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1.
Sex Transm Dis ; 50(10): 635-641, 2023 10 01.
Article in English | MEDLINE | ID: mdl-37255234

ABSTRACT

BACKGROUND: Mycoplasma genitalium infection can adversely affect female reproductive health, but data are limited about prevalence and characteristics of the infection in female adolescents. We employed a sensitive assay to detect M. genitalium infection, and we describe its characteristics in a clinical sample of women younger than 21 years. METHODS: We recruited females aged 13 to 20 years in children's hospital clinics whose clinicians were testing for chlamydia/gonorrhea. Participants completed a questionnaire providing demographics, sexual history, and current symptoms. Urine/endocervical samples were tested for chlamydia/gonorrhea and partitioned for M. genitalium testing using Aptima M. genitalium assay. We reviewed records for the clinic visit to document examination, diagnosis, and results of sexually transmitted infection (STI) testing. We compared prevalence of M. genitalium infection by demographics, sexual history, symptoms, and signs. RESULTS: Of 153 participants mean age 18.07 ± 1.68 years, 58% self-identified as Hispanic, 27% Black, 64% straight/heterosexual, 27% bisexual, 1% gay/lesbian, 29% reported a prior STI diagnosis. Prevalence of M. genitalium was 11.1% (17/153), 13 of 17 were asymptomatic, 2 of 17 had pelvic inflammatory disease (PID), 3 of 17 coinfected with chlamydia or gonorrhea. Prevalence of chlamydia was 6.6% and of gonorrhea 2.6%. A logistic regression model indicated independent associations of bisexual orientation versus all other orientations (adjusted odds ratio [aOR], 4.80; 95% confidence interval [CI], 1.38-16.67), self-reported prior STI (aOR, 3.83; 95% CI, 1.10-13.37), and self-reported prior PID (aOR, 9.12; 95% CI, 1.02-81.72) with higher odds of M. genitalium infection. CONCLUSIONS: Findings suggest that in at-risk female populations younger than 21 years, M. genitalium is a prevalent STI and symptomatic adolescents may warrant testing and treatment. Further study of harms and benefits of testing asymptomatic bisexual female adolescents or those with prior STI/PID is needed.


Subject(s)
Chlamydia Infections , Gonorrhea , Mycoplasma Infections , Mycoplasma genitalium , Pelvic Inflammatory Disease , Sexually Transmitted Diseases , Child , Humans , Female , Adolescent , Young Adult , Adult , Gonorrhea/diagnosis , Gonorrhea/epidemiology , Chlamydia Infections/diagnosis , Chlamydia Infections/epidemiology , Mycoplasma Infections/diagnosis , Mycoplasma Infections/epidemiology , Mycoplasma Infections/drug therapy , Prevalence , New York/epidemiology , Sexually Transmitted Diseases/diagnosis , Sexually Transmitted Diseases/epidemiology , Chlamydia trachomatis , Pelvic Inflammatory Disease/epidemiology
2.
Open Forum Infect Dis ; 9(7): ofac191, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35794936

ABSTRACT

Incident HIV infections occurring in people on PrEP may have delayed seroconversion. New CDC guidelines recommend the addition of HIV-1 viral load for screening for all on PrEP. We believe antigen/antibody screening should continue for tenofovir-based PrEP at this time.

3.
Clin Infect Dis ; 73(7): e2243-e2250, 2021 10 05.
Article in English | MEDLINE | ID: mdl-33035316

ABSTRACT

Infectious diseases/human immunodeficiency virus (ID/HIV) physicians and other healthcare professionals advocate within the healthcare system to ensure adults and children receive effective treatment. These advocacy skills can be used to inform domestic and global infectious diseases policies to improve healthcare systems and public health. ID/HIV physicians have a unique frontline perspective to share with federal policymakers regarding how programs and policies benefit patients and public health. Providing this input is critical to the enactment of legislation that will maximize the response to infectious diseases. This article discusses the advocacy of ID/HIV physicians and other healthcare professionals in federal health policy. Key issues include funding for ID/HIV programs; the protection of public health and access to healthcare; improving research opportunities; and advancing the field of ID/HIV, including supporting the next generation of ID/HIV clinicians. The article also describes best practices for advocacy and provides case studies illustrating the impact of ID/HIV physician advocacy.


Subject(s)
Communicable Diseases , HIV Infections , Physicians , Adult , Child , HIV , HIV Infections/epidemiology , HIV Infections/prevention & control , Health Policy , Humans
4.
J Pediatric Infect Dis Soc ; 10(4): 432-439, 2021 Apr 30.
Article in English | MEDLINE | ID: mdl-33097939

ABSTRACT

ID/HIV physicians and other healthcare professionals advocate within the healthcare system to ensure adults and children receive effective treatment. These advocacy skills can be used to inform domestic and global infectious disease policies to improve healthcare systems and public health. ID/HIV physicians have a unique frontline perspective to share with federal policymakers regarding how programs and policies benefit patients and public health. Providing this input is critical to the enactment of legislation that will maximize the response to infectious diseases. This article discusses the advocacy of ID/HIV physicians and other healthcare professionals in federal health policy. Key issues include funding for ID/HIV programs; the protection of public health and access to health care; improving research opportunities; and advancing the field of ID/HIV, including supporting the next generation of ID/HIV clinicians. The article also describes best practices for advocacy and provides case studies illustrating the impact of ID/HIV physician advocacy.


Subject(s)
Communicable Diseases , HIV Infections , Physicians , Adult , Child , Delivery of Health Care , HIV Infections/prevention & control , Health Policy , Humans
5.
J Assoc Nurses AIDS Care ; 25(1): 70-82, 2014.
Article in English | MEDLINE | ID: mdl-23582578

ABSTRACT

Blacks living in the southern United States are disproportionately affected by HIV infection. Identifying and treating those who are infected is an important strategy for reducing HIV transmission. A model for integrating rapid HIV screening into community health centers was modified and used to guide implementation of a testing program in a primary care setting in a small North Carolina town serving a rural Black population. Anonymous surveys were completed by 138 adults who were offered an HIV test; of these, 61% were female and 89.9% were Black. One hundred patients (72%) accepted the test. Among those Black survey respondents who accepted an offer of testing, 58% were women. The most common reason for declining an HIV test was lack of perceived risk; younger patients were more likely to get tested. Implementation of the testing model posed challenges with time, data collection, and patient flow.


Subject(s)
Black or African American/statistics & numerical data , Community Health Centers/organization & administration , Delivery of Health Care, Integrated/methods , HIV Infections/diagnosis , Patient Acceptance of Health Care/statistics & numerical data , Adult , Female , HIV Infections/ethnology , Health Care Surveys , Humans , Male , Mass Screening/methods , North Carolina , Primary Health Care/organization & administration , Rural Population
6.
Pediatrics ; 125(6): 1142-51, 2010 Jun.
Article in English | MEDLINE | ID: mdl-20439595

ABSTRACT

OBJECTIVES: Multinational phase III trials of a human papillomavirus vaccine, Gardasil, have shown the vaccine to be generally well-tolerated, efficacious, and immunogenic. We evaluated the immunogenicity and safety of Gardasil administered concomitantly with Menactra and Adacel. METHODS: In this open-label study, boys (n = 394) and girls (n = 648) aged 10 to 17 were randomly assigned in a 1:1 ratio as follows: group A (concomitant administration) received a 0.5-mL dose of Gardasil at day 1, month 2, and month 6 and a 0.5-mL dose of Menactra and Adacel on day 1; group B (nonconcomitant administration) received Gardasil at day 1, month 2, and month 6 and Menactra and Adacel at month 1. Antibody levels for all vaccine components were measured. Systemic, injection-site, and serious adverse experiences (AEs) were monitored. RESULTS: Immune responses after concomitant administration of the 3 vaccines were noninferior to nonconcomitant administration. Seroconversion for Gardasil was > or = 99% in both groups A and B. For Menactra and Adacel, concomitant administration of the vaccines was demonstrated to be noninferior to nonconcomitant administration. Concomitant administration was generally well-tolerated. No participants withdrew because of an AE. One serious AE of transient muscular weakness of <24 hours' duration after the third Gardasil injection was reported in group B and was deemed possibly vaccine-related by the investigator. CONCLUSIONS: Overall, concomitant administration was generally well-tolerated and did not interfere with the immune response to the respective vaccines. Concomitant administration should minimize the number of visits required to deliver each vaccine individually, leading to increased compliance and more effective disease prevention.


Subject(s)
Diphtheria-Tetanus-acellular Pertussis Vaccines/pharmacology , Meningococcal Vaccines/pharmacology , Papillomavirus Vaccines/pharmacology , Adolescent , Alphapapillomavirus , Child , Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage , Drug Interactions , Female , Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18 , Humans , Male , Meningococcal Vaccines/administration & dosage , Papillomavirus Vaccines/administration & dosage , Vaccines, Conjugate/administration & dosage , Vaccines, Conjugate/pharmacology
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