Etiología de las infecciones de transmisión sexual (ITS) diagnosticadas por la técnica de PCR múltiple-hibridación en población colombiana de la ciudad de Medellín atendida en el Laboratorio Clínico VID / Etiology of sexually transmitted infections (STIs) diagnosed by multiplex PCR-hibridization assay technique in a Colombian population attending the VID Clinical Laboratory in Medellin

Introducción. Las infecciones de transmisión sexual (ITS) son y seguirán siendo un serio problema de salud pública en todo el mundo según los datos de la OMS, con el agravante que la mayoría de los casos son asintomáticos y, además, no existe otro reservorio distinto al humano. El diagnóstico se puede realizar con pruebas tradicionales y moleculares, estas últimas incluyen la reacción en cadena de la polimerasa (PCR), de las cuales existen varios tipos, entre ellas, la PCR múltiple que tiene la capacidad de detectar ITS polimicrobianas a partir de una sola muestra. El objetivo de este estudio fue establecer cuáles fueron las infecciones de transmisión sexual más frecuentes en diferentes grupos de pacientes, así como determinar la utilidad del uso de la técnica de PCR múltiple en el diagnóstico de las ITS. Metodología. Se trata de un estudio observacional de corte transversal realizado entre los años 2021 y 2022 con pacientes que acudieron al servicio de diagnóstico del Laboratorio Clínico VID por sospecha de ITS. Las muestras recolectadas fueron evaluadas utilizando una prueba comercial basada en la técnica de PCR múltiple e hibridación. Las muestras procesadas fueron: orina e hisopados de endocérvix, uretra, recto, faringe y úlceras. Resultados. Se estudiaron 1.027 pacientes, de estos, 228 (22,2 %) fueron positivos para diferentes agentes de trasmisión sexual, distribuidos así: 50 (21,9 %) mujeres, 129 (56,6 %) hombres heterosexuales y 49 (21,5 %) hombres que tenían sexo con hombres (HSH). La edad promedio de las mujeres fue 30 años, y la de ambos grupos de hombres fue 36 años. Los microorganismos más frecuentemente identificados en mujeres fueron: C. trachomatis (A-K) en 28,6 %, seguido de virus herpes simplex tipo 2 (VHS-2) en 26,8 % y N. gonorrhoeae en 17,9 %. En hombres heterosexuales fueron C. trachomatis (A-K) en 37,5 %, N. gonorrhoeae en 21,5 % y VHS-2 en 18,7 %. En HSH fueron C. trachomatis (L1-L3) en 32,7 %, seguido de N. gonorrhoeae en 27,6 %, y de C. trachomatis (A-K) y VHS-2, ambos en 13,8 %. En 11 hombres heterosexuales, 8 HSH y en 6 mujeres, se identificó infección polimicrobiana. Conclusiones. C. trachomatis (A-K) fue el microorganismo más prevalente causante de ITS, seguido de N. gonorrhoeae en ambos grupos de hombres, y de VHS-2 en las mujeres, muy similar a lo reportado a nivel mundial. La prueba de PCR múltiple permite la detección de infecciones polimicrobianas comúnmente asociadas a ITS y el diagnóstico es preciso y confiable, incluso en pacientes asintomáticos

Sexually transmitted infections (STIs) are and will continue to be a serious public health problem throughout the world according to WHO data, with the aggravating factor that most cases are asymptomatic and, furthermore, there is no other reservoir other than humans. The diagnosis can be made with traditional and molecular tests, the latter include the polymerase chain reaction (PCR), of which there are several types, among them, multiplex PCR that has the capacity to detect polymicrobial STIs from a single sample. The objective of this study was to establish which were the most frequent sexually transmitted infections in different groups of patients, as well as to determine the usefulness of the multiplex PCR technique in the diagnosis of STIs. Methodology. This is an observational, cross-sectional study carried out between 2021 and 2022 with patients who attended the VID Clinical Laboratory for suspected STIs. The collected samples were evaluated using a commercial test based on the multiplex PCR technique and hybridization. The samples processed were: urine and swabs from endocervix, urethra, rectum, pharynx, and ulcers. Results. The study included 1,027 patients, of these, 228 (22.2%) were positive for different sexually transmitted agents, distributed as follows: 50 (21.9%) women, 129 (56.6%) heterosexual men and 49 (21.5%) men who had sex with men (MSM). The average age of the women was 30 years, and that of both groups of men was 36 years. The microorganisms most frequently identified in women were: C. trachomatis (A-K) in 28.6%, followed by herpes simplex virus type 2 (HSV-2) in 26.8% and N. gonorrhoeae in 17.9%. In heterosexual men they were C. trachomatis (A-K) in 37.5%, N. gonorrhoeae in 21.5% and HSV-2 in 18.7%. In MSM they were C. trachomatis (L1-L3) in 32.7%, followed by N. gonorrhoeae in 27.6%, and C. trachomatis (A-K) and HSV-2, both in 13.8%. Polymicrobial infection was identified in 11 heterosexual men, 8 MSM, and 6 women. Conclusions. C. trachomatis (A-K) was the most prevalent STI-causing microorganism, followed by N. gonorrhoeae in both groups of men, and HSV-2 in women, very similar to that reported worldwide. The multiplex PCR test allows the detection of polymicrobial infections commonly associated with STIs and the diagnosis is accurate and reliable, even in asymptomatic patients

Infecções sexualmente transmissíveis (ist's) e sexualidade: como abordar em consultório - relato de experiência / Sexually transmitted infections (sti) and sexuality: how to approach it in the office - experience report / Infecciones de transmisión sexual (its) y sexualidad: cómo abordar en el consultorio - relato de experiencia

A Ética e a Bioética são princípios básicos que fundamentam o trabalho dos profissionais da saúde, considerados de extrema importância frente à dilemas encarados por essa equipe durante a abordagem da sexualidade e Infecções Sexualmente Transmissíveis (IST's). O evento teve como intuito abordar o direcionamento de uma relação de confiança com o paciente e o profissional de saúde, deixando-o confortável e seguro ao compartilhar informações pessoais e confidenciais. Dado o exposto, este relato tem por objetivo descrever as experiências do presente evento e destacar a importância da ética, bioética e sigilo médico para o exercício da profissão. RELATO: A atividade "IST's e Sexualidade: Como abordar em consultório" foi idealizada durante uma reunião do Eixo de Direitos Sexuais e Reprodutivos, e realizada com a colaboração de 8 (oito) coordenadores. As inscrições foram realizadas através de um formulário Google, amplamente divulgado nas mídias sociais: Instagram e WhatsApp. O evento foi realizado no dia 5 de maio de 2022, de forma presencial na Universidade Paranaense (UNIPAR), Umuarama - PR. Foram conduzidas duas palestras, a primeira por uma médica ginecologista e a segunda por uma psicóloga. DISCUSSÃO: O público foi extremamente receptivo com o evento, demonstrando grande satisfação com a forma de abordagem utilizada pelas palestrantes, além da fala clara e bastante didática a respeito de como se deve abordar esse tema frente ao paciente e qual o comportamento mais adequado para o profissional da saúde. CONCLUSÃO: Os pacientes, muitas vezes, já fragilizados e com receio do estigma buscam o acolhimento e apoio dos profissionais da saúde. O evento proporcionou esse direcionamento e orientação da abordagem das IST's e sexualidade em consultório. Portanto, o assunto faz-se de extrema relevância e destaca a necessidade de capacitação desses profissionais por meio da promoção de demais atividades que compreendam a saúde sexual.

Ethics and Bioethics are basic principles that underlie the work of health professionals, considered extremely important in face of the dilemmas faced by this team during the approach to sexuality and Sexually Transmitted Infections (STIs). The event aimed to address the direction of a relationship of trust with the patient and the health professional, making them comfortable and safe when sharing personal and confidential information. Given the above, this report aims to describe the experiences of this event and highlight the importance of ethics, bioethics, and medical confidentiality for the exercise of the profession. REPORT: The activity "STIs and Sexuality: How to approach it in the doctor's office" was conceived during a meeting of the Sexual and Reproductive Rights Axis, and carried out with the collaboration of 8 (eight) coordinators. The registrations were made through a Google form, widely publicized on social media: Instagram and WhatsApp. The event was held on May 5, 2022, in person at the Universidade Paranaense (UNIPAR), Umuarama - PR. Two lectures were conducted, the first by a gynecologist and the second by a psychologist. DISCUSSION: The audience was extremely receptive to the event, showing great satisfaction with the approach used by the lecturers, besides the clear and very didactic speech on how this theme should be approached in front of the patient and what is the most appropriate behavior for the health professional. CONCLUSION: Patients, many times already weakened and afraid of the stigma, seek the welcoming and support from health professionals. The event provided this direction and orientation on how to approach STIs and sexuality in the doctor's office. Therefore, the subject is extremely relevant and highlights the need for training of these professionals through the promotion of other activities that understand sexual health.

Ética y Bioética son principios básicos que fundamentan el trabajo de los profesionales de salud, considerados de extrema importancia frente a los dilemas enfrentados por este equipo durante el abordaje de la sexualidad y de las Infecciones de Transmisión Sexual (ITS). El evento tuvo como objetivo abordar la dirección de una relación de confianza con el paciente y el profesional de la salud, haciéndolo sentir cómodo y seguro al compartir información personal y confidencial. Teniendo en cuenta lo anterior, este informe tiene como objetivo describir las experiencias de este evento y resaltar la importancia de la ética, la bioética y la confidencialidad médica para el ejercicio de la profesión. INFORME: La actividad "ITS y Sexualidad: Cómo abordarla en el consultorio médico" fue idealizada durante una reunión del Eje de Derechos Sexuales y Reproductivos, y realizada con la colaboración de 8 (ocho) coordinadores. Las inscripciones se realizaron a través de un formulario de Google, ampliamente difundido en las redes sociales: Instagram y WhatsApp. El evento se realizó el 5 de mayo de 2022, de forma presencial en la Universidad Paranaense (UNIPAR), Umuarama - PR. Se realizaron dos conferencias, la primera por un ginecólogo y la segunda por un psicólogo. DISCUSIÓN: El público fue extremamente receptivo al evento, mostrando gran satisfacción con el abordaje utilizado por los conferencistas, además del discurso claro y muy didáctico sobre cómo este tema debe ser abordado delante del paciente y cuál es el comportamiento más adecuado para el profesional de salud. CONCLUSIÓN: Los pacientes, muchas veces ya debilitados y con miedo al estigma, buscan la acogida y el apoyo de los profesionales de salud. El evento proporcionó esta orientación y guía sobre el abordaje de las ITS y la sexualidad en el consultorio médico. Por lo tanto, el tema es extremadamente relevante y pone de relieve la necesidad de formación de estos profesionales a través de la promoción de otras actividades que entienden la salud sexual.

Colombian adolescents fail in knowledge regarding HIV and other sexually transmitted infections / Adolescentes colombianos fracasan en conocimientos sobre VIH y otras infecciones de transmisión sexual

Abstract Introduction/objective: Sexually transmitted infections (STIs) -HIV included- are a major problem in Latin America, mainly in Colombia. In 2021, 17647 cases were reported, which compared to the previous year showed an increase of 29.7%. The main aim of this study was to assess the knowledge regarding HIV and other STIs among the adolescent population in Colombia. Method: A total of 2012 Colombian adolescents between 12-19 years of age participated in this study. The HIV and Other Sexually Transmitted Infections Knowledge Scale (KSI), a self-report measure, was administered. Results: The results showed moderate to low general knowledge (M = 9.90, SD = 4.64) regarding HIV and other STIs. Adolescents did not know if a tongue-kiss led to an HIV infection (75%), or whether both the vaginal ring and the IUD were effective methods for preventing HIV/AIDS (82%). Results showed better scores in knowledge regarding HIV transmission (84%), HIV testing (66%), and condom use to prevent HIV infection (71%). Conclusions: Significant differences were observed in HIV/STIs knowledge between both sexes, but the effect magnitudes were small. Thus, these differences were neglected. This study contributes to understanding the state of knowledge and strengthening prevention strategies of professionals linked to the field of quality of life, education, and sexual healthcare in Colombia.

Resumen Introducción/objetivo: Las infecciones de transmisión sexual (ITS) y el VIH son un gran desafío en América Latina, principalmente en Colombia. Para el 2021 se reportaron 17 647 casos, que comparados con el 2019 muestran un incremento del 29.7 %. El objetivo principal de este artículo fue evaluar el conocimiento sobre el VIH y otras ITS en la población adolescente de Colombia. Método: En este estudio participaron un total de 2012 adolescentes colombianos con edades entre los 12 y los 19 años. Se administró la Escala de Conocimientos sobre el VIH y otras infecciones de transmisión sexual (KSI) y una medida de autoinforme. Resultados: Los resultados mostraron un conocimiento general de moderado a bajo (M = 9.90, SD = 4.64) sobre el VIH y otras ITS. Las adolescentes no sabían si un beso con lengua conducía a una infección por el VIH (75 %) o si tanto el anillo vaginal como el DIU eran métodos efectivos para prevenir el VIH/SIDA (82 %). Los resultados mostraron mejores puntuaciones en conocimientos sobre la transmisión del VIH (84 %), pruebas de detección del VIH (66 %) y uso de preservativos para prevenir la infección por el VIH (71 %). Conclusiones: Se observaron diferencias significativas en el conocimiento del VIH/ ITS entre ambos sexos, pero los tamaños del efecto fueron pequeños. Por tanto, estas diferencias fueron despreciadas. Este estudio contribuye a comprender el estado del conocimiento y a fortalecer las estrategias de prevención que realizan los profesionales vinculados al campo de la calidad de vida, la educación y la salud sexual en Colombia.

Acceptability of self-sampling for etiological diagnosis of mucosal sexually transmitted infections (STIs) among transgender women in a longitudinal cohort study in São Paulo, Brazil

ABSTRACT This study conducted among transgender women in São Paulo, Brazil assessed the acceptability and suitability of screening sexually transmitted infections (STIs), such as Chlamydia trachomatis and Neisseria gonorrhoeae, by sampling multiple anatomical sites (i.e. urethral, anorectal, oropharyngeal, and neovaginal), and utilizing self- or provider-collection methods. First, a convenience sample of 23 cohort participants were recruited during a scheduled study visit between October and November 2018. Data collection was through a short investigator-led quantitative survey in Portuguese, and included presentation of investigator-designed, gender-neutral instructional diagrams to guide self-sampling. Three supplemental focus group discussions (FGDs) with a total of 30 participants guided by semi-structured script were conducted in Portuguese between September and October 2019. All participants reported being assigned male sex at birth and self-identified with a feminine gender identity at time of study. All survey respondents (100%; n = 23) indicated willingness to provide samples for STI screening during a future study visit. Preference was for self-collection of urine samples (83%; n = 19), urethral swabs (82%; n = 18), and anorectal swabs (77%; n = 17). A lower preference for self-collection of oropharyngeal swabs (48%; n = 11) was observed. Most respondents (78%; n = 18) indicated that they would not prefer specimens to be collected by a health professional, mainly due to 'more privacy' (72%; n = 13). All respondents indicated that they would feel comfortable to provide a self-collected sample based on instructional diagrams shown. In FGDs, although the collection by a health professional was described as a technically safer option for some participants, there was a preference for self-collection to avoid discomfort and embarrassment in exposing the body. Overall, this sub-study suggested acceptability among transgender women of introducing self-sampling for etiological diagnosis of STIs from potential infection sites. Uptake and usability will be explored further in a cross-sectional STI prevalence study of transgender women in Brazil.

Conducta sexual y percepción del riesgo de ITS en estudiantes universitarios con enfoque de género / Sexual behavior and STI risk perception in university students with a gender perspective

Las recientes iniciativas nacionales y mundiales han llamado la atención sobre la importancia de la salud sexual para el bienestar de las personas. Estas iniciativas promueven la mejora de los esfuerzos para abordar este tema no representado en los planes de estudio de las profesiones de la salud. El presente trabajo tiene como objetivo estudiar la conducta sexual y percepción del riesgo de ITS en estudiantes universitarios de la ESPOCH, considerando el enfoque de género. Se realizó un estudio descriptivo, de corte transversal y con enfoque de género en 119 estudiantes universitarios. Primera experiencia sexual protegida, tenencia de varias parejas y necesidad de información sobre sexualidad fueron estadísticamente significativas en relación al género de los estudiantes encuestados (p <0,05). El control eficaz de las ITS requerirá respuestas de salud pública multimodales dedicadas que incluyan la promoción de la salud y la prevención. Los resultados de esta investigación pueden ser útiles para orientar el rediseño de los programas de salud sexual en los estudiantes universitarios(AU)

Recent national and global initiatives have drawn attention to the importance of sexual health for people's well-being. These initiatives promote the improvement of efforts to address this issue not represented in the curricula of the health professions. The present work aims to study sexual behavior and STIs risk perception in ESPOCH university students, considering the gender approach. A descriptive, cross-sectional study with a gender focus was carried out in 119 university students. First protected sexual experience, having several partners and the need for information on sexuality were statistically significant in relation to the gender of the students surveyed (p <0.05). Effective control of STIs will require dedicated multimodal public health responses that include health promotion and prevention. The results of this research may be useful to guide the redesign of sexual health programs in college students(AU)

Sistema de gestión TO-BE: garantizar el derecho a la salud de pacientes con ITS en Perú / TO-BE management system: guaranteeing the right to health of patients with STIs in Peru

Se realizó una investigación de campo para conocer la gestión de los procesos de solicitud y admisión de citas médicas, considerando la estigmatización y discriminación de las personas ITS, con el fin de garantizar el derecho a la salud de estos pacientes en Perú. Se ejecutó la sistematización de la información sobre los procesos y mecanismos de exigibilidad, bajo los lineamientos y manuales de los cuatro procesos estratégicos del MINSA contemplados para el otorgamiento de citas médicas, siguiendo los lineamientos de Gob.Pe, Adicionalmente, mediante verificación de los procesos se construyeron la matriz entidad-relación de la gestión por procesos del SSP, y el flujograma del proceso de solicitud y otorgamiento de citas AS-ISS. Se consideraron aspectos tecnológicos-médicos-legales con la participación de 201 pacientes independientemente del motivo o patología a consultar, identificando incidentes en la eficiencia del proceso misional. Por último, se implementó el flujograma de procesos de reserva de citas médicas a través de la aplicación ejecutable para smartphones, tabletas y otros dispositivos móviles (APP) TO-BE la cual conlleva a 10 pasos desde el registro de usuario hasta la emisión de comprobante de otorgamiento de cita médica. Se analizaron las preferencias de los usuarios sobre las causas superables en el proceso misional, mediante una encuesta estructura a 170 usuarios de SSP(AU)

A field investigation was carried out to learn about the management of the processes of request and admission of medical appointments, considering the stigmatization and discrimination of STI people, in order to guarantee the right to health of these patients in Peru. The systematization of the information on the processes and mechanisms of enforceability was carried out, under the guidelines and manuals of the four strategic processes of the MINSA contemplated for the granting of medical appointments, following the guidelines of Gov. Pe, Additionally, through verification of the processes The entity-relationship matrix of the management by processes of the SSP, and the flowchart of the process of request and granting of appointments AS-ISS were constructed. Technological-medical-legal aspects were considered with the participation of 201 patients regardless of the reason or pathology to be consulted, identifying incidents in the efficiency of the missionary process. Finally, the flowchart of medical appointment reservation processes was implemented through the executable application for smartphones, tablets and other mobile devices (APP) TO-BE, which entails 10 steps from user registration to issuance of voucher of granting a medical appointment. Users' preferences regarding causes that can be overcome in the missionary process were analyzed through a structured survey of 170 SSP users(AU)

Sexually transmitted infections among women living with HIV in a Brazilian city

ABSTRACT Background: Clinical improvements following highly active antiretroviral therapy (HAART) may increase high-risk behaviors resulting in sexually transmitted infections (STI). Optimism related to the success of HAART in slowing disease progression, reducing viral load, and improving health status might be important factors for increasing sexual risk behaviors such as less use of condoms. Objective: To determine the prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, syphilis, hepatitis B and C, high-risk HPV, and cervical cytological abnormalities among women living with HIV (WLHIV) who attended a Reference Center for STI/AIDS in Brazil. Methods: A cross-sectional study was conducted among 151 WLHIV attending an STI Clinic in Vitória city, Brazil. A structured questionnaire, including demographic, behavioral, and clinical information, was used for data collection. Serological tests for HIV, syphilis, hepatitis C and B, CD4 counts, and viral load determination were performed. Cervical samples were collected for cytology and real-time PCR for HPV, Chlamydia, and Neisseria gonorrhoeae. Results: In this study, 59% of women had at least one diagnosed STI at the time of the first clinic visit; 31% had clinical forms of anogenital HPV, 10% syphilis, 8%Neisseria gonorrhoeae, 5.0% trichomoniasis, 3% Chlamydia trachomatis, 1% hepatitis B, and 1% hepatitis C; 6.7% of the women presented with cervical cytological abnormalities. Furthermore, 46.3% of women had HR-HPV, and 17.6% had HPV 16/18. Only 5% of the women had a CD4 count <200 cells/mm3, 61.6% had undetectable HIV viral load, and 81.3% were currently on HAART. Conclusion: A high prevalence of STI and HR-HPV infections were observed among HIV-infected women in this investigation. Prevention programs need to focus on counseling WLHIV and their regular partners with focused interventions such as couples counseling and education programs.

Nivel de conocimiento de Sífilis en adolescentes de dos Instituciones Educativas del distrito de Buenaventura / Level of knowledge of Syphilis in adolescents of two Educational Institutions of the Buenaventura district

Objetivo: Establecer el nivel de conocimiento de sífilis en adolescentes de dos Instituciones Educativas del distrito de Buenaventura de grados: noveno, décimo y once. Material y métodos: Estudio descriptivo de corte transversal en jóvenes entre 12 y 18 años; muestra a conveniencia de 420 estudiantes. Se aplicó una encuesta anónima dividida en 5 secciones. Se determinaron características sociodemográficas, hábitos, vida sexual y conocimiento sobre ITS. Resultados: 91% manifestó conocer sobre las ITS; 22,4% expresó conocer los signos y síntomas. 3,1& presentó diagnóstico de ITS; no reportaron casos de sífilis; 51,9% manifestó conocer la sífilis; el 10% expresó conocer signos y síntomas. 16% manifestó conocer mecanismo de prevención. 4% de los estudiantes tiene un buen nivel de conocimiento sobre sífilis. Sobre actividad sexual, 58,7% había iniciado vida sexual, 28% tuvo su primer encuentro a los 11 años o menos, siendo mayormente de género masculino. 33,8% habían tenido 1 pareja sexual, seguido de 23,8% con 6 o más parejas sexuales. El análisis de conocimiento sobre sífilis según institución educativa evidenció que el 8,9% y el 3% de los estudiantes tenía un nivel bueno de conocimiento, en la institución rural y urbana respectivamente. Al evaluar el conocimiento sobre ETS, se encontró que el 85% y 96% de estudiantes en zona rural y urbana respectivamente afirman tener conocimiento; sobre la sintomatología, 21% y 23 % es conocedor de esta, en área rural y urbana respectivamente. Conclusiones: Un alto porcentaje de estudiantes encuestados tienen un bajo nivel de conocimiento sobre sífilis; las mayores falencias se presentan en manifestaciones clínicas, la prevención y la cura de dicha enfermedad; aunque los adolescentes tienen múltiples fuentes de conocimiento, dicha información es deficiente, especialmente la transmitida por los padres y la pareja.

Objective: To establish the level of knowledge about syphilis in adolescents of two Educational Institutions in the district of Buenaventura of the ninth, tenth and eleventh grades. Material and methods: Descriptive cross-sectional study in young people between 12 and 18 years; convenience sample of 420 students. An anonymous survey divided into five sections was applied. Sociodemographic characteristics, habits, sexual life, and knowledge about STIs were determined. Results: 91% said they know about STIs, and 22.4% said they knowing the signs and symptoms. STI diagnoses were presented in 3.1%; not report syphilis cases. 51.9% said that knew about syphilis, 10% said they know signs and symptoms. 16% said they knew about mechanism prevention. 4% of students have a good level of knowledge about syphilis. About sexual activity 58.7% had started sexual life, 28% had their first encounter at age 11 or less, they were principally male. 33.8% had one sexual partner, followed by 23.8% with six or more sexual partners. Institutional Analysis showed that 8.9% (rural) and 3% (urban) of the students, were at a good level of knowledge. When evaluating knowledge about STDs, it was found that 85% (urban) and 96% (rural) students say they know, however, when inquiring about the symptoms, in rural and urban areas, 21 % and 23% respectively are aware of it. Conclusions: The highest percentage of students surveyed has a bad level of knowledge about syphilis, where the highest % was in clinical manifestations, the prevention, and cure of said disease; although adolescents have multiple sources of knowledge, this information is deficient, especially that shared by the parents and the couple.

Gynaecological bacterial infections: the physical and psychosocial consequences and challenges of management in resource-limited settings

Gynecological bacterial infections (GBIs) are prevalent in our environment and as a result pose a number of physical, social and psychological consequences. These infections are acquired through several ways. Treating GBIs is a daunting task making its control the most important strategy to alleviating its physical and psychosocial consequences. To highlight the physical, social, and psychological consequences of gynaecological bacterial infections in our resource limited setting. To highlight the hugely unresolved challenges associated with the management of gynecological bacterial infections in our resource-limited setting. Several databases (Medline, Google Scholar, Pubmed, WHO’s Hinari and Wikipedia) and some selected websites were searched using the following keywords: gynecological infections, vaginal infections and discharges, vaginal flora, sexually transmitted infections, pelvic inflammatory disease, syndromic management and challenges, psychosocial consequences, alternative medicine. A total of 5470 relevant articles were obtained between 1947 and 2018. Out of these only 256 relevant articles on the topic were reviewed. However, 213 were dropped for having an incomplete submission. Forty-three (43) articles were fully accessed and referenced. The high prevalence of GBIs poses a lot of burden on the reproductive and socio-economic lives of our women. This should be matched by behavioral changes, prompt diagnosis and early treatment; facilitated by accessible and affordable health care through improved government funding.

Prevalence of Sexually Transmitted Infections and its Associated factors among women living with HIV/AIDS

Background: Sexually transmitted infections (STIs) are significant public health problem in India. Studies have shown a considerably higher prevalence of STIs among females as well as in high-risk groups. Thus, we conducted this study to estimate the prevalence of STIs and to find out its associated factors among women living with HIV/AIDS. Material & Methods: A cross-sectional study was conducted at the ART centre, Aligarh. A total of 170 HIV positive women were approached with study tools comprising of pre-structured proforma. NACO STIs Syndromes were used to estimate STIs. Data was analyzed using the SPSS version 20.0, keeping significance at p<0.05. Results: We found the self-reported prevalence of STIs in HIV positive women to be 18.2% (31/170) at the time of interview and 49.4% (84/170) ever since the diagnosis of HIV. Most of the HIV women were presently having vaginal/cervical or urethral discharge syndrome (93.5%) and genital ulcer syndrome (16.1%). STIs were significantly associated with uneducated females and with irregular use of condoms. Conclusion: This study found the prevalence of STIs to be still higher among HIV positive women, in spite of years of targeted interventions reducing it. A proper action and further researches are required to explore and manage variables associating STIs for reducing its prevalence

Development of an evidence-based model of rapid testing, counseling and referral patients with HIV, HVC and other STDs in Mexican addiction treatment centers / Desarrollo de un modelo basado en evidencia de pruebas rápidas, orientación y derivación de pacientes con VIH, VHC y otras ITS en centros mexicanos de tratamiento de adicciones

Abstract Introduction Efforts to identify new cases of HIV, HVC and other STIs, through the application of quick tests, focus on people who inject drugs, without taking into account the fact that the use of alcohol and other drugs of abuse inhibits decision making, increasing the transmission of STIs through risky sexual practices. Accordingly, it is necessary to have detection algorithms that consider people who use multiple drugs to improve the identification of new cases and their subsequent linkage with health services. Objective This paper describes the development process of the OPB-APR model for the detection, counseling and referral of people with HIV and other STIs at addiction treatment centers. Method The procedure is divided into three phases: 1. A literature review to identify the basic concepts of HIV and other STIs, substance use, risky sexual behaviors, quick tests, and specialized psychological counseling; 2. A feasibility study in which a health professional is trained to implement the OPB-APR model; 3. Drafting of the final version. Results The final version of the OPB-APR model was obtained, which describes standardized procedures for detection, counseling and referral to health services. Discussion and conclusions The OPB-APR model aims to strengthen the public health system by increasing the coverage of services for the detection of HIV, HCV and other STIs. The above through the implementation of standardized procedures among specialized and non-specialized health professionals of addiction care centers.

Resumen Introducción Los esfuerzos para la identificación de nuevos casos de VIH, VHC y otras ITS, mediante la aplicación de pruebas rápidas, se centra en personas que se inyectan drogas, sin considerar que el consumo de alcohol y otras drogas de abuso inhiben la toma de decisiones incrementando el riesgo de contagio de ITS durante prácticas sexuales de riesgo. Por este motivo, es necesario contar con algoritmos de detección que consideren a personas con múltiples consumos para incrementar la identificación de nuevos casos y su posterior vinculación a servicios de salud. Objetivo Describir el proceso de desarrollo del modelo OPB-APR para la detección, orientación y referencia de personas con VIH y otras ITS en centros de tratamiento de adicciones. Método El procedimiento se dividió en tres fases: 1. Revisión de literatura para identificar conceptos básicos sobre el VIH y otras ITS, consumo de sustancias, conductas sexuales de riesgo, pruebas rápidas, y orientación psicológica especializada; 2. Estudio de factibilidad en el que se entrenó a profesionales de la saludpara implementar el modelo OPB-APR; 3. Integración de la versión final. Resultados Se obtuvo la versión final del modelo OPB-APR el cual describe procedimientos estandarizados para la detección, orientación y referencia a servicios de salud. Discusión y conclusión El modelo OPB-APR pretende fortalecer al sistema público de salud al incrementar la cobertura de servicios para la detección del VIH, VHC y otras ITS. Lo anterior mediante la implementación de procedimientos estandarizados entre los profesionales de la salud especializados y no especializados de centros para la atención de adicciones.

Clinicoepidemiological profile of sexually transmitted disease (STD) patients presenting in a tertiary care center

Background: Sexually transmitted infections (STIs) constitute a major health problem in the developing countries and prevalence of STIs varies from region to region in our country. Aim: To study the pattern and prevalence of sexually transmitted infections and HIV seropositivity among patients presenting in a tertiary care center. Materials and methods: A retrospective data was collected in the department of Dermatology at Shri Guru Ram Rai Institute of Medical and Health Sciences (SGRRIHMS), Shri Mahant Indiresh Hospital (SMIH), a tertiary care center in Dehradun, Uttarakhand, India, from January 2011 to December 2018. A total of 525 patients were analyzed in this study. Results: A total of 525 patients were enrolled in our study. STIs were more common in men, with male (365): female (160) ratio of 2.2:1. Maximum numbers of patients were in the age group of 25 to 34 years. Unskilled workers (22.28%) and housewives (20.00%) constituted major proportion. Majority of the cases presented with warts (38.09%) followed by molluscum contagiosum (20.95%) and herpes genitalis (19.61%). But herpes genitalis (27.39%) was found to be the most common STD seen among males and warts (68.75%) among the females. HIV seropositivity was seen among 20 (3.80%) patients and was most commonly associated with herpes genitalis infection (60.00%). Gunjan Gupta, Jitendra Singh Bist, Rahul Sudan, Kewal Krishan, Neeti Kumari. Clinicoepidemiological profile of sexually transmitted disease (STD) patients presenting in a tertiary care center. IAIM, 2019; 6(2): 7-12. Page 8 Conclusion: Increased prevalence of viral STDs like herpes genitalis, genital warts and mollascum contagiosum was seen in our study. Widespread use of antibacterial lead to falling trend of bacterial STDs.

Association of Socioeconomic Status on STI/STD Awareness Among OPD patients attending a Tertiary Care Hospital

Background: Sexually transmitted infections (STI) are a major public health, social, and economic problem leading to morbidity, mortality and stigma. This study was conducted to determine the relationship between the STIs and demographic factors. In Indian society, discussing STDs is considered taboo; where ethics and social factors give rise to many obstacles. This study is designed to explore the conception and knowledge about protection against STDs within the patient community. In the present study we aim to study the association of various socioeconomic variables; and the knowledge and awareness level of STI/STDs. Methods: The convenience sample was taken from the adult patients attending and consenting to participate in the study during April- June 2018, using a semi-structured Performa. Collected data was analysed using SPSS soft ware. Results: Age, Education, and income were associated with the awareness about the STI/STD awareness. Conclusions: Socio-economic factors have an association with STI/STD awareness, and hence carry public health importance.

A study on knowledge and protective practices of STIs among patients attending tertiary care center at Bikaner, Rajasthan

The increased risk of the transmission of HIV is known to be associated with the presence of STIs and despite the presence of the National STI Control Program in India the number of people with STIs remains high. More than 1 million people acquire a STI every day. The true prevalence of STIs can never be known because of inadequate reporting due to secrecy and stigma associated with them and most of them are not even notifiable. Objectives: (1) To study socio-demographic factors of patient's attending STI clinic (2) To assess knowledge of patients about STI/HIV. (3) To assess protective practices of patients towards STIs. Material and Methods: This cross sectional was conducted in STI clinic, PBM hospital, Bikaner from Dec 2014- Jan 2016 using pre-tested and pre-structured questionnaire. The study variables were analyzed using Epi-Info7 software with application of Mean, Proportion and OR, Chi-square. Results: Out of 97 patients 83.5% knew about STIs. 79.4% reported having knowledge about symptoms of STIs and most common symptom reported was itching over genitals and discharge (85.5%). Statistically significant difference was present between male and female patient's knowledge about premarital sex as a factor for acquisition of STIs. 79.3% were using condoms to protect from STIs. The difference was statistically significant between knowledge and practice regarding condom use (χ2 = 6.544, df=1, p=0.01). Statistically significant difference was present between male and female patients practice regarding regular visit to STI clinic. Conclusion: Knowledge of patients regarding protective practices is not matching with their protective behavior.

"La solución es la tijera": Programa de Salud Sexual para Mujeres Lesbianas y Bisexuales / "La solución es la tijera": Programa de Saúde Sexual Orientado a Mulheres Lésbicas e Bissexuais / "La Solución es la Tijera" (The Solution is Scissors): Sexual Health Programme Oriented to Lesbian and Bisexual Women

RESUMEN La inclusión de las mujeres lesbianas y bisexuales en las agendas de promoción de la salud sexual es escasa. Sin embargo, los riesgos en sus prácticas sexuales han sido reconocidos científicamente. Este artículo presenta los resultados principales del programa de intervención "La solución es la tijera" dirigido a mujeres lesbianas y bisexuales jóvenes de Cali, Colombia. Participaron 23 mujeres entre los 18 y los 25 años de edad (X= 21.7; DS=1.78). La evaluación se realizó de manera pre- post a través de una metodología mixta. Se encontró un cambio significativo en los niveles de conocimientos y las actitudes frente al VIH. Asimismo, se reportó el fortalecimiento de la identidad, el empoderamiento en su sexualidad y los conocimientos sobre derechos sexuales y reproductivos.

RESUMO A inclusão das mulheres lésbicas e bissexuais na agenda de promoção de saúde é escassa. No entanto, os riscos existentes em suas práticas sexuais foram cientificamente reconhecidos. Este artigo pretende apresentar os principais resultados do programa "La Solución es la Tijera" orientado para mulheres lésbicas e bissexuais de Cali, na Colômbia. Vinte e três mulheres entre 18 e 25 anos de idade (X = 21,7; DS = 1,78) participaram deste estudo. A avaliação do programa foi realizada com um design de pre-post, usando metodologias mistas. Foram encontradas alterações significativas nos níveis de conhecimento e atitudes em relação a HIV. Da mesma forma, relatou-se reforço em sua identidade e empoderamento em sua sexualidade e conhecimento sobre direitos sexuais e reprodutivos.

ABSTRACT The inclusion of lesbian and bisexual women on health promotion agenda is scarce. However, the existing risks in their sexual practices have been scientifically recognized. This article presents the main results of the program "La Solución es la Tijera" oriented to lesbian and bisexual women from Cali, Colombia. Twenty-three women between 18 and 25 years old ((X= 21.7; DS=1.78) participated in this study. The program evaluation was conducted with a pre-post design, using mixed methodologies. Significant changes in the knowledge level and attitudes towards HIV were found. Likewise, a strengthening in their identity and an empowerment in their sexuality and knowledge about sexual and reproductive rights was reported by the participants.

Integración de la perspectiva de género en la prevención de las ITS/VIH/sida en atención primaria de salud / Integration of the gender-related perspective in the prevention of STIs/HIV/AIDS in primary healthcare

Introducción: en Cuba se ha trabajado para promover la transversalización del género en la respuesta nacional a las ITS/VIH/sida, pero es un reto incorporar este aspecto a las intervenciones de salud a desarrollar en la comunidad.Objetivo: diseñar un curso sobre integración de la perspectiva de género en las acciones de educación, promoción y prevención de las ITS/VIH/sida dirigido a la capacitación de los profesionales de la salud del nivel primario de atención. Métodos: se realizó una investigación de desarrollo-descriptiva que culminó con el diseño de un curso para la capacitación de los profesionales de la salud del nivel primario de atención en La Habana en el periodo comprendido entre abril y diciembre de 2015. Se emplearon técnicas como revisión bibliográfica y documental. Se tuvieron en cuenta criterios de expertos para la definición de objetivos, contenidos y estructura organizativa del curso. Resultados: el curso posgrado se desarrolló en 6 temas: Generalidades sobre género y VIH, Desigualdad y violencia de género y VIH, Investigaciones de género y Salud Sexual Reproductiva, Género en la prevención del VIH, Género y atención en salud, Legislación vigente vinculada al VIH/sida y género. El curso tuvo un enfoque dinámico, activo, participativo, enfatizando en las diferentes modalidades propias de la educación en el trabajo. Conclusiones: el curso se diseñó para responder a la necesidad imperante de la integración de la perspectiva de género en las acciones de educación, promoción y prevención de las ITS/VIH/sida a desarrollar por los profesionales de salud en su comunidad(AU)

Introduction: In Cuba, work has been done to promote gender transversalization in the national response to STIs/HIV/AIDS, but incorporating this aspect into the health interventions for community development is a challenge. Objective: To design a course on gender transversalization in education, promotion and prevention of STIs/HIV/AIDS aimed at training health professionals at the primary level of care. Methods: A descriptive-development research was carried out that culminated with the design of a course for the training of health professionals at the primary level of care in Havana in the period between April and December 2015. Techniques such as bibliographic and documentary review were used. Experts' criteria were taken into account for the definition of objectives, contents and the organizational structure of the course. Results: The postgraduate course was developed in six subjects: Fundamentals on Gender and HIV, Inequality and Gender Violence and HIV, Gender Research and Reproductive Sexual Health, Gender in HIV Prevention, Gender and Health Care, Current HIV/AIDS and Gender Legislation. The course had a dynamic, active, participatory approach, emphasizing the different modalities of education at work. Conclusions: The course was designed to respond to the prevailing need for the integration of the gender perspective in education, promotion and prevention of STIs/HIV/AIDS to be developed by health professionals in their community(AU)

Impacto de la implementación de la prueba rápida del VIH/ITS en un centro de atención especializada en Brasil / Impact of the Implementation of the Rapid HIV/STI Test in a Specialized Care Center in Brazil / Impacto da implementação de teste rápido do VIH/ITS em um centro de atenção especializada no Brasil

Resumen Objetivo: evaluar el impacto de la implementación de la consejería y prueba rápida del VIH e infecciones de transmisión sexual en un centro especializado de consejería y diagnóstico de VIH (CE). Método: estudio analítico con un grupo de intervención y un grupo control en el cual fueron comparadas las medias mensuales de las pruebas y consejerías realizadas entre un centro especializado que implementó la prueba rápida de VIH para todos los pacientes (CE caso) y otro centro especializado que utiliza la modalidad tradicional de la prueba (diagnóstico en treinta días) (CE control). Resultados: el CE (caso) tuvo un aumento significativo en el número de pruebas realizadas entre los dos periodos. En el CE (caso) hubo una disminución en la proporción de personas de la población general que se hicieron la prueba y un aumento en las personas más vulnerables al VIH. Conclusiones: la implementación de la prueba rápida tuvo un impacto positivo en el número de pruebas realizadas y también en el acceso a las personas en situación de vulnerabilidad.

Abstract Objective: to evaluate the impact of the implementation of counseling and rapid testing of HIV and sexually transmitted infections in a specialized HIV counseling and diagnosis center (CE). Method: analytical study with an intervention group and a control group; a comparison was established between the monthly means of tests and counseling sessions performed in a specialized center that implemented the HIV rapid test for all patients (case CE) and another specialized center which uses the traditional form of the test (diagnosis in thirty days) (control CE). Results: CE (case) had a significant increase in the number of tests performed between the two periods. In the CE (case) there was a decrease in the proportion of people in the general population who were tested and an increase in the people most vulnerable to HIV Conclusions: the implementation of the rapid test had a positive impact on the number of tests carried out and also on the access provided to people in vulnerable situations.

Resumo Objetivo: Avaliar o impacto da implantação do aconselhamento e teste rápido de HIV e doenças sexualmente transmissíveis em um Centro de Testagem e Aconselhamento (CTA). Método: Estudo analítico com um grupo de intervenção e um grupo controle em que foram comparadas as médias mensais de Testagem e Aconselhamento realizada em um CTA (caso) que implementou o teste rápido de HIV para todos os pacientes e outro CTA (controle) que utiliza o teste tradicional de HIV em que o resultado fica disponível em 30 dias. Resultados: O CTA (caso) teve um aumento significativo no número de testes realizados entre os dois períodos. Em CTA (caso), houve uma diminuição na proporção de pessoas que realizaram o teste da população geral e o aumentou da realização dos testes pelas pessoas consideradas mais vulneráveis ao HIV Conclusões: A implantação do teste rápido teve um impacto positivo sobre o número de testes realizados e acesso a pessoas em situação de vulnerabilidade.

Detección molecular de agentes infecciosos de transmisión sexual en un grupo de hombres sintomáticos y su relación con la conducta sexual / Molecular detection of sexually transmitted agents in a symptomatic group of men and its relationship with sexual behavior

Background: Sexually transmitted infections (STIs) affect sexual and reproductive health of millions of men. Pathogens such as human papillomavirus (HPV), herpes simplex virus type 1 and 2 (HSV-1 y HSV-2), Chlamydia trachomatis,Mycoplasmagenitalium,Mycoplasma hominis and Ureaplasma urealyticum are associated with STIs. Aim: To detect pathogens associated with STIs in symptomatic men and its relationship with sexual behavior. Methodology: DNA was obtained from exfoliated cells of penis from 20 symptomatic men. Pathogens were detected using qPCR or PCR followed by reverse line blot. Sexual behavior was evaluated through a survey. Results: Two or more infectious agents were detected in 50% of samples. U. urealyticum was found in 25%, meanwhile C. trachomatis and M. hominis were detected in 15%. VHS-1, VHS-2 andM. genitalium were detected only in 5%. HPV was found in all samples. The most frequent HPV genotypes were VPH 16, 11, 70. There were no statistical link found between sexual behavior and the studied microorganisms Conclusion: Infectious agents associated with STIs were detected in symptomatic men. HPV was the most frequent pathogen and it was detected in multiple genotypes. It is necessary to increase the sample size to associate significantly the sexual behavior with the results.

Introducción: Las infecciones de transmisión sexual (ITS) afectan la salud sexual y reproductiva de millones de hombres. Patógenos como virus papiloma humano (VPH), virus herpes simplex (VHS-1 y VHS-2), Chlamydia trachomatis, Mycoplasma genitalium, Mycoplasma hominis y Ureaplasma urealyticum están asociados a ITS. Objetivo: Detectar patógenos asociados a ITS en hombres sintomáticos y relacionarlos con su conducta sexual. Metodología: Se obtuvo ADN de exfoliado celular del pene de 20 hombres sintomáticos de ITS. Los patógenos fueron detectados por RPC cuantitativa o RPC seguida de reverse line blot. La conducta sexual se evaluó mediante una encuesta. Resultados: En 50% de las muestras se detectaron dos o más agentes infecciosos; U. urealyticum fue detectado en 25% de los casos, mientras que C. trachomatis y M. hominis en 15%. VHS-1, VHS-2 y M. genitalium sólo en 5%. VPH se encontró en todas las muestras y los genotipos más frecuentes fueron VPH 16, 11, 70. No se encontró relación estadística entre los microorganismos estudiados y la conducta sexual de los encuestados. Conclusión: Se detectaron agentes infecciosos asociados a ITS en hombres sintomáticos, siendo VPH el más frecuente y encontrándose en múltiples genotipos. Es necesario aumentar el tamaño de muestra para asociar significativamente la conducta sexual a los resultados.

Perception of sex workers of Lucknow City, Uttar Pradesh, India towards sexually transmitted infections.

The prevention, control, and management of sexually transmitted infections/reproductive tract infection (STI/RTI) are well-recognized cost-effective strategies for controlling the spread of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). A cross-sectional descriptive study was done over a period of 1 year to assess the prevalence of STI, knowledge level about STI, and the STI-HIV link among the female sex workers (FSWs) of Lucknow city, Uttar Pradesh, India along with their biosocial characteristics. Most of the FSWs were illiterate, married, Hindus, and belonged to general category. The prevalence rates of STI among street-based and home-based FSWs were 50.6% and 29.8%, respectively. Knowledge about the role of condom in prevention of STI and the STI-HIV link was significantly less among home-based FSWs than those who are street-based. There is a great lack in the awareness among FSWs regarding STI and their prevention. Behavior change communication (BCC) and advocacy strategy were developed, especially for the home-based group, to strengthen their knowledge regarding the STI-HIV link.

Asymptomatic reproductive tract infections/sexually transmitted infections among HIV positive women.

This study aims to highlight the importance of screening all HIV positive women for various reproductive tract infections/sexually transmitted infections (RTIs/STIs) irrespective of symptoms and to determine its occurrence in asymptomatic HIV positive women. Relevant specimens were collected for diagnosis of various RTIs/STIs. STIs were diagnosed in nearly one‑third of the HIV positive asymptomatic patients which is quite high. The national strategy for STIs/RTIs control misses out large number of asymptomatic RTIs/STIs in HIV positive women which is responsible for silently transmitting these infections in the community. So this strategy should be modified to include screening of all HIV positives women irrespective of symptoms of STIs/RTIs.