bluuebunny/crossref_metadata_2025 huggingface dataset:
P1-S6.31 HIV intertest interval among MSM in King County, Washington
Authors: Katz D , Dombrowski J , Buskin S , Golden M , Stekler J
Published: July 2011

Background

HIV testing remains one of the most effective HIV prevention interventions because most persons newly diagnosed with HIV alter their behaviours to reduce the risk of transmission to others. We examined temporal trends and correlates of the frequency of HIV testing among men who have sex with men (MSM) in King County, WA.

Methods

We evaluated electronic medical records of MSM testing for HIV at the Public Health—Seattle & King County (PHSKC) STD Clinic. The intertest interval (ITI) was defined as the number of days between the last reported HIV test and the current visit. ITIs ≤30 days were not considered to be new tests. Correlates of the ITI were determined using Wilcoxon rank-sum tests, Spearman's correlation coefficients, and median regression.

Results

Between 1 January 2003 and 7 December 2010, there were 13 637 HIV testing visits among MSM who reported a prior negative HIV test or did not know their status. These men reported a median ITI of 215 days (range: 31–8536; IQR: 124–409); 10 567 (77%) reported an ITI consistent with at least annual testing (<15 months) and 1693 (12%) reported no HIV test in the last 2 years. The median ITI decreased from 229 days in 2003 to 198 days in 2010 (p<0.001). Having sex with men only (vs men and women; p<0.0001), ≥10 male sex partners (p<0.0001), unprotected anal intercourse with a male partner of unknown or positive HIV status (p<0.0001), methamphetamine use (p=0.018), and poppers use (p<0.0001) in the last year were all associated with shorter ITIs, as were decreasing age (p<0.0001) and ever having been diagnosed with syphilis, gonorrhoea, or chlamydial infection (p<0.0001). Race, ethnicity, and injection drug use were not associated with ITI. In multivariate analyses, decreasing age, later visit year, sex with men only, ≥10 male sex partners in the last year, and history of bacterial STI remained associated with shorter ITIs (p<0.001 for all). The median ITI was longer in the 337 men (2.5%) newly diagnosed with HIV compared to those who tested HIV-negative (279 vs 213 days, respectively; p<0.0001).

Conclusions

From 2003 to 2010, the median ITI among MSM attending the PHSKC STD Clinic was 215 days, and this has decreased over time. Encouragingly, MSM at highest risk for HIV acquisition have even shorter ITIs, although those newly diagnosed with HIV continue to have longer ITIs. Further efforts are needed to reduce the time that HIV-infected persons are unaware of their status.
P1-S6.32 Optimising clinical systems to increase HIV/STI testing in gay men: the eTEST project
Authors: Drummond F , Lewis L , Bourne C , Ramanathan V , Hocking J , Wand H , Donovan B , Kaldor J , Guy R
Published: July 2011

Background

Despite HIV/STI testing rates being high (∼60%) on an annual basis in gay men in Australia, the proportion of “high risk” gay men having two or more HIV/STI tests per year, as specified in clinical guidelines, appears quite low (20%). Mathematical modelling predicts that increasing the frequency of HIV/STI testing among gay men with high numbers of sexual partners to 3–6 monthly would effectively stop the HIV and syphilis epidemics over a ten year period. We developed a multi-faceted intervention package based on information technology which aims to increase STI/HIV testing in high-risk men gay men. We describe the process and outcomes of the development stage of the intervention.

Methods

The intervention will be conducted over 2 years at 10–15 general practice clinics which see a high case load of gay men. These clinics provide both general healthcare and specialist sexual health and HIV management. All of these clinics utilise different patient management systems. We engaged a software company to develop a program adaptable to multiple clinic systems which aims to increase clinic efficiency and enhance sexual health testing. The process was undertaken over 12-month period in 2010 and involved extensive consultation with clinicians, stakeholders and information technology specialists.

Results

The program has now been developed and has four key elements: (i) passive prompts to remind clinicians when the next HIV/STI test is due based on the patient's risk assessment profile, testing guidelines and clinic record of past testing; (ii) SMS-based recalls which are automatically sent to patients when HIV/STI testing is overdue; (iii) a sexual health resource tool bar on the computer desktop of primary care providers to provide partner notification websites, up-to-date education brochures and referral systems that support collaboration between providers; and (iv) a reporting enhancement which allows practice staff to look at their data for the achievement of best practice and data quality targets. Further details of the system and functionality will be provided in the poster.

Conclusion

The program is the first clinical intervention we are aware of that addresses a range of important barriers to HIV/STI testing in a single information technology program. The system is currently being rolled out into the 10–15 clinics in Sydney and the impact of this intervention will be assessed by measuring the change in HIV/STI testing rates before-and-after the program. Interviews will also be conducted with clinicians and practice managers before and after the intervention to assess barriers to testing and acceptability and transferability of the intervention.
P1-S6.35 One finger stick, two tests: integrating syphilis and HIV Rapid tests for antenatal care and reproductive health services
Authors: Valderrama M , Chiappe M
Published: July 2011

Background

Mother-to-Child Transmission of HIV and Congenital Syphilis are two important public health problems in many developing countries. In Peru, coverage of syphilis screening is suboptimal, test results can take weeks and a high proportion of women screened are not treated, much less their sex partners. The objective of this study was to demonstrate the feasibility of implementing syphilis and HIV rapid tests at antenatal care and reproductive health services and to measure its effect on coverage of maternal syphilis screening and treatment coverage.

Methods

We trained midwives from 16 health centers, to offer syphilis rapid tests (Syphilis 3.0 BioLine) to women 16 to 55 years old receiving antenatal care (ANC) and seen at the delivery or miscarriage services, and to integrate it with HIV rapid tests already in place at the health network, but which were until then done from venous blood by laboratory technicians and with results given in 15 to 30 days.

Results

4497 women were screened, from January to November 2010. Prevalence of syphilis (RPR reactive, TPPA(+)) was 0.9% in ANC, 0.7% in delivery services and 1.9% at the miscarriage services. The prevalence of HIV by rapid test was 0.3%. The overall coverage for syphilis and HIV rapid tests was 93% during the study, compared to the 35% coverage of RPR testing reported for 2009 (Abstract P1-S6.35 figure 1). Previous coverage of HIV testing was not documented. Test results were given to 100% of women within 20 min of finger stick blood collection during the first contact with health providers, compared to a 27 days delay found in 2009. Treatment rates for syphilis also improved from 51% in 2009 to 93% in 2010. Whereas previously there was no system in place for registering partner treatment, our data shows that 59% of partners of positive women received treatment for syphilis during the study period. Key factors in the success of implementation in Callao-Peru; were ongoing training, monitoring, and supervision of health providers who performed the rapid tests.

Abstract P1-S6.35 Figure 1

Coverage of Syphilis screening by year and service Callao, Peru 2009–2010.

Conclusions

Implementation of syphilis rapid test proved feasible, acceptable and effective in improving screening and treatment coverage and can serve as a powerful catalyst for improvements in quality of care.
P1-S1.26 Prevalence ofTrichomonas vaginalisinfection during the first trimester of pregnancy in pregnant women on Maternal and Perinatal Institute
Authors: Cortez L
Published: July 2011

Summary Objective

To determine the prevalence ofTrichomonas vaginalisinfection during the first trimester of pregnancy in pregnant women in a Maternity Institute.

Methods

We contacted and recruited a total of 105 women with up to 3 months gestation who attended the outpatient. All of them filled out a consent form and were collected a sample of vaginal secretion, which was analysed for direct observation and inoculated into the culture medium InPouch TV (Biomed Diagnostics, White City, Oregon, USA) and incubated for up 72 h at 37°C. The samples were observed under the microscope for the presence of mobile parasites. Besides demographic data were collected.

Results

The prevalence of infection withT vaginaliswas 5.71% and 3.8% by culture and direct observation, respectively. The growing use of laboratory performance improvement in the report of the prevalence ofT vaginalis. Close supervision of this parasite during pregnancy using more sensitive laboratory methods see Abstract P1-S1.26 Figure 1.

Abstract P1-S1.26 Figure 1

“Prevalence ofTrichomonas vaginalisinfection during the first trimester of pregnancy in pregnant women”. Instituto Especializado Materno Perinatal. Lima, Mayo, Julio 2004.
P1-S6.36 Cost-effectiveness of rapid tests to improve access to syphilis prevention among pregnant women in Peru
Authors: Mallma P , Carcamo C , Valderrama M , Chiappe M , La Rosa S , Garcia P , Weaver M , Holmes K , Terris-Prestholt F , Peeling Rossana
Published: July 2011

Background

Several recent articles compared the cost and cost-effectiveness syphilis testing strategies to avert congenital syphilis in settings with high syphilis prevalence. Current study contributes analysis in low-prevalence setting. Methods. Rapid syphilis testing (RST) was implemented at two different settings, both with syphilis prevalences of around 1%: (a) The Ventanilla-Network of outpatient clinics and a small hospital at a peripheral district in Peru, where the rapid syphilis test was implemented together with the rapid HIV testing (One finger stick, two tests"); (b) The National Maternal and Perinatal Institute (INMP) a tertiary hospital with a high number of patients, and Initially in both settings the only test available was RPR with low coverage. For the costing of RPR we included supplies, capital costs, human resources and costs associated to treatment. For the costing of RST, we included also start up costs (advocacy meetings with authorities, training, supervision, monitoring) and the cost of implementing a quality assurance system. Cost-effectiveness analyses compared the cost of screening and treatment for the joint program to the disability adjusted life-years saved when congenital syphilis was averted.

Results

For the Ventanilla-Network the total cost was $5.98 for RST and $5.22 for RPR per woman screened and $580.83 and $1845.55 respectively per woman treated. In contrast, the total cost was $2.53 for rapid syphilis test and $3.15 for RPR per woman screened (the lower costs probably associated to the economy of scale, due to the large number of women seen at the INMP) and $336.80 and $1051.59 at INMP. At Ventanilla-Network, the cost per DALY saved from averting cases of congenital syphilis was $35.23 for rapid syphilis test and $111.95 for RPR. In incremental analysis, the rapid test was cost-saving. At INMP, the cost per DALY saved was $20.43 for rapid syphilis test and $63.79. For the Ventanilla-Network and the INMP the RST was cost-effective by the WHO standard of $64/DALY.

Conclusion

Syphilis screening is cost-effective even in a low-prevalence setting. To the extent that HIV rapid tests are funded by PMTCT programs, the cost of scaling up rapid syphilis tests would be lower than these estimates, because the joint cost of blood sample collection would be borne by the PMTCT program.
P1-S6.39 Can professional midwives interpret rapid syphilis tests accurately?
Authors: Gutiérrez M A Chiappe , Soto K , Lopez-Torres L , Cárcamo C , Calderón M I Valderrama , La Rosa S , Mallma P , Garcia P , Peeling R
Published: July 2011

Background

Congenital syphilis produces miscarriage and severe complications in newborns. Rapid syphilis testing (RST, Syphilis 3.0 Bioline) was introduced in antenatal care and reproductive health services of 16 health centers at Ventanilla (Callao), Peru, aiming to improving access to syphilis screening and treatment in the first contact of pregnant women with professional midwives. We present the results of a quality control assessment evaluating internal (IQC) and external quality control (EQC) of such tests when performed by professional midwives.

Methods

We developed quality controls panels consisting of the Dried Tube Specimen (DTS). Open label positive and a negative control DTS were distributed as IQC bimonthly to services performing RST, to evaluate the test performance under the service storage conditions. Additionally, closed label controls (EQC) were distributed biyearly to evaluate the performance of each professional midwife performing RST. The ECC panel was composed of a weak positive, an intermediate and a strong positive DTS, as well as a negative DTS. Midwives were trained in DTS reconstitution, as well as result interpretation and recording.

Results

28 DTS panels were distributed for IQC (16 to antenatal and 3 to emergency services), with 100% concordance. 119 DTS panels were distributed as EQC, with 100% concordance observed in most (95%) of midwifes evaluated. Six midwives read the weak positive DTS as negative (75% concordance). These six professionals were retrained in their health centers. IQC and EQC were well accepted by midwifes, giving them a sense of confidence with their performance with the test.

Conclusion

Excellent IQC and EQC results were observed, with good acceptance of the evaluation by midwives.
P1-S6.42 HPV vaccine and sexual behaviour among US adolescent and young adult women
Authors: Liddon N , Leichliter J S , Hood J , Markowitz L E
Published: July 2011

Background

Monitoring HPV vaccine uptake can identify potential disparities in coverage and guide vaccine implementation efforts. While there are several national estimates of HPV vaccine uptake among US women, there are few data on vaccination status in relation to sexual behaviour. We analysed receipt of HPV vaccine and intent to get vaccinated by demographic and sexual behaviour data from a nationally representative US survey.

Methods

In 2007–2008, 1243 females aged 15–24 years in a nationally representative US survey answered questions about receipt of at least one dose of HPV vaccine. Unvaccinated women were asked about their intent to get vaccinated in the next 12 months. Demographic and sexual behaviour correlates were evaluated in bivariate and multivariable analyses by age for (a) receipt of HPV vaccine and (b) intention to receive HPV vaccine.

Results

Overall, 23.1% of respondents reported receiving HPV vaccine; significantly more 15–19 year olds were vaccinated compared to 20–24 year olds (30.3% vs 15.9%, p<0.001). There was no difference in receipt of vaccine by race/ethnicity for 15–19 year olds, but 20–24 year old non-Hispanic blacks were less likely than non-Hispanic whites to have received vaccine [aOR=0.2 (0.1, 0.4)]. Women who had insurance were more likely to have received HPV vaccine. HPV vaccination was not associated with being sexually active or lifetime number of sex partners. Among sexually active 15–19 year olds, those who received HPV vaccine were more likely to report always wearing a condom [aOR=3.0 (1.1, 7.9)] than those who had not received vaccine. A majority of unvaccinated women in both age groups are not likely to get vaccinated in the next 12 months (62% of 15–19 year olds and 58.0% of 20–24 year olds). Sexually active women were more likely to intend to get vaccinated [15–19 year olds: aOR=2.6 (1.2, 5.5); 20–24 year olds: aOR=2.2 (1.1, 4.3)].

Conclusions

These nationally representative data from the US highlight disparities in HPV vaccine uptake by insurance status among 15–24 year old women and by race/ethnicity among women above age 19. Our data do not suggest that HPV vaccination results in more sexually-risky behaviour, however, further data on timing of vaccination and sexual initiation are needed. Continued efforts are needed to encourage vaccination before initiation of sexual activity when the benefit of vaccination would be greatest.
P1-S1.27 Intravaginal practices, lubrication, and bacterial vaginosis among women in Los Angeles
Authors: Brown J , Hess K , Brown S , Murphy C , Waldman A , Hezareh M
Published: July 2011

Background

Bacterial vaginosis (BV) has been associated with HIV acquisition and transmission. Intravaginal practices may affect women's vulnerability to BV and HIV/STIs, and may influence results of trials of microbicides for HIV prevention through effects on the vaginal environment and on adherence to investigational microbicidal products. We measured the prevalence and frequency of intravaginal hygiene and lubricant use and their association with BV among both HIV-positive and HIV-negative women.

Methods

Between October 2008 and June 2009, we recruited women aged 18 years and older in Los Angeles. At the enrolment visit and 12 months later, participants underwent a self-administered, web-based questionnaire covering demographics, sexual behaviours, intravaginal hygiene, and lubricant use. HIV was diagnosed by rapid ELISA, with confirmation by Western blot. BV was diagnosed by Nugent criteria from a self-collected vaginal swab. Here we report data collected at enrolment.

Results

We enrolled 141 women (34% identified as White, 40% Black, 26% Hispanic; the median age was 33 years (IQR=25–44)). Overall, 56% of women reported intravaginal cleaning and 45% reported douching over the past month. Overall, nearly three-quarters (73.8%) reported intravaginal insertion of a lubricating product over the past month; commercial lubricant (42.6%), lotion (12.1%), petroleum jelly (10.6%), and oil (7.8%) were the most commonly reported lubricants. The prevalence of BV was 21% and HIV was 27%. In multivariable analysis, intravaginal insertion of oil, lotion, or petroleum jelly (aOR=3.4 (95% CI=1.2 to 9.7)) was associated with BV controlling for douching, age, race, HIV status, and multiple sexual partners.

Conclusion

Use of intravaginal lubricating products not specifically designed for sexual intercourse is common among women. The use of such lubricants and their association with BV is of particular concern and warrants further study; not only in light of the direct association with BV, but also because of the link between BV and HIV infection.
P1-S6.48 Identifying women at risk: Can an STD diagnosis help target women for risk reduction counselling? Miami-Fort-Lauderdale, 2000–2009
Authors: Brewer T H , Peterman T A , Newman D R , Shiver S
Published: July 2011

Background

The Miami-Fort Lauderdale metropolitan statistical area has one of the highest rates of HIV in the US and 29% of cases are among women. We explored STD history as an HIV risk factor for women.

Objective

To determine if reported gonorrhoea (GC), chlamydia (CT), early syphilis (ES) or demographic factors predict the risk of subsequent HIV infection among women.

Methods

We linked STD surveillance data (2000–2006) and HIV report data (2000–2009) to identify HIV infection rates among females >10 years of age, who acquired HIV >60 days after an STD diagnosis. Census data were used to estimate HIV infection rates for women without an STD diagnosis. Multivariate analysis was used to identify correlates of HIV-infection in women with an STD diagnosis.

Results

Of 46 318 women diagnosed with an STD from 2000 to 2006, 534 (1.2%) were subsequently reported to be HIV-infected by 2009 (median time to diagnosis 3.0 years, mean 3.5 years). Most, 446 (83.5%), were Black. Of the 604 Black women aged 20–24 years diagnosed with HIV, 167 (27.6%) had been diagnosed with at least one STD. However, 9187 Black women aged 20–24 had an STD in 2000–2006, so the risk of HIV following an STD diagnosis was relatively low for these women. Of 371 181 Black female area residents, 6077 with no STD were reported HIV-positive in the time frame (0.16% per person-year). Risks for Black women with STD were: CT 0.23% per person-year; GC 0.54% per person-year; and ES 1.70% per person-year. In multivariate analysis, among women with an STD, HIV risk factors were: Black race (adjusted prevalence rate ratio (PRR) 4.8, 95% CI 3.1 to 7.3); age at STD diagnosis <15 years (PRR 2.1, 95% CI 1.4 to 3.3) or between 35and 49 years (minimal PRR 1.9, 95% CI 1.4 to 2.5) compared to 20–24 years; residence in a high morbidity zip code (PRR 2.1, 95% CI 1.8 to 2.5); and diagnosis of GC (PRR 2.0, 95% CI 1.8 to 2.5) or ES (PRR 7.9, 95% CI 5.7 to 10.9) compared with CT.

Conclusion

STDs are common in young women. However, these data demonstrate that STDs in younger and older women, particularly Blacks with gonorrhoea or syphilis are indicators of increased risk of subsequent HIV infection. These women can be easily identified in clinical settings and targeted for risk-reduction interventions.
P1-S6.53 Antiretroviral therapy reduces HIV transmission in discordant couples in Northern Malawi
Authors: Glynn J , Price A , Floyd S , Molesworth A , Kayuni N , Chihana M , Nyirenda V , Crampin A , French N
Published: July 2011

Background

Antiretroviral therapy (ART) reduces viral load and has been suggested as a prevention measure to reduce transmission. However there are concerns that this may be counterbalanced to some extent by increased sexual activity associated with improved health and decreased condom use. The impact of ART on rates of HIV-transmission was investigated within HIV discordant couples in rural, Northern Malawi.

Methods

The study was conducted as part of the Karonga Prevention Study. A demographic surveillance system was started in 2001 and annual home-based HIV sero-surveys added from 2007, with individual counselling and consent. From the first round of the sero-survey, 201 HIV discordant couples (147 male positive, female negative; 54 male negative, female positive) were identified for whom follow-up HIV data were available in the negative partner. Free ART is available at local health facilities and ART use was determined by linkage of data to a clinic based cohort and self-report. Patients attend ART clinics with a guardian who may be the spouse, and are counselled about the need for safer sex. For this analysis participant exposure to ART was defined as having started ART prior to study entry, and follow-up was censored at time of last observation, HIV seroconversion, last negative HIV test, death, departure or dissolution of marriage. Follow-up with re-testing is ongoing.

Results

So far there are 249 and 99 person-years of follow-up in HIV negative women and men, respectively. 55 of the 201 positive partners had commenced ART at entry and within these couples no HIV transmission occurred over a 3-year follow-up period. Among 146 discordant couples without ART the rate of transmission to females was 5.2 / 100 person years (95% CI 2.7 to 10.5) and to males 1.3/100 person years (95% CI 0.18 to 9.4).

Conclusions

In HIV discordant couples ART is associated with reduced rates of HIV transmission within partnerships.
P2-S1.02 Safe spaces: youth friendly centre used to promote HIV education in Nairobi slums
Authors: Baru Musya P Chacha , Johnston C , Mokaya P , Mbenya L , Nyambura H , Nduku V
Published: July 2011

Background

Kenya's National HIV/AIDS Strategic Plan deems youth, 14–24, most-at-risk. Risk is elevated in slums where poverty is prevalent and access to condoms and health education is limited. Peer health educators who come from the community and speak the same language are able to engage trust and confidence of the target population. In 2010 a unique partnership was formed, between youth, AIDS service organizations (ASO), and Goal Kenya, with the objective of increasing HIV education among youth in Nairobi. One outcome from this partnership was the creation of a youth friendly centre.

Methods

Peer educators created a safe space within the slum, Lunga Lunga Youth Centre, where youth are invited to “hang-out”, engage in off street activities (computer games, theatre, music etc), and receive health education and services. Information on HIV/STI prevention is shared and youth are taught to make informed decisions related to sexual activity and are encouraged to test for HIV /STI at the adjoining clinic.

Results

In the first four months of the project 2424 youths, 40% female and 60% male used the centre. 933 youth received health counselling, 98.6% male and 1.4% female. The youth friendly space allowed for a safe and open environment for youth to receive and discuss HIV/STI information as well as access testing and health services. Using non-literature based activities increased HIV/STI knowledge and prevention methods were learnt, barriers to education such as illiteracy were circumvented.

Conclusion

Given the overwhelming positive response to the youth specific space more youth friendly spaces in other parts of the slum should be made available, and ASO and youth partner organizations should be supported to enhance services. There needs to be more emphasis on engaging young women in health counselling programs.
P2-S1.03 Our adolescents! My sexuality matters (MSM) the lessons we have learnt
Authors: Peter O D Obi
Published: July 2011

Background

As in many developing countries, as in Nigeria STI is increasing among the adolescents. While life skills can improve their behavioural practices, traditional training approaches may not be a feasible approach to be reaching the vast number of adolescents that are sexually active, who do not know both STI and HIV status. Many youth initiate sexual risk behaviours in preadolescence, yet STI, HIV prevention programmes are typically implemented in adolescence, missing an important window for prevention. Pre-risk prevention efforts are needed to equip youth with knowledge and skills to make healthy and responsible decisions about sexual behaviour against STIs.

Methods

My Sexuality Matters, a re-orientation base programming was employed to reach out to youth early with sexual health prevention messages through the parents. Parent-child communication, we developed and rigorously evaluated program that enables parents to help shape their children's decisions about sexual behaviour. My sexuality Matters (MSM) is base on intervention provided directly by parents who are care givers of children; this gives parents knowledge and skills to communicate about sexuality with their children. Lesson Learnt: Significant cultural taboos exist in Nigeria that bars parents from speaking with children about sexuality and sexual decision making. Additional challenges include rites of passing rituals, and cultural Challenges that the altered the context of sexuality education. Despite these challenges, over 40 000 Nigerian families have participated in My Sexuality Matters (MSM), and the program has been adopted by other countries and many families have continued embracing MSM initiatives.

Conclusion

The success of MSM demonstrates that programmes involving parents as sexuality educators and motivators can be implemented and embraced and reduce to the vulnerability of adolescent, youths to STIs. The willingness of parents to rebrand the cultural norms to protect their children's sexual health.
P2-S1.06 Adolescents' willingness to participate in HIV vaccine clinical trial preparedness in Nigeria
Authors: Otuonye N , Onwuatuelo R , Onwuamah C
Published: July 2011

Background

Routine vaccination of recommended vaccines in adolescents/children from 1999 would prevent >14 million disease cases and 33 000 deaths over the lifetime of each birth cohort. Data from National sero-prevalence surveys estimate the prevalence of HIV among 15–24 years old to be 5.2%. Therefore including adolescents in HIV vaccine trials makes them an important target for research in primary prevention of HIV infection which they are increasingly at risk of. This study evaluated adolescent perception towards HIV vaccine trial in Nigeria.

Methods

Two hundred and ninety one consenting adolescents were randomly selected for this study. They were recruited from some secondary schools class rooms, university undergraduates' hostels and some traders at the shopping malls within Lagos State Metropolis. Data were collected using semi-structured questionnaire. Information was obtained from knowledge of HIV status, willingness to participate in vaccine trial in future were obtained. Additionally, sexual risk behaviour, stigmatisation, obtain parental permission (required or not required), and function of efficacy of HIV vaccine and perceived self risk of HIV vaccine were collated and analysed using EPI INFO 2002 software (CDC, USA).

Result

Of the 291 respondents interviewed, 96% were single. 72.7% who were willing to participate in the HIV vaccine trial (p<0.05), were educated (97.5%) have Knowledge of HIV vaccine (73.5%), and have no perceived risk of HIV vaccine infection from immunisation (66.2%). Few respondents (31.3%) know their HIV status. Contrarily, those seeking parental permission (66.2%) would significantly reduce willingness to participate (p>0.05).

Conclusion

Efforts should be made on sustained education campaigns on HIV vaccine involving adolescents/parents' consent, otherwise there would be potential obstacle to hypothetical vaccine acceptance and believe. Sexual high risk behaviour is an important factor in the retention of adolescents in future vaccine. studies. A number of other ethical and social issues need to be addressed before adolescent HIV vaccine trials in Nigeria.
P2-S1.09 Associations between early sexual debut and two types of sexual risk behaviour in Nova Scotia adolescents
Authors: Langille D , Andreou P , Wilson K
Published: July 2011

Background

This study sought to test associations between early sexual debut (first vaginal intercourse before age 15) and later sexual risk-taking among adolescents aged 15 to 19.

Methods

Self-report surveys were administered to 433 high school students in Yarmouth, Nova Scotia, Canada in May 2009. The surveys asked about general demographics, socio-economic status, substance use, depression, peers' attitudes towards sex, and the sexual behaviours of students. Categorical principal components analysis was used to determine whether several of the outcome variables could be combined, and logistic regressions were used to assess the associations between predictor and outcome variables.

Results

Two factors emerged among the risk behaviours: i) recreational sex (having many sexual partners, having sex while using substances and having casual partners); and; ii) inconsistent condom use, each of which was predicted by a distinct set of variables. Adjusted logistic regressions revealed that early sexual debut was associated with an increased risk of having used condoms inconsistently in the last year (OR 4.7; 95% CI 1.0 to 21.5) and having had recreational sex in the same period (OR 2.5; 95% CI 0.1.0 to 6.4) among girls. The association between early debut and sexual risk behaviours was not seen in boys.

Conclusions

Early sexual debut predicted of sexual risk taking among girls but not boys. Our findings offer a partial replication and expansion on recent research examining this issue. Asking high school students about age of their sexual debut and other factors might allow healthcare professionals to identify high risk individuals.
P2-S1.12 Project prepare Tanzania: engaging multiple stakeholders to develop a school-based sexual health curriculum for adolescents
Authors: McCree-Hale R , Kajula-Maonga L , Sheya wa Mnyakaya Tatizo Ramatu , Joachim J , Mrumbi K , John E , Kaaya S
Published: July 2011

Background

The objective of this formative research was to engage multiple stakeholders to identify specific factors that may influence program development for Project Prepare Tanzania- an innovative, school-based sexual health curriculum for young adolescents in Tanzania.

Methods

Focus group discussions (FGDs) and structured interviews were used to elicit data for program development from students, teachers, parents, and healthcare workers. 12 FGDs were conducted with male and female adolescents (n=90) from 6 randomly selected schools in Dar es Salaam, Tanzania. Individual interviews (n=16) were conducted with boys (n=8) and girls (n=8). Key informant interviews were conducted with teachers (n=12) and parents (n=12). Community social workers (n=6) and healthcare workers (n=4) also participated in key informant interviews. Interview and FGD guides were designed to elicit data on: sexuality communication, self-efficacy, parenting and sexuality, inclusion of sexual health education in schools and knowledge, attitudes, and perceptions related to peer-education and skills-building for sexual health. NVivo 8 software was used to analyse data and help develop salient qualitative themes.

Results

Salient themes were related to sexuality communication, attitudes towards skills building for condom use and negotiation of safe sex, access to correct information for sexual health, and partnership building to strengthen links between stakeholders. Factors that may influence communication about sexual health among adolescents include: fear associated with talking to parents, fear of being perceived as immoral, and inadequate opportunities to discuss sexuality including puberty. Parents and teachers reported needing skills to discuss puberty, sexually transmitted infections and sexual health. Teachers indicated that curricula should be expanded to include a sexual health component. There is a need for values clarification between parents and teachers regarding teaching about condoms and healthy sexual scripts for negotiation of safe sex. All participants suggested strengthening links between stakeholders to promote more communication.

Conclusions

Project Prepare Tanzania will address the facilitators and barriers identified in this formative research to develop a culturally acceptable, innovative and sustainable sexual health curriculum for adolescents.
P2-S1.13 Why individuals do not return their requestedChlamydia trachomatis(CT) home collection kit: results from a Qualitative Study
Authors: KoekenbierL Kalma R , Zuure F , Davidovich U
Published: July 2011

Background

A systematic and selective screening programme for CT was set up in the Netherlands, in which adolescents were invited by a personal letter to request a home collection kit online (http://www.chlamydiatest.nl). After collection, the kit could be returned to the laboratory by mail. In the first screening round (2008/2009), 20% (52 346/261 053) of the adolescents requested a kit. Of those, 22% (11 317/52 346) did not return the kit (non-testers). Here, we describe a qualitative study examining motives of non-testers for requesting a home collection kit, and their barriers for using it.

Methods

Semistructured telephone interviews were conducted with non-testers from the second screening round (2009/2010) until data saturation was reached (n=25). They were invited for participation by email. Transcribed interviews were analysed qualitatively using Flexible Content Analysis, and interpreted using health behavioural theories that is, the Health Action Process Approach (HAPA).

Results

Motives of participants to request a kit related to perceived risk for CT were: for certainty/reassurance, having complaints, or to take responsibility for one's own health. Motives related to specific features of the screening procedures were: it avoids invasive screening at STI-clinic or GP, procedures are simple, or because the screening is anonymous. Barriers for using a kit related to perceived risk for CT were: recently being tested, worries about the consequences of a positive test-result on the relationship, having no time, giving testing no priority, or laziness. Barriers related to specific features of the screening were: making wrong assumptions about the term of preservability of an unused test kit or about the term of the screening round, the user manual is unclear, being afraid to make mistakes during the collection procedures, the method of collection is unpleasant, or worries about privacy.

Conclusions

Motives to request the CT home collection kit were related to the participants perceived risk of acquiring CT, and to advantages of the screening procedures compared to conventional testing. Barriers for using the test kit were related to low personal risk perception, unclear procedures of the screening, and fear for a positive test result. To overcome these barriers, the ease of contracting CT, and consequences of an untreated infection, should be emphasised. Furthermore, screening procedures should be optimised according to the users experiences.
P2-S1.17 Evaluating native STAND: a peer education curriculum for healthy decision-making for native youth
Authors: de Ravello L , Rushing S C , Doshi S , Smith M U , Tulloch S
Published: July 2011

Background

American Indian/Alaska Native (AI/AN) youth are disproportionately affected by a myriad of health and social conditions. Compared to other US teens, AI/AN youth have higher rates of sexually transmitted infections, teen pregnancies, tobacco use, alcohol use, and substance use. Native STAND (Native Students Together Against Negative Decisions), a 29-session peer educator curriculum was developed to address a range of sexual and reproductive health topics, including important communication and peer education skills. It is the first peer educator curriculum for healthy decision making developed for AI/AN youth.

Methods

Eighty students attending four Bureau of Indian Education (BIE) boarding schools were selected to be trained as peer educators. The curriculum was delivered by trained adult staff at each school and the sessions occurred over the course of the school year with each session approximately 90 min in length. A pre- and post-test using Computer Assisted Self-Interviewing (CASI) was administered to the participants. At the end of the program, focus groups with peer educators and school staff and key informant interviews with facilitators and school administration were conducted to identify programmatic strengths and weaknesses and inform final program revisions.

Results

Overall, analysis of pre- and post-test CASI data showed students at all four schools experienced increases in talking to peers about sexual health; in STI/HIV prevention and reproductive health knowledge; in the intention to use condoms to avoid pregnancy and STIs; and in condom self-efficacy indices. Focus groups and key informant interviews revealed that facilitators and students felt they learnt a lot through the curriculum and enjoyed the program; they saw the program as a badly needed source of clear and honest information; and they voiced their desire to have the program continue.

Conclusions

Native STAND was well-received at all four sites by students, facilitators, and school administrators. Almost everyone felt that no topics should be eliminated and that all the curriculum's activities were relevant and important to include to address the unique needs of Native youth. We will incorporate findings from the evaluation into the curriculum and make it widely available.
P2-S2.02 Role of decision makers in the lives of migrant sex workers-focus on families: an qualitative assessment
Authors: Ramanaik S , Sabnis V , Gurav K , Banandur P , Buzdugan R , Halli S , Blanchard J
Published: July 2011

Background

This study is aimed to understand the role of family members in decision-making process of female sex worker (FSW) migration and its impact on HIV risk, vulnerability and transmission dynamics in Bagalkot, Bijapur and Belgaum districts of Northern Karnataka and southern Maharashtra.

Methods

Qualitative in-depth interviews were conducted with family members of the migrant and non-migrant female sex workers (FSWs) as a part of a large cohort study to understand the patterns and determinants of FSW migration from northern Karnataka to southern Maharashtra, South India. The present paper specifically focuses on the findings generated from in-depth, qualitative interviews with 30 family members of migrant and non-migrant (15 each) FSWs who entered into sex work through the traditional” devadasi system.

Results

Economic factor is inherent in the sex work initiation and FSW migration. Families (mainly mother in the family) are playing a prominent role in the decision regarding the initiation, migration, selection of destinations, brothel madams, financial dealings and the contract agreement with brothel madams. Peer influence, economic status of a family and established contacts with destinations are supportive factors for FSW migration. Migrant sex workers are made to believe that they have the responsibility of fulfilling families' economic needs including the repayment of loans.

Conclusions

Information on role of a decision maker in the lives of migrant sex workers can be used to decide regarding resource allocation and programmatic prioritisation. Building strong rapport with families and linking the place of origin and destination may increase the ability to reach FSWs at an early stage of sex work profession.
P1-S1.03 Undiscovered burden of STIs in Russia: current system shortcomings
Authors: Anisimova N , Ivanova T , Guschin A , Simonova E , Zakharova A , Novoschilova O , Shakhzadov V , Shevchenko A
Published: July 2011

Background

At the moment the major source of statistical data on STIs in Russia is the system of dermatovenerologic clinics (DVC). In accordance with Russian legislation DVCs perform periodic screening of economically active population for asymptomatic STIs disclosure and recording. We need to underline that microscopy forTrichomonas vaginalisandNeisseria gonorrhoeaeis the only method involved in this screening. PCR is not approved for the program which means that there is no control overChlamydia trachomatisburden. Thereby, this study was set to evaluate the screening efficacy in terms of one DVC in Moscow, Russia.

Methods

This study included asymptomatic women aged 16–45 invited for periodic screening. In the DVC Gram stained smear microscopy for TV and GC was used in accordance with regulatory documents. In addition to the standard process a swab for multiplex PCR analysis (GC/CT/TV/MG) was obtained from each participant. All positive results were confirmed with monoplex PCR assays.

Results

According to the official statistical report the overall quantity of people screened in this particular DVC throughout the year 2010 was 16 231. In this study samples from 1125 (6.95%) of them were examined. PCR detected 20 (1.78%)CTcases; 20 (1.78%) MG; 13 (1.16%) TV; 3 (0.27%) GC, whereas microscopy showed no TV or GC positive results. That means that screening revealed no STIs in this group at all. The study showed that the majority of women screened were aged 35–44 (44.2%), p<0.05, whereby the maximum prevalence of CT was observed among 20–34-years-old women (3.5%), p<0.001, MG among 25–34-years-old women (3.3%), p<0.001. We registered no significant TV or GC prevalence distribution among the age groups. It is important to note that the overall STI burden reported by this DVC for 2010 comprised of 9 (0.05%) TV positive cases, no GC was detected among 16 231 persons screened. The data observed in this study allows us to suggest that PCR could reveal the following amounts of STIs in this group—Ct-288 (95% CI 159 to 418); Mg-288 (95% CI 159 to 418); Tv-187 (95% CI 90 to 285); Ng-43 (95% CI 0 to 92).

Conclusions

The data obtained shows the inefficacy of the routine STI screening in Russia. Low sensitivity diagnostic tools prevent us from revealing huge amounts of positive results. At the same time implementation of modern methods with higher sensitivities to the ongoing system will lead to more effective STI uncovering, especially in the groups of higher risk.
P1-S1.30 Chlamydia trachomatisprevalence and detection in men attending the urologist's office to get tested for sexually transmitted infections in St Petersburg
Authors: Smelov V , Ouburg S , Catsburg A , Pleijster J , Gorelov A , de Vries H , Novikov A , Morre S
Published: July 2011

Objectives

The data about the prevalence sexually transmitted infection (STI) asChlamydia trachomatis(CT) among the Russian population is limited and controversial. This information is of great scientific and health care interest. The aim of the study was to evaluate the prevalence of genital CT infection among male attendees of the urologist's office in STI clinics in St. Petersburg and the role of molecular tests in low-resource settings.

Methods

The prospective, multicenter study was undertaken throughout urologist's offices in St. Petersburg during the January 2007—December 2009 timeframe. Urethral samples from 907 men (mean age 31.7 years), who were seeking to be routinely tested for STIs and with no HIV, gonorrhoea, syphilis andTrichomonas vaginalisdetected in the time of study, were collected to be tested for CT infection by culture and in-house RT-PCR assays in St. Petersburg and to be confirmed in Amsterdam.

Results

The results are presented in the Abstract P1-S1.30 table 1. In total CT infection was found in 6.4% of men tested by RT-PCR. Urethral specimens were tested by culture and RT-PCR assays for CT finding positivity rates of 2.2% (n=466 culture samples) and 7.6% (n=804 RT-PCR samples). Use of only culture test would result in missing up to 60% of CT+ cases (p<0.0001). Symptoms were presented in 48% of CT+ men. CT was less often detected in men reporting previous CT infection, as compared with first CT infection—4.3% vs 7.4% (p=0.0475). Only 14/907 (1.5%) questioned men openly reported being MSM but CT prevalence in this small group was 28.6% (p<0.0001). CT positivity assessed in St. Petersburg by culture and in-house RT-PCR tests was confirmed in Amsterdam by a molecular CE marked CT test.

Abstract P1-S1.30 Table 1

Chlamydia trachomatisprevalence, detected by culture and RT-PCR tests, among male attendees of the urologist's office in St. Petersburg

No men testedChlamydia trachomatis(CT) detectionCT−CT+CT prevalenceIn total907849586.4%Culture test, only466456102.2%RT-PCR test, only804747577.6%Culture and RT-PCR, both376351256.7%

Conclusions

Our study showed that—(1) CT prevalence among the Russian population is still high especially in MSM. (2) Risk factor include—being symptomatic at the time of testing (p=0.0043), inconsistent condom use and practicing sex with men (both—p<0.0001). (3) All samples found culture and/or RT-PCR CT+ in Russia were confirmed CT+ using molecular biological techniques in Amsterdam, showing the validity of CT detection in this study in St. Petersburg. At the moment we additionally—A) extent.