bluuebunny/crossref_metadata_2025_split huggingface dataset:
P5-S5.05 Partner notification uptake for sexually transmitted infections in China: a systematic review
Authors: Wang A , Peng R , Tucker J , Chen X S , Cohen M 
Published: July 2011

BackgroundChina's sexually transmitted HIV and resurgent syphilis epidemics require comprehensive control programs. Partner services are traditional pillars of sexually transmitted infection (STI) control but have not been widely implemented in China. This systematic review of English and Chinese literature examined the feasibility and uptake of partner notification (PN) in China.MethodsFour English language and four Chinese language databases were searched from 1980 to 2010 to identify original articles on partner services in China. A systematic review was performed to assess: (1) willingness to notify via patient, provider, or contract notification; and (2) PN uptake, defined as the number of partners successfully notified, evaluated, and treated per index case. Approaches to partner services in China, perceived barriers, and implementation consequences were also abstracted. χ2tests were used to compare the proportions of index patients willing to notify partners using different PN methods.ResultsA total of 441 citations were identified, and 17 studies (3 English and 14 Chinese), published between 1997 and 2010, examined PN willingness and uptake. All three types of PN--patient, provider, and contract--were assessed. Overall willingness to notify was 67% (SD±25.0) in nine studies (n=2145). Six studies (n=1380 index cases) reported median STI PN uptakes of: 0.9 (IQR 0.5–1.2) notified, 0.7 (IQR 0.4–0.9) evaluated, and 0.3 (IQR 0.2–0.3) new infections detected. Partner services counselling was shown to reduce reinfection rates, and no adverse events were reported. Perceived patient barriers included social stigma, fear of relationship breakdown, right to confidentiality, and lack of partner contact information. Perceived infrastructure barriers included lack of available patient education, limited resources and trained staff, mistrust between patients and health providers, and lack of partner services regulations. All studies were in heterosexual populations; none examined partner services in men who have sex with men (MSM).ConclusionsAlthough STI PN is not widespread in China, these limited studies suggest that more structured pilot programs could be feasible. More research on STI partner services, particularly among MSM and other high-risk groups, is an important public health priority.
P5-S6.02 Sexual education and citizenship construction: Colombia (2006–2008). What does this mean?
Authors: Estrada-Montoya J H 
Published: July 2011

BackgroundCurrent Sexual education program in country wide Colombia has been analysed. Conceptual frame of pedagogical approaches used in the program was analysed as well. Other issues including context, background, gender and social class were the main aspects evaluated.MethodsQualitative research methods were performed for this pedagogical evaluation. Four phases were developed during the evaluation: Data collection (documentary analysis of official documents and 40 in-depth interviews with teachers and government employees) information organisation, analyse/critical evaluation and result dissemination.ResultsThe results show that Program's main approach is competence-based education. Results of this research suggest that program intends to arrange and to conduct people's sexual life. Values underling program's approach are those of a society looking for order, stability and individual freedom. Narrow analyses of sex-gender duality predominate such as: permanent monogamy, mandatory heterosexuality and marriage keeping an eye on different options for sexual practice. Sexuality presented in the program reflects the moral values of the prevailing group. Current implemented program is clearly the expression of the Colombian government ideological perspective leaded by the elites. Controlling and oppressive approaches for the vast majority were identified as being an important axis of evaluated program.ConclusionsNew citizenship construction in a Latin American country implies abandon of existing racial, sexual, and class-based educational approaches. This requires the implementation of a wide approach underlying elimination of ideological and material conditions driving to different forms of oppression, subjugation or marginalisation. Design of educational programs must consider historical, social, economic and politic context in which people live. States should be able to guaranty human rights.
P1-S1.56 The incidence ofMycoplasma genitaliumin a cohort of young Australian women
Authors: Walker J , Fairley C , Bradshaw C , Tabrizi S , Chen M , Twin J , Taylor N , Donovan B , Kaldor J , Hocking J 
Published: July 2011

BackgroundMycoplasma genitalium(Mg) is an emerging sexually transmitted infection that has been associated with serious upper genital tract infections in women such as cervicitis, pelvic inflammatory disease and endometritis. The burden of disease for Mg in Australia is unknown as there are no current population prevalence or incidence data.MethodsWomen aged 16–25 years were recruited from sexual health clinics (SHC) and general practice clinics (GP) in South-Eastern Australia and consented to participate in a 12-month study providing vaginal swabs through the mail. Women were tested at 6-monthly intervals for chlamydia and Mg.ResultsOverall, 1116 women were recruited from 29 clinics; with 79% of women retained at the conclusion of the study. The prevalence of Mg at recruitment was 2.4% (95% CI 1.5 to 3.3). Increased numbers of sexual partners was strongly associated with Mg (adjusted OR [AOR]=2.2; 95% CI 1.0 to 4.6), as was being recruited from SHC (AOR=3.4; 95% CI 1.5 to 5.3). Mg incidence was 1.2 per 100 women years (95% CI 0.7 to 2.1) and was associated with women recruited from SHC (HR=4.9; 95% CI 1.5 to 16.3) and having increased numbers of new sexual partners (HR=5.7; 95% CI 1.4 to 23.1). We found a median organism load of 1.4×103/5?L, which was 100 times less than that found in chlamydia positive samples. We also found an azithromycin failure rate of 15% (95% CI 3.2 to 37.9).ConclusionMg is common in young Australian women, and consistent with international studies, Mg was less prevalent than chlamydia.
P5-S6.04 HIV testing of homosexual men: clinicians as part of the testing equation
Authors: Chen M , Petlo T , Fairley C , Whitton B 
Published: July 2011

IntroductionHigh HIV testing coverage of men who have sex with men (MSM) attending clinical services has been advocated to improve early HIV detection. The proportion of MSM tested has been used as a measure of service quality. The aim of this study was to determine HIV testing rates and predictors of testing among MSM attending a sexual health service, including the impact of the treating clinician.MethodsHIV testing rates among MSM attending the Melbourne Sexual Health Centre between 2003 and 2009 for the first time were calculated for individual treating clinicians. Factors independently associated with HIV testing were determined by logistic regression. Medical records were audited to ascertain the reasons why HIV tests were not performed.ResultsOverall, 78% of 4425 men were tested for HIV. Men reported a median of six male partners in the prior year with 51% reporting unprotected anal sex. Seventy six per cent of men reported a previous HIV test, performed a median of 12 months prior to their visit. HIV testing rates were higher for nurses (median 89%; range 77–95%) than doctors (median 73%; range 45–88%) with significant differences between doctors but not nurses (p<0.001). Men were less likely to be tested if they presented with symptoms of an STI (AOR 2.7, p<0.001) and if they saw a doctor vs a nurse (AOR 1.9, p<0.001) independent of recent sexual risk and duration since their last HIV test. Reasons for not testing included patient decline (28%) and recent testing (15%); however, no reason was documented in 39%.ConclusionsWhile overall HIV testing rates were high, substantial differences in testing rates between clinicians were evident. Strategies geared at optimising HIV testing need to take into account the frequency with which clinicians offer testing.
P5-S6.06 Utilisation and cost of diagnostic methods for STD screening among insured American Youth, 2008
Authors: Owusu-Edusei K , Nguyen H , Gift T 
Published: July 2011

BackgroundInformation on the private sector utilisation and cost of sexually transmitted disease (STD) screening and diagnostic testing in the USA is limited. We present STD diagnostic method-specific utilisation and cost estimates for persons aged 15–25 years.MethodsWe used current procedural terminology (CPT) (or diagnostic methods) codes for seven major STDs (human papillomavirus (HPV), genital herpes simplex virus type 2 (HSV-2), hepatitis B virus (HBV), chlamydia (CT), gonorrhoea (GC), trichomoniasis (TV) and syphilis) to identify outpatient claims for persons aged 15–25 years in the MarketScan database for 2008, excluding codes for procedures that could be used to identify claims for non-STD-related tests. Utilisation was measured as the number of claims per 100 000 enrollees (ie, claims rate). We estimated CPT code-specific claims rates for each STD and average costs stratified by gender. Finally, we estimated the overall total cost of STD testing.ResultsWe found 24 CPT codes for HPV; 2 for HSV-2; 11 for HBV; 9 for CT; 4 for GC; 2 for TV; and 5 for syphilis. The claims rate (all diagnostic methods included) for HPV was the highest (17 239/100 000, significantly higher (p<0.01) than all the STDs), while the claims rate (all testing methods included) for TV was the lowest (507/100 000, significantly lower (p<0.01) than all the STDs). Claims rates (for all STDs combined) for females were significantly (p<0.01) higher than for males for all the STDs. Estimated average costs (for diagnostic methods) were: HPV ($35), HSV-2 ($24), HBV ($32), CT ($46), GC ($45), TV ($30), and syphilis ($29). Average costs did not differ significantly between males and females. The estimated total cost of screening for all seven STDs was $90 million for the insured population aged 15–25 years.ConclusionsThe claims data provide an estimate of STD testing patterns among privately-insured persons. These can be compared to surveillance data and guidelines to assess testing vs disease prevalence and recommendations. The low utilisation rates we assessed for TV are likely attributable, at least in part, to our exclusion of claims that could be related to non-STD-related tests (such as wet mount). The low utilisation rates might also reflect the lack of attention to TV in STD prevention that has been reported in the literature.
P5-S6.08 STD surveillance and control: do STD and family planning clinics matter?
Authors: Doshi S , Owusu-Edusei K 
Published: July 2011

BackgroundInformation on the potential impact of the presence of an STD and/or family planning (FP) clinic on STD surveillance and control is scant. In the study, we examine the impact of STD and/or publicly funded Title V, X, and XX FP clinics on county-level surveillance and control of three reportable STDs (chlamydia (CT), gonorrhoea (GC) and primary and secondary syphilis (P&S)) in Texas during 2000 and 2007. Specifically, we examined the following two questions: (1) Are the counties with STD/FP clinics reporting relatively more cases of STDs? (2) Does having STD service(s) (the presence of an STD/FP clinic) in a county matter?MethodsWe used spatial regression to analyse the impact of STD/FP clinics on county-level STD morbidity using surveillance data on CT, GC, and P&S. the impact of STD/FP clinics on STD control was examined using a backward stepwise regression on the changes in incidence rates between 2000 and 2007. Dummy variables represented the presence of STD/FP clinic(s). Incidence rates were transformed into natural logs. County-level demographics for 2000 and 2007 were used as control variables.ResultsThe coefficients on the dummy variables representing the presence of STD/FP clinics were: 0.11 (95% CI 0.05 to 0.16, p<0.01) in 2000 and 0.07 (CI 0.02 to 0.12, p<0.01) in 2007 for CT; 0.13 (CI 0.05 to 0.20, p<0.01) in 2000 and 0.06 (CI −0.002 to 0.12, p<0.01) in 2007 for GC and 0.18 (CI 0.12 to 0.23, p<0.01) in 2000 for P&S (2007 was not significant). This implies that the transformed GC and CT rates in the counties with STD/FP clinics increased by at least 6% in 2000 and 2007, while P&S increased by 18% in 2000. The coefficient for the changes in rates between 2000 and 2007 were: −0.04 (CI 0.01 to −0.09, p<0.10) for CT; −0.08 (CI −0.02 to −0.14, p<0.01) for GC and −0.09 (CI −0.03 to −0.15, p<0.01) for P&S. Thus, the transformed incidence rates of GC and P&S reduced by 8% and 9%, respectively, between 2000 and 2007 for those counties that had at least one STD/FP clinic.ConclusionThe results from this ecological study are consistent with (but do not establish) a causal relationship between having an STD/FP clinic and improved surveillance and/or reduction in STDs at the county-level in Texas. However, the results suggest that STD/FP clinics play an important role in STD surveillance and control. Finer level analyses (such as census block or cities) may be able to establish a strong causal relationship.
P5-S6.12 Control of sexually transmitted infections (STI) in Guyana: plan to integrate into existing programmes
Authors: Scotland S , Singh S , Hernandez R , Springer D , LaFleur C , Boyle K , Singh A 
Published: July 2011

BackgroundOver the last decade, Guyana has developed and strengthened surveillance, prevention and care and treatment for HIV. These interventions have resulted in a decline in HIV prevalence in antenatal as well as most at risk populations (MARPs defined as female sex workers, men who have sex with men (MSM), in and out of school youth, military and police). For non-HIV STI, a structured programme did not exist prior to 2005. From 2007 to 2009, the reported cases of STI increased significantly. In addition to HIV, non HIV STI has been identified as a priority for prevention and control by the National AIDS Program Secretariat (NAPS), Guyana Ministry of Health (MOH).MethodsIn conjunction with the Pan American Health Organisation and other international and local stakeholders, NAPS/MOH worked with local and external consultants to develop a STI strategy. Consultation meetings were held in Guyana and relevant documents were reviewed.ResultsA STI strategy for 2011–2020 has been developed. The strategy outlines activities that will build on existing HIV, antenatal and visualisation under acetic acid (VIA) programmes. In addition, activities have been outlined to build on existing second generation HIV surveillance initiatives currently in place in MARPs. Strategies to ramp up the provision of care and treatment for STI in existing primary care settings have also been addressed. The strategy highlights activities under five priority areas: (1) Programme Management and Coordination, (2) Prevention, (3) Laboratory, (4) Care and Treatment and (5) Surveillance. Under each priority area, broad goals, guiding principles, specific objectives, performance milestones and activities have been developed. A Monitoring and Evaluation plan will be a key part of the document to monitor progress during the strategy. The strategy will coordinate the activities of international and local agencies including non governmental and faith based organisations as well as persons from MARPs.ConclusionsGuyana has developed a comprehensive 10-year plan for the prevention and control of non HIV sexually transmitted infections which will build on existing programmes for HIV, antenatal and VIA programmes.
P1-S1.57 Epidemiology ofMycoplasma genitaliumand Genital HIV-1 RNA - a Longitudinal Study among HIV-infected Zimbabwean women
Authors: Mavedzenge S N , Müller E E , Lewis D A , Chipato T , Morrison C , Weiss H A 
Published: July 2011

BackgroundMycoplasma genitalium(MG) is an emerging STI associated with reproductive tract syndromes in men and women, and with HIV in cross-sectional studies. MG is common in HIV-infected women, but there have been no longitudinal studies of MG and genital HIV RNA among HIV-infected women.MethodsThe study is nested in a cohort of 131 HIV-infected, ART-naïve Zimbabwean women aged 19–37 years. Real-time PCR was used to test for presence and quantity of MG DNA in 420 stored cervical samples (1–4 visits per woman). Genital and plasma HIV viral load, CD4 count and presence of other STI and reproductive tract infections were collected at each visit, together with clinical and behavioural data. Logistic and linear random-effects models were used to analyse i) factors associated with detection of MG, and ii) the association of detection and quantity of MG with detection and quantity of genital HIV RNA.ResultsMG was detected at 44/420 (10.5%) visits, with a median bacterial load of 1497 copies/ml (range <300–3 240 000 copies/ml). MG was twice as prevalent asN gonorrhoeae(5.0%) orC trachomatis(4.8%). Of the 33 women with MG detected at least once, six were infected at ≥2 consecutive visits, persisting for up to 43 weeks. In multivariable analyses, MG was independently associated with bacterial vaginosis (OR=2.24, 95% CI 1.03 to 4.85), HSV2 (OR=8.56, 95% CI 0.99 to 74.24) and younger age (OR=2.92, 95% CI 1.10 to 7.76). Cleaning inside the vagina was protective against MG infection (OR=0.33, 95% CI 0.15 to 0.71). Genital HIV RNA was detected at 237/397 (59.7%) visits, with a mean viral load of 5.14 log10 copies/ml. MG was independently associated with detection of genital HIV RNA (OR=2.73, 95% CI to 1.02–7.33) after adjusting for confounders including plasma viral load, CD4 count, HSV2, andN gonorrhoeae. Higher MG bacterial load was weakly associated with detection of genital HIV RNA (OR=1.75, 95% CI 0.96 to 3.19) but there was little association with quantity of HIV RNA.ConclusionsThis cohort study confirms previous cross-sectional results showing an association of genital HIV DNA detection with MG infection. Further research is needed to explore factors mediating this association, as MG was not associated with plasma viral load or measured markers of inflammation. The growing evidence for an association of MG with HIV genital shedding, and the high prevalence and persistence of MG infection, suggests that screening and treatment of MG may be warranted among HIV-positive women.
P5-S6.14 Qualitative assessment of facilitators and barriers to HPV vaccination among providers serving a high-risk community
Authors: Javanbakht M , Stahlman S , Walker S , Gottlieb S , Markowitz L , Liddon N , Plant A , Guerry S 
Published: July 2011

BackgroundMaximising HPV vaccine uptake among those at highest risk for cervical cancer is critical. We explored healthcare provider perspectives on factors influencing HPV vaccination among adolescent girls in a community with high cervical cancer rates.MethodsFrom March to May 2009, we conducted in-depth interviews with 21 physicians and other staff providing care to adolescent girls at two clinics in Los Angeles, CA, serving a predominantly Hispanic population with high cervical cancer rates. The semi-structured interviews explored HPV vaccination processes and potential barriers to vaccination.ResultsProviders overwhelmingly focused on parental beliefs as barriers to HPV vaccination, though noted other factors including the lack of school requirements and barriers related to serving a low-income, immigrant clientele. Perceived parental misconceptions acting as barriers included the belief that adolescents do not need vaccinations and that no-cost vaccine programs like Vaccines for Children are only available for younger children. Perceived parental concerns that the vaccine will promote sexual activity were prevalent, especially for parents of 11–12-year-old girls, which prompted providers to frame HPV vaccine as a “routine,” “cervical cancer” vaccine. However, providers felt mothers with experience with abnormal Pap tests and those with a supportive friend or relative were more likely to request HPV vaccine. Providers noted that for Hispanic parents the “preferred” source of information is peers; if the “right people” in the community were supportive of HPV vaccine, parents were more willing to vaccinate. Most providers noted that because HPV vaccine is not “required” for school, it was difficult to get eligible girls into clinic and to reinforce to parents the need for the vaccine. Other barriers included lack of immunisation records among immigrant parents and a difficult-to-reach, mobile clientele.ConclusionsProviders noted a number of barriers to HPV vaccination, including some perceived parental misconceptions that could be addressed with education about the need for adolescent vaccines and available free vaccine programs. Because community support appears particularly important to Hispanic parents, the use of promotoras—peer liaisons between health organisations and the community—may increase HPV vaccine uptake in this population. Future research should explore how well providers' perceptions align with parents' actual concerns.
P5-S6.16 Novel modular teaching of HIV patients in resource-limiting setting: effect of learning outcomes on adherence to highly active antiretroviral therapy (HAART)
Authors: Busari O , Busari O , Adeyemi A , Nakayima M 
Published: July 2011

BackgroundPatient education is a crucial aspect of antiretroviral treatment of HIV patients and plays a significant role in adherence to HAART, development of OIs, hospitalisation and mortality. Unfortunately, in most resource-poor setting, this is not often done, and when it is done, often casually.ObjectiveObjective was to compare a modular teaching method (MTM) with traditional patient education (TTM), and evaluate its effectiveness on adherence to HAART, development of OIs, hospitalisation and mortality.Methods420 HIV-positive patients on HAART, zidovudine, lamivudine and nevirapine, were recruited and randomly divided into subject and control groups. A pre-test and post-test time-series design was used to collect data using a 30-item knowledge and skills assessment schedule with items rated on a 5-point Linkert-type scale. The schedule was pre-tested on 50 patients with Cronbach's Score of 0.92 and a test-retest co-efficient of 0.89 at a 4-week interval. The MTM consist of 10 modules which address issues on adherence such as benefits of treatment, family and social support, adverse drug effects, psychological factors, substance abuse, patient-provider relationship, patient's self efficacy and effect of traditional/cultural values. MTM was used to educate subject group while the controls received the traditional teaching by nurses on the wards. Teaching was done throughout the period of hospitalisation. All the patients were followed for 8 months at 4-week intervals via outpatient clinic and home visits. χ2and t-tests were used; p<0.05 was considered significant.ResultsMean age was 28.7±6.9 years. Mean adherence rate for the subjects was 98.9±1.0% and for controls, 87.6±2.4% (p<0.001). Frequency of OIs per patient per month was lower in subjects than in controls (0.51 vs 1.31, p=0.002). Mean number of readmissions per patient per month during the 8-month follow-up was 0.18±0.01 for subjects and 0.89±0.02 for controls (p=0.0012). Subject group had shorter hospital stay (6.2±2.6 days vs 15.7±4.8 days, p=0.002) and lower mortality (p=0.008) than the controls.ConclusionMTM has significant effect on adherence to HAART, development of OIs, readmission rate, hospital stay and mortality. MTM is recommended as a core aspect of adherence counselling and antiretroviral treatment programme.