Advancing Integration of HIV, STD, and Viral Hepatitis Services: State Perspectives

Whiticar, Peter M.; Liberti, Thomas M.

doi:10.1177/00333549071220s218

Cited by 9 publications

(8 citation statements)

References 15 publications

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“…Besides, patients seeking an HIV test following unprotected sex are at risk of multiple STIs . The potential of voluntary counselling and testing could be maximised by providing tests for Chlamydia, and possibly other STIs, integrated in a single service visit [21, 22]. …”

Section: Discussionmentioning

confidence: 99%

Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?

et al. 2016

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BackgroundPatients asking for a free anonymous HIV test may have contracted other sexually transmitted infections (STIs) such as Chlamydia trachomatis, yet Chlamydia prevalence in that population is unknown. This study aimed to assess the prevalence and factors associated with Chlamydia infection in patients seeking HIV testing at local public health authorities (LPHA) in order to evaluate whether Chlamydia testing should be routinely offered to them.MethodsWe conducted a cross-sectional study among patients (≥18 years) attending 18 LPHA in North Rhine-Westphalia from November 2012 to September 2013. LPHA collected information on participants’ socio-demographic characteristics, sexual and HIV testing behaviours, previous STI history and clinical symptoms. Self-collected vaginal swabs and urine (men) were analysed by Transcription-Mediated Amplification. We assessed overall and age-stratified Chlamydia prevalence and 95 % confidence intervals (95 % CI). Using univariate and multivariable binomial regression, we estimated adjusted prevalence ratios (aPR) to identify factors associated with Chlamydia infection.ResultsThe study population comprised 1144 (40.5 %) women, 1134 (40.1 %) heterosexual men and 549 (19.4 %) men who have sex with men (MSM); median age was 30 years. Chlamydia prevalence was 5.3 % (95 % CI: 4.1–6.8 %) among women, 3.2 % (95 % CI: 2.2–4.4) in heterosexual men and 3.5 % (95 % CI: 2.1–5.4) in MSM. Prevalence was highest among 18–24 year-old women (9 %; 95 % CI: 5.8–13) and heterosexual men (5.7 %; 95 % CI: 3.0–9.8 %), respectively. Among MSM, the prevalence was highest among 30–39 year-olds (4.4 %; 95 % CI: 1.9–8.5 %). Among those who tested positive, 76.7 % of women, 75.0 % of heterosexual men and 84.2 % of MSM were asymptomatic. Among women, factors associated with Chlamydia infection were young age (18–24 years versus ≥ 40 years, aPR: 3.0, 95 % CI: 1.2–7.8), having had more than 2 partners over the past 6 months (ref.: one partner, aPR: 2.1, 95 % CI: 1.1–4.0) and being born abroad (aPR: 1.9, 95 % CI: 1.0–3.5). Among heterosexual men, young age was associated with Chlamydia infection (18–24 years versus ≥ 40 years, aPR: 4.1, 95 % CI: 1.3–13). Among MSM, none of the variables were associated with Chlamydia infection.ConclusionsLPHA offering HIV tests should consider offering routine Chlamydia testing to women under 30 years. Women with multiple partners and those born abroad may also be considered for routine testing. Our results also suggest offering routine Chlamydia testing to heterosexual men under 25 years old. For MSM, we cannot draw specific recommendations based on our study as we estimated the prevalence of urethral Chlamydia infection, leaving out rectal and pharyngeal infections.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?

et al. 2016

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“…Structural challenges such as incompatible data systems 13 and policies and laws that restrict combining funding streams and sharing data can inhibit efforts to form a PCSI approach to address disease burden in a jurisdiction. 4,17 All levels of government will need to address these and other challenges and to support local and state PCSI initiatives to provide comprehensive services to communities.…”

Section: Discussionmentioning

confidence: 99%

Program Collaboration and Service Integration Activities among HIV Programs in 59 U.S. Health Departments

et al. 2014

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“…Acceptance of a new diagnostic approach will involve a cultural change from syndromic management in many LMICs. STI programmes are not sufficiently supported by donors in these settings, and even though some countries make efforts to integrate STIs into HIV programmes, integration challenges have been identified, including a lack of policy and guidelines, inadequately trained providers, vertical programming, provider work overload, and a weak health system [68].…”

Section: Plos Onementioning

confidence: 99%

Developing target product profiles for Neisseria gonorrhoeae diagnostics in the context of antimicrobial resistance: An expert consensus

et al. 2020

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Background There is a need for a rapid diagnostic point of care test to detect Neisseria gonorrhoeae (NG) infection to prevent incorrect, lack or excess of treatment resulting from current syndromic management in low-resource settings. An assay to identify NG antimicrobial resistance (AMR) is also highly desirable to facilitate antibiotic stewardship. Here we describe the development of two target product profiles (TPPs): one for a test for etiological diagnosis of NG and Chlamydia trachomatis (CT) (TPP1) and one for the detection of NG AMR/susceptibility (TPP2). Methods Draft TPPs were initially developed based on a landscape analysis of existing diagnostics and expert input. TPPs were refined via an online Delphi survey with two rounds of input from 68 respondents. TPP characteristics on which <75% of non-industry respondents agreed were further discussed and revised by an expert working group.

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Advancing Integration of HIV, STD, and Viral Hepatitis Services: State Perspectives

Cited by 9 publications

References 15 publications

Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?

Prevalence of Chlamydia trachomatis infection in women, heterosexual men and MSM visiting HIV counselling institutions in North Rhine-Westphalia, Germany - should Chlamydia testing be scaled up?

Program Collaboration and Service Integration Activities among HIV Programs in 59 U.S. Health Departments

Developing target product profiles for Neisseria gonorrhoeae diagnostics in the context of antimicrobial resistance: An expert consensus

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