bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S4.32 Recruiting via social networking sites for sexual health research (assessing chlamydia and HPV knowledge)
Authors: Garland S M , Wark J D , Tabrizi S N , Jayasinghe Y , Moore E , Fletcher A , Gunasekaran B , Ahmed N , Fenner Y 
Published: July 2011

BackgroundRecruiting participants into population health studies has become increasingly challenging: traditional strategies have limitations including low participation rates and high costs. Social networking sites, commonly used for communication by young people, present an unique opportunity for innovative recruitment modalities.MethodThis is part of a larger feasibility study assessing use of Facebook to recruit subjects for a novel prospective health study, the Young Female Health Initiative (YFHI). Women aged 16 to 25 years, living in Victoria, Australia were eligible to participate. An advertisement was placed on Facebook between May—and October 2010 and was visible to a random sample of eligible women. Women clicking on the advertisement were redirected to our website (http://www.yfhi.org) and invited to provide their contact details. They were contacted by a researcher and asked to complete a survey at the YFHI study site, or to complete the questionnaire online. The survey contained demographic questions, plus sensitive questions about sexual history, experience and knowledge ofChlamydia trachomatis, human papillomavirus (HPV) and HPV vaccines.Results551 women responded to the advertisement (recruitment could be scaled up or down by changing the advertising frequency). We enrolled 426 respondents, of whom 278 completed the survey within the time available (50% at the study site, 50% online). Respondents' age and geographical distribution (urban, regional, rural) was representative of the target population; women over 18 years were 37% more likely to enrol and complete the survey than 16–17-year olds (p<0.05). Despite the sensitive nature of some questions, over 98% of participants found the survey not at all, or only slightly, embarrassing. Overall, 63% had heard of HPV: of these, 73% knew that HPV is sexually acquired and 94% knew that it causes cancer. 78% had heard of chlamydia: those who were sexually active were more likely to know of chlamydia than virgins (p<0.01), while 63% knew it could cause chronic pelvic pain, and 86% that it could cause infertility. This recruitment method also was cost-effective ($USD 20 per compliant participant).ConclusionsResults demonstrate excellent potential for such information and communication technologies (ICT) to engage young women in health research, including those from regional and rural communities, and support the use of ICT in future population-based studies, including sexual health research.
P1-S4.33 Effectiveness of respondent driven sampling among undocumented Central American Immigrant Women in Houston, Texas, 2010
Authors: Montealegre J , Risser J , Selwyn B J , Sabin K 
Published: July 2011

BackgroundRespondent driven sampling (RDS) is a social research method that uses participants’ social networks (SNs) to access members of hidden populations for which there is no sampling frame. RDS is widely used for HIV behavioural research among sex workers, drug users, and other hidden populations. However, it has had minimum application in migrant populations. We used RDS to conduct an HIV behavioural survey among undocumented Central American immigrant women in Houston, Texas (specifically, Guatemalan, Honduran, and El Salvadoran females, ages 18–50 years, residing in Houston without a valid US visa or residency papers). Here we describe the effectiveness of RDS to recruit members of this population.MethodsFormative research indicated that social ties are mainly formed by country of origin, age, and number of years living in the USA. Measures of effectiveness were survey duration, participants' adoption of the recruitment system, SN density, homophily, and attainment of equilibrium. SN density is the average number of social ties per participant. Homophily is the likelihood that individuals recruit individuals like themselves; scores range from −1 to 1, where 1=100% within-group recruitment and 0=100% random recruitment. Equilibrium is the stable sample composition that indicates independence from initial non-randomly selected participants.ResultsBeginning with three initial participants, we recruited a sample of 230 immigrant women over 16 weeks. Participants adopted the recruitment system with reasonable ease (46% recruited ≥1 peers) and SNs were dense (mean SN size=20). Homophily (H) was moderate by country of origin (Guatemalans: H=0.52; El Salvadorans: H=0.42) and low by age and number of years in the USA (H≤0.25). Equilibrium was attained for all demographic and sexual behaviour characteristics.ConclusionsThis study is the first to evaluate RDS in a migrant population. SNs in this population were dense, allowing recruitment to be sustained. While recruitment was moderately influenced by country of origin, women did not affiliate exclusively with those like themselves. This sociometric diversity allowed the sample to attain an equilibrium composition independent of initial participants. Overall, RDS was easy to implement, attained a large sample in a relatively short period of time, and reached an otherwise hidden population. RDS is an effective method for recruiting undocumented Central American immigrant women for HIV behavioural surveys in Houston.
P1-S5.01 Heterosexual Anal Sex, Lubrication, HIV, and HSV-2 infection among women
Authors: Brown J , Hess K , Brown S , Murphy C , Waldman A , Hezareh M 
Published: July 2011

BackgroundAnal intercourse (AI) is associated with increased HIV and STI risk. Anal douching and use of AI lubrication may increase susceptibility to infection and may influence results of trials of microbicides for HIV prevention through effects on the rectal environment and on adherence to investigational microbicidal products. We measured the frequency of heterosexual AI, anal practices and lubricant use and their association with HIV and HSV-2 infection among women.MethodsBetween October 2008 and June 2009, we recruited women age 18 years and older in Los Angeles. At the enrolment visit and at the 12-month visit, participants underwent a self-administered, web-based questionnaire covering demographic factors, sexual Behaviours, and anal practices. HSV-2 was diagnosed by IgG ELISA, and HIV was diagnosed by rapid ELISA with confirmation by Western blot. Here we report data collected during the enrolment visit.ResultsWe enrolled 141 women (34% identified as White, 40% Black, 26% Hispanic; the median age was 33 years (IQR=25–44)). Overall, 71% reported ever having AI, and 8% reported AI as current means of contraception. Overall, 18% reported AI over the past month, and among these women, the median number of monthly AI acts was 2 (IQR=1–3), 50% reported unprotected AI, 8% reported anal douching, and 58% reported using lubricant during AI. Commercial lubricants (38%), saliva (23%), petroleum jelly (15%), and lotion (12%) were the most commonly reported lubricants. The prevalence of HIV was 27% and HSV-2 was 57%. In multivariable analysis, AI was associated with testing positive for HIV (aOR=7.8 (95% CI=1.6 to 37.6)) and HSV-2 infection (aOR=3.3 (95% CI=1.2 to 9.1)) controlling for age, race, and lifetime sexual partners.ConclusionAI is associated with HSV-2 and HIV infection, and anal douching and use of anal lubricating products not specifically designed for intercourse is common among women. The frequency and health effects of anal practices and lubricants warrant further study.
P1-S5.04 HSV-2 Prevalence and Incidence among Stable HIV-1 Discordant Couples in Nairobi, Kenya
Authors: Muiru A , Bosire R , Guthrie B , Choi R , Merkel M , Chohan B , Kiarie J , Lohman-Payne B , Farquhar C 
Published: July 2011

BackgroundTo describe HSV-2 prevalence, incidence and their correlates among stable HIV-1 discordant heterosexual couples enrolled in an HIV-1 prevention cohort study in Nairobi, Kenya.MethodsBetween 2007 and 2009, 469 HIV-1 discordant couples were recruited from VCT centers, and were followed up quarterly for up to 2 years. Clinical staff administered a questionnaire assessing socio-demographics, behaviour, and biological characteristics. HSV-2 status was assessed using Focus Herpe-Select2 HSV IgG ELISA. Correlates of HSV-2 infection at enrolment, and during follow-up were identified by logistic regression and Cox proportional hazards analysis respectively.ResultsOf the couples, 189 (40%) were HSV-2 concordant positive, 114 (24%) were HSV-2 discordant, and 85 (18%) were concordant negative. The incidence of HSV-2 infection was 8.7 cases/100 person-years. 19 (17%) individuals in an initially HSV-2 discordant partnership and 11 (13%) in an initially HSV-2 concordant negative partnership acquired HSV-2 during follow-up. Of these 11 individuals, 9(81%) were the HIV-1 positive index case in the HIV-1 discordant relationship. In a multivariate analysis, HSV-2 prevalence at baseline was significantly associated with female gender (OR 4.4; (95% CI 2.9 to 6.7)), having an HSV-2 positive partner (OR 7.6; (95% CI 5.1 to 11.2)), being HIV positive (OR 2.2; (95% CI 1.5 to 3.1)), increasing age (OR 1.08; (95% CI 1.05 to 1.1)), and older age at sexual debut was protective (OR 0.87; (95% CI 0.83 to 0.93)). HSV-2 incidence during follow-up was significantly associated with female gender (HR 3.5; (95% CI 1.6 to 8.0)), having an HSV-2 positive partner (HR 4.9; (95% CI, 2.0 to 9.9)), and history of any other STI (HR 2.6; (95% CI 1.3 to 5.8)).ConclusionsThis is the first large study to report the prevalence and incidence of HSV-2 among sexual partners who are in a stable HIV-1 discordant relationship. Female gender, a history of any other STI, and having an HSV-2 positive partner were associated with an increased risk of acquiring HSV-2. 11 individuals a majority of them with HIV acquired HSV-2 during follow-up despite being in HSV-2 concordant negative relationship at enrolment. The high incidence of HSV-2 in couples who were initially HSV-2 concordant negative or HSV-2 discordant highlights the dire need for continuing comprehensive STD prevention programs particularly among high risk population Sub-Saharan Africa.
P1-S5.06 Oral sex and risk of sexually transmitted infections
Authors: Flagg E , Weinstock H , Workowski K , Peterman T 
Published: July 2011

BackgroundOral sex is a common sexual practice in the United States; in 2002, almost 90% of sexually active adults ages 20–44 and over half of teens 15–19 years reported having had oral sex with an opposite sex partner. Oral sex is thought by some men who have sex with men to have lower risk for HIV acquisition, and is a prevalent practice in this population. However, the risk of acquiring a given sexually transmitted infection (STI) from oral sex may depend on a number of factors, including the specific STI, particular oral sex practice, prevalence of the STI in the population, and the number of oral sex acts performed. It is difficult to quantify the risk of getting an STI from a specific type of oral sex activity, or compare risks due to specific sex acts, because most people who have oral sex also have vaginal and/or anal sex.MethodsIn order to develop public health messages on oral sex and STI risk, we performed a review of the scientific literature to assess the state of current knowledge for risks of seven STIs (including HIV) and six oral sex practices: insertive and receptive fellatio, cunnilingus, and anilingus. Approximately 200 publications between 1979 and 2010 were reviewed; only 65 reported novel findings for one or more of these 42 potential associations.ResultsThe clearest evidence of risk was found for syphilis (all oral sex practices), chlamydia (insertive and receptive fellatio; receptive anilingus), gonorrhoea (insertive and receptive fellatio), herpes (insertive fellatio; receptive cunnilingus), and HIV (receptive fellatio). For example, for pharyngeal gonorrhoea 4 of 4 studies reported association with receptive fellatio; 1 of 1 study found none for insertive anilingus. Other STI and oral sex associations were less well-studied, or have not been documented. No reports allow direct per-contact estimates, but some facilitate comparisons with non-oral types of sexual contact. A number of studies did not specify whether ejaculation or use of barrier protection was assessed.ConclusionsAll oral sex practices are associated with risk of transmission of one or more STIs; however the relations between specific oral sex practices and risk of infection are not well-characterised for several STIs. Despite this, it is important to formulate appropriate public health messages regarding oral sex and STI risk. Future studies should clearly distinguish between specific oral sex practices and consider these factors in sample size determination.
P1-S5.10 Acute genital ulceration in South African Men: importance of age and sexual risk behaviours
Authors: Leichliter J , Lewis D , Paz-Bailey G 
Published: July 2011

BackgroundHerpes simplex virus (HSV) is the leading cause of genital ulcer disease (GUD) in Africa. Although some studies have examined the demographics and sexual behaviours of men with GUD, less is known about the differences that may exist between men with new sexually-acquired ulcers and men with other forms of GUD.MethodsMen with GUD (n=615), who were 18 years and older, were recruited from several primary healthcare clinics in Gauteng Province, South Africa. Participants received syndromic management, were tested for ulcer aetiology and urethritis pathogens by PCR, and for HIV, syphilis and HSV-2 by serology. We used survey and STI test data to examine correlates of initial vs recurrent HSV and acute ulcer outcomes. Of men with HSV (n=451), initial HSV was defined as a HSV-positive ulcer specimen and HSV-negative serology. Recurrent herpes was defined as a positive HSV specimen and serology. For all men, the acute ulcer outcome compared men who had initial HSV or who hadTreponema pallidum,Haemophilus ducreyi, orChlamydia trachomatisL1–L3 detected in their ulcer specimens (termed “acute ulcers”) to men with GUD who did not have any of the four etiologies (termed “non-acute ulcers”). Correlates consisted of demographic characteristics and sexual behaviours often associated with STI.ResultsAmong all men, 29% had an acute ulcer, and of those with HSV, 30% had initial HSV. As compared to men with a non-acute ulcer, men with an acute ulcer were younger (p<0.01), more likely to be single (p<0.05), less likely to always use condoms with regular partners (p=0.03), had more casual partners in the last 3 months (p=0.03) but had fewer lifetime partners (p=0.02). As compared to men with recurrent HSV, men with initial HSV were significantly more likely to be younger (p<0.01), have multiple regular partners (p=0.03), and report having sex in last week (p=0.04), but were less likely to report ever exchanging sex for money (p=0.01) and had fewer lifetime partners (p<0.01).ConclusionsFindings suggest that young age and recent sexual behaviour were associated with initial HSV and acute ulcers in this group of men. These data emphasise the importance of targeting STI/HIV prevention programs in South Africa to young men engaging in high-risk sexual activities. To facilitate this, it is important to ensure that young men are equipped with the appropriate knowledge and skills to either avoid acquiring, or to seek early treatment for, STIs.
P1-S1.19 Herpes simplex virus type 2 infection—seroprevalence in Siberia
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.ObjectivesAim of the present study was to evaluate the seroprevalence of HSV-2 infection 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. Sera were tested for IgG antibodies to HSV-2 infection with type-specific ELISA (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%. 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.
P1-S5.14 Risk factors associated with HIV acquisition: a comparative analysis of older and younger women who participated in the MDP301 trial in Johannesburg
Authors: Delany-Moretlwe S , Nanoo A , Nagpal A , Moultrie H , Delany S , Rees H 
Published: July 2011

BackgroundYoung women are known to be particularly at risk for HIV infection. Identifying characteristics associated with HIV-acquisition in younger and older women could assist with developing effective interventions which target the determinants of HIV.MethodsThe MDP301 study was an international, multi-centre, randomised controlled trial to assess the efficacy of 0.5% PRO2000/05 microbicide gel. 2508 HIV-negative women, ≥18 years, were enrolled in Soweto and Orange Farm and followed up for 12 months. Associations between baseline demographic, behavioural and clinical risk factors and HIV acquisition were assessed using univariate Poisson regression.ResultsData on 2451 women were analysed. 110 seroconversions were observed over 2356.5 woman-years (wy). Overall, HIV incidence was 46.7/1000 wy (95% CI 38.7 to 56.3). Younger women (18–24 years) were more likely to acquire HIV (IRR1.4, 95% CI 1.0 to 2.0) than older women (≥25 years). Difficulty accessing money for medical treatment (IRR 1.5, 95% CI 0.06 to 2.0, p=0.019) and being HSV2 seropositive at baseline (IRR1.7, 95% CI 0.99 to 2.8, p=0.055) were associated with an increased risk of seroconversion in younger women. In older women, decreasing partner contribution to the household economy (IRR 1.3, 95% CI 1 to 1.7) andTrichomonas vaginalisinfection at enrolment (IRR 2.3, 95% CI 1.1 to 4.9) were associated with increased risk of HIV acquisition. Older women who reported condom use at last sex act had a greater risk of acquiring HIV (IRR 2.8, 95% CI 1.3 to 5.9), which could reflect high risk sexual behaviour in this group. Reporting multiple partners was associated with increased risk of HIV acquisition in both younger (2.6, 1.3 to 5.3) and older women (2.8, 1.3 to 6.1).ConclusionsSTIs remain an important marker of ongoing HIV risk. Interventions that address the economic context of women's HIV risk will be important to evaluate. Additional investigation using multivariate analysis may elucidate these findings further.
P1-S5.15 Contribution of condom breakage to the HIV epidemic among men who have sex with men in Karnataka, India
Authors: Pickles M , Vickerman P , Bradley J , Ramesh B M , Isac S , Washington R , Prudden H , Mitchell K , Alary M , Boily M C 
Published: July 2011

BackgroundCondom promotion among female sex workers (FSWs) and men who have sex with men (MSM) is one of the key components of the Avahan HIV intervention currently underway in India. High rates of consistent condom use are reported across sites. However, condoms are only effective if they do not break or slip during intercourse, which occur frequently, especially in MSM.MethodsWe use a deterministic compartmental mathematical model of MSM divided into high and low risk, with average condom use increasing over time, to investigate how breakage influences the course of the epidemic. High-risk MSM (HRMSM) sell sex or have many casual partners, and typically have mostly receptive anal sex. Prior parameter ranges (including condom use) for the model are based on one round of cross-sectional behavioural and biological (IBBA) surveys of HRMSM from four districts in Karnataka state in 2008. In these surveys 16.7% (82/491) of MSM report condom breakage in the last sex act. Condom use increased to 93% by 2008, and was assumed to be constant afterwards. The prior ranges are sampled using Latin hypercube sampling. Model runs that agree with measured HRMSM HIV prevalence (12.7–18.9%) provide the posterior parameter set fitting the data, and are used to make predictions of HIV prevalence with and without condom breakage after the start of the intervention in 2004.ResultsAbstract P1-S5.15 figure 1 shows change in high/low risk prevalences with and without condom breakage. Even with high rates of condom breakage, HIV prevalence among MSM declines from 16.7% (95% CI 12.7 to 20.8%) in 2004 to 7.9% (5.9 to 9.8%) in HRMSM by 2015. Without condom breakage HIV prevalence declines faster, to 5.6% (4.2 to 6.9%) by 2015. Compared to no condom breakage, there will be 10.3% (10.7%) more cumulative infections with breakage in high-risk (low-risk) MSM from 2004 until 2015. The annual extra fraction of new infections due to condom breakage increases from 4.1% (4.3%), in 2004, to 158.9% (165.3%), in 2015 in high-risk (low-risk) MSM, although the absolute number of infections due to condom breakage decreases as the epidemic is declining and condom use increases.Abstract P1-S5.15 Figure 1HIV prevalence against time for high-risk MSM (upper curves)and low-risk MSM (lower curves). Shaded region shows 2.5–97.5 percentiles and IQR with breakage. The dashed lines show the 2.5, 97.5 percentiles and quartiles without condom breakage.ConclusionsHIV prevalence is projected to decline in MSM in Karnataka, given high rates of reported condom use, even with frequent breakage. However, there will be a large fraction of extra infections due to condom breakage. HIV intervention programmes should examine reasons for high rates of breakage and take steps to address this.