scholarly journals Why is syphilis rising in Europe? Multi-level modelling of alternative hypotheses in 31 countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Mendez-Lopez ◽  
D Stuckler ◽  
T Noori ◽  
J C Semenza
Keyword(s):  
Risky Sexual Behavior ◽  
Population Level ◽  
Internet Survey ◽  
Probability Models ◽  
Syphilis Infection ◽  
Detection Rates ◽  
Substantial Impact ◽  
Multi Level ◽  
Sex With Men ◽  
Linear Probability

Abstract Background Syphilis transmission has increased markedly over the past two decades in Europe, concentrated in men who have sex with men. We test alternative potential social and behavioral individual- and population-level determinants of this resurgence. Methods Two rounds of the cross-sectional European Men who have sex with men Internet Survey (EMIS 2010 and 2017, n = 272,902) were used to fit multi-level linear probability models to evaluate determinants of the incidence of self-reported syphilis, capturing risky sexual behaviours and pre-exposure prophylaxis use, among others, adjusting for potential sociodemographic confounders. Results Self-reported syphilis incidence rates rose by about 1.8 percentage points (within the last 12 months) and 3.9 (within the last 5 years) between the 2010 and 2017 waves, after adjusting for sociodemographic factors. HIV status was a major risk factor for syphilis infection (27.6 ppt higher incident rate, 95%CI: 24.7 to 30.5). A dose-response relationship was observed between greater numbers of condomless non-steady partners and syphilis infection, with more than 10 partners estimating increases in the probability of diagnosis of over 25 ppt (11-20 partners vs none: 24.5 ppt, 95%CI: 20.5 to 28.5); further, we observed evidence of mediation for number of condomless non-steady partners, which attenuated the estimated rise in 2017 vs 2010 by about 35%. STI testing uptake also accounted for a substantial increase in syphilis incidence signaling higher detection rates over time. While country-level PrEP use was linked to greater number of condomless partners, there was no substantial impact of population-wide factors, including GDP and PrEP use, on overall syphilis trends. Conclusions Risky sexual behavior changes, particularly condomless sex with non-steady partners, appears to be a major contributing factor to rising syphilis incidence. Further research is needed to understand what accounts for this substantial behavior change. Key messages Increased number of condomless non-steady partners accounts for a substantial rise in syphilis trends. Population-level PrEP use was linked to increasing numbers of condomless non-steady partners but had no substantial impact on overall syphilis trends.

Political trust, political party preference and trust in knowledge-based institutions

2019 ◽  
Vol 40 (1/2) ◽  
pp. 154-168 ◽  
Author(s):  
Arttu Saarinen ◽  
Aki Koivula ◽  
Teo Keipi
Keyword(s):  
Political Party ◽  
Party System ◽  
Political Trust ◽  
Population Level ◽  
Past Research ◽  
Probability Models ◽  
Content Type ◽  
Knowledge Based ◽  
Party Preference ◽  
Linear Probability

Purpose The purpose of this paper is to analyze the association between political party preference and trust in knowledge-based institutions, while also considering how political trust facilitates the association. The authors focus on the opinions of supporters of the six largest parliamentary political parties in Finland. Design/methodology/approach The data are based on a population level survey. First, the authors compared party supporters’ trust in universities and YLE media. Second, the authors analyzed how political trust contributes to party supporters’ trust in knowledge-based institutions by estimating predicted probabilities. Third, the authors derived the partial correlations from the non-linear probability models incorporated separately between trust in YLE, Universities and political trust, and compared the correlations across the parties. Finally, the authors conducted the logit models from which the authors post-estimated the predicted probabilities of having high trust in YLE and Universities according to the levels of political trust separately for each party. Findings The results showed a cumulation of trust, reflecting especially on the attitudes of the populist party supporters who tended to have lower trust in knowledge-based institutions and distrust was highly associated with low political trust. This cumulation of trust shows an interesting dynamic in how closely institutions are linked together in terms of attitudes on their legitimacy. Originality/value This study assesses the cumulation of distrust, while providing an alternative political spectrum to the US two party system that has been the major focus of past research. Furthermore, the study fills a gap in the research by being the first to assess the intersection of the trust dimensions.

scholarly journals Chances of Pregnancy After Dropping Out From Infertility Treatments: Evidence From A Social Survey in Japan

2021 ◽  
Author(s):  
Marie Hirakawa ◽  
Emiko Usui ◽  
Nahoko Mitsuyama ◽  
Takashi Oshio
Keyword(s):  
Descriptive Analysis ◽  
Infertility Treatment ◽  
Internet Survey ◽  
Dropping Out ◽  
Probability Models ◽  
Infertility Treatments ◽  
Patient Will ◽  
Future Pregnancy ◽  
Linear Probability

Abstract Background: Previous studies have examined the factors that predict whether a patient will discontinue infertility treatments. However, little is known about a patient’s chances of pregnancy after dropping out.Method: Drawing from a nationwide Internet survey in Japan with 1,930 respondents, we used data from 199 individuals (109 women and 90 men) who had undergone an infertility treatment. Besides conducting a descriptive analysis to examine the probability of pregnancy after the treatment, we estimated linear probability models to investigate the extent to which the probability of pregnancy was affected by dropping out after controlling for a couple’s attributes.Results: Among the 199 respondents who had experienced an infertility treatment, 91 (45.7% of the entire sample) became pregnant during the treatment, and 108 (54.3%) dropped out. Among these 108 dropouts, 66 (33.2%) eventually became pregnant. After controlling for a couple’s attributes, we found that treatment discontinuation reduced the probability of pregnancy by 35.4% (standard error: 5.0%). A relatively limited reduction in the chances of pregnancy was also observed after a patient dropped out of any of the three treatment stages (timed intercourse, artificial insemination with the husband’s semen, and in vitro fertilization).Conclusions: The results suggest that dropping out from infertility treatments does not preclude any chance of a future pregnancy; in fact, the chances remain relatively high. Further analysis of a patient’s chances of pregnancy after dropping out is required to evaluate the effectiveness of infertility treatments appropriately. Additionally, more follow-up attention should be provided to dropout patients.

Increasing gay men’s testing rates and enhancing partner notification can reduce the incidence of syphilis

Sexual Health ◽  
2012 ◽  
Vol 9 (5) ◽  
pp. 472 ◽  
Author(s):  
Ian Down ◽  
David P. Wilson ◽  
Pol Dominic McCann ◽  
Richard Gray ◽  
Alexander Hoare ◽  
...  
Keyword(s):  
Mathematical Model ◽  
Gay Men ◽  
Online Survey ◽  
Partner Notification ◽  
Population Level ◽  
Anal Intercourse ◽  
Syphilis Infection ◽  
Substantial Impact ◽  
Syphilis Testing ◽  
Sexually Transmissible Infections

Background We sought to determine whether gay men would be willing to increase syphilis testing and partner notification, and assessed the possible epidemiological impact these changes might have in the Australian population. Methods: We conducted an online survey (n = 2306) and focus groups to determine whether interventions to increase testing for syphilis and enhanced partner notification are likely to be acceptable to gay men in Australia. An individual-based mathematical model was developed to estimate the potential population-level impact of changes in these factors. Results: Of all men surveyed, 37.3% felt they should test more frequently for sexually transmissible infections. Men who recent unprotected anal intercourse with casual partners and men who reported a higher number of partners were more likely to indicate a greater willingness to increase testing frequency. HIV-positive men were more likely to indicate that their frequency of syphilis testing was adequate, incorporated as part of their regular HIV monitoring. Lack of convenience was the main barrier reported. Partner notification was broadly acceptable, although perceived stigma presented a potential barrier. The mathematical model indicated that increasing testing rates would have a substantial impact on reducing rates of syphilis infection among gay men and partner notification would further reduce infections. Conclusions: Interventions promoting testing for syphilis among gay men and increases in partner notification may be acceptable to gay men and are likely to result in decreased infection rates. Rapid testing and modern communication technologies could strengthen these interventions, and have an impact on the syphilis epidemic.

scholarly journals A community intervention to reduce alcohol consumption and drunkenness among adolescents in Sweden: a quasi-experiment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Robert Svensson ◽  
Björn Johnson ◽  
Karl Kronkvist
Keyword(s):  
Alcohol Consumption ◽  
Community Intervention ◽  
Parental Attitudes ◽  
Compulsory Education ◽  
Self Report ◽  
Probability Models ◽  
Drinking Habits ◽  
Adolescent Drinking ◽  
Quasi Experimental ◽  
Linear Probability

Abstract Background Several studies have examined the effect of community interventions on youth alcohol consumption, and the results have often been mixed. The aim of this study is to evaluate the effectiveness of a community intervention known as the Öckerö Method on adolescent alcohol consumption and perceived parental attitudes towards adolescent drinking. Method The study is based on a quasi-experimental design, using matched controls. Self-report studies were conducted among adolescents in grades 7–9 of compulsory education in four control and four intervention communities in the south of Sweden in 2016–2018. Baseline measures were collected in autumn 2016 before the intervention was implemented in the intervention communities. Outcomes were the adolescents’ alcohol consumption, past-year drunkenness, past-month drunkenness and perceived parental attitudes towards alcohol. Results Estimating Difference-in-Difference models using Linear Probability Models, we found no empirical evidence that the intervention has any effect on adolescents’ drinking habits, or on their perceptions of their parents’ attitudes towards adolescent drinking. Conclusion This is the first evaluation of this method, and we found no evidence that the intervention had any effect on the level of either young people’s alcohol consumption or their past-year or past-month drunkenness, nor on their parents’ perceived attitudes toward adolescent drinking. A further improvement would be to employ a follow-up period that is longer than the three-year period employed in this study. Trial registration ISRCTN registry: Study ID: 51635778, 31th March 2021 (Retrospectively registered).

scholarly journals Excellent Self-Rated Health among Swedish Boys and Girls and Its Relationship with Working Conditions in School: A Cross-Sectional Study

2021 ◽  
Vol 18 (3) ◽  
pp. 1310
Author(s):  
Sara Brolin Låftman ◽  
Maria Granvik Saminathen ◽  
Bitte Modin ◽  
Petra Löfstedt
Keyword(s):  
Academic Success ◽  
Working Conditions ◽  
Cross Sectional Study ◽  
Probability Models ◽  
Positive Health ◽  
Cross Sectional ◽  
School Aged Children ◽  
Self Rated Health ◽  
Linear Probability ◽  
Classmate Support

The aim of this study was to investigate the extent to which school demands, teacher support, and classmate support were associated with excellent self-rated health among students, and to examine if any such statistical predictions differed by gender. Data were drawn from the Swedish Health Behaviour in School-aged Children (HBSC) study of 2017/18, performed among adolescents in grades five, seven, and nine (n = 3701). Linear probability models showed that school demands were negatively associated with excellent self-rated health, whereas teacher and classmate support showed positive associations. The link with school demands was stronger for girls than boys, driven by the finding that in grades five and nine, school demands were associated with excellent self-rated health only among girls. In conclusion, the study suggests that working conditions in school in terms of manageable school demands and strong teacher and classmate support may benefit adolescents’ positive health. The finding that the link between school demands and excellent self-rated health was more evident among girls than among boys may be interpreted in light of girls’ on average stronger focus on schoolwork and academic success. The study contributes with to knowledge about how working conditions in school may impede or promote students’ positive health.

Increases in both HIV and syphilis among men who have sex with men in Vietnam: Urgent need for comprehensive responses

2021 ◽  
pp. 095646242110364
Author(s):  
Thuong V Nguyen ◽  
Hau P Tran ◽  
Nghia V Khuu ◽  
Phuc D Nguyen ◽  
Tu N Le ◽  
...  
Keyword(s):  
Sexual Debut ◽  
Temporal Trends ◽  
Consistent Condom ◽  
Test Results ◽  
Syphilis Infection ◽  
Early Sexual Debut ◽  
Sti Prevention ◽  
Factors Associated ◽  
Hiv Test ◽  
Sex With Men

The objective of this study was to determine the temporal trends and factors associated with HIV and syphilis infection among men who have sex with men (MSM) in southern Vietnam. Data from the 2014–2018 national HIV sentinel surveillance of MSM aged 16 years or older were collected from three provinces, including An Giang ( N = 761), Can Tho ( N = 900), and Ho Chi Minh City ( N = 1426), and examined for changes in prevalence rates of HIV and syphilis and risk behaviors over time. Multivariate logistic regression was performed to assess the trends and correlates of HIV and syphilis infections among MSM. There were upward trends for HIV (9.5% in 2014 to 14.2% in 2018, p-trend<0.01), syphilis (4.9% in 2014 to 8.0% 2018, p-trend<0.01), and HIV/syphilis co-infection (1.9% in 2014 to 3.1% in 2018, p-trend=0.01). Factors associated with HIV infection included place of residence, early sexual debut, consistent condom use and not engaging in anal sex during the past month, not knowing one’s HIV test results, having ever injected drugs, and having active syphilis. Additionally, early sexual debut and being HIV positive were associated with syphilis infection. Rising prevalences of these infections among MSM suggests an urgent need for comprehensive intervention packages for HIV/STI prevention.

Triple site sexually transmitted infection testing as a crucial component of surveillance for men who have sex with men: A prospective cohort study

2021 ◽  
pp. 095646242110474
Author(s):  
Roy Zucker ◽  
Michael Gaisa ◽  
Keith Sigel ◽  
Ilan Singer ◽  
Amos Adler ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Study Groups ◽  
Sexual Risk Taking ◽  
Syphilis Infection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Crucial Component ◽  
Sex With Men

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are common among men who have sex with men (MSM). Many oropharyngeal and anorectal infections remain asymptomatic. We aimed to evaluate triple-site screening following PrEP introduction. We enrolled a prospective cohort study including 210 asymptomatic MSM during 2019–2020, analyzed by groups: HIV positive (HIV+), HIV−uninfected using PrEP (HIV−/PrEP+), or HIV-uninfected not using PrEP (HIV−/PrEP−). A self-administered questionnaire captured demographic information and sexual risk-taking behaviors. CT/NG testing results were compared between study groups and predictors of infection were evaluated. We included 59 HIV+, 70 HIV−/PrEP+, and 81 HIV−/PrEP− subjects. 30% ( n = 62) of participants tested positive for CT/NG. HIV−/PrEP+ group had highest proportion of infections ( n = 33, 47%) followed by HIV−/PrEP− ( n = 16, 22%) and HIV+ ( n=13, 20%; p < .001). Importantly, 98% (80/82) of pharyngeal/anorectal CT/NG infections were missed in genitourinary tract screening alone. PrEP use and previous syphilis infection were the strongest risk factor for CT/NG. Extra-genital asymptomatic CT/NG infections were prevalent among MSM. These data highlight the importance of routine extra-genital CT/NG testing in asymptomatic sexually active MSM. The study describes the consequences for three-site testing lack of implementation in the PrEP era.

scholarly journals Implementation of a Rapid Entry Program Decreases Time to Viral Suppression Among Vulnerable Persons Living With HIV in the Southern United States

2018 ◽  
Vol 5 (6) ◽  
Author(s):  
Jonathan Colasanti ◽  
Jeri Sumitani ◽  
C Christina Mehta ◽  
Yiran Zhang ◽  
Minh Ly Nguyen ◽  
...  
Keyword(s):  
United States ◽  
Viral Suppression ◽  
Hiv Transmission ◽  
Positive Impact ◽  
Population Level ◽  
The United States ◽  
Clinic Visit ◽  
Art Initiation ◽  
Persons Living With Hiv ◽  
Sex With Men

Abstract Background Rapid entry programs (REPs) improve time to antiretroviral therapy (ART) initiation (TAI) and time to viral suppression (TVS). We assessed the feasibility and effectiveness of a REP in a large HIV clinic in Atlanta, Georgia, serving a predominately un- or underinsured population. Methods The Rapid Entry and ART in Clinic for HIV (REACH) program was implemented on May 16, 2016. We performed a retrospective cohort study with the main independent variable being period of enrollment: January 1, 2016, through May 15, 2016 (pre-REACH); May 16, 2016, through July 31, 2016 (post-REACH). Included individuals were HIV-infected and new to the clinic with detectable HIV-1 RNA. Six-month follow-up data were collected for each participant. Survival analyses were conducted for TVS. Logistic and linear regression analyses were used to evaluate secondary outcomes: attendance at first clinic visit, viral suppression, TAI, and time to first attended provider visit. Results There were 117 pre-REACH and 90 post-REACH individuals. Median age (interquartile range [IQR]) was 35 (25–45) years, 80% were male, 91% black, 60% men who have sex with men, 57% uninsured, and 44% active substance users. TVS decreased from 77 (62–96) to 57 (41–70) days (P &lt; .0022). Time to first attended provider visit decreased from 17 to 5 days, and TAI from 21 to 7 days (P &lt; .0001), each remaining significant in adjusted models. Conclusions This is the largest rapid entry cohort described in the United States and suggests that rapid entry is feasible and could have a positive impact on HIV transmission at the population level.

scholarly journals Assessing mobile technology use and mHealth acceptance among HIV-positive men who have sex with men and transgender women in Malaysia

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248705
Author(s):  
Archana Krishnan ◽  
Damian Weikum ◽  
Claire Cravero ◽  
Adeeba Kamarulzaman ◽  
Frederick L. Altice
Keyword(s):  
Mobile Technology ◽  
Risky Sexual Behavior ◽  
Technology Use ◽  
Treatment Strategies ◽  
Transgender Women ◽  
Hiv Positive ◽  
Art Adherence ◽  
Unsafe Sex ◽  
Cross Dressing ◽  
Sex With Men

Background Mobile health (mHealth) can be beneficial in monitoring the complex healthcare regimen for people with HIV that includes adhering to medication and refraining from risky practices such as unsafe sex and injection drug use. Not only is mHealth often implemented without appropriate feasibility and acceptability research, but there is limited mHealth research among key HIV-positive populations such as men who have sex with men (MSM) and transgender women (TGW). Methods This study assessed access to and use of mobile technology and acceptability of mHealth among 150 HIV-positive MSM and TGW who were prescribed antiretroviral therapy (ART) in Malaysia–an emerging economy with rapid telecommunications growth and societal stigma against these groups. Results Findings among the 114 MSM and 36 TGW reveal high levels of depression (42%), stigma (2.53/4.00) and risky sexual behavior (30%), and suboptimal ART adherence (22%). On the other hand, the sample had excellent access to smartphones (75.3%) and the internet (78%), and had high acceptance of mHealth especially for those with suboptimal ART adherence. Conclusion In settings like Malaysia where homosexuality and cross-dressing are socially and legally stigmatized, HIV prevention and treatment strategies delivered using an mHealth platform have the potential to overcome in-person barriers.

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