bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S5.19 Marriage dissolution and HIV prevalence in rural Zimbabwe 2003–2008
Authors: Schumacher C , Nyamukapa C , Garnett G , Gregson S 
Published: July 2011

BackgroundOver the past decade, HIV prevalence in Zimbabwe has significantly declined, with recent research attributing this decline to wide-spread behaviour change such as reductions in extramarital sexual partnerships. Despite these reductions in risky sexual Behaviours, infections could still be transmitted from one marital union to another as divorced or widowed HIV-positive persons remarry.MethodsUsing information collected through face-to-face interviews in 2003–2005 AND 2006–2008, we compared HIV prevalence and basic demographics among women and their spouses (married, or in a long-term or cohabiting relationship for >12 months) in Manicaland, Zimbabwe. We used logistic regression to assess differences in marital history and basic demographics between HIV seronegative concordant couples, HIV serodiscordant couples and HIV seropositive concordant couples.ResultsIn nearly one-third of the 2836 (27.8%) of marital unions interviewed, at least one member was infected with HIV (n=787); both members were HIV positive in 372 couples (13%). Of the 415 serodiscordant couples, 157 (5.5%) were serodiscordant female positive. Overall, compared to those in seronegative concordant (NC) partnerships, women in female-positive discordant (FP) or seropositive concordant (PC) partnerships were older (25–34 years vs 15–24; OR 1.7, 95% CI 1.17 to 2.47; OR 3.35, 2.52 to 4.45, respectively), more likely to been divorced (FP OR 4.19, 2.83 to 6.20; PC OR 4.12, 3.10 to 5.48), and more likely to have been widowed (FP OR 7.83, 3.65 to 16.76; PC OR 7.86, 4.30 to 14.36). Similar but weaker trends in divorce/widowhood were observed among men in male-positive discordant relationships compared to men in SN relationships. Women in FP and PC partnerships both were nearly three times as likely to report >1 lifetime sex partners than women in SN partnerships (FP OR 2.82, 2.02 to 3.92; PC OR 2.86, 2.27 to 3.59); mean lifetime sex partners reported by women in FP and PC partnerships was similar (FP: 2.11 lifetime partners; PC 2.06).ConclusionsHIV prevalence is high among persons in long-term, stable partnerships, and strongly associated with one or both partners reporting a history of divorce or being widowed. In particular, widowed and divorced women may play an important role in ongoing HIV transmission dynamics. VCT services and other interventions that target couples should be promoted among divorced and widowed individuals.
P1-S5.20 Multi-level analysis of the predictors of HIV prevalence among pregnant women enrolled in sentinel surveillance in four Southern India states
Authors: Thamattoor U , Thomas T , Banandur P ,   R S, Duchesne T , Abdous B , Washington R , Ramesh B M , Moses S , Alary M 
Published: July 2011

BackgroundThe heterogeneity of HIV epidemic in the districts of four Southern states of India is reflected in HIV prevalence in pregnant women (ANC HIV prevalence) as well. Earlier studies have attempted to identify district level high risk population parameters that influenced ANC HIV prevalence. It is important to identify other district and individual level factors that influence ANC HIV prevalence to plan effective interventions.MethodsThe data from cross-sectional studies, known as integrated biological and behavioural assessments (IBBA), carried out between 2004 and 2007 among female sex workers (FSWs), their clients and men who have sex with men (MSM) in 24 districts were used to generate district-level variables concerning high-risk sub-population. The data on HIV sentinel surveillance in the ANC population (dependent variable) were obtained from the National AIDS Control Organization (NACO) for the same years. Other district level data were obtained from various governmental agencies and other reliable sources. Multilevel logistic regression analysis was used to identify individual and district-level factors associated with ANC HIV prevalence.ResultsThe mean annual ANC HIV prevalence between 2004 to 2007 in the 24 districts considered ranged from 0.25 to 3.25%. In the multilevel model, individual level factors such as age ≥25 years [Adjusted OR (AOR): 1.49; 95% CI 1.27 to 1.76], being illiterate (AOR: 1.64; 95% CI 1.07 to 2.53) and being employed (AOR: 1.38; 95% CI 1.17 to 1.64) were significantly associated with high risk of being infected by HIV. HIV prevalence among FSWs at the district level, which was a significant high risk population parameter in the earlier studies, remained significant in the current study (AOR: 1.03; 95% CI 1.01 to 1.05). The only other district level factor which was considered in the final model was percentage of women who married below age of 18 years (AOR: 1.02; 95% CI 1.00 to 1.04).ConclusionHIV prevalence among FSWs is a key determinant of HIV prevalence among pregnant women in Southern India. Illiteracy of women and high prevalence of women marrying under 18 years at district level are both indicators of low socio economic status. Therefore in addition to targeted interventions for FSWs, awareness programs among individuals from lower socio economic status might help in reducing incidence of HIV in pregnant women.
P1-S5.21 Self-esteem and STI/HIV prevalence among residents of a Tanzanian sugar plantation
Authors: Rice C , Turner A N , Norris A , Mtweve S 
Published: July 2011

BackgroundSexually transmitted infections (STIs), including HIV, lead to significant reproductive morbidities worldwide. The association between risky sexual behaviours and increased STI/HIV prevalence has been well-documented. In addition, low self-esteem appears to lead to higher-risk sexual behaviours. However, the direct association between self-esteem and STI/HIV has not been well studied. We aimed to examine whether self-esteem directly affects STI/HIV prevalence, after adjusting for risky sexual behaviour.MethodsWe conducted a secondary analysis of a cross-sectional study of sugar plantation residents in Tanzania. The 2004 study included a self-administered survey with self-esteem assessment and testing for syphilis, herpes simplex virus type 2 (HSV-2) and HIV. We restricted our analysis to individuals with valid STI/HIV results and complete self-esteem data. Through principal component analysis, the 8-item self-esteem scale was reduced to a single variable. This variable was further categorised as low, medium, and high self-esteem and was the primary exposure variable in a multivariable log binomial model with a combined outcome representing any prevalent STI/HIV (syphilis, HSV-2, or HIV).ResultsFrom the full study sample of 556 residents, 431 (78%) individuals had both complete STI/HIV data and self-esteem assessment and were included in the analysis. The analysis population was 51% male and 49% female. Nearly 60% (n=254) had at least one STI/HIV. We observed no significant heterogeneity by gender in the effect of self-esteem on STI/HIV prevalence. Gender, transactional sex and alcohol use were retained as confounders in the final model; no other demographic or behavioural variables met our a priori statistical criteria for confounding. The adjusted prevalence ratios (PR) for STI/HIV for individuals with low self-esteem compared to those with medium self-esteem and high self-esteem were 0.95 (95% CI 0.80 to 1.13) and 0.92 (95% CI 0.67 to 1.27), respectively.ConclusionSelf-esteem was not independently associated with STI/HIV prevalence in plantation residents in Tanzania. Our findings suggest that the role of self-esteem in reproductive health may be limited to its association with increased sexual risk behaviour, which subsequently affects STI/HIV prevalence. Interventions aimed at improving self-esteem may only be appropriate if they reduce likelihood of participation in risky behaviours.
P1-S1.02 Assessing heterogeneity in the incidence of chlamydia and gonorrhoea in an urban Canadian setting—a population-based analysis
Authors: Shaw S , Whitlock M , Nowicki D , Plourde P , Mahmud S 
Published: July 2011

IntroductionA combination of increased testing and improved testing modalities has contributed to substantially higher incidences of chlamydia (CT) and gonorrhoea (GC) infections globally. Previous studies have noted the differing epidemiological profiles of CT and GC, resulting in different public health prevention and intervention strategies. Using a population-based perspective, this study describes recent trends, and assesses inequalities in the geographic distribution of CT and GC in a Canadian city.MethodsAnalyses included all laboratory-confirmed cases of CT and GC among residents of the Winnipeg Health Region from 1996 to 2008. Annual CT and GC incidence rates were directly age-standardised to the 2000 Winnipeg Health Region population. Adjusted rate ratios (ARR) for the effect of age and gender, and 95% 95% CI, were estimated by negative binomial regression models. Generalised estimating equations (GEE) were used to correct for clustering within neighbourhood areas (n=25). Inequalities in the neighbourhood area distribution of annual CT and GC rates were measured by the Gini coefficient, with 95% CI estimated by bootstrapped samples. For regression and Gini analyses, cases were grouped into 10–19, 20–29 and 30+ age groups.ResultsThe age-adjusted incidence of CT increased from 198/100 000 in 1996 to 513/100 000 in 2008. During this same time period, GC increased from 62/100 000 to 89/100 000, with a peak of 133/100 000 in 2006. For females, and compared to those aged 30 or over, equally high rates of CT were observed in those 10–19 (ARR 24.2; 95% CI 18.7 to 31.4, p<0.0001) and 20–29 years (ARR 24.4; 95% CI 18.8–31.7, p<0.0001). For males, differences in rates were observed in those aged 10–19 (ARR 5.3; 95% CI 4.1 to 6.9, p<0.0001) and 20–29 (ARR 10.5; 95% CI 8.2 to 13.5, p<0.0001) years. A similar pattern was detected for GC infections. Inequality by neighbourhood area, as measured by Gini coefficients decreased over time for CT infections, regardless of age group. For GC infections, increases were observed in those 30 years or older, for both males and females.ConclusionSince 1996, the distribution of CT incidence is suggestive of a generalised spread; while for GC the distribution has narrowed in those aged 30 or over, suggestive of concentration among core populations within this age group. CT and GC continue to display differing and dynamic epidemiological profiles.
P1-S1.20 Seroprevalence of herpes simplex virus type I and II infections in Russian Federation
Authors: Khryanin A , Reshetnikov O , Kandrushina M 
Published: July 2011

BackgroundHerpes simplex virus type 2 (HSV-2) is a common sexually transmitted infection worldwide, and its prevalence has increased significantly over the last 2 decades in many developed countries. The prevalence rates of HSV-2 infection differ between populations; however, HSV-2 seropositivity is uniformly higher in women than in men and increases with age. However, HSV-1 has been recently identified as a genital infection.ObjectivesAim of the present study was to evaluate the seroprevalence of HSV-1, and HSV-2 infections among various population groups in Siberia, Russia.MethodsA sample of 1014 persons aged 14–64 years (47% males) were randomly selected from the general population in urban Novosibirsk (predominantly Caucasians) and rural regions of Tyva and Altai Republic (predominantly persons of Asian origin). The study includes data obtained in 1994–2005. The current investigation was performed as an optional fragment of international WHO MONICA study, and HAPIEE study (Wellcome Trust Fund 064947/Z/01/Z and 081081/Z/06/Z). Sera were tested for IgG antibodies to HSV infections with type-specific ELISA (VectoHSV-1 IgG, VectoHSV-2 IgG, Vector-Best, Novosibirsk, Russia).ResultsThe overall prevalence of HSV-2 positivity was 21% being higher in females (26.4%) compared to males (17.0%, p=0.01). Seroprevalence rates increased with age from 0% at 14–17 years to 22.8% at 55–64 years in males and from 1.8% at 14–17 years to 31.6% at 55–64 years in females. Neither difference was observed between urban and rural population, nor in surveyed persons of Caucasian and Asian origin. Ten-year trend showed a decrease in the frequency of HSV-2 detection equally in different populations by 20%. HSV-1 seroprevalence was uniformly high in each population group (99–100%). In conclusion, HSV-2 is common in Russia with the prevalence rates close to USA and Scandinavian countries. The sex and age distribution of the infection in Russia is similar to other populations. In Siberia, ethnicity and standard of living do not influence HSV-2 prevalence. However, HSV-1 infection rates may influence HSV-2 infection distribution by cross-reactive immunity patterns.
P1-S5.24 Prevalence ofChlamydia trachomatisamong women infected by HIV attending the institute of tropical medicine in Amazonas, Brazil
Authors: Miranda A , Silva L , Sardinha F , Talhari S 
Published: July 2011

BackgroundChlamydia trachomatis(CT) is one of the world's most frequent sexually transmitted infections (STI), having great impact on sexual and reproductive health.ObjectivesTo describe clinical profile of and the prevalence of CT infection in HIV women attending the Institute of Tropical Medicine in Manaus, Amazonas, Brazil Methods: A cross-sectional study performed among women attending the AIDS clinic from March to December 2010. They were invited to take pat in the study and answered an interview including demographic, behavioural and clinical data. They underwent in a gynaecological examination where it was collect a cervical sample for diagnosing CT by hybrid capture.ResultsA total of 330 women were included in the study. Median age was 32 (IQR (IQR): 27; 38) years and median of schooling 9 (IQR: 4; 11) years. Prevalence rate of CT was 4.5% (95% CI 2.3%—to 6.7%). Median of first sexual intercourse was 16 (IQR: 14; 17) years and 53.9% were married or reported a stable partner. A total of 70.9% reported regular use of condoms in the last year. Risk factors reported were: injecting drug use (1.2%), no-injecting drugs (15.2%), previous STI (32.4%), commercial sex workers (16.4%), more than one partners in the last year (12.7%) and in life (94.5%). Regarding clinical symptoms, 51.1% reported chronic pelvic pain, 55.2% vaginal discharge, 23.0% dysuria and 10.0% genital bleeding. CD4 counts were more than 500 cells/mm3in 21.8% and viral load were less than 100 copies/mm3in 55.2%. In the final model of logistic regression the only variable remained was having more than one partner in life.ConclusionsHealth programmes need to pay attention to the need to screen for easily curable sexually transmitted infections, such as Chlamydia trachomatis, in populations that are more vulnerable and at greater risk, as women living with HIV.
P1-S5.30 Relationship between syphilis and HIV: lessons from a Nigerian surveillance survey
Authors: Adeyemi A , Oyediran K , Azeez A , Kawu I , Fakunle O 
Published: July 2011

BackgroundSexually transmitted infections (STI) including syphilis are associated with risks of acquiring HIV infection. Behaviours that increase STI also play important role in increasing the risk of HIV. Transport workers are highly mobile population often predisposed to STI including HIV due to the nature of their business. Similarly, they are potential bridge population between female sex workers and the general population. This study assesses relationship between syphilis and HIV among transport workers in Nigeria.MethodsSecondary data analysis of a survey conducted in 2007 among 2233 transport workers in six Nigerian states. Time location sampling was employed. The relationship between HIV and syphilis was evaluated using multivariate logistic regressions while controlling for confounding factors such as demographic, knowledge and behavioural variables.ResultsMedian age was 33 years with age range: 18–49 years and all participants were male. Syphilis prevalence among transport workers was 1.6%. State-level prevalence of syphilis was: 4.2% in Anambra, 1.1% in Cross Rivers, 0.7% in Edo state, 1.8% in FCT, 0.8% in Kano and 1.9% in Lagos. HIV prevalence was 3.8% with the highest prevalence (6%) in Cross Rivers and the lowest (1.6%) in Kano. Also, 33.5% had genital discharge; 14.5% had genital ulcers/sores; 12.2% used marijuana; 25.0% were away from home for >1 month; 55.5% had secondary education and 67.2% had ever been married. Only 17.3% used condom in the last sex with non-regular partner; 31.0% had sex with a girlfriend in the past 12 months and 4.3% paid for sex in the last 12 months. Syphilis was not associated with HIV infection OR=1.54 95% CI 0.90 to 2.65. However, risks for HIV infection included being away from home for >1 month OR=1.8 95% CI 1.4 to 2.3; sex without condom in the last 12 months OR=1.5 95% CI 1.2 to 1.9; sex with female sex workers OR 1.7 95% CI 1.2 to 2.2 while secondary education was protective with OR: 0.6 95% CI 0.4 to 0.8.ConclusionsMore researches are needed to investigate the relationship between syphilis and HIV in Nigeria as little evidence is available from the national survey. These findings have implication of promoting secondary education and condom uptake in non-marital relationships among transport workers in Nigeria.
P1-S5.31 Coinfection and concurrent sexually transmitted infections (STIs) in sexual partnerships: potential impact of partner notification and treatment in STD control
Authors: Canchihuaman F , Hawes S , Holmes K , Garcia P , Carcamo C 
Published: July 2011

BackgroundPartner notification and treatment has the potential to be one of the most important strategies in the control of STIs. However, studies indicate that this approach is not often used. Additionally, there is not much information about STIs among sexual partnerships.ObjectivesTo determine the prevalence of several STIs in sexual partnerships and to estimate the potential utility of partner treatment.MethodsWe enrolled males and females 18–29 years of age from a random household sample in 24 cities in Peru and enrolled same-residence sex partners of the participants. Participants and partners responded to demographic and sexual behaviour questionnaires and provided biological samples tested forNeisseria gonorrhoeae,Chlamydia trachomatis, andTrichomonas vaginalis, syphilis, HSV-2 and HIV.ResultsOf 2302 couples enrolled, 2163 couples had laboratory results available for either CT or TV and 1696 couples for either HIV, HSV-2 or early syphilis. CT, TV, early syphilis, HSV-2, and HIV were found in 7.1%, 4.4%, 1.2%, 24.8%, and 0.2% of couples, respectively. Among couples in which at least one subject was affected by a specific STIs, both partners had CT in 53 (39.3%) couples, TV in 22 (25.0%) couples, early syphilis in 3 (14.3%) couples, HSV-2 in 215 (51.1%) couples, and HIV in 2 (66.7%). Of couples affected by CT, 18/131(13.7%) had TV; 1/109 (1.3%) had early syphilis; 41/109 (41.6%) had HSV-2; and no one had HIV. Among females affected only by CT, 52.3% of partners had CT and 2.6% had TV; and among those only affected by TV, 13.7% of partners had CT and 26.2% had TV. Among males affected only by CT, 68.8% of partners had CT and 14.3% had TV; and among those affected only by TV, 11.5% of partners had CT and 84.6% had TV.ConclusionsA relatively high proportion of males and females affected by an STI had the same infection than their partners and not an infrequent number had different infections. Strategies to increase utilisation of partner notification and treatment may help STI control. Further review of partner treatment guidelines needs to be performed.
P1-S1.21 Incidence rate of Herpes Simplex Virus type 2 (HSV-2) in the USA, 1988–2008
Authors: Gerver S 
Published: July 2011

BackgroundHSV-2 infection remains a major public health problem in the USA, where the prevalence is 16.2% in persons aged 14–49. In this report, we provide national estimates of new HSV-2 infections in the USA and examine trends in incidence over the past 2 decades.MethodsA simple catalytic model was used to estimate HSV-2 force of infection (FOI), defined as the incidence of HSV-2 in the susceptible population, from National Health and Nutrition Examination Surveys (NHANES) in the USA from 1988 to 2008. HSV-2 serology was included in the nationally representative surveys during 1988–1994 (NHANES III) and in continuous NHANES from 1999 to 2008. Incidence rates and trends over time were estimated by age, sex and race/ethnic group for non-Hispanic whites, non-Hispanic blacks, and Mexican-Americans.ResultsHSV-2 FOI rates were highest in non-Hispanic blacks and lowest in non-Hispanic whites, with the FOI among 25-year-old non-Hispanic black women more than 13 times greater than white men of the same age. Rates were highest between ages 25 and 35 years for all sex-race/ethnicity groups (peak in non-Hispanic white and black women aged 25 years, in non-Hispanic white and black men aged 35 years and in Mexican-American women in their early-30s) except for Mexican-American men, for whom there was less variation in FOI by age. Over the last 20 years, age-adjusted FOI rates were stable for the sex-race/ethnicity groups examined except for non-Hispanic white and Mexican-American women, in which there were decreases after 2002 and 2001, respectively. FOI rates were lower in men than women among non-Hispanic blacks and Mexican-Americans, and in non-Hispanic whites prior to 2002. Overall, the estimated number of new HSV-2 infections in 2007–2008, among these three groups, aged 14–49 years, was in excess of 750 000, with 48% (∼360 000) occurring in women and 52% (∼392 000) in men. Nearly half (45%) of all infections occurred in persons under 25 years old (34% and 57% of infections in men and women, respectively).ConclusionRisk of HSV-2 infection varies substantially across the US adult population, with the highest risk among non-Hispanic black men and women. Information on the detailed distribution of new infections can help improve the efficiency of interventions. In addition, although we found evidence for substantial reductions in the risk of HSV-2 among some race/ethnicity groups, FOI in groups with the highest rates has not changed in 20 years.