Association between rectal douching and HIV and other sexually transmitted infections among men who have sex with men: a systematic review and meta-analysis

2019 ◽  
Vol 95 (6) ◽  
pp. 428-436 ◽  
Author(s):  
Peiyang Li ◽  
Tanwei Yuan ◽  
Thomas Fitzpatrick ◽  
Kumi Smith ◽  
Jin Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Rectal Mucosa ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Rectal Douching ◽  
B Virus ◽  
Newcastle Ottawa Scale ◽  
Sex With Men ◽  
Health Education Materials

BackgroundMen who have sex with men (MSM) are disproportionately affected by HIV and other STIs worldwide. Rectal douching, which is commonly used by MSM in preparation for anal sex, may increase the risk of HIV and other STIs by injuring the rectal mucosa. Results from individual studies reporting associations between rectal douching and HIV and other STIs among MSM are inconsistent. We performed a systematic review and meta-analysis to estimate the association between rectal douching and HIV and other STIs among MSM.MethodsWe searched PubMed, Embase, Scopus and Web of Science for studies published from January 1970 to November 2018. Studies that reported ORs and 95% CIs of associations between rectal douching and infection with HIV/STIs, or reported enough data to calculate these estimates, were included. We assessed risk of bias using the Newcastle-Ottawa Scale. ORs were pooled using a random effects model.ResultsTwenty-eight eligible studies were identified in our review, of which 24 (20 398 participants) were included in the meta-analysis. Rectal douching was associated with increased odds of infection with HIV (OR 2.80, 95% CI 2.32 to 3.39), and any STI other than HIV (including hepatitis B virus (HBV), hepatitis C virus (HCV), chlamydia, gonorrhoea, syphilis and human papillomavirus) (OR 2.46, 95% CI 1.95 to 3.11) among MSM. For specific STIs, douching was associated with increased odds of viral hepatitis (HBV, HCV) (OR 3.29, 95% CI 2.79 to 3.87), and chlamydia or gonorrhoea (OR 3.25, 95% CI 2.02 to 5.23). These associations remained significant in studies that adjusted for potential confounders.ConclusionRectal douching may put MSM at increased risk for infection with HIV and other STIs. Longitudinal studies are needed to clarify this association, and health education materials should inform men of the potential for increased risk of infection with rectal douching.

Prevalence and Genotype distribution of Human Papillomavirus Infection in Different Anatomical Sites among Men Who Have Sex with Men (MSM): A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Mohammad Farahmand ◽  
Seyed Hamidreza Monavari ◽  
Ahmad Tavakoli
Keyword(s):  
Systematic Review ◽  
Human Papillomavirus ◽  
High Risk ◽  
Sexual Behaviors ◽  
Meta Analysis ◽  
Hpv Infection ◽  
Genotype Distribution ◽  
Increased Risk ◽  
Pertinent Data ◽  
Sex With Men

Abstract Background: Homosexual men or men who have sex with men (MSM) are at increased risk of human papillomavirus (HPV) infection because of their high-risk sexual behaviors. In this large study, a meta-analytic approach was used to systematically analyze the literature to elucidate the prevalence and genotype distribution of anal, penile, oral, and urethral HPV infection among MSM in the world.Methods: To carry out this systematic review, five electronic databases were searched for relevant studies published from January 2012 through to November 2019, and pertinent data were collected from the eligible articles. The pooled HPV prevalences were calculated for each anatomical region using random-effect model weighted by the inverse variance method. Subgroup analyses were performed to identify the probable sources of heterogeneity. The meta-analysis was performed using the “Metaprop” function in the R package Meta.Results: The overall pooled prevalence of anal, penile, oral, and urethral HPV infection among MSM were 78.11 % (95% CI: 75.50%-80.52%), 36.26% (95% CI: 29.13%–44.05%), 17.33% (95% CI: 13.65%–21.75%), and 15.40% (95% CI: 7.86%–27.97%), respectively. Stratified analyses showed that the prevalences of HPV were significantly higher in HIV-positive than HIV-negative MSM. The most frequent HPV high-risk type detected in the anus, penis, and oral cavity was HPV-16 (20.32%, 4.96%, and 3.16%, respectively). Conclusion: HPV infection is on the dramatic rise in MSM because of high-risk sexual behaviors, strongly suggesting the increased risk of developing HPV-related diseases and malignancies in this population. Among different sexual orientations, male homosexuality is associated with the highest risk of acquiring sexually transmitted infections.

scholarly journals Association between health literacy and mortality: a systematic review and meta-analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Zhao-ya Fan ◽  
Yuan Yang ◽  
Fan Zhang
Keyword(s):  
Systematic Review ◽  
Health Literacy ◽  
English Language ◽  
Meta Analysis ◽  
Correlation Coefficients ◽  
Functional Health ◽  
Risk Of Death ◽  
Number Of Patients ◽  
Increased Risk ◽  
Newcastle Ottawa Scale

Abstract Background To identify the relationship between health literacy (HL) and mortality based on a systematic review and meta-analysis. Methods Literature published from database inception until July 2020 was searched using the PubMed and Web of Science databases, using relevant keywords and clear inclusion and exclusion criteria. The search was limited to English language articles. Two reviewers independently selected studies and extracted data. Pooled correlation coefficients and their 95% confidence intervals (CI) between HL and mortality were estimated using Stata 15.0 software. Potential sources of heterogeneity were explored using subgroup analysis, sensitivity analysis, and meta-regression. Quality of the original studies that were included in the meta-analysis was evaluated using the Newcastle–Ottawa Scale. A funnel plot and Egger’s test were used to determine whether significant publication bias was present. Results Overall, 19 articles were included, reporting on a total of 41,149 subjects. Eleven were prospective cohort studies, and all articles were considered “good” quality. The most used screening instruments were the short Test of Functional Health Literacy (S-TOFHLA) in Adults and the Brief Health Literacy Screen (BHLS). Among 39,423 subjects (two articles did not report the number of patients with low HL), approximately 9202 (23%) had inadequate or marginal HL. The correlation coefficient between HL and mortality was 1.25 (95%CI = 0.25–0.44). Conclusion Lower HL was associated with an increased risk of death. This finding should be considered carefully and confirmed by further research.

scholarly journals Serosorting and HIV/STI Infection among HIV-Negative MSM and Transgender People: A Systematic Review and Meta-Analysis to Inform WHO Guidelines

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Caitlin E. Kennedy ◽  
Laura J. Bernard ◽  
Kathryn E. Muessig ◽  
Kelika A. Konda ◽  
Elie A. Akl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Condom Use ◽  
Meta Analysis ◽  
Consistent Condom ◽  
Transgender People ◽  
Random Effects Models ◽  
Sexually Transmitted ◽  
Increased Risk ◽  
Meta Analyses ◽  
Hiv Negative

We conducted a systematic review and meta-analysis to assess the association between serosorting and HIV infection, sexually transmitted infections (STIs), and quality of life among men who have sex with men (MSM) and transgender people. Two reviewers independently screened abstracts and abstracted data. Meta-analyses were conducted using random effects models. Of 310 citations reviewed, 4 observational studies, all with MSM, met inclusion criteria. Compared to consistent condom use, serosorting was associated with increased risk of HIV (3 studies, odds ratio (OR): 1.80, 95% confidence interval (CI):1.21–2.70) and bacterial STIs (1 study, OR: 1.62, 95% CI: 1.44–1.83). Compared to no condom use, serosorting was associated with reduced risk of HIV (3 studies, OR: 0.46, 95% CI: 0.25–0.83) and bacterial STIs (1 study, OR: 0.81, 95% CI: 0.73–0.91). Among HIV-negative MSM, condom use appears to be more protective against HIV and STIs than serosorting and should be encouraged. However, serosorting may be better than no condom use as a harm reduction strategy.

scholarly journals Are Patients with Coronavirus Disease 2019 and Obesity at a Higher Risk of Hospital and Intensive Care Unit Admissions? A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (F) ◽  
pp. 410-419
Author(s):  
Anggi Lukman Wicaksana ◽  
Nuzul Sri Hertanti ◽  
Raden Bowo Pramono ◽  
Yu-Yun Hsu
Keyword(s):  
Systematic Review ◽  
Intensive Care ◽  
Severe Obesity ◽  
Meta Analysis ◽  
Icu Admission ◽  
Effect Measure ◽  
Increased Risk ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

BACKGROUND: Obesity, common condition among patients with COVID-19, contributes to illness severity during hospitalization. To date, knowledge on the prevalence, risk of hospital and intensive care units (ICU) admissions and mortality is limited. Therefore, systematic review and meta-analysis were conducted using a PRISMA guideline. PURPOSE: The study aimed to address the prevalence, risk of hospital and ICU admissions and mortality among patients with COVID-19 and obesity. METHODS: The Newcastle–Ottawa scale was used to assess the quality of a study. Primary outcomes were the prevalence and risk of hospitalization, and secondary outcomes were the risk of ICU admissions and mortality risk. Mantel–Haenszel with random effects was applied, and the effect measure was odds ratio (OR) with 95% confidence interval (CI). RESULTS: Nine studies were included in the systematic review, and only four studies for meta-analysis. Among 29,776 patients with COVID-19, obesity was identified as the second-highest comorbidity. The prevalence rates of obesity and severe obesity among patients with COVID-19 were 26.1% and 15.5%, respectively. Obesity resulted in significantly increased risk of hospital admission (OR = 1.99, 95% CI = 1.12–3.53, p = 0.02) and ICU admission (OR = 1.77, 95% = CI 1.52–2.06, p < 0.00001). Severe obesity had a significantly increased risk of ICU admission (OR = 1.79, 95% CI = 1.42–2.25, p < 0.00001). The mortality rate of patients with COVID-19 and obesity was about 30.5% (438/1,434), and 19.7% (2,777/14,095) of them recovered from COVID-19. CONCLUSION: Obesity poses as nearly twice the risk of hospital and ICU admissions, and severe obesity contributes to almost twice the risk of ICU admissions.

Maternal Infection During Pregnancy and Risk of Cerebral Palsy in Children: A Systematic Review and Meta-analysis

2020 ◽  
pp. 088307382097250
Author(s):  
Erfan Ayubi ◽  
Saeedeh Sarhadi ◽  
Kamyar Mansori
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
Publication Bias ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Fixed Effects Model ◽  
Maternal Infection ◽  
Relative Risks ◽  
Increased Risk ◽  
Newcastle Ottawa Scale

Background and aim: The association between maternal infection during pregnancy and the risk of cerebral palsy has been previously reported. However, their results were relatively inconsistent. This systematic review and meta-analysis were carried out to investigate the association between maternal infection during pregnancy and the risk of cerebral palsy in children. Methods: PubMed, Scopus, and Web of Sciences databases were searched from inception to October 28, 2019. Heterogeneity was assessed using the I2 value. In case of substantial heterogeneity (I2 > 50%), a random effects model was applied, otherwise, a fixed effects model was used. The pooled associations were expressed as relative risks (RRs) and 95% confidence intervals (CIs). Publication bias and quality of studies included in the systematic review were checked using the Egger’s regression test and Newcastle-Ottawa Scale (NOS), respectively. Results: Thirty-seven studies were included in the systematic review. Among them, 21 studies were eligible for the meta-analysis. The pooled RR of cerebral palsy risk was 2.50 (95% CI 1.94, 3.21; I2 = 88.7%, P < .001) among children born to mothers who had any infection during pregnancy. The risk was increased to 2.85 (95% CI 1.96, 4.15; I2 = 75.9%, P < .001) when the mother was diagnosed with chorioamnionitis. Publication bias tests suggested no evidence of potential publication bias and 76% of the studies included in the meta-analysis were of high quality (NOS ≥ 6). Conclusion: This systematic review and meta-analysis provides evidence that maternal infection during pregnancy may be associated with an increased risk of cerebral palsy in children.

scholarly journals EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

2021 ◽  
pp. 174749302110042
Author(s):  
Grace Mary Turner ◽  
Christel McMullan ◽  
Olalekan Lee Aiyegbusi ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

scholarly journals Effect of interventions based on educational technologies on the prevention of sexually transmitted infections in incarcerated women: protocol of a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043373
Author(s):  
Isaiane da Silva Carvalho ◽  
Ryanne Carolynne Marques Gomes Mendes ◽  
Priscila de Oliveira Cabral Melo ◽  
Caroline Ferraz Simões ◽  
Luciana Pedrosa Leal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Education ◽  
Sexually Transmitted Infections ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Incarcerated Women ◽  
Mean Difference ◽  
World Health ◽  
Educational Technologies ◽  
Sexually Transmitted

IntroductionPrisons are places with high vulnerability and high risk for the development of sexually transmitted infections. World Health Agencies recommend establishing intervention measures, such as information and education, on the prevention of diseases. Thus, technologies as tools for health education have been used to reduce sexually transmitted infections. However, no systematic review has investigated the effectiveness of these interventions. Therefore, this review’s objective is to examine the effect of educational technologies used for preventing sexually transmitted infections in incarcerated women.Methods and analysisPreferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be strictly followed. The following electronic databases will be searched: Scopus; Cumulative Index of Nursing and Allied Health, Education Resources Information Center, Embase, PsycINFO, PubMed/Medline, Web of Science and Google Scholar. Randomised clinical trials of interventions that used educational technologies to prevent sexually transmitted infections in incarcerated women will be searched in the databases from the beginning of 2020 until December by two researchers independently. A narrative synthesis will be constructed for all included studies, and if there are sufficient data, a meta-analysis will be performed using the Review Manager software (V.5.3). Continuous results will be presented as the weighted mean difference or the standardised mean difference with 95% CIs. Under the heterogeneity of the included studies, a random-effects or fixed-effects model will be used. The studies’ heterogeneity will be assessed by the I2 method. The sensitivity analysis will be carried out to examine the magnitude of each study’s influence on the general results. A significance level of p≤0.05 will be adopted.Ethics and disclosureEthical approval is not required because no primary data will be collected. The results will be published in journals reviewed by peers.PROSPERO registration numberCRD42020163820.

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