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Piera Valenti, Luigi Rosa, Daniela Capobianco, Maria Stefania Lepanto, Elisa Schiavi, Antimo Cutone, Rosalba Paesano, Paola Mastromarino
The innate defense system of the female mucosal genital tract involves a close and complex interaction among the healthy vaginal microbiota, different cells, and various proteins that protect the host from pathogens. Vaginal lactobacilli and lactoferrin represent two essential actors in the vaginal environment. Lactobacilli represent the dominant bacterial species able to prevent facultative and obligate anaerobes outnumber in vaginal microbiota maintaining healthy microbial homeostasis. Several mechanisms underlie the protection exerted by lactobacilli: competition for nutrients and tissue adherence, reduction of the vaginal pH, modulation of immunity, and production of bioactive compounds...
2018: Frontiers in Immunology
Melissa A Habel, Kathryn A Brookmeyer, Robin Oliver-Veronesi, Michelle M Haffner
BACKGROUND: National-level data suggest that sexually transmitted infection (STI) testing rates among young adults are low. The purpose of this study was to evaluate the acceptability of an STI self-testing program at a university health center. Few evaluations on the acceptability of collegiate self-testing programs and their effect on testing uptake have been conducted. METHODS: To assess acceptability and uptake of self-testing (urine and self-collected vaginal swab), we conducted a brief self-administered survey of students accessing a large US-based university health center from January to December 2015...
April 2018: Sexually Transmitted Diseases
Vikram Singh, Manju Bala, Aradhana Bhargava, Monika Kakran, Ravi Bhatnagar
BACKGROUND: Recent WHO guidelines recommend dual therapy with ceftriaxone or cefixime plus azithromycin for gonorrhea. Azithromycin in combination with gentamicin or spectinomycin has been recommended in treatment failure cases. Due to emergence of multi-drug resistant (MDR) and extensively-drug resistant (XDR) Neisseria gonorrhoeae strains, it is important to look for efficacy of these combinations and also of others that might be used in future. Therefore, we aimed to evaluate in vitro synergy of 21 dual combinations including current and alternative WHO recommended treatment regimens and other dual combinations...
2018: PloS One
Melissa Oney
This study estimates changes in sexually transmitted disease rates for young adults in the United States following the Affordable Care Act's dependent coverage mandate; a provision that allows dependents to remain covered under their parents' health insurance plans until the age of 26. This study is the first to analyze changes in reported chlamydia and gonorrhea rates resulting from the dependent coverage mandate. Utilizing a difference-in-differences framework coupled with administrative data from the Centers for Disease Control and Prevention, I find that reported chlamydia rates increased for males and females ages 20-24 relative to comparison groups of males and females ages 15-19 and 25-29 following the mandate...
February 22, 2018: Social Science & Medicine
Chelsea L Shover, Matthew R Beymer, Erin M Unger, Marjan Javanbakht, Robert K Bolan
PURPOSE: This study analyzed the accuracy of presumptive gonorrhea treatment in a sexual health clinic serving primarily gay, bisexual, and other men who have sex with men (MSM). Treating suspected gonorrhea before laboratory confirmation can reduce symptoms and transmission; however, this strategy can overtreat uninfected individuals, which may promote antimicrobial resistance. We identified differences in accuracy of gonorrhea presumptive treatment by site of infection and presence of signs or symptoms...
February 2018: LGBT Health
Peter R Reuter, Shannon McGinnis, Kim E Reuter
Young adults have a higher risk of contracting sexually transmitted infections (STIs) than other age groups. This risk may be mediated by their social and cultural setting which can impact young adults' awareness of, beliefs in, and risk of contracting STIs (including HIV/AIDS). In order to understand how these factors vary among young adults of different cultures, it is important to study these issues on a cross-cultural scale. This study aimed to increase understanding of the relationship between the culture of a place of study and: (1) STI awareness; (2) belief in STIs; and (3) self-reported STI prevalence in the study population...
2018: PeerJ
Oliver N Refugio, Jeffrey D Klausner
Syphilis continues to be a growing epidemic among men who have sex with men (MSM), particularly for those living with the human immunodeficiency virus (HIV). In 2016, MSM accounted for 80% of primary and secondary syphilis diagnoses in men in the United States; almost half of who were also HIV-infected. The synergistic relationship between HIV and syphilis has significant implications not only for HIV patient management, but also for sexually transmitted infection (STI) control among MSM. Areas covered: We review the literature on STI screening and treatment barriers at the patient-, provider-, and health system-levels, and present strategies to incorporate STI prevention into HIV care settings...
March 5, 2018: Expert Review of Anti-infective Therapy
Elizabeth A Torrone, Charles S Morrison, Pai-Lien Chen, Cynthia Kwok, Suzanna C Francis, Richard J Hayes, Katharine J Looker, Sheena McCormack, Nuala McGrath, Janneke H H M van de Wijgert, Deborah Watson-Jones, Nicola Low, Sami L Gottlieb
BACKGROUND: Estimates of sexually transmitted infection (STI) prevalence are essential for efforts to prevent and control STIs. Few large STI prevalence studies exist, especially for low- and middle-income countries (LMICs). Our primary objective was to estimate the prevalence of chlamydia, gonorrhea, trichomoniasis, syphilis, herpes simplex virus type 2 (HSV-2), and bacterial vaginosis (BV) among women in sub-Saharan Africa by age, region, and population type. METHODS AND FINDINGS: We analyzed individual-level data from 18 HIV prevention studies (cohort studies and randomized controlled trials; conducted during 1993-2011), representing >37,000 women, that tested participants for ≥1 selected STIs or BV at baseline...
February 2018: PLoS Medicine
Marjan Javanbakht, Drew Westmoreland, Pamina Gorbach
BACKGROUND: The objective of this study was to examine the proportion of missed infections and correlates of pharyngeal gonorrhea among young people attending public STD clinics. METHODS: We conducted a case control study of 245 young men and women between April 2012 and May 2014. Participants were eligible for inclusion if they were: (1) age 15 - 29 years, (2) reported giving oral sex to a partner of the opposite sex, in the past 90 days, and (3) attended one of twelve public STD clinics in Los Angeles County...
February 26, 2018: Sexually Transmitted Diseases
Achilleas Tsoumanis, Niel Hens, Chris Richard Kenyon
BACKGROUND: Neisseria gonorrhoeae (gonorrhea) could become untreatable in the near future. Indeed, while the treatment of symptomatic gonorrhea in core groups, such men who have sex with men (MSM), is crucial for gonorrhea control programs, screening for and treating asymptomatic gonorrhea/Chlamydia trachomatis(chlamydia) in MSM may contribute to antibiotic resistance in gonorrhea. In this systematic review we aim to assess if there is evidence that screening MSM for gonorrhea/chlamydia is associated with a decline in the prevalence of these infections...
February 26, 2018: Sexually Transmitted Diseases
Herng-Ching Lin, Li-Ting Kao, Shiu-Dong Chung, Chung-Chien Huang, Ben-Chang Shia, Chao-Yuan Huang
Alzheimer's disease and cancer are increasingly prevalent with advancing age. However, the association between Alzheimer's disease and prostate cancer remains unclear. The aim of this study was to examine the relationship between prior Alzheimer's disease and subsequent prostate cancer using a population-based dataset in Taiwan. Data for this study were sourced from the Taiwan Longitudinal Health Insurance Database 2005. This case-control study included 2101 prostate cancer patients as cases and 6303 matched controls...
January 26, 2018: Oncotarget
Michelle M Butler, Samanthi L Waidyarachchi, Kristie L Connolly, Ann E Jerse, Weirui Chai, Richard E Lee, Stephan A Kohlhoff, Dean L Shinabarger, Terry L Bowlin
Bacterial sexually transmitted infections are widespread and common, with Neisseria gonorrhoeae (gonorrhea) and Chlamydia trachomatis (chlamydia) being the two most frequent causes. If left untreated, both infections can cause pelvic inflammatory disease, infertility, ectopic pregnancy and other sequelae. The recommended treatment for gonorrhea is ceftriaxone plus azithromycin (to empirically treat chlamydial co-infections). Antibiotic resistance to all existing therapies has developed in gonorrheal infections...
February 26, 2018: Antimicrobial Agents and Chemotherapy
Jose Lucar, Rachel Hart, Nabil Rayeed, Arpi Terzian, Amy Weintrob, Marc Siegel, David M Parenti, Leah E Squires, Rush Williams, Amanda D Castel, Debra A Benator
Background: Washington, DC, has one of the highest rates of HIV infection in the United States. Sexual intercourse is the leading mode of HIV transmission, and sexually transmitted infections (STIs) are a risk factor for HIV acquisition and transmission. Methods: We evaluated the incidence and demographic factors associated with chlamydia, gonorrhea, and syphilis among HIV-infected persons enrolled at 13 DC Cohort sites from 2011 to 2015. Using Poisson regression, we assessed covariates of risk for incident STIs...
February 2018: Open Forum Infectious Diseases
Harrell W Chesson, Robert D Kirkcaldy, Thomas L Gift, Kwame Owusu-Edusei, Hillard S Weinstock
Preventing the emergence of ceftriaxone-resistant Neisseria gonorrhoeae can potentially avert hundreds of millions of dollars in direct medical costs of gonorrhea and gonorrhea-attributable HIV infections. In the illustrative scenario we examined, emerging ceftriaxone resistance could lead to 1.2 million additional N. gonorrhoeae infections over 10 years, costing $378.2 million.
September 22, 2017: Sexually Transmitted Diseases
A M Roth, B Aumaier, M Felsher, S L Welles, A P Donate-Martinez, M Chavis, B Van Der Pol
BACKGROUND: In 2015 approximately 50,000 new HIV infections occurred in the United States, 2,400 of which were attributable to injection drug use in. Pre-exposure prophylaxis (PrEP) has the potential to curb HIV acquisition, however, uptake remains low among persons who inject drugs (PWID). The purpose of the study is to describe PrEP eligibility, willingness to use PrEP, and ability to access PrEP among PWID recruited from a pilot program that paired screening and treatment for sexually transmitted infections with mobile syringe exchange program (SEP) services...
October 4, 2017: Sexually Transmitted Diseases
Emily J Weston, Robert D Kirkcaldy, Mark Stenger, Eloisa Llata, Brooke Hoots, Elizabeth A Torrone
To assess trends in Neisseria gonorrhoeae among gay, bisexual, and other men who have sex with men (MSM), we reviewed existing and published gonorrhea surveillance data in the United States (U.S.). Data identified in this review include: national gonorrhea case report data and data from three other surveillance programs, the Gonococcal Isolate Surveillance Project (GISP), the STD Surveillance Network (SSuN), and National HIV Behavioral Surveillance (NHBS).Rates of reported cases of gonorrhea among men increased 54...
October 6, 2017: Sexually Transmitted Diseases
Leandro Mena, Richard A Crosby, Nicholas Chamberlain
OBJECTIVES: This study of young Black MSM (YBMSM) assessed the prevalence of extra-genital chlamydia and gonorrhea among those testing negative for urethral infections, and compared prevalence of both by HIV status. METHODS: A convenience sample of 609 YBMSM was recruited for a cross-sectional study from two sexual health clinics located in Jackson, MS. To detect C. trachomatis and N. gonorrhoeae, NAAT was performed on urine, rectal swabs, and oral swabs. OraSure was used to detect HIV...
October 19, 2017: Sexually Transmitted Diseases
Christine M Khosropour, Teal R Bell, James P Hughes, Lisa E Manhart, Matthew R Golden
BACKGROUND: United States guidelines recommend azithromycin or doxycycline for chlamydia (CT) treatment. These therapies are similarly efficacious for urogenital infections when outcomes are measured 7-42 days following treatment, though doxycycline may be superior for rectal infections. Some investigators have suggested that persistent rectal infections may lead to autoinfection of the urogenital tract, potentially resulting in higher rates of recurrent infection in azithromycin-treated women...
November 16, 2017: Sexually Transmitted Diseases
Z Mike Chirenje, Nicholas Dhibi, H Hunter Handsfield, Elizabeth Gonese, Beth Tippett Barr, Lovemore Gwanzura, Ahmed S Latif, Dumisili Venessa Maseko, Ranmini S Kularatne, Mufuta Tshimanga, Peter H Kilmarx, Anna Machiha, Owen Mugurungi, Cornelis A Rietmeijer
INTRODUCTION: Symptomatic vaginal discharge is a common gynecological condition managed syndromically in most developing countries. In Zimbabwe, women presenting with symptomatic vaginal discharge are treated with empirical regimens that commonly cover both sexually transmitted infections (STI) and reproductive tract infections, typically including a combination of an intramuscular injection of kanamycin, and oral doxycycline and metronidazole regimens. This study was conducted to determine the current etiology of symptomatic vaginal discharge and assess adequacy of current syndromic management guidelines...
November 29, 2017: Sexually Transmitted Diseases
Philip A Chan, Christina Crowley, Jennifer S Rose, Trace Kershaw, Alec Tributino, Madeline C Montgomery, Alexi Almonte, Julia Raifman, Rupa Patel, Amy Nunn
BACKGROUND: Sexually transmitted diseases (STDs) are increasing among gay, bisexual, and other men who have sex with men (MSM). Little is known about the use of websites and mobile phone applications to meet sexual partners ("hookup sites") and association with STD diagnoses. METHODS: We performed a demographic and behavioral assessment of 415 MSM presenting to the Rhode Island STD clinic. Bivariate and multivariable analyses assessed associations between using hook up sites and testing positive for syphilis, gonorrhea, or chlamydia...
January 4, 2018: Sexually Transmitted Diseases
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