scholarly journals Optimizing Screening for HIV

2020 ◽  
Author(s):  
Antoine Chaillon ◽  
Martin Hoenigl ◽  
Lorri Freitas ◽  
Haruna Feldman ◽  
Winston Tilghman ◽  
...  
Keyword(s):  
At Risk ◽  
Screening Program ◽  
Demographic Data ◽  
The United States ◽  
Hiv Prevalence ◽  
Screening Tests ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
At Risk Populations ◽  
Zip Code

Abstract Background The HIV epidemic is unevenly distributed throughout the United States, even within neighborhoods. This study evaluated how effectively current testing approaches reached persons at risk for HIV infection across San Diego (SD) County, California. Methods HIV case and testing data, sexually transmitted infection (STI) and socio-demographic data for SD County were collected from the SD Health and Human Services Agency and the ‘Early Test’ community-based HIV screening program between 1998 and 2016. Relationships between HIV diagnoses, HIV prevalence, and STI diagnoses with screening at zip code level were evaluated. Results Overall, 379,074 HIV tests were performed. The numbers of HIV tests performed on persons residing in a zip code or region overall strongly correlated with prevalent HIV cases (R2=0.714), new HIV diagnoses (R2=0.798), and STI diagnoses (R2=0.768 [chlamydia],0.836 [gonorrhea], 0.655 [syphilis]) in those regions. Zip codes with the highest HIV prevalence had the highest number of tests per resident and fewest number of tests per diagnosis. Even though most screening tests occurred at fixed venues located in high prevalence areas, screening of residents from lower prevalence areas was mostly proportional to the prevalence of HIV and rates of new HIV and STI diagnoses in those locales. Conclusion This study supported the ability of a small number of standalone testing centers to reach at-risk populations dispersed across SD County. These methods can also be used to highlight geographic areas, or demographic segments that may benefit from more intensive screening.

Value of targeting at-risk populations at outreach venues: findings from a local sauna

2009 ◽  
Vol 20 (9) ◽  
pp. 642-643 ◽  
Author(s):  
J Arumainayagam ◽  
R Grimshaw ◽  
S Acharya ◽  
S Chandramani ◽  
I A Morrall ◽  
...  
Keyword(s):  
At Risk ◽  
Hepatitis B ◽  
Sexually Transmitted Infection ◽  
Hepatitis B Vaccination ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
At Risk Populations ◽  
Sex With Men

An assessment of the need to increase access to an outreach venue, the local sauna in Walsall, UK, frequented only by men who have sex with men, was undertaken. A case-notes review of the clients who attended the monthly outreach sessions at the sauna in the year 2007 was performed. Among the 287 men seen at the 12 outreach sessions, 37% had a sexually transmitted infection (STI). Of those tested positive, 88% had never had a previous STI. Twenty-one men had syphilis and a further six tested positive for HIV. Hepatitis B vaccination was completed for 41% of the clients seen. Those who tested positive for an STI said they would not have attended a conventional setting but accepted screening at the sauna. This confirmed the need to increase access at this outreach venue, and further funding has now been provided to have outreach sessions twice a month.

scholarly journals Suppressive valacyclovir therapy to reduce genital herpes transmission: Good public health policy?

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Paul E Bonnar
Keyword(s):  
Genital Herpes ◽  
Screening Program ◽  
Antiviral Agent ◽  
Suppressive Therapy ◽  
Number Needed To Treat ◽  
Economic Costs ◽  
Transmitted Infection ◽  
Herpes Simplex Viruses ◽  
Sexually Transmitted ◽  
Individual Level

Genital herpes is a widespread sexually transmitted infection caused by the herpes simplex viruses (HSV). Suppressive valacyclovir therapy has been shown to significantly reduce HSV transmission. The benefits and costs of using valacyclovir to reduce transmission in couples discordant for genital herpes will be analyzed in order to better inform decision-making. By reducing transmission, the physical and psychological harms of living with symptomatic genital herpes will be prevented while saving on certain healthcare costs. However, the large number needed to treat and the low symptomatic rate among infected individuals may outweigh these benefits. The costs of trying to achieve a significant reduction in incidence include the psychological harms of identifying asymptomatic individuals through a large screening program and the economic costs of the antiviral agent and screening. When these issues are weighed, the high economic costs render a program to reduce incidence unfeasible. Nevertheless, it is clinically important to consider the consequences of transmission at an individual level. The specific circumstances that influence the decision to use suppressive therapy are identified.

scholarly journals Association between intensity of STI screening and development of antimicrobial resistance in N. gonorrhoeae in 12 cities in the USA: An ecological study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1237
Author(s):  
Chris R. Kenyon
Keyword(s):  
United States ◽  
Antimicrobial Resistance ◽  
Ecological Study ◽  
Geometric Mean ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Antimicrobial Sensitivity ◽  
The Usa ◽  
Sex With Men

In this study, we assessed if there was a city-level association between sexually transmitted infection (STI) screening intensity in men who have sex with men and antimicrobial sensitivity in Neisseria gonorrhoeae in the United States, 2007 to 2013.  We found positive associations between STI screening intensity and increases in minimum inhibitory concentrations for cefixime and azithromycin, but not ceftriaxone when using change in city geometric mean N. gonorrhoeae MIC between 2005 and 2013.

scholarly journals Incidence, risk factors and distribution of syphilis in the end-stage renal disease population in the USA

2019 ◽  
Vol 13 (4) ◽  
pp. 625-630
Author(s):  
Erena N Weathers ◽  
Jennifer L Waller ◽  
N Stanley Nahman ◽  
Rhonda E Colombo ◽  
Mufaddal F Kheda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
The United States ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
The Usa ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract Background Syphilis is a sexually transmitted infection with an incidence of 14.9 cases per 100 000 persons in the USA in 2011. Untreated syphilis may remain quiescent for years but can also result in clinical sequelae, including neurosyphilis. End-stage renal disease (ESRD) patients may be at risk for syphilis due to a higher incidence of risk factors for the disease, including human immunodeficiency virus (HIV). Despite the presence of these risk factors, the incidence of syphilis in the ESRD population has not been reported. To address this issue, we investigated the incidence and risk factors for syphilis in the ESRD population using the United States Renal Data System (USRDS). Methods This study analyzed incident ESRD patients from 2004 to 2010. Based on International Classification of Diseases, Ninth Revision codes for syphilis, we determined the incidence and risk factors for syphilis following an inpatient diagnosis. Generalized linear modeling was used to examine the relative risk (RR) for the disease when controlling for demographic and other clinical risk factors. Results A total of 383 diagnoses of syphilis were identified after screening 759 066 patients. The 8-year incidence of any type of syphilis was 50.45 cases per 100 000 person-years. Other unspecified syphilis (29.77 cases per 100 000 person-years) and neurosyphilis (10.93 cases per 100 000 person-years) were the most common diagnoses. The greatest incidence was found on the East and West Coasts. Patients with the disease were younger and more likely to be black and non-Hispanic. In the final model, the adjusted RR for syphilis was significantly increased with HIV (7.61), hepatitis C (3.57), herpes simplex (2.06) and hepatitis B (1.75). Conclusions The incidence of syphilis is >3-fold greater in ESRD patients when compared with the general population and is associated with sexually transmitted viral infections. Neurosyphilis is a common occurrence and is treatable, suggesting that all assessments of confusion in dialysis patients should include screening for the disease.

scholarly journals Genital Herpes Has Played a More Important Role than Any Other Sexually Transmitted Infection in Driving HIV Prevalence in Africa

PLoS ONE ◽  
2008 ◽  
Vol 3 (5) ◽  
pp. e2230 ◽  
Author(s):  
Laith J. Abu-Raddad ◽  
Amalia S. Magaret ◽  
Connie Celum ◽  
Anna Wald ◽  
Ira M. Longini ◽  
...  
Keyword(s):  
Genital Herpes ◽  
Sexually Transmitted Infection ◽  
Hiv Prevalence ◽  
Transmitted Infection ◽  
Sexually Transmitted

Mechanisms of HIV Transmission

2017 ◽  
Author(s):  
Puja Nambiar ◽  
William R. Short
Keyword(s):  
Hiv Transmission ◽  
Hiv Infections ◽  
The United States ◽  
Antiretroviral Drugs ◽  
Oral Sex ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Mucous Membranes ◽  
Perinatal Treatment ◽  
Hiv Negative

HIV is a sexually transmitted infection. Most new HIV infections in the United States are the result of sex, but it is rare for HIV to be transmitted through oral sex. The risk of HIV transmission to a receptive partner remains higher than that to an insertive one; however, both are at risk. Anything that compromises the integrity of mucous membranes, such as sexually transmitted infections, may increase the risk of transmission. Although not 100% effective, keeping an infected partner’s viral load low reduces the risk of transmission to an HIV-negative partner. Maternal transmission is a larger concern in developing countries due to lack of access to perinatal treatment with antiretroviral drugs.

scholarly journals Expansion of Comprehensive Screening of Male Sexually Transmitted Infection Clinic Attendees with Mycoplasma genitalium and Trichomonas vaginalis Molecular Assessment: a Retrospective Analysis

2016 ◽  
Vol 55 (1) ◽  
pp. 321-325 ◽  
Author(s):  
Erik Munson ◽  
David Wenten ◽  
Sheila Jhansale ◽  
Mary Kay Schuknecht ◽  
Nicki Pantuso ◽  
...  
Keyword(s):  
Sexually Transmitted Infection ◽  
Trichomonas Vaginalis ◽  
Screening Program ◽  
Mycoplasma Genitalium ◽  
Transmitted Infection ◽  
Additional Specimen ◽  
Content Type ◽  
Sexually Transmitted ◽  
High Prevalence ◽  
Infection Clinic

ABSTRACTOf 1,493 encounters of males at a sexually transmitted infection (STI) clinic in a community with a high prevalence of STI,Chlamydia trachomatiswas detected in 8.7% andNeisseria gonorrhoeaewas detected in 6.6%. AdditionalTrichomonas vaginalisandMycoplasma genitaliumscreening found 17.4% and 23.9% of the encounters, respectively, to be positive for STI. STI agents were detected in 13.7% of urine specimens; addition of pharyngeal and rectal collections to the analysis resulted in detection of STI agents in 19.0% and 23.9% of encounters, respectively. A total of 101 (23.8%) encounters of identified STI involved sole detection ofM. genitalium. Expansion of the STI analyte panel (includingM. genitalium) and additional specimen source sampling within a comprehensive STI screening program increase identification of male STI carriers.

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