bluuebunny/crossref_metadata_2025_split huggingface dataset:
P2-S4.03 Prevalence and risk factors forChlamydia trachomatisinfection among female medical students and women attending family planning clinics in Northern Italy
Authors: Biglino A , Montrucchio G , Moglia R , Concialdi E , Bolla C , Tramontano M , Ferrero D V 
Published: July 2011

BackgroundPrevalence and risk data concerningChlamydia trachomatisCT in Italy is scare. We present a study of the prevalence and predictive risk factors for CT infection by comparing two different female populations at risk because of age (18–26) but with different socio-cultural backgrounds.MethodsAn anonymous questionnaire concerning sexual behaviour was given to 493 female medical students aged 18–26 at the University of Torino and to women aged 18-26 attending three Family Planning Clinics (FPC) in Asti, Italy. A first-catch urine sample was collected into a liquid transport medium (UPT, Becton Dickinson) from each subject who completed the questionnaire. Nucleic acid amplification testing for CT was performed using the BD ProbeTec ET assay. Age and behavioural characteristics were compared.Results6 women of 493 medical students tested (1.22%) were positive for CT, while 11 of 262 women attending FPC had a positive CT result (4.2%) (χ2=5.7; p=0.017). Different behaviours between the female medical students and the FPC population respectively for non-barrier contraceptive methods were: (34% vs 59%); age <18 at first intercourse (40% vs 60%); more than 1 partner during last year (16% vs 20%), or the last 5 years (2% vs 56%). Risk of infection was associated with >4 partners during the last 5 years both in medical students and to a lesser extent in women attending FPC (OR 10.7; CI 2 to 49 and, respectively (OR 3.7; CI 1.2 to 12). Age at first intercourse was also a factor. Women in FPC whose age was <18 at first intercourse were at higher risk of CT (OR 7.6; CI 1.1 to 30) than the female medical students (OR 1.5; CI 0.3 to 8). Logistic regression confirmed that >4 partners during the last 5 years in both groups (Wald 7.3; p<0.01 [students]; 3.7 p<0.05 [FPC subjects]) and an age <18 at first intercourse only in FPC subjects (Wald 3.5; p<0.06) were independent predictors of infection.ConclusionsFemale medical students showed a significantly lower prevalence of CT compared to the female population of same age but different socioeconomic background. The number of partners in the last 5 years and age at first intercourse were the factors regarding this difference. Awareness and the level of knowledge, possibly dependent on cultural factors, seem to reduce the prevalence. The importance of targeted CT screening programs to groups at greatest risk, while promoting widespread educational efforts and awareness of risk among general population is apparent.
P2-S4.04 Motivational interviewing is effective for reducing high risk sexual behaviour
Authors: Boman J , Lindqvist H , Brandell-Eklund A , Forsberg L , Nylander E 
Published: July 2011

BackgroundMotivational interviewing (MI) can be effective for behaviour change even when tailored to brief encounters. MI is focused on resolving the ambivalence that might prevent change. We have developed and evaluated simple tools to facilitate MI based counselling for reducing high risk sexual behaviour.MethodPatients attending a drop-in STI services reception were offered 20–30 min of MI-based risk-reducing counselling. Out of 110 eligible patients (56 men and 54 women) who had had at least 4 sexual partners during the previous year, 72 patients aged 17–34 years (mean 24.8) participated. A structured manual was developed containing 14 questions, the first 5 of which were aimed at developing and amplifying the patient's motivation to reduce risky behaviour. We discussed with the patients their own perception of STI risks and the importance of not becoming infected, not infecting sexual partners and avoiding pregnancy. At the end of the session, patients were asked to assess their future commitment to changing risky sexual behaviour and a plan for accomplishing this change was drawn up. To ensure treatment fidelity, MI skill was assessed using the Motivational Interviewing Treatment Integrity Coding System (MITI 3.0).ResultsAt baseline, 4 of 32 men (12.5 %) and 6 of 40 women (15 %) had a genital CT infection. After intervention, the incidence of CT was 6 % in men and 0 % in women in the following12 months. Of those CT-infected at start, none was re-infected within the next year. At baseline, men reported on average 8 (4-35) partners in the previous12 months and women 6 (4–17). On a scale from 0 to 10 men rated their STI-risk in the previous year as 5.5 (1–10) and women as 6.3 (2–10). The corresponding rating for pregnancy risk was 2.7 (0–8.5) for men and 3.3 (0–9) for women. Men rated the importance of not becoming infected as 8.5 (5–10) and women as 9.5 (5–10). The importance of not infecting a sexual partner was rated as 9.2 (2.5–10) in men and 9.6 (6–10) in women. The importance of avoiding pregnancy was rated as 9.2 (5–10) in men and 9.5 (2–10) in women. The ability to reduce sexual risks was judged as 8.4 (5–10) in men and 8.6 (3.5–10) in women. At the end of the session, patients' commitment to reducing STI risks was 9.1 (6–10) for men and 9.3 (8–10) for women.ConclusionBrief MI-based single-session counselling aimed at assessing personal risks, resolving ambivalence, developing risk-reduction strategies and implementing safer sex behaviours is effective in the reduction of high-risk sexual practices and CT incidence.
P2-S4.06 Knowledge of HSV-2 serostatus in asymptomatic adults may result in change in sexual behaviour and possible risk reduction
Authors: Cuyugan M G , Mulugeta W , Thabolingam-Haridas M , Wilson T , Augenbraun M , Elsassy T , Cerniglia B 
Published: July 2011

BackgroundHSV-2 is the main cause of genital ulcer disease worldwide. It is frequently under- recognised because it is often clinically silent. Serologic testing for HSV antibody reliably identifies individuals infected with HSV-2. There is little literature investigating whether serologic screening of asymptomatic patients changes sexual behaviour and risk reduction.MethodsPatients >18 yrs old who came to an urban STD clinic in Brooklyn with no previous history of HSV or HIV, no genital ulcer at initial visit, and sexually active in the preceding 3–6 months were administered a questionnaire. HSV1/2 IgG testing using HerpesSelect (Becton Dickinson and Company in Sparks MD) was used and patients were told about the results after 1 week. Participants were educated regarding natural history of HSV and asked to come back after 3 months to complete a follow-up questionnaire. Changes in sexual behaviour including number of sexual partner, condom use and psychological stress were the primary outcome of interest of this study.ResultsA total of 193 eligible participants were included for analysis and follow-up is available for 101(51%). There was no significant difference among baseline characteristics (age, gender, no. of sexual partners) among participants. Majority of participants were heterosexuals (95.8%) and black immigrants (92.3%). The seroprevalence of HSV2 IgG was 35%. More women were HSV + (67%) and more HSV + participants reported having non-steady partners (p 0.027). When analysing change (from baseline to follow-up), there was a significant decrease in number of non-steady partners among HSV + and HSV—participants (p 0.004 and p 0.0049 respectively). There was no statistically significant difference in the frequency of condom use between HSV + and HSV—participants (p=0.448 and p=0.91). Discussion: There was a significant decrease in the number of non-steady partners after knowing HSV status among both HSV+ and HSV- participants but no change in frequency of condom use. This finding is important because this suggests that knowledge of HSV status may impact sexual behaviour that can potentially reduce risk of transmission. However, both groups had a significant change in the number of non-steady partners regardless of HSV results, which may suggest that being tested for HSV-2 is enough to alter certain risky sexual behaviours. This can be potentially useful to patients visiting STD clinics for screening.
P2-S4.08 Patterns and correlates of condom use at last sex episode in a population presenting for voluntary HIV counselling and testing in Soweto, Johannesburg
Authors: Nshimiyimana T , Thandekile E , Katz I , Martinson N , Gray G , de Bruyn G 
Published: July 2011

BackgroundPromotion of condom use remains an important public health intervention to prevent HIV transmission and acquisition. Routine data from voluntary counselling and testing (VCT) can inform evaluation of prevention efforts that emphasise condom use. This study uses a Johannesburg township VCT data to characterise the correlates of condom use at the sexual episode that preceded VCT visit.MethodsThis retrospective analysis uses a service level data on 2829 individuals seeking VCT at a Soweto-based testing center between 2008 and 2010. Multivariate models were used to compare the correlates of condom use with clients' HIV-1 serostatus.ResultsWomen were 1800 (63.6%) with a mean age of 32 while men were 1029 (36.4%) with a mean age of 35. Out of 1,862 clients reporting sexual intercourse within the month that preceded VCT visit, 27.8% were HIV-1 infected. Among 1,916 HIV-1 seronegative clients, 51.8% reported not using condom at last sexual episode compared to 44% among 911 clients in the HIV-1 seropositive subgroup. HIV-1 seropositive clients reporting not having a sex partner but who described their most recent sexual episode as casual were less likely to have used a condom during that sex act compared to those who reported having their last sex with their regular partners (Adjusted Odd Ratios [AOR], 0.4; 95% CI, 0.2 to 0.6). This difference was not observed in the HIV-1 seronegative subset. In the HIV-1 seropositive subgroup, those reporting previous exposure to VCT were more likely to have used a condom during the sex episode that preceded their VCT visit compared to those reporting it was their first encounter with VCT (AOR, 2.6; 95% CI 1.6 to 4.3). However, the effect of previous exposure to VCT on condom use was not significant in the HIV-1 seronegative subset. For both the HIV-1 seronegative and seropositive subsets, condom use likelihood was higher among men compared to women (AOR, 1.6; 95% CI 1.2 to 2.0 and AOR 1.7; 95% CI 1.1 to 2.7), respectively.ConclusionThe findings underline a need for distinguishing HIV risk reduction counselling targeted at the HIV-1 infected from those aimed at the HIV-1 uninfected, especially in Soweto context.
P2-S4.10 Characteristics associated with condom breakage/slippage or partial use during vaginal sex with main and non-main partners: findings from the Safe City Project Study
Authors: D'Anna L , Margolis A , Warner L , Korosteleva O , O'Donnell L , Rietmeijer C , Klausner J , Malotte C K 
Published: July 2011

BackgroundCondom use problems including breakage, slippage, or partial use (delayed application or early removal) jeopardise condom effectiveness. Our research aims were to: 1) assess the prevalence of condom use problems among urban US STD clinic users; 2) identify participant and partner characteristics and Behaviours associated with condom use problems; and 3) examine how these characteristics are associated with the odds of experiencing condom breakage/slippage or partial use during vaginal sex.MethodsPatients (n=1609) attending STD clinics in 3 cities (Denver, Long Beach, and San Francisco) between June 2004 and May 2005 were enrolled in a study evaluating the behavioural effects of a video-based waiting room intervention modelling couples overcoming barriers to safer sexual behaviours. Two surveys were conducted (baseline and 3-months) measuring behaviours during the previous 3 months. Bivariate analysis using χ2and multivariable analysis using logistic regression were conducted.ResultsAt baseline, 767 men and women (median age=26 years) reported using a condom at least once during vaginal sex with their most recent partner (64.4% main and 35.5% non-main) in the preceding 3 months. A majority did not use condoms consistently (62.3%). Among 100% condom users, 152 (52.6%) reported no errors, while 137 (47.4%) experienced errors (56 breakage, 49 partial use, and 32 both errors). Among all users, the per-condom use rates of breakage/slippage, but not partial use, varied significantly by partner type (5.96% main and 9.35% non-main). Multivariable analysis revealed the following characteristics associated with increased odds for condom breakage/slippage: African American race (OR=2.0; CI 1.3 to 3.1), Latino ethnicity (OR=2.0; CI 1.3 to 3.1), drunk/high during sex (OR=1.5; CI 1.1 to 2.1), STI among recent sex partner (OR=1.7; CI 1.2 to 2.3); and main partner status (OR=1.8; CI 1.3 to 2.6); and for partial use: female gender (OR=1.4; CI 1.0 to 1.9), drunk/ high during sex (OR=1.5; CI 1.1 to 2.0), and main partner status (OR=1.4; CI 1.0 to 2.0).ConclusionsIn this population of condom users at high risk for STI/HIV, inconsistent condom use and consistent condom use with errors were reported frequently. These results suggest that clinicians should not assume that patients use condoms correctly, and that patients may benefit from condom use counselling tailored to individual and partnership characteristics and behaviours.
P2-S5.03 Hyperfeminine and vulnerable: gender identities and HIV/AIDS in transgender women in BogotÁ, Colombia
Authors: Estrada-Montoya J H , García-Becerra A 
Published: July 2011

BackgroundStudies in current literature show high HIV prevalence rates in transgender women all around the world. Transgender women face very high-levels of marginalisation, violence, stigma and discrimination, which in turn affect their access to housing, employment, healthcare and put them in a high risk of STD. These characteristics are shared with sex workers, injecting drug users and men who have sex with men. However, gender identity has led to a particular combination of vulnerabilities, ultimately resulting in a much higher risk of HIV infection among the male-to-female transgender population as mentioned above.MethodsWe conducted an exploratory descriptive study and collected data with surveys, in-depth interviews, focus groups and ethnographic strategies with 18 transgender women. The collected information was analysed, taking into account the following dimensions of interpretation: 1-Love, erotic, and sexual relations. 2- Gender and sexual identities. 3-Sexual behaviour and practices. 4-Self-care, HIV-risk perception and life goals.ResultsTransgender women believed that they needed to perform an overtly feminine identity (hyperfeminine). They think this performance involves taking sexual risks assigned traditionally by the social space such as street prostitution. In this role transgender women's negotiation power is significantly reduced. Many transgender women assumed and accepted this gender disparity social structure that increased their vulnerability to STI/HIV.ConclusionsThis research intended to identify the most significant ways in which sexuality is represented and imagined within the culture of transgender women in Colombia. Special emphasis was placed on discovering transgender women's logics, or thinking processes, which are capable of perpetuating their high vulnerability to HIV/AIDS. Transgender women in Colombia construct their gender identities within contexts of stigmatisation, social marginalisation, and multiple symbolic and physical forms of violence. Our work critiques approaches based on androcentrism that perceive gender identities as essential and fixed, and assume sexual binaries that oppress the lived experience of human bodies. We propose a peer-led educational strategy focused on the deconstruction and reconstruction of gender identities and interventions with transgender women that reduce stigma through enhancing autonomy, joy, and self-care. We argue that these are the central elements for a “life with quality” in which equal citizenship can be exercised.
P1-S1.35 Declining positivity among 15–24-year-olds screened for chlamydia in England - a sign of falling prevalence or a symptom of changing uptake?
Authors: Woodhall S C , Mercer C H , Soldan K 
Published: July 2011

BackgroundThe number of tests performed as part of the National Chlamydia Screening Programme (NCSP) has increased since the start of the programme in 2003 and the positivity has declined. We explored the extent to which available data can be used to adjust for changes in who is being screened in order to estimate any changes in the population prevalence up to 2010.MethodsAnalyses of positivity trends were conducted using available data for opportunistic asymptomatic tests (screens) from the NCSP national dataset for 2005 to 2010 from areas that implemented screening throughout this time period. Age, sex, ethnicity, sexual behaviour, regional and venue of screen weights for the English population of 15–24-year-olds were derived (from national sources where available) and applied to the dataset.ResultsFrom 2005 to 2010 there was an increase in screens among men. There were no major changes in characteristics known to be associated with infection (year of age, sexual behavioural variables). Available data on sexual behavioural variables and ethnicity decreased over time. There were some changes in venue use over time. Weighting for 5-year age group, sex, <2 sexual partners in past 12 months, ethnicity and region lowered positivity in each year but slightly increased the decline in positivity from an average decline of 13% per year (from 11% in 2005 to 6% in 2010) to an average of 14% per year (from 10% to 4%). Additional standardisation by screening venue did not reduce the overall observed decline in positivity during this period. Differences in positivity between venues remained, but were slightly reduced, after weighting for differences in known characteristics of screened clients.ConclusionsThe observed decline in positivity over time among screens was not accounted for by weighting for known characteristics of those screened or changes in testing venues. Together with the consistency of declining positivity in all sub-categories this suggests that a true decline in population prevalence may have occurred. Further analyses of the potential effects of data limitations and using regression techniques with additional variables (eg, deprivation) are in progress to better understand the relationship between screen positivity and population prevalence at different levels of screening uptake in England.
P2-S5.09 Transgenders and HIV: a literature review of HIV risk behaviours and prevalence rates
Authors: Butt S , Mena L , Muzny C 
Published: July 2011

BackgroundTransgenders (TG) are a marginalised population that has been greatly impacted by the HIV/AIDS epidemic. The objective of this study is to review the current literature citing risk factors and prevalence rates for HIV infection among male to female (MTF) and female to male (FTM) TG in the USA.MethodsA review of the original research articles published from 1981 to 2010 was performed through a Pubmed search using the terms “HIV risk” and “Transgender”.ResultsThirty-five articles were identified, with MTF described in thirty-three and FTM described in nine. Collectively all racial groups were represented. The majority of research was done in large urban cities in the Southwest, Midwest, and Northeast. Most studies relied on self-report of HIV infection; and only six studies tested participants for HIV. The prevalence rates of HIV infection ranged from 2.2% to 68.0%. Unprotected receptive anal intercourse (URAI), commercial sex work (CSW), and African American (AA) race were the most frequent HIV risk factors identified. Homelessness and financial instability were frequent among adolescents. When compared to men who have sex with men (MSM) and heterosexual females, MTF are more likely to have URAI with multiple sexual partners. Among MTF participants, AA and Hispanics were more likely to participate in CSW than Caucasians. Self reported prevalence of HIV was low in FTM population (0–2%), except in one study which tested for HIV and found similar HIV prevalence in both FTM (10%) and MTF (10%); risk factors associated with HIV infection in this study were unprotected sex with a partner of unknown HIV status and location in an urban metropolitan area.ConclusionsHIV rates among TG are high, especially among AA and Hispanics. Majority of MTF participate in high risk sexual activities. Geographically and ethnically diverse studies including MTF and FTM are needed to test HIV prevalence and associated risk factors in TG population.
P2-S5.10 Sexual behaviours among injecting drug users (IDUs) in North-East India
Authors: Mishra R K 
Published: July 2011

BackgroundThe North-East Indian states of Nagaland and Manipur have among the highest HIV prevalence in India, fuelled by an epidemic of injecting drug use. In 2008, the HIV prevalence among IDUs in Manipur was 28.65% and in Nagaland was 3.16% in 2008 as per National Surveillance data. Proximity to Myanmar, high unemployment and ongoing violent insurgencies serve to exacerbate the problem. Project ORCHID, an initiative funded by the Bill and Melinda Gates Foundation, has been running HIV prevention programs with high risk groups through local NGOs in these two states since 2004. Methodology: To evaluate risk behaviours among the IDU communities served by Project ORCHID, polling booth surveys (PBS) were conducted in all 26 intervention sites across both states in 2010. Participants were purposively selected from a broad geographical area, and asked to anonymously answer questions through a ballot box.ResultsIn total, 558 IDUs in Manipur and 440 IDUs in Nagaland were sampled for the PBS. They reported high rates of access to needles/syringes from ORCHID projects (82% in Manipur and 96% in Nagaland). In both states, three-quarters had injected in the previous week. Among these, the mean weekly injection frequency was 11 times in Manipur and 5 in Nagaland. The proportion of injecting episodes using a clean needle/syringe was 77% in Manipur and 94% in Nagaland. Needle sharing in the previous month was reported by 38% in Manipur and 25% in Nagaland. Manipur had less IDUs who had been sexually active in the previous week (46% vs 71% in Nagaland) but consistent condom use was lower in Manipur than Nagaland (30% vs 76%).ConclusionHigher rates of risky injecting and sexual behaviour were found in Manipur IDUs, which together with the much higher injection frequency and HIV prevalence of 28.65% underlines the need for continued behaviour change communication. Low injecting rates and moderate to high sexual activity among Nagaland IDUs indicates communication strategies should shift towards sexual risk behaviours. The 3rd PBS is underway and will enable to see how behaviours are changing over time.