Timmermannfitzpatrick7376

The objective of this study was to evaluate a culturally adapted evidence-based intervention (EBI) called EMPWR for impacts on sexually transmitted infection (STI) screening and sexual health risk behaviors.

We enrolled Native American adults with recent binge substance use from a rural, reservation community in the Southwest into a 11 randomized controlled trial (RCT) conducted July 2015 to June 2019. All participants were offered non clinic-based self-administered STI screening. Data were collected via self-report at baseline, 3-months and 6-months post-intervention. Baseline and endline data are presented.

301 participants enrolled and had mean age of 33.8 years; 46.5% of the sample were female, and 9.1% were employed at baseline. EMPWR participants were more likely to complete STI self-screening than control participants (38.2% vs. https://www.selleckchem.com/products/gsk621.html 23.8%, p=0.0275). EMPWR participants reported fewer unprotected sex acts in the past 3 months (9.3 vs. 16.0, p= 0.001) and were more likely refuse sex if their partner wavancing sexual health equity in this high priority population.

Knowing the number of persons at risk for sexually transmitted diseases (STD) and their risk behaviors are needed to allocate limited resources, set targets for prevention and care activities, gauge the reach of programs, and assess their impact. Female sex workers (FSW) are a population at high risk for STD worldwide; little is known about FSW in Bhutan.

We conducted a community-based survey and population size exercise of FSW in Bhutan. The survey used a hybrid venue-based/peer-referral sampling method. Population size estimation methods were key informant mapping, census and enumeration, unique object multiplier, and capture-recapture.

Of 517 women surveyed, 67.5% provided sex for money in the last year. Compared to FSW at venues, FSW referred by peers were more likely to have sex with alcohol (80.1% vs 51.5%, p<0.001) and more paying partners (mean 3.5 vs 2.0, p=0.001), and less likely to have tested for an STD (28.3% vs 51.0%, p<0.001) or have outreach worker contact (27.6% vs 41.5%, p=0.007). The estimated number of FSW in the nine districts was 353 (95% CI 345-362). Extrapolation to the whole country projected 597 (417-777) FSW nationally.

Our estimate of the number of FSW in Bhutan corresponds to 0.71% of adult urban women, a figure in line with other countries in South and Southeast Asia. Our data highlight the need for outreach beyond venues where women are employed to reach FSW at higher risk for STD but who have less access to interventions.

Our estimate of the number of FSW in Bhutan corresponds to 0.71% of adult urban women, a figure in line with other countries in South and Southeast Asia. Our data highlight the need for outreach beyond venues where women are employed to reach FSW at higher risk for STD but who have less access to interventions.

Black men who have sex with men are at disproportionate risk for sexually transmitted infections (STI). Understanding the drivers of those disparities can lead to culturally-tailored interventions. We aimed to characterize the incidence and correlates of STI among Black individuals from HPTN 061, a multi-city cohort study conducted from 2009-2011 in the US.

We used Cox proportional hazards regression to estimate adjusted hazard ratios (aHR) accounting for within participant correlation over multiple follow-up visits (enrollment, 6- and 12-month). We examined correlates of incident rectal and urethral STI as well as incident syphilis.

Among 1522 individuals, the incidence of urethral and rectal Neisseria gonorrhoeae infection was 1.0 (95%CI 0.6, 1.8) and 4.6 (95%CI 3.5, 6.3) cases per 100 person-years, respectively. The incidence of urethral and rectal Chlamydia trachomatis infection was 2.5 (95%CI 1.7, 3.6) and 2.5 (95%CI 1.7, 3.7) cases per 100 person-years, respectively. The incidence of syphilis was 3.6 (95% CI 2.7-4.9) cases per 100 person-years. Younger age was associated with increased odds of incident urethral (aHR=5.1; 95% CI 2.3-11.1) and rectal (aHR=2.6; 95% CI 1.6-4.3) STI. Diagnosis of a rectal STI at baseline (aHR=2.3; 95% CI 1.1-4.0), use of saliva as lubricant (aHR=1.7; 95% CI 1.1-2.8) were associated with incident rectal STI. Diagnosis of syphilis at baseline was associated with incident syphilis during follow-up (aHR 5.6; 95% CI 2.5-12.2).

Younger participants had the highest STI incidence. Use of saliva as lubricant may be a driver of rectal infection, which deserves further study.

Younger participants had the highest STI incidence. Use of saliva as lubricant may be a driver of rectal infection, which deserves further study.

No studies have focused on the prevalence and clinical manifestations of penile gonococcal cutaneous and accessory gland infections in men with gonorrhea.

We enrolled patients with penile gonococcal cutaneous and accessory gland infections and patients with urethral gonorrhea from January 2014 to February 2020. Demographic data, occurrence sites, and manifestations of all patients were recorded.

Fifty-one patients with penile gonococcal cutaneous and accessory gland infections were observed among 1,994 (2.6%; 95% CI, 1.9%-3.4%) patients with urethral or penile gonorrhea. Lesions were present at the external urethral orifice in 22(43%) patients, at the glans in 11 (21%), in the side of the frenulum of the prepuce in 7 (14%), in the penile raphe in 5 (10%), in the inner plate of the prepuce in 1 (2%), in the external urethral orifice and side of the frenulum of the prepuce in 3 (6%), and in the glans and side of the frenulum of the prepuce in 2 (4%). The lesions manifested as sinus-like lesions in 22 (43%) patients, abscesses in 14 (27%), nodules in 10 (20%), pustules in 3 (6%), nodules with sinus tracts in 1 (2%), and ulcers in 1 (2%).

Penile gonococcal cutaneous and accessory gland infections in men probably are more common than previously understood. They mainly involve the paraurethral duct, glans, Tyson's gland, and penile raphe. Lesions mainly present as sinus-like lesions, abscesses, and nodules.

Penile gonococcal cutaneous and accessory gland infections in men probably are more common than previously understood. They mainly involve the paraurethral duct, glans, Tyson's gland, and penile raphe. Lesions mainly present as sinus-like lesions, abscesses, and nodules.Cervical cancer is five times more likely among women living with HIV (WHIV), likely due to higher prevalence of HPV. Despite evidence of higher rates with multiple HPV genotypes in WHIV, there are no recommendations for triage by HPV genotyping specific to WHIV. In Latin America/Caribbean (LAC) rates are high and vary significantly. To guide optimization of HPV-based cervical cancer screening among WHIV in LAC, review of current literature was completed to assess HPV genotype distribution by cervical disease grade in WHIV in this region; and further expanded globally for comparison across regions.A systematic review of the literature from June 2016 to January 2020 revealed 15 studies reporting HPV genotype distribution by cervical disease state (normal, low-grade disease, high-grade disease, and invasive cervical cancer) across different global regions.Across all studies, there were 6,928 WHIV from 4 global regions, 3,952 of whom were HPV-positive. Three studies from LAC were reviewed, with one providing enough detail to describe HPV genotypes by cervical disease grade and identified type 31 and 35 in high-grade cervical lesions. Of the studies included, 4 from Africa and Europe/North America each, and 1 from Asia included data that were able to be summarized.Latin America, a region which experiences high rates of HPV, HIV, and cervical disease, had few published studies reporting HPV genotypes by cervical disease grade, with one reporting individual HPV genotype and specific cervical disease grade. Identifying HPV types associated with CIN2+ in WHIV in this region has the potential to improve screening and treatment for cervical cancer prevention and should be the focus of future research.

US guidelines recommend human papillomavirus (HPV) vaccination for males and females up to 26, with more recent extended coverage for those 27-45 years based on discussion with patients' clinician. This study seeks to assess trends and disparities of vaccination in the United States based on demographic characteristics.

Data was obtained from the National Health and Nutrition Examination Survey between 2007 and 2016. Chi-squared analyses were utilized for statistical methods.

Of 12,844 participants (median age 22; range 9-36 years), 2,711 (21.3%) initiated HPV vaccination; of which 1,358 (56.3%) completed the 3-dose vaccination series. Vaccination rates were higher in females compared to males (24.6% vs. 13.0%; p<0.001) and in Whites compared to Mexican Americans (22.6% vs. 19.4%; p=0.02). The uninsured had lower vaccination rates than private insurance and Medicaid (12.5% vs. 22.4% vs. 28.5%; p<0.001). We divided the 10 year study into five separate time periods (2007-2008, 2009-2010, 2011-2012, 2013-2014, and 2015-2016) to analyze trends. Vaccine initiation increased from 19.6% to 49.6% for 14-19-year olds (p<0.001), 10.4% to 35.5% for females (p<0.001), and 8.5% to 32.9% for Blacks (p<0.001). Although on trend analyses, the vaccination rates with the highest proportional increase were found in those over 25-29 year olds (4.56 fold), Mexican Americans (4.56 fold), below high school education (2.32 fold), and low income group (2.90 fold) over time.

HPV vaccination rates in Mexican Americans increased nearly 5-fold over the last 10 years. However, their vaccination rates continue to lag behind Whites and Blacks.

HPV vaccination rates in Mexican Americans increased nearly 5-fold over the last 10 years. However, their vaccination rates continue to lag behind Whites and Blacks.

While molecular testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) is highly sensitive than traditional approaches, the cost can be prohibitive. Those high costs are amplified when the recommended screening approach is used, which requires separate testing of specimens from three anatomic sites (rectal, pharyngeal and urogenital). While individual molecular testing is standard of care (SOC), pooled testing may offer a cost-saving alternative.

Using the Xpert® CT/NG assay (Cepheid, Sunnyvale, CA) we tested urine, rectal and pharyngeal swabs for CT and NG in a high-risk cohort of participants assigned male at birth who reported sex with other persons who were assigned male at birth. Remnant specimens (0.34 mL from each anatomic site) were combined to perform a single 'pooled' test. We calculated positive and negative percent agreement between the pooled testing results with SOC Xpert CT/NG test results as the reference.

We conducted 644 pooled tests. Of those, 598 (92.3%) gave CT and NG results. The CT positive and negative percent agreement were 90.1% (95% CI 80.7%, 95.9%) and 99.2% (98.1%, 99.8%), respectively. The NG positive and negative percent agreement were 96.2% (95% CI 86.8%, 99.5%) and 99.8% (95% CI 99.0%, 100%), respectively. Pooled testing identified 4 CT and 1 NG infections that were negative at all anatomic sites by individual testing.

Three-site pooled CT and NG testing performs similarly to single anatomic site testing among tests providing a valid result. Future cost analyses should evaluate the cost effectiveness of pooled three-site testing to determine if such a strategy improves the feasibility and accessibility of molecular STI testing.

Three-site pooled CT and NG testing performs similarly to single anatomic site testing among tests providing a valid result. Future cost analyses should evaluate the cost effectiveness of pooled three-site testing to determine if such a strategy improves the feasibility and accessibility of molecular STI testing.