Dysmenorrhea

2021 ◽  
Keyword(s):  
Physical Examination ◽  
Sexually Transmitted Infections ◽  
School Absenteeism ◽  
Imaging Studies ◽  
Endometrial Polyps ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Key Points ◽  
Secondary Dysmenorrhea ◽  
Careful History

Key Points Dysmenorrhea (ie, painful menses) is a frequent cause of school absenteeism in girls.Primary dysmenorrhea typically occurs 1 to 2 years after menarche.Common causes of secondary dysmenorrhea including sexually transmitted infections (STIs), pelvic inflammatory disease, endometriosis, outflow tract obstruction, and endometrial polyps or fibroids.A careful history and physical examination are sufficient to diagnose primary dysmenorrhea.Secondary dysmenorrhea may require additional evaluation, including STI testing, imaging studies, and referral to a specialist.

scholarly journals STI initiative: Improving testing for sexually transmitted infections in women

2018 ◽  
Vol 7 (4) ◽  
pp. e000461 ◽  
Author(s):  
Ryan Christopher Chadwick ◽  
Kathleen McGregor ◽  
Paula Sneath ◽  
Joshua Rempel ◽  
Betty Li Qun He ◽  
...  
Keyword(s):  
Health Care ◽  
Sexually Transmitted Infections ◽  
Economic Cost ◽  
Incidence Rates ◽  
Nucleic Acid Amplification ◽  
Urgent Care ◽  
Quality Improvement Initiative ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Opt Out

Canadian urgent care and walk-in medical clinics provide health care for a population that may be poorly covered by traditional health care structures. Despite evidence suggesting that women with urinary complaints experience a high incidence of sexually transmitted infections (STIs), this population may be under-tested in this particular setting. The aim of this quality improvement initiative was to increase STI testing in women presenting with GU complaints. Implementation of an opt-out method of STI testing for women ages 16 and older was introduced at three walk-in clinics. Women presenting with GU complaints were given the opportunity to provide samples for both conventional urine culture and nucleic acid amplification testing (NAAT) for non-viral STIs. Patients received treatment according to standard of care and public health was notified as per local regulations. Testing rate and STI incidence was tracked via clinic electronic medical records (EMRs). Overall results were tracked using run charts and compared to historical data for the year prior to the start of the project. Over a 1 year period prior to this intervention, only 65 STI tests were performed in over 1100 GU complaints (5.5%). Six STIs were identified during this time. During the 36-week project period, testing increased to 45% of the patient population (320/707). The STI detected incidence increased from 0.51% to 1.4% in all women, and from 0.84% to 3.4% in women aged 16–29 years. An opt-out method was an effective intervention for increasing STI testing within the walk-in clinic setting. With optimisation, significant increases in testing rates can be obtained without substantially increasing clinic workload and at no economic cost to the clinic. As expected, detected incidence rates of STIs were higher than the recognised population prevalence.

Acceptability and feasibility of screening pregnant women for sexually transmitted infections in Rawalpindi, Pakistan

2021 ◽  
pp. 095646242110076
Author(s):  
Ameen E Chaudry ◽  
Rizwana Chaudhri ◽  
Aasia Kayani ◽  
Lamar W Hayes ◽  
Claire C Bristow ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Sexually Transmitted Infections ◽  
Sexually Transmitted Infection ◽  
Trichomonas Vaginalis ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Sexual Histories

Objectives: To understand the acceptability and feasibility of sexually transmitted infection (STI) testing during antenatal care, along with the prevalence of STIs, in Rawalpindi, Pakistan. Methods: We enrolled pregnant women seeking antenatal care and performed STI testing using Cepheid GeneXpert® CT/NG and TV kits and Alere Determine™ HIV and syphilis tests. We used interviewer-administered surveys to collect medical, social, and sexual histories. Participants testing positive for STIs and their partners were treated. Results: We enrolled 1001 women from September to December 2019. Nearly all women offered to participate in this study enrolled. Most women understood the effects an STI can have on their pregnancy (99.6%) and valued STI screening during pregnancy (98.1%). 11 women tested positive for any STI: ( Chlamydia trachomatis = 4, Neisseria gonorrhoeae = 1, and Trichomonas vaginalis = 6). Of those, six presented for a test-of-cure, and two were positive for Trichomonas vaginalis. None tested positive for HIV infection or syphilis ( n = 503). Conclusions: STI testing during antenatal care in Rawalpindi was acceptable, valued, understood, and feasible. The prevalence of STIs in pregnant women was low. Continued prevalence monitoring is warranted.

scholarly journals Transverse Testicular Ectopia: A Rare Case Report

2021 ◽  
Vol 16 (1) ◽  
pp. 52-54
Author(s):  
Swapan Kumar Biswas ◽  
Saiful Islam Khan ◽  
Muhammad Mofazzal Hossain
Keyword(s):  
Physical Examination ◽  
Preoperative Diagnosis ◽  
Rare Case ◽  
The Other ◽  
Imaging Studies ◽  
Transverse Testicular Ectopia ◽  
Hernial Sac ◽  
Rare Case Report ◽  
Testicular Ectopia ◽  
Careful History

Transverse testicular ectopia (TTE) is a rare but well-known congenital anomaly that occurs 1 in 4 million in which both testes migrate toward the same hemiscrotum. In most of the cases it is an intra-operative finding, but preoperative diagnosis can be made by careful history taking, physical examination and imaging studies. Further evaluation is very important because it can be associated with other congenital anomalies. We report a case of TTE in a 32 years old male who presented with sudden painful swelling in right inguinoscrotal region. Physical examination revealed right sided obstructed inguinal hernia and left sided non palpable testis with underdevelopment of left hemiscrotum. On exploration, one testis is found within the hernial sac and the other testis within scrotum of same side. The testis which was already in right side of scrotum was kept in same place and the other testis which was found within hernial sac was kept in subdartos pouch at the root of right side of scrotum. Faridpur Med. Coll. J. 2021;16(1):52-54

scholarly journals 168. Testing, Diagnosis, and Incidence of Sexually Transmitted Infections Among People with Substance Use Disorders in the Veterans Health Administration, 2019

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S101-S101
Author(s):  
Holly Villamagna ◽  
Lauren Beste ◽  
Joleen Borgerding ◽  
Elliott Lowy ◽  
Ronald Hauser ◽  
...  
Keyword(s):  
Substance Use ◽  
Sexually Transmitted Infections ◽  
Substance Use Disorders ◽  
Veterans Health Administration ◽  
Incidence Rates ◽  
Veterans Health ◽  
Health Administration ◽  
Sexually Transmitted ◽  
Stimulant Use ◽  
Sti Testing

Abstract Background People with substance use disorders (SUDs) are at increased risk of acquiring sexually transmitted infections (STIs.) In response to the syndemic of STIs and SUDs, the Department of Health and Human Services’ 2020 STI National Strategic Plan called for increased STI testing among people with SUDs and integration of testing and treatment into non-traditional settings. Existing data describing STI testing and incidence rates among people with SUDs are limited to single or regional medical centers. National samples are needed to target interventions. We report on STI testing, test positivity, and incidence rates among people with SUDs who receive medical care in the Veterans Health Administration (VHA). Methods We performed a retrospective cohort study of individuals with SUDs who received VHA care in 2018 or 2019. Data were obtained from the Corporate Data Warehouse, a national database that includes data from VHA’s electronic medical record. For individuals with alcohol, opioid, cocaine, and/or other stimulant (e.g. methamphetamine) use disorders, we collected demographic data, testing and results for gonorrhea (GC), chlamydia (CT), syphilis, and HIV during 2019. We calculated rates of testing, test positivity, and incidence rates. Results Incidence of all four STIs was highest in the other stimulant use disorder group; incidence of syphilis was particularly elevated at 922.4 cases/100K. Veterans with multiple SUDs were three times more likely to be houseless in 2019 than those with a single SUD and had higher incidence of all STIs than those with single SUDs, except for people with other stimulant use disorders. People with alcohol use disorder (AUD) had a higher incidence of GC, CT, and syphilis than those with opioid use disorder despite similar testing rates. Percent positivity for HIV ranged from 0.27% for AUD to 2.0% for other stimulant use disorders. Conclusion High incidence of STIs among people with non-cocaine stimulant use disorder indicates a need for comprehensive testing. The data suggests that veterans with AUD would benefit from increased testing. Houselessness and mental health diagnoses were common, and comprehensive STI testing and treatment programs, including an assessment of HIV risk, should be integrated into programs addressing these comorbidities. Disclosures Holly Villamagna, MD, Nothing to disclose

scholarly journals Hot, horny and healthy—online intervention to incentivize HIV and sexually transmitted infections (STI) testing among young Mexican MSM: a feasibility study

mHealth ◽  
2020 ◽  
Vol 6 ◽  
pp. 28-28
Author(s):  
Zafiro Andrade-Romo ◽  
Laura Chavira-Razo ◽  
Raluca Buzdugan ◽  
Elena Bertozzi ◽  
Sergio Bautista-Arredondo
Keyword(s):  
Sexually Transmitted Infections ◽  
Feasibility Study ◽  
Online Intervention ◽  
Sexually Transmitted ◽  
Sti Testing

scholarly journals Barriers to Testing for Sexually Transmitted Infections among HIV-Serodiscordant Couples: The Influence of Discrimination

2020 ◽  
Vol 30 (2) ◽  
pp. 261-268 ◽  
Author(s):  
Jenna Alarcon ◽  
Tamra B. Loeb ◽  
Alison B. Hamilton ◽  
Nicholas J. Moss ◽  
Condessa M. Curley ◽  
...  
Keyword(s):  
Los Angeles ◽  
Sexually Transmitted Infections ◽  
African American Women ◽  
Baseline Survey ◽  
Care Utilization ◽  
Hiv Positive ◽  
Health Seeking ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
The Impact

Objectives: African Americans face chal­lenges in accessing services for sexually transmitted infections (STIs). From 2012- 2016, the EBAN II intervention was funded by the NIH to test the effectiveness of implementing a culturally congruent, evidence-based HIV/AIDS prevention program in Los Angeles and Oakland, California. This study examined the impact of personal characteristics and experiences of discrimination on the likelihood of being tested for STIs.Method: Participants (N=91) completed a baseline survey. Descriptive statistics were used to test for differences between those who did and did not obtain STI testing. Factors included HIV serostatus, sociodemo­graphic variables, STI history, the presence of outside partners, and discrimination ex­periences. Multiple logistic regressions were conducted for men and women separately.Results: Participants with no recent experi­ences of discrimination were more than 3 (3.4) times more likely to obtain a baseline STI test than those who reported discrimina­tion experiences. HIV-positive women with no recent experiences of discrimination were 11 times more likely than those with reports of recent discrimination to obtain STI tests.Conclusions: It is often women who are the gatekeepers for health seeking in families and the same may be for these couples. Ex­periences of discrimination may impede STI testing, and heighten several health risks, particularly among HIV-positive African American women in HIV-serodiscordant relationships. Addressing the impact of dis­crimination experiences may be important for STI prevention and treatment efforts in interventions promoting health care utilization. Ethn Dis. 2020;30(2):261-268; doi:10.18865/ed.30.2.261 

scholarly journals Identifying youth at high risk for sexually transmitted infections in community-based settings using a risk prediction tool: a validation study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katharina Kranzer ◽  
Victoria Simms ◽  
Ethel Dauya ◽  
Ioana D. Olaru ◽  
Chido Dziva Chikwari ◽  
...  
Keyword(s):  
Risk Factor ◽  
Sexually Transmitted Infections ◽  
Risk Prediction ◽  
Prediction Tool ◽  
Operating Characteristics ◽  
Community Based ◽  
Cut Points ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Number Needed To Screen

Abstract Background  Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most common bacterial sexually transmitted infections (STIs) worldwide. In the absence of affordable point-of-care STI tests, WHO recommends STI testing based on risk factors. This study aimed to develop a prediction tool with a sensitivity of > 90% and efficiency (defined as the percentage of individuals that are eligible for diagnostic testing) of < 60%. Methods This study offered CT/NG testing as part of a cluster-randomised trial of community-based delivery of sexual and reproductive health services to youth aged 16–24 years in Zimbabwe. All individuals accepting STI testing completed an STI risk factor questionnaire. The outcome was positivity for either CT or NG. Backwards-stepwise logistic regression was performed with p ≥ 0.05 as criteria for exclusion. Coefficients of variables included in the final multivariable model were multiplied by 10 to generate weights for a STI risk prediction tool. A maximum likelihood Receiver Operating Characteristics (ROC) model was fitted, with the continuous variable score divided into 15 categories of equal size. Sensitivity, efficiency and number needed to screen were calculated for different cut-points. Results From 3 December 2019 to 5 February 2020, 1007 individuals opted for STI testing, of whom 1003 (99.6%) completed the questionnaire. CT/NG prevalence was 17.5% (95% CI 15.1, 19.8) (n = 175). CT/NG positivity was independently associated with being female, number of lifetime sexual partners, relationship status, HIV status, self-assessed STI risk and past or current pregnancy. The STI risk prediction score including those variables ranged from 2 to 46 with an area under the ROC curve of 0.72 (95% CI 0.68, 0.76). Two cut-points were chosen: (i) 23 for optimised sensitivity (75.9%) and specificity (59.3%) and (ii) 19 to maximise sensitivity (82.4%) while keeping efficiency at < 60% (59.4%). Conclusions The high prevalence of STIs among youth, even in those with no or one reported risk factor, may preclude the use of risk prediction tools for selective STI testing. At a cut-point of 19 one in six young people with STIs would be missed.

scholarly journals 851. Rate of Sexually Transmitted Infections and Engagement in HIV Pre-Exposure Prophylaxis at the Veterans Affair Maryland Health System

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S515-S516
Author(s):  
Omar Harfouch ◽  
Emily Comstock ◽  
Roman Kaplan ◽  
Rohit Talwani ◽  
Eleanor Wilson
Keyword(s):  
Sexually Transmitted Infections ◽  
International Classification Of Diseases ◽  
P Value ◽  
Chi Square ◽  
Sexually Transmitted ◽  
Sti Testing ◽  
Hiv Test ◽  
Significant Difference ◽  
Exposure Prophylaxis ◽  
Chi Square Tests

Abstract Background Rates of sexually transmitted infections (STIs) and uptake of HIV pre-exposure prophylaxis (PrEP) during the 2020 coronavirus pandemic are unknown. We evaluated data from the Veterans Affair Maryland Health Care System (VAMHCS) data to determine rates of STI and PrEP linkage in our Veterans. Methods We extracted patient-level data on demographics, STI testing (chlamydia, gonorrhea, and syphilis), International Classification of Diseases (ICD) diagnosis codes and refills of TDF-FTC and TAF-FTC. We compared the ratio of positive STI tests in 2018, 2019 and 2020 using chi-square tests. Individuals eligible for PrEP were defined as patients with a newly positive STI result or an ICD diagnosis of: high risk sexual behavior; an STI mentioned above; or gender identity disorder. We excluded anyone with a positive HIV test or a creatinine &gt;1.8. We identified patients initiated on PrEP through pharmacy refill data to define initiation of care. Finally, we used chi-square tests to compare differences of initiation of PrEP between years and demographics. Results The STI positivity rate significantly increased (p&lt; 0.01) from 44.2% (2018) and 42.9% (2019) to 61.6% (2020) [Table 1]. The median ages of those who had a positive STI test were 50 (2018), 44 (2019) and 44 (2020). In 2020, 17% of patients eligible for PrEP filled PrEP. Engagement was similar (p=0.33) in 2019 and 2018, where 14% and 11.6% of patients eligible for PrEP received a prescription (p-value=0.33) [Figure 1]. The median age of those refilling PrEP were: 44 (2018); 43 (2019) and 41 (2020)). In 2020, we observed a statistically significant difference (p&lt; 0.01) in initiation of PrEP in care among Black patients with 11.7% of eligible patients filling PrEP as compared to white patients (26.2%) and other races (23.3%) [Figure 2]. Table 1. Rate of positive tests at VAMHCS from 2018-2020. Figure 1. PrEP Cascade at VAMHCS by year. Non-statistically significant (P=0.33) when comparing engagement in care between different years. Figure 2. Racial distribution of PrEP eligibility and initiation by year at the VAMHCS. Conclusion While during the coronavirus pandemic in 2020, fewer Veterans sought STI testing at the VAMHCS, the number of positive STI results remained steady, leading to a higher positivity rate. The rate of initiation of PrEP did not differ between 2020, 2019 and 2018. Racial inequities in initiation of PrEP increased in 2020. Disclosures All Authors: No reported disclosures

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