Mapping online information needs of Sexually Transmitted Diseases’(STD) patients: A grounded theory investigation (Preprint)

2021 ◽  
Author(s):  
Pavankumar Mulgund ◽  
Raj Sharman ◽  
Sandeep Purao ◽  
Sagarika Suresh ◽  
Peter Winklestein
Keyword(s):  
Grounded Theory ◽  
Information Needs ◽  
Transmitted Disease ◽  
Incidence Rates ◽  
World Health ◽  
Online Information ◽  
Online Forums ◽  
Patient Journey ◽  
Sexually Transmitted ◽  
The World

BACKGROUND According to the World health organization (WHO), more than one million sexually transmitted infections are acquired each day across the world. The incidence rates of STDs in the US are at a record high for the fourth consecutive year. Due to the stigma associated with the incidence of STD, there is a general reluctance to seek information in person, and online information sources remain the primary avenues of information seeking. However, these sources are designed without a comprehensive understanding of the information needs of individuals who have contracted STDs. OBJECTIVE To discover the information needs of individuals who (suspect they) have contracted a sexually transmitted disease (STD). A better understanding of their information needs can drive the design of more effective online forums. METHODS This is a qualitative and analytical study of 549 transcripts (consisting of queries posted over the last ten years) from online forums of the American Sexual Health Association, which allows patients, volunteers, and healthcare providers to connect anonymously. The analysis follows a grounded theory (GT) approach with multiple coding stages to discover categories and themes. RESULTS Three categories of information needs emerge. The first two, Clinical and Logistical, are similar to other contexts. However, our analysis shows that there is a significant need for the last category - Psychosocial information. Approximately 59% of instances are linked to concerns such as confusion, discretion, remorse, and others. These needs vary across the stages of a patient journey (from symptom manifestation to treatment maintenance). CONCLUSIONS Responding to the needs of individuals who (suspect they) have contracted an STD requires compassionate and personalized responses (beyond factual clinical and logistical information). Online forums provide anonymity but do not adequately incorporate mechanisms, practices, or incentives to respond to diverse psychosocial concerns. Innovative approaches to add such support can make the online forums more effective for this group of individuals.

A taxonomy of the scope and organization of local sexually transmitted disease services for policy and practice

2018 ◽  
Vol 29 (14) ◽  
pp. 1375-1383
Author(s):  
Hector P Rodriguez ◽  
Summer Starling ◽  
Zosha Kandel ◽  
Robert Weech-Maldonado ◽  
Nicholas J Moss ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Discriminant Analysis ◽  
Critical Role ◽  
Transmitted Disease ◽  
The United States ◽  
Incidence Rates ◽  
Contact Tracing ◽  
Cluster Solution ◽  
Local Health ◽  
Sexually Transmitted

Local health departments (LHDs) and their organizational partners play a critical role in controlling sexually transmitted diseases (STDs) in the United States. We examine variation in the differentiation, integration, and concentration (DIC) of STD services and develop a taxonomy describing the scope and organization of local STD services. LHD STD programs (n = 115) in Alabama (AL) and California (CA) responded to surveys assessing STD services available in 2014. K-means cluster analysis identified LHD groupings based on DIC variation. Discriminant analysis validated cluster solutions. Differences in organizational partnerships and scope of STD services were compared by taxonomy category. Multivariable regression models estimated the association of the STD services organization taxonomy and five-year (2010–2014) gonorrhea incidence rates, controlling for county-level sociodemographics and resources. A three-cluster solution was identified: (1) low DIC (n = 74), (2) moderate DIC (n = 31), and (3) high DIC (n = 10). In discriminant analysis, 95% of jurisdictions were classified into the same types as originally assigned through K-means cluster analysis. High DIC jurisdictions were more likely (p < 0.001) to partner with most organizations than moderate and low DIC jurisdictions, and more likely (p < 0.001) to conduct STD needs assessment, comprehensive sex education, and targeted screening. In contrast, contact tracing, case management, and investigations were conducted similarly across jurisdictions. In adjusted analyses, there were no differences in gonorrhea incidence rates by category. Jurisdictions in CA and AL can be characterized into three distinct clusters based on the DIC of STD services. Taxonomic analyses may aid in improving the reach and effectiveness of STD services.

scholarly journals Compliance and Treatment Outcomes of Various Regimens for Trichomoniasis in Trinidad and Tobago

2019 ◽  
Vol 7 (10) ◽  
pp. 97
Author(s):  
Divakaruni ◽  
Mahabir ◽  
Orrett ◽  
Adidam ◽  
Venkata ◽  
...  
Keyword(s):  
Single Dose ◽  
Side Effects ◽  
Trichomonas Vaginalis ◽  
Transmitted Disease ◽  
World Health ◽  
Sexually Transmitted ◽  
Treatment Regimens ◽  
Significant Difference ◽  
Compliance To Treatment ◽  
Health Organization

Trichomoniasis is the most common non-viral sexually transmitted disease (STD) globally and yet is not a reportable disease. Trichomonas vaginalis is an important source of reproductive morbidity and may increase risk of acquisition and transmission of human immunodeficiency viruses (HIV). The World Health Organization (WHO) and the Control Disease Center (CDC) recommend various regimens of nitroimidazole s for treatment. The common nitroimidazoles used for trichomoniasis are metronidazole and tinidazole, which vary in their cost, efficacy, and side effect profile. It is relevant to study these factors for better management of the patients. This study aimed to compare and study the efficacy, compliance of various treatment regimens, their outcomes, and side-effects for trichomoniasis, among STI clinic attendees in Trinidad. A clinical trial study was designed, and after obtaining the informed consent, a routine clinical examination was conducted and the swabs for trichomoniasis tests were collected for diagnosis from the 692 participants. Out of 692 participants, 82 patients with positive diagnosis of Trichomonas infection were treated according to the patient’s choice, using different drug regimens. Compliance to treatment, side effects, and outcome were evaluated. The prevalence of trichomoniasis in the population attending our STI clinic is 11.9% and prevalence of HIV is 9%. Of the total 82 participants for the treatment, 80% were females; nearly 90% of the patients belonged to age group 15–45 years, and over 60% were below 30 years. Among those diagnosed for Trichomonas vaginalis, 14.6% had coexistent HIV infection. The compliance with respect to single dose treatment was significantly better than the long-duration oral regimen and has a significant relation with side effects of the treatment. The outcome is generally better and comparable and shows no significant difference between different treatment regimens used in the study. Metronidazole and tinidazole are commonly used drugs in various regimens. Compliance is better with those treated with tinidazole and metronidazole single dose than with other groups. Outcome is comparable between these regimens, especially when combined with other important factors like abstinence and treatment of the partners. The treatment regimens mainly differed in the compliance side effects profile and duration of therapy, which suggests that to improve the compliance of the drugs with fewer side effects, short course regimen would be a preferred choice.

43. MEASURING TRENDS IN STI SYNDROME AETIOLOGIES AND ANTIBIOTIC RESISTANCE PATTERNS: THE SOUTH AFRICAN EXPERIENCE

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 301
Author(s):  
D. A. Lewis
Keyword(s):  
South Africa ◽  
Care Facility ◽  
Global Strategy ◽  
World Health ◽  
Management Approach ◽  
Syndromic Management ◽  
Genital Ulceration ◽  
Sexually Transmitted ◽  
The World ◽  
Clinical Surveillance

The World Health Organization's Global strategy for the prevention and control of sexually transmitted infections (STIs): 2006-2015 highlighted the need for STI surveillance as a cornerstone for national programmes. Yet, in many countries of the world, little or no surveillance exists and, when it does, it is often clinical in nature. Much of the world's resource-poor areas use the syndromic management approach, which includes a recommendation for periodic surveillance of antimicrobial resistance in Neisseria gonorrhoeae. It is also important to perform aetiological surveillance, to assess the common causes of the main STI syndromes, such as genital ulceration (GUS), male urethritis syndrome (MUS) and the vaginal discharge syndrome (VDS). This allows observation of trends and ensures that the drugs used in the syndromic management flow chart as still valid. South Africa started to build a national microbiological and clinical surveillance programme in 2004. Prior to that, microbiological data came from surveillance among particular core groups, such as miners, that could not be extrapolated to the general population. 30 sentinel sites (primary healthcare facilities) were set up in each of the country's nine provinces for the purpose of enhanced clinical surveillance. Data were collected on all the main syndromes in terms of episodes per year. At the same time, microbiological surveillance was initiated in the following provinces: the Northern Cape, Mpumalanga, the Western Cape and Gauteng. Plans are to conduct further surveillance in the Free State and possibly the Eastern Cape later in 2007. Within each province, one primary health care facility was chosen on the criteria of a large STO caseload and proximity to the laboratory doing the initial culturing of N. gonorrhoeae. Consecutive patients were recruited using informed consent and anonymous specimens collected. Patients were treated syndromically in the normal manner according to national STI management guidelines. Gonococcal isolates, obtained from men with urethral discharge, were tested for ciprofloxacin and ceftriaxone resistance using E tests. In addition, swabs were collected from MUS patients and VDS patients for multiplex polymerase chain reaction (M-PCR) based testing for the following four pathogens: N. gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis and Mycoplasma genitalium. Ulcer swabs were also tested by M-PCR for herpes simplex virus (HSV), Haemophilus ducreyi and Treponema pallidum. A separate PCR was used to test the extracted DNA for C. trachomatis L1-L3. Serum was taken from all participants and tested for syphilis (RPR plus TPPA), HSV-2 and HIV antibodies. Key findings have confirmed the decline of chancroid to below 1% of genital ulcers and the predominance of genital herpes as the major cause of genital ulceration in South Africa. Gonorrhoea continues to be the major cause of urethritis in men and prevalence far exceeds Chlamydial infection. Approximately 10% of men with MUS are also infected/colonized with T. vaginalis. Only about one third of VDS cases appear to be caused by sexually transmitted pathogens. HIV infection rates exceed those recorded in the annual antenatal surveys and are highest among genital ulcer patients (70%). RPR seropositivity in non-ulcer patients is around 5% and antibodies to HSV-2 occur in about 50!!60% of patients overall. The surveillance has also demonstrated alarming rises in the prevalence of ciprofloxacin resistant gonorrhoea since 2004.

AIDS as a moral metaphor: An analysis of the politics of the ‘Third Epidemic’

1989 ◽  
Vol 30 (2) ◽  
pp. 243-273 ◽  
Author(s):  
Laurence J. Ray
Keyword(s):  
Sexual Intercourse ◽  
Sexually Transmitted Disease ◽  
Transmitted Disease ◽  
Rare Condition ◽  
Sexual Contact ◽  
Traditional Values ◽  
Sexually Transmitted ◽  
The Third ◽  
Social Events ◽  
The World

This paper examines some of the moral meanings of aids, and argues that in addition to understanding aids in the context of the sexual counter-revolution, it also needs to be placed in the wider context of global economic and ideological crises, and the ‘New Right's’ struggle for hegemony. Denis Altman refers to aids as ‘the most political of diseases’ (Altman 1986, p. 11). A few years ago, Evans Stark pointed out that all epidemics are ‘social events’, even though they may appear as natural, random phenomena. This is because they have become the focus of struggles for control over resources (principally housing, medicines, and sanitation) (Stark 1977). Epidemics further tend to throw into relief deeply held social tensions and anxieties, which can become triggers for social reorganisation around traditional values. It is not difficult to see how this is the case with aids, which is infused in particular with tensions over sexuality and desire. In relation to this it is important to emphasize first, that sexual contact is estimated to be responsible for around two-thirds of reported aids cases amongst adults in the U.S.A. (Gracie et al. 1986), but it is not actually an exclusively sexually transmitted disease; and secondly that compared with other major causes of morbidity and mortality, aids remains a relatively rare condition in many parts of the world. It is sociologically significant though, that the two major routes of transmission, IV use and penetrative sexual intercourse, involve issues of control over body boundaries.

scholarly journals Hepatitis C Worldwide and in Brazil: Silent Epidemic—Data on Disease including Incidence, Transmission, Prevention, and Treatment

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Iara Fabricia Kretzer ◽  
Andrea do Livramento ◽  
Joel da Cunha ◽  
Sabrina Gonçalves ◽  
Iraci Tosin ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Viral Hepatitis ◽  
Universal Access ◽  
Public Health Problem ◽  
Incidence Rates ◽  
World Health ◽  
Current Status ◽  
The World ◽  
Prevention And Treatment ◽  
Health Organization

Hepatitis C virus (HCV) is endemic worldwide and according to the World Health Organization (WHO), there are about 150 million chronic carriers worldwide. The infection is a leading cause of liver diseases like cirrhosis and hepatocellular carcinoma (HCC); thus, HCV infection constitutes a critical public health problem. There are increasing efforts worldwide in order to reduce the global impact of hepatitis C through the implementation of programmatic actions that may increase the awareness of viral hepatitis and also improve surveillance, prevention, and treatment. In Brazil, about 1,5 million people have been chronically infected with HCV. The country has a vast territory with uneven population density, and hepatitis C incidence rates are variable with the majority of cases concentrated in the most populated areas. Currently, the main priorities of Brazilian Ministry of Health's strategies for viral hepatitis management include the prevention and early diagnosis of viral hepatitis infections; strengthening of the healthcare network and lines of treatment for sexually transmitted diseases, viral hepatitis, and AIDS; improvement and development of surveillance, information, and research; and promotion of universal access to medication. This review aims to summarize the available data on hepatitis C epidemiology and current status of efforts in prevention and infection control around the world and in Brazil.

scholarly journals Antimicrobial resistance in sexually transmitted infections

2019 ◽  
Vol 27 (1) ◽  
Author(s):  
Vivian Tien ◽  
Chitra Punjabi ◽  
Marisa K Holubar
Keyword(s):  
Antimicrobial Resistance ◽  
Condom Use ◽  
Sexually Transmitted Infections ◽  
Mycoplasma Genitalium ◽  
Therapeutic Options ◽  
World Health ◽  
Drug Resistant ◽  
Intrinsic Resistance ◽  
Sexually Transmitted ◽  
The World

Abstract Rationale for review International travel facilitates the spread of drug-resistant infections, including sexually transmitted infections (STIs). In 2016, the World Health Organization highlighted the global burden of ‘curable’ STIs, estimating 376 million new infections of gonorrhoea, chlamydia, syphilis and trichomoniasis annually, with considerable geographic variation in both the burden of disease and prevalence of resistance. Travelers’ risk of contracting and transmitting drug-resistant STIs depends in part on their geographic exposure. In this review, we describe the epidemiology of antimicrobial resistance (AMR) and the management of these four common STIs and Mycoplasma genitalium, an increasingly recognized cause of non-gonococcal urethritis. Key findings Multi-drug and extensively drug resistant gonorrhoea strains have been associated with international spread, particularly in travelers returning from Southeast Asia. Chlamydia is the most common bacterial STI worldwide. Although in vitro resistance has been reported, surveillance data suggest that clinically significant resistance to macrolides and tetracyclines is rare. Macrolide resistance in syphilis is now endemic in much of the world but there is no documented penicillin resistance, which remains first-line therapy. Trichomoniasis is the most common non-viral STI worldwide. Although clinical failure after treatment occurs, resistance to metronidazole is thought to be uncommon. Mycoplasma genitalium exhibits intrinsic resistance to many antibiotics, and the prevalence of resistance to both first- and second-line regimens (macrolides and fluoroquinolones) is increasing worldwide, with limited alternative therapeutic options. Recommendations International travelers are at risk for acquiring resistant STIs with limited therapeutic options. Improved diagnostics are urgently needed to improve AMR surveillance and the management of infected patients. As no vaccinations are currently available for these STIs, and pre-exposure prophylaxis is an area of active study with limited data, condom use is critical for prevention. Travel medicine providers should incorporate STI risk reduction counselling, with an emphasis on condom use, into the routine pre-travel consultation.

scholarly journals Virginity Testing Beyond a Medical Examination

2015 ◽  
Vol 8 (7) ◽  
pp. 152 ◽  
Author(s):  
Mehri Robatjazi ◽  
Masoumeh Simbar ◽  
Fatemeh Nahidi ◽  
Jaber Gharehdaghi ◽  
Mohammadali Emamhadi ◽  
...  
Keyword(s):  
Sexually Transmitted Diseases ◽  
Cultural Values ◽  
Violence Against Women ◽  
Medical Examination ◽  
World Health ◽  
Structured Interviews ◽  
Sexually Transmitted ◽  
The World ◽  
Health Organization ◽  
Virginity Testing

<p>Apart from religious values, virginity is important in different communities because of its prominent role in reducing sexually transmitted diseases and teen pregnancies. Even though virginity testing has been proclaimed an example of violence against women by the World Health Organization, it is still conducted in many countries, including Iran. 16 in-depth, semi-structured interviews were conducted with participants aged 32 to 60 years to elucidate the perceptions and experiences of Iranian examiners of virginity testing.</p><p>The perception and experience of examiners were reflected in five main themes. The result of this study indicated that virginity testing is more than a medical examination, considering the cultural factors involved and its overt and covert consequences. In Iran, testing is performed for both formal and informal reasons, and examiners view such testing with ambiguity about the accuracy and certainty of the diagnosis and uncertainty about ethics and reproductive rights. Examiners are affected by the overt and covert consequences of virginity testing, beliefs and cultural values underlying virginity testing, and informal and formal reasons for virginity testing.</p>

What do we need to learn for policy decision-making on sexually transmitted infections prevention and treatment in Israel?

2012 ◽  
Vol 23 (9) ◽  
pp. e11-e15 ◽  
Author(s):  
D Chemtob ◽  
JM Zenilman ◽  
D Gandacu
Keyword(s):  
Sexually Transmitted Infections ◽  
Age Groups ◽  
Policy Decision ◽  
Incidence Rates ◽  
Case Definition ◽  
World Health ◽  
Evidence Based ◽  
Sexually Transmitted ◽  
Evidence Based Policy ◽  
Hiv Aids

The rising trend of sexually transmitted infections (STIs) reported in several western countries has also affected Israel. To review epidemiological trends and to address additional issues needed for a wider overview on STIs in Israel, we analysed notified data on infectious syphilis, gonorrhoea, Chlamydia trachomatis and HIV/AIDS during 1998–2007, by age groups, and each available publication on STIs in Israel. The trend of each disease had a unique pattern, probably influenced by different screening procedures, case definition, mix of populations and better access to care for high-risk populations. Higher rates were found among patients aged 25–34 years. Rates found in different peak years for gonorrhoea, HIV, chlamydia and infectious syphilis reached 43.6, 18.9, 10.8 and 8.1 cases per 100,000 population, respectively. We compare trends to those of countries from World Health Organization (WHO) European Region and discuss interventions for subpopulations on which additional data are needed for evidence-based policy-making. Incidence rates of syphilis, gonorrhoea, chlamydia and HIV/AIDS are still low in Israel. We propose additional components needed for a more comprehensive evidence-based policy on STIs.

scholarly journals South Africa and national TB control: Are we making progress?

2017 ◽  
Vol 59 (2) ◽  
pp. 4
Author(s):  
Gboyega A Ogunbanjo
Keyword(s):  
South Africa ◽  
World Health Organisation ◽  
Incidence Rates ◽  
World Health ◽  
Hiv Positive ◽  
Western Cape ◽  
Eastern Cape ◽  
Tb Control ◽  
Kwazulu Natal ◽  
The World

South Africa accounts for the worst global tuberculosis epidemics fuelled by the spread of HIV infection. The tuberculosis (TB) incidence increased from 300 per 100,000 people in the early 1990s to more than 950 per 100,000 in 2012.1 In addition, the country remains one of the countries with the highest TB burden globally, with the World Health Organisation (WHO) statistics giving an estimated incidence of 454,000 cases of active TB in 2015.2 This means that about 0.8% of South Africa’s population of 54 million develop active TB disease annually. Of the 454 000 TB cases in South Africa in 2015, WHO estimated that about 57% (258,000) were HIV positive. It also estimated that of 157,505 whose status was known, and who were known to be HIV positive, some 85% (133,116) were on antiretroviral therapy.3 From the same 2015 report, Eastern Cape, KwaZulu-Natal and Western Cape provinces had the highest incidence rates of 692, 685 and 681 per 100,000 respectively. The most notable decline was in KwaZulu-Natal where the incidence decreased from 1,185 to 685 per 100,000 over the last five years.1

Sign in / Sign up

Export Citation Format

Share Document