bluuebunny/crossref_metadata_2025_split huggingface dataset:
O2-S5.06 Health-seeking behaviours among female sex workers in a community randomised trial in Peru (The Peru-PREVEN Study)
Authors: Kohler P , Campos P E , Buendia C , Carcamo C , Garcia P J , Hughes J , Mejia C , Garnett G , Holmes K 
Published: July 2011

BackgroundThis study aims to evaluate health-seeking and HIV/STD preventive behaviours among FSW in mid-sized cities in Peru associated with a community randomised trial intervention and with venue of sex work.MethodsThrough the Peru PREVEN multi-component intervention, mobile team outreach to FSW was conducted in an effort to lower STD rates and increase condom use as well as care-seeking from local Ministry of Health clinics for screening and evaluation of STDs. Relative risks for behavioural outcomes were calculated using multivariate Poisson regression models with robust standard errors and accounting for clustering by city. Analyses were adjusted for city-specific baseline outcomes and by brothel venue, as there were a higher proportion of brothels in intervention cities. A sub-analysis of outcomes associated with brothel venue did not control for baseline but did adjust for age, marital/cohabitation status, alcohol use, geographical region, education and randomisation arm.Results4156 FSW were enrolled in 20 cities; 2063 from control and 2093 from intervention cities. The median age at first paid sex was 21 years and the median duration of sex work was 20 months. Sex work was relatively frequent, with a median of 6 days worked in the last week, 4 weeks in the last month and 8 months in the last year. Frequency of sex work increased with age (p<0.001). Twenty-one per cent of FSW were brothel based, 23% street based and 56% were bar or nightclub based. Although proportions of care-seeking behaviours were higher in intervention cities, differences were not statistically significant. In evaluating relationships of venue and health-seeking behaviours, brothel-based FSW reported significantly lower rates of non-condom use with clients (RR=0.18; 95% CI 0.07% to 0.44%), and higher rates of recent health screening exams (RR=1.97; 95%CI 1.58% to 2.45%) and of HIV testing in the last year (RR=1.74; 95% CI 1.45% to 2.09%), compared with FSW who were street or bar-based. Brothel-based FSW also more frequently reported knowledge of STDs (RR=1.07; 95% CI 1.04% to 1.09%) and recognition of STD symptoms in women (RR=1.39; 95%CI 1.22% to 1.59%) and in men (RR=1.32; 95% CI 1.12% to 1.57%).ConclusionsSex work venue is significantly associated with the health care-seeking and STD preventive behaviours of sex workers. Interventions to promote STD detection and prevention among FSW should consider structural or regulatory factors related to sex work venue.
O2-S6.01 Non-consensual sex and association with HIV infection among women: a Cohort Study in rural Uganda, 1990–2008
Authors: Birdthistle I , Mayanja B , Maher D , Floyd S , Seeley J , Weiss H 
Published: July 2011

BackgroundNon-consensual sex is associated with HIV infection in Africa, but there is little longitudinal data on this association. We describe reported non-consensual sex among women over two decades in rural southwest Uganda, including associations with incident HIV infection.MethodsBetween 1990 and 2008 in rural southwestern Uganda, consenting individuals in a population cohort who recently seroconverted to HIV were enrolled into a clinical cohort, along with randomly selected HIV-negative controls. Participants were invited to the study clinic every 3 months, and females asked about recent experiences of sex against their will (since their last visit). At enrolment, associations of non-consensual sex with HIV status were analysed using conditional logistic regression. With data from all visits, this association was analysed using logistic regression, with OR adjusted for age and year of interview, allowing for within-woman correlation.Results476 women aged 14–81 enrolled and attended 10 475 visits over 19 years. At the time of enrolment, 24% (41/188) of incident HIV and 16% (23/166) of HIV-negative participants reported non-consensual sex in the past year (adjusted OR=0.93, 95% CI 0.47% to 1.82%). Among those who reported recent non-consensual sex (since their last visit) at any visit, most (80/119) did so more than once, including 48% in over half their visits. Using data from all visits, reports of recent non-consensual sex were higher among HIV-positive than HIV-negative participants (22% vs 9%; aOR=2.29, 95% CI=1.03% to 5.09%), with the strongest associations among women aged 14–22, those over 50 years, and married participants.ConclusionsThe study shows high levels of repeated sex against one's will, with many women in this Ugandan population reporting new episodes of non-consensual sex in most or all of their visits. Non-consensual sex was most often reported by the youngest and oldest HIV positive women. Gender-sensitive HIV programmes should address repeated sexual coercion before and subsequent to HIV infection.
LBP-1.04 International validation of AmpliSens NAAT systems manufactured in Russia for diagnosis ofNeisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitaliumandTrichomonas vaginalis
Authors: Domeika M , Savicheva A , Shipitsyna E , Chen C Y , Skov-Jenssen J , Hjelmevoll O , Ballard R , Unemo M 
Published: July 2011

ObjectivesData regarding the performance characteristics of STI diagnostic tests used in Eastern Europe are very scarce. The objective of this study was to validate the AmpliSens test systems (Central Research Institute for Epidemiology, Moscow, Russia), compared to internationally acknowledged and validated tests, for genetic detection ofN gonorrhoeae (NG),C trachomatis (CT),M genitalium(MG) andT vaginalis (TV).MethodsIn total, 319 females and 127 males were recruited. For evaluation of the TV tests, additional 33 patients with diagnosed trichomoniasis at dermatovenereological dispensaries (VD) were involved. Conventional AmpliSens PCR assay (cPCR), real-time PCR assay (rtPCR), and a real-time nucleic acid sequence-based amplification assay for detection of NG or CT were evaluated. Furthermore, AmpliSens cPCR and rtPCR for detection of MG or TV were tested. As international reference tests an internationally validated real-timeN gonorrhoeaeporA pseudogene PCR, Cobas Amplicor CT PCR and LightMix 480HT CT PCR, MG rtPCR targeting the MgPa adhesin gene with positive results confirmed by two MG cPCRs targeting the 16S rRNA gene and MgPa gene, and a TV rtPCR targeting a TV specific repeat DNA fragment, respectively, were used.ResultsThe overall prevalence of CT infection was 12.6%. The AmpliSens CT NAATs and the reference methods displayed a high level of concordance (97.9%–99.2%). The prevalence of NG was 2.7% and 16% among the urogenital and extragenital samples, respectively. The AmpliSens NG NAATs and the reference method displayed high level of concordance (99.4–100%). The prevalence of MG was 2.5% among females and 9.6% among males. The highest sensitivity (71.4%–100% in different specimens) was exhibited by the AmpliSens rtPCR. All tests had a 100% clinical specificity. The prevalence of TV was 1.2% among the females, and all additional VD patients tested positive. The sensitivity and the specificity of both Russian TV tests validated was 100%.ConclusionIt seems clear that the biomedical industry in Eastern Europe has the potential for producing reliable reagents and tests kits at affordable prices for genetic diagnosis of STIs. This would open new perspectives for the whole region and could also be cost-effective for some other regions experiencing financial constraints. However, more comprehensive evaluations of regionally manufactured tests should be conducted according to internationally accepted guidelines.
LBP-1.06 Infectious syphilis in New Brunswick: using data for action in a small Canadian province
Authors: Frosst G , Tremblay F W , Allard D 
Published: July 2011

BackgroundNew Brunswick (NB) has experienced a resurgence of infectious syphilis with a 10-fold increase in the incidence rate between 2007 and 2010. In response to this increase in cases, an outbreak control team was convened and enhanced surveillance of syphilis was implemented to better understand the epidemiology of infectious syphilis in NB and to inform public health action.MethodsA standardised enhanced surveillance investigation form was developed to collect detailed information about syphilis cases, their sexual contacts, and risk factors. Since December 2010, all new cases of infectious syphilis reported in NB are followed up by regional Public Health staff using the standardised form, where completed forms are faxed to the provincial office for entry into a central database. Results are disseminated regularly to stakeholders through descriptive epidemiologic reports. Social network analysis (SNA) of cases, contacts, and meeting places for sexual partners (ie, venues) is also occurring to identify routes of transmission and points of intervention.ResultsFifty-six cases of infectious syphilis have been reported in NB since November 2009, corresponding to annual incidence rates of 5.0 per 100 000 in 2010 and a projected 6.1 per 100 000 in 2011. The majority of cases are located in the small urban centers of Moncton and Fredericton with sporadic cases located in Saint John and rural NB. Ninety-three per cent of cases are male with the highest incidence rate among males aged 20–24 years (58.8 per 100 000 population from November 2009 to April 2011). Five male cases are co-infected with HIV. Eighty-eight per cent of male cases are men who have sex with men, most of whom reported having multiple casual or anonymous sex partners in the months preceding diagnosis. Venues for meeting sex partners include websites, bars, and bathhouses. The epidemiologic reports and SNA informed the first phase of a province-wide social media campaign launched in February 2011. The campaign targets men aged 18–55 years and includes distribution of posters, condom matchbooks, and online advertisements at venues identified by cases.ConclusionsNB is currently experiencing an outbreak of infectious syphilis. Enhanced surveillance activities, regular epidemiologic reporting, and SNA have informed the development of public health interventions targeting adult males, primarily men who have sex with men in Moncton and Fredericton.
LBP-1.07 Ecology of Human papillomavirus (HPV) infections in the male, studied using Expressed Prostate Secretions (EPS)
Authors: Smelov V , Eklund C , Dillner J 
Published: July 2011

BackgroundIn a new era of Human papillomavirus (HPV) vaccination, adequate diagnostics of the viral infection in men becomes more important: the monitoring of the vaccination effect requires evaluating whether vaccine HPV types disappear from and how the prevalence of non-vaccine types is affected in either high-risk groups or general population. Detection methods and anatomical sites for optimal HPV sampling are of high interest among healthcare specialists. Expressed prostate secretion (EPS) obtained during digital rectal examination—a daily routine urological diagnostic procedure—and following massage of the prostate, represents an alternative sampling material for the study of HPV ecology in the male. We present the results from the first study on HPV detection in EPS, as detected using a reference method used at the WHO HPV LabNet global reference laboratory, a multiplex high-throughput genotyping using the Luminex system.MethodsThe EPS samples were from 186 heterosexual men (mean age 32 (range 19–60) years (median sexual life start at 17.6 (9–25) years; 33 (1–500) median life-time sex partners; no concurrent STDs at the time of the study) were collected in a urology outpatient unit in St. Petersburg and tested for the presence of HPV DNA in Stockholm by the Luminex assay.ResultsThe results are presented in the Abstract LBP-1.07 table 1. HPV prevalence in the study population was 25.3% for all HPV types with 11.8% for oncogenic types only. High-risk (HR−) HPV 16 and 66 were the most common types 3.7 and 2.7% of men, respectively. Interestingly, untypable HR-HPV types were found in 3.2% of EPS samples. Multiple oncogenic types were found in 22.7% of all HR-HPV+ EPS samples.ConclusionsEPS can be used for HPV studies in men: additional investigation of EPS may result in better understanding the transmission of HPV infection and to develop strategies for HPV prevention. For the first time, the full range of HPV types in the EPS of men with no STDs was explored.Abstract LBP-1.07 Table 1HPV infection prevalence in the prostate (EPS) samples of 186 menHPV typesLow-risk HPV typesHigh-risk HPV typesUntypable types61142435367707481878991Multi1618313545565866Men, HPV+11211131161515732421156 (3.2%)22 (11.8%)21 (11.3%)47 (25.3%)Total186
LBP-1.10 Misclassification of syphilis cases using a reactive enzyme immunoassay and reactive RPR algorithm alone for diagnosis
Authors: Singh A , Fonseca K , Mukhi S , Gratrix J , Plitt S , Read R , Sutherland K , Zahariadis G , Tyrrell G , Lee B 
Published: July 2011

BackgroundRecent recommendations propose that samples dually reactive by a syphilis enzyme immunoassay (sEIA) and RPR be reported as positive for syphilis without confirmatory testing.MethodsSamples from 1 September 2007 to 19 March 2011 testing reactive by sEIA and tested by INNO-LIA (IL) were extracted from the Alberta Provincial Laboratory for Public Health's DIAL (Data Integration for Alberta Laboratories), a web based application. Syphilis testing history was reviewed for all patients with a reactive sEIA and reactive RPR and negative (NEG) or indeterminate (IND) result by IL. Syphilis infection was defined by a positive confirmatory test (majority IL; a few TPPA and FTA-ABS). The significance of RPR titres in patients NEG/IND by IL with or without evidence of syphilis infection was analysed using χ2test. Median standard cut-offs (s/co) for the sEIA were compared using the Mann–Whitney U test.Results6195 samples from 4695 patients with reactive sEIA were also tested by IL: 15 samples (0.2%) had no reported RPR result, 4232 (48.3%) were non-reactive by RPR, and 1948 (31.4%) samples from 1753 patients were reactive by RPR. 72 (4.1%) of the 1753 patients with reactive RPR had at least one specimen tested NEG/IND by IL (Abstract LBP-1.10 figure 1). 3 of the 72 patients (4.2%) had a serological history of syphilis infection not recognised initially, 15 (20.8%) had no follow-up testing, 23 (31.9%) had a subsequent positive IL, and 31 (43.1%) did not demonstrate syphilis infection on follow-up testing. For the 31 patients with no serological evidence of syphilis infection, 24 remained NEG/IND by IL and seven tested negative by sEIA on follow-up. Overall, 31 patients (1.7%) would have been misclassified as infected based upon an algorithm of dually reactive sEIA and RPR without confirmatory testing. 14.7% of samples that tested negative or IND for IL in confirmed syphilis had RPR titres =1:8 as compared to 20.0% of samples from patients without syphilis on follow-up serology (p=0.5). The median s/co of the screening sEIA for samples from the patients who were infected (4.8, range: 1.0–24.20) differed from the s/co (2.6, range: 1.0–12.4) for those uninfected (p<0.05).ConclusionsIn our experience, 1.7% (31 patients) would have been misclassified as a case of syphilis if a third confirmatory test for syphilis had not been conducted. Additional evaluation of syphilis testing algorithms is warranted before a two test algorithm is widely employed.Abstract LBP-1.10 Figure 1Misclassification syphilis cases
LBP-1.13 LEEP conisation and the risk for preterm birth: new health registry based data from Finland
Authors: Paavonen J , Heinonen A , Gissler M , Tapper A M , Jakobsson M 
Published: July 2011

ObjectivesTo study whether the increasing severity of cervical intraepithelial neoplasia (CIN) by LEEP (loop electrosurgical excicion procedure) cone correlates with the risk for preterm birth. We also wanted to study whether the time period from LEEP or repeat LEEP correlates with the risk.MethodsRetrospective register-based study from Finland during 1997–2009. We collected data from the Hospital Discharge Register. We linked the data with data from the Finnish Medical Birth Register. The study population consisted of 20 011 women who had LEEP during 1998–2009 and a subsequent delivery during 1997–2009. Controls were women with no previous LEEP (n=430 975). The main outcome measure was preterm birth (<37 gestational weeks) rate.ResultsThe risk for preterm birth was increased after LEEP (OR 1.82, CI 1.62 to 2.03). In primiparous women this risk was slightly lower OR 1.61 (CI 1.42 to 1.83). Repeat LEEP was associated with almost threefold risk for preterm birth (OR 2.71, CI 1.98 to 3.69). Increasing severity of CIN did not correlate with the preterm birth rate. LEEP for carcinoma in situ or microinvasive cancer, however, increased the risk threefold (OR 3.25, CI 1.92 to 5.50). The risk was also increased for HPV-related non-CIN lesions (OR 2.55, CI 1.72 to 3.78). Time period since LEEP was not associated with the risk for preterm birth. Adjusting for maternal age, parity, socio-economic status, or marital status, or history of previous preterm birth did not change the results.ConclusionThe risk for preterm birth was increased after LEEP, but was not associated with the severity of CIN. Repeat LEEP had highest risk. Unnecessary LEEP should be avoided especially among young women.
LBP-1.14 Genital warts: Canadians' perception and health related behaviours
Authors: Steben M , Labelle D 
Published: July 2011

BackgroundA high level of anxiety is associated with a diagnosis of genital warts but health-related behaviours are less well known.ObjectiveTo gauge the perceptions of Canadians towards genital warts and associated treatments.MethodsA survey supported by an unrestricted grant from Graceway Canada was conducted in February 2011 by Leger Marketing using their online panel (LegerWeb). It included 17 questions (2 multiple-choice, 15 4-point rating from strongly agree to strongly disagree]) relating to genital wart perception plus nine demographic questions.ResultsThe survey was completed by 1520 Canadian adults aged 18–75+ years, of which 52% were female. Fifty-two per cent of respondents stated that they would monitor an unrecognised spot on their genitals and only seek medical assistance if it did not go away. Only 43% said they would stop having sex until the spots were gone. Concerns of being judged by friends/family were high (44%). Regarding prevention, 32% of respondents believed that monogamy would protect against genital warts, and 25% believed they are not at risk if they use a condom. Treatment preference was in favour of a cream rather than an invasive treatment (58%), particularly among younger (67%) and male respondents (63%). Over 60% would worry that genital warts could not be resolved. Women were less likely to believe that genital warts could be cured (13% vs 23%), and more likely to believe that they would recur (46% vs 42%) see Abstract LBP-1.14 Figure 1.ConclusionAmong Canadians, genital warts were associated with a fair degree of social stigma and worries regarding their resolution, and future recurrences. Non-invasive treatment options were preferred.Abstract LBP-1.14 Figure 1
LBO-1.3 Syphilis infection and associated behaviours among transgender women, Chicago 2010
Authors: Gratzer B , Hotton A , Pineda M , Pohl D , Martinez L 
Published: July 2011

BackgroundTransgender women are an underserved and understudied population with unique medical and behavioural risk profiles. High rates of STIs and HIV in this population have been reported, although accurately quantifying STI rates and associated risks is difficult because of limitations in measurement of gender identity, lack of standardised reporting measures, and conflation between Men who Have Sex with Men (MSM) and transgender identities. In 2009 we reported a substantial increase in syphilis among transgender women at our clinic (from two cases in 4 years to ten cases in 1 year); in 2010 we identified 20 new cases, another substantial increase. We sought to describe morbidity and behavioural characteristics of these cases to better understand trends among this population.MethodsData were gathered using clinic-based sentinel surveillance systems and through abstraction of Interview Records completed upon DIS interview.ResultsTransgender women represented an increasing proportion of total syphilis cases identified from 2009 (3.7% or 10/269) to 2010 (6.4% or 20/313). The 20 cases identified in 2010 were among 19 transgender women; one client was re-infected. Of these, 2 (10%) were primary, 12 (60%) were secondary, 5 (25%) were early latent, and 1 (5%) was latent of unknown duration syphilis. The mean age increased slightly from 21.4 years (range 19–24) in 2009 to 24.9 years (range 19–41) in 2010. Reported race/ethnicity included: 13 (65%) non-Hispanic black, 3 (15%) Hispanic, 2 (10%) non-Hispanic white, 1 (5%) Asian/Pacific Islander and 1 (5%) American Indian/Alaskan Native. HIV co-infection was similar to rates observed in Men who Have Sex with Men (MSM) populations (60%); 25% of HIV-positive clients had been diagnosed in the prior year. Forty-five per cent had a history of STI (non-HIV). High rates of transient housing (30%), unemployment (55%), incarceration (25%), and transactional sex (40%) in the prior 12 months were reported. Median number of sex partners in the past year was 10 (range 0–60). No common sex partners were named during case investigation interviews during 2009 or 2010.ConclusionsIncreases in syphilis among transgender women in Chicago highlight a need for enhanced screening and targeted prevention messages for this population. High levels of risk and HIV co-infection reflect potential for ongoing transmission of both HIV and other STIs.
LBO-1.4 Increasing macrolide resistance inMycoplasma genitalium
Authors: Anagrius C , Loré B , Jensen J S 
Published: July 2011

BackgroundTo evaluate therapy outcome inM genitaliuminfection with standard chlamydia treatment doxycyclin 9 days and azithromycin 1 g stat compared to extended azithromycin 15 g for 5 days and to evaluate macrolide resistance.MethodsPatients attending the STD-clinic in Falun, Sweden between January 1998 and December 2005 with a positive PCR test forM genitaliumroutinely had a test of cure. Response was determined to doxycycline, azithromycin 1 g as a single dose and 15 g extended treatment primary and secondary when persistence after doxycycline. Macrolide resistance was monitored at base as well as after treatment in those testing positive after treatment with azithromycin. Macrolide resistance also was monitored yearly 2006–2010 in patients with newly detectedM genitaliuminfection.ResultsTotally 313/407 (77%) had a test of cure, 254/313 (81%) within 12 weeks. The eradication rate with doxycycline was 43% totally, 46% for women and 38% for men, with azithromycin 1 g 92% totally, 96% for women and 89% for men and with azithromycin extended dosage 96% totally, 100% for women and 93% for men. Confirmed macrolide resistance developed in 7/7 (100%) of those testing positive after azithromycin 1 g. In 2006–2007 we found no, in 2008 and 2009 1/year and in 2010 11 patients with macrolide resistance in newly detectedM genitalium.ConclusionsThese findings confirms the results from other studies that doxycycline is inefficient in eradicating infection withM genitalium. Although the treatment outcome with azithromycin 1 g was not significantly lower than with extended dosage for 5 days it was in this study associated with 100% induced macrolide resistance in those with treatment failure. A remarkable higher proportion of macrolide resistance in 2010 than earlier years was found. We will try to monitor yearly prescription of azithromycin 1 g in our county and all Sweden last years. Is there an increase explaining the higher proportion 2010? Azithromycine 1 g should be avoided as recommended therapy forM genitaliumas well as for chlamydia and non-gonococcal urethritis. Specific diagnostics forM genitaliumas well as monitoring of resistance is urgent.