bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S1.12 Age-specific incidence of chlamydia, gonorrhoea, and trichomoniasis infection in adolescent women
Authors: Tu W , Batteiger B , Ofner S , Van Der Pol B , Fortenberry D 
Published: July 2011

BackgroundAge-specific incidence rates of sexually transmitted infections (STI) withChlamydia trachomatis(CT),Neisseria gonorrhoeae(GC), andTrichomonas vaginalis(TV) are not well characterised in adolescents and young adult women. In this research, we described the CT, GC, and TV incidence rates in young women as functions of age.MethodsYoung women aged 14 and 17 were recruited from three adolescent medicine clinics in Indianapolis, Indiana. Study participants were followed longitudinally for up to 8.2 years. Participants were tested for CT, GC, and TV at the time of enrolment, and at subsequent quarterly visits. Infected individuals were treated at or shortly after each visit. We analysed the longitudinally measured incidence infections with CT, GC, and TV using generalised additive mixed effect models (GAMM) with a logit link for binary outcomes. The age effect on STI incidence was modelled as a smooth non-linear function in the GAMM analysis and a random subject effect was included to accommodate the correlations among repeated STI assessments within each individual. Estimated incidence rates (with 95% CIs, in colour) for each organism were reported as smooth functions of age.ResultsThe cohort included 386 young women. The average age at enrolment of study participants was 15.3 years (SD=1.1 years). A majority (89.1%) of study participants were African-American. The average age at first sexual intercourse was 14.2 years (SD=2, median=14 years). The mean cumulative number of sexual partners measured at the time enrolment was 3 (SD=4, median=2). The average length of follow-up was 3.5 years (SD=2.2 years). Baseline prevalence rates were 10.9%, 4.4% and 6.0% for CT, GC, and TV, respectively. The age-specific incidence rates for the three organisms and any STI are seen in the Abstract P1-S1.12 figure 1.Abstract P1-S1.12 Figure 1WTU.ConclusionsThe estimated STI incidence rates clearly differ by organisms, not only in magnitude but also in peak age. While the prevalence rates of the respective organisms in the partner population may be a contributor to the differential risk of STI acquisition, the fact that such differences were observed from the same group of individuals with the same sexual partners and sexual behaviours raises questions about age-related differences in susceptibility to infection by the three organisms.
P1-S2.65 Crack/cocaine use among MSM in Latin America: a multilevel analysis of RDS studies to identify drug use patterns and associated factors across cities
Authors: Jacobson J O , Alonso-Gonzalez M , Ramachandran D , Morales-Miranda S , Carballo-Dieguez A , Medrano J , Solano T , Rosales-Perez M D 
Published: July 2011

BackgroundIn Latin America (LA), men who have sex with men (MSM) are the population most affected by HIV, crack/cocaine production and trafficking routes are well-established, and local consumption has risen sharply in recent years. Yet, drug use and associations with sexual risk behaviours among MSM remain largely unexamined LA despite being recognised as important drivers of HIV transmission in the USA. Variation in crack/cocaine consumption within LA is also unknown.MethodsData from participants self-identifying as MSM and aged 18 years and older in recent (2006−2009) respondent-driven sampling (RDS) studies using similar survey methodologies in nine high-population cities in Argentina, Bolivia, Costa Rica, El Salvador and Honduras (N=2081) were pooled and analysed in a multilevel statistical framework to increase statistical power to evaluate past 12-month crack/cocaine consumption (CC). CC prevalence was estimated by study site, adjusting for sampling weights incorporating personal network and population sizes. Logistic, multilevel models identified correlates of CC, adjusted for intraclass correlation within levels defined by study site and recruitment chain, and partitioned variance in CC among levels.ResultsCC prevalence was 21.7% (95% CI 17.4 to 26.7) in the pooled sample and varied significantly across cities from 0.1% in Cochabamba, Bolivia to 44.5% in Ceiba, Honduras. In multivariate analysis, daily alcohol consumption (adjusted OR [AOR]=4.0), sexual debut of ≤ 12 (AOR=3.1) and 13−17 (AOR=1.9) years old, self-identifying as transexual/transgender/transvestite (TTT) (AOR=2.2), age 18−22 (vs >40) years (AOR=2.0), having a stable female partner (AOR=1.8) and ever purchasing sex (AOR=1.6) were associated with CC (p<0.05). Significant city-level random effects expressed as AOR were 5.4 (SE=1.3) and 2.7 (SE=1.3) in Ceiba and San Pedro Sula, Honduras, respectively and 3.4 (SE=1.2) in Buenos Aires, Argentina. Of the total variance in CC, 29.3% was associated with unobserved differences among cities. Associations between CC and condom use at last sex, and recruitment chain, were non-significant (p>0.1).ConclusionsCC prevalence among MSM, and variation among cities in LA, are considerable. Associations with frequent drinking and sexual risk Behaviours likely compound HIV transmission risk among MSM and to female partners. Substance abuse prevention and treatment for MSM are needed, particularly among TTT, and in Honduras and Argentina.
P1-S2.72 Predictors of HSV-2 seroprevalence and willingness to accept a prescription for suppressive therapy among recently incarcerated women
Authors: Roth A , Van Der Pol B , Reece M , Dodge B , Zimet G 
Published: July 2011

BackgroundHSV-2 seropositivity has direct links with one's increased risk for HIV acquisition. Given that increases in HIV incidence are highest among women of colour in the USA, they may benefit from HSV-2 control efforts. We evaluated the acceptability of a community-based HSV-2 screening program for women in the justice system and assessed factors related to HSV-2 positivity and willingness to accept a prescription for suppressive therapy.MethodsAs part of a larger randomised controlled trial, recently arrested women were recruited from a community court handling lower-level misdemeanour cases, including prostitution, in a large Midwestern city. Individuals completed an interviewer administered survey assessing factors related to HSV-2 screening intentions and were offered no-cost of point-of-care HSV-2 testing. Individuals screening positive were offered low-cost ($4) suppressive therapy.ResultsParticipants included 136 women, 18−62 years old (median=31) with reported ethnicities of White (51%), Black (43%) and other (6%). Most (51%) had less than a high school education, were unemployed (68%) and 28% were currently facing prostitution charges. The majority (64%) of participants accepted testing and 60% tested HSV-2 seropositive. Factors associated with an infection included age (OR=1.09; 95% CI 1.03 to 1.16), Black race (OR=50.06; 95% CI1.1.70 to 1472.14), lower educational attainment (OR=5.86; 95% CI 1.13 to 30.37), current genital symptoms (OR=6.5; 95% CI 1.25 to 34.17), and lifetime number of sexual partners (OR=102.33; 95% CI 6.62 to 1581.73). Being recently arrested for prostitution was not associated with an HSV-2 diagnosis. The majority of women testing positive (84.6%) accepted a prescription for suppressive therapy.ConclusionWe detected very high rates of HSV-2 among recently incarcerated women, especially among Black women. Nearly all women who tested positive accepted a prescription for Acyclovir, indicating they were interested in suppressive therapy which could provide some benefit in preventing HIV acquisition. These results highlight how non-traditional public health partnerships, like academic-judicial system collaborations, provide an opportunity for STD control programs to intervene with high-risk individuals.
P1-S2.73 Exploring the relationship between Rural-to-Urban circular migration and HIV: a qualitative study of migrants and persons living with HIV in North India
Authors: Rai T , Lambert H , Piot P , Agarwal K , Ward H 
Published: July 2011

BackgroundMigrant workers may be at increased risk of acquiring HIV and have been described as a potential bridge between high- and low-prevalence geographic areas and groups. The National AIDS Control Organisation of India has prioritised interventions for migrant workers with the aim of curbing the spread of HIV from high to low prevalence parts of the country. We describe links between migration and HIV and explore variations in risk between migrants.MethodsA qualitative study in Allahabad district, Uttar Pradesh, India. Interviews, focus groups and observations were carried out in two rural villages with high temporary out-migration of men, and in an HIV treatment centre in Allahabad. For this study we defined migrants as those who leave and return to their place of origin once or more in a year. Participants included key informants (14), rural migrant men (20), and men and women living with HIV/AIDS (PLHAs) (30).ResultsPLHA and migrant men described a range of ways in which migration could lead to an increase in the potential or actual risk of acquiring HIV. These included separation from wives and opportunities for other relationships, exposure to sexual abuse in destination workplaces, sex between men, and exposure to unregulated injections. These risks varied according to destination, with less opportunity for sexual risk-taking in factories where men were housed in closely-supervised factory accommodation. HIV in turn affected migration with a particular impact on the ability to make money and care for families. For some men illness or the fear of becoming unwell limited further migration, and thus reduced income; others increased migrant labour in order to plan for an uncertain future for their dependents. An HIV diagnosis meant some lucrative international destinations became inaccessible, so they moved elsewhere for work.ConclusionsLabour migration can increase vulnerability to infection for migrants and their families. However, this relationship appears to be more complex than is often assumed. Unprotected heterosexual intercourse may not be the only way in which migration increases HIV risk as there are numerous other risky encounters that migrant workers may have due to their circumstances. Planned programmes to increase HIV awareness and promote condom use at destination and source locations have to be combined with a systematic examination of the effect of social and sexual networks and power relationships in the labour market.
P1-S2.74 How patterns of migration may influence heterosexual HIV transmission
Authors: van Veen M , Xiridou M , Prins M , Coutinho R 
Published: July 2011

BackgroundEthnic minorities originating from countries with high HIV prevalence account for a large number of heterosexually acquired HIV infections in Western European countries. These groups may be infected before migrating and they may engage in unsafe sexual practices both in the country of residence and in their country of origin. We investigate how patterns of migration may affect the heterosexual HIV epidemic in the Netherlands.MethodsA mathematical model was used that describes the transmission of HIV infection in heterosexual partnerships between African migrants, Caribbean migrants, and the local Dutch population. Acquiring HIV infection before migrating to the Netherlands or during trips to the country of origin was also accounted for in the model.ResultsThe estimated HIV incidence among adult heterosexuals in 2010 was 1.50 new infections per 100 000 individuals per year. If the number of migrants entering the country increases, then the incidence of HIV will increase, although the change among the local Dutch will be negligible. Moreover, if HIV prevalence among those migrating to the Netherlands (at the time of entry to the country) is higher, then the incidence in the respective ethnic groups will increase; among the other ethnic groups, the increase will be very small.ConclusionsChanges in patterns of migration can have a considerable impact on HIV transmission within ethnic minority communities in the Netherlands, but they hardly have any impact on transmission in the local population. Therefore, limiting migration and introducing travel restrictions would likely have no effect on HIV incidence in countries with low HIV prevalence among heterosexuals. Policy making should focus on targeted interventions, to reduce the burden of HIV disease in migrant communities.
P1-S2.75 Are sex/drug risk behaviours in sending countries predictive of sex/drug risk behaviours in receiving countries? The case of Latino migrant men in New Orleans
Authors: Kissinger P , Mills J , Schmidt N , Salinas O , Hembling J , Aran A , Shedlin M 
Published: July 2011

BackgroundMigration and mobility have been associated with higher drug and sex risk behaviour. Whether this increased risk is a result of the characteristics of mobile persons or environmental influences in a receiving community has not been well elucidated. The purpose of this analysis was to determine if risk behaviour was a continuation of sending country practices or if it was adopted in the new receiving environment (ie, New Orleans).MethodsA cohort of Latino migrant men (n=93) were interviewed at baseline, 3 and 6-month visits and asked about past month behaviour. At a subsequent visit, they were also asked about behaviours in their sending country. All interviews were conducted in Spanish by trained staff. Four behaviours were examined: patronage of a female sex worker (FSW), sex with a man (MSM), binge drinking, and crack cocaine use. Cross-tabulations and McNemar tests were performed.ResultsAt baseline, the men were mostly Honduran (71.0%), migrated directly to New Orleans from their country of origin (62.0%), were single (50.5%) with a median age of 28 (range 18−50) and a median of 6 years of schooling. The percentage of men reporting patronage of FSW, MSM and crack cocaine use was significantly higher in New Orleans than in the sending country, and high proportion of those reporting the behaviours in New Orleans, did not practice these behaviours in the sending country. When comparing sending country to New Orleans behaviour in order to examine discrepancies for behaviours, all but binge drinking were significantly different (p<0.04) with adoption of the behaviour in New Orleans accounting for >85% of the discrepancy see Abstract P1-S2.75 Table 1.Abstract P1-S2.75 Table 1Behaviours in sending country and in New Orleans (N=93)BehavioursPatronage of FSWMSMBinge*Crack cocaineReported in sending country16/93 (17.2%)3/93 (3.2%)39/91 (42.9%)2/93 (2.2%)Reported in New Orleans60/93 (64.5%)10/93 (10.8%)35/91 (38.5%)12/93 (12.9%)Not reported in sending country (of those reported in New Orleans)50/60 (83.3%)8/10 (80.0%)15/35 (42.9%)12/12 (100.0%)*2 men had missing information.ConclusionRates of these four risky behaviours were high and, with the exception of binge drinking, were largely behaviours adopted in the USA Newly arrived migrant men are a group at high risk for sex and drug related STI/HIV. Interventions to prevent transmission in this vulnerable, difficult-to-access and highly mobile population are greatly needed.
P1-S2.76 Sexual concurrency among Latino migrant men in New Orleans
Authors: Kissinger P , Anderson-Smits C , Kovacs S , Salinas O ,   J H, Schmidt N 
Published: July 2011

BackgroundSexual concurrency and migration have both been implicated in the spread of HIV/STI. Migrant men are highly mobile, but their level of sexual concurrency has not been well studied. The purpose of this study was to examine the prevalence of and factors associated with sexual concurrency and to examine condom use within concurrent relationships among a group of newly arrived Latino migrant men (LMM) in New Orleans.MethodsLMM enrolled in an ongoing cohort study, who had at least one female sexual partner during follow-up were interviewed a three time points over 6 months. Concurrency was calculated by asking start and stop date of each sexual relationship as well as intention to continue. Partnerships that had overlapping dates were considered concurrent. The association between selected individual and environmental factors and sexual concurrency was examined using generalised estimated equations (GEE).ResultsAt baseline, LMM (n=90) were mostly Honduran (77.9%), employed (80.0%), worked in construction (55.6%), were uncircumcised (88.9%), were living with family (51.1%) and did not have a main sex partner (74.4%). Their mean age was 35.4 (SD 10.6) and they had been in New Orleans for average of 4.70 years (SD 0.89). During follow-up, 30 (33.3%) had at least one concurrent relationships, 10 (11.1%) had only concurrent relationships, and 59 (65.6%) had no concurrent relationships. In 239 observations, sexual partnering and consistent condom use was: concurrent (18.0%/53.5%), multiple but non-concurrent partners (5.9%/78.6%), and monogamous (50.6%/30.8%), while 25.5% were abstinent. Factors associated with sexual concurrency included: younger age, drug use, and living in crowed housing while belonging to organizations or sport team was protective. Of these 43 concurrent events, 21.0% included a risky partner (ie, female sex worker or casual partner) and main partner and 65.2% had at least one non-Latina partner. Of the 29 concurrent relationships that included a FSW, 5 (17.2%) did not use a condom with the sex worker.ConclusionThis sample of LMM exhibited high rates of concurrency with a potential for bridging. Drug prevention and interventions that promote social connectedness are needed to reduce concurrency among this mobile group.
P1-S3.01 Trends in the incidence of hospitalisation for chlamydia-related sequelae among women
Authors: Liu B , Donovan B , Wand H , Guy R , Hocking J , Kaldor J 
Published: July 2011

BackgroundChlamydia infection is thought to increase the risk of infertility and ectopic pregnancy. Over the last 10 years in Australia, chlamydia testing and notifications have increased dramatically, particularly in young women. As it is unclear how much increasing notifications reflect a true increase in chlamydia incidence, we sought to investigate rates of hospitalisation for the chlamydia-related sequelae, infertility and ectopic pregnancy in New South Wales (NSW), Australia's largest state with a population of 7 million.MethodsRoutine data on hospitalisations for infertility and ectopic pregnancy, perinatal data, and population census data from 2001 to 2008 were used to estimate annual age-specific hospitalisation rates for infertility and ectopic pregnancy in women aged 15 to 44 years for the entire state of New South Wales. Hospital separations occuring within each year belonging to the same woman were linked using probabilistic linkage of identifiers so that multiple admissions by one woman were only counted once.ResultsFrom 2001 to 2008 the number of women hospitalised for infertility increased from 7050 to 9978. The greatest increase was seen in women aged 35 to 44 years, from 6.4 [95% CI 6.2 to 6.6] to 11.2 [10.9 to 11.5] per 1000 population (p trend<0.001). There was no significant change among women aged 15 to 24 years (ptrend=0.3); see Abstract P1-S3.01 figure 1A. For women with ectopic pregnancy overall the number of women hospitalised decreased from 1204 to 1192, a decrease in annual rates from 14.3 [13.5 to 15.1] to 12.6 [11.9 to 13.3] per 1000 births (p trend<0.001) but this decrease was mostly in women aged between 25 to 44 years. There was no appreciable fall in hospitalisations for ectopic pregnancy in women aged 15 to 24 years (13.1 [11.5 to 15.0] to 13.1 [11.4 to 15.0] per 1000 births; ptrend=0.9; see Abstract P1-S3.01 figure 1B).Abstract P1-S3.01 Figure 1Women hospitalised for A) infertility and B) ectopic pregnancy in NSW, 2001 to 2008.ConclusionsAmong women aged 25 to 44 years decreases in hospitalisations for ectopic pregnancy and increases in hospitalisations for infertility were observed. The relationships between chlamydia prevalence, testing and notifications do not appear to be straightforward.
P1-S3.02 The economic burden of chlamydia and gonorrhoea in Canada
Authors: Smylie L , Lau P , Lerch R , Kennedy C , Bennett R , Clarke B , Diener A 
Published: July 2011

BackgroundThe latest estimate of the economic burden of chlamydia and gonorrhoea in Canada was modelled with data from 1990 and was published in 1992 by Ron Goeree and Paul Gully. Given the changes that have occurred since in diagnostic testing technology, the availability of new data sources and increasing rates of the two infections, a new model using updated data from 2000 is called for.MethodsDiagnostic test costs were estimated using provincial laboratory data on the number of diagnostic tests performed forChlamydia trachomatis(CT) andNeisseria gonorrhoeae(GC) for the year 2000. Direct costs of CT and GC from drugs, hospitals, and physician billings were estimated using the Economic Burden of Illness in Canada (EBIC) data. Direct costs of associated sequelae of each infectious disease were also included in the model. Indirect costs estimated in the model included production losses from both infectious diseases and their associated sequelae. Sensitivity analyses were conducted to provide upper, base and lower-bound estimates of the total cost.ResultsThe preliminary combined estimate for both direct and indirect costs of CT and GC (in 2000 dollars) ranges from approximately $31.5 to $178.4 million (CAD).ConclusionsFurther work is required to improve data access and estimates of the burden of infection in Canada. A top priority should be to improve the data infrastructure by expanding data linkages within and among provinces around laboratory tests. The majority of costs related to CT and GC are attributable to drug, hospital and physician costs, suggesting that much of the burden of these two infections can be reduced through implementation of effective prevention programs. The number of CT infections has increased exponentially since 2000, warranting further modelling considering current incidence rates and inflation costs.