bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S2.36 Prevalence and risk factors of HSV-2 infection among men who have sex with men in China
Authors: Chen S , Yin Y P , Wang H C , Wei W H , Wang A L , Han Y , Peng R R , Chen X S , Wang B X 
Published: July 2011

BackgroundHIV prevalence among MSM is high, and epidemiological surveys have confirmed that HSV-2 infection can increase the risk of HIV infection and that HIV seroconversion is closely related to HSV-2 infection. In spite of high prevalence of HIV in MSM and strong association between HSV-2 infection and HIV seropositivity, there have been few studies about the prevalence of HSV-2 among MSM in China. To prevent the spread of HIV among this high risk population, there is an urgent need to investigate the HSV-2 prevalence and potential demographic and behavioural risk factors among MSM in China.MethodsA total of 1462 men who have sex with men were randomly selected from three regions (Changzhou, Guangzhou and Shenzhen) in China. Sera were tested to estimate the prevalence of HSV-2 (ELISA for the detection of HSV-2 type specific IgG) and HIV (ELISA for screening and WB for confirmation), while univariate and multivariate logistic regression analyses were used to estimate the degree of association between HSV-2 infection and potential demographic and behavioural risk factors. Results—The prevalence of HSV-2 antibodies was 16.0% (234 out of 1462). Factors independently associated with higher prevalence of HSV-2 antibodies were—age, educational level, exchange of sex for money and HIV status (see Abstract P1-S2.36 table 1).Abstract P1-S2.36 Table 1Multivariate analysis of risk factors associated with HSV-2 seropositivity among 1462 MSM in ChinaCharacteristicAOR (95% CI)p ValueAge ≤301 >301.988 (1.426 to 2.771)<0.05Educational level 0–9 yr2.247 9–12 yr1.479 (1.520 to 3.321)<0.05 >12 yr1 (1.020-2.144)<0.05Exchange of sex for money Sometimes1 Never0.583 (0.407 to 0.835)<0.05HIV status Positive2.763 Negative1 (1.850 to 4.128)<0.05ConclusionsThe high prevalence of HSV-2 among MSM and strong association between HSV-2 infection and HIV seropositivity suggests the urgent need for intervention to prevent HSV-2 and HIV infections in high-risk MSM in China.
P1-S2.37 Incidence of urethral discharge syndrome among men who have sex with men and associated risk factors in India; a cohort analysis of clinic attendees
Authors: Gurung A , Das A , Naryanan Prakash , Neilson G , Morineau Guy , George Bitra 
Published: July 2011

BackgroundMonitoring data from a cohort of men who have sex with men (MSM) attending 421 clinics located in six states of India from January 2004 to December 2009 were studied. These clinics were supported by Avahan (the India AIDS initiative of the Bill & Melinda Gates Foundation) and provided services for sexually transmitted infections (STIs) including presumptive treatment for gonorrhoea and chlamydia; risk reduction counselling, treatment of STI syndromes and regular STI check-ups.MethodsIndividual tracking data from the clinical forms were collected, merged and cleaned. Observed episodes of urethral discharge (UD) were counted as incident cases when clinical record prior to the episode reported no UD or if the patients had received the clinics' standard single dose directly observed treatment. The mid-point between visits was considered as the time of incident UD. Cox proportional hazard models were used to assess associations between incidence of UD and reported behaviours.ResultsA total of 82 690 MSM made 508 469 visits to the clinics, constituting a cohort of 88 458 person-years (median duration of follow-up 0.86 years; maximum, 5.9 years). 7292 cases of UD were considered as incident giving an incidence rate (IR) of 8.2 per 100 person years (PYs). The IR decreased from 82.7 per 100 PYs in 2005 to 2.8 per 100 PYs in 2009; the first year of follow-up having the highest incidence (HR =1.5, p<0.001). Factors influencing the risk of UD were—number of years in commercial sex; the first year being the most risky, (HR=4.3, p<0.001); having more than ten clients per week (HR=1.6, p<0.001); not using condoms at last sex (HR=2.3, p<0.001); self-reported sexual identity of a penetrative role in anal sex (HR=1.4, p<0.001), and not receiving treatment in the first three clinic visits, (HR=2.8, p<0.001). Increasing frequency of clinic visits per year had a protective role (HR=0.9, p<0.001). MSM visiting the clinics more than five times a year had an IR below 1 per 100 PY. While one-time presumptive treatment increased the risk of UD (HR=3.2, p<0.001), there were no episodes of UD when the treatment was given at more than one consecutive visit.ConclusionUrethral discharge syndrome among MSM shows a decline and could be a good proxy to include in future STI surveillance in resource-constrained scenarios. An analysis of MSM risk behaviour in India can help in risk profiling for targeted interventions.
P1-S2.42 STI prevalence and condom use in men who have sex with men attending STI Services, Honduras 2010
Authors: Tinajeros F , Artiles N , Farach N , Castro L , Maradiaga V , Sevilla A , Mendoza S , Urquia M , Galindo H , Paz-Bailey G 
Published: July 2011

BackgroundMen who have sex with men and the transgender population have the highest prevalence of HIV in Honduras. Specialised services for MSM were established at three public clinics in San Pedro Sula, La Ceiba and Tegucigalpa, with the objective of improving STI management and access to HIV testing and counselling among MSM and transgender populations. STI and HIV testing and management were strengthened at three STI clinics in early 2010. Health workers were trained on HIV/STI services, including counselling and reducing stigma and discrimination.MethodsDiscussions with MSM organizations were carried out to determine the type of clinical and counselling services as well as a referral strategy for MSM. A standardised form was designed and implemented to collect key clinical, laboratory and behavioural indicators and entered into an electronic system in Epi-Info. The diagnostic tests offered at no charge were—rapid test and ELISA for HIV, PACE II forChlamydia trachomatisandNeisseria gonorrhoeae, and RPR with TPPA for syphilis. All men attending the clinics in 2010 were included in this analysis.ResultsBetween January and December 2010, 227 MSM received STI services in the VICITS clinics in Tegucigalpa, San Pedro Sula and La Ceiba. Patients' mean age was 27.4 years. Overall 60.8% (135/222) reported alcohol use and 34.7% (76/219) reported drug use during the last year. An STI in the previous 12 months was reported by 37.6% (83/221) and 13.6% (30/219) reported engaging in sex work. Out of those patients who reported engaging in sex work, 86.5% (94/109) used a condom during their most recent sexual encounter, 88.3% (147/166) reported using a condom with casual partners and 64.5% (74/115) with stable partners. Overall, 12.3% (10/81) were infected with HIV, 10.3% (13/126) had a confirmed syphilis infection, 3.6% (5/138) were infected with chlamydia and gonorrhoea.ConclusionsResults from the first year of STI clinics for MSM evidence high HIV and syphilis prevalence rates. Behaviour change interventions targeting this community should focus on increasing condom use. Efforts should be made to increase the number of MSM attending specialised services.
O1-S01.01 Chlamydia trends in the USA: results from multiple data sources
Authors: Satterwhite C , Weinstock H , Datta D 
Published: July 2011

BackgroundChlamydia is the most commonly reported notifiable disease in the US, with over 1.2 million cases reported in 2009 (409.2 per 100 000 population). While rates based on case reports have been climbing steadily over the past 20 years (155% increase), interpretation of trends is difficult due to better disease detection, reporting, and screening coverage among sexually active women aged 15–24 years. Prevalence data from other sources may be more reflective of national morbidity trends.MethodsChlamydia trends were analysed using data from three alternative sources. Using data from the National Health and Nutrition Examination Survey (NHANES), chlamydia prevalence from 1999 to 2006 was assessed in a nationally representative sample of the US population aged 14–39. Using data from the Infertility Prevention Project (IPP), two analyses of chlamydia positivity trends in different populations were conducted. The first analysis modelled trends among women aged 15–24 years tested in family planning clinics from 2004 to 2008; the second evaluated women aged 15–24 years who were tested in prenatal clinics from 2004 to 2009. Finally, data collected through the National Job Training Program (NJTP) on trends from 2003 to 2007 among high-risk men and women aged 16–24 years, were modelled. Models (IPP and NJTP analyses) controlled for age, race, geography, and test technology.ResultsBased on analyses of data from each of these populations, chlamydia prevalence trends were flat or decreasing. In NHANES, prevalence declined 48% (95% CI: 23% to 72%), from 2.6% (95% CI: 1.9% to 3.5%) in 1999–2000 to 1.4% (95% CI: 0.9% to 2.0%) in 2005–2006. In IPP prenatal clinics, chlamydia positivity also decreased; the adjusted odds of having a positive chlamydia test declined by 35% from 2004 to 2009. Likewise, in the NJTP, the odds of a positive test decreased by 19% in women and 8% in men from 2003 to 2007. In IPP family planning clinics, positivity neither increased nor decreased from 2004 to 2008.ConclusionsAlthough rates of chlamydia based on case reports are increasing, analyses of prevalence data suggest that the overall prevalence of chlamydia may be decreasing. Reported chlamydia case rates are likely reflections of policy and programmatic changes and do not accurately reflect morbidity trends.
O2-S6.04 An exploratory survey of male sex workers and HIV risk in an urban area of Southwest China
Authors: Yu B N , Wang X A , Yu F , Wang J , Blanchard J 
Published: July 2011

BackgroundLittle knowledge is available on risk behaviours of HIV and basic demographic characteristics in male sex workers (MSW) in the population of men who have sex with men (MSM) in China. The objective of this study is to explore the risk to HIV/STI of MSW in southwest China through a convenience sample of an HIV surveillance survey of MSM.MethodThose who self-reported had been paid for sex or “engaging in money exchange for sex” were identified as MSW or “Money Boys”. Data of the past five cycles (2004–2008) of an HIV surveillance survey were included in this study. Descriptive statistics were employed to describe demographics, sex practices, and HIV prevalence in these male sex workers.ResultsA total of 117 men self-identified as MSW in five consecutive cross-sectional surveys (2004 n=54, 2005 n=39, 2006 n=45, 2007 n=34, and 2008 n=45). The median age of participants ranged from 25 to 27 years. In the 6 months prior to the survey, the median number of male sex partners ranged from 4 to 11; the median of number of female sex partners ranged from 0 to 2; over 90% (89%–98%) of MSW reported anal sex and 26% of them engaged in group sex; but proportions who reported always using condoms for anal sex were less than 60% (ranged from 28% to 60%). HIV screening positive rate was 9% in both 2007 and 2008 see Abstract O2-S6.04 table 1. HIV positive rate is associated with the number of male sex partners and condom use frequency in both 2007 and 2008.Abstract O2-S6.04 Table 1Demographic characteristics of men who provided sex services for money in 2008 surveyIncome US $/monthNo income9% <$1459% $145–28529% $285–43020% $430–57013% >$57020%Education Primary education13% Junior high13% High school47% University27%1st sex partner Male53% Female44%Place for soliciting sex partners Bar, dance-hall, tea house, club31% Bath-house, massage parlour7% Public place: park, toilet etc.20% Internet38% Other4%Sex orientation Gay40% Heterosexual11% Bi-sexual40% Not sure9%Last 6 months sex with men98%Last 6 month sex with women40%Group sex activity27%ConclusionMSW have been emerging in the sex trade industry in China. Behavioural risk factors and high prevalence of HIV in the MSW survey sample signalled a need for further understanding of this special population. Effective public health intervention strategy and programs are in urgent demand.
O2-S6.05 Sexual violence against men who have sex with men and transgenders (MSM-T) in southern India
Authors: Shaw S , Lorway R , Deering K , Mohan H L , Bhattacharjee P , Isac S , Ramesh B M , Washington R , Reza-Paul S , Moses S , Blanchard J 
Published: July 2011

IntroductionSexual violence (SV) has been associated globally with vulnerability to HIV and other sexually transmitted infections (STIs) in marginalised populations. There is little information on SV among men who have sex with men and transgendered individuals (MSM-T) in South Asia. Societal sanctions resulting in stigma and discrimination may place MSM-T at especially high risk for both SV and HIV/STIs. We investigated factors associated with SV among MSM-T, and the relationship between health care utilisation patterns and reported SV.MethodsData were obtained from cross-sectional surveys in four districts in Karnataka state, south India. Bivariate and multivariable logistic regression models were constructed to examine factors related to SV. Multivariable negative binomial regression models examined the association between physician visits and SV. Normalised weights were used to account for a complex sampling design.ResultsThe total sample size was 543. The prevalence of SV in the past year was 18%, with a range by district of 12%–31%. HIV prevalence among those reporting SV was 20%, compared to 12% among those not reporting SV. In a multivariable model, among those reporting sex work involvement, having anal sex with five or more casual sex partners in the past week was associated with SV (AOR: 4.1; 95% CI: 1.2% to 14.3%, p=0.03). Of those not reporting sex work, feminised sexual identities (AOR: 6.10; 95% CI: 1.3% to 28.8%, p=0.03) and younger age (AOR: 0.9; 95% CI: 0.9% to 1.0%, p=0.002) were associated with SV. There was no significant association between numbers of partners and SV among those not reporting sex work. Increased physician visits among those reporting SV was reported only for those involved in sex work (AOR: 1.7; 95% CI: 1.1% to 2.7%, p=0.01).ConclusionsThere was a trend towards higher HIV prevalence overall among MSM-T reporting sexual violence, as well higher HIV prevalence among important sub-groups experiencing SV. These findings highlight the importance of integrating programs to address sexual violence into STI/HIV prevention programs among MSM-T, and of understanding that there is considerable contextual heterogeneity in vulnerability to violence in this population. The demonstrated higher rates of physician utilisation by male sex workers who report sexual violence suggests an important point of contact for a population which may otherwise be quite hidden.
O2-S6.06 Sexual practices of transgender community in Pakistan
Authors: Ahmad Z 
Published: July 2011

IssuePakistan, the second most populous Muslim nation in the world, has started to finally experience and confront the HIV/AIDS epidemic. The country had been relatively safe from any indigenous HIV cases for around two decades, with most of the infections being attributable to deported HIV positive migrants from the Gulf States. However, the virus finally seems to have found a home-base, as evidenced by the recent HIV outbreaks among the injection drug user community. Extremely high-risk behaviour has also been documented among Hijras (sex workers) and long-distance truck drivers. The weak government response coupled with the extremely distressing social demographics of this South-Asian republic also helps to compound the problem. The time is ripe now to prepare in advance, to take the appropriate measures to curtail further spread of the disease. If this opportunity is not utilised right now, little if at all could be done later. Objective: To assess risk behaviours including number and type of sex partners, condom use, knowledge of STIs and HIV/AIDS among hijras (eunuch) of Lahore, Pakistan.MethodsTwo hundred hijras were recruited through Respondent Driven Sampling and interviewed by a team of experienced interviewers. Lessons Learnt: The mean age of the respondents was 29.2±6.3 years (Range 18–55). More than two third (68.5%) were illiterate; 23% were married. Among married, 89% were married to women and had 1 to 7 children. Sixty per cent had taken some hard drug (Cocaine, Heroin, Morphine and Amphetamine) during the last 12 months and 3% had injected drugs. Eight per cent had sex with a woman during the last year. During the last 1 week, 82% respondents had 1–21 new clients and 69.5% never used condom; 21.5% had oral sex with new clients. During the same period, 72% respondents had 1–12 regular clients and 71.5% of them never used condom while 7% respondents had 1–5 non-paying partners. During the last 1 month, five hijras had paid women to have vaginal sex. Nineteen hijras paid another man to have sex with them. Only 27.1% were not aware of any symptom of sexually transmitted Infections. Majority of the hijras (81.5%) were familiar with HIV/AIDS. However knowledge about its mode of transmission was faulty.ConclusionDue to low level of accurate knowledge regarding STI/HIV and pernicious risk behaviours, hijras may become a potent source of HIV transmission, if necessary remedial measures are not taken.
O3-S1.04 Performance characteristics of bioplex 2200 syphilis IgG and Liaison Treponema automated assays for detection of antibodies toTreponema pallidum
Authors: Fakile Y , Kikkert S , Ballard R , Cox D 
Published: July 2011

BackgroundSerological testing continues to be a crucial tool for syphilis diagnosis and control. The commonly accepted syphilis screening algorithm is screening with non-treponemal tests such as RPR or VDRL, and confirming with treponemal tests such as TP-PA. Recently, automation has been introduced whereby serological screening using treponemal tests has resulted in reduced labour time and removal of the subjectivity associated with the traditional testing algorithm. The objective of this study was to compare the performance characteristics of two FDA approved automated tests, the BioRad BioPlex 2200 Syphilis IgG and the DiaSorin LIAISON treponemal assays, with known predicate tests. The BioPlex 2200 syphilis IgG is a multiplex test that utilises three analytes (15-, 17-, & 47-kDa) to detect specific IgG antibodies, whereas the LIASION treponemal assay uses only one analyte (17 kDa) in a single step sandwich method to detect both syphilis IgG and IgM antibodies.MethodsA total of 1086 commercially obtained sera tested in this study consisted of: 430 from pregnant women, 409 from HIV positive individuals, and 111 from known syphilis patients of various disease stages. Characterised syphilis samples (n=140) were also obtained from the CDC serum repository. All samples were screened by the Bioplex IgG, Liaison, RPR and TP-PA tests. Any indeterminate results were repeated at least once.ResultsOf the 1086 samples tested, the syphilis reactivities were the following: 551 (50.7%) by BioPlex IgG, 528 (48.6%) by LIAISON, and 509 (46.9%) by TP-PA. The sensitivity and specificity when compared to TP-PA for LIASION was 98.8% and 90.5% respectively. The BioPlex IgG sensitivity and specificity when compared to TP-PA was 85.1% and 80% respectively. Overall, 443 (40.8%) samples were found to be reactive and 450 (41.4%) non reactive to both LIAISON and BioPlex IgG. All three tests agreed on 877 (81%) samples. On the 209 discordant samples TP-PA agreed with LIAISON 85.2% (n=178), BioPlex 7.2% (n=15), but disagreed with both tests 7.7% (n=16).ConclusionBoth tests have high throughput, walk-away capability, and would be useful in low prevalence settings. There was good agreement between the LIAISON and the BioPlex IgG in 893 (82%) samples (Cohen's κ=0.64). The LIAISON had higher sensitivity most likely due to its detection of both IgG and IgM, while the BioPlex detected only IgG antibodies. Both tests show significant promise in the future of syphilis serology.
O3-S2.03 The spectrum of genital HPV infection among men attending a Swedish STI Clinic: HPV typing and clinical presentation
Authors: Wikström A , Hedblad M A , Syrjänen S 
Published: July 2011

BackgroundSome Swedish studies on HPV typing in men exist. Most earlier studies have used less sensitive HPV typing techniques. The purpose of this study is to see if the HPV types in genital HPV associated lesions have changed since the 80ies, and to describe the lesions in detail.MethodsBetween 2004 and 2007, male patients attending the STI clinic of Karolinska Hospital with genital HPV induced lesions planned for surgery, were asked to participate in the study. All men exhibited multiple lesions—men with solitary lesions were excluded. Two clinically identical lesions on the same genital site, were collected by punch biopsy or by scissor excision. One sample was put in formalin for histopathological routine preparation, and the other sample was frozen in −70°C for PCR analysis using a highly sensitive nested PCR technique, detecting 24 different HPV types. The macroscopic morphology of the lesions was classified in acuminate, papular, macular and seborrhoeic keratosis like. The colour of the lesions and the location were recorded. Data on previous therapy and how long time the patients had been afflicted with genital symptoms/and or warts was also noted.ResultsTotally 303 men were included in the study. Of these, 47 men (16%) exhibited lesions of PIN and have been described previously. The remaining 256 men had benign lesions and are described here. Acuminate lesions dominated, occurring in 106 (41%) of the men, followed by papular lesions found in 88 (34%) men. The penile shaft, the pubic area and the foreskin were the most common locations for the HPV induced lesions, afflicted in 36%, 29% and 25% of the men, respectively. Pink and brown were the dominating colours of the leions. HPV was detected in 233 (91%) lesions. Low risk HPV types only, were found in 75% of the lesions. On the other hand, 7% of the lesions contained only high risk HPV types, and 9% had a mix of low- and high risk HPV types. Multiple HPV types were found in 13%. HPV 6 was the most common HPV type (70% of the lesions were positive for HPV 6 only). Duration of genital symptoms and/or warts was mean 24 months and 211 of the men had previously been treated.ConclusionUsing a highly sensitive PCR technique, a high HPV detection rate of 91% was found. As in earlier studies, HPV 6 was most common, but also other HPV types including high-risk types were detected. As expected, most of the benign lesions were acuminate, but the morphology as well as the genital location varied.