Background Internet-based screening for vaginal sexually transmitted infections (STI) has been shown to reach high-risk populations. Published studies of internet-based screening for rectal STIs in women are needed. Our objectives were to describe the female users of a rectal internet-based screening intervention and assess what factors correlated with rectal positivity for STIs. Methods The website http://www.iwantthekit.org offers free STI testing via home self-sampling kits. Women could order vaginal and rectal kits, both containing questionnaires. Rectal and vaginal swabs were tested for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using nucleic acid amplification tests. Data were analysed from 205 rectal kits from January 2009 through February 2011. Self-reported characteristics of participants were examined, and correlates of rectal STI positivity were analysed. Results Of the 205 rectal samples returned and eligible for testing, 38 (18.5%) were positive for at least one STI. The women were young (mean age 25.8 years), mostly African–American (50.0%), and only 14.0% always used condoms. After adjusting for age and race, Black race (AOR=3.06) and vaginal STI positivity (AOR=40.6) were significantly correlated with rectal STI positivity. Of women testing positive for rectal STIs who also submitted vaginal swabs, 29.4% were negative in the vaginal sample. Conclusions Internet-based rectal screening can reach populations that appear to be at high risk for rectal STIs (18.5% prevalence) and led to the diagnosis of STIs in women who would not have been diagnosed vaginally. Black race and vaginal STI positivity were highly correlated with rectal STI positivity.
Background Partner notification (PN) for sexually transmissible infections (STIs) is a vital STI control method. The most recent evaluation of PN practices in the United States, conducted in 1999, indicated that few STI patients were offered PN services. The objectives of this study were to obtain a preliminary understanding of the current provision of PN services in HIV/STI testing sites throughout the US and to determine the types of PN services available. Methods A convenience sample of 300 randomly selected testing sites was contacted to administer a phone survey about PN practices. These sites were from a large database maintained by the Centers for Disease Control and Prevention. Sites were eligible to participate if they provided testing services for chlamydia, gonorrhoea, HIV or syphilis and were not hospitals or Planned Parenthood locations. Results Of the 300 eligible sites called, 79 sites were successfully reached, of which 74 agreed to participate, yielding a response rate of 24.7% and a cooperation rate of 93.7%. Most surveyed testing sites provided some form of PN service (anonymous or non-anonymous) on site or through an affiliate for chlamydia (100%), gonorrhoea (97%), HIV (91%) and syphilis (96%) infection. Anonymous PN services were available at 67–69% of sites. Only 6–9% of sites offered Internet-based PN services. Conclusions Most surveyed testing sites currently offer some type of PN service for chlamydia, gonorrhoea, HIV or syphilis infection. However, approximately one-third of surveyed sites do not offer anonymous services. Novel, Internet-based methods may be warranted to increase the availability of anonymous services.
in married women, and 5.4% (4.1% to 7.0%) in divorced/widowed women. HIV prevalence was higher in women with concurrent partners than in those without (55.7% vs 25.4%; aOR, 3.26, 2.08 to 5.11) even after excluding women who had not started sex (aOR, 2.83; p<0.001). For males, non-spousal concurrency fell from 11.7% (95% CI 10.8% to 12.7%) in 1998e2000 to 6.1% (5.3% to 7.0%) in 2001e2003 and 4.3% (3.7% to 5.0%) in 2006e2008; prevalence of spousal concurrency fell from 3.7% (3.2% to 4.3%) to 2.6% (2.0% to 3.2%) to 1.3% (1.0% to 1.7%) over the same period. For females, concurrency declined from 1.7% (1.4% to 2.1%) in 1998e2000 to 1.0% (0.7% to 1.3%) in 2001e2003 and 0.5% (0.3% to 0.7%) in 2006e2008. Conclusion A 2/3rds reduction in (mainly non-spousal) concurrency may have contributed to HIV decline in east Zimbabwe.
Purpose This study investigated the difference of effects between advanced partner notification (APN) and traditional partner notification (TPN). Methods The subjects who had Western bolt test or newly diagnosed with HIV were recruited. All subjects were randomly assigned into experimental and control group, 30 subjects in each group. Advanced Partner Notification was therefore developed based on the self-efficacy concept of Bandura. The process of APN includes advanced interaction model, comprehensive assessment model for partner information, and promoting self-efficacy of partner notification model. In control group, 30 subjects accepted the process of TPN. Results Sixty participants were men who have sex with men and unmarried. The mean age was 28.3 years (SD = 4.64). The results revealed that the index cases of APN were significantly better than the group of TPNM in provided more contactable partner of 107 cases (t = 2.16, p = 0.037), successed notified more partner of 73 cases (t = 2.25, p = 0.029), receiving HIV test more partner of 25 cases (t = 2.05, = 0.046). There were 22 partners whose HIV test were positive in APN group (HIV positive rate was 41.51%) and 7 partners whose HIV test were positive in TPN group (HIV positive rate was 25.0%). The HIV positive partners in APN group were 15 cases (t = 2.64, p = 0.01) more than those in TPN group. In addition, the mean difference in safer sexual knowledge, number of sexual partners, frequency of unsafe sexual behaviours, frequency of safer sexual behaviours, frequency of resource referral numbers, and process evaluation of PN were significantly better than those in TPN group. Conclusion The process of APN is better than the process of TPN in many aspects. The result can improve the quality of current partner notification policy and practise. Background Partner notification (PN) is seen as a vital tool to break HIV/STI transmission chains. In the Netherlands, studies assessing PN effectiveness were lacking. Here, we evaluated effectiveness of current PN practises in STI clinics to provide recommendations to further enhance PN. Methods PN outcomes were collected through a newly developed registration system from index patients with HIV, syphilis, and gonorrhoea visiting five STI centres in 2010-2011. PN outcomes for men who have sex with men (MSM) and heterosexuals included partners: at risk, notifiable, notified, tested and diagnosed with STI/HIV. Results Of all index patients newly diagnosed with HIV/STI (N = 388) for whom PN was indicated, 312 MSM, 35 heterosexual men and 41 women reported respectively 2042, 126 and 82 partners at risk (6.5, 3.6 and 2.0 partners per index). Proportions of notifiable partners differed significantly by sexual preference (MSM: 46%, heterosexual men: 63%, women: 87%, p < 0.001). Proportions of notified partners (of those notifiable) were lowest for heterosexual men (77% versus 92% for MSM and 83% for women, p < 0.001). STI positivity rates among partners were high for all groups: 33%-50%. Partner notifiCation outComes for msm an...
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