scholarly journals Characteristics of youth agreeing to electronic sexually transmitted infection risk assessment in the emergency department

2017 ◽  
Vol 35 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Fahd A Ahmad ◽  
Donna B Jeffe ◽  
Katie Plax ◽  
Kenneth B Schechtman ◽  
Dwight E Doerhoff ◽  
...  
Keyword(s):  
Demographic Data ◽  
Chief Complaint ◽  
Sexual History ◽  
Computer Assisted ◽  
Inconsistent Condom ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Multiple Partners ◽  
Sti Testing ◽  
To Receive

ObjectivesAdolescents and young adults are at high risk for sexually transmitted infections (STIs). We previously reported an increase in STI testing of adolescents in our ED by obtaining a sexual history using an Audio-enhanced Computer-Assisted Self-Interview (ACASI). We now examine associations among demographics, sexual behaviour, chief complaint and willingness to be tested.MethodsThis was a prospective study conducted in a paediatric ED between April and December 2011. After triage, eligible patients between 15 and 21 years presenting with non-life-threatening conditions were asked to participate in the study. Consenting participants used an ACASI to provide their demographic data and answer questions about their sexual history and willingness to be tested. Our primary outcome was the association of demographics, chief complaint and ACASI recommendation with the participant’s willingness to be tested.ResultsWe approached 1337 patients, of whom 800 (59%) enrolled and completed the ACASI. Eleven who did not answer questions related to their sexual history were excluded from analysis. Of 789 participants, 461 (58.4%) were female and median age was 16.9 years (IQR 16.0–17.8); 509 (64.5%) endorsed a history of anal, oral and/or vaginal intercourse. Disclosing a sexual history and willingness to be tested did not differ significantly by gender. 131 (16.6%) had a chief complaint potentially referable to an STI; among the 658 participants with non-STI-related complaints, 412 (62.6%) were sexually active, many of whom disclosed risky behaviours, including multiple partners (46.4%) and inconsistent condom use (43.7%). The ACASI identified 419 patients as needing immediate STI testing; the majority (81%) did not have a chief complaint potentially related to STIs. 697 (88.3%) participants were willing to receive STI testing. Most (94.6%) of the patients with STI-related complaints were willing to be tested, and 92.1% of patients with a recommendation for immediate testing by the ACASI indicated a willingness to be tested.ConclusionsAdolescents were willing to disclose sexual activity via electronic questionnaires and were willing to receive STI testing, even when their chief complaint was not STI related. The ACASI facilitated identification of adolescent ED patients needing STI testing regardless of chief complaint.

scholarly journals Acceptability of remote prescribing and postal delivery services for contraceptive pills and treatment of uncomplicated Chlamydia trachomatis

2020 ◽  
pp. bmjsrh-2020-200687
Author(s):  
Tom Nadarzynski ◽  
Ynez Symonds ◽  
Robert Carroll ◽  
Jo Gibbs ◽  
Sally Kidsley ◽  
...  
Keyword(s):  
Online Survey ◽  
Home Delivery ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Contraceptive Pills ◽  
Remote Management ◽  
Delivery Services ◽  
The Cost ◽  
To Receive

ObjectivesThe digitalisation of sexual and reproductive health (SRH) services offers valuable opportunities to deliver contraceptive pills and chlamydia treatment by post. We aimed to examine the acceptability of remote prescribing and ‘medication-by-post’ in SRH.Study designAn online survey assessing attitudes towards remote management was distributed in three UK SRH clinics and via an integrated sexually transmitted infection (STI) postal self-sampling service. Logistic regressions were performed to identify potential correlates.ResultsThere were 1281 participants (74% female and 49% <25 years old). Some 8% of participants reported having received medication via post and 83% were willing to receive chlamydia treatment and contraceptive pills by post. Lower acceptability was observed among participants who were: >45 years old (OR 0.43 (95% CI 0.23–0.81)), screened for STIs less than once annually (OR 0.63 (0.42–0.93)), concerned about confidentiality (OR 0.21 (0.90–0.50)), concerned about absence during delivery (OR 0.09 (0.02–0.32)) or unwilling to provide blood pressure readings (OR 0.22 (0.04–0.97)). Higher acceptability was observed among participants who reported: previously receiving medication by post (OR 4.63 (1.44–14.8)), preference for home delivery over clinic collection (OR 24.1 (11.1–51.9)), preference for home STI testing (OR 10.3 (6.16–17.4)), ability to communicate with health advisors (OR 4.01 (1.03–15.6)) and willingness to: register their real name (OR 3.09 (1.43–10.6)), complete online health questionnaires (OR 3.09 (1.43–10.6)) and use generic contraceptive pills (OR 2.88 (1.21–6.83)).ConclusionsPostal treatment and entering information online to allow remote prescribing were acceptable methods for SRH services and should be considered alongside medication collection in pharmacies. These methods could be particularly useful for patients facing barriers in accessing SRH. The cost-effectiveness and implementation of these novel methods of service delivery should be further investigated.

College students’ preferences for information on self-initiated sexually transmitted infection testing

2020 ◽  
pp. 001789692095969
Author(s):  
Oluwamuyiwa Winifred Adebayo ◽  
Jocelyn C Anderson ◽  
Britney M Wardecker
Keyword(s):  
College Students ◽  
Sexually Transmitted Infection ◽  
Qualitative Content Analysis ◽  
Low Cost ◽  
Transmitted Disease ◽  
Structured Interview ◽  
Sexual History ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing

Objective: The purpose of this study was to identify preferences for content, method of delivery and frequency of information to encourage self-initiated sexually transmitted infection (STI) testing. Design: Qualitative study involving individual in-depth interviews with 35 college students aged 18–24 years. Setting: A university in Central Pennsylvania, USA. Method: Data were collected using a demographic and sexual history questionnaire, Sexually Transmitted Disease Knowledge Questionnaire and a semi-structured interview guide. Transcribed interviews were analysed using qualitative content analysis. Results: Findings from the study document STI testing information preferences as they relate to self-initiated testing. The majority of participants preferred receiving STI testing information through email. Themes within their accounts included Actionable Information Content, Frequently Accessed Delivery Method, and Routine STI Testing Information. Conclusion: The high incidence of STIs among US college students is an indication of the need to increase diagnosis and treatment to reduce transmission. Study findings have implications for the development and evaluation of low-cost interventions to improve the uptake of STI testing and reduce STI burden among college students.

scholarly journals “You can smell the freedom”: a qualitative study on perceptions and experiences of sex among Swedish men who have sex with men in Berlin

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e024459 ◽  
Author(s):  
Nicklas Dennermalm ◽  
Kristina Ingemarsdotter Persson ◽  
Sarah Thomsen ◽  
Birger C Forsberg
Keyword(s):  
Qualitative Study ◽  
High Mobility ◽  
Structured Interviews ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Cultural Aspects ◽  
Multiple Partners ◽  
Sti Testing ◽  
Sex With Men ◽  
Exposure Prophylaxis

PurposeThe purpose of this study was to explore the perceptions and experiences of sex among Swedish Men who have Sex with Men (MSM) in Berlin.BackgroundMSM are disproportionally affected by HIV.Berlin is also a key destination when looking into where Swedish MSM sero-convert, while travelling.MethodA qualitative study with semi-structured interviews using open-ended questions with participants recruited through network sampling. Data were analysed with content analysis.Participants15 Swedish cis-men (as in non-transgender) who have sex with men aged 25–44 years, who travelled to or were living in Berlin. To be included in the study, the participants had to be cis-MSM, Swedish citizens, spending time in Berlin and having sex in both settings.ResultsFor a majority of the participants, sex was the main reason for going to Berlin but cultural aspects like art and the techno scene were also important. Berlin was perceived as a sex-oriented city providing venues where respondents did not have to care about reputation and status and where social and sexual spaces co-existed side by side. This in sharp contrast to Sweden, which represented a limiting environment both in culture and what was available culturally and sexually.ConclusionThe men interviewed experienced multiple partners and had a broad sexual repertoire both abroad and at home. However, the behaviour was amplified in Berlin. The men did not alter their safer sex practice depending on if they had sex in Sweden or Berlin. The high mobility and vulnerability for HIV/sexually transmitted infection (STI) among these men highlights the need of increased access to antiretroviral treatment, pre-exposure prophylaxis for HIV and low-threshold HIV/STI testing services in Europe.

Regular STI testing amongst men who have sex with men and use social media is suboptimal – a cross-sectional study

2016 ◽  
Vol 28 (6) ◽  
pp. 573-583 ◽  
Author(s):  
Jamie Frankis ◽  
Lisa Goodall ◽  
Dan Clutterbuck ◽  
Abdul-Razak Abubakari ◽  
Paul Flowers
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Anal Intercourse ◽  
Sex Partners ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Male Sex ◽  
Sex With Men

Sexually transmitted infections (STIs) disproportionately affect men who have sex with men, with marked increases in most STIs in recent years. These are likely underpinned by coterminous increases in behavioural risks which have coincided with the development of Internet and geospatial sociosexual networking. Current guidelines advocate regular, annual sexually transmitted infection testing amongst sexually active men who have sex with men (MSM), as opposed to symptom-driven testing. This paper explores sexually transmitted infection testing regularity amongst MSM who use social and sociosexual media. Data were collected from 2668 men in Scotland, Wales, Northern Ireland and the Republic of Ireland, recruited via social and gay sociosexual media. Only one-third of participants report regular (yearly or more frequent) STI testing, despite relatively high levels of male sex partners, condomless anal intercourse and high-risk unprotected anal intercourse. The following variables were associated with regular STI testing; being more ‘out’ (adjusted odds ratio = 1.79; confidence interval = 1.20–2.68), HIV-positive (adjusted odds ratio = 14.11; confidence interval = 7.03–28.32); reporting ≥10 male sex partners (adjusted odds ratio = 2.15; confidence interval = 1.47–3.14) or regular HIV testing (adjusted odds ratio = 48.44; confidence interval = 28.27–83.01). Men reporting long-term sickness absence from work/carers (adjusted odds ratio = 0.03; confidence interval = 0.00–0.48) and men aged ≤25 years (adjusted odds ratio = 0.36; 95% confidence interval = 0.19–0.69) were less likely to test regularly for STIs. As such, we identify a complex interplay of social, health and behavioural factors that each contribute to men’s STI testing behaviours. In concert, these data suggest that the syndemics placing men at elevated risk may also mitigate against access to testing and prevention services. Moreover, successful reduction of STI transmission amongst MSM will necessitate a comprehensive range of approaches which address these multiple interrelated factors that underpin MSM's STI testing.

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.

scholarly journals 1296. Potential use of Sexually Transmitted Infection (STI) Testing for Expanding HIV Pre-Exposure Prophylaxis (PrEP) at an Urban Hospital Center

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S396-S396
Author(s):  
Robert Pitts ◽  
Robert Holzman ◽  
Richard Greene ◽  
Emily Lam ◽  
Ellie Carmody ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Medical Center ◽  
Positive Test ◽  
Prescription Data ◽  
Urban Hospital ◽  
Enrichment Programs ◽  
Transmitted Infection ◽  
Missed Opportunities ◽  
Sexually Transmitted ◽  
Sti Testing

Abstract Background Despite the high efficacy of PrEP, it continues to be underutilized. We examined the extent to which patients with a documented positive test for STIs were provided PrEP at an urban municipal medical center. Methods We reviewed data of all patients seen between January 1, 2014 and July 30, 2017 who were &gt; 18 years old and had an initial HIV negative test and ≥1 positive test for Chlamydia, Gonorrhea, or Syphilis. We examined PrEP prescription data by gender, race/ethnicity, and clinic location. Differences between groups were compared using Chi-squared analysis and logistic regression. Results Of 1,142 initially HIV− patients who were identified as having a positive STI result, 52% were female, 89% either Black or Hispanic, with a median age of 40 years (quartiles 30, 47). 58% had Medicare/Medicaid and 34% were self-pay or uninsured (Table 1). Only 25 (2.1%) of 1,142 patients who had ≥1 STI test positive were prescribed PrEP. No women received PrEP. Whites (aOR: 21.7 [95% CI:4.4, 107, P &lt; 0.001] and Hispanics (aOR:6.64 [95% CI:1.35, 32.8, P = 0.02] were both more likely to receive PrEP than Blacks, after adjusting for age, sex, marital status, and insurance. All PrEP prescriptions originated from the Medicine, Emergency, or HIV specialty clinics although most STI testing was obtained in Emergency and Obstetrical/Gynecological clinics (Table 2). Conclusion There were significant missed opportunities for HIV prevention among patients with STIs within the medical center, particularly among Hispanic and Black patients. Enrichment programs to educate providers and increase PrEP prescriptions may have a major impact on expanding HIV prevention, especially for women. Disclosures All authors: No reported disclosures.

scholarly journals Challenges and motivators for male partner involvement in prenatal care for HIV testing in a tertiary setting in Brazil

2019 ◽  
Vol 30 (9) ◽  
pp. 875-884
Author(s):  
Nava Yeganeh ◽  
Tara Kerin ◽  
Mariana Simon ◽  
Karin Nielsen-Saines ◽  
Jeffrey D Klausner ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Hiv Testing ◽  
Male Partner ◽  
Computer Assisted ◽  
Transmitted Infection ◽  
Entire Family ◽  
Middle Income ◽  
Sexually Transmitted ◽  
Male Partner Involvement ◽  
Partner Involvement

Male partner involvement in prenatal care has been shown to improve outcomes for the entire family in low- and middle income countries. In Brazil, partners of pregnant women are encouraged to attend prenatal care for HIV testing. From November 2016 to July 2017, male partners of women delivering at Hospital Conceiçao were interviewed using computer-assisted telephone interviews regarding individual, relationship and system-wide facilitators and barriers to attending prenatal care. Of 403 men interviewed, 202 attended prenatal care and 201 did not. Individual factors that predicted prenatal care attendance included over-estimating the risk of mother to child transmission (AOR 2.13, 95% CI: 1.35–3.4), and endorsing that HIV-infected individuals can live satisfying lives (AOR 7.24, 95% CI: 1.9–47.5). Partnership factors associated with attendance included invitation by partner (AOR 5.6, 95% CI: 2.4–15.6). Systemic factors negatively associated with prenatal care attendance included a history of not being able to afford medical care (AOR 0.3, 95% CI: 0.15–0.6) and identifying work as a barrier to prenatal care attendance (AOR 0.19 95% CI: 0.11–0.31). Partners should be actively invited to prenatal care during flexible flexible hours. Once involved, almost all would accept HIV and sexually transmitted infection (STI) testing to protect partners and unborn infants during this vulnerable period.

Safeguarding outcomes of 16 and 17-year-old service users of Sexual Health London (SHL.uk), a pan-London online sexual health service

2020 ◽  
Vol 31 (14) ◽  
pp. 1373-1379
Author(s):  
Sara Day ◽  
Ryan Kinsella ◽  
Sophie Jones ◽  
Victoria Tittle ◽  
Tara Suchak ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Sexual Health ◽  
Social Services ◽  
Child Protection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Health Clinics ◽  
Sti Testing ◽  
Sexual Health Service ◽  
Sexual Health Clinics

Guidance around how to safeguard young people using online sexual health services (e-SHSs) is limited. Sexual Health London (SHL.uk) is an e-SHS, integrated with London’s sexual health clinics (SHCs), offering users aged 16 years and above sexually transmitted infection (STI) testing. For a safeguarding risk assessment, under 18s must complete a safeguarding e-triage, and any concern raised results in a ‘call back’ (CB) by the SHL.uk team. The safeguarding outcomes of CBs between 8 January 2018 and 18 September 2018 were reviewed; 261/454 (57.5%) users never triggered a CB on their e-triage (non-CB group) and 193/454 (42.5%) users triggered one or more CB(s) (CB group). Safeguarding concerns disclosed predominantly related to drug/alcohol use and partner's age imbalance. Successful telephonic risk assessment took place in 84.5% CB cases. Safeguarding outcomes comprised referrals to: SHC in 35.5%; child protection team in 8.5%; social services in 7%. STI positivity was 16.4% and 15.2% in the CB and non-CB groups, respectively. Although a high number of safeguarding triggers were disclosed, only a small proportion warranted referral for further support/intervention. Using e-triage with telephony support to screen and safeguard adolescents accessing an e-SHS was acceptable to users and enabled their clinical and safeguarding needs to be safely met. e-SHS integration within a network of SHCs further supported this model.

scholarly journals Sex-habit and Sexually Transmitted Infection (STIs) Among The Drug Abusers Undergoing Detoxification

2013 ◽  
Vol 14 (1) ◽  
pp. 5-10
Author(s):  
Kazi Jahangir Hossain ◽  
Md. Rizwanul Karim ◽  
Abul Masud Md. Nurul Karim ◽  
Md. Mustafa Kamal
Keyword(s):  
Addiction Treatment ◽  
Illicit Drugs ◽  
Drug Abusers ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Multiple Partners ◽  
Injection Drugs ◽  
Treatment Centre ◽  
N 93 ◽  
Drug Habit

Drug abuse is increasing alarmingly with time among the young-adults in Bangladesh. The objective of the study was to investigate sex-habit and STIs of the drug abusers. A total of 1076 drug abusers undergoing detoxification voluntarily at the Central Drug Addiction Treatment Centre (CTC), Tejgaon, Dhaka were investigated from September 2010 to August 2011. They were selected consecutively on the basis of defined selection criteria. Research instrument was an interviewer questionnaire and blood specimen. Results showed that 82.1% (n=883) were heterosexual and 16.2% (n=174) had no sex. The majority of them (55.3%, n=595) had enjoyed sex with multiple partners. They enjoyed sex with commercial sex sellers (11.1%, n=119) but majority of them (34.2%, n=368) had sex with all categories including spouse. Results also showed that majority of them had unethical sex, of which 24.9%(n=268) had experience about extramarital sex and 30.4%(n=327) premarital sex respectively. Around 55.0%(n=594) of them did not use condom during sex and 21.9%(n=236) used it occasionally. The 14.5%(n=156) of them had signsymptoms of gonorrhea and syphilis, of which 1.8%(n=19) had genital ulcer, 3.7%(n=40) genital discharge and 9.0%(n=97) had both ulcer and discharge respectively. In laboratory analysis, 16.3%(n=175) had STIs positive results, of which 9.9%(n=107) were RPR reactive, 1.8%(n=19) URS reactive and 4.6%(n=49) both RPR and URS reactive respectively. In drug habit, results also showed that 82.6% (n=889) of them had been using heroin and the rests used cannabis (8.6%, n=93), phensedyl (5.4%, n=58) and injections (3.3%, n=25) respectively. Forty two percent (n=455) of them had been abusing it for 1-5 years, 31.4% (n=338) for 6-10 years and 26.3%(n=283) for 11-20 years. Most of them (91.1%, n=980) used multiple illicit drugs and their ultimate choice of drug was heroin (77.3%, n=832). About 22.6%(n=243) addicts abused injection drugs in their lifetime. Altering behaviors, especially their drug habit and sexual lifestyle are still the only applicable ways to stop this human catastrophe. DOI: http://dx.doi.org/10.3329/jom.v14i1.14529 J MEDICINE 2013; 14 : 5-10 

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