bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S6.54 Medical male circumcision may be protective of urogenitalMycoplasma genitaliuminfection: results from a randomised trial in Kisumu, Kenya
Authors: Mehta S , Gaydos C , Maclean I , Odoyo-June E , Moses S , Murugu R , Agunda L , Nyagaya E , Quinn N , Bailey R 
Published: July 2011

BackgroundWe determined the prevalence ofMycoplasma genitalium(MG) and whether this was associated with circumcision status, among men enrolled in the randomised trial of medical male circumcision (MMC) to prevent HIV acquisition in Kisumu, Kenya.MethodsMG was detected in first void urine (FVU) by APTIMA transcription mediated amplification (TMA) assay. FVU and urethral swabs were assessed forNeissseria gonorrhoeae(NG) andChlamydia trachomatis(CT) by PCR, and forTrichomonas vaginalis(TV) by culture. HSV-2 detection was by IgG ELISA. Personal interview assessed socio-demographic and behavioural risks. All men underwent standardised medical history and physical examination.ResultsJuly through September 2010, 52 (9.9%; 95% CI: 7.3 to 12.4%) MG infections were detected among 526 men. The prevalence of NG (1.4%) and TV (2.7%) did not differ by MG status. CT prevalence was 5.8% among MG-infected men, and 0.8% among MG-uninfected men (p=0.02). CT infection at enrolment was more prevalent among MG infected men (27% vs 9% uninfected, p=0.005); NG and TV at enrolment were not associated with MG. Current urethral discharge symptoms and exam findings did not vary by MG status (1.9% positive vs 1.5% negative, p=0.80), but remote history of urethral discharge (past 6 months) was 5.8% among men with MG vs 2.1% uninfected (p=0.10). The prevalence of MG was 13.4% in uncircumcised men vs 8.2% in circumcised men (p=0.06). In multivariable logistic regression, circumcision status nearly halved the odds of MG [adjusted OR=0.54; 95% CI 0.29 to 0.99], adjusted for variables significant at the p<0.05 level: HSV-2 infection [aOR=2.05; 95% CI 1.05 to 4.00], CT infection at enrolment or at follow-up [aOR=2.69; 95% CI 1.44 to 5.02], washing the penis ≤1 h after sex [aOR=0.47; 95% CI 0.24 to 0.95]. The prevalence of MG did not differ by HIV status, age, education, marital status, number of sex partners, condom use, or sex during menses. There were no interactions with circumcision status.ConclusionsProspective study is needed to verify the potential protective association between MMC and MG. The mechanism by which MMC may protect against MG is unclear. Randomised trials have not found MMC to protect against other urethral infections (NG, CT, TV), though circumcised and uncircumcised men may have different peri-urethral bacteria and penile microbiome. The role of MG in STI morbidity, syndromic management algorithms and antibiotic regimens for men and women in this region should be evaluated.
P2-S1.01 Beyond the ABC in HIV/AIDS prevention: a systematic literature review of sexual education programs for young people
Authors: Estrada-Montoya J H 
Published: July 2011

BackgroundLatin-American young people are the fastest growing group living with, or at high risk of acquiring HIV. Young people are vulnerable due to sexual behaviour; use of illicit drugs; lack of access to education and health services; cultural and social-economical factors; structural violence; marginalisation and poverty. Acceptable success for sexual education programs are decrease in adolescent pregnancy, STD and HIV infection rates. This study tried to identify those characteristics of programs that achieved one or more of mentioned success criteria and could be adapted and implemented in Latin America, taking into account its particular historical and contextual conditions.MethodsA systematic literature review of evaluations of HIV educational programs for young people published in international databases within the last 4 years was performed. Specialised educational evaluation books, primary and secondary documents and unpublished literature were also consulted.ResultsThe review identified 182 documents related to the evaluation of HIV educational programs. Successful programs had at least one of the following characteristics: exceeded the ABC (Abstinence, Be faithful, Condom use) methodology; were supported by national authorities; used participative instruction methods; presented comprehensive information, including general HIV education, risk reduction practices, methods of contraception and condom use, respect for sexual/gender diversity; and guaranteed that young people joined and remained into the educational programs.ConclusionsSuccessful HIV/AIDS educational programs should promote the acquisition of protective though processes and behaviours by focusing on the historical, contextual, psycho-social, and sexual factors that affect behaviour and health. An education committed to HIV/AIDS prevention should be accessible to young people through the schools and must support life conditions that allow them to take advantage of the different learning opportunities. Literature review suggests that youngs may acquire the knowledge, abilities, competences, values, and attitudes that make possible to overcome the conditions of vulnerability to HIV they face.
P1-S1.28 The prevalence and incidence of bacterial vaginosis in a cohort of young Australian women
Authors: Walker J , Hocking J , Fairley C , Tabrizi S , Chen M , Bowden F , Gunn J , Donovan B , Kaldor J , Bradshaw C 
Published: July 2011

BackgroundBacterial vaginosis (BV) is a common condition of unknown aetiology that can be associated with late miscarriage, pre-term delivery, PID and increased susceptibility to HIV & other STIs. In Australia, treatment is restricted to women who are symptomatic or pregnant or undergoing gynaecological treatment, however, recurrent infection is common following treatment. Currently, there are no community based BV prevalence or incidence data for Australia.MethodsWomen aged 16 to 25 years were recruited from sexual health clinics (SHC) and general practice clinics (GP) in South-Eastern Australia and provided with kits containing vaginal swabs and microscope slides to self-collect vaginal smears at 0, 6 and 12 months; 6- and 12-month samples were returned via post. Vaginal smears were scored using the Nugent method. BV prevalence was measured at time of recruitment and adjusted ORs (AOR) calculated to explore associations; BV incidence was measured over the study period and adjusted HRs (AHR) calculated to explore predictors of infection. Incident BV was diagnosed if a participant at baseline had a Nugent score <7 followed by a subsequent Nugent score of 7–10 at 6 or 12 months. Women diagnosed with BV at recruitment were excluded from the incidence analysis.ResultsOverall, 1116 women were recruited from 29 clinics; slides were available for 1112 (99%) women at the baseline and 875 women (79%) at study completion. The prevalence of BV at recruitment was 11.8% (95% CI 9.9 to 13.7). Prevalent BV was associated with increased numbers of recent male sexual partners (AOR=2.2; 95% CI 1.0 to 4.6), a recent female sexual partner (AOR=3.2; 95% CI 1.6 to 6.5), being recruited from SHC (AOR=1.7; 95% CI 1.1 to 2.5) and having a lower level of education (AOR=0.5; 95% CI 0.3 to 0.7). There were 88 cases of incident BV yielding an incidence of 8.8 per 100 women years (95% CI 7.1 to 10.8). Incident BV was associated having increased numbers of new sexual partners (AHR=1.7; 95% CI 1.1 to 2.5). Both prevalent and incident infections were associated with increased numbers of self-reported symptoms, in particular “abnormal vaginal discharge” and “abnormal vaginal odour”.ConclusionThese are Australia's first community-based BV prevalence and incidence estimates and show that BV is very common among young women and frequently associated with increased sexual activity.
P2-S1.10 Identifying key elements describing sexual behaviour in the Danish Population: a Qualitative Study
Authors: Jørgensen M J , Maindal H T , Olesen F , Andersen B 
Published: July 2011

BackgroundSurveying the sexual behaviour of the general population serves to identify key points of intervention, monitor the effect of such an intervention and interpret changes in the spread of sexually transmitted infections over time. Validated questionnaires describing sexual behaviour could be adapted from other countries, but due to cultural differences this could result in the need to add additional or other questions in order to describe the important Danish issues sufficiently. With a view to designing and initiating a sexual behaviour surveillance program in Denmark, the aim of this qualitative study was to identify points of particular importance to adolescents' sexual behaviour.MethodWe conducted four semi-structured focus group interviews with a total of 19 sexually experienced adolescents aged 18 to 23. Boys and girls were interviewed separately. Each group contained pupils from the same Danish Folk High School, but with different social and educational backgrounds. The interview guide was developed on the basis of literature reviews and hypotheses based on many years of experience with sexually transmitted infections from an epidemiological perspective as well as treatment of patients with sexually transmitted infections. Data were transcribed verbatim and analysed using qualitative description.ResultsWe identified four major categories of risk behaviour: 1) Alcohol consumption is associated with “no condom use”. 2) Nights on the town and meetings in foreign counties or at festivals are associated with one night stands and often lead to unsafe sex. 3) Low self-esteem increases the risk of pushing one's personal boundaries, thus resulting in promiscuous sexual behaviour. 4) Increased sexual experience is associated with lack of condom use. Surprisingly, the informants did not consider drug abuse and internet dating to be triggers of unsafe sex see Abstract P2-S1.10 Figure 1.Abstract P2-S1.10 Figure 1Important risk factors for unsafe sex among adolescents.ConclusionDanish adolescents identified four key elements that could lead to unsafe sex. These results differed slightly from our expectations and will be included in a sexual behaviour questionnaire to describe important elements influencing the sexual behaviour of Adolescents.
P2-S1.11 Factors surrounding lack of condom use at first intercourse and later onset of condom use: a study of college-age men
Authors: Warner L ,   K M, Gavin L , Macaluso M 
Published: July 2011

BackgroundCondom use at first coitus is associated with greater lifetime condom use. Little is known, however, about factors which influence non-use of condoms at first coitus.MethodsData were analysed from a cross-sectional study on condom use behaviours conducted among 98 heterosexual male students attending two Georgia universities. Men were asked to recall condom use during first and subsequent coitus. Multivariable logistic regression was conducted to evaluate factors associated with non-use of condoms at first coitus and how non-use influenced their future condom beliefs and use.ResultsParticipant averaged 22.4 years at interview, 16.8 years at first intercourse (range:13–23), and 5.6 years (range:0–12) between first condom use and time of interview. Overall, 47 men (48%) reported not using condoms at first coitus, and not initiating use until an average of 13 acts after sexual debut (med=5; range:1–100). Reasons for eventual condom initiation included: concern about infection/pregnancy (53%), partner insistence (32%), and condoms being available (15%). Compared with men who used condoms at first intercourse, men initiating use afterwards were significantly more likely to report their first condom experience was negative (62% vs 35%, aOR=2.8, 95% CI 1.1 to 7.2), and were less inclined to use condoms subsequently based on this first experience (34% vs 14%, aOR=3.4, 95% CI 1.2 to 8.8). However, measurement of condom use during most recent coitus did not differ significantly between men who initiated condom use after vs at their first intercourse both at last sex (43% vs 55%) and for both consistent use during the last month (43% vs 39%) and year (26% vs 20%).ConclusionsPublic health efforts should emphasise the importance of condom use at first intercourse. Counselling should be provided to help prepare men for a positive first experience with condoms, given that this experience may affect immediate subsequent condom use following sexual debut.
P1-S1.29 Use of molecular sequencing to compare the vaginal microbiota of healthy women and women with bacterial vaginosis in India
Authors: Kotian S , Arun A , Krupp K , Srinivas V , Madhivanan P , Riley L , Raphael E , Reingold A , Klausner J 
Published: July 2011

BackgroundLactobacillus species is an integral part of vaginal microbiota that maintains a healthy environment and plays an important role in preventing STI and HIV. We examined 20 women to investigate the difference in the diversity of Lactobacillus species present when the women are healthy or have Bacterial Vaginosis (BV).MethodBetween February and November 2010, samples from a total of 20 women attending Prerana Women's Health Clinic were collected. Out of 20, 10 women were considered healthy and 10 women were diagnosed with BV based on Amsel's Criteria. In addition, Gram stained smears of vaginal fluid were Nugent scored as negative, intermediate, or positive for BV. Based on the Nugent score criteria, nine were Positive, nine were negative and two showed “Intermediate” Nugent Score. Vaginal swabs were taken from the women with informed consent after ethical approval and grown in MRS broth. Gram positive Lactobacilli generating about 600–800 bp amplicon by16SrDNA PCR were further characterised by sequencing.ResultLactobacillus crispatus(40%) andLactobacillus jensenii(40%) were the most common Lactobacillus species found in the vaginas of healthy women, the same Lactobacillus species found in healthy women in other countries.L crispatuswas cultured from 40% of healthy women and none of women with BV.L jensenii,L gasseri, andL acidophiluswere cultured from 40%, 10% and 10% of healthy women respectively; and none of the women with BV.Lactobacillus inerswas not detected among healthy women or women with BV in our sample. Other organisms found among women wereStaphylococcus epidermidis(60% among women with BV and 30% among healthy women),Streptococcus anginosus(40% among women with BV and 20% among healthy women). SomeCorynebacteriumspp were common among both women with BV and healthy women. Among the two women with “Intermediate” nugent score, one did not show growth of any Lactobacillus and in the other case there was growth ofLactobacillus salivarius.ConclusionOur findings showed Lactobacilli species present in healthy vagina of women in India do not differ from those reported from other countries. This information is useful for the development of microbicides for HIV prevention as well as better understanding of the reproductive health of women in India.
P2-S1.16 Social influences on relationship fidelity and concurrency patterns among Latino adolescents in San Francisco
Authors: Minnis A , van Dommelen-Gonzalez E 
Published: July 2011

BackgroundOur previous research in San Francisco's Mission District, a predominantly Latino neighbourhood characterised by high immigration, poverty, and gang-related violence, highlighted diverse partnership patterns among youth and the role of gang affiliation in high-risk sexual activity and pregnancy. 38% of Latino youth reported concurrent partnerships.MethodsWe conducted 33 semi-structured in-depth interviews with immigrant and US-born male and female Latino youth aged 16–21 to explore how the social environment affected partnership formation and STI risk. Participants were recruited from community venues; interviews were conducted in Spanish or English. Interview transcripts were coded in Atlast.ti. We analysed the following themes: relationship fidelity; STI prevention; and concurrency norms (agreement with the statement, Many Mission youth in a relationship are also seeing someone on the side).ResultsParticipants were 48% female; had a mean age of 17.5 years; and 55% were immigrants from Mexico or Central America. 27 of 30 believed that concurrency is widespread, described as “cheating” (having a “main girl with ‘friends with benefits’ on the side”) or resulting from initiating new relationships before ending existing ones or between serial break-ups with a main partner. Infidelity was motivated by machismo, a cultural notion of masculinity that was heightened for men respected for having multiple partners; boredom with a single partner; an ideal that fidelity was only relevant within marriage with cheating expected prior to that; and revenge for known, suspected or pre-emptive cheating. Street gangs introduced distinct reasons for young males preferring multiple, casual partnerships: limited time for relationships because of obligations to the gang first and foremost; disinterest in committed relations to avoid emotional vulnerability given emotional demands of street life; and multiple partners bringing status: “you got more game; you got more reputation.” Young women recognised that having partners in a gang brought social prestige and articulated strategies for increasing intimacy (eg, pregnancy) to draw partners away from the street and strengthen commitment to the relationship. Despite a perception of pervasive concurrency, STI risk perception was low.ConclusionsMany relationship norms and expectations held by youth supported concurrency, highlighting the importance of addressing social influences like gangs in STI prevention.
P2-S2.01 Support groups as a strategy for reducing HIV vulnerability among female sex workers in Bellary, Northern Karnataka, India
Authors: Chintada D R , Pillai P , Mahadevapappa S , Mohammed P , Isac S , Ramesh B M , Ramappa V , Bhattacharjee P , Moses S 
Published: July 2011

BackgroundThe Karnataka Health Promotion Trust implements HIV preventive interventions for female sex workers (FSWs) in Karnataka, South India, in partnership with non-governmental and community-based organizations (NGOs and CBOs). These interventions are supported by the Bill & Melinda Gates Foundation. Community mobilisation and collectivisation are key vulnerability reduction strategies. In Bellary district, FSWs are encouraged to form site-level groups of 10–12 members which meet regularly. They discuss STIs, HIV, condom negotiation skills, and other important issues. They also support members during crises, and engage in savings and credit activities. We attempted to understand the impact in Bellary of collective membership and the availability of economic support on two measures of safer sex behaviour: clinic attendance and condom use with last client.MethodsMultivariate logistic regression was used to measure the association between the outcome variables and collective membership, using data from a round of integrated behavioural and biological assessments conducted in Bellary in 2008. We also conducted focus group discussions (FGDs) with members and non- members of collectives, to understand the reasons for observed associations.Results34% of FSWs were members of collectives. Members were 7 times more likely to have used condoms with their last client (adjusted OR [AOR]: 7.5, 95% CI 1.9 to 30.1, p<0.05). Additionally, collective members were 4 times more likely to visit an STI clinic than non-members (AOR: 4.6, 95% CI 2.0 to 10.6, p<0.05). FGDs revealed that alternate sources of economic activity, such as savings enhancement and low interest loans to collective members, reduced sex workers' dependence on exploitative sources of credit, enabling them to better negotiate condom use with clients who resisted unprotected sex. Further, the sex worker collectives helped FSWs to overcome their fears of stigmatisation, creating a more enabling environment that positively influenced access to clinics for STI care.ConclusionsMembership in site-level groups considerably increased access of FSWs to program services. Activities to address the economic vulnerability of female sex workers were key factors in enabling greater condom use. Savings and access to credit helped FSWs to reduce their dependency on sex work, and enabled them to more readily negotiate condom use with clients.
P2-S2.03 Reaching the new and young migrant sex workers: strategies for intervention
Authors: Ramanaik S , Doddamane M , Srikantamurthy S , Ravindra I , Meti R , Hiremath T , Mirji A , Holidasar G , Pudur M , Ragavendra T , Bhattacharjee P 
Published: July 2011

BackgroundLarge numbers of young girls enter sex work are migrating from source villages in North Karnataka to the brothels in destination cities in Maharashtra facilitated by families, brothel madams and network operators in a very confidential way. Though there is strong evidence that girls from the North Karnataka region start sex work at the age of 15 and are not reached adequately by traditional targeted intervention programmes in either source or destinations. New and young sex worker (FSW) are particularly vulnerable to HIV as they have higher clients, work under power structures where condom negotiation or access to services is poor and do not possess skills to negotiate condoms with clients. Evidence from Integrated Behaviour and Biological Survey in Karnataka show the HIV infection among young FSWs is 28.3% and 16.7% in 2009 and 09 respectively and even it is very high (38.5% & 35.6%) with the women enter through traditional devadasi system.MethodsThe project is providing workable strategies to work with new and young migrant FSWs who are one of the crucial links in HIV prevention. A team of migration counsellors (MCs) tracking and connecting them to the organizations working at source and destination to ensure, they have access to condoms and services. Providing pre-departure and post-arrival counselling, connecting family at source and the free helpline services is also made available. Intervention with brothel madams and family member is an advantage to reach early. The project also working with adolescent girls in traditional devadasi community by developing their life skills to ensure that they are aware of HIV prevention methods and have skills to negotiate their use if and before they enter sex work.ResultsIn 1-year period, 1200 young and new migrant FSWs are registered and availing services at both the places. MCs are regularly visiting destinations and able to track 90% of migrant FSWs on every month. 7500 pre departure and post arrival counselling sessions were conducted and all the families at source are contacting regularly. 223 brothel madams are identified and all are actively involved in the program. 1464 adolescent girls are enrolled for life skill education program at source villages.ConclusionsYoung and adolescents' preference for brothel-based sex work suggests the need for programmatic focus on brothel madams, family members and adolescents program at source as an effective way to reach these young FSWsAbstract P2-S2.03 Figure 1Logic Model to Reach New & Young FWS.