scholarly journals Point-of-Care Testing to Guide Treatment and Estimate Risk Factors for Sexually Transmitted Infections in Adolescents and Young People With Human Immunodeficiency Virus in Eswatini

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Caitlyn L Jasumback ◽  
Sarah H Perry ◽  
Tara E Ness ◽  
Martha Matsenjwa ◽  
Zandile T Masangane ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Young Adults ◽  
Sexually Transmitted Infections ◽  
Sexual Partner ◽  
Adolescents And Young Adults ◽  
World Health ◽  
Sexually Active ◽  
Sexually Transmitted ◽  
Life Years ◽  
Immunodeficiency Virus

Abstract Background The World Health Organization (WHO) estimates 127 million new cases of Chlamydia trachomatis (CT), 87 million new cases of Neisseria gonorrhea (NG), and 156 million new cases of Trichomonas vaginalis (TV) each year, which corresponds to 355 (219–606), 303 (216–468), and 243 (97.6–425) thousand disability-adjusted life-years. In low-resource settings, however, sexually transmitted infections (STIs) are treated syndromically and many individuals with asymptomatic infection may be missed, especially adolescents and young adults with human immunodeficiency virus (HIV). Methods We enrolled patients aged 15–24 with HIV (N = 300) attending a family-centered HIV clinic in Mbabane, Eswatini. Participants completed a sexual history questionnaire and provided urine as well as oropharyngeal and/or vaginal swabs, if sexually active, for testing with Xpert CT/NG and TV tests. Analysis included bivariate and multivariate odds ratios and test sensitivity and specificity. Results Sexually transmitted infection rates were highest (25.0%; 95% confidence interval [CI], 15.2–37.3) in females ages 20–24 who were ever sexually active. In patients with confirmed STIs, NG (15 of 32, 47%) was more common than CT (9 of 32, 28%) and TV (8 of 32, 25%). Syndromic screening alone had a sensitivity of 32.0% (95% CI, 14.9–53.3) and specificity of 86.0% (95% CI, 79.0–91.4) but varied by gender. The presence of an STI was associated with reporting new sexual partner(s) (OR = 2.6; 95% CI, 1.1–6.4), sometimes to never using condoms (OR = 4.2; 95% CI, 1.7–10.2), most recent sexual partner >25 years old (OR = 3.2; 95% CI, 1.3–7.9), and HIV diagnosis at age ≥15 years (OR = 3.4; 95% CI, 1.4–8.2). Conclusions Syndromic screening alone performed poorly. Routine diagnostic testing significantly increases STI detection and should be considered in high-risk populations, such as adolescents and young adults with HIV.

scholarly journals Medico-Legal Aspects of Containment of the Spread of Sexually Transmitted Infections

2019 ◽  
pp. 1005-1009
Author(s):  
Alexander Alexandrovich Sizov ◽  
Irina Vladimirovna Pashina ◽  
Natalya Gennadievna Lischuk ◽  
Marina Evgenievna Alferova ◽  
Andrew Vladimirovich Lyaskovets ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Sexually Transmitted Infections ◽  
Immune Deficiency Syndrome ◽  
Legal Regulation ◽  
Legal Aspects ◽  
Deficiency Syndrome ◽  
World Health ◽  
Sexual Life ◽  
Sexually Transmitted ◽  
Immunodeficiency Virus

Sexually transmitted infections are a group of diseases that include syphilis, gonorrhea, chlamydial and mycoplasma infections, trichomoniasis, herpes and HPV infections of the genital organs. In addition, sexually transmitted human immunodeficiency virus, causing a disease called acquired immune deficiency syndrome. According to the World Health Organization, every year more than 340 million people aged 15-49 suffer from sexually transmitted infections worldwide. The basis for the prevention of the spread of sexually transmitted infections and infection with the human immunodeficiency virus should be considered the presence of internal moral attitudes. The motive for the start of sexual life should be your own conscious decision, and not pressure from a partner, fear of losing him, desire to please him and preserve the relationship. Despite the rather wide spread of sexually transmitted infections and the occurrence of infection with human immunodeficiency virus, the implementation of the simplest recommendations guarantees the safety of intimate life and preservation of health. A clear legal regulation of actions of a sexual nature, associated with the risk of infection or entailing infection with sexually transmitted infections, helps to curb their distribution. It is essential for maintaining the sexual health of people of young and mature age, which is an important resource of any country.

Human Immunodeficiency Virus Pre-exposure Prophylaxis and Increased Incidence of Sexually Transmitted Infections in the United States

2019 ◽  
Vol 70 (9) ◽  
pp. 1884-1890 ◽  
Author(s):  
Jose A Serpa ◽  
Gabriel N Huynh ◽  
Julie B Nickell ◽  
Hongyu Miao
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Sexually Transmitted Infections ◽  
State Level ◽  
The United States ◽  
Incidence Rates ◽  
Interrupted Time Series Analysis ◽  
Sexually Transmitted ◽  
Immunodeficiency Virus ◽  
Exposure Prophylaxis

Abstract Background Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) decreases HIV transmission. Some studies have raised concerns about a potential association between the implementation of HIV PrEP and the growing incidence rates of sexually transmitted infections (STIs) in the United States. Methods We conducted a quasi-experimental (interrupted time series) analysis of STI (syphilis, gonorrhea, and chlamydia) rates before (2000–2012) and after (2013–2017) the implementation of HIV PrEP. We also performed correlations between HIV PrEP utilization and STI cases at the national (2012–2017) and state (2017) levels. We defined HIV PrEP utilization as the number of people taking tenofovir disoproxil fumarate/emtricitabine for HIV prevention. Results HIV PrEP implementation was associated with 25% (relative risk [RR] 1.254, 95% confidence interval [CI] 1.245–1.263; P < .001) and 26% (RR 1.260, 95% CI 1.257–1.264; P < .001) increases in syphilis and gonorrhea rates, respectively, and a 12% reduction in chlamydia rates (RR: 0.884, 95% CI 0.883–0.885; P < .001). HIV PrEP utilization was correlated with the numbers of syphilis, gonorrhea, and chlamydia cases (spearman coefficients 1.00, 0.94, and 0.94, respectively; P < .001, P < .01, and P < .01, respectively). At the state level, HIV PrEP was also correlated with the number of cases of syphilis, gonorrhea, and chlamydia (spearman coefficients 0.85, 0.81, and 0.85, respectively; Ps < .001 for all correlations). Conclusions The implementation and utilization of HIV PrEP in the United States were associated with increased rates of STIs. Further studies to confirm these associations and to elucidate potential causes are needed.

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