bluuebunny/crossref_metadata_2025 huggingface dataset:
P2-S6.13 Gay men's assessment of sexual and social risks in the context of a recent HIV-positive diagnosis
Authors: Grace D , Kwag M , Steinberg M , Rekart M
Published: July 2011

Background

Technological innovations in HIV testing that allow for the diagnosis of very recently-acquired HIV infections provide opportunities to understand sexual and social risk perceptions before and after an HIV-positive diagnosis. Longitudinal interviews with a group of gay men who have received an early or acute HIV diagnosis represent an important opportunity to understand risk assessment beyond individual-level paradigms of risk analysis and to broaden our understanding of social and structural risk factors associated with HIV infection, diagnosis and disclosure.

Methods

Study recruitment is being conducted through six clinical sites in British Columbia, Canada (April 2009—December 2012) by the CIHR Team in the Study of Acute HIV Infection in Gay Men. Participants (n=12 at time of analysis) completed a series of self-administered questionnaires and semi-structured face-to-face interviews. Baseline qualitative interviews were recorded, transcribed verbatim and analysed. A thematic analysis, informed by a social organization of knowledge perspective, was conducted.

Results

Three interrelated domains of risk assessment emerged from the interviews. First, we explicate how men calculated the epidemiological or sexual risks of transmitting HIV before and after their diagnosis, and how such an assessment informed their sexual behaviours. Second, men described a myriad of experienced and perceived social risks, such as stigma and rejection, associated with the disclosure of their HIV-status to their family, friends, colleagues and intimate partners. Third, men identified potential problems with technologies of status notification which create a set of institutional risks related to the processes by which patients learn of their HIV-positive status. The relationship between these textually-mediated fields of risk is examined.

Conclusion

A stratified conception of risk allows us to understand the everyday situations in which people assess HIV-related 'dangers' in their social and sexual lives. This formative research has important implications for educational campaigns on HIV transmission risk assessment for both HIV negative and positive gay men. This work can also inform counselling and support services to address how disclosure risks are negotiated during an early or acute HIV diagnosis. Important implications for clinical and public health practices, including how and when people are given their HIV diagnosis, are raised.
P2-S6.14 Sexual behaviour, vulnerabilities and clinical intervention among men who have sex with men (MSM) attending STI clinic; study from South India
Authors: Prasad V S , Shekhar S
Published: July 2011

Introduction

Timely uptake of clinical services by highly mobile MSM is pre-requisite to halt and reverse STI prevalence among communities in India. It is imperative to understand risk behaviour and vulnerable factors that lead to the spread of STI among communities. A study was undertaken to understand the sexual behaviour, vulnerabilities, among MSM attending STI clinic of the CBO at Kancheepuram District, Tamilnadu, India.

Method

In the study 69 (72%) clinic attendees for a period of 9 months were followed up and interviewed at the STI clinic within the project. Consent and commitment was taken from the clinical attendees to be enrolled in the study. The project counsellor administered the questionnaire followed by clinical examination by the project Clinical provider.

Results

Among the 69 MSM, 75.3%were 20–30 years & 11%were 31–40 years, 4.3% were above 50 years. Majority were from lower socioeconomic strata of the society and consisted of illiterate people also. 10% were uneducated, 27% Graduates and 44% had 5–10th grade education. About one-third (23.2 %) were married heterosexually. 65% reported travel to other states and 88% reported travel to other districts during the period of study. Among these 70% reported unprotected anal sex with casual partners during travel. Sexual behaviour: During the study period more than two-third (75.3%) had anal sex and all 69 MSM had oral sex. Condom usage, before and after counselling was 6% and 53.6% respectively. 15.9 % had sex with female sex workers and 25% received money for sex. 43% MSM had sex only for pleasure and 32% have sex for both pleasure and money.

Conclusion

It is imperative that the project develop specific programs like Partners meet or Lovers meet to introduce their partners to the project and thereby sensitise them on prevention of STI and increase condom use. Programs like “pre-departure counselling” about risks on unprotected casual encounters for MSM planning travel and “post- travel STI screening” should be attempted. Regular and periodic STI screening among MSM and partners may be implemented. This will help the project in addressing the risk of transmission of infections among the partners. Partners meet will be a platform for addressing greater Sexual behavioural issues beyond normative clinical interventions. Early diagnosis and Intervention of anal STI, regular Condom use and repeated Counselling are imperative to halt and reverse the STI epidemic among the MSM community.
P2-S7.01 Condom use and the disposition to it among HIV positive women accessing care at an antiretroviral clinic in Ibadan, Nigeria
Authors: Adefolarin A O , Arulogun O S , Adewole I F
Published: July 2011

Background

Condon use remains one of the ways to prevent sexual transmission of HIV. However, its use among women living with HIV has not been well documented in Nigeria. This study therefore documented the use of condom among women living with HIV attending an ARV clinic in Ibadan, Nigeria.

Method

This descriptive study was carried out among 396 consenting HIV positive women selected using a systematic random sampling technique in President Emergency Program For AIDS Relief clinic Ibadan. Data was collected using validated interviewer administered questionnaire and analysed using descriptive and χ2statistics.

Result

The mean age of the participants was 34.8±9.0 years, 62.6% were currently married. 96 (24.2%) 13.2% were never married and 66.2% had disclosed their status to their partners. Three hundred and fourteen (79.3%) of the respondents reportedly were sexually active, of these 134 (42.7%) reportedly use condom in all sexual intercourse with their partners while 28.0% never used at all. A significant relationship was found between condom use and serostatus disclosure (p<0.05). Reported experiences among the 226 (72.0%) who use condom included endurance 115 (50.9%), enjoyment (39.8%), complaint 12 (5.3%), fed up (2.2%) and annoyance (1.8%).

Conclusion

Condom use is prevalent among the study group and not many derived enjoyment from it, therefore health promotion strategies such as individual psychotherapy, health education on proper use of condom and provision of free varieties of condoms should be put in place to encourage its use.
P2-S7.04 Maximising the impact of positive prevention practices in people living with HIV: learning's from Karnataka, South India
Authors: Jayanna K , Washington R , Moses S
Published: July 2011

Background

We tried to understand the positive prevention practices in people living with HIV in Karnataka with specific focus on behaviours related to seeking treatment for sexually transmitted diseases and condom use. This gives an indication of programmatic efforts to further halt the transmission of virus and promote healthy behaviours within communities.

Methods

During 2010, a cross-sectional survey was administered to 282 PLHIV across three districts of Karnataka in the context of large scale HIV care and support program. Information related to positive prevention practices surrounding STIs and condom use were collected, as well as socio-demographic details.

Results

Of the eligible 338 PLHIV, 283 participated with a response rate of 83.7% (144 men and 139 women). Majority of the men were married (66%) while women were either widowed or separated (57%). Knowledge about STIs among women was better than men (94.8%, 51.1%), but women reported more STIs in the last one year compared to men (36.3%: 14.7%, p<0.001). 17.5% of never married, 21% of married and 33% of separated/ widowed also reported STIs. 98.6% of those who reported STIs had accessed treatment, but only 64.7% completed treatment for any particular STI. Treatment completion rate for separated or divorced PLHIVs was poorest (60.7%). Reported condom use with regular partners was reported as lowest by the widowed persons (50%) followed by elderly PLHIVs (61%) and never married (71%). People who were contacted by peer supported programs reported better knowledge about STIs and more consistent condom use with regular partners (86% vs 78%, p<0.01).

Conclusions

The study reveals that certain profiles of people living with HIV such as females in general and widows in particular; younger and never married PLHIVs are more vulnerable than the rest and hence need more attention in terms of prevention efforts by the programs. Better micro-planning and peer mediated outreach efforts focused on these profiles can yield better impact in resource constrained settings.
P2-S7.06 Factorial validity and internal consistency of the scale of attitude towards people living with HIV and AIDS
Authors: Beaulieu M , Adrien A , Potvin L , Dassa C
Published: July 2011

Background

The objective of the study was to investigate the factorial validity and internal consistency of the Scale of Attitude towards People Living with HIV and AIDS (SAPLWHA).

Methods

Between 15 March and 2 April 2010, a telephone survey was conducted among a representative sample of 1500 English and French speaking Quebecers between the ages of 15–64 years. The factorial validity of the scale was investigated in two steps: first, with exploratory factor analyses (EFA) (Principal Axis Factoring with oblique rotation) and second, with confirmatory factor analyses (CFA) (Weighted Least Squares estimation with polychoric correlations). The original sample was randomly separated into two subsamples and independently used for the EFA and CFA. Different indicators were used to assess the factorial structure.

Results

The best EFA model had a simple structure of seven moderately correlated factors: (F1): Fear of being infected; (F2): Personal contact; (F3): Prejudice, perceptions of risk groups; (F4): Liberalism; (F5): Social Support; (F6): Right to be informed / HIV confidentiality; (F7): Support to the criminalisation of disease transmission. This factor structure explained 44% of the variance which represents 76% of the total variance when the data are reduced to 7 dimensions. The reliability analysis showed a high internal consistency for the total scale (0.89), adequate values for all factors except F6 (0.70 to 0.79), and a moderate value for F6 (0.59). Although the CFA χ2test was not significant, fit indexes indicated that the seven factor model fits the data (Root Mean Square Error Of Approximation=0.0396; Comparative Fit Index=0.950; Non-Normed Fit Index=0.942; Goodness-of-Fit Index=0.981).

Conclusions

Results suggest that the SAPLWHA is a measure that adequately documents the current attitudes towards PLWHA. Factorial scores derived from this scale will allow external validity assessment as well as provide useful information for future awareness and compassion campaigns designed for the general population.
P2-S7.07 Adherence and difficulties with antiretroviral medication in an Australian sample of people living with HIV
Authors: Lyons A , Grierson J , Koelmeye R , Smith A , Pitts M
Published: July 2011

Background

While combination antiretroviral therapy (cART) has revolutionised the course of HIV infection, a high level of adherence to cART is required to achieve the full mortality benefit. While a number of studies have investigated factors associated with non-adherence to cART, there has been considerable variability in the findings. In this study we set out to determine which personal, socioeconomic, treatment-related and disease-related factors are independently associated with adherence to ARV in an Australian sample of PLWH.

Methods

Using data from the HIV futures six survey, an anonymous cross-sectional survey of PLWH conducted in 2009, we conducted bivariate and multivariate analyses to assess the association of factors with self-reported difficulty taking ARV. Chi-square and t tests were used for bivariate analysis. A two-step logistic regression modelling procedure based on backwards stepwise regression was used for multivariate analysis. Factors that demonstrated a significant association at α=0.2 in bivariate analysis were included in multivariate analysis.

Results

We identified 75 variables within our data that were likely to be associated with difficulty taking ARV. 45 met multivariate analysis inclusion criteria. Factors found to be independently associated at a=0.05: younger age, alcohol and party drug use, diagnosis of mental health condition, poor or fair self-reported health, living in a regional centre, taking more than 1 ARV dose/day, experiencing adverse physical events in the last 12 months, health service discrimination in the last 2 years, using a nucleotide analogue reverse transcriptase inhibitor or protease inhibitor and specific attitudes: not believing in the benefits of ARV, concern about medication efficacy in the future and thinking that ARV tablets were an unwanted reminder of having HIV.

Conclusion

The multitude of factors found to be independently associated with difficulty taking ARV reaffirms the dynamic nature of adherence behaviour and the ongoing importance of addressing adherence behaviour in the clinical management of PLWH.
P2-S7.08 Psychosocial support and therapeutic adherence of HIV positive pregnant women at HIV Treatment Hospital of Suru LÉrÉ in Cotonou (Benin)
Authors: Codjo K Adolphe , Mistourath S S
Published: July 2011

Context

The sociocultural contexts and social environnement of people living with HIV and especially of HIV positive pregnant women are poorly documented and often not integrated with global care of HIV in Benin. This study describes and analyzes the interactions between healthcare professionals and HIV positive pregnant women to better understand the challenges of the medical staff to guide patients in their social environment.

Method

Data were collected through documentary analysis, direct observation, semi structured interview, Focus Group with healthcare professionals, HIV positive pregnant women, their family and social environment. The study focused on 130 respondents. Analysis was done with the triangulation method and content analysis.

Result

Academic training, professional experiences with patients direct the activities and practices of nursing staff. Therapeutic Relations determine the management of confidentiality. For 90% of HIV positive pregnant women interviewed, it is within the system or hospital or medical device (with the health personnel) that they find psychosocial support to be safe from the stigmatisation. It results in low therapeutic adherence and barriers to the Preventing Mother to child transmission of HIV.

Conclusion

The stigmatisation of people with the AIDS virus remains present in society and influenced the Behaviours of Patients. The healthcare professionals—patient relationships built on mutual trust and focused primarily on the medical device to the detriment of the social environment of HIV positive pregnant women not guarantee continuity of care and support for people living with HIV.
P2-S8.05 Use of cellular telephones in a study of high-risk patients
Authors: Craig D , Hensel D , Fortenberry J D , Harezlak J , Jones K
Published: July 2011

Objectives

To describe interest, uptake, advantages and problems associated with the use of cellular phones in a study of incident STDs in a high-risk population.

Methods

Study participants (SP) (N=357; 18–29 yrs; 91% African American; 19.9% incident STD at enrolment: Chlamydia, Gonorrhoea and Trichomoniasis) were enrolled in a 12-week study involving weekly STD sampling and three times daily electronic diary submission via cellular phone. SPs received 3 months of free unlimited calling, texting and internet browsing as part of study and an option to retain the phone at study conclusion.

Results

Eligible SPs, the majority of whom were self-referred, were placed on a waiting list (volume range: 50–150 people) until space in the study was available (avg time: 4 months). About 50% of persons on the waiting list were not enrolled; common barriers included invalid contact information and no call back. Advantages to SP cell phone use included: paperless data collection (SPs who completed the study [N=261] submitted 89.99% of expected diaries), facilitated communication between SP and study staff, free cell minutes/texting and internet, and the option to keep phone at study conclusion (about 80%) as incentives to SPs. Challenges with cell phone use included issues with actual use (most common: failing to charge phone or poor care of phone), technical problems (most common: equipment failure [11.2%] and connectivity problems [21.1%]), theft (about 10%) and equipment breakage/damage [14.8%]). Once SP reported equipment issues, the time to replacement was short (average: 2 days).

Conclusion

The data support the feasibility of using cellular phones in a high-risk population. Participants were not recruited for the waiting list, but self-referred. SPs were able to complete and submit surveys correctly and work with technical issues encountered.
P1-S1.38 Emergence ofNeisseria gonorrhoeaeisolates With decreased susceptibilities to Ceftriaxone and Cefixime in Canada - 2001–2010
Authors: Martin I , Sawatzky P , Allen V , Hoang L , Lefebvre B , Mina N , Gilmour M
Published: July 2011

Background

In Canada, the susceptibilities for ceftriaxone and cefixime inNeisseria gonorrhoeaeare gradually decreasing and there has been a shift in the modal minimum inhibitory concentrations (MICs) from 0.016 μg/ml in 2000 to 0.032 μg/ml in 2008. We examined the phenotypic and genetic characteristics ofN gonorrhoeaewith decreased susceptibilities to 3rd generation cephalosporins isolated in Canada between 2001 and 2010.

Methods

N gonorrhoeaeisolates were collected by Canadian provincial public health laboratories. MICs were determined by agar dilution at the National Microbiology Laboratory (NML) and isolates displaying decreased susceptibilities to cefixime (MIC=0.25 mg/l and 0.5 mg/l) and ceftriaxone (MIC=0.125 mg/l and 0.25 mg/l) were examined using multi-antigen sequence typing (NG-MAST) and sequencing of resistance determinants associated with decreased cephalosporin susceptibilities (penA, mtrR, ponA, porB).

Results

A total of 155N gonorrhoeaeisolates with decreased susceptibility MICs to ceftriaxone and cefixime were identified from the following provinces - Ontario (53.5%, N=83); British Columbia (34.2%, N=53); Québec (12.3%, N=19). Of the 155 isolates observed with reduced susceptibility, 23 were observed between 2001 and 2007 (14.8%), whereas in 2008, 2009 and 2010 there were 84 isolates (54.2%), 23 isolates (14.8%) and 25 isolates (16.1%) observed, respectively. Thirty-eight different NG-MAST sequence types were identified among the isolates; ST-3158, ST-225 and ST-1407 were the most prevalent at 25.9%, 19.4% and 14.8%, respectively. The mtrR resistance determinants were present in 95.5% of the isolates. The penA mosaic was present in 60% of the isolates, with the most common penA mosaic types XXXII and X identified at 51.0% and 7.7%, respectively, while the non-mosaic penA type XII was identified in 36.8% of the isolates. The G101K alteration in porB was present in 97.4% of the isolates and the A102N and A102D alterations in porB were found in 49.7% and 45.8% of the isolates, respectively. L421P alterations in ponA were present in all the isolates.

Conclusions

In Canada,N gonorrhoeaeisolates with decreased susceptibilities to 3rd generation cephalosporins, including cefixime and ceftriaxone have increased over the years. The alterations in penA, mtrR and porB are important determinants identified in these isolates. The most common ST types identified among these Canadian isolates have also been reported worldwide.
P2-S8.06 Using electronic diaries prospectively to capture STI-related phenomenology
Authors: Hensel D , Fortenberry J D , Harezlak J , Jones K , Craig D
Published: July 2011

Objective

To describe electronic diary study adherence, completion and sexual behaviour patterns among a high-risk sample clinically recruited for a prospective study of incident STI.

Method

Participants (N=243; 18–29 yrs; 61% female; 88% African American) completed 12-weeks of weekly STI testing and 3x/day electronic diaries assessing individual and partner-specific affect, daily activities, substance use and sexual and contraceptive behaviour. We analysed event- and subject-level completion rates, and subject-level STI and behaviour response effects among subjects who had completed the study and who had not been incarcerated during study.

Results

In total, 82.3% (200/243) of participants individually submitted at least 250 diaries (252 expected) during the study; as a group, participants submitted 89.7% (54 900/61 236) of the total number diaries expected. The average number of diaries weekly submitted varied between 17.03 and 19.45 (21 expected). Total and weekly submissions were similar by gender, age and race. The overall median survey completion time was 1.77 min (1.68 min: if no partners; 3.00 min: if any partners). Among those with only one partner, median completion time when no sex occurred was 2.47 min and was 3.87 min when any sex occurred. About 35% (85/243) of participants had an STI at some point in the study. Subjects reported the following sexual behaviours: vaginal sex (86.4%: 210/243), anal sex (29.6%: 72/243), giving oral sex (70.8%: 172/243) and receiving oral sex (82.7%: 201/243). Of those reporting vaginal sex, 60.4% (127/210) had only one partner and 23.3% (49/210) reported two partners. The median number of partner changes was one. Event level data suggest no response effects: sensitive behaviours, such as substance use or vaginal sex, exhibited similar stability in reports over time as compared to non-sexual activities such as eating or taking a walk.

Conclusion

Data suggest excellent study protocol adherence and stable behaviour reporting among a high-risk sample. These findings demonstrate the feasibility of prospective, incident STI data collection methods, particularly in clinically recruited samples, which are often assumed to be non-compliant or unreliable around such methods.
P2-S8.09 What are they asking? An analysis of STD related calls to CDC-INFO
Authors: Kachur R , Thompson N , Haecker S , Jones R
Published: July 2011

Background

Launched in 2005, CDC-INFO is the Center for Disease Control and Prevention's (CDC) national contact center, which responds to health related enquiries from the general public and healthcare providers and partners 24 h a day, 7 days a week. STD-related topics have consistently been among the top ten most frequently asked questions. In order to better understand what information is being sought, telephone calls and emails to CDC-INFO were analysed for STD specific topics and topic frequencies.

Methods

STD-related calls and emails made to CDC-INFO between October 2009 and September 2010 (FY2010) were analysed for topic content and frequency.

Results

In FY2010, there were 44339 STD-related calls and 2123 STD-related emails to CDC-INFO. Enquiries fell into 11 main categories. The top 3 telephone enquiries were about Herpes (26%), Testing and Counselling (25%) and Human Papillomavirus (HPV) (18%). The top 3 email enquiries were about Herpes (34%), HPV (21%) and Other Sexually Transmitted Diseases (12%). The most common STD question to CDC-INFO was Can you help me locate a STD testing site in my area?", although the largest percentage of questions were about Herpes, followed by HPV, Testing and Counselling and Chlamydia. Findings from CDC-INFO correlate with findings from traffic to the Division of STD Prevention (DSTDP) website (http://www.cdc.gov/std/) which also finds that Genital Herpes and HPV are the most frequently visited pages on the website. A CDC-INFO satisfaction survey conducted between October 2009—and March 2010 found that among STD related telephone callers, 63% were female, over 65% were 34 years old or younger, 34% were White and 35% were Black/African American. Of those qualitatively interviewed, 91% (n=199) reported learning new information as a result of the call to CDC-INO and 68% indicated a desire to change a behaviour based on the new information. Reducing risky sexual behaviour was the most common type of behaviour change indicated.

Conclusions

Information about Genital Herpes, HPV, and STD testing locations are the most frequently sought after topics by those accessing CDC-INFO. Regularly analysing enquiries to CDC-INFO can help the DSTDP identify topics of most concern to the general public, possibly detect emerging trends and tailor communications accordingly. Further research should be done to determine how DSTDP communication and prevention priorities correspond to general public enquiries and concerns.
P2-S8.11 Co-creating the Dutch Safe Sex Campaign 2011: Using social media and municipal health centres (MHC) to improve implementation intentions of condom use
Authors: Zimbile F , Fisser E
Published: July 2011

In the period 2008–2009 the Dutch Safe Sex Campaign (DSSC) effectively improved the attitudes and intentions among young people (18–25 yrs) to maintain condom use in a new relationship until both partners have done a STI test. The positive intentions increased from 50% (Aug 2008) to 73% (Nov 2009). However, no changes were seen in self-reported condom use in this period. Theoretical models show that in case of positive intentions a strategy aimed at improving implementation intentions can be effective on behavioural level. In line with this strategy DSSC 2011 is designed to improve implementation intentions in the chain of skills which are relevant for condom use: buying—carrying—communicating about and using condoms.

Method

The campaign strategy consists of three stages. In the third stage (Sep 2011) an e-learning module will be launched which will train condom skills and help to concretely plan condom use. The first two stages are especially designed to generate content for the e-learning module in co-creation with the target group members and the MHC. In the first (awareness) stage of the campaign (Feb 2011) members of the target group were invited to report about the campaign. A kick off session was organised for editors of school magazines and popular vloggers (video webloggers). During the kick off the young reporters were facilitated to produce their own safe sex campaign materials. They were also given the opportunity to interview a Dutch celebrity about the campaign topic. The results were used to promote the campaign on YouTube, Twitter and local school magazines. At the same time discussions and polls about the campaign topic were initiated on several community sites. In the first stage, the campaign also provided a game to the MHC. This game is played in school classes with students of secondary education. The game consists of settings that are relevant for the e-learning module: a drugstore (buying condoms), schoolyard and disco (carrying condoms), bedroom (communicating and using condoms). The MHC officers invited the student to discuss the condom skills in these settings and register the advices that are most relevant to them. These advices will be used as content in the e-learning module. In the second stage (April—June 2011) the target population will be mobilised to participate in the campaign through popular social media. The target group will be asked to reflect on the results of the discussions and polls in the first stage. They will also be invited to send in their ideas for a TV-campaign. The concept of the winner will be used as input for the definite TV-commercial(s) broadcasted in September 2011.

Results

Almost 200 school magazine reporters and 11 vloggers participated in the first stage of the campaign. More than 80 000 people viewed the nine vlogs that were produced in the first week.

Conclusion

Social media offer good opportunities to co-create safe sex campaigns with the target group.
P2-S9.06 Vaginal film microbicides for HIV prevention: a mixed methods study of women's preferences
Authors: Fan M , Ferguson L , Rohan L , Meyn L , Hillier S
Published: July 2011

Background

Quick-dissolve films hold promise for HIV microbicide formulation with regards to low cost and scalable manufacture. Consideration of women's preferences enhances probable use of promising microbicides. This study examined preferred physical characteristics of quick-dissolve vaginal films for HIV prevention and factors that influenced valuation of HIV prevention.

Methods

We conducted a cross-sectional mixed methods study of women aged 18-30 years from two counties in southwestern Pennsylvania to qualitatively and quantitatively assess preferences. During focus groups women handled and evaluated films of varying texture, thickness, size, shape, and appearance. A pre-focus group survey collected demographics, sexual history, and valuation of vaginal product characteristics. A post-focus group survey collected attitudes towards vaginal microbicides. We carried out thematic analysis of focus group transcripts using modified grounded theory. We examined relationships between participant characteristics and valuing HIV prevention using Fisher's exact test.

Results

Eighty-four women participated, with a mean age of 23 years and largely white (54%) and black (43%). Only three reported previous use of a vaginal film. Participants preferred films to be smooth and thin (63%), translucent (48%), and 2×2" square size (36%). Translucent and smooth, thin films were perceived as likely to disintegrate rapidly. Smooth, thin films were perceived as more comfortable and less irritating than textured, thick films. Translucent films were thought to represent a balance between discretion and visual discernibility. Easy, accurate insertion, uniform coverage, and adequate HIV prevention efficacy were viewed as advantages of 2"×2" square size films. Engaging in at least one episode of binge drinking in the past year was associated with rating HIV prevention as important (p=0.048). Participants expressed concern regarding sexual intercourse in the context of alcohol intoxication. Factors associated with ranking HIV prevention as the most important characteristic of a vaginal product included higher number of lifetime vaginal sex partners (p=0.001) and black race (p=0.011).

Conclusions

Smooth, thin, translucent, and 2"×2" square films were perceived to offer features valued by women in our sample. Women were concerned with issues of use, including insertion, disintegration, and comfort, as well as issues of discretion and efficacy.
P2-S9.11 HIV infection and violence against married/cohabiting women: findings from a national household survey in Rwanda
Authors: Kayibanda J F , Alary M , Bitera R
Published: July 2011

Objectives

We used the third Rwanda demographic and health survey (DHS) data to examine relationship between violence, gender attitudes and HIV prevalence among women and men in union.

Methods

The third Rwanda DHS is a nationally representative household-based survey conducted in 10 272 households in 2005. Analyses were restricted to 2715 women and 2461 men who were legally married or cohabiting. HIV prevalence was the dependent variable whereas sexual risk factors, gender attitudes, emotional and domestic violence were independent variables. A face-to-face interview covered socio-demographic characteristics, sexual risk behaviour, domestic violence and gender attitude. Domestic violence was measured by questions from the Conflict Tactics Scale Questionnaire. HIV antibodies testing was performed using ELISA tests. Logistic regression was used for statistical analysis.

Results

HIV prevalence was significantly higher among women who reported ever having experienced any form of emotional violence (4.7% vs 2.1%; p=0.019), who reported ever been threaten by their husband or cohabiting partner (6.1% vs 2.3%; p=0.026) and among those who reported that their fathers beat their mothers (3.4% vs 1.9% p=0.029). HIV prevalence was higher among men who reported that they are justified to hurt or beat their wives if they argue with them (10.1% vs 2.9 p=0.03). After adjustment for age, geographic area, number of lifetime partners, history of genital ulcers in the previous year, women who experienced at least one form of violence (either, emotional, inter parental, or intimate partner violence) demonstrated a much higher HIV prevalence [adjusted OR (AOR): 2.75; 95% CI 1.08 to 7.02]. Compared to those who confirmed that it is not justified for a husband to hurt or beat his wife if she argues with him, men who agreed with this statement had a fourfold higher HIV-prevalence (AOR: 4.15; 95% CI 1.69 to 10.17).

Conclusion

Violence experienced by women and the acceptance of wife beating by men are independent risk factors for HIV infection among married/cohabiting population in Rwanda. Interventions to prevent any form of violence towards women and hostile gender attitudes should be integrated into HIV programs.
P2-S9.12 Descriptions of behaviours by partner type for ethnic minority female adolescents with histories of abuse
Authors: Collins J , Champion J D
Published: July 2011

Background

Identifying the sexual risk behaviour associated with relationship status informs researchers and clinicians concerning female adolescent conceptualisation of partnerships in the context of risk recognition, sexual boundaries, and social expectations of relationships. This study describes risk behaviour of high-risk ethnic minority female adolescents with STI and abuse histories reporting either dating one person exclusively, not currently being in relationship, or dating more than one person.

Methods

African-and Mexican-American adolescent women aged 13–18 years (n=559) were enrolled in a randomised trial of a behavioural intervention. At study entry, participants completed semi-structured interviews including questions addressing primary outcomes including STI infection, abuse recurrence, unintended pregnancy, sexual behaviour, substance use, and contraceptive use. Descriptive, χ2analyses, and t-tests for bivariate analysis of differences between groups by relationship status at study entry were conducted.

Results

Participants (59%) reported dating one person exclusively, not currently involved with a partner (29.2%), and dating more than one person (4.3%). Participants not currently in a relationship vs those who were with one partner exclusively described more often a most recent partner who would physically harm them if she had sex with another man χ2(1, N=527) =4.51, p=0.034; having more guy friends they just have sex with χ2(1, N=531) =7.74, p<0.005; and not having a steady relationship with their most recent partner χ2(1, N=529) =174.86, p<0.0001. Of participants not currently in relationship, (30.7%) reported they would still have sex with their most recent partner yet 95% stated they currently do not have a monogamous relationship with this partner.

Conclusions

Female adolescents with abuse histories who describe relationship status as not involved or involved with more than one partner engage in more risk behaviour than those who report exclusive relationships with one partner. Explicating behaviour that occurs by relationship status has implications for interpreting and addressing risk for intervention and practice guidelines.
P1-S1.40 Emerging molecular mutations of reduced susceptibility to third-generation Cephalosporins inNeisseria gonorrhoeaeisolates from Saskatchewan, Canada
Authors: Thakur S D , Nagle E , Levett P N , Horsman G B , Liao Mingmin , Dillon J R
Published: July 2011

Background

Third-generation cephalosporins (eg, ceftriaxone, Cro) are the antimicrobials of choice for the treatment of gonorrhoea. The molecular mechanisms causing reduced susceptibility to these antibiotics inNeisseria gonorrhoeae(Ng) isolates differ between isolates from different geographic regions. The objective of this research was to characterise mutations in penA, mtrR, porB and ponA associated with Cro reduced susceptibility (CroRed) in Ng isolates from Saskatchewan (SK), Canada.

Methods

A total of 320 of Ng isolates (2003 to 2008) from SK were tested for their antimicrobial susceptibility to Cro using the CLSI agar dilution method. 7% of the isolates (n=23) had Cro MICs of 0.03–0.06 mg/l and were defined as having CroRed phenotypes and 93% of the isolates (n=297) had MICs of <0.03 mg/l which were classified as susceptible (CroS). All CroRed isolates were analysed for mutations in penA (PBP2), mtrR (MtrR), porB (PorB) and ponA (PBP1). 123 (42%) CroS isolates were randomly selected as coselected

Results

In total, nine mutation patterns were observed in penA. Patterns I (31.7%), IX (29.2%) and XXII (26%) were most common in the 123 CroS isolates; while patterns IX (60.8%, p<0.05) and XXII (21.5%, p>0.05) were predominant in the 23 CroRed isolates. The mosaic penA pattern X was observed in only one isolate (Cro MIC=0.06 mg/l). Seven mutation patterns were noted in mtrR. Among the CroS isolates, 35.8% had a single mutation (G45D or A39T) in the DNA binding domain (DBD) and 17.8% of the isolates carried an A" nucleotide deletion (A−) in the mtr promoter coupled with a G45D mutation. Among the CroRed isolates, 65.2% carried G45D or A39T single mutations, significantly higher than that of CroS isolates (p<0.05). The mutation of A−/H105Y was observed in 21.7% of CroRed isolates as compared to 4% of CroS isolates (p<0.05). Five mutation patterns at residues G120 and A121 of PorB were observed in the CroRed isolates including double (47.8% vs 13% CroS isolates, p<0.05) or single (21.7% vs 26% CroS isolates, p>0.05) mutations. L421P in PBP1 was detected in 87% CroRed and 13% CroS isolates, respectively (p<0.05).

Conclusions

Mosaic penA pattern X was only observed in one CroRed isolate. The mutations associated with CroRed phenotypes include pattern IX of PBP2, mutations in DBD and a double mutation of A−/H105Y in mtrR, double mutations in PorB (positions G120 and A121) and L421P of PBP1.
P2-S9.14 A qualitative, longitudinal study of post-diagnosis reactions among HSV-2 serologic positive women
Authors: Brand J E , Van Der Pol B
Published: July 2011

Background

Herpes simplex virus type 2, the main cause of genital herpes, is found worldwide among populations. US National seroprevalence is estimated at 16.2%, with highest rates among women (20.9%) & non-Hispanic blacks (39.2%). Medical consequences of HSV-2 infection includes a two- to five-fold increased risk for HIV 1 transmission & neonatal herpes. The advent of type-specific HSV serologic tests offers accurate methods of diagnosis for those who are asymptomatic. However, diagnosis of HSV-2 has been noted to be distressing for those who are asymptomatic & unaware of infection. The purpose of this study is to understand social & emotional impact of HSV-2 serodiagnosis on asymptomatic women over time.

Methods

Purposeful sampling was conducted & 28 women, newly diagnosed as HSV-2 serologic positive & asymptomatic, were recruited from a Midwestern STD clinic & urban community court. A series of three open-ended interviews were conducted over 6-month period. Interviews were audio recorded & transcribed. Important areas explored: emotional & social responses to diagnosis; motivations for (non) disclosure of HSV-2 status; exploration of sexual behaviour post-diagnosis; use of condoms & suppressive therapy. Qualitative analysis was done using manual coding.

Results

Age of participants ranged from 19 to 61 yrs. Majority were African-American (71%) with 21% white. No participants reported knowledge of HSV-2 status at diagnosis. Five themes emerged during analysis of first interviews: rumination & disclosure anxiety; knowledge deficit anxiety; stigmatisation & alteration in self-concept; fear/apprehension regarding future; impact on sexuality & partnering. With analysis of 6-month interviews there was an iteration of two themes--alteration in self-concept & impact on sexuality & partnering. Of 23 participants who completed three interviews-22% had no plans for sex after diagnosis, 39% never disclosed HSV-2 status to partners & 56% never used suppressive therapy.

Conclusions

Findings suggest that despite increased public information related to HSV-2, initial diagnosis remains traumatic, & for a small percentage anxiety lingers for at least 6 months. Providers should be aware of need for written information targeted to non-clinicians & that further follow-up should be initiated after diagnosis to reinforce learning, clarify concerns, counsel & support. Providers should plan additional time for client integration of diagnosis, implications & questions.
P3-S1.01 Prevalence of genital Chlamydia and gonococcal infections in at-risk women in the Kumasi metropolis of Ghana
Authors: Opoku B
Published: July 2011

Background

To study the prevalence of genital chlamydia and gonococcal infections in women at risk of acquiring sexually transmitted infections in the Kumasi metropolis, Ghana.

Methods

Structured interviews and clinical examination of participants aged between 18 and 35 years (inclusive) were carried out. Other inclusive criteria were having at least three sexual acts per week and having had at least two sexual partners in the preceding 3 months. Vaginal swabs were also obtained to test for gonorrhoea and chlamydia infections.

Results

One thousand and seventy women participated in the study. Genital chlamydia infection was found in 4.8% of participants whilst gonococcal infection was found in 0.9% of participants.

Conclusion

The prevalence of genital chlamydia and gonococcal infections was low in these at-risk women. The prevalence is also lower than reported in other female populations in the country.
P3-S1.04 Abnormal prostate cancer markers in a man with symptomaticC trachomatisinfection
Authors: Smelov V , Novikov A
Published: July 2011

Objectives

In men ascendingChlamydia trachomatis(CT) infection may result in the inflammatory process in the prostate. It has been suggested that chronic inflammation and infectious agents related to prostatitis may be involved in prostate cancer (PrCa) susceptibility. Nevertheless, the role of CT in the pathogenesis of this common among sexually active men morbidity is still not clear. Better understanding of the host's response to CT and the precise pathways in the PrCa development are of great interest. Up to now prostate biopsy (PBx) remains the only test that can confirm the diagnosis of PrCa. Serum prostate-specific antigen (PSA) test has been used worldwide to screen men for PrCa but can results in a significant proportion of negative PBx and prostate cancer antigen 3 (PCA3, first catch of the urine collected after prostate massage) test may be of valuable help in some PSA quandary situations. We present a clinical case with symptomatic CT infection affecting the PrCa diagnosis.

Methods

In October 2010, a white man 38 y.o. with a history of unprotected sex and followed lower urinary tract symptoms (LUTS) and erectile dysfunction for more than 3 months was applying for STIs and PrCa testing. CT infection was detected by RT-PCR. Physical and digital rectal examinations (DRE) were performed and the number of WBC in the prostate secretion was counted. The results of PSA and PCA3 tests resulted in PBx.

Results

The results are presented in the Abstract P3-S1.04 table 1. CT positivity was assessed in St. Petersburg by in-house RT-PCR test that was confirmed by an internationally validated molecular test as it has been described elsewhere. No other STIs were detected. The prescribed treatment succeeded: LUTS were released, no CT infection was detected. Interestingly, serum PSA tests showed abnormal results before and 1 month after antibacterial treatment. A cut-off score was exceeded in an additionally prescribed PCA3 test. PBx was performed but histological examination revealed no evidence of PCa but prostate inflammation.Abstract P3-S1.04 Table 1

Abnormal prostate cancer markers in a man with symptomaticC trachomatisinfection

First visitFollow-up visits1 month3 monthsCT infection, tested by RT-PSRPositiveNegativeNegativeSymptomaticYesNoNoDigital rectal examinationAbnormalAbnormalAbnormalWBCs, counted in hpf30–400–20–1PSA test, 0–4 ng/ml13.9 Abnormal9.8 Abnormal1.5 NormalPCA3 test, a cut-off score of 3538 AbnormalProstate biopsy, to diagnose cancerNegative

Conclusions

Further studies to evaluate the time course of prostatitis/STIs on PrCa risk, particularly among a young cohort of men, have been warranted. New diagnostic markers are needed to investigate the pathways between the acquisition of CT and its impact on the prostate. This is the first report on detection of abnormal PSA and PCA3 tests in a Chlamydia-infected man suffering from LUTS, while no PrCa was histologically detected.
P3-S1.08 Are there acceptable alternatives to syndromic management for the diagnosis of sexually transmitted infections in HIV positive Kenyan women?
Authors: Woo V , Cohen C R , Bukusi E A , Huchko M J
Published: July 2011

Background

Control of sexually transmitting infections (STIs) is an important aspect of HIV prevention and care. Syndromic management for vaginal discharge, despite a recognised low sensitivity and specificity, is widely employed for STI management among HIV-1 infected women in resource-limited settings. In this pilot study, we evaluated the incremental increase in sensitivity and specificity of multiple, low-cost diagnostic strategies for non-ulcerative STIs diagnosed among HIV-1 infected women receiving care in Kenya.

Methods

This cross-sectional study was done among a cohort of HIV-1 infected women enrolled at Family AIDS and Care and Treatment Services (FACES) clinics in Kisumu, Kenya. During their routine clinic visit, participants reported any health complaint and later were asked about general vaginal symptoms (brief symptom ascertainment) and specific complaints of pruritis, odour and discharge (detailed symptom ascertainment). Clients were then examined for cervicitis and vaginal discharge, followed by specimen collection for STI testing. Results ofChlamydia trachomatisandNeisseria gonorrhoeaenucleic acid amplification test andTrichomonas vaginalis(TV) by wet mount was used as the gold standard for sensitivity and specificity calculations.

Results

Of the 155 women who were screened between the ages of 23–53 years, the prevalence ofN gonorrhoeaewas 1.9% (3/155), TV was 6.4% (10/155) and no cases ofC trachomatiswere detected. See Abstract P3-S1.08 table 1.

Abstract P3-S1.08 Table 1

Sensitivity and specificity of multiple diagnostic strategies for STI diagnosis among HIV-1 infected women receiving care at FACES

Evaluation technique N=155Per cent positive resultsSensitivity for any STI*Specificity for any STI*Positive predictive valueSelf report (current standard of care)3% (5)0 (0)97% (137)0 (0)Intensified symptom ascertainment, brief26% (40)23% (3)75% (107)8%Intensified symptom ascertainment, detailed26% (40)31% (4)75% (106)10%Gynaecologic exam9.0% (14)46% (6)94% (134)46%*

IncludesN gonorrhoeae, C trachomatisandT vaginalis.

Conclusions

Syndromic management had a very poor sensitivity for detecting STIs in HIV-1 infected women. The addition of specific questions about STI-related symptoms improved STI detection rates, while a speculum exam led to greater sensitivity and specificity. The feasibility and effectiveness of alternative approaches such as routine use of speculum exams, and point-of-care testing forT vaginalisshould be explored to improve the management of STIs among HIV-1 infected women in similar low-resource settings.