Assuntos
Antibacterianos/administração & dosagem , Azitromicina/administração & dosagem , Infecções por Chlamydia/diagnóstico , Chlamydia trachomatis/isolamento & purificação , Gonorreia/diagnóstico , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Programas de Rastreamento/estatística & dados numéricos , Metronidazol/administração & dosagem , Neisseria gonorrhoeae/isolamento & purificação , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Tinidazol/administração & dosagem , Vaginite por Trichomonas/diagnóstico , Trichomonas vaginalis/isolamento & purificação , Adulto , Infecções por Chlamydia/tratamento farmacológico , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/prevenção & controle , Estudos Transversais , República Democrática do Congo/epidemiologia , Estudos de Viabilidade , Feminino , Gonorreia/tratamento farmacológico , Gonorreia/epidemiologia , Gonorreia/prevenção & controle , Humanos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Cuidado Pré-Natal , Resultado do Tratamento , Vaginite por Trichomonas/tratamento farmacológico , Vaginite por Trichomonas/epidemiologia , Vaginite por Trichomonas/prevenção & controleRESUMO
BACKGROUND: Gay, bisexual, and transgender youth and homeless youth are at high risk for sexually transmitted infections (STIs). However, little recent data exist describing STI positivity by anatomical site among those groups. We determined the positivity of Chlamydia trachomatis (CT) infection, Neisseria gonorrhoeae (NG) infection, and syphilis antibody reactivity among lesbian, gay, bisexual, transgender, and homeless youth. METHODS: We recruited 1,264 adolescents with high risk behavior aged 12 to 24 years from homeless shelters, lesbian, gay, bisexual, and transgender organizations, community health centers, and using social media and online dating apps in Los Angeles, California and New Orleans, Louisiana from May 2017 to February 2019. Participants received point-of-care pharyngeal, rectal, and urethral/vaginal CT and NG testing and syphilis antibody testing. We calculated STI positivity by anatomical site and compared positivity by participant subgroups based on human immunodeficiency virus (HIV) status, sex assigned at birth, and gender identity. RESULTS: CT and NG positivity and syphilis antibody reactivity was higher among HIV-infected adolescent men who have sex with men (MSM) than HIV-uninfected adolescent MSM (40.2% vs. 19%, P < 0.05), particularly CT or NG rectal infection (28% vs. 12.3%, P < 0.05). Of participants with positive CT or NG infections, 65% had extragenital-only infections, 20% had both extragenital and urogenital infections, and 15% had urogenital-only infections. CONCLUSIONS: Sexually transmitted infection positivity was high, particularly among transgender women and MSM. The high proportion of rectal and pharyngeal infections highlights the importance of both urogenital and extragenital STI screening. More accessible STI testing is necessary for high-risk adolescent populations.
Assuntos
Anticorpos Antibacterianos/sangue , Infecções por HIV/epidemiologia , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/microbiologia , Adolescente , Bissexualidade/estatística & dados numéricos , Criança , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/imunologia , Feminino , Gonorreia/diagnóstico , Gonorreia/imunologia , Infecções por HIV/diagnóstico , Pessoas Mal Alojadas/estatística & dados numéricos , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Los Angeles/epidemiologia , Masculino , Nova Orleans/epidemiologia , Fatores de Risco , Minorias Sexuais e de Gênero/estatística & dados numéricos , Infecções Sexualmente Transmissíveis/epidemiologia , Sífilis/diagnóstico , Sífilis/imunologia , Pessoas Transgênero/estatística & dados numéricos , Adulto JovemRESUMO
PURPOSE OF REVIEW: Sexually transmitted infection (STI) incidence is on the rise in the United States. The increase is especially pronounced in adolescents (15-24 years of age). Despite making up only a quarter of the population, adolescents account for approximately half of new STIs in the United States every year. This review summarizes recent developments in the field of STIs, excluding HIV, in adolescents. RECENT FINDINGS: In this review, we examine the epidemiology, screening, management, and prevention of STIs in adolescents. STI rates in adolescents have been rising since 2014, with young women and MSM at particularly high risk. Barriers to STI screening for adolescents include confidentiality concerns and lack of access to health services. Prevention through STI vaccines represents a promising way to combat the epidemic. SUMMARY: STIs are a growing concern for adolescents. Routine screening and management are of critical importance. Furthermore, prevention efforts such as human papillomavirus vaccination should be prioritized. Much of the current literature on STIs does not address the unique nature of STIs in adolescents, and additional research into effective prevention and treatment strategies of STIs in adolescents is urgently needed.
Assuntos
Infecções Sexualmente Transmissíveis/epidemiologia , Adolescente , Humanos , Programas de Rastreamento , Fatores de Risco , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/terapia , Infecções Sexualmente Transmissíveis/transmissão , Estados Unidos/epidemiologiaRESUMO
Hepatitis E virus (HEV) infection uncommonly causes chronic hepatitis and neurologic disease. We describe a case of genotype 3a HEV meningoencephalitis diagnosed by metagenomic next-generation sequencing, illustrating the power of an unbiased molecular approach to microbial testing and the first reported case of HEV infection presumably acquired through lung transplantation.