scholarly journals Online prescribing for sexually transmitted infections – what’s on offer? An evaluation of internet pharmacies based in the United Kingdom

Author(s):  
Elizabeth Okecha ◽  
Emily Boardman ◽  
Saleha Patel ◽  
Emile Morgan

AbstractBackgroundOnline pharmacies offer an alternative approach for patients to manage their sexual health. Our aim was to determine the type of antimicrobials sold as treatment for sexually transmitted infections (STIs) by UK internet pharmacies and if providers were adhering to national guidelines.MethodsA search engine results page (SERP) generated a list of registered UK online pharmacies offering treatment for the following infections: Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex and Trichomonas vaginalis. An initial audit in 2017 benchmarked each provider against the British Association of Sexual Health & HIV (BASHH guidelines. Results were fed back to each provider before re-audit in 2020. Websites selling antibiotics for non-gonococcal urethritis (NGU) and Mycoplasma genitalium were included at re-audit.ResultsThere were 30 pharmacies identified in 2017 of which, five were excluded. Treatment could be obtained for Neisseria gonorrhoeae from five pharmacies without providing a culture result; three (60%) pharmacies sold BASHH approved antibiotics for Neisseria gonorrhoeae. All 25 pharmacies sold Chlamydia trachomatis treatment; 22 (88%) offered first line treatment options but no website assessed for proctitis. Herpes simplex treatment was sold on 22 websites of which, 13 (59%) offered treatment recommended by BASHH. Trichomonas vaginalis treatment was sold by four websites in line with BASHH. Results at re-audit showed an improvement in standards, although advice before, during and after treatment remained variable.DiscussionOur work has allowed us to engage with providers to improve prescribing within the UK online pharmacy industry. However, tougher regulation is needed in order to embed sustainable change for patients who choose to access treatment online.

Pathogens ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1618
Author(s):  
Fabiola Hernández-Rosas ◽  
Manuel Rey-Barrera ◽  
Ulises Conejo-Saucedo ◽  
Erika Orozco-Hernández ◽  
Liliana Maza-Sánchez ◽  
...  

Background. Globally, Sexually Transmitted Infections (STIs) are a major cause of morbidity in sexually active individuals, having complications in reproduction health and quality of life. In concordance with the Sustainable Development Goals (SDG), the study aimed to investigate the prevalence of Candida spp., Ureaplasma spp., Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, HSV, and Mycoplasma spp. from cervicovaginal samples and to correlate them with the gynecological history of the patients. Methods. Our analytical, prospective, and cross-sectional study included 377 women who participated in a reproductive health campaign during 2015–2016. Anthropometric and gynecological variables were obtained. Cervicovaginal specimens were collected and analyzed with a multiplex in-house PCR to detect Candida spp., Ureaplasma spp., Trichomonas vaginalis, Neisseria gonorrhoeae, HSV, Mycoplasma spp., and Chlamydia trachomatis. Results. The positive cases were 175/377 (46.4%) to at least one of the microorganisms. The most frequent pathogen detected in this population was Ureaplasma spp. (n = 111, 29.4%), followed by Mycoplasma spp. (n = 56, 14.9%) and Candida spp. (n = 47, 12.5%); 33.7% of the positive cases were single infections, whereas 12.7% had coinfection. The multiplex PCR assay was designed targeting nucleotide sequences. Conclusions. Our data demonstrated that monitoring STIs among asymptomatic patients will encourage target programs to be more precisely and effectively implemented, as well as make these programs more affordable, to benefit society by decreasing the prevalence of STIs.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ana Paula Almeida Cunha ◽  
Ilka Kassandra Pereira Belfort ◽  
Francisco Pedro Belfort Mendes ◽  
Gerusinete Rodrigues Bastos dos Santos ◽  
Lucas Henrique de Lima Costa ◽  
...  

Objective. To verify the association between HPV infection and the presence of coinfections (Chlamydia trachomatis, Trichomonas vaginalis, and Neisseria gonorrhoeae) in women in the state of Maranhão. Methods. HPV-DNA detection was performed by the nested PCR, using the primers PGMY09/11 and GP + 5/GP + 6. For the identification of sexually transmitted agents, conventional PCR was performed using the following primers: KL1/KL2 (Chlamydia trachomatis), TVA5/TVA6 (Trichomonas vaginalis), and HO1/HO3 (Neisseria gonorrhoeae). DNA-HPV positive samples were subjected to automated sequencing for genotyping. Results. Among the 353 women evaluated, 204 (57.8%) had HPV-DNA, of which 140 (68.6%) exhibited HPV/STIs, while 64 (31.4%) had the only HPV. T. vaginalis infection showed a positive association with HPV ( p = 0.003 ). Women without cervical lesions were predominant (327/92.6%); however, the largest number of lesions was reported in women who had HPV/coinfections (18/8.8%). Multiple regression analysis showed that both HPV only and the concomitant presence of HPV/STI were able to indicate the occurrence of epithelial lesions (R = 0.164; R2 = 0.027). Conclusion. The findings suggest that the presence of T. vaginalis can contribute to HPV infection, and HPV/IST association may influence the development of cervical intraepithelial lesions that are precursors of cervical cancer.


2017 ◽  
Vol 28 (11) ◽  
pp. 1130-1134 ◽  
Author(s):  
Claire C Bristow ◽  
Patricia Mathelier ◽  
Oksana Ocheretina ◽  
Daphne Benoit ◽  
Jean W Pape ◽  
...  

In Haiti, routine screening for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) among pregnant women is not conducted; yet these sexually transmitted infections (STIs) are associated with adverse birth and newborn health outcomes. We aimed to assess the acceptability and feasibility of screening and the prevalence of STIs among pregnant women in Port-au-Prince, Haiti. Pregnant women of at least 18 years of age who attend Haitian Study Group for Kaposi’s sarcoma and Opportunistic Infections (GHESKIO) clinics in Port-au-Prince, Haiti provided self-collected vaginal swab specimens. Laboratory testing was done with Xpert® CT/NG and Xpert® TV. The results of this study showed that of the 322 pregnant women who visited GHESKIO for their regular scheduled appointments, 300 (93.2%) consented for CT, NG, and TV testing. Of those, 107 women (35.7%) tested positive for at least one STI. There were 42 (14.7%) cases of CT, 8 (2.8%) NG, and 83 (29.0%) TV infections. Most infections were treated – 122 of 133 (91.7%). In summary, we found that it was highly acceptable and feasible to implement CT, NG, and TV screening among pregnant women in Port-au-Prince, Haiti. We found high prevalence of STIs among pregnant women, which suggest that STI screening in this population may be warranted.


2015 ◽  
Vol 88 (1) ◽  
pp. 33-37
Author(s):  
Alecsandra Iulia Grad ◽  
Mihaela Laura Vica ◽  
Horea Vladi Matei ◽  
Doru Lucian Grad ◽  
Ioan Coman ◽  
...  

Background and aim. Sexually transmitted infections are a very frequent and under-diagnosed cause of illness worldwide. A high number of detection methods and a large range of specimens in which sexually transmitted infections can be determined are available at the moment. Polymerase chain reaction performed on first void urine offers the advantage of being non-invasive, self-collectable and has high sensitivity and specificity. We looked to determine the frequency of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma urealyticum in symptomatic and asymptomatic patients.Methods. Six sexually transmitted infections were determined in the first void urine of 15 symptomatic and asymptomatic patients by polymerase chain reaction. We used “Epicenter MasterPure™ Complete DNA and RNA Purification Kit” for the DNA purification and “Seeplex® STD6 ACE Detection” for the DNA amplification. The results were examined in UV light.Results. A number of 5 patients had positive results for Chlamydia trachomatis or Neisseria gonorrhoeae. Sexually transmitted infections are more frequent in men between 27 and 40 years old.Conclusions. Polymerase chain reaction is a good diagnostic tool for sexually transmitted infections because it has a high sensitivity and specificity. Chlamydia trachomatis is the most frequent sexually transmitted infection, followed by Neisseria gonorrhoeae.


World Science ◽  
2018 ◽  
Vol 2 (8(36)) ◽  
pp. 4-7
Author(s):  
Fedorych P. V. ◽  
Mavrov G. I.

Introduction.The structure of incidence of sexually transmitted infections is changing constantly. Information on such changes supports correct planning of clinical and diagnostic activities of institutions providing specialized medical care by qualified specialists.Objective:to investigate the prevalence of sexually transmitted infections with pathogens clinically significant to the genitourinary system in Ukraine and at the local level.Materials and methods. Polymerase chain reaction was used to test the biological material obtained from the genitourinary clinical specimens from subjects with sexually transmitted infections, who underwent clinical and laboratory examinations in Oleksandrivsk Clinical Hospital (Kyiv, Ukraine) for Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, Ureaplasma urealyticum, Trichomonas vaginalis, Human papillomavirus, and Neisseria gonorrhoea. During 2017, 607 subjects of both genders, including 295 (48.6%) females and 312 (51.4%) males, were examined. Their mean age was 32±3.5.Findings. Chlamydia trachomatis was found in 159 (26.2%) of 607 examined subjects – 85 males and 74 females. Mycoplasma hominis was found in 122 of 585 (21.1%) examined subjects – 64 males and 58 females. Mycoplasma genitalium, respectively, in 17 (6.62%) of 258 subjects – 6 males and 11 females. Ureaplasma urealyticum was found in the largest number of subjects (305, i.e. in 48.77% of 601 examined subjects) – 157 males and 148 females. Trichomonas vaginalis was found in 28 (5.23%) of 535 subjects – 15 males and 13 females. Human papillomavirus was found in 158 of 297 (53.2%) examined subjects – 88 males and 70 females. Neisseria gonorrhea was found in 33 of 297 (8.45%) subjects – 8 males and 25 females.Conclusions. As suggested by the local study of the sexually transmitted infections incidence in Ukraine, the most clinically significant for the genitourinary system are Human papillomavirus (53.2%), Ureaplasma urealyticum (48.77%), Chlamydia trachomatis (26.2%) and Mycoplasma hominis (21.1%). Therefore, tests for these pathogens in the specified region is currently the most appropriate during diagnostic examinations and counselling of subjects with genitourinary infections.


2021 ◽  
Vol 9 (9) ◽  
pp. 1864
Author(s):  
Shu-Fang Chiu ◽  
Po-Jung Huang ◽  
Wei-Hung Cheng ◽  
Ching-Yun Huang ◽  
Lichieh Julie Chu ◽  
...  

The three most common sexually transmitted infections (STIs) are Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and Trichomonas vaginalis (TV). The prevalence of these STIs in Taiwan remains largely unknown and the risk of STI acquisition affected by the vaginal microbiota is also elusive. In this study, a total of 327 vaginal swabs collected from women with vaginitis were analyzed to determine the presence of STIs and the associated microorganisms by using the BD Max CT/GC/TV molecular assay, microbial cultures, and 16S rRNA sequencing. The prevalence of CT, TV, and GC was 10.8%, 2.2% and 0.6%, respectively. A culture-dependent method identified that Escherichia coli and Streptococcus agalactiae (GBS) were more likely to be associated with CT and TV infections. In CT-positive patients, the vaginal microbiota was dominated by L. iners, and the relative abundance of Gardnerella vaginalis (12.46%) was also higher than that in TV-positive patients and the non-STIs group. However, Lactobacillus spp. was significantly lower in TV-positive patients, while GBS (10.11%), Prevotella bivia (6.19%), Sneathia sanguinegens (12.75%), and Gemella asaccharolytica (5.31%) were significantly enriched. Using an in vitro co-culture assay, we demonstrated that the growth of L. iners was suppressed in the initial interaction with TV, but it may adapt and survive after longer exposure to TV. Additionally, it is noteworthy that TV was able to promote GBS growth. Our study highlights the vaginal microbiota composition associated with the common STIs and the crosstalk between TV and the associated bacteria, paving the way for future development of health interventions targeting the specific vaginal bacterial taxa to reduce the risk of common STIs.


Author(s):  
Janet Medforth ◽  
Linda Ball ◽  
Angela Walker ◽  
Sue Battersby ◽  
Sarah Stables

This chapter is mainly concerned with sexually transmitted infections and covers a range of issues, including Chlamydia, gonorrhoea, hepatitis B and C, herpes, syphilis, and other vaginal infections such as Candida, Trichomonas vaginalis, and bacterial vaginitis. Each of these is taken separately with reference to a screening programme, if appropriate, clinical symptoms and appearance, diagnosis, the latest guidance on treatment, and considerations for pregnancy. Fetal and neonatal infections, congenital transmission, treatment, and surveillance options for the neonate, along with specific advice for the mother are also given.


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