Normanenglish9975

Chlamydia, gonorrhea, and primary/secondary syphilis rates in 2018 were significantly higher in counties located in states without Medicaid expansion compared to those with Medicaid expansion. For STI combined, 59.9% of counties without Medicaid expansion were in the highest two STI rate quartiles compared to 42.2% of counties with Medicaid expansion (p less then 0.0001).

Gonorrhea is a sexually transmitted infection of global concern. We investigated whole genome sequencing (WGS) as a tool to measure and enhance partner notification (PN) in gonorrhea management.

Between May-November 2018, all N. gonorrhoeae isolated from patients attending Leeds Sexual Health, UK, underwent WGS. Reports listing sequences within 20 single nucleotide polymorphisms (SNPs) of study isolates within a database containing select isolates from April 1 2016 to November 15 2018 were issued to clinicians. The proportion of cases with a potential transmission partner identified by PN was determined from patient and PN data. WGS reports were reviewed to identify additional cases within ≤6 SNPs and verified for PN concordance.

380 isolates from 377 cases were successfully sequenced; 292 had traceable/contactable partners and 69 (18%) had a potential transmission partner identified by PN. Concordant PN and WGS links were identified in 47 partner pairs. Of 308 cases with no transmission partner by PN, 185 (60%) had a case within ≤6 SNPs; examination of these cases' PN data identified seven partner pairs with previously unrecognized PN link, giving a total of 54 pairs; all had ≤4 SNP differences. WGS clusters confirmed gaps in partner finding, at individual and group levels. Despite the clinic providing sexual health services to the whole city, 35 cases with multiple partners had no genetically related case, suggesting multiple undiagnosed infections.

WGS could improve gonorrhea PN and control by identifying new links and clusters with significant gaps in partner finding.

WGS could improve gonorrhea PN and control by identifying new links and clusters with significant gaps in partner finding.

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. 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). Epigenetic inhibitor price 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.