Sifílide opalina como única manifestación de la sífilis secundaria / Opaline syphilid as the only manifestation of secondary syphilis i: en

Se describe el caso clínico de un paciente de 62 años de edad, quien fue atendido en la consulta de dermatología del Policlínico Aquiles Espinosa Salgado de Las Tunas, por presentar una lesión blanca, de aspecto perlado, de 0,5 cm, en la punta de la lengua. Teniendo en cuenta las características de dicha lesión, se estableció el diagnóstico de sospecha de sífilis secundaria. Se le indicó la prueba serológica para la detección de sífilis, cuyo resultado fue de 128 diluciones, por lo que se confirmó que se trataba de una sifílide opalina, como manifestación de la sífilis en estadio secundario. Se efectuó el control de foco y la fuente de contagio estaba aún sin precisar. Con el tratamiento indicado evolucionó favorablemente, pero se mantuvo el seguimiento clínico y serológico según lo establecido.

The case report of a 62 years patient who was assisted in the Dermatology Service of Aquiles Espinosa Salgado Polyclinic in Las Tunas is described, who presented a 0.5 cm white lesion, of pearly aspect, in the tip of the tongue. Taking into account the characteristics of this lesion the suspected diagnosis of secondary syphilis was established. The venereal disease research laboratory test was ordered and its result was 128 dilutions, reason why an opaline syphilid was confirmed, as a manifestation of syphilis in secondary stage. The focus control was carried out and the source of infection was still without specifying. With the suitable treatment, he had a favorable clinical course, but clinical and serologic follow up was maintained as established.

Epidemiological characteristics of sexually transmitted diseases in Dehong Prefecture， Yunnan Province from 2010 to 2022 / 上海预防医学

ObjectiveTo understand the epidemiological characteristics and trends of sexually transmitted diseases （STDs） in Dehong Prefecture， Yunnan Province from 2010 to 2022， so as to provide a basis for the prevention and control of STDs in Dehong Prefecture. MethodsThe 2010‒2022 epidemic cards of STD cases in Dehong Prefecture were downloaded from the China Disease Control and Prevention Information System， and descriptive analysis of the incidence rate and demographic characteristics by disease type was conducted. The syphilis screening data of various populations in Dehong Prefecture between 2014 and 2022 were obtained from the National STD Control and Management Information System， and the syphilis positivity rates of key populations were calculated. ResultsA total of 18 225 STD cases were reported in Dehong Prefecture from 2010 to 2022， and the reported incidence rate increased from 17.1/105 in 2010 to 172.0/105 in 2022， showing an increasing trend （χ2trend=42.9， P<0.001）. The number of reported cases of gonorrhea， syphilis， condyloma acuminatum， genital chlamydia infection， and genital herpes were 7 801 （42.8%）， 4 563 （25.0%）， 3 462 （18.8%）， 1 660 （9.1%）， and 775 （4.3%）， respectively. The majority of the reported STD cases were males （12 336 cases， 67.7%）， young adults aged 15 to <45 years （15 839 cases， 87.2%）， and farmers （9 230 cases， 50.7%）. The elderly group aged 65 years and over accounted for 10.5% of syphilis cases. Among different types of key populations， the highest syphilis positivity rate was found among men who have sex with men （10.1%）， followed by STD clinic attendees （8.1%）， and the syphilis positivity rates among clandestine prostitutes， voluntary counseling and testing population， drug addicts， and drug rehabilitation center/re-education through labor center population were 2.2%， 1.6%， 1.4%， and 1.3%， respectively. ConclusionFrom 2010 to 2022， the STD epidemic in Dehong Prefecture showed a rapidly increasing trend， with a higher incidence of gonorrhea and syphilis， and a higher syphilis positivity rate among men who have sex with men， drug addicts， clandestine prostitutes， and STD clinic patients. In the future， publicity， education and behavioral interventions for these groups should be strengthened to reduce the prevalence and transmission of STDs.

Human papillomavirus prevalence and frequency of sexually transmitted diseases in encarcered women by self-sampling approach

SUMMARY OBJECTIVE: This study aimed to assess the sociodemographic and clinical profile of women deprived of their liberty and to identify the prevalence of sexually transmitted diseases and human papillomavirus through self-sampling samples. METHODS: This is an epidemiological, cross-sectional, observational, and descriptive study of the prevalence and correlation of the diagnosis of human papillomavirus infection in 268 encarcered women in Amazonas submitted to self-sampling from June 2019 to September 2020 using the genotyping analysis. Patients with positive and inconclusive results were evaluated by commercialized PCR to detect pathogens causing sexually transmitted diseases. The sample size used was based on a convenience sample. RESULTS: In 268 women, human papillomavirus DNA was detected in 87 (32.5%) of them. Sexually transmitted diseases were detected in 30 (34.48%) of the 87 women with a positive or inconclusive result for human papillomavirus. Women with more than three pregnancies had a higher risk of human papillomavirus detection (p=0.004). CONCLUSION: The prevalence of human papillomavirus and other sexually transmitted diseases in encarcered women in Amazonas is 32.5 and 34.48%, respectively. Most women were single (60.4%) and reported having had more than 15 partners (90.8%).

Distribución de virus de papiloma humano de alto riesgo oncogénico y otras infecciones de transmisión sexual en mujeres paraguayas con y sin virus de la inmunodeficiencia humana

El virus de papiloma humano de alto riesgo oncogénico (VPH-AR) es causa necesaria pero no suficiente para la ocurrencia de cáncer de cuello uterino (CCU). Mujeres portadoras del virus de inmunodeficiencia humana (VIH) presentan mayor riesgo de desarrollar lesiones precursoras del cáncer de cuello de útero, por ello, el objetivo del presente trabajo prospectivo de corte transversal fue determinar la frecuencia de VPH-AR y otras infecciones de transmisión sexual-ITS (condilomas, sífilis, virus del herpes simple, gonorrea, citomegalovirus, hepatitis B) en 218 mujeres con y sin VIH que acudieron al Programa Nacional de Lucha contra el SIDA (PRONASIDA) desde julio 2017 hasta marzo 2021. Se encontró que 16/54 (29,6%) mujeres VIH-positivas presentaron infección por VPH-AR en comparación a 41/164 (25%) mujeres VIH-negativas (p>0,05). En relación a la edad, mujeres VIH positivas presentaron una frecuencia comparable de infección por VPH-AR (30 años 30,2%), a diferencia de mujeres VIH negativas donde hubo una disminución significativa de la infección por VPH-AR luego de los 30 años (30 años 18,8%, p= 0,028). Esto podría explicarse por la inmunosupresión observada en mujeres VIH positivas que podría favorecer infecciones persistentes, sugiriendo que deben ser controladas más cercanamente. Además, se observó mayor frecuencia de otras ITS en mujeres VIH positivas (29,6% vs 15,8%, p=0,026), lo cual sugiere que aparte del monitoreo más cercano, es fundamental fortalecer la educación sobre factores de riesgo para la ITS sobre todo VPH y VIH, así como la realización de prevención primaria por vacunación contra el VPH.

High-risk human papillomavirus (HPV-HR) is a necessary but not sufficient cause for cervical cancer (CC). Women carriers of human immunodeficiency virus (HIV) present an increased risk for the development of cervical cancer precursor lesions, therefore, the objective of the present prospective cross-sectional study was to determine the frequency of HPV-HR and other sexually transmitted infections-STIs (condylomas, syphilis, herpes simplex virus, gonorrhoea, cytomegalovirus, hepatitis B) in 218 women with and without HIV who attended the Ministry of Health from July 2017 to March 2021. It was found that 16/54 (29.6%) HIV-positive women had HPV infection compared to 41/164 (25%) HIV-negative women (p>0.05). In relation to age, HIV-positive women had a comparable frequency of HPV infection (30 years 30.2%), unlike HIV-negative women whom above 30 years of age presented a significant decrease in HPV-AR infection (30 years 18.8%, p:0.028). This could be explained by the immunosuppression observed in HIV-positive women which could favour persistent infections, suggesting that they should be controlled more closely. In addition, other STIs were observed to be more frequent in HIV-positive women (29.6% vs 15.8%, p:0.026), which suggests that apart from closer monitoring, it is essential to strengthen education on risk factors for STIs, especially HPV and HIV, as well as the implementation of primary prevention by vaccination against HPV.

Experiencia en cirugía de condilomas anales en mayores de 15 años / Experience in anal condyloma surgery in patients older than 15 years

Resumen Objetivo: Describir la experiencia en cirugía electiva de condilomas anales en pacientes mayores de 15 años en un hospital terciario de la Región Metropolitana. Material y Método: Estudio observacional retrospectivo y descriptivo, en el cual se analizan las intervenciones quirúrgicas electivas realizadas entre 2008 a 2021. Resultados: Dentro del período analizado se obtuvo 165 cirugías de condilomas anales, lo que corresponde a 137 pacientes en total. El 85% de los pacientes son de sexo masculino, el 68% de los pacientes son VIH positivo, un 87% de los pacientes MSM (hombres que tienen sexo con otros hombres) son VIH positivo, el 34% de los pacientes tiene antecedente de ETS, el 46% de los pacientes recibió terapia tópica como tratamiento preoperatorio o posoperatorio. Un 25% de los pacientes presenta recidiva en su historia personal, un 21% de los pacientes presenta lesiones anales intraepiteliales de alto grado, un 6% presenta carcinoma escamoso infiltrante. No hubo mortalidad descrita. Discusión: El presente estudio, describe la experiencia en cirugía de condilomas de un hospital terciario de la Región Metropolitana de Chile, cuya población corresponde a un estrato socioeconómico medio y bajo. Se logra describir a la población que es intervenida de condilomas acuminados, además de sus resultados quirúrgicos precoces y a largo plazo. Conclusión: El presente estudio, presenta una población de 137 pacientes operados de condilomas anales, a partir de los hallazgos de la cirugía. Se cumple el objetivo del estudio de caracterizar en un período de 12 años los resultados quirúrgicos de dicha serie, algo no reportado previamente en la literatura chilena.

Objective: To describe the experience in elective surgery for anal condylomas in patients over 15 years of age in a tertiary hospital in the Metropolitan Region. Materials and Method: Retrospective and descriptive observational study about elective surgical interventions performed between 2008 to 2021. Results: Within the analyzed period, 165 anal warts surgeries were obtained, corresponding to 137 patients. 85% of the patients are male, 68% are HIV positive, 87% of the MSM patients are HIV positive, 34% of the patients have a history of STDs, 46% of the patients received topical therapy as preoperative or postoperative treatment. 25% present recurrence in their personal history, 21% present high-grade anal intraepithelial lesions, 6% present infiltrating squamous carcinoma. There was no reported mortality. Discussion: The present study describes the experience in condyloma surgery in a tertiary hospital in the Metropolitan Region of Chile, whose population corresponds to a medium and low socioeconomic stratum. It is possible to describe the population that undergoes surgery for this reason, in addition to its early and long-term surgical results. Conclusion: The present study presents a population of 137 patients operated on for anal condylomas, based on the findings of the surgery. The objective of the study to characterize the surgical results of this series over a 12-year period is fulfilled, something not previously reported in the Chilean literature.

Práticas educativas para a prevenção de infecções sexualmente transmissíveis na adolescência: uma revisão realista / Educational practices for the prevention of sexually transmitted infections in adolescence: a realistic review / Prácticas educativas para la prevención de infecciones de transmisión sexual en la adolescencia: una revisión realista

Objetivo: analisar as evidências científicas acerca das práticas educativas para a prevenção de infecções sexualmente transmissíveis na adolescência. Método: foi realizada uma revisão realista, utilizada para o embasamento de práticas e políticas de intervenção em realidades sociais complexas, em fevereiro de 2022, para responder à questão norteadora: quais são as práticas educativas para a prevenção de infecções sexualmente transmissíveis na adolescência? Resultados: foram incluídos 17 estudos, dos quais emergiu o preceito teórico: práticas dialógicas e participativas a respeito das infecções sexualmente transmissíveis, realizadas em grupo, no ambiente escolar e de longa duração favorecem a adesão à participação nas atividades educativas e são mais bem recebidas e avaliadas pelos adolescentes. Conclusão: a revisão realista alcançou os seus propósitos em determinar: o que, como, para quem e em quais circunstâncias, determinada intervenção funciona em um contexto social.

Objective: to analyze the scientific evidence about educational practices for the prevention of sexually transmitted infections in adolescence. Method: a realistic review was carried out, used as a basis for intervention practices and policies in complex social realities, in February 2022, to answer the guiding question: what are the educational practices for the prevention of sexually transmitted infections in adolescence? Results: 17 studies were included, from which the theoretical precept emerged: dialogic and participatory practices regarding sexually transmitted infections, carried out in groups, in the school environment and on a long-term basis, favor adherence to participation in educational activities and are better received and evaluated by adolescents. Conclusion: the realist review achieved its purposes in determining what, how, for whom and under what circumstances a given intervention works in a social context.

Objetivo: analizar la evidencia científica sobre prácticas educativas para la prevención de infecciones de transmisión sexual en la adolescencia. Método: se realizó una revisión realista, utilizada para sustentar prácticas y políticas de intervención en realidades sociales complejas, en febrero de 2022, para responder a la pregunta orientadora: ¿cuáles son las prácticas educativas para la prevención de las ITS en la adolescencia? Resultados: se incluyeron 17 estudios, de los cuales surgió el precepto teórico: las prácticas dialógicas y participativas en torno a las infecciones de transmisión sexual, realizadas en grupo, en el ámbito escolar y a largo plazo, favorecen la adherencia a la participación en las actividades educativas y son mejor recibidas y evaluadas por adolescentes. Conclusión: la revisión realista logró sus propósitos al determinar: qué, cómo, para quién y en qué circunstancias funciona una determinada intervención en un contexto social.

Características epidemiológicas y manifestaciones clínicas de pacientes con proctitis infecciosa / Epidemiologic characteristics and clinical manifestations in patients with infectious proctitis

Resumen Objetivo: Describir y caracterizar los aspectos epidemiológicos y clínicos de los pacientes con proctitis infecciosa en nuestro hospital. Materiales y Método: Se trata de un estudio de tipo transversal de pacientes con sintomatología perianal y del canal anal, concordante con proctitis, que consultaron en el policlínico de coloproctología entre enero de 2017 y diciembre de 2018, a quienes se les realizó estudio de secreción anal para confirmar infección de transmisión sexual. Resultados: Son 46 pacientes hombres, 26 años promedio de edad, un 6% heterosexuales. Un 65% había consultado previamente (ninguno a un coloproctólogo). El síntoma más frecuente: ano húmedo (97,8%) y el signo: dermitis perianal (100%). De este grupo, 20 nunca se habían realizado estudio de VIH y 50% resultó ser seropositivo. Presentaban infecciones de transmisión sexual más comunes: Gonorrea (43,4%) y sífilis (31,2%) y en un 32% hubo presencia de más de un germen. Discusión: Los resultados sugieren que la proctitis infecciosa es una patología de pacientes jóvenes quienes tienen relaciones sexuales sin protección, más del 50% no utiliza condón. La mayoría de los pacientes presentan consultas previas con médicos no proctólogos. Los gérmenes con mayor frecuencia que provocan proctitis infecciosa: Neisseria gonorrhoeae, Chlamydia trachomatis, Treponema pallidum. Conclusión: La presencia de una dermitis perianal sin respuesta a tratamiento habitual, muy severa y/o en pacientes de riesgo, debe hacer sospechar proctitis infecciosa.

Objective: Describe and characterize epidemiological and clinical aspects of patients with infectious proctitis at our hospital. Materials and Method: This is a cross-sectional study of patients with perianal and anal canal symptoms consistent with proctitis, who consulted at the Clinical Hospital of The University of Chile coloproctology outpatient clinic between January 2017 and December 2018, with perianal and anal canal symptoms, consistent with proctitis, and with confirmed sexually transmitted disease by anal secretion study. Results: Total of 46 patients, all male with average age of 26 years old. 6% heterosexuals. 65% had previous medical consults (none with a proctologist). The most common symptom was wet anus (97.8%), and the most common physical finding was perianal dermatitis (100%). 20 patients had never been tested for HIV, and 50% were positive for this disease. The most common sexually transmitted diseases were gonorrhea (43.4%) and syphilis (31.2%). In 32% of the patients, the culture informed more than one pathogen. Discussion: The results suggest that infectious proctitis is a disease of young patients who have unprotected sex. More than 50% do not use a condom. Most patients have prior consults, but none with a proctologist. The most frequent pathogen that causes infectious proctitis: Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum. Conclusion: The presence of severe perianal dermatitis, lack of response to common treatment, and/or in patients with risk factors, infectious proctitis should be suspected.

Epidemiological characteristics and trends of five sexually transmitted diseases in Gongshu District of Hangzhou City from 2012 to 2019 / 上海预防医学

Objective:To investigate epidemiological characteristics and trends of five sexually transmitted diseases （STDs） in Gongshu District of Hangzhou City， and to provide evidence for the development of control strategies. Methods:Data of five STDs from 2012 to 2019 in Gongshu District were collected and then analyzed by descriptive epidemiological methods. Results:In 2012－2019， a total of 9 767 STD cases were reported in Gongshu， with an average incidence rate of 218.35 per 100 000. The overall incidence rate of STD tended to decline over years （χ2=82.60，P<0.001）.The areas with high incidence were mainly Xiangfu sub-district， Shangtang sub-district and Daguan sub-district with a total of 4 136 cases， accounting for 42.34%.The occupations with the highest proportion were business service （35.89%）， worker （19.03%）， household work and unemployment （15.94%）. Latent syphilis was the main stage of syphilis， which increased at an average annual rate of 14.08%. The proportion of primary syphilis and secondary syphilis decreased over years， with the average annual reduction rate of 36.86% and 18.77%， respectively. The average annual incidence of genital chlamydia trachomatis infection in females （100.03 per 100 000） was higher than that in males （31.88 per 100 000）.The average annual incidence of condyloma acuminatum in males （24.68 per 100 000） was higher than that in females （16.80 per 100 000）.The average annual incidence of gonorrhea in males （75.41 per 100 000） was higher than that in females （13.06 per 100 000）. Conclusion:The incidence of five STDs in Gongshu District is effectively controlled. It warrants health education， behavioral intervention， STD screening， and standardized diagnosis and treatment services for high-risk groups in high-risk areas to control the epidemic of STDs. Gender differences in reported incidence of condyloma acuminatum， gonorrhea and genital chlamydia trachomatis infection may be reduced by strengthening outpatient health education and optimizing laboratory examinations.

Epidemiological characteristics of sexually transmitted diseases from 2005 to 2017 in Mengla County， Yunnan Province / 上海预防医学

Objective:To determine the epidemiological characteristics and incidence trends of sexually transmitted diseases （STD） in Mengla County of Yunnan Province， and provide evidence for future prevention and control of STD. Methods:STD case information from 2005 to 2017 was extracted from the National Notifiable Infectious Disease Report Information System. Data were collected by year and disease type，and the incidence rate， epidemic characteristics and suspicious contact history of STD were statistically analyzed. Results:A total of 1 251 STD cases were reported in Mengla county from 2005 to 2017， including 490 gonorrhea， 483 syphilis， 216 condyloma acuminatum， 16 genital chlamydial infection and 46 genital herpes. The average annual incidence of STD was 35.57/100 000. The majority of STD cases were 20-29 years old （n=541，43.25%）， married （n=603，48.20%）， Han people （n=638，50.10%）， with education of middle school （n=536，42.85%）， and occupation of farmers （n=702， 56.12%）. The 42.61% of STD cases had non-marital sexual contact history， in which the proportion was significantly higher among male （55.05%） than female （28.98%）. In addition， the proportion of non-marital sex among STD cases increased gradually by year and significantly differed. Conclusion:The epidemic status of STD in Mengla county is relatively low. However， STD incidence increased gradually by year， which warrants more and specific measures on the STD control and prevention.

Syphilis seroprevalence among HlV-infected males in Istanbul, Turkey / Seroprevalencia de la sífilis entre hombres infectados con el HIV en Estambul, Turquía

Abstract Syphilis has become a serious issue for human immunodeficiency virus (HIV)-infected patients worldwide in recent years; however, the studies related to HIV coinfection and syphilis reinfections in Istanbul, Turkey, are limited. Ourobjective was to determine the seroprevalence of syphilis among HIV-infected men in the city which has one of the highest HIV prevalence rates in Turkey. Two hundred and forty four (244) HIV-positive men were evaluated at Istanbul Medical Faculty, Department of Medical Microbiology from March to June 2018. Serum samples were screened for the presence of antibodies against Treponema pallidum using the chemilumines-cent microparticle immunoassay (CMIA). Samples found to be positive were investigated with the rapid plasma reagin (RPR) test and the T. pallidum hemagglutination assay (TPHA). The patients completed a questionnaire for sociodemographic data. The mean age was found to be 41.8 years; 35.6% were men who havesexwith men (MSM). The overall seroprevalence of syphilis among the patients was 19.3%. MSM had a significantly higher seroprevalence than heterosexual patients (28.7%). In Turkey, there is a high seroprevalence of syphilis in HIV-infected patients, MSM being the most affected group. Therefore, HIV-infected patients should be screened for syphilis at least annually and should be informed about sexually transmitted diseases (STDs).

Resumen En los últimos años, la sífilis se ha convertido en un problema grave para los pacientes infectados por el virus de la inmunodeficiencia humana (HIV) en todo el mundo; sin embargo, los estudios relacionados con la coinfección por HIV y las reinfecciones por sífilis en Estambul, Turquía, son limitados. Nuestro objetivo fue determinar la seroprevalencia de la sífilis entre los hombres infectados por el HIV en Estambul, ciudad con las tasas de prevalencia del HIV más altas de Turquía. Se evaluaron 244 hombres con HIV entre marzo y junio de 2018 en la Facultad de Medicina de Estambul, Departamento de Microbiología Médica. Las muestras de suero se analizaron para detectar la presencia de anticuerpos contra Treponema pallidum con un inmunoensayo de micropartículas quimioluminiscentes (CMIA). Las muestras que resultaron positivas en dicha prueba se investigaron con la prueba de reagina plasmática rápida (RPR) y el ensayo de hemoaglutinación T. pallidum (TPHA). Los pacientes completaron un cuestionario de datos sociodemográficos. La media de la edad fue de 41,8 anos; 35,6% eran hombres que tienen sexo con hombres (HSH). La seroprevalencia global de sífilis entre los pacientes fue del 19,3%. Los HSH tuvieron una seroprevalencia significativamente mayor que los pacientes heterosexuales (28,7%). En Turquía, existe una alta seroprevalencia de la sífilis en pacientes infectados por el HIV y los HSH son el grupo más afectado. Por lo tanto, los pacientes infectados por el HIV deben someterse a la detección de sífilis al menos una vez al año y deben ser informados sobre las enfermedades de transmisión sexual (ETS).

Identifiying some risk factors for female infertility in Mongolian population / Шинэ санаа Шинэ нээлт

Purpose@#Researchers suggest that the prevalence of infertility varies between developing and developed countries, with differences in infertility care, socioeconomic status, lifestyle, and reproductive disorders such as pelvic inflammatory disease and sexually transmitted infections being the main risk factors. The research project aims is to define risk factors for female fertility in the Mongolian population. @*Methods@#This study was conducted between 2016-2018 using a cross-sectional survey of analytical research. Participants were randomly selected from Ulaanbaatar and the Central, Western, Eastern, and Khangai provinces according to Mongolia’s regional geographic model. The contents of a questionnaire were comprised of 5 units with 95 questions including socio-economic, geographical, lifestyle, health education, reproductive health indicators, sexual behavior. General physical characteristics were measured according to the standard. @*Results@#The prevalence of the female fertility rate in the Mongolian population is 7.4%. Female participants were classified into 2 groups, namely infertile and fertile, and we developed a case-control study. Among the socio-economic factors influencing infertility, primary education aOR: 1.6 (95% CI 0.98-2.66), monthly household income lower than the average aOR: 1.1 (95% CI 0.77- 1.66), living in rural areas OR: 2.3 ( 95% CI 1.46-3.68) were crucial risk factors. As for reproductive and general health indicators, STIs aOR: 1.8 (95% CI 0.98-3.50), especially gonorrhea OR: 2.8 (95% CI 1.14-6.91), and thyroid disorders OR: 1.7 (95% CI 1.03). -2.97), grade 3 obesity OR: 3.8 (95% CI 1.05-13.95) are estimated risk factors for infertility.@*Conclusions@#Of all potential socio-economic factors, residence status, education and financial situation are significant for female infertility meanwhile reproductive health indicators include sexually transmitted infections, thyroid disease, and obesity.

Preventive interventions and existing problems of HIV infection in patients with sexually transmitted diseases / 上海预防医学

A large amount of evidence has showed that sexually transmitted infection is an important synergistic factor of human immunodeficiency virus (HIV) infection.Therefore, this paper reviews the current situation of sexually-transmitted diseases (STD) and HIV infection, introduces HIV prevention and intervention measures and problems for STD patients at home and abroad, and proposes that behavior-psychology-society integrated intervention model should be constructed based on the characteristics of STD patients.

Ações de prevenção e enfrentamento das IST/AIDS vivenciadas por mulheres encarceradas / Actions to prevent and cope with the STI/AIDS experienced by women in prison / Acciones de prevención y enfrentamiento a las IST/SIDA vivenciadas por mujeres encarceladas

Objetivo: analisar ações de prevenção e enfrentamento das IST/AIDS em mulheres encarceradas, considerando as dimensões de vulnerabilidade. Método: pesquisa qualitativa com aporte teórico-metodológico da Narrativa de Vida de Bertaux. Teve como cenário de estudo o Conjunto Penal de Jequié-BA. Os dados foram coletados através da entrevista aberta com 15 mulheres encarceradas. Estudo aprovado POR Comitê de Ética em Pesquisa. Dados tratados por meio da análise temática de Bertaux. Resultados: a utilização de preservativo, seguindo critérios pessoais e culturais, e acesso aos serviços de saúde e insumos proporcionados pelo presídio constituem ações preventivas que as mulheres não teriam fora dele. Contudo, práticas sexuais desprotegidas prevalecem sobre a decisão em utilizar medidas protetivas, pois é fortemente determinada pela cultura e hábitos pregressos, bem como pela dinâmica do presídio. Conclusão: as ações de prevenção podem reduzir a vulnerabilidade das mulheres encarceradas, porém medidas individuais e institucionais voltadas para estas práticas preventivas efetivas permanecem como desafio dentro do sistema prisional.

Objective: to examine STI/AIDS prevention and coping measures for women in prison, considering the dimensions of vulnerability. Method: this qualitative study drew theoretically and methodologically on Bertaux's Life Narrative. The study setting was the penal facility at Jequié, Bahia. Data were collected through an open interviews of 15 women inmates. The study was approved by the research ethics committee. Data were analyzed by Bertaux thematic analysis. Results: condom use, on personal and cultural criteria, and access to health services and materials provided by the prison are preventive measures that women would not have on the outside. Nonetheless, unprotected sex practices prevail over the decision to use protective measures, which is strongly determined by culture and past habits, as well as by the dynamics of the prison. Conclusion: preventive measures can reduce vulnerability of women in prison, but individual and institutional measures directed to these effective preventive practices remain a challenge within the prison system.

Objetivo: analizar acciones de prevención y enfrentamiento de las IST/SIDA en mujeres encarceladas, considerando las dimensiones de vulnerabilidad. Método: investigación cualitativa con aporte teórico-metodológicamente de las Narrativa de Vida de Bertaux. El escenario de estudio fue el Conjunto Penal de Jequié-BA. Los datos han sido recolectados a través de la entrevista abierta con 15 mujeres encarceladas. Estudio aprobado por el Comité de Ética en Investigación. Los datos han sido tratados por el análisis temático de Bertaux. Resultados: la utilización del preservativo, siguiendo criterios personales y culturales, y el acceso a los servicios de salud e insumos proporcionados por la prisión, constituyen acciones preventivas que las mujeres no tendrían fuera de ella. Sin embargo, las prácticas sexuales desprotegidas prevalecen por encima de la decisión de utilizar medidas protectoras, pues son fuertemente determinadas por la cultura y los hábitos pasados, así como por la dinámica de la cárcel. Conclusión: las acciones de prevención pueden reducir la vulnerabilidad de las mujeres encarceladas, pero medidas individuales e institucionales volcadas a estas prácticas preventivas efectivas permanecen como desafío dentro del sistema penitenciario.

Avaliação Psicométrica da versão brasileira do "Questionário sobre Conhecimento de Doenças Sexualmente Transmissíveis" / Psychometric Evaluation of the Brazilian Version of the "Sexually Transmitted Disease Knowledge Questionnaire"

Resumo Este estudo analisou as propriedades psicométricas da versão brasileira do Questionário sobre Conhecimento de Doenças Sexualmente Transmissíveis (STD-KQ). Participou uma amostra de conveniência de 429 estudantes de uma universidade pública brasileira. A análise fatorial exploratória sugere uma estrutura com um fator (variância explicada = 61,1%; eigenvalue = 7,2), sendo corroborada pela análise confirmatória (Root Mean Square Error of Approximation = 0,04; Comparative Fit Index = 0,91; Tucker-Lewis Index = 0,90; Standardized Root Mean Square Residual = 0,05). Cinco itens apresentaram carga menor que 0,30 e por isso foram excluídos. O instrumento demonstrou consistência interna (confiabilidade composta = 0,97; alfa de Cronbach = 0,83) e estabilidade temporal (correlação de Pearson = 0, 86; kappa = 0,16) para um curto período. O conhecimento significativamente variou conforme a idade, o sexo e o curso. Concluindo, o presente estudo destaca as satisfatórias propriedades psicométricas da versão brasileira do STD-KQ em estudantes universitários.

Abstract This study evaluated the psychometric properties of the Brazilian version of the Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ). A convenience sample of 429 students of a Brazilian public university participated in the study. Exploratory Factor Analysis suggested one factor solution (variance explained = 61.1%, eigenvalue = 7.2), confirmed by the confirmatory analysis (Root Mean Square Error of Approximation = 0.04; Comparative Fit Index = 0.91; Tucker-Lewis Index = 0.90; Standardized Root Mean Square Residual = 0.05). Five items feature charges less than 0.30 and wer eliminated. The instrument demonstrated internal consistency (Composite reliability = 0.97; Cronbach's alpha = 0.83) and temporal stability (Pearson correlation = 0.86; kappa = 0.16) over a brief period. The knowledge significantly varies by age, sex and course of study. In conclusion, this study highlights the satisfactory psychometric proprieties of the Brazilian version of STD-KQ in university students.

Percepção dos Idosos em Relação a Vida Sexual e as Infecções Sexualmente Transmissíveis na Terceira Idade / Perception of the Elderly in Relation to the Sexual Life and the Sexually Transmitted Infections

Objetivo: conhecer a percepção dos idosos em relação à vida sexual na terceira idade e às infecções sexualmente transmissíveis. Metodologia: estudo qualitativo com abordagem descritiva, realizado em um município da Região do Médio Vale do Itajaí em Santa Catarina. A coleta de dados foi realizada em uma instituição pública, que desenvolve atividades voltadas ao público idoso. Foram entrevistados dez sujeitos, com idade superior a 60 anos, por meio de uma entrevista aberta. Para análise dos dados, foram estabelecidas categorias através da técnica de análise de conteúdo. Resultados: a partir da análise das falas dos entrevistados, emergiram três categorias de análise, sendo elas: sexualidade na terceira idade: os aspectos físicos e emocionais sob o olhar dos idosos; a percepção dos idosos sobre as infecções sexualmente transmissíveis; a visão do idoso e o seu entendimento sobre a prevenção de infecções sexualmente transmissíveis. Conclusão: os resultados evidenciaram que os idosos possuem conhecimento acerca das infecções sexualmente transmissíveis e sua forma de prevenção. Porém, em sua maioria não realizam a prevenção por confiar no parceiro ou por não considerar necessário na sua condição atual. (AU)

Objective: to know the perception of the elderly in relation to the sexual life in the third age and to the sexually transmissible infections. Methodology: qualitative study with a descriptive approach, carried out in a municipality of the Region of the Middle Vale do Itajaí in Santa Catarina. Data collection was performed in a public institution, which develops activities aimed at the elderly public. Ten subjects, aged over 60 years, were interviewed through an open interview. For data analysis, categories were established through the technique of content analysis. Results: from the analysis of the interviewees' speeches, three categories of analysis emerged: sexuality in the third age: the physical and emotional aspects under the eyes of the elderly; the perception of the elderly about sexually transmitted infections; the view of the elderly and their understanding about sexually transmitted infections. Conclusion: the results showed that the elderly have knowledge about sexually transmitted infections and their form of prevention. However, most do not carry out prevention by relying on the partner, or by not considering it necessary in their current condition. (AU)

Sexually transmitted infections: Need for extragenital screening

Extragenital infections can occur concurrently with simultaneous urogenital infections. Extragenital sites are believed to serve as hidden reservoirs and play a critical role in their transmission. The etiological relationship of the most widespread Sexually transmitted diseases (STD) pathogen to reproductive tract has long been established, but the distribution to extragenital sites appears to be infrequent and its correlation with the sexual practice still requires to be investigated. Optimal-screening strategies for extragenital infections are largely unknown. However, there is a lack of data on clinical outcomes and optimal treatment regimens for rectal and pharyngeal extragenital infections. Further studies are needed in settings other than reproductive health and STD clinics, especially in primary care clinics and resource-limited settings.

Concepções Psicossociais acerca do Conhecimento sobre a AIDS das Pessoas que Vivem com o HIV / Psychosocial Perceptions of Persons with HIV about Knowledge of AIDS / Concepciones psicosociales sobre el conocimiento del SIDA de las personas que viven con VIH

Resumo A presente pesquisa teve como objetivo principal identificar as concepções psicossociais acerca do conhecimento sobre a AIDS por parte de pessoas que convivem com o Hiv. A amostra foi composta por 44 pessoas com o Hiv de ambos os se xos, com idades variando de 23 a 67 anos, e que estavam em acompanhamento no Centro de Testagem e Aconselhamento (OTA). Foram utilizados para a coleta dos dados, um questionário sócio demográfico e uma pergunta semiestruturada. No geral, os resultados apontaram que a AIDS para eles é uma doença contagiosa, sem cura e que traz muito preconceito, e o nível de conhecimento a respeito da AIDS é ambivalente.

Summary The principle aim of this study was to identify the psychosocial perception towards AIDS held by persons with HIV. The sample was composed of 44 persons of both sexes between the ages of 23 and 67 who carried the virus and were being monitored by the Testing and Advisory Center (CTA, acronym in Portuguese). We collected data using a sociodemo-graphic questionnaire and a semi-structured interview. In general, the results indicated that these persons regard AIDS as a contagious disease, without cure and giving rise to many prejudices. Similarly, they see that the level of knowledge of AIDS is ambivalent.

Resumen Esta investigación tuvo como objetivo principal identificar las concepciones psicosociales sobre el SIDA que tienen las personas que conviven con el VIH. La muestra estuvo compuesta por 44 sujetos de ambos sexos portadores del virus, con edades entre los 23 y los 67 años, quienes estaban en seguimiento en el Centro de Pruebas y Asesoramiento (CPA). Para la recolección de datos fueron utilizados un cuestionario sociodemográfico y una entrevista semiestructurada. En general, los resultados apuntaron a que el SIDA es considerado por ellos como una enfermedad contagiosa, sin cura y que da lugar a muchos prejuicios. Del mismo modo, se reconoce que el nivel de conocimiento acerca del SIDA es ambivalente.

Secondary syphilis: The great imitator can't be forgotten / Sífilis secundária: a grande imitadora não pode ser esquecida

Summary Syphilis is an infection caused by Treponema pallidum, mainly transmitted by sexual contact. Since 2001, primary and secondary syphilis rates started to rise, with an epidemic resurgence. The authors describe an exuberant case of secondary syphilis, presenting with annular and lichen planus-like lesions, as well as one mucocutaneous lesion. Physicians must be aware of syphilis in daily practice, since the vast spectrum of its cutaneous manifestations is rising worldwide.

Resumo A sífilis é uma infecção causada pela espiroqueta Treponema pallidum, transmitida principalmente por contato sexual. Desde 2001, houve o ressurgimento dessa epidemia, com aumento das taxas de sífilis primária e secundária. Os autores descrevem um caso exuberante de sífilis secundária apresentando lesões cutâneas anulares e lesões que lembram líquen plano, além de uma lesão mucocutânea. Médicos de todas as especialidades devem estar cientes das diversas apresentações de sífilis: o vasto espectro de manifestações cutâneas da sífilis secundária e as crescentes taxas dessa patologia representam um desafio.

HIV/STD prevalence and related behaviors among male STD clinic attendees in Xi'an and Xianyang cities, Shaanxi province / 中华流行病学杂志

Objective To compare the prevalence of HIV/STD and related health care seeking behaviors among male STD clinic attendees between Xi'an and Xianyang cities.Methods During June and July 2016,206 male STD clinic attendees were studied in Xi'an city,with another 221 male STD clinic attendees in Xianyang city.Cross-sectional questionnaire survey was used to collect attendees' behavioral information.Blood samples were collected via HIV/HCV/Syphilis testing.Results The prevalence rate of HIV infection was 2.4％ (5/206) in Xi'an and 0.9％ (2/221) in Xianyang,with no statistical significant difference between the two cities.The prevalence rate of syphilis was 4.9％ (10/206) in Xi'an,which was significantly lower than 13.6％ (30/221) in Xianyang.The proportion of respondents,diagnosed with other sexually transmitted diseases,in Xi'an was higher than that of Xianyang.The proportions of commercial heterosexual sex and sex with temporary sexual partners in the past 3 months were 18.0％ (37/206) and 15.5％ (32/206) in Xi'an,lower than 46.6％ (103/221) and 15.8％ (35/221) in Xianyang (x2 =39.70,P ＜0.01;x2 =-0.01,P=0.93).The proportions of condom use with commercial sex workers or temporary sexual partners in the past 3 months among Xi'an were 37.8％ (14/37) and 6.3％ (2/32),lower than 93.1％ (95/102)and 57.1％ (20/35) in Xianyang (x2=49.06,P＜0.01;x2=19.63,P＜0.01).Conclusion Differences were noticed between Xi'an and Xianyang city in terms of STD and HIV prevalences,behaviors related to commercial sex and use of condoms among the male STD clinic attendees that calling for targeted actions in control of high risk behaviors in both HIV/AIDS and STDs transmission.

Genital Chlamydia trachomatis infection and associated risk factors in male clients attending sexually transmitted disease clinics in 9 cities in Guangdong province / 中华流行病学杂志

Objective To investigate the prevalence of genital Chlamydia trachomatis (GCT) infection and associated risk factors in male clients attending sexually transmitted disease (STD) clinics in Guangdong and provide integrated intervention strategy for this group.Methods Convenient sampling was used to recruit participants from April to June in 2015 in Guangdong province.The information about their socio-demographic characteristics and sexual behaviors were collected by using a questionnaire,and blood samples were taken from them to test the antibodies against HIV,syphilis and HCV.First pass urine was taken to test GCT and gonorrhea.Results A total of 1 749 participants with the average age of 39.53 years were recruited.The majority of them were married (73.87％,1 292/1 749),residents of Guangdong (92.28％,1 614/1 749) and in Han ethnic group (99.49％,1 740/1 749).The positive rates for GCT,HIV,syphilis,HCV,Neisseria gonorrhea,and WBC in urinalysis were 6.06％ (106/1 749),0.46％ (8/1 749),3.43％ (60/1 749),0.45％ (7/1 550),2.74％ (48/1 749),7.89％ (138/1 749) respectively.Multivariate analysis showed that risk factors for GCT infection include IDUs (OR=13.98,95％CI:3.35-58.38),anal sex with men (OR=3.11,95％ CI:1.45-6.71),Neisseria gonorrhea positive (OR =9.64,95％ CI:5.09-18.24),and WBC positive (OR =1.96,95％ CI:1.08-3.55).Conclusions This study demonstrated the high prevalence of GCT infection in male clients attending STD clinics in Guangdong.Therefore precision intervention should target this population at high-risk.