2021 CDC Update: Treatment and Complications of Sexually Transmitted Infections (STIs)

The Centers for Disease Control and Prevention (CDC) recently updated their Sexually-Transmitted Infection (STI) Treatment Guidelines with a revision to the approach to gonococcal infections in December 2020 and other STIs in July 2021. This article reviews the new recommendations and highlights important updates from the 2015 iteration that are crucial for primary care and community health practice.

Knowledge, attitudes and perceptions about HIV self-testing amongst college students in Namibia

Background: In 2019, the Namibian Ministry of Health introduced HIV self-testing (HIVST) as an additional strategy to increase uptake of HIV self-testing in traditionally hard-to-reach subpopulations, such as young adults and males. It is unclear how the utilisation of HIV self-testing iw optimised in young adults. The study objective is understanding knowledge, attitudes, and perception levels amongst college-going young adults in Namibia. Methods: This quantitative study utilised a sample of 97 young college students who received a pre-test structured questionnaire. One sample t-test was used to analyse the average score from the Likert scale. A cut-off p-value of 0.05 to determine statistical significance of variables was used. Logistic regression computation was used to identify independent variables significantly associated with the dependent variable. A univariate analysis was done on awareness and acceptability with statistical significance of p<0.05 to obtain preliminary insights into the association between independent and dependent variables. The net effect variables are assessed using multivariate analysis using STATA 13.1, taking into account confounding factors. Results: Out of the 97 participants, only 23.7% knew about HIV self-testing. The logistic regression had a significant association with awareness of HIV self-testing (p≤0.05): on condom use during a first sexual encounter; being with a single sexual partner in the last 12 months; not having a sexually transmitted infection. The univariate analysis revealed an association with the acceptability of HIV self-testing from females; those who live in urban settlements; having not had sexually transmitted infection in the last twelve months. Moreover, findings reveal there are low levels of awareness, yet participants had positive attitudes and levels of acceptability to HIV self-testing. Conclusion: This study shows promise if awareness through health education and promotion about HIV self-testing can be increased. This can form part of scaling up HIV testing in Namibia.

Informing Young Girls about the Risk of HPV Infection in Developing Cervical Cancer and Preventing

This study aims to provide detailed information about HPV as a widespread sexually transmitted infection, which is considered one of the most important factors in the occurrence of cervical cancer in young girls,emphasizing the connection between infection.Participants were 126 randomly choosed young girls at the master's level student at Sport University of Tirana.Date were collected using a questionnaire investigating risk factors as well as knowledge on this sexually transmitted infection of HPV where through a descriptive and informative letter which was distributed to all girls participating in this study.From this study it was observed that a significant number of them were aware of the virus and ways of transmission 81 girls (64.28%),of which 22 girls (17.46%) had in hearing that it was a sexually transmitted virus, 11 girls (8.73%) had read that this virus could cause cervical cancer, 9 (7.14%) of whom had heard of an HPV-related vaccine,while 3 of them (2.39) refused to complete this questionnaire.From the data collected in this study it was noticed that information and awareness campaigns should be carried out immediately for this age group as the most at risk in relation to sexually transmitted infections and in particular HPV,enabling in this form the ability to care more specifically for their health thus preventing very dangerous pathologies such as cervical cancer.However for this aspiration to be realized,in practice requires a greater understanding on the part of these young girls of the natural history of early HPV infection and its role in creating cervical epithelial abnormalities.

Capturing missed HIV pre-exposure prophylaxis opportunities—sexually transmitted infection diagnoses in the emergency department

The United States Centers for Disease Control and Prevention (CDC) recommends HIV pre-exposure prophylaxis (PrEP) be considered for all patients diagnosed with a sexually transmitted infection (STI). Emergency departments (EDs) are an important site for diagnosis and treatment of STIs for under-served populations. Consequently, we identified 377 patients diagnosed with a bacterial sexually transmitted infection (gonorrhea, chlamydia, and/or syphilis) at a major New York City emergency department between 1/1/2014 and 7/30/2017 to examine associations between key sociodemographic characteristics and missed opportunities for PrEP provision. In this sample, 299 (79%) emergency department patients missed their medical follow-up 90 days after STI diagnosis, as recommended. Results from adjusted generalized estimating equation regression models indicate that patients >45 yo (aOR = 2.2, 95% CI 1.2–3.9) and those with a primary care provider in the hospital system (aOR = 6.8, 95% CI 3.8–12.0) were more likely to return for follow-up visits, whereas Black patients (aOR = 0.44, 95% CI 0.25–0.77) were less likely to return for follow-up visits. These findings indicate that lack of STI treatment follow-up visits are significantly missed opportunities for PrEP provision and comprehensive human immunodeficiency virus prevention care.

Diagnosis and treatment of hepatitis B. What contributions can prisons make?

Hepatitis B is a parenterally and sexually transmitted infection. Vaccination for the disease is highly effective, and its inclusion in Spain as part of a systematic and universal schedule for newborns has led to a significant decrease of incidence in the national population. However, the number of inmates born in other countries - some from endemic areas of HBV infection -, the mechanisms of transmission and lack of vaccination in third world countries mean that its prevalence in the prison population is higher than in the general population. These institutions therefore play an essential role in detecting and managing hepatitis B. In this paper, the situation of hepatitis B in prisons is reviewed and recommendations are proposed to optimize its control.