Analysis of contraceptive behavior of female athletes of reproductive age

The article presents the materials of a large-scale study devoted to the study of the contraceptive behavior of female athletes of reproductive age, representing different sports. It has been established that the most commonly used types of contraception, in all age categories, are: interrupted intercourse, spermicides, barrier contraception (male condoms), hormonal patches. The most rarely used are hormonal contraception (single-phase and three-phase combined oral contraceptives) and intrauterine contraception. It has been established that the choice of a particular type of contraception among athletes is determined by such leading factors as sexual activity, frequency of sexual contacts, the number of sexual partners, the presence or absence of a family and marriage.

A novel high performing multiplex immunoassay Multi-HTLV for serological confirmation and typing of HTLV infections

Background Human T-Cell Lymphotropic Viruses (HTLV) type 1 and type 2 account for an estimated 5 to 10 million infections worldwide and are transmitted through breast feeding, sexual contacts and contaminated cellular blood components. HTLV-associated syndromes are considered as neglected diseases for which there are no vaccines or therapies available, making it particularly important to ensure the best possible diagnosis to enable proper counselling of infected persons and avoid secondary transmission. Although high quality antibody screening assays are available, currently available confirmatory tests are costly and have variable performance, with high rates of indeterminate and non-typable results reported in many regions of the world. The objective of this project was to develop and validate a new high-performance multiplex immunoassay for confirmation and discrimination of HTLV-1 and HTLV-2 strains. Methodology/Principal findings The multiplex platform was used first as a tool to identify suitable antigens and in a second step for assay development. With data generated on over 400 HTLV-positive blood donors sourced from USA and French blood banks, we developed and validated a high-precision interpretation algorithm. The Multi-HTLV assay demonstrated very high performance for confirmation and strain discrimination with 100% sensitivity, 98.1% specificity and 100% of typing accuracy in validation samples. The assay can be interpreted either visually or automatically with a colorimetric image reader and custom algorithm, providing highly reliable results. Conclusions/Significance The newly developed Multi-HTLV is very competitive with currently used confirmatory assays and reduces considerably the number of indeterminate results. The multiparametric nature of the assay opens new avenues to study specific serological signatures of each patient, follow the evolution of infection, and explore utility for HTLV disease prognosis. Improving HTLV diagnostic testing will be critical to reduce transmission and to improve monitoring of seropositive patients.

Human Immunodeficiency Virus Type 2: The Neglected Threat

West Africa has the highest prevalence of human immunodeficiency virus (HIV)-2 infection in the world, but a high number of cases has been recognized in Europe, India, and the United States. The virus is less transmissible than HIV-1, with sexual contacts being the most frequent route of acquisition. In the absence of specific antiretroviral therapy, most HIV-2 carriers will develop AIDS. Although, it requires more time than HIV-1 infection, CD4+ T cell decline occurs more slowly in HIV-2 than in HIV-1 patients. HIV-2 is resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs) and some protease inhibitors. Misdiagnosis of HIV-2 in patients mistakenly considered HIV-1-positive or in those with dual infections can cause treatment failures with undetectable HIV-1 RNA. In this era of global integration, clinicians must be aware of when to consider the diagnosis of HIV-2 infection and how to test for this virus. Although there is debate regarding when therapy should be initiated and which regimen should be chosen, recent trials have provided important information on treatment options for HIV-2 infection. In this review, we focus mainly on data available and on the insight they offer about molecular epidemiology, clinical presentation, antiretroviral therapy, and diagnostic tests of HIV-2 infection.

Filiform projections of the vestibular mucosa: What’s your diagnosis?

29-year-old recently married woman was reffered by her gynecologist to our dermatology department for suspected vulvar condyloma acuminatum. She had no history of any extramarital sexual contacts and her partner was free of any clinical features of genital HPV infections. She was anxious about the origin of her lesions and the risk of her husband’s contamination. She reported burning sensation, irritation and vulvar pain. On clinical examination soft digitate mucous colored papules with a smooth surface were noted at the vulvar vestibule. These papillomatous projections were pearly, uniformly arranged and had separate bases (Fig. 1). Dermatoscopy demonstrated regular and linear pinkish projections arranged in a symmetric distribution. Irregular linear vascular channels were observed (Fig. 2). Figure 1: Clinical aspect: multiple skin-colored filiform and soft projections. Figure 2: Dermatoscopy showing regular and linear pinkish projections arranged in a symmetric distribution. WHAT’S YOUR DIAGNOSIS? ANSWER: Vestibular Papillomatosis Vestibular papillomatosis (VP) is a normal variant of the female genital mucosa [1,2]. It is first described in 1981 by Altemeyer and named pseudocondylomata of the vulva [3]. VP is frequently misdiagnosed as condyloma acuminatum and presents a source of anxiety in patients, aggressive investigations and inappropriate treatment [2]. This entity is most often asymptomatic, but it can be accompanied, as our case, by a feeling of burning, pain or dyspareunia. To avoid the misdiagnosis of VP as genital warts, Moyal-Barranco et al. had proposed five clinical parameters [4]. Unlike condyloma acuminatum, VP is formed by regular, soft and pink-colored papillae arising from a separate base. It is also characterized by the lack of circumscribed whitening on 5% acetic acid application. Dermoscopy can help to differentiate these two conditions by allowing a better identification of these clinical parameters. Linear vessels may sometimes be observed in the transparent core of the finger-like projections [5]. On the other hand, dermoscopy of condyloma acuminatum shows irregular whitish projections with tapering end that arise from a common base and comprise conglomerate vessel. Based on these clinical criteria and the dermoscopic aspect, biopsies will be unnecessary to confirm the diagnosis of VP.

Contribution of men who have sex with men (MSM) attending due to contact tracing to the diagnoses of HIV, syphilis and gonorrhoea in MSM from a clinic-based population

ObjectivesRates of HIV, syphilis and gonorrhoea have increased over the past 20 years in men who have sex with men (MSM). Contact tracing strategies have increased the number of MSM attending clinics as sexual contacts. Understanding the outcomes of contact tracing could inform future public health policies to reduce the burden of STIs in MSM.MethodWe aimed to describe the contribution of MSM attending as notified sexual contacts of patients with HIV, syphilis and gonorrhoea to the overall diagnoses of HIV, syphilis and gonorrhoea in MSM in a cross-sectional study. We collected data on all MSM diagnosed with HIV, syphilis and gonorrhoea in 2019 and evaluated which of these MSM were tested due to attending as a sexual contact.ResultsSexual contacts of HIV, syphilis and gonorrhoea contributed to 20% (95% CI=17.3% to 23.7%) of all diagnoses of HIV (3 of 30, 10%), syphilis (28 of 183, 15%) or gonorrhoea (98 of 420, 23%) in the study period. Asymptomatic sexual contacts contributed to 12% (95% CI=9.6% to 14.9%) of all diagnoses of HIV (3 of 30, 10%), syphilis (16 of 183, 9%) and gonorrhoea (57 of 420, 14%). The proportion of MSM diagnosed with gonorrhoea attending as sexual contacts of gonorrhoea (21%) was significantly greater than MSM diagnosed with HIV, attending as sexual contacts of HIV (3%) or MSM diagnosed with syphilis, attending as a sexual contact of syphilis (4%) (p<0.001). Furthermore, the proportion of MSM diagnosed with syphilis, attending as a sexual contact of another STI (11%) was significantly greater than MSM diagnosed with HIV, attending as a contact of another STI (7%) or MSM diagnosed with gonorrhoea, attending as a sexual contact of another STI (2%) (p<0.001).ConclusionContact tracing contributes significantly to the overall diagnoses of HIV, syphilis and gonorrhoea including asymptomatic sexual contacts in our population. Further efforts to increase the yield from contact tracing may continue to reduce the burden of HIV, syphilis and gonorrhoea within sexual networks of MSM.

A Tail… Film Metaphors of Bodily Transgressions in Human and Animal World

Andrzej Pitrus writes about films showing the transgression of man towards animality. He is interested in human-animal hybrids, as well as prohibited sexual contacts between representatives of different species. These motifs are present in the cinema, but they are a kind of taboo, a line which filmmakers rarely cross. It turns out, however, that they can effectively problematize fundamental existential issues and more.

HIV epidemic situation in the penitentiary system of the Tyumen region

In the biggest Area of Ural Federal District with the high level of prevalence of HIV one of the leading roles in dynamics of epidemic is played by group of the population in which the consumers of injecting drugs, men having sexual contacts with men are most concentrated, workers of commercial sex is group of prisoners. Despite number of the held preventive actions, by the beginning of 2019 the prevalence HIV-infection among these special squads has reached the maximum indicator. Aims. Revealing the development of the epidemic process of HIV infection in the institution of the Federal Penitentiary Service of the Tyumen Region over a long period. Materials and methods. In work statistical data of GBUZ TO «The center for fight about AIDS» of Tyumen, Department of Rospotrebnadzor for the Tyumen region are used. Results. In the Tyumen region the number living with HIV has exceeded 1% of the population, and the prevalence rate infection was 1129.5 on 100 thousand population. Prisoners in places of detention enter into group of the increased risk of infection of HIV (cumulative share in structure of HIV-positive people – 24.4%). The maximum rate of gain of HIV infection among prisoners was +44.0%, minimum – 27.0%. Places of detention need to be considered as one of the main places with high probability of infection of HIV and its carrying out of limits of penal system. Conclusion. Intensity of epidemic process of HIV infection in places of detention are caused by conditions of restriction of freedom and prevalence of the population that demands optimization of system of preventive actions with participation of bodies of health care, services of execution of the punishment and social departments.

Streptococcus agalactiae and genital ulcers in a heterosexual male

Streptococcus agalactiae (S. agalactiae) is a microorganism that asymptomatically colonizes the female genital and gastrointestinal tracts of humans. It produces infections in extreme ages of life and in pregnant women. The case of an adult male is presented, with frequent heterosexual intercourse with different partners. He consulted for itching and burning in the penis' glans. His partner had marked vaginal dryness as a result of early ovarian failure. The patient had ulcerative, non-painful, erythematous lesions with raised edges and little yellow-green discharge. No Donovan bodies were found in the discharge smear and the culture was positive for S. agalactiae. His asymptomatic partner had negative microbiological tests. Both with negative serologies for Chlamydia, HIV and syphilis. No information was obtained from other sexual contacts. It cannot be ascertained that it was a venereal event, it is more likely that the injuries are related to repeated coital trauma.