How can sexual history taking for sexually transmitted infection partner notification be improved?

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.

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Partner notification and treatment outcomes among South African adolescents and young adults diagnosed with a sexually transmitted infection via laboratory-based screening

International Journal of STD & AIDS ◽

10.1177/0956462420915395 ◽

2020 ◽

Vol 31 (7) ◽

pp. 627-636 ◽

Cited By ~ 1

Author(s):

Pooja Chitneni ◽

Mags Beksinska ◽

Janan J Dietrich ◽

Manjeetha Jaggernath ◽

Kalysha Closson ◽

...

Keyword(s):

Young Adults ◽

Sexually Transmitted Infection ◽

Trichomonas Vaginalis ◽

Partner Notification ◽

Mycoplasma Genitalium ◽

Adolescents And Young Adults ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Care Cascade ◽

Essential Components

Partner notification and treatment are essential components of sexually transmitted infection (STI) management, but little is known about such practices among adolescents and young adults. Using data from a prospective cohort study (AYAZAZI) of youth aged 16–24 years in Durban, South Africa, we assessed the STI care cascade across participant diagnosis, STI treatment, partner notification, and partner treatment; index recurrent STI and associated factors; and reasons for not notifying partner of STI. Participants completed laboratory-based STI screening ( Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis) at enrollment and at 12 months. Of the 37/216 participants with STI (17%), 27/37 (73%) were women and 10/37 (27%) were men. Median age was 19 years (IQR: 18–20). Of the participants with STI, 23/37 (62%) completed a Treatment and Partner Tracing Survey within 6 months of diagnosis. All survey participants reported completing STI treatment (100%), 17/23 (74%) notified a partner, and 6/23 (35%) reported partner treatment. Overall, 4/23 (11%) participants had 12-month recurrent C. trachomatis infection, with no association with partner notification or treatment. Stigma and lack of STI knowledge were reasons for not notifying partner of STI. STI partner notification and treatment is a challenge among youth. Novel strategies are needed to overcome barriers along the STI care cascade.

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Tackling STI epidemics through the HIV clinic: is sex high enough on the agenda?

International Journal of STD & AIDS ◽

10.1258/ijsa.2008.008048 ◽

2008 ◽

Vol 19 (10) ◽

pp. 711-712 ◽

Cited By ~ 3

Author(s):

R A Ferrand ◽

S De Silva ◽

J D Cartledge

Keyword(s):

Significant Proportion ◽

Sexual History ◽

High Rate ◽

Hiv Positive ◽

Medical Problems ◽

Transmitted Infection ◽

Sexually Transmitted ◽

Sexual History Taking ◽

Sex With Men ◽

A Prospective Study

Sexually transmitted infection (STI) rates among men having sex with men continue to increase. HIV services may operate independently to genitourinary medicine clinics and the sexual health of HIV-positive patients may be of low priority in the context of medical problems related to HIV. A prospective study of HIV-positive gay men was conducted in a London outpatient clinic over a three-month period. Data were available for 90 men. Forty-five percent had STI screens in the preceding six months. These revealed a high rate of infections; 26 infections diagnosed in 14 men in the study period. Fifty-seven percent of the 90 men in the study had more than one partner in the past three months and approximately one-third had unprotected sexual activity. A significant proportion of men were unaware of recent outbreaks of hepatitis C and lymphogranuloma venereum and of HIV postexposure prophylaxis. We therefore recommend that sexual history-taking, STI screens and health promotion should become a routine feature of HIV outpatient consultations in this group.

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857. Discussion and Initiation of HIV Pre-exposure Prophylaxis Were Rare Following Diagnoses of Sexually Transmitted Infections among Veterans

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.1052 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S519-S520

Author(s):

Takaaki Kobayashi ◽

Puja Van Epps ◽

Marissa Maier ◽

Lauren Beste ◽

Brice Beck ◽

...

Keyword(s):

Sexually Transmitted Infections ◽

Chart Review ◽

Case Control Study ◽

Case Control ◽

Sexual History ◽

History Taking ◽

Sexually Transmitted ◽

Sexual History Taking ◽

Exposure Prophylaxis ◽

Control Study

Abstract Background Healthcare encounters for the diagnosis and treatment of sexually transmitted infections (STIs) are common and represent a window of opportunity to discuss and initiate HIV pre-exposure prophylaxis (PrEP). Little is known about how frequently PrEP is discussed and initiated in association with encounters for STIs. Methods We conducted a retrospective cohort and nested case control study in the national Veterans Administration (VA) healthcare system to determine the frequency of PrEP discussion and initiation in association with clinical encounters for bacterial STIs (i.e. early syphilis, gonorrhea, and chlamydia). We used administrative data to identify patients with a first STI based on ICD 9 / 10 codes from January 2013–December 2018 , excluding patients with prior HIV diagnosis or PrEP use, or STI diagnosed in context of a visit to initiate PrEP (Figure 1). We used pharmacy data to determine the frequency of PrEP initiation within 90 days of the encounter for STI in this cohort. In the case control study, we matched 90 PrEP starters to 180 non-starters by day of STI diagnosis and reviewed chart notes from the STI diagnosis encounter to determine frequency of documentation of sexual history taking and PrEP discussions among subsequent PrEP initiators and non-initiators. Results We identified 23,312 patients with a first STI, of whom 90 (0.4%) started PrEP within 90 days. Adjusting for age, PrEP initiation was associated with urban residence (OR=5.0, 95Cl 1.8–13.4), White compared to Black race (OR=1.7, 95 Cl 1.1–2.8), and syphilis diagnosis (OR = 7.4, 95 Cl 4.7–11.6, table 1). Chart review revealed that discussion of PrEP was rare among people with STIs who did not subsequently start PrEP (1.1%, 95 CI 0.1–4.0, table 2). PrEP initiation was associated with documentation of any sexual history (80.0% of initiators vs. 51.0% of non-initiators, p < 0.01) and discussion of PrEP (52.2% vs. 1.1%, p < 0.01) during the initial STI diagnosis encounter. Figure 1. Study flow chart Table 1. Characteristics of patients with a first healthcare encounter with an STI diagnosis, by PrEP initiation within 90 days of encounter. N= 23,312 Table 2. Chart review findings from case control study. Ninety people who initiated PrEP (i.e., “cases”) were randomly matched to 180 who did not initiate PrEP (i.e., “controls”) by date of STI. Conclusion Discussion and initiation of PrEP were rare in association with healthcare encounters for STIs. Not all individuals with STIs will benefit from starting PrEP, but interventions are needed to improve low rates of sexual history-taking and discussion of PrEP during healthcare encounters for STIs. Disclosures Bruce Alexander, PharmD, Bruce Alexander Consulting (Independent Contractor)

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Rectal cancer mimic: a rare case of syphilitic proctitis

BMJ Case Reports ◽

10.1136/bcr-2020-235522 ◽

2020 ◽

Vol 13 (12) ◽

pp. e235522

Author(s):

Rajashri Veeresh Patil ◽

Iain Stephenson ◽

Cathy J Richards ◽

Yvette Griffin

Keyword(s):

Rectal Cancer ◽

Sexually Transmitted Infection ◽

Rare Case ◽

Surgical Intervention ◽

Secondary Syphilis ◽

Sexual History ◽

Diagnostic Challenge ◽

Rare Presentation ◽

Transmitted Infection ◽

Sexually Transmitted

Syphilitic proctitis is a rare presentation of sexually transmitted infection that poses a diagnostic challenge as it mimics rectal cancer clinically, radiologically and endoscopically. We report a case of a 66-year-old male patient with a background of HIV infection presenting with obstructive bowel symptoms and initial diagnosis of rectal cancer on CT. Sigmoidoscopy and histopathology were non-diagnostic. A diagnosis of secondary syphilis was suspected after obtaining sexual history and diagnostic serology, avoiding planned surgical intervention.

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Outcome of partner notification in patients diagnosed with genital warts attending a provincial clinic in East Anglia, England

International Journal of STD & AIDS ◽

10.1258/ijsa.2012.011462 ◽

2012 ◽

Vol 23 (7) ◽

pp. 518-519

Author(s):

L Mercer ◽

T C Harry

Keyword(s):

Confidence Interval ◽

Sexually Transmitted Infection ◽

Odds Ratio ◽

Partner Notification ◽

Genital Warts ◽

First Episode ◽

Transmitted Infection ◽

East Anglia ◽

Sexually Transmitted ◽

Relationship Duration

We retrospectively reviewed partner notification of patients diagnosed with first episode genital warts seen in the genitourinary (GU) medicine clinic, Great Yarmouth, UK, from January 2005 to December 2008. Of 947 patients diagnosed with genital warts, 486 (51.3%) were men, median age 25 years; 461 (48.7%) were women, median age 21 years and the partner notification index was 32.9%. In our cohort, 310 patients 33.2% reported having had a casual partner that could not be traced. The median relationship duration of partners whose contact attended was nine months and those whose contact did not attend was two months, (χ2 = 49.72, P < 0.0001). The odds ratio (OR) of a contact attending after seeing a health adviser was 2.94 (95% confidence interval [CI] = 1.79–4.86). In our cohort 35.6% of contacts whose partners saw a health adviser attended compared with 15.7% of contacts whose partner did not see a health adviser (χ2 = 19.7, P < 0.0001). Among the contacts 26% had genital warts, 28% had another sexually transmitted infection (STI) and 12% had both genital warts and another STI. The low partner notification index was associated with the reported casual partnerships seen in the cohort. Partner notification was enhanced when patients saw a health adviser.

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