Incidence and time-varying predictors of HIV and sexually transmitted infections among male sex workers in Mexico City.

BACKGROUND: Male sex workers are at high-risk for acquisition of sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). We quantified incidence rates of STIs and identified their time-varying predictors among male sex workers in Mexico City. METHODS: From January 2012 to May 2014, male sex workers recruited from the largest HIV clinic and community sites in Mexico City were tested for chlamydia, gonorrhea, syphilis, hepatitis, and HIV at baseline, 6-months, and 12-months. Incidence rates with 95% bootstrapped confidence limits were calculated. We examined potential time-varying predictors using generalized estimating equations for a population averaged model. RESULTS: Among 227 male sex workers, median age was 24 and baseline HIV prevalence was 32%. Incidence rates (per 100 person-years) were as follows: HIV [5.23; 95% confidence interval (CI): 2.15-10.31], chlamydia (5.15; 95% CI: 2.58-9.34), gonorrhea (3.93; 95% CI: 1.88-7.83), syphilis (13.04; 95% CI: 8.24-19.94), hepatitis B (2.11; 95% CI: 0.53-4.89), hepatitis C (0.95; 95% CI: 0.00-3.16), any STI except HIV (30.99; 95% CI: 21.73-40.26), and any STI including HIV (50.08; 95% CI: 37.60-62.55). In the multivariable-adjusted model, incident STI (excluding HIV) were lower among those who reported consistently using condoms during anal and vaginal intercourse (odds ratio = 0.03, 95% CI: 0.00-0.68) compared to those who reported inconsistently using condoms during anal and vaginal intercourse. CONCLUSIONS: Incidence of STIs is high among male sex workers in Mexico City. Consistent condom use is an important protective factor for STIs, and should be an important component of interventions to prevent incident infections.

The Stigma of Sexually Transmitted Infections.

Evidence-based guidelines have improved diagnosis and treatment of sexually transmitted infections (STI). Social stigma remains a barrier to STI testing and is associated with underutilization of prevention services. Alternatives for STI testing (eg, in-home testing) are convenient. However, some individuals decline follow-up treatment in fear of unintentional disclosure of their diagnosis. This article reviews STI treatment guidelines and examines the impact of stigma and ethical issues on testing, adherence, partner notification, and transmission rates. An understanding of STI-associated ethical issues and controversies is an important step toward eliminating stigma and reducing STI prevalence and morbidity.

Update on Guidelines for Sexually Transmitted Infection Treatment and Management in the Adult and Adolescent Population.

Sexually transmitted infections (STIs) are a prevalent global health care problem. Incidence rates are rising yearly. STI incidence is highest for adolescents and young adults ages 15 to 24, who are diagnosed with half of all new STIs. Chlamydia trachomatis and Neisseria gonorrhea are common STIs caused by bacteria. Treatment guidelines change frequently as a result of antimicrobial resistance and public health trends. It is important for primary care providers to remain up to date with new guidelines. This article provides updates on pharmacologic treatment as well as patient education and follow-up specific to the primary care setting.

Assessment of STI screening in Romania using a multiplex PCR technique.

INTRODUCTION: Most sexually transmitted infections (STIs) are curable, but inappropriate treatment can lead to serious complications. The importance of setting up STI screening programs has been highlighted in various studies, the absence of such national programs accounting for the lack of STI statistics in Romania. The purpose of our study was to evaluate multiplex PCR as a screening method for the most common 6 STIs and establish their frequency in a group of symptomatic and asymptomatic patients. We aimed to highlight STI associations and correlations between STI pathogens and symptomatology, demographic status, antecedents or sexual partners. METHODOLOGY: A total of 249 patients, both symptomatic and asymptomatic, were included in this study. Chlamydia trachomatis (CT), Neisseia gonorrhoeae (NG), Trichomonas vaginalis (TV), Ureaplasma urealyticum (UU), Mycoplasma hominis (MH) and Mycoplasma genitalium (MG) were all identified in urine samples via multiplex Polymerase Chain Reaction (PCR). The SPSS IBM program was employed for statistical analysis. RESULTS: 32.12% of the patients were found positive, some presenting multiple infections. The results are representative for the Romanian male population. 107 STI pathogens were identified, most frequent being CT, UU and NG. Several statistical correlations between patient characteristics and the presence of STIs have been demonstrated. CONCLUSIONS: The results suggest that multiplex PCR meets all the prerequisites for a screening method, allowing the use of multiple specimens and enabling simultaneous detection of multiple pathogens in a short period of time. STI identification via multiplex PCR proved to be an effective method for quantifying their frequency in Romania.

Risk factors associated with sexually transmitted infections and HIV among adolescents in a reference clinic in Madrid.

INTRODUCTION: Adolescents have a higher incidence of sexually transmitted infections (STIs) than persons of older age groups. The WHO emphasises the need to adopt specific and comprehensive prevention programmes aimed at this age group. The objective of this work was to analyse the prevalence of HIV/STIs among adolescents and to identify the sociodemographic, clinical and behavioural markers associated with these infections, in order to promote specific preventive strategies. METHODOLOGY: Retrospective descriptive study of adolescents, aged 10-19 years, who were attended to for the first consultation between 2016 and 2018 in a reference STI clinic in Madrid. All adolescents were given a structured epidemiological questionnaire where information on sociodemographic, clinical and behavioural characteristics was collected. They were screened for human inmmunodeficiency virus (HIV) and other sexually transmitted infections (STIs). The processing and analysis of the data was done using the STATA 15.0 statistical package. RESULTS: The frequency of HIV/STIs detected among all adolescents was: gonorrhoea 21.7%, chlamydia 17.1%, syphilis 4.8% and HIV 2.4%. After conducting a multivariate analysis, the independent and statistically significant variables related to the presence of an STI were having first sexual relations at a young age and having a history of STIs. Latin American origin was just below the level of statistical significance (p = 0.066). DISCUSSION/CONCLUSIONS: Adolescents who begin sexual relations at an early age or those who have a history of HIV/STIs are at higher risk of acquiring STIs. Comprehensive prevention programmes aimed specifically at adolescents should be implemented, especially before the age of 13 years.

Wikipedia como fuente de información sobre las enfermedades de transmisión sexual curables / Wikipedia as a source of information about curable sexually transmitted diseases

OBJETIVO: Determinar la pertinencia de la terminología de la edición española de Wikipedia como fuente de información sobre enfermedades de transmisión sexual curables (ETSc) y el uso y consulta por parte de la población. MÉTODOS: Diseño descriptivo transversal. Los términos se tomaron del glosario InfoSIDA, mediante muestreo aleatorio y seleccionando además las 4 ETSc (sífilis, gonorrea, clamidiasis y tricomoniasis). La existencia del término y su pertinencia se constató accediendo a la edición española de Wikipedia. Las variables cualitativas se describieron por su frecuencia y porcentaje; las cuantitativas, mediante media y desviación estándar. La existencia de asociación, entre variables cualitativas, se analizó mediante la prueba de chi-cuadrado y la diferencia de medias mediante la prueba t de Student. RESULTADOS: Se determinaron 261 términos adecuados. Los datos medios por término fueron: edad 4286,05 +/- 64,88 días; actualización 129,56 +/- 12,78 días; ediciones 454,34 +/- 40,04 y consultas 61735,25 +/- 4168,44 en 90 días. Los resultados sobre las 4 ETSc curables presentaron mayor número de ediciones y consultas. CONCLUSIONES: La presencia de términos y el elevado número de consultas que se realizan en Wikipedia la dotan de un enorme potencial para la transmisión del conocimiento sobre las ETS. La pertinencia de la información sobre las 4 ETSc, a excepción de la entrada sobre Tricomoniasis, podría considerarse apropiada. Sin embargo, existen lagunas que deben ser corregidas para ofrecer una correcta información a la población

OBJECTIVE: To determine the relevance of the terminology of the Spanish edition of Wikipedia as a source of information on curable sexually transmitted diseases (cSTD) and the use and consultation by the population. METHODS: Cross sectional study. The terms were taken from the AIDSinfo glossary, through random sampling and also selecting the 4 cSTD (syphilis, gonorrhea, chlamydia and tricomoniasis). The existence of the term and its relevance was verified accessing the Spanish edition of Wikipedia. The qualitative variables were described by their frequency and percentage; the quantitative ones, by mean and standard deviation. The existence of association among qualitative variables was analyzed using chi-square test and the difference of mean by the test t-Student. RESULTS: 261 terms were determined appropriate. Middle term data were: age 4286. 05 +/- 64. 88 days; update 129.56 +/- 12.78 days; editions 454.34 +/- 40.04 and consultations 61735.25 +/- 4168.44 in 90 days. The results on the 4 cSTD curable had greater numbers of editions and consultations. CONCLUSIONS: The presence of terms and the high number of consultations carried out in Wikipedia give it an enormous potential for the transmission of knowledge about STDs. The suitability of the information on the 4 cSTD, with the exception of the entry on tricomoniasis, could be considered appropriate. However, there are gaps that should be corrected to provide accurate information to the population

Treponema pallidum infection predicts sexually transmitted viral infections (hepatitis B virus, herpes simplex virus-2, and human immunodeficiency virus) among pregnant women from rural areas of Mwanza region, Tanzania.

BACKGROUND: Sexually transmitted infections (STIs) is a global health problem with increased risk and morbidities during pregnancy. This study investigated the magnitude of viral STIs among pregnant women from three rural hospitals/clinics providing antenatal care in Mwanza region, Tanzania. METHODS: Between February and May 2018, a total of 499 pregnant women were enrolled and tested for Human immunodeficiency virus (HIV), Herpes simplex virus-2 (HSV-2), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) using rapid immunochromatographic tests and for syphilis using non-treponemal and treponemal antibody test. RESULTS: The median age of enrolled women was 25 (IQR: 22-31) years. Seventy eight (15.6, 95% CI: 12-18) of women tested had at least one sexually transmitted viral infection. Specific prevalence of HIV, HBV, HCV, HSV-2 IgG and HSV-2 IgM were found to be 25(5.0%), 29(5.8%), 2(0.4%), 188(37.7%) and 24(4.8%), respectively. The odds of having viral infection was significantly high among women with positive T. pallidum serostatus (adjusted odd ratio (aOR): 3.24, 95%CI; 1.2-85). By multivariable logistic regression analysis, history of STIs predicted HSV-2 IgM seropositivity (aOR: 3.70, 95%CI: 1.43-9.62) while parity (aOR: 1.23, 95%CI: 1.04-1.46) predicted HBV infection and syphilis positive results (aOR: 8.63, 95%CI: 2.81-26.45) predicted HIV infection. CONCLUSION: A significant proportion of pregnant women in rural areas of Mwanza region has at least one sexually transmitted viral infection which is independently predicted by positive T. pallidum serostatus. The strengthening and expansion of ANC screening package to include screening of STIs will ultimately reduce the viral STIs among pregnant women hence reduce associated morbidities and mortalities.

Acquiring of knowledge about sexual health by blind people: an action research. / Aquisição de conhecimentos sobre saúde sexual por pessoas cegas: uma pesquisa-ação.

OBJECTIVE: to evaluate knowledge about sexual health, with blind people, before and after educational intervention. METHOD: action research conducted with 58 blind people enrolled in a philanthropic educational institution. A form with sociodemographic and knowledge variables about Sexually Transmitted Infections was used. The Chi-square and Fisher tests were performed. RESULTS: men presented higher frequency of alcoholism (p <0.001) and illicit drugs (p = 0.006). It was found that they used a male condom more frequently than women using a female condom (p = 0.003), although they had more knowledge about the prevention of Sexually Transmitted Infections (p = 0.006). Among these infections, Trichomonas vaginalis (52.4%) was more frequent. Knowledge gaps on risk factors and safe sex were identified. After the intervention, an increase in the knowledge about sexual health was detected. CONCLUSION: the educational intervention, in the light of problematizing pedagogy, (re) constructed the knowledge on sexual health, empowering the participants regarding the prevention of Sexually Transmitted Infections. Therefore, it is necessary that nurses carry out educational interventions with this clientele, aiming to soften deficits of knowledge about the thematic in screen.

Mycoplasma Genitalium and Mycoplasma Hominis are prevalent and correlated with HIV risk in MSM: a cross-sectional study in Shenyang, China.

BACKGROUND: A high proportion of men who have sex with men (MSM) use geosocial networking apps (Apps) to seek partners. However, the relationship of app use with HIV risk is unknown. Further, the risks of some sexually transmitted infection (STIs), including Mycoplasma genitalium, have seldom been studied among MSM. METHODS: MSM were enrolled at a community-based HIV testing site in Shenyang, China. After completing a questionnaire survey, we collected rectal swabs and venous blood specimens. We then simultaneously tested for ten STIs (Chlamydia trachomatis [CT], Neisseria gonorrhea [NG], Ureaplasma urealyticum [Uu], Ureaplasma parvum species [Up1, Up3, Up6, Up14), Mycoplasma hominis [Mh], Mycoplasma genitalium [Mg], and Herpes Simplex Virus Type 2 (HSV-2) using multiple PCR. We also performed blood tests for HIV, Syphilis, Hepatitis C antibody (HCV-Ab), Hepatitis B Surface Antigen (HBsAg), and Hepatitis A-IgM (HAV-IgM), etc. RESULTS: One hundred and eighty-three MSM participated in this study, of which 51.4% reported seeking partners through apps in the past year. The prevalence of HIV was 19.7%, Syphilis 12.0%, HAV 1.1%, rectal Mg 15.3% and Mh 7.1%. Multivariable logistic regression showed that HIV infection was independently correlated with app-using behavior (adjusted odds ratio[aOR] = 2.6), Mg infection (aOR = 3.2), Mh infection (aOR = 4.1) and Syphilis infection (aOR = 3.1) (each P < 0.05). CONCLUSIONS: App use, Mg, Mh and Syphilis infection were correlated with higher HIV Risk in MSM. Geosocial networking apps should be utilized for HIV interventions targeting MSM. There is a need for more expansive STIs screening, particularly for Mg, Mh and Syphilis in MSM.

Prevalence of sexually transmitted infections and bacterial vaginosis among lesbian women: systematic review and recommendations to improve care.

Our aim was to systematically review data about the risk of sexually transmitted infections (STI) and bacterial vaginosis among lesbian women and to suggest strategies to improve prevention, diagnosis and treatment. A search strategy for lesbian, STI and bacterial vaginosis was applied to PubMed, LILACS and BDENF databases. Of 387 unique references retrieved, 22 fulfilled the inclusion criteria (cross-sectional studies reporting prevalence for 8 STIs/bacterial vaginosis and history of a STI). The most frequent infection reported was bacterial vaginosis, and none study reported data on hepatitis B. A wide range of prevalence was observed for most infections. In terms of risk factors, the number of sexual partners, the past or current smoking, a history of forced sex and sexual stigma seem to increase the risk of STI and bacterial vaginosis. The findings of this review are discussed considering guidelines directly addressing the LGBT community's health and relevant studies investigating both safe sexual practices and the intricate relationship between LGBT people and their care providers. A set of recommendations to improve preventive care for lesbian women is proposed. Affirming that little is known about the extent of STIs and bacterial vaginosis transmission in female-to-female sexual activities or about the risk factors for STI and bacterial vaginosis among lesbian women is reasonable. In fact, the overall quality of the studies was low or very low with significant uncertainty around their findings. However, we consider that the available knowledge indicates some paths to be followed by care providers and policy decision-makers to improve their actions towards better sexual health of lesbian women.

Prevalence of sexually transmitted infections and bacterial vaginosis among lesbian women: systematic review and recommendations to improve care / Prevalência de infecções sexualmente transmissíveis e vaginose bacteriana em mulheres lésbicas: revisão sistemática e recomendações para melhoria do cuidado / Prevalencia de infecciones sexualmente transmisibles y vaginosis bacteriana entre mujeres lesbianas: revisión sistemática y recomendaciones para mejorar el cuidado

Our aim was to systematically review data about the risk of sexually transmitted infections (STI) and bacterial vaginosis among lesbian women and to suggest strategies to improve prevention, diagnosis and treatment. A search strategy for lesbian, STI and bacterial vaginosis was applied to PubMed, LILACS and BDENF databases. Of 387 unique references retrieved, 22 fulfilled the inclusion criteria (cross-sectional studies reporting prevalence for 8 STIs/bacterial vaginosis and history of a STI). The most frequent infection reported was bacterial vaginosis, and none study reported data on hepatitis B. A wide range of prevalence was observed for most infections. In terms of risk factors, the number of sexual partners, the past or current smoking, a history of forced sex and sexual stigma seem to increase the risk of STI and bacterial vaginosis. The findings of this review are discussed considering guidelines directly addressing the LGBT community's health and relevant studies investigating both safe sexual practices and the intricate relationship between LGBT people and their care providers. A set of recommendations to improve preventive care for lesbian women is proposed. Affirming that little is known about the extent of STIs and bacterial vaginosis transmission in female-to-female sexual activities or about the risk factors for STI and bacterial vaginosis among lesbian women is reasonable. In fact, the overall quality of the studies was low or very low with significant uncertainty around their findings. However, we consider that the available knowledge indicates some paths to be followed by care providers and policy decision-makers to improve their actions towards better sexual health of lesbian women.

Nosso objetivo foi revisar sistematicamente dados sobre o risco de infecções sexualmente transmissíveis (ISTs) e vaginose bacteriana em mulheres lésbicas e sugerir estratégias para melhorar prevenção, diagnóstico e tratamento. Uma estratégia de busca para lésbica, ISTs e vaginose bacteriana foi aplicada às bases PubMed, LILACS e BDENF. De 387 referências únicas identificadas, 22 preenchiam os critérios de inclusão (estudos seccionais relatando a prevalência de 8 ISTs/vaginose bacteriana e histórico de ISTs). A infecção mais frequentemente relatada foi vaginose bacteriana e nenhum estudo relatou dados sobre hepatite B. Uma ampla gama de prevalências foi observada para a maioria das infecções. Em termos de fatores de risco, o número de parceiras sexuais, ser ou ter sido fumante, histórico de sexo forçado e estigma sexual parecem aumentar o risco de ISTs e vaginose bacteriana. Os resultados desta revisão são discutidos à luz de diretrizes que abordam diretamente a saúde da comunidade LGBT e também de estudos relevantes que investigaram tanto práticas de sexo seguro quanto a complexa relação entre pessoas LGBT e profissionais de saúde. Um conjunto de recomendações para melhorar o cuidado preventivo para mulheres lésbicas é proposto. É razoável afirmar que pouco se sabe sobre a dimensão da transmissão de ISTs e vaginose bacteriana em atividades sexuais entre mulheres ou sobre os fatores de risco para ISTs e vaginose bacteriana em mulheres lésbicas. De fato, a qualidade dos estudos foi, de forma geral, baixa ou muito baixa, com incerteza significativa quanto a seus resultados. Contudo, consideramos que o conhecimento disponível indica alguns caminhos a serem seguidos por profissionais de saúde e na elaboração de políticas públicas para melhorar ações em direção a uma melhor saúde sexual de mulheres lésbicas.

Nuestro objetivo fue realizar una revisión sistemática de los datos sobre infecciones de trasmisión sexual (ITS) y riesgo de vaginosis bacteriana entre mujeres lesbianas y sugerir estrategias para mejorar su prevención, diagnóstico y tratamiento. La estrategia de búsqueda de lesbiana, ITS y vaginosis bacteriana se realizó en las bases de datos de PubMed, LILACS y BDENF. De 387 referencias únicas recogidas, 22 reunían criterios de inclusión (estudios transversales informaron sobre la prevalencia de 8 ITS/vaginosis bacteriana e historial de una ITS). La infección más frecuente fue vaginosis bacteriana y ningún estudio proporcionó datos sobre hepatitis B. se observó un amplio rango de prevalencia para la mayoría de las infecciones. En términos de factores de riesgo, el número de parejas sexuales, ser fumador o exfumador, un pasado de abusos sexuales, así como el estigma sexual parece que incrementaron el riesgo de ITS y vaginosis bacteriana. Los hallazgos del presente estudio se discuten a la luz de las directrices de salud directamente dirigidas a la comunidad LGBT, y también a estudios relevantes que investigaban tanto las prácticas sexuales seguras, como la relación intricada entre individuos del colectivo LGBT y sus proveedores de salud. Se propone un conjunto de recomendaciones para mejorar el cuidado preventivo de mujeres lesbianas. Es razonable afirmar que se conoce poco sobre el grado de transmisión de las ITS y vaginosis bacteriana en las relaciones sexuales entre mujeres o sobre los factores de riesgo para las ITS y vaginosis bacteriana entre mujeres lesbianas. De hecho, la calidad general de los estudios fue baja o muy baja con una incertidumbre significativa sobre sus resultados. No obstante, consideramos que el conocimiento disponible indica algunos caminos que pueden recorrer proveedores de salud y tomadores decisiones para mejorar sus acciones orientadas a una mejor salud sexual de las mujeres lesbianas.

The UALE project: a cross-sectional approach for trends in HIV/STI prevalence among key populations attending STI clinics in Guatemala.

OBJECTIVE: To describe and compare trends in prevalence, sexual behaviour and HIV transmission knowledge data related to sexually transmitted infections (STI) and HIV in patients attending three STI clinics over an 8-year period in Escuintla Department, Guatemala. METHODS: STI clinic attendees were classified into transmission groups as follows: female sex workers (FSW), men who have sex with men (MSM) and 'high-risk heterosexuals' (HRH). Annual cross-sectional analysis and multivariable Poisson regression adjusted for sociodemographic variables were used for prevalence comparisons and adjusted prevalence trends for HIV/STI outcomes and used for adjusted trends in proportions in sexual behaviour and HIV transmission knowledge outcomes. Endocervical swabs were obtained to detect trichomonas, chlamydia and neisseria infections. Serologies for syphilis and HIV were performed using rapid tests. For reactive HIV samples, positivity was confirmed by an ELISA. All reactive syphilis samples were further confirmed for diagnosis of active syphilis disease. RESULTS: From a total of 4027 clinic attendees, 3213 (79.78%) were FSW, 229 (5.69%) were MSM and 585 (14.53%) were HRH. The proportion of FSW, MSM and HRH who had a single visit was 56.42%, 57.23% and 91.10%, respectively. Overall, HIV prevalence was 2.10% in FSW, 8.17% in MSM and 4.12% in HRH. Prevalence trends in HIV and syphilis decreased in FSW. Prevalence trends in gonorrhoea did not decrease over time neither in FSW nor in HRH. Chlamydia and trichomonas infections in HRH showed an increase prevalence trend. In FSW, trends in condom use in last sexual intercourse with regular and occasional clients were above 93%. CONCLUSIONS: FSW show a decreasing trend in HIV, syphilis and chlamydia prevalence. Gonorrhoea prevalence in FSW and HRH did not decrease over time. HRH is a hard to engage population with low follow-up rates and high potential to act as a bridge population.

Caracterización de la sífilis temprana en el municipio Colón. 2011-2015 / Characterization of the early syphilis in the municipality Colón. 2011-2015

Introducción: las infecciones de transmisión sexual representan un importante riesgo para la vida. Se ha documentado con revisiones nacionales e internacionales el incremento de casos de sífilis, sobre todo en varones homosexuales. Objetivo: caracterizar la morbilidad por sífilis en el municipio Colón. Materiales y métodos: se realizó un estudio descriptivo transversal con un universo de 81 pacientes notificados de sífilis en el municipio de Colón durante quinquenio 2011 al 2015. Se obtuvo la información de las tarjetas de Enfermedad de Declaración Obligatoria y de las historias clínicas. Se manejaron variables epidemiológicas: edad, sexo, ocupación, año de diagnóstico, etapa de notificación, serología inicial y orientación sexual. Se introdujeron los datos en excel y se utilizaron medidas estadísticas de frecuencia absoluta y relativa. Previo al proceso se solicitó el consentimiento del consejo científico. Resultados: se constató un aumento progresivo de la incidencia en el quinquenio con relevancia de los dos últimos años. Prevaleció la enfermedad en jóvenes entre 20 y 29 años. Hubo un predominio de hombres. Más de la tercera parte de los hombres tenían una orientación homosexual. Un 16.7% de las mujeres estaban en gestación. Se destacaron las personas sin vínculo laboral y educacional dado por un 41.9%. Las diluciones altas en las serologías iniciales y el secundarismo como etapa de notificación fueron variables representadas por más de la mitad de los pacientes analizados. Conclusiones: la sífilis está en reemergencia. El municipio de Colón aporta un número importante en las estadísticas con un ascenso en sus notificaciones. Se evidencian grupos vulnerables para adquirir esta infección y en los que se debe enfocar el control de foco para modificar su incidencia hacia indicadores favorables (AU).

Introduction: the infections of sexual transmission represent an important risk for the life. It has been documented with national and international revisions the increment of cases of syphilis, mainly in homosexual males. Objective: to characterize the morbilidad for syphilis in the municipality Columbus. Materials and methods: He/she was carried out a traverse descriptive study with an universe of 81 notified patients of syphilis in the municipality of Columbus during five year period 2011 at the 2015.Se he/she obtained the information of the cards of EDO and of the clinical histories. Epidemic variables were managed: age, sex, occupation, year of diagnostic, notification stage, initial serología and sexual orientation. The data were introduced in excel and statistical measures of absolute and relative frequency were used. Previous to the process the consent of the scientific advice was requested. Results: A progressive increase of the incidence was verified in the five year period with the two year-old relevance. The illness prevailed in youths between 20 and 29 years. There was a prevalence of men. More than the third part of the men they had a homosexual orientation. 16.7% of the women was in gestation. People stood out without labor and educational bond given by 41.9%. The high dilutions in the initial serologías and the secundarismo like notification stage were variable represented for more than half of the analyzed patients. Conclusions: the syphilis is in reemergencia. The municipality of Columbus contributes an important number in the statistics with an ascent in its notifications. Vulnerable groups are evidenced to acquire this infection and in those that the focus control should be focused to modify its incidence toward favorable indicators (AU).

Caracterización de la sífilis temprana en el municipio Colón. 2011-2015 / Characterization of the early syphilis in the municipality Colón. 2011-2015

Introducción: las infecciones de transmisión sexual representan un importante riesgo para la vida. Se ha documentado con revisiones nacionales e internacionales el incremento de casos de sífilis, sobre todo en varones homosexuales. Objetivo: caracterizar la morbilidad por sífilis en el municipio Colón. Materiales y métodos: se realizó un estudio descriptivo transversal con un universo de 81 pacientes notificados de sífilis en el municipio de Colón durante quinquenio 2011 al 2015. Se obtuvo la información de las tarjetas de Enfermedad de Declaración Obligatoria y de las historias clínicas. Se manejaron variables epidemiológicas: edad, sexo, ocupación, año de diagnóstico, etapa de notificación, serología inicial y orientación sexual. Se introdujeron los datos en excel y se utilizaron medidas estadísticas de frecuencia absoluta y relativa. Previo al proceso se solicitó el consentimiento del consejo científico. Resultados: se constató un aumento progresivo de la incidencia en el quinquenio con relevancia de los dos últimos años. Prevaleció la enfermedad en jóvenes entre 20 y 29 años. Hubo un predominio de hombres. Más de la tercera parte de los hombres tenían una orientación homosexual. Un 16.7% de las mujeres estaban en gestación. Se destacaron las personas sin vínculo laboral y educacional dado por un 41.9%. Las diluciones altas en las serologías iniciales y el secundarismo como etapa de notificación fueron variables representadas por más de la mitad de los pacientes analizados. Conclusiones: la sífilis está en reemergencia. El municipio de Colón aporta un número importante en las estadísticas con un ascenso en sus notificaciones. Se evidencian grupos vulnerables para adquirir esta infección y en los que se debe enfocar el control de foco para modificar su incidencia hacia indicadores favorables (AU).

Introduction: the infections of sexual transmission represent an important risk for the life. It has been documented with national and international revisions the increment of cases of syphilis, mainly in homosexual males. Objective: to characterize the morbilidad for syphilis in the municipality Columbus. Materials and methods: He/she was carried out a traverse descriptive study with an universe of 81 notified patients of syphilis in the municipality of Columbus during five year period 2011 at the 2015.Se he/she obtained the information of the cards of EDO and of the clinical histories. Epidemic variables were managed: age, sex, occupation, year of diagnostic, notification stage, initial serología and sexual orientation. The data were introduced in excel and statistical measures of absolute and relative frequency were used. Previous to the process the consent of the scientific advice was requested. Results: A progressive increase of the incidence was verified in the five year period with the two year-old relevance. The illness prevailed in youths between 20 and 29 years. There was a prevalence of men. More than the third part of the men they had a homosexual orientation. 16.7% of the women was in gestation. People stood out without labor and educational bond given by 41.9%. The high dilutions in the initial serologías and the secundarismo like notification stage were variable represented for more than half of the analyzed patients. Conclusions: the syphilis is in reemergencia. The municipality of Columbus contributes an important number in the statistics with an ascent in its notifications. Vulnerable groups are evidenced to acquire this infection and in those that the focus control should be focused to modify its incidence toward favorable indicators (AU).

Dificultad en el diagnóstico de una infección de transmisión sexual cada vez más frecuente / Increasingly frecuent difficulty in the diagnosisof a sexually transmitted disease

La sífilis es una infección de transmisión sexual (ITS) curable, causada por una bacteria llamada Treponema pallidum. Es de transmisión sexual y vertical en el embarazo. Esta patología se presenta en diferentes estadios, y cada uno se manifiesta con lesiones bucales particulares. El objetivo del presente trabajo es caracterizar las diversas manifestaciones clínicas en el período secundario aportando con imágenes propias de la experiencia en la práctica diaria. Esta etapa secundaria se expresa con gran variabilidad y multiplicidad de lesiones, lo que desorienta y crea dificultades a lahora del diagnóstico. Es de interés también actualizar el conocimiento a los profesionales de la salud y al odontólogo general sobre las pruebas serológicas que lo ayudarán a complementar y confirmar el diagnóstico de certeza.

Syphilis is a curable sexually transmitted disease (STD), caused by a bacterium called Treponema pallidum.It is transmitted sexually and vertically in pregnancy. This pathology occurs in different stages, andeach of them manifests particular oral lesions.The objective of the present article is to characterize the various clinical manifestations in the secondary period contributing with images of the experience in daily practice. This secondary stage expresses great variability and multiplicity of lesions, which is disorienting and creates difficulties when it comes to diagnosis.It is also of interest to update the knowledge for health professionals and general dentists on the serological tests that will help to complement and confirm the firm diagnosis.

Sexual violence cases in a hospital setting in Hong Kong: victims' demographic, event characteristics, and management.

INTRODUCTION: Rainlily, the first one-stop crisis centre in Hong Kong, was set up in 2000 to protect female victims of sexual violence. This study aimed to analyse the characteristics of sexual assault cases and victims who presented to two hospitals in Hong Kong. The data are invaluable for health care professionals and policymakers to improve service provision to these victims. METHODS: This retrospective analysis of hospital records was conducted in two acute hospitals under the Hospital Authority in Hong Kong. Sexual assault victims who attended the two hospitals between May 2010 and April 2013 were included. Characteristics of the cases and the victims, the use of alcohol and drugs, involvement of violence, and the outcome of the victims were studied. RESULTS: During the study period, 154 sexual assault victims attended either one of the two hospitals. Their age ranged from 13 to 64 years. The time from assault to presentation ranged from 1 hour to more than 5 months. Approximately 50% of the assailants were strangers. Approximately 50% of victims presented with symptoms; the most common were pelvic and genitourinary symptoms. Those with symptoms (except pregnancy) presented earlier than those without. The use of alcohol and drugs was involved in 36.4% and 11.7% of cases, respectively. Approximately 10% of the screened victims were positive for Chlamydia trachomatis. There were 11 pregnancies with gestational age ranged from 6 weeks to 5 months at presentation. Less than half of the victims completed follow-up care. CONCLUSIONS: Involvement of alcohol and drugs is not uncommon in sexual assault cases. Efforts should be made to promote public education, enhance coordination between medical and social services, and improve the accessibility and availability of clinical care. Earlier management and better compliance with follow-up can minimise the health consequences and impact on victims.

Intimate partner violence after the diagnosis of sexually transmitted diseases.

OBJECTIVE To assess the prevalence and factors associated with intimate partner violence after the diagnosis of sexually transmitted diseases. METHODS This cross-sectional study was conducted in Fortaleza, CE, Northeastern Brazil, in 2012 and involved 221 individuals (40.3% male and 59.7% female) attended to at reference health care units for the treatment of sexually transmitted diseases. Data were collected using a questionnaire applied during interviews with each participant. A multivariate analysis with a logistic regression model was conducted using the stepwise technique. Only the variables with a p value < 0.05 were included in the adjusted analysis. The odds ratio (OR) with 95% confidence interval (CI) was used as the measure of effect. RESULTS A total of 30.3% of the participants reported experiencing some type of violence (27.6%, psychological; 5.9%, physical; and 7.2%, sexual) after the diagnosis of sexually transmitted disease. In the multivariate analysis adjusted to assess intimate partner violence after the revelation of the diagnosis of sexually transmitted diseases, the following variables remained statistically significant: extramarital relations (OR = 3.72; 95%CI 1.91;7.26; p = 0.000), alcohol consumption by the partner (OR = 2.16; 95%CI 1.08;4.33; p = 0.026), history of violence prior to diagnosis (OR = 2.87; 95%CI 1.44;5.69; p = 0.003), and fear of disclosing the diagnosis to the partner (OR = 2.66; 95%CI 1.32;5.32; p = 0.006). CONCLUSIONS Individuals who had extramarital relations, experienced violence prior to the diagnosis of sexually transmitted disease, feared disclosing the diagnosis to the partner, and those whose partner consumed alcohol had an increased likelihood of suffering violence. The high prevalence of intimate partner violence suggests that this population is vulnerable and therefore intervention efforts should be directed to them. Referral health care services for the treatment of sexually transmitted diseases can be strategic places to identify and prevent intimate partner violence.

Sexually transmitted infections.

In no other medical field former rare infections of the 1980(th) and 1990(th) occur again as this is seen in the field of venerology which is as well based on the mobility of the population. Increasing rates of infections in Europe, and increasing bacteriological resistances face health professionals with new challenges. The WHO estimates more than 340 million cases of illnesses worldwide every year. Diseases caused by sexually transmitted infections (STI) in a strict sense are syphilis, gonorrhea, lymphogranuloma venereum, granuloma inguinale, and chancroid. In a wider sense, all illnesses are included which can mainly be transmitted through sexual contact. The term "sexual contact" has to be seen widely, from close physical contact to all variants of sexual behavior. This CME article is an overview of the most common occurring sexually transmitted infections in clinical practice. Both, basic knowledge as well as recent developments are discussed below.

Classification of incidence and prevalence of certain sexually transmitted infections by world regions.

OBJECTIVES: This study sought to assess if there is a meaningful way in which variations in sexually transmitted infection (STI) prevalence can be classified at the level of world regions. METHODS: Linear regression was performed to assess if the incidence and prevalence of six STIs (HIV, herpes simplex virus type 2, chlamydia, gonorrhea, syphilis, and trichomoniasis) by world region was positively correlated. Partitioning around medoids (PAM) was then used to assess if the regions of the world can be classified according to the incidence and prevalence of these STIs. RESULTS: We found evidence that STI incidence/prevalence varies considerably in different regions around the world. Linear regression revealed that the incidence and prevalence of certain STIs by world region was positively correlated (Pearson's correlation coefficient varied from 0.664 to 0.985). PAM provided support for dividing the world regions into two, three, or four STI incidence/prevalence categories, but it provided most support for the two-category system. In each of these systems the East Asia/Pacific and North Africa/Middle East regions were in the lowest STI category and Sub-Saharan Africa was the only region in the high STI category. CONCLUSIONS: The incidence and prevalence of certain STIs by world region are positively correlated. The world regions can be meaningfully classified according to STI incidence/prevalence.