Predicting Sexually Transmitted Infections Among HIV+ Adolescents and Young Adults: A Novel Risk Score to Augment Syndromic Management in Eswatini

2020 ◽  
Vol 85 (5) ◽  
pp. 543-552
Author(s):  
Neil Thivalapill ◽  
Caitlyn L. Jasumback ◽  
Sarah H. Perry ◽  
Lindokuhle Dlamini ◽  
Martha Matsenjwa ◽  
...  
Keyword(s):  
Young Adults ◽  
Sexually Transmitted Infections ◽  
Risk Score ◽  
Adolescents And Young Adults ◽  
Syndromic Management ◽  
Sexually Transmitted

scholarly journals The Risk of Sexually Transmitted Infections Following First-Episode Schizophrenia Among Adolescents and Young Adults: A Cohort Study of 220 545 Subjects

2020 ◽  
Vol 46 (4) ◽  
pp. 795-803 ◽  
Author(s):  
Chih-Sung Liang ◽  
Ya-Mei Bai ◽  
Ju-Wei Hsu ◽  
Kai-Lin Huang ◽  
Nai-Ying Ko ◽  
...  
Keyword(s):  
Young Adults ◽  
Young People ◽  
Sexually Transmitted Infections ◽  
Adolescents And Young Adults ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Research Database ◽  
Cox Regression Analysis ◽  
Sexually Transmitted ◽  
First Episode Schizophrenia

Abstract Young people are disproportionately affected by sexually transmitted infections (STIs). The risk of STIs in young people following first-episode schizophrenia is unknown. This study using Taiwan’s National Health Insurance Research Database enrolled 44 109 adolescents and young adults with first-episode schizophrenia and 176 436 age- and sex-matched controls without schizophrenia from 2001 through 2009 and followed to the end of 2011. New-onset STIs were identified. Survival analysis was performed. Cox regression analysis was used to examine the effects of comorbid substance use disorder (SUD), schizophrenia medications, and schizophrenia severity. The E value for causality of evidence was calculated. We found that young people had a higher risk of STIs following first-episode schizophrenia compared with controls without schizophrenia (hazard ratio [HR] = 2.35, 95% CI = 2.08–2.64); these STIs included human immunodeficiency virus (HIV) (3.70, 2.60–5.28) and syphilis (5.35, 3.96–7.23). They also showed a disproportionate distribution of STIs, with an increased proportion of syphilis (20.4% vs 8.2%) and HIV (9.1% vs 6.0%). When presenting with SUD, the risks of HIV (11.00, 7.02–17.25) and syphilis (9.11, 6.16–13.47) were further increased. The severe schizophrenia group had an extremely high risk of syphilis (41.26, 27.69–61.47) and HIV (7.50, 3.85–14.62). Schizophrenia medications may provide beneficial effects against contracting STIs (0.77, 0.68–0.89). We concluded that following first-episode schizophrenia, young patients are at higher risk of STIs, particularly HIV and syphilis. The risk further increased when subjects presented with SUD or severe schizophrenia. Importantly, antipsychotic treatment may lower the risk of STIs.

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 A review of current guidelines and research on the management of sexually transmitted infections in adolescents and young adults

2020 ◽  
Vol 7 ◽  
pp. 204993612096066
Author(s):  
Kathryn E. Gannon-Loew ◽  
Cynthia Holland-Hall
Keyword(s):  
Young Adults ◽  
Sexually Transmitted Infections ◽  
Trichomonas Vaginalis ◽  
Treatment Guidelines ◽  
Adolescents And Young Adults ◽  
Medical Complications ◽  
Ongoing Research ◽  
Sexually Transmitted ◽  
Simplex Virus ◽  
Current Guidelines

Adolescents and young adults are at high risk for sexually transmitted infections (STIs). Providers have the responsibility to accurately manage these infections to prevent medical complications and the spread of STIs. This article will review the epidemiology, screening recommendations, diagnostic tests, and treatment guidelines for STIs most commonly encountered in this population: Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus, and Trichomonas vaginalis, as well as the sexually associated infection bacterial vaginosis. This review will discuss ongoing research that explores ways to improve the management of STIs in adolescents and young adults.

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