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Introduction The development of discrimination scales is an emerging field of enquiry in the area of social determinants of health. However, published scales cannot distinguish health consequences of discrimination as a result of the exposure to differential treatments of any kind from the strict attribution of these events to discrimination. We report the development of a scale that may clarify the relative importance of the effects of these cognitive mechanisms for health outcomes. Methods Successive versions of the instrument were developed based on a systematic review of racial discrimination scales, focus groups and an evaluation by a panel of experts. Instrument refinement was achieved via cognitive interviews and pilot-testing, so that the final scale version was administered to 424 university students in Rio de Janeiro, Brazil. Structural dimensionality, two types of reliability and construct validity were assessed. Results Exploratory factor analysis corroborated the hypothesis of unidimensionality, and the experts indicated that scale items were face and content valid. Internal consistency, estimated by Cronbach's a, was 0.8, and test-retest reliability was higher than 0.5 for 14 out of the 18 items, according to the weighted k statistics. The scale's score was statistically higher among socially disadvantaged individuals and correlated with adverse health behaviours and outcomes. Nevertheless, the low test-retest reliability and the observed invariance of specific items indicate that the scale should be assessed in other population domains. Conclusion The proposed scale will enable the investigation of aspects of the relationship between discrimination and health not previously documented in the literature.

Objetives To determine the prevalence and aetiology of lower genital tract infections (LGTIs) in symptomatic women of reproductive age and describe the risk factors. Methods Cross sectional study. Symptomatic women who consulted at three ambulatory care centres in Bogotá, Colombia. Exclusions: pregnancy, hysterectomy, antibiotics in the previous 7 days. Samples were obtained for etiologic diagnosis using gold standard tests for: bacterial vaginosis (VB) by Nugent's criteria; blood agar culture for Candida and a wet smear and In pouch™ culture for T. vaginalis. PCR for C. trachomatis (CT) and N. gonorroheae (NG), and serologic tests for syphilis (RPR, TPHA) and HIV. Results 1385 women were recruited from February to December 2010. 115 (8.3%) of them were sexual workers. A LGTI was confirmed in 731 (52.7%); 560 (40.4%) had an endogenous infection and 170 (12.3%) a sexually transmitted infection (STI). The most frequent aetiology was VB in 549 (39.6%), followed by candidiasis in 153 (11%). CT was detected in 134 (9.7%), NG in 19 (1.4%), Trichomonas by wet smear in 11 (0.8%) and by culture in 8/634 (1.2%), syphilis in 12 (0.8%) and HIV in 1 case. The risk factors of STI are: sex workers (OR: 2.0, CI 95% 1.2 -3.3), younger age (28 ± 7.8 vs. 32 ± 8.9 (mean ± SD), no health insurance (23.5 vs. 15.4%) and alcohol users (OR: 2.6 (95% CI: 1.4 -4.5)) Conclusions: 52.7% of women who consult for symptoms of LGTIs an aetiology can be identified, being BV the most common and Chlamydia the most frequent STI. Almost the same number of women (47.3%) has no specific aetiology identified, even with the use of gold standard diagnostic technology. This information should be used by policy makers and clinicians for prioritisation of prevention and diagnosis of LGTIs and use of syndromic management Background Recommendations for the frequency of STI screening in high-risk populations are limited by lack of data about when infections occur following a negative screening test. Methods Participants (18-29 years of age; women [N = 192] and men [N = 156]) in a 12-week study of incident STI were recruited from a county STI clinic. Self-collected vaginal samples (women) and urine samples (men) were obtained weekly at participant's home. Nucleic acid amplification tests (NAAT) were used for diagnosis of C. trachomatis, N. gonorrhoeae, and T. vaginalis infections. Infections diagnosed at enrollment were treated immediately. Based on cumulative diary reports of partner-specific sexual behaviours, an exposure variable was created to indicate vaginal exposure with only one partner, or with more than one partner. Time to infection was modelled using Kaplan-Meier curves; group differences were