Pub Date : 2024-08-19DOI: 10.1136/sextrans-2024-056185
Rhian Jenkins, Clare Taverner, Justine Orme, Natalie Edelman, Colin Fitzpatrick, Daniel Richardson
{"title":"Recurrent pelvic pain in people who disclose domestic and sexual violence: a call for a trauma-informed approach.","authors":"Rhian Jenkins, Clare Taverner, Justine Orme, Natalie Edelman, Colin Fitzpatrick, Daniel Richardson","doi":"10.1136/sextrans-2024-056185","DOIUrl":"10.1136/sextrans-2024-056185","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141184252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19DOI: 10.1136/sextrans-2024-056179
Eilidh Jane Ferguson
{"title":"Sexual health elective.","authors":"Eilidh Jane Ferguson","doi":"10.1136/sextrans-2024-056179","DOIUrl":"10.1136/sextrans-2024-056179","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19DOI: 10.1136/sextrans-2024-056136
Marc Tweed, Gillian Louise Dean, Stephen Taylor
{"title":"A tale of two Fast-Track Cities.","authors":"Marc Tweed, Gillian Louise Dean, Stephen Taylor","doi":"10.1136/sextrans-2024-056136","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056136","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19DOI: 10.1136/sextrans-2023-055971
Cyrus Ghaznavi, Peter Ueda, Shuhei Nomura, Masahiro Ishikane, Shunsuke Uno, Haruka Sakamoto
Objectives: Approximately half of Japanese men aged 20-49 years have purchased sexual services, but data concerning the use of commercial sex work (CSW) in Japan remain scarce.
Methods: We used online survey data from the National Inventory of Japanese Sexual Behavior conducted in 2022 (N=4000 Japanese men aged 20-49 years). We calculated the median number of paid sexual partners over the lifetime. We performed logistic regression analysis to determine the sociodemographic, anthropometric and attitudinal factors associated with any lifetime CSW use among men in Japan.
Results: The median number of paid sexual partners reported among men who had ever used CSW was 6 (IQR 3-17) across the lifetime; the corresponding value for those who had ever used CSW in the past year was 2 (IQR 1-4) over the last 12 months. In general, those reporting lifetime use of CSW were significantly more likely than their CSW-naïve counterparts to be older, be married, be heterosexual or bisexual, have higher income and have higher education. Those reporting higher self-rated attractiveness, high or low satisfaction with their sex lives, a desire to increase their frequency of sex and considering sex to be an important aspect of their lives were also found to have a higher likelihood of having used CSW.
Conclusions: High rates of CSW use in Japan likely reflect ease of access, low stigma with respect to use of sexual services and the diversity in the type of services offered. High-income, employed older men have more financial resources at their disposal to purchase services, which can be cost-prohibitive for part-time or unemployed young men with low incomes. These findings will serve as a launchpad for public health efforts directed at promoting safe sexual practices and improved sexually transmitted infection screening rates among users of CSW in Japan.
{"title":"Factors associated with lifetime use of commercial sex work services among Japanese men aged 20-49: findings from a quasi-representative national survey, 2022.","authors":"Cyrus Ghaznavi, Peter Ueda, Shuhei Nomura, Masahiro Ishikane, Shunsuke Uno, Haruka Sakamoto","doi":"10.1136/sextrans-2023-055971","DOIUrl":"10.1136/sextrans-2023-055971","url":null,"abstract":"<p><strong>Objectives: </strong>Approximately half of Japanese men aged 20-49 years have purchased sexual services, but data concerning the use of commercial sex work (CSW) in Japan remain scarce.</p><p><strong>Methods: </strong>We used online survey data from the National Inventory of Japanese Sexual Behavior conducted in 2022 (N=4000 Japanese men aged 20-49 years). We calculated the median number of paid sexual partners over the lifetime. We performed logistic regression analysis to determine the sociodemographic, anthropometric and attitudinal factors associated with any lifetime CSW use among men in Japan.</p><p><strong>Results: </strong>The median number of paid sexual partners reported among men who had ever used CSW was 6 (IQR 3-17) across the lifetime; the corresponding value for those who had ever used CSW in the past year was 2 (IQR 1-4) over the last 12 months. In general, those reporting lifetime use of CSW were significantly more likely than their CSW-naïve counterparts to be older, be married, be heterosexual or bisexual, have higher income and have higher education. Those reporting higher self-rated attractiveness, high or low satisfaction with their sex lives, a desire to increase their frequency of sex and considering sex to be an important aspect of their lives were also found to have a higher likelihood of having used CSW.</p><p><strong>Conclusions: </strong>High rates of CSW use in Japan likely reflect ease of access, low stigma with respect to use of sexual services and the diversity in the type of services offered. High-income, employed older men have more financial resources at their disposal to purchase services, which can be cost-prohibitive for part-time or unemployed young men with low incomes. These findings will serve as a launchpad for public health efforts directed at promoting safe sexual practices and improved sexually transmitted infection screening rates among users of CSW in Japan.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-19DOI: 10.1136/sextrans-2024-056176
Cassandra Laurie, Mariam El-Zein, Eduardo L Franco
Background: Carrageenan-containing gels researched for the prevention of sexually transmitted infections (STIs) have shown promising results for human papillomavirus prevention in women, but not in men. We conducted a narrative review to assess the safety of these gels for genital use.
Methods: We searched PubMed using MeSH terms and keywords on 5 November 2023. Title/abstract of articles were screened to identify relevant ones. Full-text screening determined eligibility: empirical study evaluating safety of carrageenan-containing gel(s) for genital use.
Results: Of the 125 identified records, 15 were eligible, comprising 14 (10 randomised controlled trials and 4 cohorts) unique study populations. Studies included women only (n=11), men only (n=1) or both (n=3); number of participants ranged from 4 to 6202. Safety was assessed for vaginal (n=13), penile (n=3) and anal use (n=2). Most studies assessed safety of Carraguard (53%), followed by Divine9 (14%), and one each of iota-carrageenan gel, lambda-carrageenan gel, Carvir, PC-6500 (griffithsin and carrageenan) and PC-1005 (MIV-150/zinc acetate/carrageenan). Safety assessment relied on self-report (80.0%), testing for STIs (53.3%), investigator-identified genital findings (93.3%) and/or testing for changes in genital flora (60.0%). Adverse events (AEs) were described by investigators as mostly mild, (mostly) comparable between groups, not observed and/or not significant for vaginal and penile use. Only one study, assessing anal use of carrageenan, reported a significantly higher proportion of AEs in the carrageenan compared with placebo group.
Conclusions: Carrageenan-based gels are generally well tolerated for vaginal and penile, but not anal use. Studies on carrageenan gel's safety for anal use are scarce.
{"title":"Safety of carrageenan-based gels as preventive microbicides: a narrative review.","authors":"Cassandra Laurie, Mariam El-Zein, Eduardo L Franco","doi":"10.1136/sextrans-2024-056176","DOIUrl":"10.1136/sextrans-2024-056176","url":null,"abstract":"<p><strong>Background: </strong>Carrageenan-containing gels researched for the prevention of sexually transmitted infections (STIs) have shown promising results for human papillomavirus prevention in women, but not in men. We conducted a narrative review to assess the safety of these gels for genital use.</p><p><strong>Methods: </strong>We searched PubMed using MeSH terms and keywords on 5 November 2023. Title/abstract of articles were screened to identify relevant ones. Full-text screening determined eligibility: empirical study evaluating safety of carrageenan-containing gel(s) for genital use.</p><p><strong>Results: </strong>Of the 125 identified records, 15 were eligible, comprising 14 (10 randomised controlled trials and 4 cohorts) unique study populations. Studies included women only (n=11), men only (n=1) or both (n=3); number of participants ranged from 4 to 6202. Safety was assessed for vaginal (n=13), penile (n=3) and anal use (n=2). Most studies assessed safety of Carraguard (53%), followed by Divine9 (14%), and one each of iota-carrageenan gel, lambda-carrageenan gel, Carvir, PC-6500 (griffithsin and carrageenan) and PC-1005 (MIV-150/zinc acetate/carrageenan). Safety assessment relied on self-report (80.0%), testing for STIs (53.3%), investigator-identified genital findings (93.3%) and/or testing for changes in genital flora (60.0%). Adverse events (AEs) were described by investigators as mostly mild, (mostly) comparable between groups, not observed and/or not significant for vaginal and penile use. Only one study, assessing anal use of carrageenan, reported a significantly higher proportion of AEs in the carrageenan compared with placebo group.</p><p><strong>Conclusions: </strong>Carrageenan-based gels are generally well tolerated for vaginal and penile, but not anal use. Studies on carrageenan gel's safety for anal use are scarce.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-13DOI: 10.1136/sextrans-2023-056015
Jacob Lindman, Mamadu Aliu Djalo, Ansu Biai, Fredrik Månsson, Daniel Golparian, Joakim Esbjörnsson, Marianne Jansson, Patrik Medstrand, Magnus Unemo, Hans Norrgren
Objective: To estimate the prevalence of the curable sexually transmitted infections (STIs) Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis and Treponema pallidum, to identify associated risk factors and to assess ciprofloxacin resistance in N. gonorrhoeae-positive specimens among female sex workers (FSWs) in Guinea-Bissau.
Methods: For this cross-sectional study, FSWs were recruited from October 2014 to May 2019. A questionnaire on STI risk factors was completed by the study participants, and the women were asked to provide a vaginal swab for nucleic acid amplification tests for C. trachomatis, N. gonorrhoeae, M. genitalium, T. vaginalis (Aptima, Hologica), as well as a blood sample for T. pallidum serological testing and discriminatory HIV-testing. The prevalence of STIs was determined, and multivariate logistic regression was used to identify STI risk factors.
Results: The study included 467 women. The prevalence of current infection with any curable STI was 46.7%, and the most common pathogen was T. vaginalis (26.3%), followed by M. genitalium (21.9%), C. trachomatis (11.8%), N. gonorrhoeae (10.1%) and T. pallidum (2.8%). The proportion of asymptomatic infections among the diagnosed STIs was 61.8%, 61.5%, 55.3%, 55.3% and 52.2% for C. trachomatis, T. pallidum, N. gonorrhoeae, T. vaginalis and M. genitalium, respectively. The prevalence of the gyrA S91F mutation conferring ciprofloxacin resistance in N. gonorrhoeae-positive specimens was 84.0%. Significant risk factors for having a curable STI were age and HIV-1 infection, while use of female condoms was a protective factor.
Conclusion: This study demonstrated that the prevalence of curable STIs was high among FSWs in Guinea-Bissau during the study period, indicating an unmet need for STI services. Moreover, the results indicated that symptomatic treatment might be insufficient, highlighting a need for periodic aetiological testing to facilitate detection of asymptomatic as well as symptomatic STIs to stop ongoing transmission.
{"title":"Prevalence of sexually transmitted infections and associated risk factors among female sex workers in Guinea-Bissau.","authors":"Jacob Lindman, Mamadu Aliu Djalo, Ansu Biai, Fredrik Månsson, Daniel Golparian, Joakim Esbjörnsson, Marianne Jansson, Patrik Medstrand, Magnus Unemo, Hans Norrgren","doi":"10.1136/sextrans-2023-056015","DOIUrl":"https://doi.org/10.1136/sextrans-2023-056015","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of the curable sexually transmitted infections (STIs) <i>Chlamydia trachomatis</i>, <i>Neisseria gonorrhoeae</i>, <i>Mycoplasma genitalium</i>, <i>Trichomonas vaginalis</i> and <i>Treponema pallidum</i>, to identify associated risk factors and to assess ciprofloxacin resistance in <i>N. gonorrhoeae</i>-positive specimens among female sex workers (FSWs) in Guinea-Bissau.</p><p><strong>Methods: </strong>For this cross-sectional study, FSWs were recruited from October 2014 to May 2019. A questionnaire on STI risk factors was completed by the study participants, and the women were asked to provide a vaginal swab for nucleic acid amplification tests for <i>C. trachomatis</i>, <i>N. gonorrhoeae</i>, <i>M. genitalium</i>, <i>T. vaginalis</i> (Aptima, Hologica), as well as a blood sample for <i>T. pallidum</i> serological testing and discriminatory HIV-testing. The prevalence of STIs was determined, and multivariate logistic regression was used to identify STI risk factors.</p><p><strong>Results: </strong>The study included 467 women. The prevalence of current infection with any curable STI was 46.7%, and the most common pathogen was <i>T. vaginalis</i> (26.3%), followed by <i>M. genitalium</i> (21.9%), <i>C. trachomatis</i> (11.8%), <i>N. gonorrhoeae</i> (10.1%) and <i>T. pallidum</i> (2.8%). The proportion of asymptomatic infections among the diagnosed STIs was 61.8%, 61.5%, 55.3%, 55.3% and 52.2% for <i>C. trachomatis, T. pallidum, N. gonorrhoeae, T. vaginalis and M. genitalium, respectively</i>. The prevalence of the <i>gyrA</i> S91F mutation conferring ciprofloxacin resistance in <i>N. gonorrhoeae</i>-positive specimens was 84.0%. Significant risk factors for having a curable STI were age and HIV-1 infection, while use of female condoms was a protective factor.</p><p><strong>Conclusion: </strong>This study demonstrated that the prevalence of curable STIs was high among FSWs in Guinea-Bissau during the study period, indicating an unmet need for STI services. Moreover, the results indicated that symptomatic treatment might be insufficient, highlighting a need for periodic aetiological testing to facilitate detection of asymptomatic as well as symptomatic STIs to stop ongoing transmission.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-12DOI: 10.1136/sextrans-2024-056190
Michelle A Moffa, Xinyi Feng, Josephine Mpagazi, Stephen Kiboneka, Robert Ssekubugu, John Baptiste Kereba, Annet Nakayijja, Julius Tukundane, Jade Jackson, Caitlin E Kennedy, Godfrey Kigozi, Ronald M Galiwango, Yukari C Manabe, Charlotte A Gaydos, Larry W Chang, Sarah Kalibala, Steven J Reynolds, Aaron Ar Tobian, Thomas Quinn, M Kate Grabowski, Joseph Kagayi
Objectives: Migration is associated with increased risk of HIV infection in Africa, but evidence about non-HIV sexually transmitted infection (STI) burden among African migrants is limited.
Methods: We used data from the Sexually Transmitted Infection Prevalence Study, a cross-sectional population-based study of chlamydia, gonorrhoea, trichomoniasis, syphilis and herpes simplex virus type 2 prevalence in southern Uganda, to compare STI prevalence between adults aged 18 and 49 years with and without a recent history of migration. Migration status was determined using household census data, with a recent migration history defined as having moved into one's community of current residence within the last ~18 months. Unadjusted and adjusted modified Poisson regression models were used to compare individual STI prevalence risk by recent migration status with associations reported as adjusted prevalence risk ratios (adjPRRs) with 95% CIs. Adjusted models included participants' sex, age, community type, education, occupation and marital status.
Results: Among 1825 participants, 358 (19.6%) had a recent migration history. Overall, migrants exhibited a significantly higher combined prevalence of curable STIs (gonorrhoea, chlamydia, high-titre syphilis (rapid plasma regain ≥1:8) and trichomoniasis) as compared with long-term residents (34.4% vs 24.2%; adjPRR=1.23; 95% CI 1.03 to 1.47). Significant differences in curable STI prevalence by migration status were concentrated among persons living with HIV (49.4% prevalence in migrants vs 32.6% in long-term residents; adjPRR=1.42; 95% CI 1.10 to 1.85) and among women (38.8% in migrants vs 27.8% in long-term residents; adjPRR=1.26; 95% CI 1.01 to 1.58). High-titre syphilis prevalence was especially elevated among male migrants (11.2% in migrants vs 4.9% in long-term residents; adjPRR=1.82; 95% CI 1.06 to 3.13).
Conclusions: The prevalence of non-HIV STIs is higher among migrants. Tailored outreach and service delivery approaches that address the needs of mobile populations are crucial for integrated HIV and STI epidemic control in Uganda to optimise resources and reduce transmission risks.
目的在非洲,移民与 HIV 感染风险增加有关,但有关非洲移民非 HIV 性传播感染(STI)负担的证据有限:我们利用性传播感染流行率研究的数据,比较了最近有移民史和没有移民史的 18 至 49 岁成年人之间的性传播感染流行率,该研究是对乌干达南部衣原体、淋病、滴虫病、梅毒和单纯疱疹病毒 2 型流行率进行的一项基于人口的横断面研究。迁移状况是通过家庭人口普查数据确定的,近期迁移史的定义是在过去约 18 个月内迁入目前居住的社区。未调整和调整后的修正泊松回归模型用于比较近期移民状况对个人性传播感染患病风险的影响,相关性以调整患病风险比(adjusted prevalence risk ratios, adjPRRs)和 95% CIs 的形式报告。调整模型包括参与者的性别、年龄、社区类型、教育程度、职业和婚姻状况:在 1825 名参与者中,358 人(19.6%)有近期移民史。总体而言,与长期居住者相比,移民的可治愈性传播疾病(淋病、衣原体、高致病率梅毒(快速血浆回收率≥1:8)和滴虫病)综合发病率明显更高(34.4% vs 24.2%;adjPRR=1.23;95% CI 1.03 to 1.47)。可治愈的性传播感染发病率因移民身份而产生的显著差异主要集中在艾滋病毒感染者(移民发病率为 49.4%,长期居民为 32.6%;adjPRR=1.42;95% CI 1.10 至 1.85)和妇女(移民发病率为 38.8%,长期居民为 27.8%;adjPRR=1.26;95% CI 1.01 至 1.58)中。男性移民的梅毒感染率尤其高(移民为 11.2%,长期居民为 4.9%;adjPRR=1.82;95% CI 1.06 至 3.13):结论:移民的非艾滋病毒性传播感染发病率较高。为满足流动人口的需求而量身定制的外联和服务提供方法对于乌干达艾滋病和性传播疾病的综合流行控制至关重要,以优化资源并降低传播风险。
{"title":"Sexually transmitted infections and migration in Uganda: a population-based study.","authors":"Michelle A Moffa, Xinyi Feng, Josephine Mpagazi, Stephen Kiboneka, Robert Ssekubugu, John Baptiste Kereba, Annet Nakayijja, Julius Tukundane, Jade Jackson, Caitlin E Kennedy, Godfrey Kigozi, Ronald M Galiwango, Yukari C Manabe, Charlotte A Gaydos, Larry W Chang, Sarah Kalibala, Steven J Reynolds, Aaron Ar Tobian, Thomas Quinn, M Kate Grabowski, Joseph Kagayi","doi":"10.1136/sextrans-2024-056190","DOIUrl":"10.1136/sextrans-2024-056190","url":null,"abstract":"<p><strong>Objectives: </strong>Migration is associated with increased risk of HIV infection in Africa, but evidence about non-HIV sexually transmitted infection (STI) burden among African migrants is limited.</p><p><strong>Methods: </strong>We used data from the Sexually Transmitted Infection Prevalence Study, a cross-sectional population-based study of chlamydia, gonorrhoea, trichomoniasis, syphilis and herpes simplex virus type 2 prevalence in southern Uganda, to compare STI prevalence between adults aged 18 and 49 years with and without a recent history of migration. Migration status was determined using household census data, with a recent migration history defined as having moved into one's community of current residence within the last ~18 months. Unadjusted and adjusted modified Poisson regression models were used to compare individual STI prevalence risk by recent migration status with associations reported as adjusted prevalence risk ratios (adjPRRs) with 95% CIs. Adjusted models included participants' sex, age, community type, education, occupation and marital status.</p><p><strong>Results: </strong>Among 1825 participants, 358 (19.6%) had a recent migration history. Overall, migrants exhibited a significantly higher combined prevalence of curable STIs (gonorrhoea, chlamydia, high-titre syphilis (rapid plasma regain ≥1:8) and trichomoniasis) as compared with long-term residents (34.4% vs 24.2%; adjPRR=1.23; 95% CI 1.03 to 1.47). Significant differences in curable STI prevalence by migration status were concentrated among persons living with HIV (49.4% prevalence in migrants vs 32.6% in long-term residents; adjPRR=1.42; 95% CI 1.10 to 1.85) and among women (38.8% in migrants vs 27.8% in long-term residents; adjPRR=1.26; 95% CI 1.01 to 1.58). High-titre syphilis prevalence was especially elevated among male migrants (11.2% in migrants vs 4.9% in long-term residents; adjPRR=1.82; 95% CI 1.06 to 3.13).</p><p><strong>Conclusions: </strong>The prevalence of non-HIV STIs is higher among migrants. Tailored outreach and service delivery approaches that address the needs of mobile populations are crucial for integrated HIV and STI epidemic control in Uganda to optimise resources and reduce transmission risks.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-07DOI: 10.1136/sextrans-2023-056075
Luz Marina Llangarí-Arizo, Claire Elizabeth Broad, Liqing Zhou, Miguel Martin Mateo, Cristina Izquierdo Moreno, Marcelo Moreno Cevallos, Philip J Cooper, Natalia Romero-Sandoval, Syed Tariq Sadiq
Objectives: Anorectal sexually transmitted infections (STIs) such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), present treatment challenges, potentially increase antibiotic resistance selection and if undetected may facilitate onward transmission. However, there are limited global prevalence data for anorectal STIs. We conducted a cross-sectional study to assess the prevalence and risk factors of non-viral genital and extragenital STIs in female sex workers (FSW) and female non-sex workers (NSW) in Ecuador.
Methods: 250 adult street and brothel FSWs and 250 NSWs, recruited from settlements in north-west Ecuador provided oropharyngeal and vulvo-vaginal swabs (VVS) as well as socio-demographic data. FSWs also provided anorectal swabs. PCR was used to detect CT, NG, Mycoplasma genitalium (MG) from all swabs and additionally Trichomonas vaginalis (TV) from VVS. Risk factors were analysed using logistic regression.
Results: Prevalence of FSW vaginal, anorectal and oropharyngeal infection was 32.0% (95% CI 26.5% to 38.0%), 19.7% (95% CI 15.1% to 25.2%) and 3.2% (95% CI 1.6% to 6.2%), respectively, with most vaginal infections being TV (23.4%; 95% CI 18.5% to 29.2%). Overall FSW STI prevalence, at any anatomical site was 39.7% (95% CI 33.8% to 46.1%), with 12.1% (95% CI 8.5% to 16.9%) of infections detected only at the anorectum. Of all the CT and/or NG infections, 64.4% (95% CI 50.4% to 78.4%) were detected only at the anorectum. STI prevalence in NSWs in the vagina and oropharynx were 5.6% (95% CI 3.4% to 9.2%) and 0.8% (95% CI 0.2% to 2.9%), respectively, with most vaginal infections being MG (3.2%; 95% CI 1.6% to 6.2%). In multivariable analysis, risk factors among brothel-based FSWs for having an anorectal STI were vaginal CT, NG or MG (p<0.001), vaginal TV (p=0.029) and being 'in a relationship' (p=0.038).
Conclusions: High prevalence of CT and NG detected only at the anorectum in these FSWs indicate the possibility of missing significant infections if providing only genital testing and calls for greater research into the potential impact on global STI estimates if extragenital infections among at-risk women are not identified.
目的:沙眼衣原体(CT)和淋病奈瑟菌(NG)等肛门直肠性传播感染(STI)给治疗带来了挑战,可能会增加抗生素耐药性的选择,而且如果未被发现,可能会助长其继续传播。然而,全球肛门直肠性传播感染的发病率数据十分有限。我们进行了一项横断面研究,以评估厄瓜多尔女性性工作者(FSW)和女性非性工作者(NSW)的非病毒性生殖器和生殖器外性传播感染的流行率和风险因素。方法:我们从厄瓜多尔西北部的定居点招募了 250 名街头和妓院的成年女性性工作者和 250 名女性非性工作者,她们提供了口咽和外阴阴道拭子(VVS)以及社会人口学数据。家庭主妇也提供了肛门直肠拭子。采用 PCR 技术从所有拭子中检测 CT、NG 和生殖器支原体 (MG),并从外阴阴道拭子中检测阴道毛滴虫 (TV)。采用逻辑回归法分析了风险因素:金融服务妇女阴道、肛门直肠和口咽感染率分别为 32.0% (95% CI 26.5% to 38.0%)、19.7% (95% CI 15.1% to 25.2%) 和 3.2% (95% CI 1.6% to 6.2%),其中大多数阴道感染是 TV(23.4%;95% CI 18.5% to 29.2%)。在任何解剖部位,女性外阴残留感染的总体流行率为 39.7%(95% CI 为 33.8% 至 46.1%),其中 12.1%(95% CI 为 8.5% 至 16.9%)的感染仅发生在肛门直肠。在所有 CT 和/或 NG 感染中,64.4%(95% CI 50.4%至 78.4%)仅在肛门直肠处发现。阴道和口咽部的性传播感染在国家卫生系统中的流行率分别为 5.6% (95% CI 3.4% 至 9.2%) 和 0.8% (95% CI 0.2% 至 2.9%),其中大多数阴道感染为 MG(3.2%;95% CI 1.6% 至 6.2%)。在多变量分析中,在妓院工作的女性服务提供者中,感染肛门直肠性传播疾病的风险因素是阴道 CT、NG 或 MG(p 结论:仅在肛门直肠检测出 CT 和 NG 的高发病率表明,如果仅提供生殖器检测,可能会漏掉大量感染病例,因此需要进一步研究如果不识别高危妇女中的生殖器外感染病例,对全球 STI 估计值的潜在影响。
{"title":"Sexually transmitted infections among at-risk women in Ecuador: implications for global prevalence and testing practices for STIs detected only at the anorectum in female sex workers.","authors":"Luz Marina Llangarí-Arizo, Claire Elizabeth Broad, Liqing Zhou, Miguel Martin Mateo, Cristina Izquierdo Moreno, Marcelo Moreno Cevallos, Philip J Cooper, Natalia Romero-Sandoval, Syed Tariq Sadiq","doi":"10.1136/sextrans-2023-056075","DOIUrl":"https://doi.org/10.1136/sextrans-2023-056075","url":null,"abstract":"<p><strong>Objectives: </strong>Anorectal sexually transmitted infections (STIs) such as <i>Chlamydia trachomatis</i> (CT) and <i>Neisseria gonorrhoeae</i> (NG), present treatment challenges, potentially increase antibiotic resistance selection and if undetected may facilitate onward transmission. However, there are limited global prevalence data for anorectal STIs. We conducted a cross-sectional study to assess the prevalence and risk factors of non-viral genital and extragenital STIs in female sex workers (FSW) and female non-sex workers (NSW) in Ecuador.</p><p><strong>Methods: </strong>250 adult street and brothel FSWs and 250 NSWs, recruited from settlements in north-west Ecuador provided oropharyngeal and vulvo-vaginal swabs (VVS) as well as socio-demographic data. FSWs also provided anorectal swabs. PCR was used to detect CT, NG, <i>Mycoplasma genitalium</i> (MG) from all swabs and additionally <i>Trichomonas vaginalis</i> (TV) from VVS. Risk factors were analysed using logistic regression.</p><p><strong>Results: </strong>Prevalence of FSW vaginal, anorectal and oropharyngeal infection was 32.0% (95% CI 26.5% to 38.0%), 19.7% (95% CI 15.1% to 25.2%) and 3.2% (95% CI 1.6% to 6.2%), respectively, with most vaginal infections being TV (23.4%; 95% CI 18.5% to 29.2%). Overall FSW STI prevalence, at any anatomical site was 39.7% (95% CI 33.8% to 46.1%), with 12.1% (95% CI 8.5% to 16.9%) of infections detected only at the anorectum. Of all the CT and/or NG infections, 64.4% (95% CI 50.4% to 78.4%) were detected only at the anorectum. STI prevalence in NSWs in the vagina and oropharynx were 5.6% (95% CI 3.4% to 9.2%) and 0.8% (95% CI 0.2% to 2.9%), respectively, with most vaginal infections being MG (3.2%; 95% CI 1.6% to 6.2%). In multivariable analysis, risk factors among brothel-based FSWs for having an anorectal STI were vaginal CT, NG or MG (p<0.001), vaginal TV (p=0.029) and being 'in a relationship' (p=0.038).</p><p><strong>Conclusions: </strong>High prevalence of CT and NG detected only at the anorectum in these FSWs indicate the possibility of missing significant infections if providing only genital testing and calls for greater research into the potential impact on global STI estimates if extragenital infections among at-risk women are not identified.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-03DOI: 10.1136/sextrans-2024-056208
Paulo Roberto Sokoll, Celina Borges Migliavaca, Stephan Döring, Uschi Traub, Karlin Stark, Amanda Veiga Sardeli
Objectives: This systematic review aimed to identify the efficacy, adherence, safety and impact on antimicrobial resistance of postexposure prophylaxis with doxycycline (Doxy-PEP) in different populations.
Methods: We searched MEDLINE (via PubMed), Embase and Cochrane CENTRAL databases from inception to 29 May 2024. Two reviewers independently screened the studies and extracted data. We included randomised clinical trials that evaluated the efficacy of Doxy-PEP within 72 hours after condomless sex. A random-effects meta-analysis was conducted to compare the risk of bacterial sexually transmitted infections (STIs) between Doxy-PEP and no prophylaxis. The risk of bias was assessed with the risk-of-bias tool for randomized trials (RoB 2) and the certainty of evidence (CoE) with Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Results: Four studies were included in the systematic review, totalling 1727 participants. Studies were conducted between 2015 and 2022. Most participants (73%) were men who have sex with men, and the median age of participants varied from 24 to 43 years. Doxy-PEP reduced the risk of having any bacterial STI in different populations by 46% (hazard ratio (HR) 0.54; 95% CI 0.39 to 0.75; CoE moderate), the risk of chlamydia by 65% (relative risk (RR) 0.35; 95% CI 0.15 to 0.82; CoE low) and syphilis by 77% (RR 0.23; 95% CI 0.13 to 0.41; CoE high), without significant effect for risk of gonorrhoea infection (RR 0.90; 95% CI 0.64 to 1.26; CoE very low). The self-reported adherence rate of Doxy-PEP was approximately 80% and one drug-related serious adverse event was reported.
Conclusion: Doxy-PEP reduced the incidence of chlamydia and syphilis infections. No significant reduction in gonorrhoea infection was observed. This strategy seems promising for some high-risk groups; however, there is still a lack of information on the induction of bacterial resistance and long-term adverse events. PROSPERO REGISTRATION NUMBER.
目的:本系统性综述旨在确定暴露后预防使用强力霉素(Doxy-PEP)在不同人群中的疗效、依从性、安全性以及对抗菌素耐药性的影响:我们检索了从开始到 2024 年 5 月 29 日的 MEDLINE(通过 PubMed)、Embase 和 Cochrane CENTRAL 数据库。两名审稿人独立筛选研究并提取数据。我们纳入了评估无套性行为后 72 小时内强力PEP疗效的随机临床试验。我们进行了随机效应荟萃分析,比较了Doxy-PEP与无预防措施之间的细菌性传播感染(STI)风险。采用随机试验偏倚风险工具(RoB 2)评估偏倚风险,采用建议评估、发展和评价分级(GRADE)评估证据的确定性(CoE):四项研究被纳入系统综述,共有 1727 人参与。研究在 2015 年至 2022 年间进行。大多数参与者(73%)为男男性行为者,参与者的年龄中位数从 24 岁到 43 岁不等。在不同人群中,Doxy-PEP可将感染任何细菌性 STI 的风险降低 46%(危险比 (HR) 0.54;95% CI 0.39 至 0.75;CoE 中度),将衣原体感染风险降低 65%(相对风险 (RR) 0.35; 95% CI 0.15 to 0.82; CoE low),梅毒风险降低 77% (RR 0.23; 95% CI 0.13 to 0.41; CoE high),淋病感染风险无显著影响 (RR 0.90; 95% CI 0.64 to 1.26; CoE very low)。自我报告的Doxy-PEP依从率约为80%,报告了一起与药物相关的严重不良事件:结论:Doxy-PEP 降低了衣原体和梅毒的感染率。结论:Doxy-PEP 可降低衣原体和梅毒感染率,但淋病感染率未见明显降低。对于一些高危人群来说,这一策略似乎很有前景;然而,关于诱导细菌耐药性和长期不良反应的信息仍然缺乏。prospero注册号。
{"title":"Efficacy of postexposure prophylaxis with doxycycline (Doxy-PEP) in reducing sexually transmitted infections: a systematic review and meta-analysis.","authors":"Paulo Roberto Sokoll, Celina Borges Migliavaca, Stephan Döring, Uschi Traub, Karlin Stark, Amanda Veiga Sardeli","doi":"10.1136/sextrans-2024-056208","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056208","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review aimed to identify the efficacy, adherence, safety and impact on antimicrobial resistance of postexposure prophylaxis with doxycycline (Doxy-PEP) in different populations.</p><p><strong>Methods: </strong>We searched MEDLINE (via PubMed), Embase and Cochrane CENTRAL databases from inception to 29 May 2024. Two reviewers independently screened the studies and extracted data. We included randomised clinical trials that evaluated the efficacy of Doxy-PEP within 72 hours after condomless sex. A random-effects meta-analysis was conducted to compare the risk of bacterial sexually transmitted infections (STIs) between Doxy-PEP and no prophylaxis. The risk of bias was assessed with the risk-of-bias tool for randomized trials (RoB 2) and the certainty of evidence (CoE) with Grading of Recommendations Assessment, Development and Evaluation (GRADE).</p><p><strong>Results: </strong>Four studies were included in the systematic review, totalling 1727 participants. Studies were conducted between 2015 and 2022. Most participants (73%) were men who have sex with men, and the median age of participants varied from 24 to 43 years. Doxy-PEP reduced the risk of having any bacterial STI in different populations by 46% (hazard ratio (HR) 0.54; 95% CI 0.39 to 0.75; CoE moderate), the risk of chlamydia by 65% (relative risk (RR) 0.35; 95% CI 0.15 to 0.82; CoE low) and syphilis by 77% (RR 0.23; 95% CI 0.13 to 0.41; CoE high), without significant effect for risk of gonorrhoea infection (RR 0.90; 95% CI 0.64 to 1.26; CoE very low). The self-reported adherence rate of Doxy-PEP was approximately 80% and one drug-related serious adverse event was reported.</p><p><strong>Conclusion: </strong>Doxy-PEP reduced the incidence of chlamydia and syphilis infections. No significant reduction in gonorrhoea infection was observed. This strategy seems promising for some high-risk groups; however, there is still a lack of information on the induction of bacterial resistance and long-term adverse events. PROSPERO REGISTRATION NUMBER.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}