bluuebunny/crossref_metadata_2025_split huggingface dataset:
P2-S6.02 Use of a computer alert increases detection of early, asymptomatic syphilis among higher risk men who have sex with men
Authors: Bissessor M , Fairley C , Leslie D , Chen M 
Published: July 2011

BackgroundMore frequent screening of higher risk men who have sex with men (MSM) for syphilis could reduce the transmission and prevalence of syphilis. This study assessed the impact of a computer alert on the rate of syphilis testing and diagnoses among higher risk MSM.MethodsIn October 2008, a computer alert was introduced at the Melbourne Sexual Health Centre. This alert appeared during consultations for MSM who reported more than 10 male partners in the prior 12 months, reminding clinicians to test such higher risk men 3 monthly for syphilis. Syphilis testing rates and diagnoses among MSM were determined for the 12 months before and the 12 months after the introduction of the alert.ResultsThe proportion of MSM who were identified as being higher risk who were tested for syphilis in the two time periods increased from 77 % (1559/2017) to 89% (1282/1445) (p<0.001). The proportion of higher risk men diagnosed with early syphilis and who were asymptomatic for syphilis was 16% (5/31) and 53% (31/58) respectively (p=0.001). By contrast, there was no significant increase in the proportion of MSM who were identified as being lower risk who were tested for syphilis: 65% (1228/1885) and 68% (1667/2448) (p=0.4). Nor was there a significant increase in the proportion of lower risk men diagnosed with early syphilis who were asymptomatic: 10% (1/10) and 19% (3/16) respectively (p=0.6).ConclusionThe use of a computer alert was associated with increased syphilis testing of higher risk MSM attending a clinical service as well as increased detection of early, asymptomatic syphilis.
P2-S6.04 Needs assessment on STI prevention services among men who have sex with men with HIV in Guatemala City, 2010
Authors: Farach N , Boyce S , Barrington C , Galindo C , Paz-Bailey G 
Published: July 2011

BackgroundSTI prevention and support services for MSM living with HIV in Guatemala are limited. The aim of this study was to collect information on STI risk among MSM living with HIV to inform the development of integrated prevention and care services for this population.MethodsAs part of a qualitative study with MSM in Guatemala City, nine MSM living with HIV were purposely selected and interviewed in March 2010. Interviews addressed STI-related risk behaviours, experiences with HIV/STI services, social network characteristics and life after HIV diagnosis. Participants were recruited through referral from NGO representatives, key informants, clinic staff and other participants. In-depth interviews were recorded and transcribed and field notes were incorporated into the transcriptions. After multiple readings of the transcripts, key themes were identified and a codebook was developed. Codes were applied using the qualitative software Atlas.ti. Data was further analysed using analytic memos and discussions with research team.ResultsDespite reporting HIV-related risk behaviours, including multiple, concurrent sexual partners, inconsistent condom use, and alcohol and drug use, most participants did not report an STI infection after their HIV diagnosis. Attitudes towards current HIV/AIDS treatment services tended to be favourable, especially among those who compared them to earlier treatment experiences, and participants described preferences for a one-stop venue for sexual health services. Participants were generally not familiar with STI services and identified several barriers to access including insufficient information on STI, lack of confidentiality and fear of stigma and discrimination from health workers. Many participants experienced a double burden of family rejection, first for their sexual orientation and then for their HIV diagnosis. In response to this alienation, participants created alternative networks of social support, frequently with other MSM or people with HIV, which provide moral support and motivation for treatment adherence.ConclusionsSTI prevention, diagnosis and treatment services among MSM with HIV in Guatemala should be strengthened. Prevention interventions should contemplate using social support networks as an additional communication channel for STI prevention and antiretroviral adherence messages. Confidential STI prevention, diagnosis and treatment services should be integrated into existing HIV/AIDS services.
P2-S6.05 Exploring dynamics around female condom use for anal sex among MSM
Authors: Kokku S B , Tucker S , Punyam S 
Published: July 2011

BackgroundStudies around the world have reported about the use of female condom (FC) for anal sex by men who have sex with men (MSM). No studies have been conducted in India about FC use for anal sex. This study was designed to know the reasons, perceived benefits, concerns and other issues around FC use in Andhra Pradesh where India HIV/AIDS Alliance implementing a HIV prevention program.MethodsA qualitative study was carried out among MSM at three sites, selected using purposeful sampling method. Total eight Focus Group Discussions (FGDs) with 83 participants and 18 in-depth interviews (IDI) were conducted. IDI respondents were selected by purposeful sampling method from the self-reported FC users. A structured questionnaire was used for the study.ResultsIn two sites, 18 out of 53 respondents (34%) reported using FC while none of the respondents at the third site had heard of using FC for anal sex. The practice is mainly due to peer influence within the local sexual networks. The decision to use FC is made by the recipient partner who is influenced by various factors like difficult partners/clients who don't like to wear male condom and in anticipation of having sex with more than one partner or group sex etc. A few MSM (11%) are using single condom with multiple clients. The perceived benefits with FC use include sense of security, having control, client satisfaction hence better income, and they can use a single condom for multiple encounters with multiple partners. Participants reported frequent problems with FC use, particularly rectal bleeding (100%), discomfort (72%) and slippage (28%). Despite bleeding from anus on first time use, majority (83%) of them said they will continue to use FC. One of the myths observed during the FGDs is the use of spit with mud as lubricant which was attributed to better satisfaction due to the presence of finer granules in the mud.ConclusionsThe study clearly shows that despite frequent problems with FC use, considerable number of MSM (83%) prefer to continue using FC. Therefore the need for modifying condom design, conducting training, and research on safety outcomes becomes absolutely imperative. IEC (Information, Education & Communication) materials need to be designed to spread the message on proper use and disposal of FC, and also to address the use of single condom with multiple partners. Using of mud with spit as lubricant needs to be explored further to better understand its consequences.
P2-S6.08 Examining risk in high risk “populations: measuring sexual behaviour among men who have sex with men”
Authors: Rosenberger J G , Reece M , Novak D S , Herbenick D , Fortenberry J D , Van Der Pol B 
Published: July 2011

PurposeDue to the disproportionate impact of HIV and other sexually transmitted infections (STIs) on men who have sex with men (MSM), men who indicate same gendered sexual interactions are categorised as a priority population and often perceived as high-risk”. While acknowledging the potential for increased risk among certain populations is important for disease prevention and transmission efforts, this approach broadly labels men based on a limited behavioural profile without consideration for the contextual factors of a given sexual event that influence potential disease exposure. This study sought to assess sexual behaviour among MSM in the USA during their most recent sexual event and identify factors associated with decreased risk for HIV/STI.MethodsData were collected via an internet survey from 27,690 18–80-year old MSM. Measures included sociodemographics, recent/lifetime sexual behaviour history, and sexual experience items.ResultsParticipants' median age was 39.0 years, ethnicities included white (84.5%), Latino (6.4%), African American (3.5%), and most (79.9%) identified as homosexual. Most participants reported a sexual event within the past month (86.1%), with the majority indicating their most recent event in the past 7 days (60.1%). While most men reported not engaging in insertive (35.2%) or receptive (37.0%) anal intercourse, of those who did, 46.1% used a condom and almost none reported ejaculation occurring in their or their partner's anus, 2.7% and 2.5% respectively. Among men (24.5%) who described their sexual partner as a boyfriend or spouse, nearly half reported they and their partner had not had other sexual partners during the past 6 months (44.7%), and the majority had been tested for STIs (61.6%) and HIV (64.8%).ConclusionsThese data provide a large scale assessment of sexual behaviour during the most recent sexual event among MSM in the USA. Findings from this study highlight diversity in behaviours and demonstrate varying degrees of potential risk for HIV and other STIs, regardless of gender. Future prevention efforts should consider contextual components of sexual events, including partner type, HIV and STI testing patterns, and semen exposure, to more accurately develop custom risk reduction strategies.
P2-S6.12 Sexual debut and sexual health: Is early age of first anal intercourse associated with heightened HIV vulnerability among gay men?
Authors: Lyons A , Pitts M , Grierson J , Smith A , McNally S , Couch M 
Published: July 2011

BackgroundTo explore the long-term sexual health implications for gay men having first anal intercourse (FAI) at an early age.MethodsA nationwide online survey was conducted among 854 Australian gay men born between 1944 and 1993 (16–65 years).ResultsAge at FAI dropped sharply from a median of 35 years among men born 1944–1953 to 18 years among men born 1984–1993. At their most recent sexual encounter, men who reported FAI at age 16 years or younger were more than twice as likely to have had receptive anal intercourse or reciprocal anal intercourse (both insertive and receptive in the same sexual encounter), and were almost twice as likely to report having more than 10 sexual partners in the past year. These men were also nearly twice as likely to have become HIV-positive since their sexual debut and were several times as likely to report having had a hepatitis A or C diagnosis. Additional features of the sexual health and behaviour of gay men who report early FAI will be presented that further demonstrate a need to pay close attention to age at FAI.ConclusionsGay men who report early FAI are at higher risk of HIV than those who report later FAI, and are more likely to have recently engaged in risky sexual behaviour. Discussion will focus on explaining these patterns and why health service providers need to pay attention to age at FAI.
P2-S6.15 Investigating the critical programme components of HIV prevention programme among MSM-Ts in Bangalore, Karnataka
Authors: Prakash R , Isac S , Ramesh B M , Moses S , Washington R , Bhattacharjee P , Shetty B , Kumar S 
Published: July 2011

BackgroundA number of studies in the context of HIV/STI epidemic and related vulnerability have focused on the risk reduction of HIV/STI prevalence and condom use among female sex workers (FSWs). However, such studies focusing the men having sex with men (MSM) and transgender remains limited. Since the risk reduction of HIV/STI vulnerability among MSM-T are equally important, a systematic study is required to identify the critical programme indicators which increases the condom use and reduces HIV/STI prevalence among MSM-Ts.MethodsTwo rounds of IBBA data collected from the urban parts of the Bangalore district are used. Bi-variate analysis is used to cross-classify the outcome measures by those who are exposed to the programme than those who are not, whereas the application of binary logistic regression analysis is done to get the adjusted effect of programme indicators on condom related outcomes (condom breakage in past 1 month, zero unprotected sex acts with commercial clients in past 1 month, condom use at last sex with occasional clients/repeat partner/regular partner) and HIV/STI prevalence.ResultsThe sample includes 1432 MSM-T of which 56% belonged to the baseline while remaining to the follow-up survey. The mean age at sexual debut was lower and weekly client volume was higher among the MSM-Ts interviewed in the first round of survey which has shown a significant shift in positive direction in the second round of the survey. In context of programme exposure, higher percentage of MSM-T (about 75% vs 70%) reported project STI clinic visit, visit to DIC (68% vs 14%) than the baseline survey whereas the peer contact remained around 85% in both the rounds. The increased level of clinic/DIC visit found to be positively associated with higher proportion zero unprotected sex with commercial clients, consistent condom use with commercial clients/ repeat partner and with the regular partners in follow-up survey. The crude and adjusted OR shows a significantly less chances of HIV/STI among those who were contacted by peer (OR=0.78, 95% CI 0.67 to 0.99) and visited to clinic (0.82, 95% CI 0.79 to 0.96) compared to their respective counterparts after adjusting the effects of other confounders in the two rounds of the survey. The prevalence was significantly lower among those MSM-T who used condom with different type of partners at different occasions.ConclusionsThe extent of peer-led outreach remain more or less over the period of time, however, a significant improvement in clinic/DIC visit found as the critical component in reducing the HIV/STI prevalence through increased means of condom use with different types of partners.
P1-S1.37 Prevalence of and risk behaviours forNeisseria gonorrhoeaein parturient women aged 15–24 in Brazil
Authors: Miranda A , Pinto V , Szwarcwald C , Baroni C , Stringari L , Inocencio L 
Published: July 2011

BackgroundNeisseria gonorrhoeae(NG) is a sexually transmitted infection having repercussions on reproductive health and impact on the fetus. Our goal was to estimate the prevalence of and risk factors for NG in young parturient women in Brazil.MethodsA national cross-sectional study among parturient women, aged 15–24, attending Brazilian public hospitals was performed in 2009. Participants answered a questionnaire including demographic, behavioural and clinical data. A sample of urine was collected and screened for NG andChlamydia trachomatis(CT), using PCR.ResultsA total of 2400 women were selected and 2071 (86.3%) participated in the study. Mean age was 20.2 years (SD 2.7). A total of 59.1% had up to 8 years of schooling and 93.3% reported an income under US$ 500. Ninety-five per cent attended antenatal care. Prevalence of NG was 1.0% (95% CI 0.6% to 1.4%) and 4% of women infected with NG also had CT infection. First sexual intercourse was reported under 15-years old by 32.8%; 5% reported previous STI; 0.8% were commercial sex workers and 6.0% used illicit drugs. NG associated factors in the final logistic model were—being single [OR=3.2 (95% CI 1.27 to 8.01)]; having more than one sexual partner in lifetime [OR=1.6(95% CI 1.13 to 2.26)]; and CT infection [OR=7.7(95% CI 2.99 to 19.91)].ConclusionsAlthough this study shows a low prevalence of NG infection among young pregnant women in Brazil, they presented STI risk factors that justify include STI counselling for this population.
P2-S7.03 Pregnancy and contraceptive experiences of women living with HIV in Mexico
Authors: van Dijk M , Wilson K , Contreras X , Ettenger A , Fukuda H D , García S 
Published: July 2011

BackgroundIn Mexico new HIV infections are occurring increasingly in women, but little is known about the experiences of women with HIV/AIDS seeking sexual and reproductive healthcare.MethodsIn four states we conducted in-depth interviews with HIV-positive women who were pregnant or had been pregnant within the last 5 years. Participants were recruited through hospitals and clinics providing HIV care and through NGOs providing health and social services for people living with HIV.ResultsParticipants reported that the information and care they received were inadequate and influenced more by their providers' personal opinions than by their own fertility desires. They experienced provider discrimination and pressure to use particular contraceptive methods. HIV specialists and OB/GYNS differed significantly in practice, with HIV specialists focusing on prevention and condom use while OB/GYNS focused on long-acting or permanent methods of contraception. Due to gaps in contraceptive counselling and options many women had unplanned pregnancies while others resorted to sterilisation or abstinence. Furthermore, few women received adequate prenatal HIV care and counselling on pregnancy options.ConclusionsThe health sector seems to focus narrowly on disease prevention and treatment lacking a holistic approach to women's wellbeing. The experiences of women living with HIV/AIDS reveal discrepancies between policy and practice in Mexico as manifested in gaps and inconsistency in healthcare services and even failures to respect patient confidentiality and human rights. The health sector should improve the integration of HIV and sexual and reproductive healthcare through cross-training HIV specialists and OB/GYNS, and by continued sensitisation of all providers on the topic.
P2-S8.03 Did you hear about the 2010 STD treatment guidelines? Re-strategizing how we e-Communicate about STD guidance
Authors: Habel M A , Richman L , Haecker S , Verma R , Meneghetti A , Kachur R , Collins B , Barnes R , Thompson N , Workowski K 
Published: July 2011

BackgroundThe 2010 STD Treatment Guidelines advise physicians and other health-care providers on the most effective diagnostic evaluation, treatment regimens, prevention and vaccination strategies for STDs. CDC revises the Guidelines approximately every 4 years, using a scientific, evidence-based process. Previous communication efforts around the Guidelines have lacked structured promotion and evaluation strategies. 2010 communication efforts strove to improve dissemination of this important resource in the public and private sector using traditional and novel communication technologies.MethodsThe Guidelines were released online in the MMWR on 16 December 2010. A communication plan was devised involving an email distribution campaign, development of interactive elements such as webinars, podcasts, social media (Twitter), and mobile promotional efforts through a partnership with Epocrates. Click-through rates and web metrics were tracked using SiteCatalyst and tracking codes.Results45 days post-launch, the 2010 Treatment Guidelines web page was viewed 107 174 times and downloaded 47,715 times making it the second most popular download on CDC's website. An email campaign targeting more than 54,000 individuals resulted in click-through rates well above worldwide government industry standard (3.3%); ranging from 10% to 878% suggesting that emails were forwarded or the site was bookmarked. A January 13 live webinar resulted in 3200 registrations, 827 CMEs, and 742 evaluations. A podcast featured on Medscape was viewed 12 296 times within 30 days; traffic was 3 times that of a June Chlamydia podcast. Preliminary Twitter data show that tweets were clicked on or retweeted at least 50 times during a 4-day period. A Dec 21 Epocrates DocAlert was delivered to 80 795 devices in the first 10 days, 272 857 devices by week 6, and targeted to primary care, OB/Gyn, ID, ER, urologists, etc.; 22% of responders requested detailed information and links via email or via iPhone/Android on device.ConclusionsData suggest (see Abstract P2-S8.03 Figure 1) that promotion efforts were highly successful as page view spikes coincided with email and mobile campaign pushes. Campaign tracking codes and web metrics are a simple way to evaluate health communication efforts and can offer insight on how well target audiences are being reached. Likewise, public health communicators should consider mutually beneficial partnerships with organizations that can reach providers in the private sector.Abstract P2-S8.03 Figure 1Number of page views to the STD Treatment Guidelines Homepage from 16 December 2010 to 30 January 2011.
P2-S8.04 GYT (Get Yourself Tested) campaign: getting young people talking and tested and sparking a social movement
Authors: Friedman A , Habel M , Kachur R , McFarlane M , Williamson L , Mishel M , Levine S , Binns A , Kapsimalis C , Patel A 
Published: July 2011

BackgroundAbout 19 million new STDs occur each year in the USA, almost half of which are among youth. Lack of information, misconceptions and stigma prevent many from getting tested. To normalise conversations around sexual health and destigmatize testing, the GYT Campaign was launched in April 2009, with the goal of promoting STD testing among youth ages 15–25 years.MethodsGYT was developed as part of It's Your (Sex) Life, a public information partnership of MTV and the Kaiser Family Foundation, together with the Centers for Disease Control and Prevention and Planned Parenthood Federation of America (PPFA). The campaign uses on-air, online, on-the-ground, and mobile components to increase STD testing and spark an empowering youth movement. It has expanded each year, reaching over 4,000 health centers nationwide, including school- and college-based health centers. Efforts to evaluate the campaign's reach and impact include media/materials tracking, national surveys, patient intake surveys at partnering clinics and schools, and the monitoring of STD test/positivity rates.ResultsAt campaign launch, GYT was among the most-searched terms on Google, the most-tweeted terms on Twitter, and the most discussed videos on YouTube. As of January 2010, GYT had produced >60 public service ads and original programs, airing 3200 times on MTV stations (18 h of airtime), and had 1.5 million visitors towww.itsyoursexlife.com. A national survey suggests that campaign awareness among teens (13–19 years; n=766) reached 18% in 2010, with 10–20% reporting that they talked to a friend (21%), family member (18%), partner (11%) or provider (17%) about STDs/testing; and 10% reporting having visited a doctor as a result of the campaign. Available data from participating PPFA clinics revealed a 71% increase in patients presenting for STI testing from April 2008 (pre-campaign) to April 2010, with a 25% increase from April 2009–2010. Chlamydia positivity was 6% among women and 9% among men during campaign promotion periods, indicating that GYT did not simply motivate the worried well.ConclusionsResearch suggests that GYT is effectively reaching youth and impacting sexual-health discussions and STD-testing behaviours. The public-private partnership may serve as a model for other sexual health promotion programs. Creative ways for mobilising youth and lessons learnt about campaign branding, celebrity recruitment, and evaluation will be shared.