bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1-S2.62 Factors associated with high-risk penetrative sex in a cohort of treatment experienced HIV-positive men who have sex with men (MSM) in British Columbia
Authors: Michelow W , Talany G , O'Brien N , Wang H , Forrest J , Palmer A , Montaner J S G , Hogg R 
Published: July 2011

BackgroundIn Canada, men who have sex with men (MSM) are disproportionately infected with HIV. Despite much evidence demonstrating the secondary preventive value of HAART, we have not fully capitalised on potential synergies between treatment and prevention. This study investigates high-risk sexual behaviour among treatment-experienced MSM in British Columbia, Canada.MethodsWe analysed data from the Longitudinal Investigations into Supportive and Ancillary Health Services (LISA) project on MSM (gay, bisexual, or reported sex with men in the 6 months prior to interview). High-risk sexual behaviour was penetrative anal or vaginal sex in the 6 months prior to interview with less than 100% condom use. Multivariate logistic regression was used to identify factors associated with high-risk penetrative sex.ResultsOf 346 HIV-positive MSM, median age was 46 years, 268 (78%) were currently on HAART, with 185 (54%) having ≥350 CD4 cells/μl. Ninety-eight (28%) participants endorsed seeking out HIV-positive partners for sex, and 147 (43%) reported being less likely to use a condom with an HIV-positive partner. In the regression model, HIV-positive MSM with a CD4 count ≥350 cells/μl were more likely to report unprotected penetrative sex (Adjusted OR [AOR] =2.7; 95% CI 1.5 to 5.2), more likely to not use condoms with their HIV-positive partners (AOR=12.0; 95% CI:6.4 to 22.3), and less likely to report sex with anonymous partners in the past 6 months (AOR=0.28; 95% CI 0.1 to 0.8). No significant associations were found between high-risk penetrative sex and current HAART use, viral suppression, or treatment adherence.ConclusionHIV-positive MSM who report engaging in high-risk penetrative sex are more likely to be healthier (higher CD4 counts), to have unprotected sex with other HIV-positive partners (serosorting) and with known rather than anonymous sex partners. Despite healthier MSM reporting more high-risk sex, results suggest this risk-taking is discriminate and would not necessarily lead to more onward HIV transmission.
P1-S2.64 Demographic characteristics and HIV risk behaviours among men who have sex with men in Guatemala City, Guatemala, 2010
Authors: Alvarez B , Miller W , Hernandez F M , Alvarado A , Morales S , Paz-Bailey G 
Published: July 2011

BackgroundIn Central America, surveillance of HIV has been strengthened by regular and systematic collection of HIV, sexually transmitted infection, and behavioural data among most at risk populations. In Guatemala, men who have sex with men (MSM) are a highly vulnerable to HIV infection. Behavioural data are needed to help plan for prevention interventions in this group.MethodsMale residents of Guatemala City at least 18 years of age who self-reported having had anal sex with another man in the past 12 months were invited to participate in a face-to-face structured behavioural survey using respondent-driven-sampling (RDS) from September to December 2010. Participants who provided informed consent were administered a questionnaire that collected information on socio-demographics, risk behaviour, knowledge and attitudes, access to services, and stigma and discrimination, using personal digital assistants (PDA). Medians and IQRs were calculated for continuous variables. Population proportions were calculated for categorical variables and adjusted for RDS-sampling weights using Respondent Driven Sampling Analysis Tool version 6.0.ResultsA total of 500 MSM enrolled in the study. Respondents self-identified as gay or homosexual (39.5%), bisexual (39.5%), heterosexual (11.5%), and transvestite or transgender (9.5%). Median age was 26 years (IQR 22−34 years). The majority of respondents (79.5%) reported to have access to free condoms in the past 12 months. Consistent condom use with all male partners in last 12 months and during last sex was reported by 62.2% and 75.4%, respectively. Overall, 44.3% reported having sex with a woman in the past 12 months. Consistent condom use with female sexual partners in the last 12 months and during last sex was reported by 46.1% and 66.0%, respectively. The median number of female sexual partners reported in the last 12 months was 3 (IQR: 2−5). Ever paying for sex and paying for sex in the last 12 months was reported by 16.0% and 8.3%, respectively; while 54.0% and 44.7% reported ever selling sex and in the last 12 months, respectively. Injection drug use in the last 12 months was reported by 0.8%. Overall, 73.3% of respondents reported ever having an HIV test and 43.1% had been tested in the past 12 months.ConclusionsMSM in Guatemala engage in high risk behaviours that place them and their male and female partners at high risk for HIV infection. Innovative strategies are needed to promote condom use and access to HIV testing and counselling.
P1-S2.67 Prevalence ofChlamydia trachomatisandNeisseria gonorrhoeaeamong college students who attended the Johns Hopkins University Health and Wellness Center from 2009 to 2010
Authors: Quinn N , Agreda P , Joffe A , Gaydos C 
Published: July 2011

BackgroundThe Centers for Disease Control and Prevention (CDC) recommends that sexually active women 25 years or younger be tested yearly forChlamydia trachomatis. An ongoing screening program among college students attending a university gave students the opportunity to be screened forC trachomatis(CT) andNeisseria gonorrhoeae(GC).MethodsMale and female college students attending Johns Hopkins University were offered screening for chlamydia and gonorrhoea by the Health and Wellness Center. From February 2009 to December 2010, 1114 male urines and female vaginal specimens were submitted to the STD Research Laboratory for CT and GC screening using the Gen-Probe Aptima Combo2 assay. Results were returned to the Johns Hopkins University Student Health and Wellness Center which treated the infected students. 10 students were also tested forTrichomonas vaginalis(TV) with Gen-Probe ATV Analyte Specific Reagent assay (ASR).ResultsAs of 31 December 2010, there were 284 (25.5%) males and 830 (75%) females tested, between the ages 17−48 yr. 810 (72.7%) were White, 76 (6.8%), Black, 146 (13.1%). Asian/Pacific Islander, 5 (0.44%) were American Indian, and Other/unknown 78 (7.0%). 71 (6.4%) students were Hispanic and 120 (10.8%) indicated they were symptomatic. The overall prevalence of CT and GC was 1.6% (18/1114) and 0.2% (2/1114), respectively. All TV results were negative. 8/284 (2.8%) males and 10/830 (1.2%) females were CT positive. 5/18(27.8%) were symptomatic (3 females, 2 males) and 7/8 were between 18 and 29 yrs of age (there was one 34 yr. old Black male). Among the 18 CT positive students, 13 were White, 1 Black, 2 Asian/Pacific Islander, 2 were other/unknown; 4 were Hispanic and 14 non-Hispanic. Both GC positive female students were asymptomatic; one was 19, and one was 25 yrs old. Both were non-Hispanic with one being Asian and one White.ConclusionsThis ongoing screening program of male and female students from the Johns Hopkins University Student Health and Wellness Center demonstrated a low prevalence of CT and GC among students, attending the Center. Targeted, innovative screening programs may improve outreach to populations with higher prevalences.
P1-S2.68 Targeted interventions for remote Australians; trends in chlamydia and gonorrhoea notifications in aboriginal and non-indigenous Australians 2005−2009
Authors: Graham S 
Published: July 2011

BackgroundHigher rates of chlamydia and gonorrhoea notifications have been reported in Aboriginal and Torres Strait Islander than non-Indigenous people in Australia since the early 1990s.MethodsChlamydia and gonorrhoea notification data from the National Notifiable Disease Surveillance System were analysed by age, sex, remoteness and Aboriginal status in jurisdictions where complete data were available. Population rates and χ2test for trend were calculated using STATA version 10.ResultsIn the study period, there were 14 000 (1303 per 100 000) chlamydia notifications in Aboriginal people and 111 947 (242 per 100 000) in non-Indigenous people. In both populations the highest rates were in females aged 15−19, with Aboriginal females reporting a rate four times that of the non-Indigenous females. There was a significant increasing trend in the chlamydia notification rate in Aboriginal people over the 5 years (10%, p-trend p<0.001) and also in non-Indigenous people (59% p-trend p<0.001). Over the 5 years there were 17 336 (964 per 100 000) gonorrhoea notifications in Aboriginal people compared to 14 771 (22 per 100 000) in non-Indigenous people. The highest notification rates were in Aboriginal people aged 15−19 years who lived in very remote areas while in non-Indigenous people the highest notification rates were in males aged 30−39 years. Gonorrhoea notification rates in Aboriginal people over the 5 years decreased over the time period (18%, p-trend p<0.001), but there was no significant trend in non-Indigenous people (19% p-trend p=0.667). Although the rate of gonorrhoea decreased in Aboriginal people the rate was 26 times greater than the rate in non-Indigenous people. The female to male ratio for gonorrhoea of 1.1:1 in Aboriginal people suggests mainly heterosexual transmission, while in non-Indigenous people the female to male ratio was 0.29:1 suggesting predominantly homosexual transmission. The reported rates of gonorrhoea in Aboriginal people resident in very remote areas were 19 times Aboriginal people resident in urban areas.ConclusionChlamydia is a generalised epidemic among both Aboriginal and non-Indigenous peoples. In contrast gonorrhoea is predominantly a disease of Aboriginal people in remote areas and urban gay men. We are undertaking a range of trials in quality improvement interventions with Aboriginal communities to address the continued higher burden of STIs notified among Indigenous people in Australia.
P1-S2.69 Prevalence of HPV infections in Metis and First Nations living in Manitoba, Canada
Authors: Demers A , Shearer B , Totten S , Fang L , Severini A , Kliewer E , Mao Y , Wong T , Jayaraman G 
Published: July 2011

BackgroundInformation on human papillomavirus (HPV) prevalence among Aboriginal populations (First Nations, Métis, Inuit) in Canada remains scarce but is needed for informed public health programming. This need is reinforced by the rapidly changing rates of cervical cancer screening in these populations and the introduction of prophylactic vaccines.MethodIn 2008, 52 clinics across the province of Manitoba, Canada participated in a Pap Week initiative during which left over tissues from conventional Pap tests were used for HPV typing using the Luminex method (developed by the National Microbiology Laboratory). A risk-behaviour survey was also administered to consenting women. Chi-square was used to compare frequencies and logistic regression was used to model the data. The most significant factors were included in the multivariate logistic model.ResultsOf 592 women recruited, 113 self-reported being Meti or First Nations (M/FN); 70 did not report their ethnic background and were excluded from the analysis. M/FN participants were younger than the non-M/FN participants (mean age: 39 vs 45, p<0.0001). HPV infection prevalence was 2.3 times higher in M/FN than in other participants (32.7% vs 14.2%, p<0.0001). This increase was mainly due to the higher prevalence of HPV 32, 35, 51, 58, and 62. The prevalence of HPV 16 and 18 in the M/FN population was comparable to that of the non-M/FN (p=0.64), although HPV 18 slightly higher in M/FN (5.6% vs 3.8%). Compared to their non-Aboriginal counterparts, M/FN women participating in the study were more often smokers (p<0.0001), had a higher number of sexual partners in the last year (p=0.0004), and were more often in an unstable relationship (p=0.03). The strongest predictors for HPV infection in the study population were the number of sexual partners over the last year (OR 5.71; 95% CI 3.08 to 10.58) and having reported a M/FN identity (OR 2.17; 95% CI 1.28 to 3.69).ConclusionCertain types of HPV may be more prevalent in M/FN than in the non-Aboriginal population. Although it is clear that the HPV vaccine has the potential to lower the prevalence of HPV 6, 11, 16, and 18 infections and related diseases in the M/FN population living in Manitoba, its impact could be mitigated by the relatively high prevalence of other HPV types.
P1-S2.70 The detection and management of pelvic inflammatory disease in aboriginal women in Central Australia: challenges of a remote high prevalence setting
Authors: Silver B , Knox J , Smith K , Ward J , Boyle J , Guy R , Kaldor J , Rumbold A 
Published: July 2011

BackgroundIn many remote Aboriginal communities in Australia, the prevalence of gonorrhoea and chlamydia is very high. Client mobility, frequent staff turnover and delays in laboratory results hamper timely treatment. Untreated gonorrhoea and chlamydia can lead to pelvic inflammatory disease (PID). In Central Australia, current remote health guidelines recommend three levels of criteria for diagnosing PID in women with lower abdominal pain: (1) cervical excitation or adnexal tenderness or uterine tenderness; or (2) in the absence of a bimanual examination, vaginal discharge; or (3) in the absence of vaginal discharge in women aged <35 years, intermenstrual bleeding or dyspareunia or a history of STI or PID in the past 12 months. We review adherence to these guidelines in remote primary healthcare centres.MethodsWe conducted a review of medical records of Aboriginal women aged 14−34 years attending five primary healthcare centres in areas with high STI prevalence. Any clinical presentation during 2007−2008 with documented lower abdominal pain after the exclusion of other causes was included. We ascertained if the recommended investigations, diagnosis and treatment were documented, according to the guidelines.ResultsOf the 741 medical records reviewed, there were 224 presentations with lower abdominal pain in 119 women (16%). Of these, a bimanual examination was undertaken in 15 presentations and either cervical excitation, adnexal or uterine tenderness was recorded in eight (Level 1). History taking for vaginal discharge was documented in 59 presentations (26%), and vaginal discharge recorded in 16 (Level 2). History taking for intermenstrual bleeding or dyspareunia was documented in 27 (12%) and 17 (8%) presentations, respectively and recorded in 10 and 3 presentations, respectively (Level 3). From the available records, at least 78 presentations had evidence of a positive STI or PID in the previous year (Level 3). Overall, a PID diagnosis was documented by the remote practitioner in 35 (16%) of the 224 presentations and none had the recommended treatment regime documented.ConclusionThese results show that most Aboriginal women in remote Central Australia presenting with lower abdominal pain are having inadequate investigations for PID. When a PID diagnosis is made treatment is often inappropriate. Efforts are currently being made to develop electronic diagnosis and management pathways to improve adherence to clinical guidelines.
P1-S2.71 Sexually transmitted infections in Mexico-City's penitentiary centers: the Ponte a Prueba: put yourself to the test “study”
Authors: Bautista S , Fernández-Cerdeño A , Juárez-Figueroa L , González-Rodríguez A , Sierra J , Volkow P 
Published: July 2011

BackgroundSocial and behavioural risk factors, as well as the conditions within penitentiary centers, place incarcerated people at high risk for infectious diseases. Few data exist for penitentiary health in Latin America and even fewer outside the context of small sample size studies, usually focused on a single one disease or infection. Our study aimed to probe Mexico City's inmates' health status and relevant, associated Behaviours with focus on HIV and other sexually transmitted infections (STI).MethodsA cross-sectional health survey was implemented in three penitentiary centers for male and two for female detainees, between May and September 2010. All inmates were offered voluntary HIV, Hepatitis C (HCV), Hepatitis B (HBV) and Syphilis tests, along with screening for metabolic disorders. Informed consent and usable blood samples were obtained from 78% of males (15 835/20 688) and 92% of females (1757/ 1914). A random sample of participants answered a risk-factor questionnaire. The institutional review board (IRB) at Mexico's National Institute of Public Health approved study methods. Data analysis was performed using SPSS 16.ResultsHIV prevalence was 0.7%, irregardless of sex. For HCV, we found 3.3% and 2.7% for men and women, respectively. HBV antibodies were found in 3.0% of men (of which 5% had positive surface antigen (sAg+)) and 3.2% of women (of which 9% of had sAg+). Of men, 3.6% had antitreponemic antibodies for syphilis (half of these were untreated). Among women 8.8% ever had syphilis, just over a third of these (36%) untreated. Lifetime marijuana use was 48.7% and 29.6% for men and women, respectively; 38.44% and 27.4% ever used cocaine; 5.2% and 3.5% ever injected drugs; 2.2 and 1.1 ever used heroine; 32.9% of men and 25.7% of women reported sex in prison, 75% of both genders declared unprotected last coitus.ConclusionDespite the challenges in penitentiary centers of middle-income countries, ethical testing for HIV and STIs proved feasible and acceptable. All diagnosed individuals are now receiving the follow-up or treatment they need. HIV and other STI rates were low compared with prisons in other countries but higher than the general population in Mexico. Our study provides baseline data which can be used to design and evaluate prevention strategies within the prison system.
P1-S3.05 Attributable proportion of tubal factor infertility caused by chlamydia: an estimate based on serological evidence adjusted for test resolution
Authors: Price M , Ades A E , Macleod J , Horner P 
Published: July 2011

BackgroundMany published studies compare the prevalence ofChlamydia trachomatis(CT) antibody in women with Tubal Factor Infertility (TFI) and a control group. In principle these studies can be used to estimate the attributable fraction of TFI caused by CT, however it is necessary to account for the sensitivity and specificity of the antibody tests employed.MethodsWe use sensitivity and specificity estimates from a discrepancy analysis by Morre (2002), and a study by Wills (2009) in which specificity of antibody test results was assessed in children, to derive estimates of the resolving power of three peptide-based assays and MIF; this is a reflection of the difference between sensitivity and false positive rates. Based on studies of antibody levels in different settings we adopt a model which assumes that antibody levels in women whose TFI is caused by CT are higher than levels in control women or those whose TFI has other causes. Applying this model to the data from Land (2003) we find strong support for the hypothesis of higher antibody levels in CT-related TFI, and for the estimates of test resolution from earlier studies. Using a range of assumptions about cumulative incidence of CT in the control group we were able to derive a range of estimates for the proportion of TFI cases caused by CT.ResultsOur results suggest that the sensitivity of antibody tests in women whose TFI was caused by CT is higher than in women who have previously had CT but whose TFI was due to another cause and control women. Based on our estimates of the resolving power of the tests from the Morre (2002) and Wills (2009) studies we estimate the proportion of TFI episodes that are due to Chlamydia to be between 20% and 45%. Conclusions By adjusting for the sensitivity and specificity of tests it is possible to derive a quantitative estimate of the causal rate of CT in TFI. Taken together with other findings our results suggests that detailed studies of antibody levels can be used to shed further light on the causal rate of CT.
P1-S4.06 What impact does missing Quebec data have on national HIV surveillance data?
Authors: Tomas K L , Bitera R , Alary M , Fauvel M , Parent R , Sylvain D , Hastie M , Claessens C , Halverson J , Archibald C 
Published: July 2011

ObjectiveTo quantify the difference in the exposure category breakdowns of national HIV surveillance figures if exposure data from the Institut nationale de Santé Publique du Québec (INSPQ) were included in national datasets.BackgroundNational HIV/AIDS surveillance is coordinated by the Public Health Agency of Canada's (PHAC) Surveillance and Risk Assessment Division's (SRAD). HIV is reportable in all provinces and territories, although the degree of epidemiologic information collected and submitted varies. Quebec's case reports to PHAC come from their laboratory-based surveillance system, which contains positive test reports, by age and sex. All Quebec cases are classified in SRAD's dataset as Not Reported, which contributes to the large proportion of cases at the national level with no known exposure category.MethodsQuebec's provincial HIV surveillance system “Programme de surveillance de l'infection par le VIH au Québec” collects further epidemiological information, including exposure category and risk factor information, although recorded separately from the HIV laboratory test results file. This provincial system's exposure category data was added to existing national surveillance data, and the exposure category breakdowns recalculated, in order to assess change in the proportion of unknown/not reported cases and to quantify the resulting difference in exposure category breakdowns at the national level.ResultsWith inclusion of Quebec data for 2009, there is a 50% decrease (from 45.5% to 23.1%) in the proportion of national HIV cases with unknown exposure category. There are also differences in the overall national exposure category breakdowns. For 2009, proportional increases were observed in the men who have sex with men (MSM) and heterosexual-endemic categories (5.4% and 2.8% respectively), while proportional decreases were observed in the exposure categories of injection drug use (−4.1%), heterosexual-risk (−2.0%), and no-identified-risk heterosexual (−2.2%).ConclusionsInclusion of Quebec's risk exposure data in the national HIV dataset is significant; the national dataset becomes more complete and the proportion of cases with unknown exposure category is reduced. This analysis demonstrates that inclusion of exposure category data, from the provincial HIV surveillance system of Quebec's INSPQ can alter the exposure category breakdowns at the national level, thereby offering a more accurate picture of HIV diagnoses in Canada.