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Screening for HPV-Related Oropharyngeal Cancer in Gay and Bisexual Men: Acceptability and Predicting Possible Use of "Oral Selfies" by Smartphone as a Secondary Prevention Approach. 筛查男同性恋者和双性恋者中与人乳头瘤病毒相关的口咽癌:通过智能手机拍摄 "口腔自拍照 "作为二级预防方法的可接受性和预测性。
Pub Date : 2023-12-01 Epub Date: 2023-12-07 DOI: 10.3390/venereology2040016
Michael W Ross, Sarah L Bennis, Niles Zoschke, Brian R Simon Rosser, Cyndee L Stull, Alan G Nyitray, Samir S Khariwala, Mark Nichols, Charlene Flash, Michael Wilkerson

Oropharyngeal cancers (OPCa) caused by HPV have emerged as one of the leading causes of malignancies caused by HPV infection. They are also significantly more likely to occur in males and in people with a history of oral sex with multiple partners. Gay and bisexual men are disproportionately affected by HPV-positive oropharyngeal cancers. We studied 1699 gay and bisexual men on 2 major dating sites in the US to assess their knowledge about HPV-related OPCa, attitudes toward screening for it, beliefs about oropharyngeal cancer screening based on the Health Belief Model, and attitudes toward possible screening approaches for OPCa. Knowledge on a 12-item scale was low, with a median of 5 items correct: 72% knew of the benefits of HPV vaccination. Significant predictors of needing OPCa screening included perception of risk for OPCa, seeing it as severe, having lower barriers, fewer reasons to avoid screening, higher knowledge, and being HPV vaccinated were significant predictors, explaining half the total variance. Most participants would accept routine, virtual/online doctor or dental appointments, and over half would accept an in-person screening. Nearly two-thirds stated that they would accept getting checked for OPCa if they could do self-screening at home, and half were prepared to use an online screening tool or app, where they could take an "oral selfie" and send it to a healthcare provider for examination. One-third stated that they would trust the results of a home screening completed by themselves and posted to a website equally as cancer screening completed online by a healthcare provider. Data indicate that despite low OPCA knowledge levels, the risk of HPV-associated OPCa was known. Being at personal risk and having knowledge of disease severity had 70% of the sample thinking about, or preparing to get, screening. Self-screening by a smartphone "oral selfie" transmitted to a screening website was acceptable to many gay and bisexual men, and online screening by a doctor or dentist was acceptable to most. OPCa screening in this population using electronic technology, together with the increasing incidence of HPV-associated OPCa in gay and bisexual men, brings together an opportunity to detect OPCa early.

由人类乳头瘤病毒引起的口咽癌(OPCa)已成为人类乳头瘤病毒感染引起恶性肿瘤的主要原因之一。口咽癌也更容易发生在男性和有多个性伴侣口交史的人群中。男同性恋者和双性恋者感染 HPV 阳性口咽癌的比例更高。我们在美国两大交友网站上对 1699 名男同性恋和双性恋进行了研究,以评估他们对与 HPV 相关的口咽癌的了解程度、对口咽癌筛查的态度、基于健康信念模型的口咽癌筛查信念以及对口咽癌可能筛查方法的态度。对 12 个项目的了解程度较低,正确项目的中位数为 5 个:72% 的人知道接种人乳头瘤病毒疫苗的好处。需要进行 OPCa 筛查的重要预测因素包括对 OPCa 风险的认知、将其视为严重疾病、障碍较低、避免筛查的原因较少、知识水平较高以及接种过 HPV 疫苗,其中接种过 HPV 疫苗是重要的预测因素,占总变异的一半。大多数参与者愿意接受常规的虚拟/在线医生或牙医预约,超过一半的人愿意接受面对面的筛查。近三分之二的人表示,如果可以在家进行自我筛查,他们愿意接受口腔癌检查,一半的人愿意使用在线筛查工具或应用程序,在那里他们可以拍摄一张 "口腔自拍照 "并发送给医疗服务提供者进行检查。三分之一的人表示,他们会相信由自己完成并发布到网站上的家庭筛查结果,就像相信由医疗服务提供者在线完成的癌症筛查结果一样。数据表明,尽管人们对 OPCA 的了解程度较低,但与 HPV 相关的 OPCa 风险是众所周知的。70%的样本考虑或准备接受筛查,因为他们了解个人风险和疾病的严重程度。许多男同性恋者和双性恋者都能接受通过智能手机 "口腔自拍 "传送到筛查网站进行自我筛查,大多数人也能接受由医生或牙医进行在线筛查。利用电子技术在这一人群中进行口腔癌筛查,再加上男同性恋者和双性恋者中与人乳头瘤病毒相关的口腔癌发病率不断上升,为早期发现口腔癌提供了机会。
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引用次数: 0
Racial Disparities Associated with Increased Burden of Sexually Transmitted Infections in North Carolina, Southeastern United States 在美国东南部的北卡罗来纳州,种族差异与性传播感染负担增加有关
Pub Date : 2023-11-01 DOI: 10.3390/venereology2040015
Peter D. Ahiawodzi, Cydney Nicholson, Briana Williams, Dorothea K. Thompson
Sexually transmitted infections (STIs) constitute a major public health issue in the United States. North Carolina (NC) in the southeastern U.S. ranks among the highest in STI incidence. We aimed to describe the incidence rates and identify potential risk factors of STIs in NC. The STI data reported by the NC Department of Health and Human Services for 2018 were compiled for chlamydia, gonorrhea, syphilis, and HIV infections for all 100 NC counties. Linear regression modeling was used to assess the association of STIs with predefined county-level variables. The mean STI incidence rates per 100,000 persons were highest for chlamydia (592.43 ± 30.02), followed by gonorrhea (212.06 ± 13.75), HIV (12.66 ± 0.947), and syphilis (3.33 ± 0.439). For chlamydia, higher risk was significantly associated with income (β = −0.008, SE = 0.003; p = 0.006), education (some college; β = 10.02, SE = 3.15, p = 0.002), race (Black; β = 12.17, SE = 1.57, p < 0.0001), and number of truck stops (β = 20.20, SE = 6.75, p = 0.004). The same variables, except for education, were associated with higher gonorrhea risk. Only race (being Black) was significantly associated with higher syphilis risk. Racial disparities in STI burden were significant, with race (being Black) constituting a risk factor for all four STIs. Interventions targeted to identified risk factors may help to reduce the STI burden in NC.
性传播感染(STIs)在美国构成了一个主要的公共卫生问题。美国东南部的北卡罗来纳州是性传播感染发病率最高的州之一。我们的目的是描述发病率和识别潜在的危险因素的性传播感染在NC。北卡罗来纳州卫生与公众服务部报告的2018年性传播感染数据是针对北卡罗来纳州所有100个县的衣原体、淋病、梅毒和艾滋病毒感染进行编制的。使用线性回归模型来评估sti与预定义的县级变量的关联。衣原体感染率最高(592.43±30.02),其次为淋病(212.06±13.75),HIV(12.66±0.947),梅毒(3.33±0.439)。对于衣原体,较高的风险与收入显著相关(β = - 0.008, SE = 0.003;P = 0.006),教育(一些大学;β = 10.02, SE = 3.15, p = 0.002),种族(黑色;β = 12.17, SE = 1.57, p <0.0001)和卡车停靠站数量(β = 20.20, SE = 6.75, p = 0.004)。相同的变量,除了教育程度,与较高的淋病风险相关。只有种族(黑人)与较高的梅毒风险显著相关。性传播感染负担的种族差异是显著的,种族(黑人)构成了所有四种性传播感染的风险因素。针对确定危险因素的干预措施可能有助于减少非传染性疾病的性传播感染负担。
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引用次数: 0
Seroprevalence of Human Cytomegalovirus Infection among HIV Patients in Edo State, Southern Nigeria 尼日利亚南部埃多州HIV患者巨细胞病毒感染的血清阳性率
Pub Date : 2023-10-30 DOI: 10.3390/venereology2040014
Ifueko Mercy Moses-Otutu, Nosawema Franklyn Ojo, Ogochukwu Janet Nzoputam, Chimezie Igwegbe Nzoputam
Background: Human cytomegalovirus (HCMV) is an important pathogen in immunocompromised individuals where it causes end organ diseases leading to increased morbidity and mortality. The aim of this study was to determine the prevalence of HCMV infection and its associated risk factors among HIV patients in Edo State, Nigeria. Methods: A total of 150 HIV patients consisting of 80 males and 70 females were enrolled for this study. About 4 mL of venous blood was aseptically collected from each participant by venipuncture and was centrifuged to obtain serum. The serum was screened by ELISA for HCMV IgG and IgM antibodies. Results: The results obtained were analyzed using SPSS version 20 for data analysis. An overall prevalence of 32.7% for HCMV IgM antibodies was recorded among the HIV patients. Males had a higher prevalence of 55.1% HCMV IgM antibodies than their female counterparts with 44.9% HCMV IgM antibodies. HCMV was more prevalent among the age group <19 years (51.0%), followed by the age group 20–39 years (30.6%), while the age groups >60 years, and 40–59 years recorded a prevalence of 12.2% and 6.1%, respectively. Conclusions: The co-occurrence of HCMV IgG and IgM antibodies, religion and location significantly influenced the acquisition of HCMV infection among HIV patients. Integrating HIV prevention by spreading awareness and early diagnosis of HCMV is key to reducing complications from these viral infections in HIV disease patients.
背景:人巨细胞病毒(HCMV)是免疫功能低下个体的重要病原体,可引起终末器官疾病,导致发病率和死亡率增加。本研究的目的是确定尼日利亚埃多州HIV患者中HCMV感染的流行情况及其相关危险因素。方法:共纳入150例HIV患者,其中男80例,女70例。通过静脉穿刺从每位参与者无菌采集静脉血约4ml,离心得到血清。ELISA法检测血清中HCMV IgG和IgM抗体。结果:所得结果采用SPSS version 20进行数据分析。在HIV患者中,HCMV IgM抗体的总体患病率为32.7%。男性的HCMV IgM抗体阳性率为55.1%,高于女性的44.9%。HCMV在19岁年龄组中患病率最高(51.0%),其次是20-39岁年龄组(30.6%),60岁和40-59岁年龄组患病率分别为12.2%和6.1%。结论:HCMV IgG和IgM抗体的共存、宗教信仰和地域对HIV患者HCMV感染的获得有显著影响。通过传播意识和早期诊断HCMV来整合艾滋病毒预防是减少艾滋病毒患者这些病毒感染并发症的关键。
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引用次数: 0
Advancing Syphilis Research: Exploring New Frontiers in Immunology and Pharmacological Interventions 推进梅毒研究:探索免疫学和药理学干预的新领域
Pub Date : 2023-10-22 DOI: 10.3390/venereology2040013
James Oluwagbamigbe Fajemiroye, Andre Luis Elias Moreira, Célia Regina Malveste Ito, Elson Alves Costa, Rafaella Misael Queiroz, Ogbu John Ihayi, Caroline Vitória Moreira, Rafael Fernandes Costa, Claudia Carneiro Teixeira, Miguel Júnior Sordi Bortolini, Osmar Nascimento Silva
In recent years, the global resurgence of syphilis has posed significant challenges to public health. This sexually transmitted infection, caused by the bacterium Treponema pallidum, can have severe consequences if left untreated, including neurological and cardiovascular complications. Diagnosing syphilis is complex due to its diverse clinical presentations, necessitating a multifaceted approach, including serological, molecular, and direct techniques such as dark-field microscopy. Penicillin remains the primary and effective treatment, but emerging macrolide-resistant strains have spurred investigations into alternative antibiotics. Syphilis vaccine development faces unique hurdles, yet promising strategies are under investigation. Targeted prevention strategies focus on high-risk populations such as men who have sex with men, pregnant women, and individuals with multiple sexual partners. The integration of syphilis services into primary healthcare enhances accessibility, early detection, and treatment. Innovative point-of-care diagnostics offer rapid, sensitive testing, while ongoing vaccine research holds the potential for long-term prevention. Addressing the global burden of syphilis requires a multifaceted approach, encompassing immunological advancements, innovative diagnostics, targeted prevention, and primary healthcare integration. Collaborative efforts between governments, healthcare systems, researchers, and communities are essential to effectively combat syphilis, striving toward a syphilis-free future that promotes better sexual health and overall well-being.
近年来,梅毒在全球的死灰复燃对公共卫生构成了重大挑战。这种由梅毒螺旋体(Treponema pallidum)细菌引起的性传播感染,如果不加以治疗,可能会产生严重后果,包括神经系统和心血管并发症。梅毒的诊断是复杂的,因为其临床表现多样,需要多方面的方法,包括血清学、分子和直接技术,如暗场显微镜。青霉素仍然是主要和有效的治疗方法,但新出现的大环内酯耐药菌株刺激了对替代抗生素的研究。梅毒疫苗的开发面临着独特的障碍,但有希望的策略正在研究中。有针对性的预防战略侧重于高危人群,如男男性行为者、孕妇和有多个性伴侣的个人。将梅毒服务纳入初级卫生保健可提高可及性、早期发现和治疗。创新的即时诊断提供快速、灵敏的检测,而正在进行的疫苗研究具有长期预防的潜力。解决梅毒的全球负担需要采取多方面的方法,包括免疫学进步、创新诊断、有针对性的预防和初级卫生保健整合。政府、卫生保健系统、研究人员和社区之间的合作努力对于有效防治梅毒至关重要,努力实现无梅毒的未来,促进更好的性健康和整体福祉。
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引用次数: 0
Pangenome Analysis Reveals a High Degree of Genetic Diversity in Gardnerella vaginalis: An In Silico Approach 泛基因组分析揭示了阴道加德纳菌的高度遗传多样性:一种计算机方法
Pub Date : 2023-09-30 DOI: 10.3390/venereology2040012
Andrei Giacchetto Felice, Eduarda Guimarães Sousa, Fabiana Vieira Dominici, Vasco Ariston de Carvalho Azevedo, Siomar de Castro Soares
The genus Gardnerella comprises Gram-variable, anaerobic, hemolytic, and non-motile bacilli, with four known species, where Gardnerella vaginalis is the main species responsible for bacterial vaginosis (BV). However, quantifying this species is challenging due to a lack of data and underreporting. Despite its significance, particularly for women, and the availability of several genomes in online databases, genomic analyses and studies on effective treatments still lack details. This study aimed to conduct bioinformatic analyses focused on pangenomics to investigate the complete gene repertoire of the species. Genomes of the bacterium available in online databases were used for comparative genomics, genomic plasticity, gene synteny, and pangenome prediction analyses. The results revealed considerable genome variability, indicating a highly diverse pangenome. The low number of genes in the core genome and similarity analysis confirmed this variability. Three pathogenicity islands, two resistance islands, and nine genomic islands were identified, suggesting horizontal gene transfer events during evolution. These findings underscore the need for sequencing new G. vaginalis genomes to better comprehend its variability and adaptation patterns.
加德纳菌属包括革兰氏变杆菌、厌氧杆菌、溶血性杆菌和非运动杆菌,已知有四种,其中阴道加德纳菌是引起细菌性阴道病(BV)的主要菌种。然而,由于缺乏数据和报告不足,对这一物种进行量化是具有挑战性的。尽管它具有重要意义,特别是对妇女,并且在线数据库中有几个基因组,但基因组分析和有效治疗的研究仍然缺乏细节。本研究旨在开展以泛基因组学为核心的生物信息学分析,研究该物种的完整基因库。在线数据库中提供的细菌基因组用于比较基因组学,基因组可塑性,基因合成和泛基因组预测分析。结果显示相当大的基因组变异性,表明一个高度多样化的泛基因组。核心基因组中基因数量较少和相似性分析证实了这种可变性。鉴定出3个致病性岛、2个抗性岛和9个基因组岛,表明在进化过程中存在水平基因转移事件。这些发现强调了对新的阴道毛线虫基因组进行测序以更好地了解其变异性和适应模式的必要性。
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引用次数: 0
Going Off-Script: Dilemmas in the Evaluation and Treatment of Syphilis in Four Patients 脱轨:四例梅毒患者评价与治疗的困境
Pub Date : 2023-09-12 DOI: 10.3390/venereology2030011
Benjamin Silverberg, Chad Sethman, Jonathan Williamson, Mary Craft, Melinda Sharon, Amie M. Ashcraft
Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Currently, rates of infection are increasing across all populations worldwide, with disproportionate impact on men who have sex with men, adolescents, and young adults. Syphilis is well-known for its variability in disease progression and clinical presentation, which complicates prompt and accurate diagnosis. Acute care settings have become the frontline in the battle against this syphilis surge, and providers must be prepared to recognize syphilis presentation, initiate appropriate testing, and establish contact tracing for individuals who may have been exposed. The purpose of this manuscript is to serve as a teaching tool for syphilis diagnosis and treatment, and we present four cases that showcase the risks and variable clinical presentation, discussing the challenges involved in managing each case. The authors then summarize key learning points related to diagnosis, treatment, and follow-up.
梅毒是一种由梅毒螺旋体引起的性传播感染。目前,全世界所有人群的感染率都在上升,对男男性行为者、青少年和年轻人的影响尤为严重。梅毒以其疾病进展和临床表现的多变性而闻名,这使得及时准确的诊断变得复杂。急症护理机构已成为对抗梅毒激增的第一线,提供者必须准备好识别梅毒症状,启动适当的检测,并对可能接触过梅毒的个人建立接触者追踪。这篇手稿的目的是作为梅毒诊断和治疗的教学工具,我们提出了四个病例,展示了风险和可变的临床表现,讨论了管理每个病例所涉及的挑战。然后作者总结了与诊断、治疗和随访相关的关键学习点。
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引用次数: 0
“I Use Strawberry Flavoured Condoms during My Periods”: Safe Sex Practices and STI Screening Behaviours among Female Sex Workers in Gulu City, Uganda “我经期使用草莓味避孕套”:乌干达古卢市女性性工作者的安全性行为和STI筛查行为
Pub Date : 2023-08-28 DOI: 10.3390/venereology2030010
F. Bongomin, Winnie Kibone, Pebalo Francis Pebolo, Fiona Gladys Laker, J. Okot, F. Kaducu, Grace Madraa, C. Loum, S. Awor, Agnes Napyo, D. Musoke, S. Ouma
Background: Female sex workers (FSWs) are at a higher risk of contracting and transmitting HIV and other sexually transmitted infections (STIs). We aimed to explore the sexual behaviour, knowledge and attitudes towards STIs, barriers, support and intervention for STI screening. Methods: In this community-based, concurrent quantitative–qualitative, exploratory mixed-methods study, we administered 87 semi-structured quantitative and six in-depth interviews to purposively select FSWs in Gulu City, Uganda. The qualitative methodology was based on descriptive phenomenology. Results: The quantitative study included 87 FSWs, with a median age of 28 years. Overall, 87.4% (n = 76) participants reported condom use during their last sexual encounter. Eighty-three (95.4%) participants were aware of their HIV status, with 6% (n = 5) reporting being HIV-positive. Seventy-six (87.4%) participants reported contracting at least one STI during sex work. In addition, 66.7% (n = 58) of the participants reported being screened for STIs in the past three months, with vulvovaginal candidiasis (55.3%, n = 42) and syphilis (32.9%, n = 25) being the most common STIs. However, only 2.3% (n = 2) of the participants reported current STIs symptoms. In the qualitative study, the main themes encompassed sexual behaviour, including condom-use negotiation strategies and challenges, as well as screening facilitators and barriers. Condom-use negotiation tactics involved leveraging health-risk information, increased charges for unprotected sex, and outright refusal. Complex challenges included limited agency in promoting safe sex due to economic reliance, vulnerability to violence, and difficulties in controlling the sexual environment. Facilitators for regular screening included social influences, emotional relief, established testing habits, and accessible clinics, while barriers encompassed cost, stigma, doubts about test accuracy, and inconvenient clinic hours. Conclusions: FSWs face significant vulnerabilities in Gulu City, Uganda, regarding STIs. While encouraging trends such as high HIV awareness and condom usage were observed, persistent challenges in STI screening, negotiation of safe sex practices, and access to prevention and treatment remain evident. To address these concerns, targeted interventions should be developed to enhance STI screening accessibility, empower sex workers with effective negotiation skills, and provide comprehensive support for STI prevention and treatment, thereby contributing to improved overall sexual health and well-being among this marginalized population.
背景:女性性工作者(FSWs)感染和传播艾滋病毒和其他性传播感染(STIs)的风险较高。我们旨在探讨性行为、性传播感染的知识和态度、性传播感染筛查的障碍、支持和干预措施。方法:在这项以社区为基础,同时进行定量-定性、探索性混合方法研究中,我们进行了87次半结构化定量访谈和6次深度访谈,目的是在乌干达古卢市选择fsw。定性方法以描述现象学为基础。结果:定量研究纳入FSWs 87例,中位年龄28岁。总体而言,87.4% (n = 76)的参与者报告在他们的最后一次性接触中使用了安全套。83名(95.4%)参与者知道自己的艾滋病毒状况,其中6% (n = 5)报告为艾滋病毒阳性。76名(87.4%)参与者报告在性工作期间至少感染了一种性传播感染。此外,66.7% (n = 58)的参与者报告在过去三个月内接受过性传播感染筛查,其中外阴阴道念珠菌病(55.3%,n = 42)和梅毒(32.9%,n = 25)是最常见的性传播感染。然而,只有2.3% (n = 2)的参与者报告了目前的性传播感染症状。在定性研究中,主要主题包括性行为,包括使用避孕套的谈判策略和挑战,以及筛选促进因素和障碍。使用避孕套的谈判策略包括利用健康风险信息,提高无保护性行为的费用,以及直接拒绝。复杂的挑战包括,由于经济依赖、易受暴力侵害以及难以控制性环境,在促进安全性行为方面的作用有限。定期筛查的促进因素包括社会影响、情绪缓解、既定的检测习惯和可访问的诊所,而障碍包括成本、耻辱、对检测准确性的怀疑和不方便的门诊时间。结论:在乌干达古卢市,妇女在性传播感染方面面临严重脆弱性。虽然观察到诸如提高艾滋病毒意识和使用避孕套等令人鼓舞的趋势,但在性传播感染筛查、安全性行为的谈判以及获得预防和治疗方面仍然存在明显的挑战。为了解决这些问题,应制定有针对性的干预措施,以提高性传播感染筛查的可及性,使性工作者具备有效的谈判技能,并为性传播感染预防和治疗提供全面支持,从而有助于改善这一边缘化人群的整体性健康和福祉。
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引用次数: 0
Efficacy of a Multi-Level Pilot Intervention (“Harmony”) to Reduce Discrimination Faced by Men Who Have Sex with Men and Transgender Women in Public Hospitals in India: Findings from a Pre- and Post-Test Quasi-Experimental Trial among Healthcare Workers 多层次试点干预(“和谐”)减少印度公立医院男男性行为者和变性女性面临歧视的效果:在医护人员中进行的测试前和测试后准实验试验的结果
Pub Date : 2023-07-28 DOI: 10.3390/venereology2030009
Venkatesan Chakrapani, S. Nair, S. Subramaniam, K. Ranade, Biji Mohan, Ruban Nelson, Sajeesh T. Sivaraman, M. Shunmugam, J. Kaur, S. Rawat, Theranirajan Ethirajan, Chinmoyee Das, Shobini Rajan, A. Puri, Bhawani Singh Kushwaha, Bhawna Rao, Utpal Das, V. Verma, Neha Kapoor
Reducing the stigma and discrimination faced by men who have sex with men (MSM) and transgender women (TGW) in healthcare settings is key to improving health outcomes. Using a one-group pre- and post-test design, we tested the efficacy of a theory-informed, multi-level pilot intervention (“Harmony”) among 98 healthcare workers (HCWs) to reduce sexual orientation and gender identity (SOGI)-related stigma and discrimination faced by MSM and TGW in two public hospitals. The intervention contained group-level (a half-day workshop) and individual-level (four videos) components. Using multi-level modelling, we compared knowledge, attitudes, and comfort level among HCWs across three timepoints: pre-intervention, post-intervention, and follow-up (2 months after the intervention). Client surveys were conducted among 400 MSM/TGW (two independent samples of 200 MSM/TGW) attending the intervention hospitals, before the intervention among HCWs and three months after the intervention. Generalised estimating equations assessed service users’ satisfaction with hospital services, discrimination experiences, and positive interactions with HCWs. Significant changes were observed in primary outcomes: 30% increase in positive attitude scores (incidence rate ratio (IRR) = 1.30, 95% CI 1.13–1.49) and 23% increase in the proportion of HCWs reporting being comfortable in providing care to MSM/TGW (IRR = 1.23, 95% CI 0.03–1.68). Similarly, there was a significant improvement in secondary outcomes (scores): support for non-discriminatory hospital policies (IRR = 1.08, 95% CI 1.004–1.15), the importance of asking SOGI questions in clinical history (IRR = 1.17, 95% CI 1.06–1.29), and perceived self-efficacy in providing clinical care (IRR = 1.13, 95% CI 1.01–1.27). Service users’ data provided corroborative evidence for intervention efficacy: e.g., 14% increase in the proportion of MSM reporting overall satisfaction with hospital services and 6% and 15% increase in the scores of positive interactions with HCWs in the combined sample of MSM/TGW and TGW, respectively. The Harmony intervention showed preliminary evidence for improving positive attitudes, comfort level, and understanding of the healthcare issues of MSM/TGW among HCWs, warranting large-scale implementation research.
减少与男性发生性关系的男性(MSM)和跨性别女性(TGW)在医疗环境中面临的耻辱和歧视是改善健康状况的关键。使用一组测试前和测试后设计,我们在两家公立医院的98名医护人员中测试了基于理论的多层次试点干预(“和谐”)的有效性,以减少MSM和TGW面临的与性取向和性别认同(SOGI)相关的污名和歧视。干预措施包括小组层面(半天研讨会)和个人层面(四个视频)。使用多层次模型,我们比较了干预前、干预后和随访(干预后2个月)三个时间点的HCW的知识、态度和舒适度。在干预前和干预后三个月,对在干预医院就诊的400名MSM/TGW(200名MSM/TGW的两个独立样本)进行了客户调查。广义估计方程评估了服务用户对医院服务的满意度、歧视经历以及与HCW的积极互动。主要结果发生了显著变化:积极态度得分增加了30%(发病率比率(IRR)=1.30,95%CI 1.13-1.49),报告对MSM/TGW提供护理感到满意的HCW比例增加了23%(IRR=1.23,95%CI 0.03-1.68)。同样,次要结果(得分)有显著改善:支持非歧视性医院政策(IRR=1.08,95%CI 1.004-1.15),在临床病史中询问SOGI问题的重要性(IRR=1.17,95%CI 1.06-1.29),以及在提供临床护理方面的感知自我效能感(IRR=1.13,95%CI 1.01-1.27)。服务用户的数据为干预效果提供了确证:例如,在MSM/TGW和TGW的联合样本中,MSM报告对医院服务总体满意度的比例分别增加了14%,与HCW的积极互动得分分别增加了6%和15%。Harmony干预显示了改善HCW中MSM/TGW的积极态度、舒适度和对医疗保健问题的理解的初步证据,值得进行大规模的实施研究。
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引用次数: 0
Modulatory Effect of Human Immunodeficiency Virus on Circulating p53, miR-21, and miR-125b: Any Diagnostic Implication? 人类免疫缺陷病毒对循环p53、miR-21和miR-125b的调节作用:有诊断意义吗?
Pub Date : 2023-06-25 DOI: 10.3390/venereology2030008
Jude Ogechukwu Okoye, A. Ngokere, C. C. Onyenekwe, O. Omotuyi, S. Ogenyi, C. M. Obi, S. Fasogbon
Identifying immunocompromised women who are at risk of developing cervical cancer remains a challenge for clinicians. In an effort to identify the role of HIV in cervical carcinogenesis, this study evaluated the levels of normally downregulated oncomirs (miR-21, miR-146a, miR-155, miR-182, and miR-200c) and normally upregulated tumor suppressors (miR-let-7b, miR-125b, miR-143, miR-145, and p53 expression) associated with cervical cancer in the serum of women living with HIV (HIV+) and without HIV (HIV. Method: This case-control study included 173 women; confirmed HIV+ (n = 103) and HIV− (n = 70). Serum levels of miRNAs and p53 were determined using reverse transcriptase PCR. t-test and Pearson’s correlation analyses were carried out on the generated data. Result: A higher level of miR-21 was observed among HIV+ women compared with their HIV− counterpart (p = 0.028), whereas lower levels of miR-125, and p53 gene were observed among HIV+ women compared with HIV− women at p = 0.050 and 0.049, respectively. Significant direct relationships were observed between miR-21 and other oncomirs (p < 0.05) among HIV+ women. Conclusion: This study revealed that HIV contributes to cervical carcinogenesis by modulating circulating levels of miR-21, p53, and miR-125b. It suggests that these biomarkers could be used to identify at high risk for developing cervical cancer.
对临床医生来说,确定有患宫颈癌风险的免疫功能低下妇女仍然是一个挑战。为了确定HIV在宫颈癌发生中的作用,本研究评估了正常下调的肿瘤因子(miR-21、miR-146a、miR-155、miR-182和miR-200c)和正常上调的肿瘤抑制因子(miR-let-7b、miR-125b、miR-143、miR-145和p53表达)在感染HIV (HIV+)和未感染HIV (HIV)的女性血清中与宫颈癌相关的水平。方法:本病例-对照研究纳入173名女性;确诊HIV+ (n = 103)和HIV - (n = 70)。采用逆转录酶PCR检测血清miRNAs和p53水平。对生成的数据进行t检验和Pearson相关分析。结果:在HIV阳性妇女中,miR-21水平高于HIV阴性妇女(p = 0.028),而在HIV阳性妇女中,miR-125和p53基因水平分别低于HIV阴性妇女(p = 0.050和0.049)。在HIV阳性妇女中,miR-21与其他肿瘤指标有显著的直接关系(p < 0.05)。结论:本研究揭示HIV通过调节miR-21、p53和miR-125b的循环水平参与宫颈癌的发生。这表明,这些生物标志物可以用来识别患宫颈癌的高风险人群。
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引用次数: 1
The Emerging Threat of Antimicrobial-Resistant Sexually Transmitted Infections: Epidemiology, Management and Detection 耐药性传播感染的新威胁:流行病学、管理和检测
Pub Date : 2023-05-19 DOI: 10.3390/venereology2020007
Karan Varshney
Antimicrobial resistance (AMR) has become one of the most pressing public health crises, with sexually transmitted infections (STIs) of all types rapidly becoming resistant to treatments [...]
抗菌素耐药性(AMR)已成为最紧迫的公共卫生危机之一,所有类型的性传播感染(sti)迅速对治疗产生耐药性[…]
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引用次数: 1
期刊
Venereology (Basel, Switzerland)
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