bluuebunny/crossref_metadata_2025 huggingface dataset:
P2-S8.04 GYT (Get Yourself Tested) campaign: getting young people talking and tested and sparking a social movement
Authors: Friedman A , Habel M , Kachur R , McFarlane M , Williamson L , Mishel M , Levine S , Binns A , Kapsimalis C , Patel A
Published: July 2011

Background

About 19 million new STDs occur each year in the USA, almost half of which are among youth. Lack of information, misconceptions and stigma prevent many from getting tested. To normalise conversations around sexual health and destigmatize testing, the GYT Campaign was launched in April 2009, with the goal of promoting STD testing among youth ages 15–25 years.

Methods

GYT was developed as part of It's Your (Sex) Life, a public information partnership of MTV and the Kaiser Family Foundation, together with the Centers for Disease Control and Prevention and Planned Parenthood Federation of America (PPFA). The campaign uses on-air, online, on-the-ground, and mobile components to increase STD testing and spark an empowering youth movement. It has expanded each year, reaching over 4,000 health centers nationwide, including school- and college-based health centers. Efforts to evaluate the campaign's reach and impact include media/materials tracking, national surveys, patient intake surveys at partnering clinics and schools, and the monitoring of STD test/positivity rates.

Results

At campaign launch, GYT was among the most-searched terms on Google, the most-tweeted terms on Twitter, and the most discussed videos on YouTube. As of January 2010, GYT had produced >60 public service ads and original programs, airing 3200 times on MTV stations (18 h of airtime), and had 1.5 million visitors towww.itsyoursexlife.com. A national survey suggests that campaign awareness among teens (13–19 years; n=766) reached 18% in 2010, with 10–20% reporting that they talked to a friend (21%), family member (18%), partner (11%) or provider (17%) about STDs/testing; and 10% reporting having visited a doctor as a result of the campaign. Available data from participating PPFA clinics revealed a 71% increase in patients presenting for STI testing from April 2008 (pre-campaign) to April 2010, with a 25% increase from April 2009–2010. Chlamydia positivity was 6% among women and 9% among men during campaign promotion periods, indicating that GYT did not simply motivate the worried well.

Conclusions

Research suggests that GYT is effectively reaching youth and impacting sexual-health discussions and STD-testing behaviours. The public-private partnership may serve as a model for other sexual health promotion programs. Creative ways for mobilising youth and lessons learnt about campaign branding, celebrity recruitment, and evaluation will be shared.
P2-S8.07 Keeping participants on board: optimising uptake by automated respondent reminders in an Internet-based Chlamydia Screening in the Netherlands
Authors: Koekenbier R , Dokkum N , Op de Coul E , van Bergen J , Brouwers E , Fennema H , Götz H , Hoebe C , Pars L , van Ravesteijn S
Published: July 2011

Background

A register- and Internet-based chlamydia screening started in 2008 among 16–29 year olds in Amsterdam, Rotterdam and South-Limburg, aiming to reduce population prevalence of chlamydia infections. Automated respondent reminders by letter, email and SMS were used to encourage and optimise participation. The contribution of reminders on package request and sample return was examined in relation to characteristics of the target population.

Methods

On average, 280 000 persons were annually invited by means of a personal letter. Individuals who did not respond to the invitation letter received a reminder letter after 1 month. Email- and SMS reminders were sent to individuals who requested a test kit and did not return a sample or did not check their test results online. We evaluated the effect of reminders on response and participation rates in two screening rounds. Logistic regression analyses were conducted to identify determinants of providing a GSM number, late response (requesting a test package after a reminder letter), and late participation (returning a sample after email/SMS reminders).

Results

The overall package request rate in the first round increased from 12% to 20% (see Abstract P2-S8.06 Figure 1) after the reminder letter (in round 2 from 8% to 14%). The proportion of individuals returning a sample increased from 10% to 16% after email/SMS reminders (in round 2 from 7% to 11%). Of all respondents, 99% provided an email address and 72% a GSM number. Factors associated with providing a GSM number were younger age (16–24 yrs), non-Dutch background, lower educational level, symptoms of an STI, and sexual risk behaviour in the past 6 months (p<0.05). Determinants for late response (requesting a test package after reminder letter) were male gender, young age (16–19 yrs), non-Dutch background, having a casual partner or ≥2 sex partners in ≤6 months. The email/SMS reminders resulted in more men returning a sample. Persons with a higher sexual risk more often returned their sample before these reminders.

Abstract P2-S8.07 Figure 1

Round 1time from invitation to test package request.

Conclusions

Respondents’ willingness to provide an email address or GSM number for communication during the screening procedure was high. Factors associated with providing a GSM number were also related to chlamydia positivity. Automated respondents reminders by letter influenced response rates (package request) and resulted in reaching more people at higher risk. Email- and SMS reminders contributed substantially to participation rates (sample return).
P2-S8.08 Reducing the stigma of herpes simplex virus (HSV) infection through brief publicly-generated videos
Authors: Shearer L S , Simmons L W , Mindel A , Stanberry L R , Rosenthal S L
Published: July 2011

Background

Herpes simplex virus (HSV) is one of the most prevalent sexually transmitted infections worldwide. The stigma associated with HSV infection remains problematic and may lead to negative psychological sequelae and delayed care-seeking. Media technology is an innovative tool for countering stigma. Publicly-produced media content is not well-studied in this context, but may offer key lessons on successful de-stigmatising strategies.

Methods

The Australian Herpes Management Forum and Novartis organised an online contest inviting the public to develop brief videos to de-stigmatise HSV. In the present study, content analysis was performed to identify de-stigmatising strategies employed in the videos. Two researchers independently coded each video and resolved discrepancies by consensus with a third coder.

Results

Of 113 videos, 11 were excluded from analysis because they did not mention HSV, provided inaccurate information, or had no identifiable strategy. Five de-stigmatising strategies emerged from review of the remaining videos: normalising through familiarity, providing knowledge or fostering knowledge-seeking, expressing moral indignation, promoting disclosure, and negating a negative perception. Despite employing one or more of these strategies, many videos did not successfully de-stigmatise HSV infection. Coders perceived just over half of the videos as de-stigmatising but the remainder as stigmatising, neutral, or mixed. Most de-stigmatising videos shared two important characteristics: 1) they employed familiarity“ as a strategy and 2) they acknowledged actual negative aspects of HSV infection but offered a successful positive counterpoint. Stigmatising videos did not offer sufficiently positive counterpoints. Neutral videos were primarily informational. Mixed videos had strong stigmatising and de-stigmatising messages. One barrier to success was communicating important negative information (such as symptomatology or transmissibility of HSV) without stigmatising the disease.

Conclusions

The results emphasise that de-stigmatising HSV infection is difficult. Simultaneously acknowledging negative aspects of HSV infection while providing a sufficiently strong positive counterpoint-especially by promoting familiarity-may represent a key element in developing effective media campaigns to counter HSV stigma. Future research should evaluate the hypotheses generated in this study in target audiences such as those infected with HSV and members of the public.
P2-S8.10 Measuring social media efforts: beyond click throughs
Authors: Kachur R , Richman L , Hable M , Verma R , Friedman A , Kapsimalis C , McFarlane M , Patel A
Published: July 2011

Background

With the rapid expansion of social media, public health organizations have been quick to adopt these new channels to reach target populations. Typically, however, these efforts are accompanied by minimal evaluation and results are not routinely used to inform and improve programs. The GYT: Get Yourself Tested campaign, a national, US campaign to increase STD testing and decrease stigma is a case study that illustrates the challenges and the importance of evaluating social media.

Methods

Between 1 April 2009 and 30 September 2010, metrics data for the GYT: Get Yourself Tested campaign were collected and evaluated from such social media venues as Facebook, Twitter, the GYTnow SMS code, and the GYTnow campaign website. Facebook and Twitter usage were indicators of user engagement with the campaign, and behavioural intentions were measured through use of a STD testing center locator from the GYT website and use of the GYT Short Message Service (SMS) code. A mobile phone user can send a zip code to the SMS service to receive information about local testing centers.

Results

Evaluation of the GYT social media efforts allowed campaign organisers to measure campaign reach and engagement, customer sentiment, and intentions to get tested for STDs. The campaign reached over one million people in five national, social media venues. The Facebook site recruited 4177 fans, and the Twitter account had 1719 followers. The testing center locator was used by 64 000 people; 51,000 people used the SMS code to locate services. Qualitative data provided additional information about campaign sentiment as well as barriers to participation in the campaign. Analysis of the various metrics also uncovered unexpected issues such as a significant dip in participation in April as a result of a lack of participation by one of the major phone carriers.

Conclusions

Evaluating social media metrics can provide an in-depth understanding of how well target audiences are being reached, how information and messages resonate with them and how efforts can be improved or changed. Findings from this analysis help illustrate the need to adequately evaluate social media efforts, guide future social media evaluations, and understand audience behaviours when engaging in social media activities. Additional web analytic studies are needed to better understand the impact of social media use for STD prevention.
P2-S8.12 Feasibility of using cell phones for daily data collection within adolescent cohort studies
Authors: Malotte C , Cutting A , Huettner S , Matson P , Ellen J
Published: July 2011

Background

It is widely recognised that adolescents are a population who encounter frequent changes in their daily lives. In order to capture these important oscillations, daily data are needed to accurately record and track changes in STD associated perceptions and behaviours that adolescents experience.

Methods

Adolescent females 16-19 were enrolled in the study from a reproductive healthcare clinic. They are assigned a Palm Centro smartphone, and instructed to make daily diary entries on the phones using Pendragon software continuously for up to 18 months. Field staff meet with the participants every 2 weeks to hot sync the diary data from the phones, which is then compiled into a master database.

Results

We examined the number of data points collected over all participants as compared with the costs of the phones, service plans, and person-power needed to complete data collection as well as the subjective opinions of the participants. In an ongoing study, 107 participants have received a phone, and the overall retention rate is 70%. The cost of the cell phone, voice plan and study staff support is approximately $105 per month for each participant. Participants have completed an average of 14 diary entries per month, with a total of 9916 collected. All participants who have completed 18 months in the study reported that the diary entry software was somewhat or very easy to use and 63% indicated that the cell phone was a reason that they remained in the study. Of the 185 phones that were distributed, 84 were reported broken or lost.

Conclusions

Utilising this method of data collection has yielded rich data, unlike any currently available in the literature. While the cost of the data collection process may be substantial, there are distinct advantages to the use of cell phones. These benefits include, participant satisfaction, date and time stamped data, an alarm prompt, reduced participant burden, as well as affording interactive and privacy advantages similar to ACASI technology. There are several ways to tailor the collection process so that it may be accessible to a wider variety of studies. Greater use of this technology should be an area of interest in further adolescent STD research.
P2-S9.02 Syphilis and pregnancy: social portrait of the disease in Belarus
Authors: Tsikhanouskaya I
Published: July 2011

According to the statistical data in Belarus pregnant women made of 8—17% of all women with confirmed syphilitic infection. About 15% women have primary syphilis, 30%—secondary, and 55%—latent syphilis. Aim of study. Study the social structure and concurrent pathology in pregnant women with confirmed syphilitic infection in Belarus.

Methods

95 case histories of pregnant women with confirmed diagnosis of syphilitic infection where analysed during 2003—2008. Middle age of women was 25.5±51 years.

Results

Middle gestational period when syphilitic infection was registered was 21.5±20.4 weeks (in 1—12 weeks—in 10,5% of women; in 13—24 weeks—in 56.8%, in 25—36 weeks—in 30.5%, and in 37—40 weeks—in 2.2%). Concurrent STI where registered in 66.3% of women: trichomoniasis in 11.1%, urogenital candidiasis—in 25,4%, urogenital chlamydiasis—in 12.7%, mixed infection (chlamydia and ureoplasma) in 4.8%. Anaemia was registered in 25.1% of cases, fetoplacental insufficiency—in 7.1% of cases. From all women 67.3% where not officially married and their partners where not checked up as far as they where working outside Belarus. Only 8 women (8.4%) mentioned occasional sexual contacts. Unemployed women made of 52.6% of studied patients. Majority of employed women (64%) worked as unskilled workers. Others where academics—6.67%, medical professions—8.89%, students—8.89%, others—6.67%.

Conclusion

Syphilitic infection in Belarus is detected quite late (usually 13—36 weeks). High percentage of pregnant women in Belarus are women with low social status and poor education.
P1-S1.39 Azithromycin susceptibilities in CanadianNeisseria gonorrhoeaeisolates (2006–2010)
Authors: Sawatzky P , Martin I , Allen V , Hoang L , Lefebvre B , Lovgren M , Gilmour M
Published: July 2011

Background

Canada conducts surveillance of antimicrobial susceptibilities inNeisseria gonorrhoeaestrains to support development of treatment guidelines.

Methods

N gonorrhoeaestrains were isolated or collected by Canadian provincial public health and reference laboratories. Minimum inhibitory concentrations (MICs) were determined by agar dilution for penicillin, spectinomycin, tetracycline, erythromycin (ery), ceftriaxone, ciprofloxacin (cip), cefixime, and azithromycin (az) at the provincial laboratories or the National Microbiology Laboratory (NML). Sequence types (ST), auxotypes, and plasmid profiles were also determined at the NML.

Results

Thirty-nine strains from British Columbia (n=18), Alberta (n=2), Ontario (n=9) and Quebec (n=10) were found to be az resistant (R) (MIC≥2 μg/ml) by either a provincial laboratory or NML between 2006 and 2010. Ten different resistance profiles were represented by the 39 strains. Twenty or 51.3% were Chromosomally-Mediated ResistantN gonorrhoeae/azR/cipR (CMRNG/azR/cipR), 4 (10.3%) were Probable CMRNG/azR/cipR and 3 (7.7%) were Penicillinase-ProducingN gonorrhoeae/Tetracycline-ResistantN gonorrhoeae/azR/cipR/eryR (PPNG/TRNG/azR/cipR/eryR). One strain was CMRNG/azR/cipR with reduced susceptibility to cefixime. Twenty-one different sequence types were determined, the most common being ST-1407 with 20.5% (8/39), ST-225 and ST-4815 with 10.3% (4/39) each. Although the estimated rate of azithromycin resistance between 2006 and 2009 is very low at 0.2% of all isolates tested across Canada (31/15 487), the MICs for azithromycin are gradually increasing. In 2001, the majority of strains (27.8%) had an azithromycin MIC=0.25 μg/ml which increased to 51.5% by 2006. In 2007, the majority of strains (55.9%) had azithromycin MIC=0.5 μg/ml. The highest azithromycin MIC found was ≥64 μg/ml (n=2).

Conclusions

A shift in azithromycin MICs has definitely occurred and may continue to increase. Although azithromycin is not recommended as the primary treatment for gonorrhoea, it is listed as an alternative treatment. With the increasing reduced susceptibility of our primary treatments for gonorrhoea (cefixime and ceftriaxone), azithromycin may be required to treat gonorrhoea either on its own or in combination with third generation cephalosporins. Therefore, it is imperative that azithromycin susceptibilities inN gonorrhoeaecontinue to be monitored.
P2-S9.04 Condom non-use is associated with low perception of risk for STIs in young sexually active women
Authors: Boyer C , Pollack L , Shafer M A
Published: July 2011

Background

Research indicates perception of risk is necessary for adoption of health protective behaviour. Many studies report optimistic bias in risk perceptions, ie, actual risk exceeds perceived risk. This study assessed the relationship between sexual risk behaviours and perceived risk for acquisition of an STI in a cohort of sexually experienced young women.

Methods

Female Marine Corps recruits volunteered to participate in a cognitive-behavioural intervention to decrease STIs and unintended pregnancies that took place during Recruit Training (RT). Data are from the follow-up questionnaire (median=9.8 months post RT) for women who reported vaginal/anal sex since RT (N=1192). Perceived risk was assessed by, I think my chance of getting an STI during my next 6 months in the Corps is about." (0%, 1%, 5%, then 10%–100% in 10% jumps). Sexual risk behaviours since completing RT included # sex partners (1/2/3/4/5+), # casual partners (0/1/2/3+), % of time used condoms during sex (100/90–99/60–80/50/10–40/0), frequency of sex after drinking alcohol/using drugs (never/almost never/sometimes/usually or always), and whether any partner had an STI or was having sex with others (no/possible/yes). Bivariate relationships between sexual risk behaviour and perceived risk were evaluated using negative binomial regression.

Results

Perceived risk was low (mean=6.05). All risk behaviours were significantly associated with perceived risk (p<0.001). In general, perceived risk increased as behavioural risk increased except for condom use. Pairwise comparisons show the 0% group mean (2.41) is higher than for the 100% group (1.47, p<0.05), but lower than the 90–99% group (3.96, p<0.05), and much lower than the 60-80%, 50%, and 10-40% groups (9.03, 8.88, and 11.05 respectively; all p<0.001). Restricting the analysis to participants with multiple partners or to unmarried women yielded the same results. Associations between sexual risk behaviour and two other measures of perceived risk (own risk relative to other female Marines, risk of behaviour for getting an STI; not shown) parallel the results described here.

Conclusions

There is a major disconnect between women's perception of risk and their condom use, the most effective means for preventing common STIs. Since women must negotiate with and rely on male sexual partner(s) for condom use, future research should further examine social and contextual factors that influence young women's perceptions of risk in relation to condom use.
P2-S9.05 Qualitative assessment of anal intercourse and rectal lubricant use among women in Los Angeles
Authors: Javanbakht M , Brown J , Amani B , Stahlman S , Gorbach P , Brown S , Murphy C , Hezareh M
Published: July 2011

Background

There is increasing evidence that anal intercourse (AI) is a relatively common sexual practice among women. Although AI has a high probability of transmission of STIs/HIV, circumstances surrounding AI and the potential risk context among women are not well understood.

Methods

Between May and August 2008, we recruited 30 racially and ethnically diverse women (10 African American, 10 Latina, and 10 White) age 18 years and older through community outreach efforts in Los Angeles, CA. Women underwent an in-depth interview that examined their intravaginal and anal practices. In this analysis we focus on identifying differing contextual meanings associated with AI through emergent themes and explore differences in these themes by race/ethnicity.

Results

The majority of women reported experience with anal intercourse with a substantial number reporting recent experience with AI (ie, in the past year). While there were discussions of AI from women describing casual or transactional sexual partnerships, most women reported AI in the context of serious relationships. AI had varied meanings for women such as an expression of deeper intimacy, a representation of partner's pleasure, and a method for increased sexual gratification. In terms of what AI means in relation to other sexual acts, very few women reported having only AI and in fact it was considered going all out" and generally followed oral and vaginal sex. It is unclear if the women associated STI risk with AI practices since consistent condom use with AI was rare and those who reported condom use noted it as a strategy to improve “cleanliness” (unrelated to STIs) and reduce discomfort so that AI was “not so rough.” Lubricant use for AI, including saliva, petroleum jelly, and baby oil was common and at least one woman specifically reported on the use of “spermicide jelly.” Each of the race/ethnic groups provided support for the themes identified suggesting that the groups may not differ much regarding some of the contextual factors surrounding anal intercourse.

Conclusions

These findings highlight that AI is common among women, particularly among those in serious relationships suggesting a need to reframe AI as not just risk behaviour but as a sexual health issue. While condom use with AI is not common, the use of anal lubricating products not specifically designed for intercourse is common. The frequency and potential health effects of AI lubricants warrant further study.
P2-S9.08 Baby daddy sex as a risk factor for HIV/STDs
Authors: Padgett P , Risser J
Published: July 2011

Background

Concurrent sexual relationships increase the likelihood of exposure to HIV/STDs. Sexual patterns among poor urban African-American (AA) women may help to explain the disproportionate incidence of HIV/STDs seen in this population. Single women with children by multiple fathers may engage in unprotected sex with the fathers of their children; these men are called Baby Daddies. Baby Daddy sex as a risk factor is complicated and based in a sexual reality grounded in poverty and power. This analysis focused on women who have continued sexual relationships with the father of their children in addition to other sexual relationships. We explored the psychosocial factors surrounding women who engage in unprotected Baby Daddy sex.

Methods

We conducted in-depth interviews with AA women living in low-income housing projects in Houston, TX. Study participants were at least 18 years old and involved in multiple sexual relationships. Interviews were conducted in participants' homes and lasted 1½ h. Each interview was digitally-recorded and transcribed verbatim. Participants were paid $20 US for their time. Qualitative analysis was conducted using MAXQDA10 software. We identified and organised codes, categories, and themes to form a comprehensive picture of the behaviours of our sample.

Results

Our sample included 26 AA women aged 21 to 40 years. Themes that emerged illustrated the contextual environment of women's sexual decisions and included: financial insecurity, parenting, relationship ideals, loneliness, and baby daddy sex. Participants characterised their choice to have unprotected baby daddy sex through the following categories: trust/bond based on shared child, love, compensation for financial support of children, pleasure, and longing for past relationship. These findings identified the importance and implied intimacy of the baby daddy relationships and suggested reasons for unprotected sex.

Conclusions

These findings indicate risk implications because they add concurrent sexual relationships with unprotected sex, thus increasing the potential for exposure and transmission of HIV/STDs. More importantly, this study reflects the lasting importance of a relationship resulting in children and how that relationship influences sexual health. Interventions that focus on poor urban AA women in Houston should acknowledge the cultural constructions of both sexuality and relationships in this population, both related to socioeconomic and power inequalities.
P2-S9.09 Help me understand your lab results: “an exploratory, qualitative study of discordance between biologic and self-reported measures of semen exposure in Jamaica”
Authors: Bailey A , Snead M , Costenbader E , Townsend M , Anderson C , Warner L , Kong T Hylton- , Steiner M
Published: July 2011

Background

Self-reported survey data on sexual behaviours have limitations which biological measures can complement. We assessed the feasibility of using qualitative interviews to understand discordance between a biological marker of semen exposure and self-reported sexual behaviours among women enrolled in a trial of STI counselling messages. We also investigated reasons women did not follow counselling messages.

Methods

Data are from the ACME (Assessing Counselling Message Effectiveness) study. Women age >18 years treated for infection at a Jamaica STI clinic were randomly assigned to receive counselling messages to: (1) abstain from sex or (2) abstain but use a condom if they did have sex, during a 6-day treatment period. At follow-up, women reported sexual behaviours in the last 3 days in a quantitative survey and consented to testing for recent semen exposure using a rapid, on-site test for prostate-specific antigen (PSA). Individual, qualitative interviews were subsequently conducted with a purposive sample of 17 PSA positive women, ten who did not report unprotected sex in the survey (discordant) and seven who did (concordant). Interviewers asked about recent sexual behaviour, sexual partners, counselling messages, and how they may have been exposed to semen. We analysed interview transcripts to assess whether discordance could be explained and to identify reasons counselling messages were not followed.

Results

From 8/10 to date, 262 participants completed the ACME trial. Of the 10 qualitative interview participants whose PSA and survey results were discordant, five had reported condom use and five reported abstinence. Interviewers asked these women directly about the inconsistency. This approach variably elicited little concern, discomfort, plausible and implausible explanations from participants. Three condom users and one abstinent participant gave likely reasons for semen exposure, while positive PSA results for two condom users and four abstinent participants remained unexplained. Main reasons given by participants with concordant results for having unprotected sex despite counselling messages were: wanting to please partner, delaying the start of treatment, and not being regular condom users with their partner.

Conclusions

Interviewing women about inconsistencies between their self-reported and biologic data are feasible in this context and yielded information for improving future self-reported surveys and understanding the primary study outcomes.
P2-S9.13 African- and Mexican-American adolescent women with sti and a history of abuse: biological outcome of a randomised trial of behavioural intervention
Authors: Champion J D , Collins J
Published: July 2011

Background

To implement a randomised trial of a risk-reduction intervention consisting of small group sessions, individual counselling and support groups for African- and Mexican-American adolescent women with STI and abuse history and evaluate the effects of the intervention model vs enhanced counselling for this group on STI at 6 and 12 month follow-up.

Methods

Mexican- and African-American adolescent women (n=409, 13–18 years) with STI and a history of abuse (physical, psychological, sexual) were recruited from public-health clinics in a metropolitan area of the USA. Following enrolment participants received targeted physical exams including contraception counselling and interviews including assessments for abuse, sexual risk behaviour, substance use, contraceptive use and STI. Participants were encouraged to return for unscheduled visits as needed for counselling or suspected STI or pregnancy. Scheduled follow-up rates at 6 (93%) and 12 (93%) months were high Participation in risk-reduction interventions was also high (92%). Surveillance for STI and pregnancy at off-site clinic visits was conducted and documented throughout the study.

Results

At study entry, participants reported sexual (58.9%), physical (76.8%) and psychological (82.4%) abuse histories, ever pregnant (45%), currently pregnant (18.7%), ever used birth control (29.9%), currently in school (63.2%), previous arrest (56.2%), home runaway (54.5%), any substance use (94.1%) including marijuana (82.6%), heroin (13.4%), cigarettes (74.6%), alcohol (77.5%), cocaine (41.1%) and benzodiazepine (45%); forced sex (29.1%), sex when high/out of control (13.9%), sex with friends for benefits (36.2%), steady partner in last 3 months (77.4%) however off and on (31.4%). More workshop vs control group participants reported physical abuse (82.9% vs 71.0%), home runaway (63.1% vs 46.4%), cigarettes (78.9% vs 70.5%) and alcohol use (81.4% vs 73.8%). More control group participants were currently in school (68.1% vs 58.1%) and had used condoms (95.3% vs 86.4%). These variables plus age/ethnicity were initially included in the regression model for analysis of data from 0 to 6 and 0–12 month follow-ups. Fewer STI re-infections for intervention vs control group participants at each study interval were identified; physical abuse and substance use remained in the model.

Conclusions

Behavioral interventions may reduce of STI among African-and Mexican-American adolescent women with STI and a history of abuse.
P1-S1.04 The pattern of STI burden in the Central Region of Russia: chlamydiosis vs trichomoniasis. Which one is the leader?
Authors: Ivanova T , Anisimova N , Guschin A , Simonova E
Published: July 2011

Background

Infections caused byChlamydia trachomatis(CT) are proved to lead to such dramatic complications as PID and infertility. That means that CT prevalence control is essential for arranging prophylactic actions. Official statistics claim trichomoniasis to be the most prevalent STI in Russia. For example, the amount of registered TV infections in 2009 was 1.8 times higher than the CT counts. Taking into consideration the absence of CT screening programs among general population along with the use of low sensitivity diagnostic tests (microscopy, DIF), it is reasonable to suppose that the real prevalence proportions are distinct from the official data. In this connection the aim of this study was to evaluate the STI prevalence pattern in a population sampling.

Methods

This study included patients attending STD departments of outpatient clinics of Moscow region from 2004 to 2010. Total amount—190 975 patients. For the evaluation of the STIs prevalence correlation samples from these patients we tested simultaneously for CT, GC and TV by PCR.

Results

In 2004 a total of 23 (0.86%) (95% CI 13 to 32) TV positive results were obtained; 158 (5.89%) (95% CI 133 to 182) CT positive; infection proportion was 1:6.8 (p=0.05). In 2010 a total of 577 (1.1%) (95% CI 522 to 622) TV positive results were obtained; 2886 (5.52%) (95% CI 2771 to 2980) CT positive; infection proportion was 1:5 (p=0.05). Annually this proportion did not vary dramatically and was no lower than 1:5 (p<0.05). No significant diversity in the rates of TV and GC detection was observed except for 2009, when 521 (1.22%) (95% CI 473 to 562) tested positively for TV; 364 (0.85%) (95% CI 323 to 396) for GC, infection proportion was 1:1.4 (p=0.05) see Abstract P1-S1.04 Figure 1.

Abstract P1-S1.04 Figure 1

Prevalence ofChlamydia trachomatis,Neisseria gonorrhoeae,Trichomonas vaginalis2004–2010.

Conclusions

This study shows that during the period 2004–2010 in a homogenous settings CT rates detected by sensitive methods were five or more times higher than TV rates. This might be an evidence of high CT prevalence and inappropriate official statistical recording of these infections in Russia.
P3-S1.02 Evaluation of screening tests forChlamydia trachomatis: bias associated with the patient infected status algorithm
Authors: Hadgu A , Dendukuri N , Wang L
Published: July 2011

This study illustrates the bias associated with the use of an estimation approach called the patient infected status algorithm (PISA), which has been recently introduced and is increasingly used to produce sensitivity, and specificity estimates forChlamydia trachomatissandNeisseria gonorrhoeascreening tests. PISA-based estimates have been published in the medical and microbiological literature and have been included in FDA approved package inserts of nucleic acid amplification tests for detectingChlamydia trachomatis. In this study, we show that the PISA is an estimation procedure that can produce biased estimates of sensitivity, specificity and prevalence parameters. In a series of simulated scenarios we considered, none of the 95% CIs for PISA-based estimates of sensitivity and prevalence contained the true values. In addition, we show that the PISA-based estimates of sensitivity and specificity change markedly as the true prevalence changes. Thus, like earlier estimates such as discrepant analysis based estimates and unadjusted culture-based estimates of sensitivity and specificity, PISA based estimates are also biased.
P3-S1.03 Mixed infections in women with Chlamydial genital infection
Authors: Kasymov A , Kasymov O
Published: July 2011

Background

To study the prevalence and structure of mixed infection in women with Chlamydial genital infection.

Methods

The object of research was 80 women revealed to have Chlamydial genital infection. Age varied from 16 to 47 making in average 24.2+1.6. 37 (46.3%) women of 80 patients needed medical care due to complaints, 36 (45%) women were examined due to inflammatory process in sexual partner (husband), in 7 (8.7%) cases clamidiosis was revealed during the small pelvis surgery. During the examination 23 (28.8%) patients did not complain, other patients (71.2%) complained of lower abdominal pains (45%), itching or discomfort in urethra (31.3%), pathologic discharge from genital tracts (38.7%), colic when urinating (22.5%), infertility (11.3%), menstrual abnormalities (3.7%), periodic raise of temperature (2.5%).

Results

Complex bacteriological research showed that only 28 (35%) women had Chlamydial genital infection as a monoinfection, in other cases the inflammatory process was caused by mixed-infection. By comparison of clinical data with the results of bacteriological investigation it was concluded that only 34 (42.5%) women of all undergone the examination had the combination of pathogenic and conditionally pathogenic bacteria, 28 (35%)—association of aerobes and anaerobes, 9 (11.3%)—pathogenic bacteria and fungi of Candida genus, 2 (2.5%)—conditionally pathogenic fungi. 29 (36.3%) women had the mixed infection as combination of two infections (C trachomatis+1 agent), 23 (28.7%)—three and more infections. As the accompanying infectionU urealyticumwas the most common—in 20 (25%) patients with Chlamydial genital infection,T vaginalis—in 19 (23.8%),N gonnorhea—in 13 (16.3%),S aureus—in 10 (12.5%),C albicans—in 9 (11.3%),M hominis—7 (8.7%),G vaginalis—6 (7.5%).
P3-S1.05 Incidence of STI in patients with chronic prostatitis
Authors: Khaikova A , Sohar S , Kazlouskaya V
Published: July 2011

Chronic prostatitis is a common problem among male patients. Some authors indicate that 30–40% of males have chronic prostatitis when they are 20–40 years old. Last years the tendency to begin at the earlier age is seen in patients with prostatitis. STI should be excluded while examining of patients with prostatitis. We observed 96 sexually active men with chronic prostatitis (middle age 34.2±12.7 years). All patients where checked up for STI. Microscopy and cultural method where used to diagnose gonorrhoea and trichomonas infection, PCR for chlamydia and herpes infection and Mycoplasma IST test system to diagnose mycoplasma infection. STI where founded in 44 patents (45.8%).Neisseria gonorrhoeawas founded in 10 patients (10.4%),Trichominiasis vaginalis—in two patients (2,0%),Mycoplasma hominis—in seven patients (7.3%), Herpes genitalis—in two patients (2.0%),Chlamydia trachomatis—in 23 patients (23.9%). Still in 54.2% of patients the reason remained unknown. Patient with STI should be recommended to check up for all STI. As far as association with STI is quite common it is necessary to study their possible role in the development of chronic prostatitis.Chlamydia trachomatisinfection seems to be associated with chronic prostatitis more commonly.
P3-S1.09 Validation of cobas®4800 HPV and CT/NG test in clinical samples
Authors: Basaras M , Arrese E , Andia D , Hernaez S , Esteban V , Camara M , Cisterna R
Published: July 2011

Background

Roche cobas® 4800 system performs sample preparation, real-time PCR amplification and detection using an internal control in a single tube. The cobas® 4800 human papillomavirus (HPV) test is a multiplex assay that can detect HPV 16, HPV 18 and 12 other high-risk (12-HR) carcinogenic HPV genotypes. We compared this HPV test with the Linear Array (LA) HPV genotyping assay (Roche Molecular System). Therefore, this system can simultaneously detectChlamydia trachomatis(CT) andNeisseria gonorrhoeae(NG) in urine and swab specimens, and it was evaluated and compared with routine techniques in our clinical laboratory.

Methods

462 clinical samples collected in PresevCyt® liquid media were used for the HPV test study and compared using cobas® 4800 HPV test and LA-HPV. There were also included 688 clinical samples for CT and NG testing (206 urine samples only and 241 urine and swab specimens respectively) and compared with a real-time PCR assay for CT and bacteria culture for NG.

Results

For the HPV analysis, 439 out of 462 samples examined (95%) showed positive (160 cases) and negative (302 cases) concordat results; the remaining 3 (0.65%) were invalid by the cobas® 4800 system. The positive samples were distributed: 26 samples of HPV 16, 4 of HPV 18, 110 of 12-HR and 20 samples with mixed infection (15 were 12-HR+HPV 16, four 12-HR+HPV 18 and one HPV 16+18). For CT/NG total analysis, there were only three invalid samples (0.43%) and only 4 (0.58%) discordant results. For the 206 urine samples, there were 19 CT positive, eight NG positive and two mixed CT and NG infections. These positive samples were from male with Chlamydia contact, urethritis and persons who was to STI control. For urine and swab specimens (241 of each), there were a total correlation between both types of samples. In total, there were 5% of positive samples corresponding to 13 CT positive, two NG positive and four mixed CT and NG infections. These positive samples presented clinical manifestations as urethitis or were women to get in touch with Chlamydia infected person.

Conclusions

the cobas® 4800 system is an easy system for cervical HPV screening and to detect simultaneously CT and NG in a single tube. These test and our lab techniques correlated well in this analysis. Moreover, in the case of CT/NG test the correlation between urine and swab specimens was total, therefore to use urine as clinical sample to detect these two bacteria could be easier than to use swab specimens.
P3-S1.10 Using electronic medical record data to guide expedited partner therapy implementation in an urban STD clinic system, 2009
Authors: Mulder T , Johnson K , Lifflander A , Schillinger J , Rogers M , Blank S
Published: July 2011

Background

Expedited partner therapy (EPT) is the practice of providing treatment without a clinical assessment to sex partners of patients with a diagnosed STD. EPT is legal forChlamydia trachomatis(CT) infections in New York State. To guide EPT implementation at New York City STD (NYC STD) clinics, we estimated potential EPT use and EPT treatments to dispense.

Methods

We analysed electronic medical record data for heterosexual patient visits to NYC STD clinics in 2009. To estimate potential EPT use, we measured: proportion clinic patients with presumptive diagnosis of mucopurulent cervicitis (MPC); nonspecific urethritis (NGU); contacts of both who tested positive for CT; patients with laboratory-confirmed genital CT infection; and proportion treated on day of visit. To guide policy on EPT treatments to dispense, we measured the median number of sex partners reported by CT-infected persons in the previous 3 months. To determine whether to route CT contacts to a physician (MD) visit (full STD evaluation) or an express visit (EV), we assessed STD diagnoses among CT contacts.

Results

Among clinic patients with presumptive diagnoses of MPC, NGU, and contacts of both, CT prevalence was MPC, 14% (293/2144); MPC contact, 15% (38/257); NGU, 23% (1553/6744); and NGU contact, 17% (113/677). Of 40 099 patients tested for CT, 13% (5402/40 099) had a laboratory-confirmed CT infection. Of those, 79% (4288/5402) had been treated presumptively on day of visit. Males (n=4551) and females (n=3186) reported a median of two and one sex partners, respectively. Of 3561 contacts with CT diagnosis, 2339 (66%) were asymptomatic on day of visit and were routed to EV. Of those, 936 (40%) had >1 diagnosis other than CT; 22% of those (205) had a diagnosis of herpes simplex virus, human papillomavirus, trichomoniasis, or bacterial vaginosis.

Conclusion

EPT is recommended only for heterosexual patients with laboratory-confirmed CT diagnosis because CT-prevalence was low among patients presumptively diagnosed with either MPC or NGU and their contacts. Approximately 20% of CT-infected persons qualify for EPT; the majority of CT-infected persons are treated on day of visit. EPT-eligible patients should be offered up to three treatments for sex partners. Asymptomatic CT contacts reporting they have taken EPT should be routed to EV; those who report not taking EPT should be routed to an MD visit regardless of symptoms. Symptomatic CT contacts should receive an MD visit.
P3-S1.14 Evaluation of the plateform cobas®4800 CT/NG test for detectingChlamydia trachomatisin urogenital samples
Authors: de Barbeyrac B , Mehats V , Clerc M , Le Roy C , Bébéar C
Published: July 2011

Objectives

To assess the performance of the Roche fully automated cobas® 4800 CT/NG test for the detection ofC trachomatis(CT) infection in clinical specimens compared to the current routine practice.

Methods

Consecutive clinical specimens sent to the Bacteriology department of the Bordeaux University Hospital, Bordeaux, between July and September 2010 were included. Results of the cobas® 4800 CT/NG test were compared with those obtained with the cobas® TaqMan CT 48 assay (Roche). For the latter, DNA from 200 μl of urine or swab resuspended in transport medium, (2SP or universal transport medium) was extracted on the MagNA Pure using the DNA I isolation kit (Roche) and amplified on the TaqMan 48 automates. The cobas® 4800 CT/NG performed DNA extraction from urine specimens prepared by adding 4.5 ml to 4.5 ml of cobas® PCR media, and from swabs discharged in 1.0 ml of the same media. The cobas® 4800 system loaded extracted DNA, controls and amplification reagents into 96-well amplification plates. Plates were then covered and placed into the cobas® z480 real-time PCR instrument. Retesting in both cobas® 4800 and TaqMan 48 assays was performed to further investigate specimens providing discrepant results.

Results

A total of 708 clinical specimens (293 male urines and 415 swab specimens, of which 356 self-collected vaginal swabs, 45 swabs from cervix and 14 swabs from male urethra) were analysed. The results were concordant in 98.5% of cases (697/708). Out of 708 samples, 50 provided positive results (17 men, 33 women). Three urine specimens and eight vaginal swabs provided discrepant results. Out of five specimens providing positive results in the reference CT assay, four were false-negative in the cobas® 4800 CT test. Out of six positive results by the cobas® 4800 assay, five were false-positive. After discrepancy analysis, the prevalence of the CT infection was 7.7% (55/708). The sensitivity and specificity of the cobas® 4800 CT/NG test were 92.7% (urine specimens 94.1%, swab specimens 92.1%) and 99.2%, respectively. The three false-negative results in swabs could be explained by the procedure not consistent with the manufacturer's instructions. Indeed, swabs were not inserted directly into the cobas® media vials.

Conclusion

The cobas® 4800 CT/NG test is suitable for high through-put identification of theC trachomatisinfection.
P3-S1.15 The molecular diagnosis of rectal GC and CT infections using the FTA elute card for specimen collection and the real-time multiplex PCR for detection
Authors: Chi K H , Chen C Y , Ye T , Nachamkin E , Ballard R
Published: July 2011

Background

To evaluate the potential use of the Whatman Indicating FTA Elute Micro Card for collection, transport, and storage of rectal swab specimens for subsequent detection of STD pathogens in MSM using a TaqMan-based real-time multiplex PCR.

Methods

Two rectal swabs were obtained by the physician from each participant in a study to determine carriage of STD pathogens among MSM. One of the swabs was placed into a tube containing 1 ml of Genelock transport medium and while the other swab was firmly pressed onto an FTA Card with three side to side motions held at approximately 60° angle each time. Genomic DNA was eluted from three discs (3 mm diameter) punched out of each card after storage at room temperature for up to 6 months and tested by a real-time multiplex PCR assay which simultaneously detectslymphogranuloma venereum(LGV), non- LGV,Chlamydia trachomatis(CT), andNeisseria gonorrhoeae(GC), and human DNA control. For comparison, an aliquot of sample from genelock tube was extracted using the Qiagen DNA mini kit and tested with same real-time multiplex PCR assay.

Results

Using purified DNA obtained from the Genelock specimens, the real-time multiplex PCR assay detected nine GC and 17 non-LGV CT; while 7 GC and 15 non-LGV CT were detected in DNA samples eluted from the FTA Cards and used directly for PCR. There were three GC and non-LGV co-infections and no LGV was detected using both specimen collection methods. A substantial number of specimens were found to be PCR inhibitory either collected in Genelock (18.3%) or on FTA Cards (15.4%).

Conclusions

The FTA Elute Micro Card allows stable storage and convenient transport of rectal swab specimens at room temperature. DNA can be eluted from the card with simple processes instead of numerous purification procedures for downstream real-time PCR amplification and aetiology detection. This preliminary evaluation shows the potential use of FTA Card for rectal specimen collection and PCR testing, and may also provide a cost-saving alternative to expensive international shipping of specimens on dry ice from remote study sites.