Evidence of declining STD prevalence in a South African mining community following a core-group intervention

OBJECTIVES: To reduce the prevalence of curable sexually transmitted diseases (STDs) in a South African mining community through provision of STD treatment services, including periodic presumptive treatment and prevention education to a core group of high-risk women living in areas around the mines. METHODS: Women at high risk for STDs attended a mobile clinic monthly for examination and counseling, and were treated presumptively for bacterial STDs with a directly observed 1-g dose of azithromycin. Gonococcal and chlamydial infection rates were measured by urine ligase chain reaction, and genital ulcers were assessed by clinical examination. Changes in STD prevalence among local miners were assessed through comparison of prevalence in two cross-sectional samples of miners taken 9 months apart, and through routine disease surveillance at mine health facilities. RESULTS: During the first 9 months of the intervention, 407 women used the services. Baseline prevalence of Neisseria gonorrhoeae and/or Chlamydia trachomatis in women was 24.9%; 9.7% of these women had clinical evidence of genital ulcer disease (GUD). The proportion of women with incident gonococcal or chlamydial infections at the first monthly return visit (69% follow-up rate) was 12.3%, and genital ulcers were found in 4.4% of these women. In the miner population, the prevalence of N gonorrhoeae and/or C trachomatis was 10.9% at baseline and 6.2% at the 9-month follow-up examination (P<0.001). The prevalence of GUD by clinical examination was 5.8% at baseline and 1.3% at follow-up examination (P< 0.001). Rates of symptomatic STDs seen at mine health facilities decreased among miners in the intervention area compared with miners living farther from the site and with less exposure to the project. DISCUSSION: Provision of STD treatment services to a core group of high-risk women may significantly reduce their burden of disease, and may contribute to a reduction in community STD prevalence. In the absence of sensitive and affordable screening tests for STDs in women, periodic presumptive treatment coupled with prevention education is a feasible approach to providing STD services in this population.     

The Bali STD/AIDS Study: evaluation of an intervention for sex workers.

BACKGROUND: Prostitution has been an important factor in the spread of HIV infection in Asia. Interventions need to be developed to reduce the risk of transmission of sexually transmitted infections in this area. GOALS: To educate female sex workers about sexually transmitted infections and assess the impact of the educational intervention. STUDY DESIGN: Brothel areas in Denpasar, Bali, Indonesia, were divided into areas of high and low program (interventional) effort. The intervention included educational sessions for sex workers, treatment of sex workers for sexually transmitted disease (STD), condom distribution, and printed information for clients of the sex workers. A high-effort area was one in which a more intensive educational intervention occurred. A clinic was available for STD treatment in both areas. Behavioral surveys and STD testing were used to evaluate the programs. Six hundred female sex workers participated in behavioral surveys and STD examinations every 6 months for four rounds of data collection. Each round, about half of the women were new to the study. A total of 1586 women participated in at least one evaluation round. Changes were evaluated in AIDS knowledge, STD knowledge, and condom use, as well as in the prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis, syphilis, and Trichomonas vaginalis. Testing for HIV was conducted anonymously. RESULTS: Improvements were noted in the knowledge of sex workers about AIDS and STDs and in the reduction of some bacterial STDs. Women who remained in the study area for more than one round had increased knowledge of HIV infection/STDs and condom use and had reduced levels of syphilis, gonorrhea, and trichomonas infection (P < 0.01). The additional education received by women in the high-effort program area was associated with a reduction in the prevalence of syphilis. Prevalence of HIV remained low throughout the study. The high level of turnover of female sex workers contributed to the maintenance of significant levels of STDs in this population. CONCLUSIONS: Developers of HIV/STD prevention programs for sex workers need to consider the mobility of the sex worker population. Interventions combining behavioral and medical approaches can contribute to prevention of these diseases.     

Using sexually transmitted disease incidence as a surrogate marker for HIV incidence in prevention trials: a modeling study

BACKGROUND: Because many of the sexual behaviors that place individuals at risk of acquiring HIV are the same as those that place them at risk for other sexually transmitted diseases (STDs), researchers and policymakers have called for the use of non-HIV STDs as surrogate markers for HIV infection. GOALS: This study examined the epidemiologic conditions under which changes in STD incidence are associated with changes in HIV incidence. STUDY DESIGN: A mathematical model of HIV/STD transmission was applied to empirical data from a large HIV prevention intervention. The association between participants' HIV infection risk reduction scores and their STD risk reduction scores was measured with use of the Pearson product-moment correlation. The authors examined how the strength of association varied across different epidemiologic parameters and heterosexual behaviors. RESULTS: Moderate to strong associations were noted when the infectivity of the STD was similar to the infectivity of HIV. The association was attenuated for larger STD infectivity values. The prevalence of STD infection was a less important determinant of the strength of association. Stronger associations were obtained when the number of sex partners was large or the number of sex acts was small. CONCLUSIONS: Easily transmitted STDs, such as gonorrhea, are unsuitable for general use as surrogate markers for HIV infection. Hepatitis B, syphilis, and chlamydial infection have more promising epidemiologic profiles. Careful studies of STD infectivity are needed to aid in the identification of potential marker STDs.     

Findings from STD screening of adolescents and adults entering corrections facilities: implications for STD control strategies

BACKGROUND: Persons entering corrections facilities are at high risk for sexually transmitted diseases (STDs) because of risky sexual behavior and lack of access to routine screening. GOAL: The goal of the study was to develop a national picture of STD prevalence in this population. STUDY DESIGN: We analyzed information on age, race/ethnicity, urethral symptoms (men only), and test results for approximately 85,000 chlamydia, 157,000 gonorrhea, and 293,000 syphilis tests for persons entering 23 jails and 12 juvenile detention centers in 13 US counties from 1996 through 1999. RESULTS: At adult jails in nine counties, the median percentage of persons with reactive syphilis tests by county was 8.2% (range, 0.3-23.8%) for women and 2.5% (range, 1.0-7.8%) for men. At juvenile detention facilities in five counties, the median positivity for chlamydial infection was 15.6% (range, 8.0-19.5%) for adolescent girls and 7.6% (range, 2.8-8.9%) for adolescent boys; the median positivity for gonorrhea was 5.2% (range, 3.4-10.0%) for adolescent girls and 0.9% (range, 0.7-2.6%) for adolescent boys. Of adolescent boys testing positive for chlamydial infection at three juvenile facilities, approximately 97% did not report symptoms; of adolescent boys positive for gonorrhea, 93% did not report symptoms. CONCLUSION: STD positivity among persons entering corrections facilities is high. Most chlamydial and gonococcal infections are asymptomatic and would not be detected without routine screening. Monitoring the prevalence of STDs in this population is useful for planning STD prevention activities in corrections facilities and elsewhere in the community.     

High prevalence of sexually transmitted diseases among men who have sex with men in Jiangsu Province, China

OBJECTIVE:: The objective of this study was to investigate the prevalence of sexually transmitted diseases (STDs), including HIV infection, and sexual risk behaviors among men who have sex with men (MSM) in Jiangsu Province, China. DESIGN:: The authors conducted a cross-sectional study. METHODS:: From February to July 2003, men who attended 10 participating gay bars in five cities in Jiangsu Province were asked to complete a self-administered questionnaire, including measures of alcohol use and sexual risk behaviors. Blood samples and urethral swabs were taken to examine the presence of STDs, including HIV infection. RESULTS:: A total of 144 men were recruited in the study. Forty-six percent of men reported unprotected anal intercourse with their male sexual partners in the past 3 months. No one was found to be HIV-infected, but the prevalence of STDs was high: gonorrhea 2.7%, chlamydial infection 8.0%, nonchlamydial nongonococcal urethritis 27.7%, active syphilis 6.9%, hepatitis B virus infection 9.1%, herpes simplex virus-2 infection 7.8%, and genital warts 13.2%. CONCLUSIONS:: Given that HIV prevalence among MSM in some other parts of China has been as high as 3%, STDs facilitate the transmission of HIV, and high prevalence of STDs and sexual risk behaviors among MSM exist in Jiangsu Province, the potential for the future spread of HIV is of concern, and it is urgent to provide MSMs with STD healthcare services and HIV/AIDS/STD prevention education and intervention.     

Prevention of sexually transmitted diseases (STDs) in female sex workers: prospective evaluation of condom promotion and strengthened STD services

BACKGROUND: In Perú, a previous study of government-sponsored periodic examinations of female sex workers (FSWs) found no significant impact on rates of sexually transmitted diseases (STDs). GOAL: This study assessed the impact of technically improved periodic STD services on STD prevalence and on consistent condom use (CCU). STUDY DESIGN: The study involved monthly follow-up of 917 FSWs at two STD clinics, with evaluations before and during implementation of strengthened STD services, which included periodic screening and treatment for gonorrhea, chlamydial infection, trichomoniasis, bacterial vaginosis (BV), and syphilis; counseling; and supply of condoms. Outcome analyses were adjusted for participation bias. RESULTS: During 7908 person-months of observation, the prevalences of gonorrhea, chlamydial infection, trichomoniasis, and BV declined significantly and CCU increased significantly, with similar trends in both clinics. During follow-up, gonorrhea, chlamydial infection, trichomoniasis, and BV were negatively associated with follow-up after screening. BV also was positively associated with use of an intrauterine device and negatively with douching. CCU during follow-up was associated with significantly decreased risk of gonorrhea, chlamydial infection, and trichomoniasis. CONCLUSIONS: Strengthened periodic screening for and treatment of confirmed STD, in addition to condom promotion and provision, represent feasible, effective interventions in commercial sex, and time series analyses can provide a useful approach to evaluating new interventions.     

Community based study of sexually transmitted diseases in rural women in the highlands of Papua New Guinea: prevalence and risk factors

OBJECTIVE: To estimate the prevalence of sexually transmitted diseases (STDs) and determine their risk factors/markers among a rural population of women in the highlands of Papua New Guinea. METHODS: Community based random cluster sample of women of reproductive age were interviewed and examined and had specimens collected for laboratory confirmation of chlamydial and trichomonal infection, gonorrhoea, syphilis, and bacterial vaginosis. RESULTS: Chlamydia trachomatis was detected in 26%, Trichomonas vaginalis in 46%, Neisseria gonorrhoeae in 1%, syphilis in 4%, pelvic inflammatory disease (PID) (diagnosed clinically) in 14%, and bacterial vaginosis in 9% of 201 women. 59% of the women had at least one STD. In a multivariate logistic regression analysis taking the clustered sampling into account, independent risk factors for chlamydial infection were age < or = 25 years, < four living children, visualization of yellow mucopurulent endocervical secretions on a white swab, and bacterial vaginosis. Being married to a man who did not have other wives was protective. For trichomonal infection, independent risk factors were having no formal education, infertility, more than one sexual partner in the previous 12 months, treatment for genital complaints in the previous 3 months, abnormal vaginal discharge detected on examination, and chlamydial infection. Similar levels of trichomonal infection were found in all age groups. Among married women, rates of infection correlated with their perception of their husband having had other sexual partners in the previous 3 months, and this relationship was significant for chlamydial infection among women over 25. CONCLUSION: STDs are a major problem in this population, with the risk factors varying by outcome. Current treatment regimens are inappropriate given the high prevalence of trichomonal infection, and the available services are inadequate. Effective interventions are required urgently to reduce this burden and to prevent the rapid transmission of HIV.


     

Sexually transmitted diseases among female prisoners in Brazil: prevalence and risk factors

BACKGROUND: Sexually transmitted diseases (STDs) have become an important medical problem in prisons. GOAL: To determine the prevalence of and risk factors for STDs among female inmates in a Brazilian prison. STUDY DESIGN: All female prisoners at the Espírito Santo State Prison were offered enrollment in this cross-sectional study. An interview exploring demographics, criminal charges, and risk behavior was conducted. Blood and genital specimens were collected for STD testing. RESULTS: Of 122 eligible women, 121 (99%) agreed to participate. Prevalence rates were: HIV 9.9%, human T-cell lymphotrophic virus type I 4.1%, hepatitis B virus 7.4%, hepatitis C virus 19%, syphilis 16%, gonorrhea 7.6%, chlamydial infection 11%, human papillomavirus-related cytologic changes 9.3%, trichomoniasis 30%, and bacterial vaginosis 15%. Previous or current drug abuse (54%), injection drug use (11%), and blood transfusion (16%) were associated with at least one STD. Condom use was infrequent. CONCLUSION: The prevalence of STDs and of behaviors leading to ongoing transmission are high among female inmates in Vitória, Brazil, and demonstrate the potential importance of prevention activities targeting this population.     

STD vaccines--an overview.

OBJECTIVES: To describe the role and current status of vaccine research against sexually transmitted diseases (STDs). METHODS: The available literature was reviewed with particular emphasis on bacterial STDs. RESULTS: Strategic approaches to possible implementation of STD vaccine programmes were analysed. The status of vaccines against bacterial STDs (syphilis, chancroid, gonorrhoea, and chlamydia) is described in detail. CONCLUSIONS: The development of safe and effective STD vaccines offers a potent tool for the control of STDs, including direct and indirect prevention of HIV infection. Future priorities should be in the development of vaccines against gonorrhoea, chlamydia, and syphilis. When such vaccines become available, caution should be exercised to ensure that they do not interfere with the effectiveness of other prevention programmes.     

2005年珠海市特殊人群性病流行情况分析

目的:了解2005年珠海市性传播疾病在不同人群中的流行特征,为政府制订预防控制措施提供科学依据。方法:对2005年珠海市特殊人群4030人进行了性病检查和统计分析。结果:珠海市2005年卖淫嫖娼者中性病发病率71.19%,妇科门诊患者性病发病率46.02%,两类人群中非淋菌性尿道炎(NGU)发病率最高,居性病构成比第一位,且占绝对优势,其它性病构成比基本一致;吸毒人员中梅毒感染率最高8.43%;正常献血人员中梅毒感染率0.68%。结论:卖淫嫖娼人员是性病传播的核心人群,它的发病率和病种流行状况,直接决定着妇科门诊患者中性病的流行状态;应继续加大对卖淫嫖娼者和吸毒人群的性病艾滋病防治的力度。     

Human immunodeficiency virus and other sexually transmitted infections among female sex workers in two major cities in Papua New Guinea

BACKGROUND: Treatable sexually transmitted infections are very common in developing countries and quite often are inadequately treated or remain untreated despite the fact that they enhance the transmission of human immunodeficiency virus (HIV). GOAL: To estimate the prevalence of HIV, syphilis, chlamydial infection, gonorrhea, and trichomoniasis among female sex workers in Port Moresby and Lae, Papua New Guinea, and to collect data on associated behaviors. STUDY DESIGN: Self-identified female sex workers recruited through our peer-mediated sexually transmitted disease (STD)/HIV risk-reduction community outreach program were invited to participate in the study. Participants underwent pretest counseling, were interviewed, and were asked to self-collect vaginal swab specimens for the detection of STDs and to provide 10 mL of blood for HIV and syphilis testing. RESULTS: A total of 407 female sex workers, 207 in Port Moresby and 200 in Lae, were enrolled in the study. The overall prevalence rates of HIV, syphilis, genital chlamydial infection, gonorrhea, and trichomoniasis among these women were estimated to be 10%, 32%, 31%, 36%, and 33%, respectively. The sex workers in Port Moresby had a significantly higher HIV infection rate (17%) than those in Lae (3%) and a significantly lower trichomoniasis rate (21%) than those in Lae (44%). Mixed infections were common, occurring in 45% of the cases. Despite a high rate of symptoms, the rate of treatment-seeking was low. Condom use among the sex workers was very inconsistent; 85% reported that they did not use condoms at all times when having sex with their clients. Common reasons cited were dislike by clients, unavailability, alcohol use, and familiarity with a client. CONCLUSIONS: STDs are very common among female sex workers in Port Moresby and Lae and very often present as multiple infections. Despite STD/HIV awareness campaigns, unsafe sex-particularly irregular use of condoms-continues among sex workers and their clients. Barriers to safer sexual behavior need to be addressed, as do improvements in provision of STD services.     

Are counselor demographics associated with successful human immunodeficiency virus/sexually transmitted disease prevention counseling?

BACKGROUND AND OBJECTIVE: HIV prevention counseling has changed behavior and reduced incident sexually transmitted diseases (STDs) in research participants. GOAL: This article assesses whether counselor demographics or counselor-client dyad characteristics influenced prevention counseling in Project RESPECT as measured by intervention completion and incident STD after counseling. STUDY DESIGN: We analyzed data from Project RESPECT, a randomized, controlled trial of HIV counseling interventions in STD clinics. RESULTS: There was no significant association between client failure to complete the intervention and demographic characteristics of the 32 counselors or dyad characteristics. Clients who did not complete the intervention were significantly more likely to acquire a new STD infection by the 12-month visit than those who completed the intervention (adjusted odds ratio, 1.7; confidence interval, 1.2-2.4). There was no significant association between new STDs and counselor characteristics or dyad characteristics. CONCLUSIONS: Counselor or counselor-client dyad characteristics evaluated in this study were not associated with intervention completion or the prevention of new STDs.     

2007～2011年珠海市性病流行情况分析

目的：了解2007～2011年珠海市性病的发病趋势和流行特点,为开展性病防治工作提供科学依据。方法：通过国家疾病预防控制信息系统,收集并分析珠海市19个性病哨点医院2007～2011年全年上报的病例信息。结果：2007～2011年珠海市累计上报性病病例15 186例,年均发病率为203.55/10万,发病率呈逐年上升趋势;病种构成上,衣原体感染报告数最多,占28.32%,其次为梅毒,梅毒与衣原体感染率每年增幅最大;性别分布上,男女比例1.45∶1,但有逐年缩小趋势;年龄分布上,20～34年龄段人群居多,占58.92%;职业分布上,工人、商业服务和家务待业者居多;香洲区为性病高发地区。结论：2007～2011年间,珠海市性病数逐年上升,尤其梅毒上升速度显著,应积极开展更有针对性的防治工作,控制以梅毒为主的各种性病的流行。     

Multiple partners and partner choice as risk factors for sexually transmitted disease among female college students.

Multiple sexual partners and partner choice are believed to increase the risk of sexually transmitted disease (STD), but these behaviors had not previously been assessed outside of clinical populations. In this study, a cross-sectional survey among single, white, female students in their senior year of college was conducted to measure the association between behavioral risk factors and the acquisition of self-reported STDs during college. The usable response rate was 47.2% (n = 467). The combined prevalence of chlamydial infection, gonorrhea, genital herpes, human papillomavirus (HPV) infection, syphilis, and trichomoniasis during a 3.5-year period was 11.7%. There was a strong association between number of sexual partners and having an STD: those women with 5 or more sexual partners were 8 times more likely to report having an STD than those with only 1 partner, even after adjusting for age at first intercourse (odds ratio = 8.1; 95% confidence interval = 1.99, 32.64). The prevalence of a history of STDs increased with more causal partner choice and earlier age at first intercourse, but neither factor was independently associated with a history of STDs. Of the respondents, 23% always used condoms. Future research should focus on identifying ways of effectively changing high-risk sexual behavior.     

性病与HIV感染者中HSV2、HBsAg和HCV的检测

目的 比较性病患者和HIV感染者血清中单纯疱疹病毒(HSV)、乙型肝炎病毒(HBV)及丙型肝炎病毒(HCV)的感染情况,为采取综合性的防治方案提供参考依据。方法 对经蛋白印迹法确证的HIV(+)/AIDS库存血清标本和梅毒、淋病及衣原体感染患者血清标本,用ELISA方法同时检测HSV2-IgG、HSV2-IgM、HBsAg和HCV-IgG4项指标,并对2组标本的检测结果进行比较。结果 在76份性病样品中,检出HSV2-IgG24例占31.58%;HSV2-IgM1例占1.32%;HBsAg8例占10.53%和HCV1例占1.32%。在另外分组的14例HIV阳性标本中,检出HSV2-IgG7例占50.00%;HSV2-IgM5例占35.71%;HBsAg8例占57.14%和HCV3例占21.43%。在总共90份标本中,有6例标本同时检测到HSV和HBV;2例标本同时检出HSV-IgM和HBV;2例同时检出上述4项指标。统计分析发现,HIV(+)/AIDS组中HSV、HBV和HCV的检出率明显高于性病组(P<0.05)。结论 HIV(+)/AIDS患者中合并HSV、HBV及HCV的感染率明显高于其他性病患者。     

Epidemiology of anorectal chlamydial and gonococcal infections among men having sex with men in Seattle: utilizing serovar and auxotype strain typing

BACKGROUND: Bacterial sexually transmitted diseases (STDs) among men who have sex with men (MSM) have recently increased in Seattle. GOALS: Serovar and auxotype typing of strains was used to assess the epidemiology of anorectal chlamydial and gonococcal infections among MSM attending an STD clinic. STUDY DESIGN: The prevalences of anorectal chlamydial infection and gonorrhea among MSM attending an STD clinic during the period of 1994 to 1996 were compared with prevalences during 1997 to 1999. A retrospective case-control study of MSM attending an STD clinic between 1997 and 1999 was performed. Anorectal chlamydial isolates were characterized by serovar and gonococcal isolates were characterized by serovar and auxotype. Infected MSM were mapped by residence and strain type. RESULTS: Prevalences of anorectal chlamydial and gonococcal infections increased from 4.0% and 6.3%, respectively, during 1994-1996 to 7.6% and 8.7%, respectively, during 1997-1999 (P = 0.004 and P = 0.013 for chlamydial infection and gonorrhea, respectively). Most chlamydial infections were caused by serovars G (47.9%) and D (29.6%), and most gonococcal infections were caused by auxotype/serovar classes Proto/IB-1 (43.3%), Proto/IB-3 (16.5%), and Proto/IB-2 (10.3%). MSM with anorectal chlamydial infection more often had chlamydial urethritis (P = 0.005) and were not white (P = 0.046), in comparison with controls. MSM with anorectal gonorrhea more often had pharyngeal gonorrhea (P < 0.001), had a history of gonorrhea (P = 0.003), and were younger than age 30 years (P = 0.039), in comparison with controls. Residences of MSM with anorectal gonorrhea were clustered in urban areas, whereas those of MSM with anorectal chlamydial infection were more dispersed. CONCLUSION: Prevalences of anorectal chlamydial infection and gonorrhea among MSM in Seattle have increased dramatically over the past 3 years. Serovar and auxotype analyses indicate these increases are not clonal but are due to the spread of unique distributions of strains that differ from those causing urogenital infections in the same community.     

STD/HIV intervention and research programme Mwanza Region,NW Tanzania

The social determinants and epidemiology of sexually transmitted disease (STD) were studied in rural communities in Mwanza Region, Tanzania, in the context of the phase specific model of STD transmission. The prevalence of HIV and syphilis was higher in communities close to main roads, and lower in communities living on islands in Lake Victoria, probably reflecting the proportion of high risk individuals in the population. The prevalence of Herpes simplex virus type 2 infection, gonorrhoea, chlamydial infection, and trichomoniasis was similar in all types of community, reflecting the fact that these infections remain in the hyperendemic phase. The transmission of STDs is fuelled by high population mobility and by the presence of high risk individuals in rural as well as roadside communities.     

High prevalence of sexually transmitted diseases in young women seeking HIV testing in Rio de Janeiro, Brazil

BACKGROUND AND OBJECTIVES: Few data are available on the prevalence of and risk factors for sexually transmitted diseases (STDs) other than HIV in Brazil. GOAL: The goal of this study was to determine the prevalence of HIV infection and other STDs in Brazilian women who seek HIV testing, investigate risk factors for these infections, and assess feasibility of screening in HIV test clinic settings. STUDY DESIGN: We conducted a cross-sectional study of 200 women, aged 14 to 29 years, who attended an HIV testing site in central Rio de Janeiro. Participants completed a questionnaire and received testing for HIV, syphilis, chlamydia, and gonorrhea. RESULTS: HIV and other STDs were common (HIV 8%, syphilis 6.5%, chlamydial infection 8%, and gonorrhea 9.5%). HIV was significantly associated with lower education and with having an HIV-infected partner. Other STDs were significantly associated with younger age at first intercourse, heavy alcohol consumption, and marijuana use. CONCLUSION: STDs appear to be substantial health problems among young Brazilian women seeking HIV testing. HIV testing sites in Brazil should consider offering screening and treatment for STDs and substance abuse as part of their HIV prevention services.     

Adolescent knowledge about sexually transmitted diseases

BACKGROUND: Adolescents learn about sexually transmitted diseases (STDs) from many sources, yet little is known about how well these educational sources are teaching them about STDs. GOAL: The goal was to assess basic knowledge about STDs and their prevalence, to determine the correlates of high STD knowledge levels, and to explore whether self-perceptions of STD knowledge correlated with knowledge test scores. STUDY DESIGN: A convenience sample of adolescents from waiting areas in an urban children's hospital were asked by peer educators about their STD education, the sources of this education, and their self-perception of their STD knowledge. They then were given a short assessment testing their knowledge of major, incurable, and curable STDs. RESULTS: In the 393 surveys collected from adolescents aged 12 to 21 years (mean [+/-SD] age, 16.9 +/- 1.8 years), 97% self-reported having been educated about STDs, and the reported major sources were school (70%), parents (52%), and friends (31%). Only 7 (2%) correctly named all 8 major STDs, 35 (9%) named the 4 curable STDs, and 13 (3%) named the 4 incurable STDs. HIV was the mostly commonly named of the 8 major STDs (91%), followed by gonorrhea (77%) and syphilis (65%). Trichomonas infection (22%), human papillomavirus infection (22%), and hepatitis B (15%) were the least-named STDs. Forty-six percent thought HIV was the most common STD in the Philadelphia area. The participants' mean total STD knowledge score was 3.5 +/- 1.9 (maximum possible score, 8). There were fair correlations between knowledge scores and age (correlation coefficient [r] = 0.31; P < 0.0001), as well as between knowledge score and self-perception of STD knowledge (r = 0.23; P < 0.0001). Adolescents educated by parents, school, other relatives, and friends performed better than those educated by other sources. Those educated by multiple sources outperformed those educated by one source. CONCLUSIONS: Adolescents' specific knowledge about non-HIV STDs is only cursory, despite their reports of having received education about STDs. We must attempt to improve and balance our STD education so that adolescents receive and retain detailed age-appropriate STD information that is consistent with their risk for disease.     

广州市男男性行为人群STD/HIV相关高危行为特征及就诊延误影响因素调查分析

目的:了解广州市男男性行为(MSM)人群STD/HIV相关高危行为特征和就诊延误影响因素,为制定有针对性的防控措施提供依据。方法:2014年10月至2015年9月期间,对参加STD/HIV自愿咨询检测且已经出现疑似STD/HIV感染相关症状、近2年内发生过同性性行为的MSM进行面对面问卷调查,采集静脉血检测HIV和梅毒。结果:共调查313名MSM,38.02%近2年内与异性发生过性行为,40.89%拥有固定的同性性伴,肛交性行为中每次都使用安全套的比例为47.04%。本次病程中80.51%发生就诊延误,首次就诊间隔时间平均为30天,影响就诊延误的因素主要包括职业、对同性恋的态度、近2年是否发生异性性行为、是否曾患其它非梅毒性病、就诊频次、是否暂停性生活。血清学监测结果 HIV感染率为20.77%,现症梅毒感染率为6.39%,同时感染HIV和梅毒的比例为4.79%,就诊延误发生者的HIV感染率和梅毒感染率均高于未发生就诊延误者,差异有统计学意义(P值均0.05)。结论:广州市MSM人群HIV感染率高,高危行为普遍存在,就诊延误发生率高,防控形势严峻,应加大宣传教育、提高医疗服务可及性和服务质量以减少就诊延误的发生。