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- [Study on the characteristics of serology and sexual behavior among drug users at the HIV sentinel surveillance sites in 2012]. [English Abstract, Journal Article]
- Zhonghua Liu Xing Bing Xue Za Zhi 2014 Feb; 35(2):121-3.
To analyze the serological results and sexual behavior among different types of drug users (DUS) at the HIV sentinel surveillance sites.Sentinel surveillance programs were conducted between April and June annually. DUS were those involved in custodies, living at the communities and those attending the methadone maintenance treatment clinics but with positive urine tests one month before blood sampling collected and questionnaire survey started.116 279 drug abusers were included in the analysis. The prevalence rates of HIV, Syphilis and HCV among traditional drug (heroin, etc.)users were 5.0%, 4.4% and 49.4%, while the prevalence rates of new narcotic (meth, etc.) users were 0.5%, 4.6%, 15.2%, respectively. The prevalence rates of HIV, syphilis among traditional drug uses were higher than the new narcotic users (P < 0.01). The proportion of sexual behavior in last month and the proportion of sexual behavior with casual and commercial sexual partners were 46.3%, 87.2% and 28.1% among the new narcotic users, respectively, which were higher than those among traditional drug users (40.7% , 82.8% and 22.2%). The proportion of using condom in last sexual contact with casual sexual partner was 33.3% among the new narcotic users which was less than traditional drug users (36.2%). The proportion of condom use in the last commercial sexual contact was 65.1% which was higher than those traditional drug users (62.9%). The proportion of never using condom with casual and commercial sexual partners in the past year was 43.2% and 19.0% among the traditional drug users, which were higher than those among new narcotic users (41.3%, 15.3%).Compared with the traditional drug abusers, the sexual behavior of new narcotic users seemed more active, less engaging in condom use but with higher risk of HIV transmission through sexual contact.
- Factors associated with HIV and syphilis co-infection among men who have sex with men in seven Chinese cities. [JOURNAL ARTICLE]
- Int J STD AIDS 2014 Apr 15.
HIV-syphilis co-infection is often cited as a major reason behind recent resurgence in syphilis prevalence among men who have sex with men in China. Most published literatures explore factors associated with either HIV or syphilis, but not their co-infection. We analysed data from a cross-sectional survey on men who have sex with men in seven Chinese cities. Snowball sampling was used to recruit participants for the survey. Socio-demographic and behavioral predictors for HIV-syphilis mono/co-infection were examined using ordinal logistic regression. Factor scores were used to summarise (1) HIV-related knowledge and (2) access to HIV preventive services. Prevalence of HIV, syphilis, and their co-infection, among 2936 self-identified men who have sex with men, were 7.7%, 14.3%, and 2.6%, respectively. In the adjusted analysis, the significant positive correlates of poorer diagnoses (co-infection vs mono- and no infection or co- and mono-infection vs no infection) were -30 to 39 years and ≥40 years age, education up to senior high school, unprotected anal intercourse, recent sexually transmitted disease symptoms, incorrect knowledge about routes of transmission, and access to preventive or counselling/testing services for HIV. For effective control of this dual epidemic, integrated HIV and syphilis surveillance and targeted intervention strategies for Chinese men who have sex with men are need of the hour.
- HIV Risk Perception and Behavior among Sex Workers in Three Major Urban Centers of Mozambique. [Journal Article]
- PLoS One 2014; 9(4):e94838.
HIV risk perceptions and behaviors of 236 commercial sex workers from three major Mozambican urban centers were studied using the International Rapid Assessment, Response and Evaluation (I-RARE) methodology. All were offered HIV testing and, in Maputo, syphilis testing was offered as well. Sixty-three of the 236 opted for HIV testing, with 30 (48%) testing positive for HIV. In Maputo, all 30 receiving HIV tests also had syphilis testing, with 6 (20%) found to be positive. Results include interview excerpts and qualitative results using I-RARE methodology and AnSWR-assisted analyses of the interviews and focus group sessions.
- Defining research priorities for bacterial sexually transmitted infections in Canada. [Journal Article]
- Can J Public Health 2014; 105(1):e86-90.
We aimed to define priority areas for research on chlamydia, gonorrhea, and syphilis in Canada through the use of a consensus method.A modified Delphi method was conducted, consisting of two online surveys and an in-person meeting. Participants included people working in bacterial sexually transmitted infections (STIs) across Canada, including clinicians, policy-makers, public health practitioners, and researchers.Consensus was achieved regarding the most important priority topics in bacterial STI research in Canada, within five general priority areas: the epidemiology of bacterial STIs, screening, partner notification and contact tracing, antimicrobial resistance, and identification of best practices for the prevention and control of bacterial STIs.The findings of this consensus process can be used to inform research efforts, which could contribute to more effective control of bacterial STIs in Canada.
- Prevalence and risk factors associated with HIV infection, hepatitis and syphilis in a state prison of Sao Paulo. [JOURNAL ARTICLE]
- Int J STD AIDS 2014 Apr 14.
Given the importance of the control of sexually transmitted infections in the general population and specifically in the prison system, we rolled out this cross-sectional study in 2007. Standard questionnaires and blood samples were accessed among 680 prisoners. Protocol was approved by the Ethics Committee. Results: The prevalence: HIV, 1.8% (IC95% = 0.1-3.3); HBV, 21.0% (IC95% = 17.8-25.1); HBV, 5.3% (IC95% = 3.5-7.6) and syphilis 5.3% (IC95% = 3.5-7.6). Logistic regression identified association (p < 0.05): HIV: injectable drug use (OR = 15.4), over 30 years (OR = 13.3), cocaine use (OR = 5.4) and crack-cocaine use (OR = 5.2); HBV: injectable drug use (OR = 3.4), reference to previous sexually transmitted infection (OR = 2.3), over 30 years (OR = 1.9) and more than 5 years in prison (OR = 2.2); HCV: injectable drug use (OR = 9.65), marijuana use in prison (OR = 2.9) and more than 30 years (OR = 8.4) and for syphilis: homosexual relationship (OR = 7.8) and previous syphilis reported (OR = 7.7). These prevalences remain high when compared to the general population, however, HIV infection tended to decrease in prisoners while the other studied infections remained unchanged. Preventive actions to reduce sexual and parenteral risk have been advocated. However, measures capable of controlling these infections still have not made an impact.
- Prevalence of sexually transmitted diseases in female athletes in São Paulo, Brazil. [Journal Article]
- Einstein (Sao Paulo) 2014 Mar; 12(1):31-5.
Objective : To determine the prevalence of sexually transmitted diseases in female athletes. Methods : An observational, cross-sectional study was conducted including 50 female athletes with mean age of 20±3 years. Colposcopy, pap smear, and polymerase chain reaction for Chlamydia trachomatis, human papillomavirus and Neisseria gonorrhoeae were performed. Blood samples were collected to test for the human immunodeficiency virus, syphilis, hepatitis B and C. The athletes presenting clinical diseases or conditions identifiable by laboratory tests were treated and followed up in the unit. Results : Forty-six percent of the participants were unaware of sexually transmitted diseases. The prevalence of sexually transmitted diseases among athletes was 48% (24 cases). Human papillomavirus was the most frequent agent (44%). Considering the human papillomavirus genotypes, subtype 16 was the most prevalent (53%), followed by 11-6 (22%) and 18 (13%). Two athletes tested positive for C. trachomatis. There were no cases diagnosed of infection by N. gonorrhoeae, syphilis, hepatitis B, hepatitis C and human immunodeficiency virus. However, only 26 athletes had been vaccinated for hepatitis B. Conclusion : The prevalence of sexually transmitted diseases in female athletes was high. Primary prevention measures (hepatitis B and human papillomavirus vaccination) and secondary (serology, pap smears) must be offered to this specific group of women. The matter should be further approached in sports.
- Correlates of hepatitis B among patients with mental illness in Brazil. [JOURNAL ARTICLE]
- Gen Hosp Psychiatry 2014 Mar 12.
To assess correlates of hepatitis B among adults with mental illness under care in Brazil.Cross-sectional national multicenter study of 2206 patients with mental illnesses randomly selected from 26 public mental health services. Sociodemographic and behavioral data were obtained from face-to-face interviews and psychiatric diagnoses from medical charts. Serology testing was conducted, and prevalence rate ratios were estimated by log-binomial regression.The weighted prevalence rates of current hepatitis B virus (HBV) infection (HBsAg+) and previous HBV exposure (anti-HBc+) were 2.0% [95% confidence interval (CI): 1.5%-2.7%] and 17.1% (95% CI: 16.0%-19.0%), respectively. Correlates of HBsAg+ included male gender, younger age (18-29 years), unstable place of residence, intellectual disability, main psychiatric diagnosis of dementia, presence of other medical comorbitidy, use of alcohol/drugs during sex, more than one sexual partner and use of cocaine. Correlates of anti-HBc+ included male gender, older age (≥30 years), black skin color, lower education, unstable place of residence, currently hospitalized, intellectual disability, history of any sexually transmitted disease or syphilis, poor HIV knowledge, history of imprisonment and sexual violence.Hepatitis B is an important comorbidity among psychiatric patients in Brazil. Screening for HBV, effective prevention and intervention strategies, including universal HBV immunization, should be routine practices in these mental health services.
- [The many faces of neurosyphilis]. [English Abstract, Journal Article]
- Duodecim 2014; 130(6):589-93.
Syphilis is an infectious disease caused by Treponema pallidum. We describe two patients with chronic syphilis causing neurosyphilis. The first had had several brain infarctions due to the presence of meningovascular syphilis. Second patient suffered from motor and psychiatric symptoms caused by syphilis. The symptoms of our patients were alleviated by antibiotic therapy. Recognition of the multifaceted symptom picture of syphilis is increasingly important, because the occurrence of the disease has increased in our country over the last few decades. An early enough treatment can prevent permanent disability of the patient.
- HIV and sexually transmitted infection-related risks among female sex workers in Mongolia: second-generation surveillance survey, 2011-2012. [JOURNAL ARTICLE]
- Sex Transm Infect 2014 Apr 10.
Surveillance studies among female sex workers (FSWs) in Mongolia have found no HIV but high rates of syphilis, ranging from 10.7% in 2002 to 20.8% in 2007.To determine the current prevalence of HIV and syphilis among FSWs, and to identify syphilis risk factors.761 FSWs were recruited by time-location sampling between 2 January and 29 March 2012 in Ulaanbaatar city, Darkhan-Uul, Orkhon, Khuvsgul and Dornod provinces in Mongolia. Participants were administered an anonymous structured survey. Blood samples were tested for HIV and syphilis. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with syphilis.The mean age of participants was 31 (median 30, interquartile range 24-38). HIV knowledge was modest: 41.3% correctly answered all questions. Consistent condom use with clients was reported by 49.1% of participants and exposure to HIV prevention programmes by 50.1%. Although no cases of HIV were found, syphilis prevalence was -27.8% (95% CI 24.3% to 31.7%). In multivariate analyses, variables associated with syphilis were younger age (age >30 years, OR=0.96, 95% CI 0.92 to 0.99) and occurrence of genital ulcer (OR=2.24, 95% CI 1.17 to 4.28).A syphilis epidemic continues to grow among FSWs in Mongolia. These women are at high risk of HIV transmission if introduced into their sexual networks. With the increase in migration of mining workers in Mongolia, introduction of HIV may be imminent. Efforts to intensify treatment and prevention programmes among FSWs are needed.
- The HIV, Syphilis and HCV Epidemic among Female Sex Workers in China: Results from a Serial Cross-sectional Study between 2008 and 2012. [JOURNAL ARTICLE]
- Clin Infect Dis 2014 Apr 9.
Background. The studies on transmission of HIV and STDs in FSWs have been limited primarily to inferences drawn from studies focusing in defined geographical areas. Methods and Findings. The serial cross-sectional study was conducted in all of the 31provinces, municipalities and autonomous regions in Mainland China (2008 - 2012) and the current study reports the analysis of data of 827,079 participants. We classified the venues as high-tier venues (such as karaoke bars/ hotels) and from low-tier (such as hair salons/barber shops, massage parlors and other public outdoor venues) based on socio-economic status of the participants. The participants were recruited from each venue, while all the all sex workers who worked in the sites during the study period or those who were present on the days of survey were recruited. The prevalence of HIV decreased from 0.6% in 2008 to 0.3% in 2012, the syphilis prevalence ranged between 2.4% and 3.2%, and HCV prevalence decreased from 0.9% in 2008 to 0.8% in 2012. Further, we found that the HIV, syphilis and HCV prevalence proportions were higher in the FSWs belonging to the low-tier than the high-tier FSWs. Conclusions. The HIV, syphilis and HCV prevalence among FSWs in our study decreased during the study period. However, FSWs belonged to low tier had relatively higher disease prevalence and higher risk behaviors. Comprehensive intervention strategies, particularly focusing on the low tier and older FSWs are needed in order to bring down the disease burden in this population.