bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S6.35 One finger stick, two tests: integrating syphilis and HIV Rapid tests for antenatal care and reproductive health services
Authors: Valderrama M , Chiappe M 
Published: July 2011

BackgroundMother-to-Child Transmission of HIV and Congenital Syphilis are two important public health problems in many developing countries. In Peru, coverage of syphilis screening is suboptimal, test results can take weeks and a high proportion of women screened are not treated, much less their sex partners. The objective of this study was to demonstrate the feasibility of implementing syphilis and HIV rapid tests at antenatal care and reproductive health services and to measure its effect on coverage of maternal syphilis screening and treatment coverage.MethodsWe trained midwives from 16 health centers, to offer syphilis rapid tests (Syphilis 3.0 BioLine) to women 16 to 55 years old receiving antenatal care (ANC) and seen at the delivery or miscarriage services, and to integrate it with HIV rapid tests already in place at the health network, but which were until then done from venous blood by laboratory technicians and with results given in 15 to 30 days.Results4497 women were screened, from January to November 2010. Prevalence of syphilis (RPR reactive, TPPA(+)) was 0.9% in ANC, 0.7% in delivery services and 1.9% at the miscarriage services. The prevalence of HIV by rapid test was 0.3%. The overall coverage for syphilis and HIV rapid tests was 93% during the study, compared to the 35% coverage of RPR testing reported for 2009 (Abstract P1-S6.35 figure 1). Previous coverage of HIV testing was not documented. Test results were given to 100% of women within 20 min of finger stick blood collection during the first contact with health providers, compared to a 27 days delay found in 2009. Treatment rates for syphilis also improved from 51% in 2009 to 93% in 2010. Whereas previously there was no system in place for registering partner treatment, our data shows that 59% of partners of positive women received treatment for syphilis during the study period. Key factors in the success of implementation in Callao-Peru; were ongoing training, monitoring, and supervision of health providers who performed the rapid tests.Abstract P1-S6.35 Figure 1Coverage of Syphilis screening by year and service Callao, Peru 2009–2010.ConclusionsImplementation of syphilis rapid test proved feasible, acceptable and effective in improving screening and treatment coverage and can serve as a powerful catalyst for improvements in quality of care.
P1-S1.26 Prevalence ofTrichomonas vaginalisinfection during the first trimester of pregnancy in pregnant women on Maternal and Perinatal Institute
Authors: Cortez L 
Published: July 2011

Summary ObjectiveTo determine the prevalence ofTrichomonas vaginalisinfection during the first trimester of pregnancy in pregnant women in a Maternity Institute.MethodsWe contacted and recruited a total of 105 women with up to 3 months gestation who attended the outpatient. All of them filled out a consent form and were collected a sample of vaginal secretion, which was analysed for direct observation and inoculated into the culture medium InPouch TV (Biomed Diagnostics, White City, Oregon, USA) and incubated for up 72 h at 37°C. The samples were observed under the microscope for the presence of mobile parasites. Besides demographic data were collected.ResultsThe prevalence of infection withT vaginaliswas 5.71% and 3.8% by culture and direct observation, respectively. The growing use of laboratory performance improvement in the report of the prevalence ofT vaginalis. Close supervision of this parasite during pregnancy using more sensitive laboratory methods see Abstract P1-S1.26 Figure 1.Abstract P1-S1.26 Figure 1“Prevalence ofTrichomonas vaginalisinfection during the first trimester of pregnancy in pregnant women”. Instituto Especializado Materno Perinatal. Lima, Mayo, Julio 2004.
P1-S6.36 Cost-effectiveness of rapid tests to improve access to syphilis prevention among pregnant women in Peru
Authors: Mallma P , Carcamo C , Valderrama M , Chiappe M , La Rosa S , Garcia P , Weaver M , Holmes K , Terris-Prestholt F , Peeling Rossana 
Published: July 2011

BackgroundSeveral recent articles compared the cost and cost-effectiveness syphilis testing strategies to avert congenital syphilis in settings with high syphilis prevalence. Current study contributes analysis in low-prevalence setting. Methods. Rapid syphilis testing (RST) was implemented at two different settings, both with syphilis prevalences of around 1%: (a) The Ventanilla-Network of outpatient clinics and a small hospital at a peripheral district in Peru, where the rapid syphilis test was implemented together with the rapid HIV testing (One finger stick, two tests"); (b) The National Maternal and Perinatal Institute (INMP) a tertiary hospital with a high number of patients, and Initially in both settings the only test available was RPR with low coverage. For the costing of RPR we included supplies, capital costs, human resources and costs associated to treatment. For the costing of RST, we included also start up costs (advocacy meetings with authorities, training, supervision, monitoring) and the cost of implementing a quality assurance system. Cost-effectiveness analyses compared the cost of screening and treatment for the joint program to the disability adjusted life-years saved when congenital syphilis was averted.ResultsFor the Ventanilla-Network the total cost was $5.98 for RST and $5.22 for RPR per woman screened and $580.83 and $1845.55 respectively per woman treated. In contrast, the total cost was $2.53 for rapid syphilis test and $3.15 for RPR per woman screened (the lower costs probably associated to the economy of scale, due to the large number of women seen at the INMP) and $336.80 and $1051.59 at INMP. At Ventanilla-Network, the cost per DALY saved from averting cases of congenital syphilis was $35.23 for rapid syphilis test and $111.95 for RPR. In incremental analysis, the rapid test was cost-saving. At INMP, the cost per DALY saved was $20.43 for rapid syphilis test and $63.79. For the Ventanilla-Network and the INMP the RST was cost-effective by the WHO standard of $64/DALY.ConclusionSyphilis screening is cost-effective even in a low-prevalence setting. To the extent that HIV rapid tests are funded by PMTCT programs, the cost of scaling up rapid syphilis tests would be lower than these estimates, because the joint cost of blood sample collection would be borne by the PMTCT program.
P1-S6.39 Can professional midwives interpret rapid syphilis tests accurately?
Authors: Gutiérrez M A Chiappe , Soto K , Lopez-Torres L , Cárcamo C , Calderón M I Valderrama , La Rosa S , Mallma P , Garcia P , Peeling R 
Published: July 2011

BackgroundCongenital syphilis produces miscarriage and severe complications in newborns. Rapid syphilis testing (RST, Syphilis 3.0 Bioline) was introduced in antenatal care and reproductive health services of 16 health centers at Ventanilla (Callao), Peru, aiming to improving access to syphilis screening and treatment in the first contact of pregnant women with professional midwives. We present the results of a quality control assessment evaluating internal (IQC) and external quality control (EQC) of such tests when performed by professional midwives.MethodsWe developed quality controls panels consisting of the Dried Tube Specimen (DTS). Open label positive and a negative control DTS were distributed as IQC bimonthly to services performing RST, to evaluate the test performance under the service storage conditions. Additionally, closed label controls (EQC) were distributed biyearly to evaluate the performance of each professional midwife performing RST. The ECC panel was composed of a weak positive, an intermediate and a strong positive DTS, as well as a negative DTS. Midwives were trained in DTS reconstitution, as well as result interpretation and recording.Results28 DTS panels were distributed for IQC (16 to antenatal and 3 to emergency services), with 100% concordance. 119 DTS panels were distributed as EQC, with 100% concordance observed in most (95%) of midwifes evaluated. Six midwives read the weak positive DTS as negative (75% concordance). These six professionals were retrained in their health centers. IQC and EQC were well accepted by midwifes, giving them a sense of confidence with their performance with the test.ConclusionExcellent IQC and EQC results were observed, with good acceptance of the evaluation by midwives.
P1-S6.42 HPV vaccine and sexual behaviour among US adolescent and young adult women
Authors: Liddon N , Leichliter J S , Hood J , Markowitz L E 
Published: July 2011

BackgroundMonitoring HPV vaccine uptake can identify potential disparities in coverage and guide vaccine implementation efforts. While there are several national estimates of HPV vaccine uptake among US women, there are few data on vaccination status in relation to sexual behaviour. We analysed receipt of HPV vaccine and intent to get vaccinated by demographic and sexual behaviour data from a nationally representative US survey.MethodsIn 2007–2008, 1243 females aged 15–24 years in a nationally representative US survey answered questions about receipt of at least one dose of HPV vaccine. Unvaccinated women were asked about their intent to get vaccinated in the next 12 months. Demographic and sexual behaviour correlates were evaluated in bivariate and multivariable analyses by age for (a) receipt of HPV vaccine and (b) intention to receive HPV vaccine.ResultsOverall, 23.1% of respondents reported receiving HPV vaccine; significantly more 15–19 year olds were vaccinated compared to 20–24 year olds (30.3% vs 15.9%, p<0.001). There was no difference in receipt of vaccine by race/ethnicity for 15–19 year olds, but 20–24 year old non-Hispanic blacks were less likely than non-Hispanic whites to have received vaccine [aOR=0.2 (0.1, 0.4)]. Women who had insurance were more likely to have received HPV vaccine. HPV vaccination was not associated with being sexually active or lifetime number of sex partners. Among sexually active 15–19 year olds, those who received HPV vaccine were more likely to report always wearing a condom [aOR=3.0 (1.1, 7.9)] than those who had not received vaccine. A majority of unvaccinated women in both age groups are not likely to get vaccinated in the next 12 months (62% of 15–19 year olds and 58.0% of 20–24 year olds). Sexually active women were more likely to intend to get vaccinated [15–19 year olds: aOR=2.6 (1.2, 5.5); 20–24 year olds: aOR=2.2 (1.1, 4.3)].ConclusionsThese nationally representative data from the US highlight disparities in HPV vaccine uptake by insurance status among 15–24 year old women and by race/ethnicity among women above age 19. Our data do not suggest that HPV vaccination results in more sexually-risky behaviour, however, further data on timing of vaccination and sexual initiation are needed. Continued efforts are needed to encourage vaccination before initiation of sexual activity when the benefit of vaccination would be greatest.
P1-S1.27 Intravaginal practices, lubrication, and bacterial vaginosis among women in Los Angeles
Authors: Brown J , Hess K , Brown S , Murphy C , Waldman A , Hezareh M 
Published: July 2011

BackgroundBacterial vaginosis (BV) has been associated with HIV acquisition and transmission. Intravaginal practices may affect women's vulnerability to BV and HIV/STIs, and may influence results of trials of microbicides for HIV prevention through effects on the vaginal environment and on adherence to investigational microbicidal products. We measured the prevalence and frequency of intravaginal hygiene and lubricant use and their association with BV among both HIV-positive and HIV-negative women.MethodsBetween October 2008 and June 2009, we recruited women aged 18 years and older in Los Angeles. At the enrolment visit and 12 months later, participants underwent a self-administered, web-based questionnaire covering demographics, sexual behaviours, intravaginal hygiene, and lubricant use. HIV was diagnosed by rapid ELISA, with confirmation by Western blot. BV was diagnosed by Nugent criteria from a self-collected vaginal swab. Here we report data collected at enrolment.ResultsWe enrolled 141 women (34% identified as White, 40% Black, 26% Hispanic; the median age was 33 years (IQR=25–44)). Overall, 56% of women reported intravaginal cleaning and 45% reported douching over the past month. Overall, nearly three-quarters (73.8%) reported intravaginal insertion of a lubricating product over the past month; commercial lubricant (42.6%), lotion (12.1%), petroleum jelly (10.6%), and oil (7.8%) were the most commonly reported lubricants. The prevalence of BV was 21% and HIV was 27%. In multivariable analysis, intravaginal insertion of oil, lotion, or petroleum jelly (aOR=3.4 (95% CI=1.2 to 9.7)) was associated with BV controlling for douching, age, race, HIV status, and multiple sexual partners.ConclusionUse of intravaginal lubricating products not specifically designed for sexual intercourse is common among women. The use of such lubricants and their association with BV is of particular concern and warrants further study; not only in light of the direct association with BV, but also because of the link between BV and HIV infection.
P1-S6.48 Identifying women at risk: Can an STD diagnosis help target women for risk reduction counselling? Miami-Fort-Lauderdale, 2000–2009
Authors: Brewer T H , Peterman T A , Newman D R , Shiver S 
Published: July 2011

BackgroundThe Miami-Fort Lauderdale metropolitan statistical area has one of the highest rates of HIV in the US and 29% of cases are among women. We explored STD history as an HIV risk factor for women.ObjectiveTo determine if reported gonorrhoea (GC), chlamydia (CT), early syphilis (ES) or demographic factors predict the risk of subsequent HIV infection among women.MethodsWe linked STD surveillance data (2000–2006) and HIV report data (2000–2009) to identify HIV infection rates among females >10 years of age, who acquired HIV >60 days after an STD diagnosis. Census data were used to estimate HIV infection rates for women without an STD diagnosis. Multivariate analysis was used to identify correlates of HIV-infection in women with an STD diagnosis.ResultsOf 46 318 women diagnosed with an STD from 2000 to 2006, 534 (1.2%) were subsequently reported to be HIV-infected by 2009 (median time to diagnosis 3.0 years, mean 3.5 years). Most, 446 (83.5%), were Black. Of the 604 Black women aged 20–24 years diagnosed with HIV, 167 (27.6%) had been diagnosed with at least one STD. However, 9187 Black women aged 20–24 had an STD in 2000–2006, so the risk of HIV following an STD diagnosis was relatively low for these women. Of 371 181 Black female area residents, 6077 with no STD were reported HIV-positive in the time frame (0.16% per person-year). Risks for Black women with STD were: CT 0.23% per person-year; GC 0.54% per person-year; and ES 1.70% per person-year. In multivariate analysis, among women with an STD, HIV risk factors were: Black race (adjusted prevalence rate ratio (PRR) 4.8, 95% CI 3.1 to 7.3); age at STD diagnosis <15 years (PRR 2.1, 95% CI 1.4 to 3.3) or between 35and 49 years (minimal PRR 1.9, 95% CI 1.4 to 2.5) compared to 20–24 years; residence in a high morbidity zip code (PRR 2.1, 95% CI 1.8 to 2.5); and diagnosis of GC (PRR 2.0, 95% CI 1.8 to 2.5) or ES (PRR 7.9, 95% CI 5.7 to 10.9) compared with CT.ConclusionSTDs are common in young women. However, these data demonstrate that STDs in younger and older women, particularly Blacks with gonorrhoea or syphilis are indicators of increased risk of subsequent HIV infection. These women can be easily identified in clinical settings and targeted for risk-reduction interventions.
P1-S6.53 Antiretroviral therapy reduces HIV transmission in discordant couples in Northern Malawi
Authors: Glynn J , Price A , Floyd S , Molesworth A , Kayuni N , Chihana M , Nyirenda V , Crampin A , French N 
Published: July 2011

BackgroundAntiretroviral therapy (ART) reduces viral load and has been suggested as a prevention measure to reduce transmission. However there are concerns that this may be counterbalanced to some extent by increased sexual activity associated with improved health and decreased condom use. The impact of ART on rates of HIV-transmission was investigated within HIV discordant couples in rural, Northern Malawi.MethodsThe study was conducted as part of the Karonga Prevention Study. A demographic surveillance system was started in 2001 and annual home-based HIV sero-surveys added from 2007, with individual counselling and consent. From the first round of the sero-survey, 201 HIV discordant couples (147 male positive, female negative; 54 male negative, female positive) were identified for whom follow-up HIV data were available in the negative partner. Free ART is available at local health facilities and ART use was determined by linkage of data to a clinic based cohort and self-report. Patients attend ART clinics with a guardian who may be the spouse, and are counselled about the need for safer sex. For this analysis participant exposure to ART was defined as having started ART prior to study entry, and follow-up was censored at time of last observation, HIV seroconversion, last negative HIV test, death, departure or dissolution of marriage. Follow-up with re-testing is ongoing.ResultsSo far there are 249 and 99 person-years of follow-up in HIV negative women and men, respectively. 55 of the 201 positive partners had commenced ART at entry and within these couples no HIV transmission occurred over a 3-year follow-up period. Among 146 discordant couples without ART the rate of transmission to females was 5.2 / 100 person years (95% CI 2.7 to 10.5) and to males 1.3/100 person years (95% CI 0.18 to 9.4).ConclusionsIn HIV discordant couples ART is associated with reduced rates of HIV transmission within partnerships.
P2-S1.02 Safe spaces: youth friendly centre used to promote HIV education in Nairobi slums
Authors: Baru Musya P Chacha , Johnston C , Mokaya P , Mbenya L , Nyambura H , Nduku V 
Published: July 2011

BackgroundKenya's National HIV/AIDS Strategic Plan deems youth, 14–24, most-at-risk. Risk is elevated in slums where poverty is prevalent and access to condoms and health education is limited. Peer health educators who come from the community and speak the same language are able to engage trust and confidence of the target population. In 2010 a unique partnership was formed, between youth, AIDS service organizations (ASO), and Goal Kenya, with the objective of increasing HIV education among youth in Nairobi. One outcome from this partnership was the creation of a youth friendly centre.MethodsPeer educators created a safe space within the slum, Lunga Lunga Youth Centre, where youth are invited to “hang-out”, engage in off street activities (computer games, theatre, music etc), and receive health education and services. Information on HIV/STI prevention is shared and youth are taught to make informed decisions related to sexual activity and are encouraged to test for HIV /STI at the adjoining clinic.ResultsIn the first four months of the project 2424 youths, 40% female and 60% male used the centre. 933 youth received health counselling, 98.6% male and 1.4% female. The youth friendly space allowed for a safe and open environment for youth to receive and discuss HIV/STI information as well as access testing and health services. Using non-literature based activities increased HIV/STI knowledge and prevention methods were learnt, barriers to education such as illiteracy were circumvented.ConclusionGiven the overwhelming positive response to the youth specific space more youth friendly spaces in other parts of the slum should be made available, and ASO and youth partner organizations should be supported to enhance services. There needs to be more emphasis on engaging young women in health counselling programs.
P2-S1.03 Our adolescents! My sexuality matters (MSM) the lessons we have learnt
Authors: Peter O D Obi 
Published: July 2011

BackgroundAs in many developing countries, as in Nigeria STI is increasing among the adolescents. While life skills can improve their behavioural practices, traditional training approaches may not be a feasible approach to be reaching the vast number of adolescents that are sexually active, who do not know both STI and HIV status. Many youth initiate sexual risk behaviours in preadolescence, yet STI, HIV prevention programmes are typically implemented in adolescence, missing an important window for prevention. Pre-risk prevention efforts are needed to equip youth with knowledge and skills to make healthy and responsible decisions about sexual behaviour against STIs.MethodsMy Sexuality Matters, a re-orientation base programming was employed to reach out to youth early with sexual health prevention messages through the parents. Parent-child communication, we developed and rigorously evaluated program that enables parents to help shape their children's decisions about sexual behaviour. My sexuality Matters (MSM) is base on intervention provided directly by parents who are care givers of children; this gives parents knowledge and skills to communicate about sexuality with their children. Lesson Learnt: Significant cultural taboos exist in Nigeria that bars parents from speaking with children about sexuality and sexual decision making. Additional challenges include rites of passing rituals, and cultural Challenges that the altered the context of sexuality education. Despite these challenges, over 40 000 Nigerian families have participated in My Sexuality Matters (MSM), and the program has been adopted by other countries and many families have continued embracing MSM initiatives.ConclusionThe success of MSM demonstrates that programmes involving parents as sexuality educators and motivators can be implemented and embraced and reduce to the vulnerability of adolescent, youths to STIs. The willingness of parents to rebrand the cultural norms to protect their children's sexual health.