Increases in the rates of sexually transmitted infections (STIs) suggest that control programmes may not be effectively targeting diverse subpopulations. The objective of this investigation was to examine STI transmission within different groups, using both social network analysis and cluster analysis. Routine partner notification data were analysed from individuals diagnosed with, or exposed to an STI in Manitoba. Groups were identified and characterized. Three different clusters of groups were identified, comprised of demographically and clinically distinct individuals. A greater understanding of disease transmission patterns within these groups will aid in the development of targeted education and prevention programmes for all STIs.
We evaluated the influence of the partner's human papillomavirus (HPV) status and sexual practices on prevalent HPV infection among new couples to study HPV transmission.
Women attending university or college in Montreal, Canada, and their male partners (N = 263 couples) were enrolled in 2005-2008. HPV typing was done in self-collected vaginal swabs and clinician-collected penis and scrotum swabs. The outcome measures were overall and type-specific HPV prevalence.
HPV was detected in 56% of women and men. Prevalence was higher among persons with infected partners (85%) than in those whose partners were negative (19%). Type-specific detection was substantially higher among women (OR = 55.2, 95% CI: 38.0-80.1) and men (OR = 58.7, 95% CI: 39.8-86.3) if their partner harbored the type under consideration. Prevalence among women and men with 10 or more lifetime partners was 15.4 (95% CI: 5.9-40.2) and 9.5 (95% CI: 4.4-19.8) times higher than among those with 1 partner. Frequent condom use was protective in men, particularly if his partner was HPV-infected (OR = 0.64, 95% CI: 0.50-0.82). This effect was attenuated among women with an infected partner (OR = 0.88, 95% CI: 0.69-1.11).
The current partner's status was the most important risk factor for prevalent HPV infection. Condoms exerted a stronger protective effect among men than among women.
Since sexually transmitted diseases (STDs) are a serious health problem among youth, proper understanding of knowledge about STDs, beliefs about condom use and associated factors are public health necessities. A self-administered questionnaire was sent to 2,920 randomly selected students and was returned by 59.3% of the sample. We observed a lack of knowledge in one third of students, negative beliefs on condom use for at least 20% of students and a low perceived risk to contract STDs. With multivariate analyses, we observed that male students, youths between 18-21 years of age and those who didn't have any sexual partner since their admission to the university should be the target of intervention programs.
Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Department of Obstetrics and Gynaecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
The objective was to describe the prevalence of sexually transmitted infections (STI) and blood-borne viruses (BBV), and prophylactic treatment offered to female postpubertal patients attending a Norwegian Sexual Assault Centre (SAC). We wanted to evaluate whether STIs diagnosed at the initial visit could have been assault-transmitted, and to explore whether background and assault characteristics were associated with diagnosed STI/BBV.
We included postpubertal females =12 years of age attending the SAC within 1 week of the assault. Data were collected from records. We conducted a retrospective, descriptive study, and used logistic regression analysis.
Among 412 patients with a median age of 21 years, 35 patients had an STI (8.5%), two of which probably were assault-transmitted. Chlamydia trachomatis was the dominating agent, detected in 25 patients (6.4%). At serology screening, 3.7% tested positive for hepatitis C and/or hepatitis B core antibody. Patient age 16-19 years was associated with STI, while BBV positives were older. Non-Western assailant was associated with STI, while substance abuse was associated with STI and BBV. In order to prevent potential transmission of STI not identified at the initial visit, 91% accepted prophylaxis against bacterial STI, while antiviral prophylaxis was offered to less than one-fifth of the patients.
The C trachomatis prevalence among the sexual assault patients was lower than in a comparable clinical population. The STI was suspected to be assault-transmitted in only two cases.
Center for Statistics and the Social Sciences, and Center for AIDS and Sexually Transmitted Diseases, University of Washington, Seattle, Washington 98195, USA. jameshj@stat.washington.edu
Source
Nature. 2003 Jun 5;423(6940):605-6; discussion 606
With the first report of an HIV-positive Inuit in 1985 Greenland was considered a high risk area for a self-sustained heterosexual HIV-epidemic, due to high incidences of sexually transmitted diseases. In 1986 a national HIV-intervention programme began with two major aims: Firstly, improved STD treatment and incitation to change of sexual high-risk behaviour, secondly, close monitoring of HIV-antibody test activity, partner notification and repeated surveys of knowledge and sexual behaviour in selected populations. Very early the spread of HIV in Greenland became heterosexually transmitted and self-sustained, with repeated local small-scale epidemics in a subpopulation characterized by frequent STD's, alcoholism, lack of education and vulnerable social and economic resources. From 1994 to 1997 a marked increase in new cases was reported, and in November 1997 the total number was 76 HIV-positives in the Greenlandic population of 50,000 Inuits. The successful defeat of STD's, such as gonorrhoea and syphilis has not been followed by a change in sexual behaviour among the youth in Greenland. High incidences of genital chlamydial infections, early sexual debut and high frequencies of excessive promiscuity render Greenland an alarming potential for a future HIV-epidemic. This threat calls for an intensified national prevention programme, with close monitoring of the known HIV-positives and the potentially infected persons in the population at risk, and new campaigns to reduce high-risk sexual behaviour among the youth.