scholarly journals Trends in Sexually Transmitted Infections in United States Ambulatory Care Clinics from 2005–2016

2021 ◽  
Vol 11 (1) ◽  
pp. 71
Author(s):  
Ikenna Unigwe ◽  
Seonkyeong Yang ◽  
Hyun Jin Song ◽  
Wei-Hsuan Lo-Ciganic ◽  
Juan Hincapie-Castillo ◽  
...  

We examined the prevalence trends of non-human immunodeficiency virus (HIV) sexually transmitted infections (STI) and associated patient characteristics in U.S. ambulatory-care settings from 2005–2016. We conducted a retrospective repeated cross-sectional analysis using data from the National Ambulatory Medical Care Survey (NAMCS) for individuals aged 15–64 with a non-HIV STI-related visit. Data were combined into three periods (2005–2008, 2009–2012, and 2013–2016) to obtain reliable estimates. Logistic regression was used for analysis. A total of 19.5 million weighted, non-HIV STI-related ambulatory visits from 2005–2016 were identified. STI-related visits per 100,000 ambulatory care visits increased significantly over the study period: 206 (95% CI = 153–259), 343 (95% CI = 279–407), and 361 (95% CI = 277–446) in 2005–2008, 2009–2012, and 2013–2016, respectively (Ptrend = 0.003). These increases were mainly driven by increases in HPV-related visits (56 to 163 per 100,000 visits) from 2005–2008 to 2009–2012, followed by syphilis- or gonorrhea-related visits (30 to 67 per 100,000 visits) from 2009–2012 to 2013–2016. Higher odds of having STI-related visit were associated with younger age (aged 15–24: aOR = 4.45; 95% CI = 3.19–6.20 and aged 25–44: aOR = 3.59; 95% CI = 2.71–4.77) vs. 45–64-year-olds, Black race (aOR = 2.41; 95% CI = 1.78–3.25) vs. White, and HIV diagnosis (aOR = 10.60; 95% CI = 5.50–20.27) vs. no HIV diagnosis. STI-related office visits increased by over 75% from 2005–2016, and were largely driven by HPV-related STIs and syphilis- or gonorrhea-related STIs.

2017 ◽  
Vol 43 (1) ◽  
pp. 125-134
Author(s):  
Janelle D. Branoff ◽  
Michael R. Jiroutek ◽  
Chloe R. Kelly ◽  
Sadia Huma ◽  
Beth S. Sutton

Purpose The purpose of this study was to determine if there was an association between receipt of diet/nutrition, exercise, and weight loss education in adult patients with a primary diagnosis of diabetes with various demographic and socioeconomic variables using data from the National Ambulatory Medical Care Survey (NAMCS) for the years 2008 to 2011. Methods This retrospective, cross-sectional, observational study design included patients ≥ 18 years of age with diabetes in the NAMCS between 2008 and 2011, inclusive. A series of weighted multivariable logistic regression models was constructed to evaluate predictors of diet/nutrition, exercise, and weight loss education. Odds ratios and 95% confidence intervals were reported. Results Among patients included in this study (n = 3027), 35.6% received diet/nutrition education, 21.8% received exercise education, and 13.6% received weight loss education. From the multivariable analyses, visits using “other” payment type, visits with Medicaid, and visits occurring in non-Metropolitan Statistical Areas were significantly less likely to receive diet/nutrition education; visits using other payment type, visits in non-Metropolitan Statistical Areas, and visits by those ≥ 65 and 45-64 years of age were significantly less likely to receive exercise education. No significant disparities in the receipt of weight loss education were found. Conclusion These findings indicate that although only approximately one third or fewer patients diagnosed with diabetes were receiving diet/nutrition, exercise, or weight loss education, there appeared to be limited disparities among the groups studied. Education rates appear to be trending upward over time, to be slightly improved as compared with previous studies, and to include fewer disparities.


2020 ◽  
Vol 35 (5) ◽  
pp. 207-219
Author(s):  
Nicole Early ◽  
Kathleen Fairman ◽  
Justin Ma ◽  
Kevin Hong

OBJECTIVE: To assess changes in psychotropic pharmacotherapy for patients with dementia over a three-year period.<br/> SETTING: National Ambulatory Medical Care Survey, physician office visits from 2014 to 2016.<br/> PRACTICE DESCRIPTION: Retrospective analysis of publicly available, nationally representative data on patient characteristics; diagnoses, including comorbidities; and treatments, including medications. Included were patients with a diagnosis of Alzheimer's disease or dementia who were 18 years of age or older. No sample exclusions were applied.<br/> INTERVENTION: Time period, comparing calendar year (CY) 2014 versus the calendar years 2015 and 2016 using Pearson chi-square tests.<br/> MAIN OUTCOME MEASURE(S): Prescribing rates of psychotropic medications, grouped by therapy class.<br/> RESULTS: The sample included 647 patients (337 in 2014 and 310 in 2015-2016). A majority (69.5%) of the patients were 75 years of age or older; 62.4% were female. Prescribing rates remained relatively stable for antipsychotics (15.1% in 2014 to 12.9% in 2015-16; P = 0.607); antidepressants (35.0% to 27.7%; P = 0.263); acetylcholinesterase inhibitors (38.6% to 33.9%; P = 0.446); and memantine (19.4% to 16.8%; P = 0.551). Significant increases were noted for sedatives (11.9% to 21.7%; P = 0.037) and anticonvulsants (10.0% to 27.6%, P = 0.001).<br/> CONCLUSION: Clinically significant increases in the prescribing of anticonvulsants and sedatives suggest the possibility that these agents are used to combat behavioral and psychological symptoms of dementia in patients with dementia. Further research is required to assess the rationale, efficacy, and safety of these uses.


Author(s):  
Patrick T. Adegun ◽  
Eyitope O. Amu

Abstract Background: In Nigeria, adolescents are highly vulnerable to sexually transmitted infections (STIs) which have the potential of jeopardising their future reproductive lives if poorly treated. Objective: To determine the prevalence and health care seeking behaviour for STIs among secondary school adolescents in Ado, South-Western Nigeria. Subjects: Male and female adolescents aged 10–19 years. Methods: The study employed a descriptive cross-sectional design. A pre-tested, self-administered, semi-structured questionnaire was used to elicit information from 560 adolescents selected from public and private secondary schools in Ado Local Government Area (LGA) of Ekiti State, using a multistage sampling technique. The data were analyzed using descriptive and inferential statistics. Analyzed data were presented in the form of tables and charts. Results: Two hundred and fifty-one (47.1%) respondents had previous symptoms of STIs. The commonest symptoms among the males were penile discharge (30.5%), painful micturition (30.5%) and stomach pain with swollen testes (25.4%). The commonest symptoms among the females were genital itching (27.6%), genital sores (14.1%) and painful micturition (13.1%). Only 26.7% sought treatment from a health facility; 37.0% did nothing; 15.9% went to patent medicine stores, 10.0% used herbs; the rest did self-medication or prayed. Conclusion: The prevalence of STI symptoms among adolescents in Ado-Ekiti is high but their health care seeking behaviour is poor. Health education about the dangers of untreated STI and the importance of seeking treatment early, targeted at adolescents, should be intensified.


2021 ◽  
Author(s):  
Wei Tu ◽  
Yu-Ye Li ◽  
Yi-Qun Kuang ◽  
Rong-Hui Xie ◽  
Xing-Qi Dong ◽  
...  

Abstract Background Yunnan has the highest rates of HIV in the country. Other treatable sexually transmitted infections (STIs) are associated with accelerated HIV transmission and poor ART outcomes, but are only diagnosed by syndromic algorithms. Methods We recruited 406 HIV-positive participants for a cross-sectional study (204 ART-naive and 202 ART). Blood samples and first-voided urine samples were collected. Real-time polymerase chain reaction methods were used for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Mycoplasma genitalium (MG). Syphilis and HSV-2 tests were also performed. Results Among 406 participants, the overall prevalence of STI was 47.0% and 45.1% in ART-naive individuals and 49.0% in ART individuals, respectively. Testing frequency was 11.6% (11.8% vs 11.4%), 33.2% (29.4% vs 37.1%), 3.2% (3.4% vs 3.0%), 2.0% (3.4% vs 0.5%) and 4.7% (6.4% vs 3.0%) for active syphilis, HSV-2, chlamydia, gonorrhoeae and genitalium. Percentage of multiple infections in both groups was 10.8% (22/204) in ART-naive participants and 9.9% (20/202) in ART participants. Females, age between 18 to 35 years, ever injected drugs, homosexual or bisexual, HIV/HBV coinfection, and not receiving ART were identified as risk factors. Self-reported asymptom was not eliminating of having a laboratory-diagnosed STI. Conclusions STI prevalence was 47.0% (45.1% vs 49.0%), HSV-2, syphilis and MG were the most common STIs in HIV-infected individuals. We found high prevalence (6.4%) of Mycoplasma genitalium in ART-naive individuals. ART can reduce the diversity of STI-HIV coinfection but not the prevalence. HIV-positive individuals tend to neglect or maybe hide their genital tract discomfort, thus we suggest strengthening STI joint screening and treatment services among HIV-infected individuals whether they describe genital tract discomfort or not.


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