probability of at least one positive syphilis test (33%) compared to those without eye disease (8%) ( p < 0.01). Of patients with eye disease, 77% were men who had sex with men (MSM) and 65% were HIV-positive. Patients with eye disease had 5.97 (95% CI: 3.70, 9.63) higher odds of having syphilis compared to patients without eye disease. When adjusted for age, race, gender/sexual orientation, insurance status, and HIV status, this association between positive syphilis test and eye disease decreased but was still significant (OR 2.00, 95% CI 1.17, 3.41). Patients who present with an eye diagnosis to STI/primary care clinic have a higher probability of positive syphilis tests even after adjusting for other risk factors for syphilis. High-risk patients with eye symptoms should have routine STI testing and in keeping with CDC and AAO recommendations, full ophthalmologic examination.


2021 ◽  
Vol 9 ◽  
Author(s):  
Jacqueline Cortinhas Monteiro ◽  
Ricardo Roberto de Souza Fonseca ◽  
Tuane Carolina de Sousa Ferreira ◽  
Luana Lorena Silva Rodrigues ◽  
Andreza Reis Brasil da Silva ◽  
...  

Human papillomavirus (HPV) is the most common sexually transmitted infection in the world. Several studies have shown a higher prevalence of HPV infection in HIV-infected women. The aim of this study was to determine the prevalence and the genotype diversity of HPV infection in HIV-infected women. From April 2010 to December 2012 cervical specimens were collected from 169 HIV-infected women who screening for cervical cancer at Reference Unit in Belém. The detection of HPV infection was performed by nested PCR and HPV type was performed using a commercial system. The prevalence of HPV infection was 63.3%. Of the 47 genotyped samples, 40.4% was found positive for high risk-HPV 16 and 12.8% for high risk-HPV 52. HPV infection was predominant in the group of women with no incidence of cytological abnormalities and more prevalent in women of reproductive age, unmarried, low education level, and who reported use condoms during sexual intercourse. It was observed an association between HPV infection and independent variables, such as condom use, multiple sexual partners, and history of sexually transmitted diseases. High-risk types of HPV infection were prevalent in our study. Infection with multiple high-risk HPV genotypes may potentiate the development of cervical cancer in HIV-infected women.


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