sexually transmitted diseases

性传播疾病
  • 文章类型: Journal Article
    输血有传播多种病原体的危险,包括弓形虫(T.弓形虫)和其他性病感染。进行流行病学监测以检测这些病原体的流行至关重要。该研究旨在评估梅诺菲亚省健康献血者中弓形虫的血清阳性率和常见的可输血性病感染,埃及,并确定相关的危险因素。在2023年1月至4月之间,从Menoufia大学医学院的血库中招募了四百二十名个人进行横断面描述性研究。对收集的血液样品进行抗T.gondiiIgM和IgG,HBsAg,抗HCV抗体,HIVp24抗原和抗HIV抗体,和抗梅毒螺旋体抗体.46例(11.0%)和22例供体(5.2%)的抗T.95%CI(8.3-14.6)的刚地IgG和95%CI(3.5-8.1)的IgM,分别,而1例患者(0.2%)两种抗体均为阳性。关于性病感染,12(2.9%)为HBV阳性,6例(1.4%)HCV阳性,7人(1.7%)HIV阳性,受试人群均未显示梅毒阳性。女性性别,食用生肉,农业环境,对弓形虫的认识很差,血型(尤其是AB和O组)是弓形虫感染的独立危险因素。该研究强调了对献血者进行弓形虫和常见可输血性病检测的重要性。开始健康教育计划和预防措施,例如合适的肉类处理和清洁做法,对于减少这些疾病的发生至关重要。建议进行更大规模的其他研究以确认这些结果并为公共卫生计划提供指导。
    Blood transfusion has a hazard of transmission of many pathogens, including Toxoplasma gondii (T. gondii) and other venereal infections. It is crucial to conduct epidemiological surveillance to detect the prevalence of these pathogens. The study aimed to assess the seroprevalence of T. gondii and common transfusable venereal infections among healthy blood donors in Menoufia Province, Egypt, and identify associated risk factors. Four hundred twenty individuals were recruited between January and April 2023 for cross-sectional descriptive research from the blood banks of Menoufia University medical hospitals. Collected blood samples were screened for anti-T. gondii IgM and IgG, HBsAg, anti-HCV antibodies, HIV p24 antigen and anti-HIV antibodies, and anti-Treponema pallidum antibodies. 46 (11.0%) and 22 donors (5.2%) individuals tested positive for anti-T. gondii IgG with a 95% CI (8.3-14.6) and IgM with a 95% CI (3.5-8.1), respectively, while one patient (0.2%) was positive for both antibodies. Regarding venereal infections, 12 (2.9%) were positive for HBV, 6 (1.4%) were positive for HCV, 7 (1.7%) were positive for HIV, and none of the tested population showed positivity for syphilis. Female gender, consumption of raw meat, agricultural environment, poor awareness about T. gondii, and blood group type (especially AB and O groups) were identified as independent risk factors for T. gondii infection. The study highlights the importance of testing blood donors for T. gondii and common transfusable venereal illnesses. Starting health education programs and preventative measures, such as suitable meat handling and cleanliness practices, is critical for minimizing the occurrence of these illnesses. Larger-scale additional study is advised to confirm these results and provide guidance for public health initiatives.
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  • 文章类型: Journal Article
    背景:同伴传递的HIV自我检测(HIVST)和性传播感染自我采样(STISS)可能会促进坚持口服暴露前预防(PrEP),但是没有研究在撒哈拉以南非洲的跨性别女性(TGW)中分析这种方法。
    方法:同行研究是乌干达的一项整群随机试验(2020年10月至2022年7月;NCT04328025)。
    方法:十个TGW对等组,每个都有1个TGW对等体和8个TGW,被随机分配为1:1,接受季度临床HIV检测,PrEP笔芯作为标准护理(SOC)或SOC再加上每月对患者进行口液HIVST,STISS,和PrEP笔芯(干预)。参与者随访12个月。主要结果是PrEP依从性。
    结果:我们筛选了85个TGW,登记了82个(每个臂41个)。中位年龄为22岁(四分位距[IQR]20-24)。12个月的保留率为88%(72/82)。在3、6、9和12个月的诊所就诊时,10%,5%,5%,干预组中0%的TGW的TFV-DP水平≥700fmol/punch,与7%相比,15%,7%,SOC臂中的2%,分别为(P=0.18)。在所有访问中,SOC中任何可检测的TFV-DP水平均显著高于同组分娩组(P<0.04).PrEP依从性与性工作(发生率比6.93;95%CI:2.33至20.60)和>10年教育(发生率比2.35;95%CI:1.14至4.84)相关。在干血点和尿液中检测替诺福韦之间存在很强的相关性(P<0.001)。没有发生HIV血清转化。
    结论:同行提供的HIVST和STISS并未增加乌干达TGW中口腔PrEP依从性的低水平。该人群应考虑长效PrEP制剂。
    BACKGROUND: Peer-delivered HIV self-testing (HIVST) and sexually transmitted infection self-sampling (STISS) may promote adherence to oral pre-exposure prophylaxis (PrEP), but no studies have analyzed this approach among transgender women (TGW) in sub-Saharan Africa.
    METHODS: The Peer study was a cluster randomized trial in Uganda (October 2020-July 2022; NCT04328025).
    METHODS: Ten TGW peer groups, each with 1 TGW peer and 8 TGW, were randomized 1:1 to receive quarterly in-clinic HIV testing with PrEP refills as standard-of-care (SOC) or SOC plus monthly peer delivery of oral-fluid HIVST, STISS, and PrEP refills (intervention). Participants were followed for 12 months. The primary outcome was PrEP adherence.
    RESULTS: We screened 85 TGW and enrolled 82 (41 per arm). The median age was 22 years (interquartile range [IQR] 20-24). Twelve-month retention was 88% (72/82). At the 3, 6, 9, and 12-month clinic visits, 10%, 5%, 5%, and 0% of TGW in the intervention arm had TFV-DP levels ≥700 fmol/punch, versus 7%, 15%, 7%, and 2% in the SOC arm, respectively (P = 0.18). At all visits, any detectable TFV-DP levels were significantly higher in SOC than the peer delivery group (P < 0.04). PrEP adherence was associated with sex work (incidence rate ratio 6.93; 95% CI: 2.33 to 20.60) and >10 years of schooling (incidence rate ratio 2.35; 95% CI: 1.14 to 4.84). There was a strong correlation between tenofovir detection in dried blood spots and urine (P < 0.001). No HIV seroconversions occurred.
    CONCLUSIONS: Peer-delivered HIVST and STISS did not increase low levels of oral PrEP adherence among TGW in Uganda. Long-acting PrEP formulations should be considered for this population.
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  • 文章类型: Journal Article
    背景虽然在线STI测试服务有所增长,需要更多的注意力来了解如何为使用者提供有效的治疗途径。这项研究调查了如果年轻人使用在线服务检测呈阳性,他们希望在哪里接受淋病和梅毒治疗。方法我们对16-29岁的澳大利亚人进行了一项在线调查,其中包括多项选择和关于他们接受注射抗生素的首选位置的自由文本问题。多变量多项逻辑回归检查了受访者特征与服务偏好之间的关联。内容分析用于编码自由文本响应。结果在905名受访者中,777(85.9%)回答了有关治疗偏好的问题。受访者最常选择由性健康诊所(294;37.8%)或药房护士(208;26.8%)提供的可注射抗生素。性别/性别多样化的受访者更有可能选择性健康诊所而不是一般诊所(MSMRRR2.5,95%CI1.1-5.7;WSWRRR2.6,95%CI1.1-5.7;反式/非二元RRR2.5;95%CI1.0-6.0)。年龄较大的受访者(25-29岁)更有可能选择所有替代方案,而不是一般做法,与以前测试过的人相反。从开放式文本答案中,药店的价值是为了方便,和提供非判断性的性健康诊所,由专家提供免费服务。结论某些年轻人群体的治疗偏好差异表明,不同的服务可能会影响在线STI测试服务的寻求治疗结果。
    Background Although there has been growth in online STI testing services, more attention is needed to understand how to facilitate effective treatment pathways for users. This study investigated where young people want to be treated for gonorrhoea and syphilis if they test positive using an online service. Methods We conducted an online survey of Australians aged 16-29years that included multiple choice and free-text questions about their preferred location for receiving injectable antibiotics. Multivariable multinomial logistic regression examined associations between respondent characteristics and service preferences. Content analysis was used to code free-text responses. Results Among 905 survey respondents, 777 (85.9%) answered questions on treatment preferences. Respondents most commonly preferred injectable antibiotics provided by a sexual health clinic (294; 37.8%) or a nurse in a pharmacy (208; 26.8%). Gender/sexually diverse respondents were more likely to select sexual health clinics over general practice (MSM RRR 2.5, 95% CI 1.1-5.7; WSW RRR 2.6, 95% CI 1.1-5.7; trans/non-binary RRR 2.5; 95% CI 1.0-6.0). Older respondents (aged 25-29years) were more likely to choose all alternatives over general practice, with the reverse found for those who had previously tested. From open-text answers, pharmacies were valued for their convenience, and sexual health clinics for providing non-judgemental, free services by specialists. Conclusions Differences in treatment preferences by certain groups of young people suggest that different service offerings may influence treatment-seeking outcomes from online STI testing services.
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  • 文章类型: Journal Article
    性传播感染(STIs)对全世界的性健康和生殖健康产生了深远的影响。梅毒,淋病,衣原体,滴虫病是目前可治愈的四种性传播感染。然而,大多数性传播感染病例无症状,未经实验室诊断未发现.乙型肝炎病毒,单纯疱疹病毒,人类免疫缺陷病毒(HIV),人乳头瘤病毒(HPV)是四种病毒和无法治愈的感染,但是可以通过治疗来缓解。我们调查了马普托女性中某些性传播病原体的患病率及其与HPV和HIV感染的关系。莫桑比克首都。在马普托的马瓦兰卫生机构,对233名寻求与妇科症状有关的保健的非孕妇进行了横断面研究,在2018年2月1日至2019年7月30日之间。收集宫颈刷样品并提取DNA。通过手动Hybrispot平台(体外,诊断大师,塞维利亚,西班牙)。使用快速测试进行HIV测试:确定HIV1/2测试(AlereAbbott实验室,东京,日本)进行筛选,和UniGoldHIV(三位一体生物技术,爱尔兰)进行确认。所有女性(n=233)均为杜氏嗜血杆菌和单纯疱疹病毒1(HSV-1)阴性。在233名女性中,发现性传播感染的患病率很高(89%),63%的女性HPV阳性,24%的女性HIV阳性。梅毒螺旋体(TP),阴道毛滴虫(电视),单纯疱疹病毒2型(HSV-2),沙眼衣原体(CT)检测占17%,14%,8%,8%的女性,分别。作为一种常见的现象,阴道分泌物(90%)是大多数女性报告的下生殖道症状.在56%(130/233)中检测到与任何STI和HPV的共感染,而45%(59/130)的共感染是高风险HPV(hrHPV)基因型。在HPV阳性参与者中,TP感染最普遍(27%)。总的来说,28%(66/233)的参与者对任何hrHPV基因型均为阳性。在15%(34/233)的研究参与者中发现了与任何STI和HIV的共感染。HPV感染与TP(p=0.039)和HSV-2(p=0.005)之间存在显着关联。电视,TP,和CT-S1-CT-S2阳性在HIV阳性参与者中明显更为普遍.原虫解脲脲原体/细小支原体和人型支原体分别检出84.0%(195/233)和45%(105/233),分别。本研究描述了性传播感染的高患病率。在大多数研究受试者中发现了HPV和性传播感染之间的共感染。HPV的高患病率强调需要HPV疫苗接种以预防该人群中的宫颈癌。性传播感染的管理对于出现妇科症状的妇女也很重要。
    Sexually transmitted infections (STIs) have a profound impact on sexual and reproductive health worldwide. Syphilis, gonorrhea, chlamydia, and trichomoniasis are four currently curable STIs. However, most STI cases are asymptomatic and not detected without laboratory diagnostics. Hepatitis B virus, herpes simplex virus, human immunodeficiency virus (HIV), and human papillomavirus (HPV) are four viral and incurable infections, but they can be mitigated by treatment. We investigated the prevalence of selected sexually transmitted pathogens and their relationship with HPV and HIV infection in women from Maputo, the capital of Mozambique. A cross-sectional study was conducted on 233 non-pregnant women seeking health care relating to gynecological symptoms in Mavalane Health facilities in Maputo, between the 1st of February 2018 and the 30th of July 2019. Cervical brush samples were collected and DNA was extracted. Selected STIs including HPV were detected using multiplex STD and HPV Direct Flow Chip Kits through a manual Hybrispot platform (Vitro, Master Diagnostica, Sevilla, Spain). HIV testing was performed using rapid tests: Determine HIV 1/2 test (Alere Abbott Laboratories, Tokyo, Japan) for screening, and UniGold HIV (Trinity Biotech, Ireland) for confirmation. All women (n = 233) were negative for Haemophilus ducreyi and Herpes Simplex Virus-1 (HSV-1). Among the 233 women, a high prevalence of STIs was found (89%), 63% of the women were positive for HPV and 24% were HIV positive. Treponema pallidum (TP), Trichomonas vaginalis (TV), Herpes Simplex Virus-2 (HSV-2), and Chlamydia trachomatis (CT) were detected in 17%, 14%, 8%, and 8% of the women, respectively. As a common phenomenon, vaginal discharge (90%) was the lower genital tract symptom reported by the majority of the women. Co-infection with any STI and HPV was detected in 56% (130/233) while 45% (59/130) of the co-infections were with high-risk HPV (hrHPV) genotypes. Among the HPV-positive participants, infection by TP was the most prevalent (27%). In total, 28% (66/233) of the participants were positive for any hrHPV genotypes. Co-infection with any STI and HIV was found in 15% (34/233) of the study participants. There was a significant association between HPV infection and TP (p = 0.039) and HSV-2 (p = 0.005). TV, TP, and CT-S1-CT-S2 positivity were significantly more prevalent in HIV-positive participants. Pathobionts Ureaplasma urealyticum/parvum and Mycoplasma hominis were detected in 84.0% (195/233) and 45% (105/233), respectively. This present study describes a high prevalence of STIs. Co-infection between HPV and STIs was found in the majority of the study subjects. The high prevalence of HPV emphasizes the need for HPV vaccination to prevent cervical cancer in this population. Management of STIs is also important in women presenting with gynecological symptoms.
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  • 文章类型: Journal Article
    背景:应对性传播感染(STIs)的全球挑战至关重要,需要立即关注。提高认识,改善医疗设施,必须采取预防措施,以减少传播并减轻其不利影响。与性传播感染相关的个体寻求治疗的行为是性传播感染预防和控制的重要因素。因此,本研究旨在确定东非性活跃男性中与性传播感染相关的寻求护理行为相关的因素.
    方法:对东非国家最近的人口与健康调查(DHRS)中的3,302名性活跃男性的加权样本进行分析。为了适应国土安全部数据中固有的聚类和因变量的二元性质,我们应用了多级混合效应逻辑回归模型。偏差值用于选择最佳拟合模型。协会的强度是使用调整后的赔率比估计的,以及95%的置信区间,并且在p值<0.05时确定统计学显著性。
    结果:东非性活跃男性中性传播感染相关求医行为的总患病率为71%(95CI:69.76,72.75)。在多变量多水平模型中,年龄在25-34岁(AOR=1.58,95CI:1.22,2.04)和44岁及以上(AOR=1.44,95CI:1.01,2.02)的个体,已婚人士(AOR=1.62,95CI:1.25,2.11),有1个(AOR=1.88,95CI:1.50,2.35)和≥2个(AOR=2.53,95CI:1.89,3.39)性伴侣,不包括配偶,曾经接受过HIV检测(AOR=1.86,95CI:1.52,2.28),并且有媒体暴露(AOR=1.30,95CI:1.04,1.62)与性传播感染的寻求护理行为呈正相关。
    结论:根据我们的发现,在东非,十分之七的性活跃男性表现出性传播感染的寻求护理行为。实施旨在改善年轻人寻求健康习惯的政策和战略至关重要,未婚男子。利用各种媒体平台传播有关性传播感染症状的准确信息和成功案例对于实现这一目标至关重要。
    BACKGROUND: Addressing the global challenge of sexually transmitted infections (STIs) is crucial and demands immediate attention. Raising awareness, improving healthcare facilities, and implementing preventive measures are necessary to reduce the spread and mitigate their adverse effects. The treatment seeking behavior of individuals in relation to STIs is an important factor in STI prevention and control. Thus, this study aimed to identify factors associated with STI-related care-seeking behavior among sexually active men in East Africa.
    METHODS: A weighted sample of 3,302 sexually active men from recent Demographic and Health Surveys (DHSs) in East African countries were included for analysis. To accommodate the inherent clustering in DHS data and the binary nature of the dependent variable, we applied a multi-level mixed-effect logistic regression model. The deviance value was used to select the best-fitted model. The strength of the association was estimated using an adjusted odds ratio, along with a 95% confidence interval, and statistical significance was determined at a p-value < 0.05.
    RESULTS: The pooled prevalence of STI-related care-seeking behavior among sexually active men in East Africa was 71% (95%CI: 69.76, 72.75). In the multivariable multilevel model, individuals in the age groups of 25-34 (AOR = 1.58, 95%CI: 1.22, 2.04) and 44 years and above (AOR = 1.44, 95%CI: 1.01, 2.02), those who were married (AOR = 1.62, 95%CI: 1.25, 2.11), had 1 (AOR = 1.88, 95%CI: 1.50, 2.35) and ≥2 (AOR = 2.53, 95%CI: 1.89, 3.39) sexual partners excluding their spouse, had ever been tested for HIV (AOR = 1.86, 95%CI: 1.52, 2.28), and had media exposure (AOR = 1.30, 95%CI: 1.04, 1.62) had a positive association with care-seeking behavior for STIs.
    CONCLUSIONS: Based on our findings, seven out of ten sexually active men in East Africa exhibit care-seeking behavior for STIs. It is crucial to implement policies and strategies aimed at improving the health-seeking habits of young, unmarried men. Utilizing diverse media platforms to disseminate accurate information and success stories about STI symptoms is pivotal in achieving this goal.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    目的:开发和评估移动应用程序的有效性证据,以支持护士在性传播感染的临床管理中。
    方法:方法研究分为四个步骤进行:需求的分析和定义;内容定义;具有系统设计的计算表示;以及具有测试和细化的编码。第一步,具有该主题专业知识的护士参加了,最后,具有信息和通信技术教育的专业人员。通过计算含量有效性指数(CVI)进行数据分析,考虑最小协议值0.78。为了确认CVI的可行性,通过R软件进行二项检验。p>0.05的变量表明法官之间的一致性。
    结果:内容CVI为0.98,1.0用于可用性,0.85用于功能性能,表明开发的应用程序具有很高的有效性。
    结论:相信ISTNurse®应用是加强循证护理的重要技术工具。因此建议进行干预研究。
    OBJECTIVE: to develop and evaluate the validity evidence of a mobile application to support nurses in the clinical management of sexually transmitted infections.
    METHODS: methodological study conducted in four steps: analysis and definition of requirements; content definition; computational representation with system design; and coding with testing and refinement. In the first steps, nurses with expertise in the subject participated, and in the last, professionals with education in information and communication technology. Data analysis was performed by calculating the Content Validity Index (CVI), considering the minimum agreement value of 0.78. To confirm the viability of the CVI, the binomial test was used through the R software. Variables with p > 0.05 indicated agreement between the judges.
    RESULTS: the CVI was 0.98 for content, 1.0 for usability and 0.85 for functional performance, showing that the developed application has high validity.
    CONCLUSIONS: it is believed that the IST Nurse® application represents an important technological tool in strengthening evidence-based nursing care. Intervention studies are therefore suggested.
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  • 文章类型: Journal Article
    Artisanal and small-scale mining (ASM) is a significant source of income for tens of millions of people worldwide. Consistent condom use is pivotal in the prevention of HIV/AIDS and other STIs. This study assessed sexual behaviors and factors associated with consistent condom use among young male artisanal miners in Kassanda District, Uganda. A cross-sectional survey was conducted with 304 miners aged 15-24 years. Data -analysis included frequency distributions, chi-squared tests, and binary logistic regression. 89% had sexual intercourse in the past year, 55% had multiple partners, 11% engaged in transactional sex, and only 42% used condoms consistently. Married/cohabiting young men (OR=0.41; CI=0.19-0.87), those with a neutral attitude towards condom use (OR=0.30; CI=0.11-0.85), and those with only their mothers as parents (OR=0.37; CI=0.19-0.73) were less likely to use condoms consistently. The study highlights the need for targeted interventions promoting condom use among married young men and those raised by single mothers to reduce the risk of STI transmission.
    L’exploitation minière artisanale et à petite échelle (ASM) constitue une source de revenus importante pour des dizaines de millions de personnes dans le monde. L\'utilisation systématique du préservatif est essentielle à la prévention du VIH/SIDA et d\'autres IST. Cette étude a évalué les comportements sexuels et les facteurs associés à l\'utilisation systématique du préservatif chez les jeunes mineurs artisanaux du district de Kassanda, en Ouganda. Une enquête transversale a été menée auprès de 304 mineurs âgés de 15 à 24 ans. L\'analyse des données comprenait des distributions de fréquences, des tests du chi carré et une régression logistique binaire. 89 % ont eu des rapports sexuels au cours de l\'année écoulée, 55 % ont eu plusieurs partenaires, 11 % se sont livrés à des relations sexuelles transactionnelles et seulement 42 % ont utilisé des préservatifs de manière constante. Jeunes hommes mariés/cohabitants (OR=0,41 ; IC=0,19-0,87), ceux ayant une attitude neutre à l\'égard de l\'utilisation du préservatif (OR=0,30 ; IC=0,11-0,85) et ceux dont la mère est seule comme parent (OR=0,37 ; IC=0,19-0,73) étaient moins susceptibles d’utiliser régulièrement des préservatifs. L\'étude souligne la nécessité d\'interventions ciblées promouvant l\'utilisation du préservatif parmi les jeunes hommes mariés et ceux élevés par des mères célibataires afin de réduire le risque de transmission des IST.
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  • 文章类型: Journal Article
    性传播感染(STIs)是与性健康和生殖健康有关的最重要问题之一,据估计,全球每天有超过100万新感染,以及这些感染的患病率和发病率的数据,尤其是年轻人,正在增加。然而,有一些知识和行为的差距,年轻人需要更多的学校和家庭网络支持来保护自己和同龄人。因此,我们设计了一项多中心前瞻性干预研究,涉及公立初中和高中学生,他们的父母和老师(ESPRIT)。干预将在2023-2024学年进行,学生将与专家会面并参与同伴教育。而成年人(父母和老师)将参加远程和面对面的培训。所有目标群体将完成KAP(知识,态度,实践)参与干预前后的问卷调查,以衡量其有效性。这项研究的结果将有助于评估和提高初中和高中学生的知识水平,特别是关于性传播感染和HPV的家长和老师,提高对性健康和生殖健康问题的认识,包括疫苗接种,在初中和高中学生及其家庭中,并评估这些干预措施在改善知识、改变态度和行为方面的有效性。该研究方案已获得FriuliVeneziaGiulia地区独特伦理委员会(CEUR-2023-Sper-34)的批准。该项目正在意大利卫生部的技术和财政支持下进行。
    Sexually transmitted infections (STIs) are one of the most important issues related to sexual and reproductive health, as it is estimated that more than 1 million new infections are acquired every day worldwide and data on the prevalence and incidence of these infections, especially among young people, are increasing. Nevertheless, there are some knowledge and behavioral gaps, and young people need more support from their school and family network to protect themselves and their peers. Therefore, we have designed a multicenter prospective intervention study involving public lower and upper secondary school students, their parents and teachers (ESPRIT). The intervention will take place in the school year 2023-2024, where students will meet with experts and be involved in peer education, while adults (parents and teachers) will participate in distance and face-to-face trainings. All target groups will complete KAP (knowledge, attitudes, practice) questionnaires before and after participating in the intervention to measure its effectiveness. The results of this study will help to assess and improve the level of knowledge of lower and upper secondary school students, parents and teachers about STIs and HPV in particular, raise awareness of sexual and reproductive health issues, including vaccination, among lower and upper secondary school students and their families, and evaluate the effectiveness of these interventions in terms of improving knowledge and changing attitudes and behaviors. The study protocol has been approved by the Regional Unique Ethics Committee of Friuli Venezia Giulia (CEUR-2023-Sper-34). The project is being carried out with the technical and financial support of the Italian Ministry of Health-CCM.
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  • 文章类型: Journal Article
    背景:孕妇的普遍抗逆转录病毒治疗(ART)显着降低了母婴传播风险。然而,并非所有接受ART的女性在怀孕和哺乳期间都受到病毒抑制。除了对ART的依从性差之外,已知共感染,特别是其他性传播感染(STIs)会增加艾滋病毒感染和艾滋病毒传播的风险。虽然怀孕期间性传播感染的患病率已经得到了很好的研究,产后性传播感染的患病率及其与HIV病毒抑制的相关性被低估.
    方法:在这项横断面研究中,我们确定了在南非HIV高发地区的青春期女性和年轻女性(AGYW)中,感染HIV(WLHIV)和未感染HIV(WNLHIV)的青春期女性(AGYW)产后6~14周门诊就诊时的性传播感染患病率.检查所有妇女的STI相关症状,并收集阴道拭子并储存用于以后的STI测试。对阴道拭子进行了阴道毛滴虫测试(T。阴道),沙眼衣原体(C.沙眼),淋病奈瑟菌(N.淋病)和单纯疱疹病毒2(HSV-2)使用PCR。使用Nugent评分标准对所有女性进行细菌性阴道病(BV)测试。WLHIV收集了HIV病毒载量的血液样本,乙型肝炎和梅毒。
    结果:本分析包括82个WLHIV和102个WNLHIV。产后6至14周,40(21.7%)AGYW对任何STI均呈阳性,其中15(37.5%)是有症状的,并接受了经验性治疗。沙眼衣原体最常见(10.9%),其次是HSV-2(7.7%),阴道奈瑟氏球菌(3.8%)和淋病奈瑟氏球菌(1.6%)。与WNLHIV相比,WLHIV更有可能对STI(OR2.0;0.96-3.96)和BV(OR4.2;95CI2.1-8.1)检测呈阳性。在ART上的WLHIV中,70.5%具有检测不到的血浆病毒载量(PVL),20.5%具有>1000拷贝/ml的PVL。产后访视时任何STI或BV检测阳性与PVL>1000拷贝/ml无关(OR1.33;95CI0.38-4.64)。
    结论:我们报告了产后早期大部分无症状性性传播感染和BV的高患病率,WLHIV中的性传播感染与未抑制的PVL无关。WNLHIV的高性传播感染阳性率对产后期间的HIV风险有影响。以及随后的母乳喂养传播。
    BACKGROUND: Universal antiretroviral treatment (ART) for pregnant women has reduced mother-to-child transmission risk significantly. However, not all women on ART are virally suppressed during pregnancy and lactation. In addition to poor adherence to ART, co-infections particularly other sexually transmitted infections (STIs) are known to increase the risk of HIV acquisition and HIV transmission. While the prevalence of STIs during pregnancy has been well studied, the prevalence of STIs in the postpartum period and its association with HIV viral suppression are underreported.
    METHODS: In this cross-sectional study, we determined the prevalence of STIs among adolescent girls and young women (AGYW) living with HIV (WLHIV) and without HIV (WNLHIV) at their 6-14 week postnatal clinic visit in a high HIV prevalence district in South Africa. All women were examined for STI-related symptoms and had vaginal swabs collected and stored for later STI testing. Vaginal swabs were tested for Trichomonas vaginalis (T.vaginalis), Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoea) and herpes simplex virus-2 (HSV-2) using PCR. All women were tested for bacterial vaginosis (BV) using the Nugent scoring criteria. WLHIV had a blood sample collected for HIV viral load, Hepatitis B and syphilis.
    RESULTS: Included in this analysis were 82 WLHIV and 102 WNLHIV. Between 6 and 14 weeks postpartum, 40 (21.7%) AGYW tested positive for any STI and among these 15 (37.5%) were symptomatic and received empirical treatment. C. trachomatis was most commonly detected (10.9%), followed by HSV-2 (7.7%), T. vaginalis (3.8%) and N. gonorrhoea (1.6%). WLHIV were more likely to test positive for an STI (OR 2.0; 0.96-3.96) and BV (OR 4.2; 95%CI 2.1-8.1) compared to WNLHIV. Among WLHIV on ART, 70.5% had an undetectable plasma viral load (PVL) and 20.5% had a PVL > 1000 copies/ml. Testing positive for any STI or BV at the postpartum visit was not associated with PVL > 1000 copies/ml (OR 1.33; 95%CI 0.38-4.64).
    CONCLUSIONS: We report a high prevalence of largely asymptomatic STIs and BV in the early postpartum period and STIs in WLHIV were not associated with unsuppressed PVL.The high STI positivity rate among WNLHIV has implications for HIV risk during the postpartum period, and subsequently breastfeeding transmission.
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