Epidemiology of HIV and sexually transmitted infections in Thailand

There are very few developing countries in the world where public policy has been effective in preventing the spread of HIV/AIDS on a national scale. Thailand is an exception, a massive program to control HIV has reduced visits to commercial sex workers by half, raised condom usage, decreased sexually transmitted infections dramatically, and achieved substantial reductions in new HIV infections. However, unless past efforts are sustained and new sources of infection are addressed, the striking achievements made in controlling the epidemic could be put at risk. There is a need in Thailand to continue strong HIV/AIDS prevention and education efforts in the future, as well as to provide treatment and care for those living with HIV/AIDS.     

Epidemiology of sexually transmitted infections in France

BACKGROUND: Sexually transmitted infections (STI) in France are reported on a voluntary basis through several sentinel surveillance systems. METHODS: To monitor STI, sentinel laboratory- or clinician-based surveillance systems were set up by the Institut de Veille Sanitaire: gonorrhea surveillance (Renago) in 1986, Chlamydia infections surveillance (Renachla) in 1989, and more recently, syphilis surveillance in 2000 and rectal lymphogranuloma venereum (LGV) in 2004. RESULTS: From 2000 to 2003, 1,089 syphilis infections were reported. Most of the cases were diagnosed in men having sex with men (MSM) and were mainly reported by STI clinics located in the Paris area. From 1997 to 2000, an increase of gonorrhea was observed each year. After two years of stable trend, the prevalence of gonorrhea increased again in 2003. From 2002 to 2004, 123 LGV cases were diagnosed in France and were observed only in MSM. Since 2001, Chlamydia infections have steadily increased, particularly in women. COMMENTS: Because STI surveillance is based on a voluntary basis, the number of reported cases is probably lower than the number of STI diagnosed in France. However, the data provided by the different surveillance systems reveals that STI have been increasing in France since 1997. Moreover, the resurgence of syphilis in 2000 and the emergence of rectal LGV in 2004 indicate that these STI occur mainly in MSM. Trends on incidence and patients characteristics observed in France are similar to those of several Europeans countries. European Public Health interventions are becoming necessary to prevent and control STI.     

Surveillance of sexually transmitted infections among persons living with HIV

Objectives  

Surveillance of sexually transmitted infections (STI) among HIV patients in AIDS Reference Centers aims at identifying risk groups and detecting specific STI emerging in this population.     

Contraception and sexually transmitted infections

This contribution considers links between different methods of contraception and the risk of acquiring sexually transmitted infections (STIs). This is a major public health issue, because STIs cause a huge disease burden that affects women disproportionately. Worldwide each year, there are 340 million new cases of curable STIs in 15-49-year-olds. In developing countries, STIs, even excluding HIV, are second only to maternal factors as causes of disease, death and life lost. There is particular concern about a putative link between hormonal contraception and STIs. However, the methodological problems facing investigation of a putative link are formidable. They include confounding between sexual behaviour and choice of contraceptive, choice of appropriate control group, and lack of precise measures of level of HIV/STI exposure and other risk factors. The current situation can be summarized as follows. The risk of acquiring HIV/STIs is substatially reduced by barrier methods of contraception. Hormonal contraception is a widely used, safe and highly effective method of preventing unintended pregnancy. Its relationship to HIV/STI transmission remains uncertain. In the absence of better evidence, current approaches to promoting hormonal contraception should continue. The importance and effectiveness of consistent condom use to protect against HIV/STI should be stressed, regardless of whether other contraceptive methods are being used. Future contraceptive research should focus on the dual goal of protection against HIV/STIs and unintended pregnancy.     

广西地区性病门诊人群HIV感染的流行病学研究

目的了解广西地区性病门诊人群中HIV感染状况及相关流行病学特点,为制定HIV防治措施和决策提供依据。方法对广西地区8个城市14个性病门诊符合条件的就诊者,由首诊医生进行问卷调查,然后静脉采血,采用ELISA法检测HIV抗体,初筛阳性者采用免疫印迹法进行确认。结果共有11 461名性病门诊患者符合条件并入组,133人被检测出HIV抗体阳性,感染率为1.2%;其中男性HIV感染率为1.4%,女性为1.0%;汉族人群HIV感染率为0.9%,壮族为2.7%。多因素Logistic分析发现,未婚(OR=1.73,95%CI:1.00~2.99,P=0.048)、受教育程度低(OR=4.21,95%CI:1.21~14.58,P=0.022)、娱乐行业人员(OR=3.98,95%CI:1.14~13.88,P=0.032)、有静脉吸毒行为(OR=25.09,95%CI:10.43~60.39,P=0.007)、最近性行为中未使用安全套(OR=4.97,95%CI:1.38~17.88,P=0.012)等因素,是性病门诊人群中感染HIV的危险因素。对不同地区之间的比较发现,柳江(OR=11.48,95%CI:2.05~64...     

Managing sexually transmitted infections in pregnant women

Sexually transmitted infections (STIs) constitute a major public health problem in the UK and may result in very costly complications. Many STIs pose the risk of a number of adverse pregnancy outcomes including miscarriage, still birth, preterm delivery, low birth weight and ophthalmia neonatorum. National guidelines for the management of STIs are produced and regularly revised by the British Association of Sexual Heath and HIV. This review outlines the latest recommended treatment options during pregnancy for the commonly encountered STIs.     

Effectiveness of condoms in preventing sexually transmitted infections

In June 2000, the United States National Institutes of Health (NIH) organized a review of the scientific evidence on the effectiveness of condoms in preventing sexually transmitted infections (STIs). The review concluded that condoms were effective in protecting against transmission of HIV to women and men and in reducing the risk of men becoming infected with gonorrhoea. Evidence for the effectiveness of condoms in preventing other STIs was considered to be insufficient. We review the findings of prospective studies published after June 2000 that evaluated the effectiveness of condoms in preventing STIs. We searched Medline for publications in English and included other articles, reports, and abstracts of which we were aware. These prospective studies, published since June 2000, show that condom use is associated with statistically significant protection of men and women against several other types of STIs, including chlamydial infection, gonorrhoea, herpes simplex virus type 2, and syphilis. Condoms may also be associated with protecting women against trichomoniasis. While no published prospective study has found protection against genital human papillomavirus (HPV) infection, two studies reported that condom use was associated with higher rates of regression of cervical intraepithelial neoplasia and clearance of cervical HPV infection in women and with regression of HPV-associated penile lesions in men. Research findings available since the NIH review add considerably to the evidence of the effectiveness of condoms against STIs. Although condoms are not 100% effective, partial protection can substantially reduce the spread of STIs within populations.     

Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm

Control of sexually transmitted infections (STIs) is feasible, leads to improved sexual and reproductive health and contributes to preventing HIV transmission. The most advanced HIV epidemics have developed under conditions of poor STI control, particularly where ulcerative STIs were prevalent. Several countries that have successfully controlled STIs have documented stabilization or reversal of their HIV epidemics.STI control is a public health outcome measured by reduced incidence and prevalence. The means to achieve this include: (i) targeting and outreach to populations at greatest risk; (ii) promoting and providing condoms and other means of prevention; (iii) effective clinical interventions; (iv) an enabling environment; and (v) reliable data.Clinical services include STI case management, screening and management of STIs in sex partners. Syndromic case management is effective for most symptomatic curable STIs and screening strategies exist to detect some asymptomatic infections. Presumptive epidemiologic treatment of sex partners and sex workers complement efforts to interrupt transmission and reduce prevalence. Clinical services alone are insufficient for control since many people with STIs do not attend clinics. Outreach and peer education have been effectively used to reach such populations.STI control requires effective interventions with core populations whose rates of partner change are high enough to sustain transmission. Effective, appropriate targeting is thus necessary and often sufficient to reduce prevalence in the general population. Such efforts are most effective when combined with structural interventions to ensure an enabling environment for prevention. Reliable surveillance and related data are critical for designing and evaluating interventions and for assessing control efforts.     

Risk factors for sexually transmitted infections in adolescents

The prevalence of sexually transmitted infections (STI) among young people in Russia is examined for the recent decade. Risk factors and organization of STI patients detection, the knowledge of young people about STI are analyzed. Approaches to prevention of these diseases in the society are outlined.     

HIV seroprevalence surveys in sexually transmitted disease clinics

The Centers for Disease Control, in cooperation with State and local health departments, is conducting human immunodeficiency virus, type 1 (HIV), seroprevalence surveys, using standard protocols, in sexually transmitted disease (STD) clinics in selected metropolitan areas throughout the United States. The surveys are blinded (serologic test results not identified with a person) as well as nonblinded (clients voluntarily agreeing to participate). STD clinics are important sentinel sites for the surveillance of HIV infection because they serve persons who are at increased risk as a result of certain behaviors, such as unprotected sex, homosexual exposure, or intravenous drug use. HIV seroprevalence rates will be obtained in the sentinel clinics each year so that trends in infection can be assessed over an extended period of time. Behaviors that place clients at risk for infection, or protect against infection, are being evaluated in voluntary, nonblinded surveys to define groups for appropriate interventions and to detect changes in response to education and prevention programs. Although inferences drawn from the surveys are limited by the scope of the clinics and clients surveyed, HIV trends in STD clinic client populations should provide a sensitive monitor of the course of the acquired immunodeficiency syndrome (AIDS) epidemic among persons engaging in high-risk sexual behaviors.     

2018年8月全国艾滋病性病疫情

  目的  了解广西壮族自治区中越边境市性病门诊男性就诊者艾滋病病毒（HIV）感染情况并探讨其影响因素,为制定干预策略提供参考依据。  方法  于2010 — 2016年在广西壮族自治区中越边境凭祥市某性病门诊监测哨点对性病门诊男性就诊者9 221人进行问卷调查,同时进行HIV、梅毒和丙肝血清学检测。  结果  2010 — 2016年广西壮族自治区中越边境市共监测9 221人,年龄为15～95岁,84.50 % 就诊者年龄为20～59岁。2010 — 2016年共检测出HIV抗体阳性感染者136人,检出率为1.47 %,HIV感染率呈下降趋势（趋势χ² = 18.673,P = 0.005）;梅毒患者检出223人,检出率为2.24 %;丙肝阳性患者66人,检出率为0.72 %;艾滋病知识答对6条及以上知晓率为92.51 % （8 488/9 221）;最近3个月与暗娼发生过性行为的比例占29.4 % （2 715/9 221）;最近3个月与临时性伴发生性行为的比例占22.24 % （2 051/9 221）;注射过毒品的比例占0.74 % （68/9 221）;与同性发生过肛交性行为的比例占0.17 % （16/9 221）;最近1年接受过干预服务的比例为62.6 % （5 776/9 221）。多因素logistic回归分析结果显示,年龄处于60～79岁（aOR = 1.144,95 % CI = 0.327～4.002）、注射过毒品（aOR = 6.439,95 % CI = 1.874～22.128）、与同性发生过肛交性行为（aOR = 7.362,95 % CI = 1.281～ 42.329）和最近1年患过性病（aOR = 1.922,95 % CI = 1.137～3.248）为性病门诊就诊者感染HIV的危险因素,知晓艾滋病知识为保护因素（aOR = 0.054,95 % CI = 0.037～0.075）。  结论  2010 — 2016年广西壮族自治区中越边境市性病门诊就诊者HIV感染率虽有所下降但情况依然不容乐观,仍需加大力度坚持宣传艾滋病相关知识,并从行为上加强预防干预。