Diversification of the Prevention of Sexually Transmitted Infections

Frickmann, Hagen

doi:10.2217/fmb-2019-0261

Cited by 9 publications

(9 citation statements)

References 12 publications

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“…The reasons, firstly, the condom is a closed tool, which can effectively prevent the infection of bacteria, viruses and fungi [ 23 ]. The second condom is equipped with lubricant, which can reduce local friction during sexual intercourse, so as to reduce the generation of micro wounds and reduce the subclinical infection and colonization of HPV [ 24 ]. Thirdly, condoms need to be used correctly.…”

Section: Discussionmentioning

confidence: 99%

Establishing a prediction model for recurrence of condyloma acuminatum

et al. 2022

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We collected the clinical data of 156 patients diagnosed with condyloma acuminatum (CA), including age, gender, marriage, education level, stay up late, smoking, drinking, number of sexual partners, HPV infection status of sexual partners, genitourinary and anal diseases, condom use, other diseases of HPV infection, location and number of warts, HPV typing, etc. Analyze the risk factors affecting the recurrence of CA, explore the influencing factors and independent influencing factors of CA recurrence, establish the prediction model of CA recurrence, and evaluate its prediction value. Univariate analysis showed that stay up late, HPV infection status of sexual partners, urogenital diseases, condom use, other diseases of HPV infection and the number of CA were the influencing factors of CA recurrence. Multivariate analysis showed that condom use (OR = 0.166), HPV infection status of sexual partners (OR = 4.848), number of warts (OR = 1.212) and urogenital diseases (OR = 3.179) were independent factors affecting the recurrence of CA (P < 0.05). Therefore, the prediction model of CA recurrence can be established, and the area under the curve AUC of the prediction model was calculated to be 0.867 (95% CI 0.812–0.923). The model established in this study has certain prediction value for the recurrence of CA and can be used to preliminarily predict the recurrence of CA.

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Section: Discussionmentioning

confidence: 99%

Establishing a prediction model for recurrence of condyloma acuminatum

et al. 2022

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“…The inclusion of respective temporary variations in consequence of a hypothetical STI screening prior to antibiotic therapy are, however, affected by multiple factors that are hardly predictable. An example is the “risk compensation” phenomenon mediated by the so-called Peltzmann effect [ 44 ] as reported for PrEP-based HIV-prevention [ 45 ]. Third, a theoretical modelling cannot definitively ensure a practical impact of a preventive medical approach, requiring a future proof-of-principle study to verify or falsify the hypotheses of the study presented here.…”

Section: Discussionmentioning

confidence: 99%

Testing as Prevention of Resistance in Bacteria Causing Sexually Transmitted Infections—A Population-Based Model for Germany

Hahn¹,

Frickmann

Loderstädt

2021

Antibiotics

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Prescribed antibiotic treatments which do not match the therapeutic requirements of potentially co-existing undetected sexually transmitted infections (STIs) can facilitate the selection of antibiotic-drug-resistant clones. To reduce this risk, this modelling assessed the potential applicability of reliable rapid molecular test assays targeting bacterial STI prior to the prescription of antibiotic drugs. The modelling was based on the prevalence of three bacterial STIs in German heterosexual and men-having-sex-with-men (MSM) populations, as well as on reported test characteristics of respective assays. In the case of the application of rapid molecular STI assays for screening, the numbers needed to test in order to correctly identify any of the included bacterial STIs ranged from 103 to 104 for the heterosexual population and from 5 to 14 for the MSM population. The number needed to harm—defined as getting a false negative result for any of the STIs and a false positive signal for another one, potentially leading to an even more inappropriate adaptation of antibiotic therapy than without any STI screening—was at least 208,995 for the heterosexuals and 16,977 for the MSM. Therefore, the screening approach may indeed be suitable to avoid unnecessary selective pressure on bacterial causes of sexually transmitted infections.

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“…It should be noted here that the probability of the occurrence of the symptoms may differ and that they are therefore Poisson binomially distributed. As recently demonstrated by our group based on three previous modelling approaches [8][9][10] and summarized in a mini-review [11], a combination of self-testing and the testing of potential sexual partners applying traditional or molecular rapid diagnostic testing (RDT) strategies can be a promising approach for the transmission prevention of sexually transmitted infections (STIs) for individuals who do not want to use condoms. As discussed previously [8][9][10][11][12], the effectiveness of such test-based preventive strategies depends on various factors, including the availability of reliable and easy-to-apply diagnostic point-of-care-testing (POCT) solutions even for diagnostic laymen, window-periods of the applied tests as well as the tests' sensitivity and specificity.…”

Section: The Mathematical Background Underlying the Exemplary Modellingmentioning

confidence: 99%

Optimization of Case Definitions for Sensitivity as a Preventive Strategy—A Modelling Exemplified with Rapid Diagnostic Test-Based Prevention of Sexual HIV Transmission

Hahn¹,

Frickmann

Loderstädt

2021

Diagnostics

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In clinical studies, case definitions are usually designed to optimally match the desired clinical state, because lacking specificity is associated with a risk of bias regarding the study outcome. In preventive medicine, however, high sensitivity is sometimes considered as more critical in order not to overlook infectious individuals, because the latter may be associated with ongoing spread of a transmittable disease. Accordingly, this work was focused on a theoretical model on how the sensitivity of case definitions can be optimized by adding clinical symptoms to diagnostic results for preventive purposes, if the associated reduction in specificity is considered as acceptable. The model was exemplified with an analysis on whether and in how far exposure risk can be reduced by the inclusion of observable symptoms during seroconversion syndrome in case of rapid diagnostic test-based prevention of sexual HIV transmission. The approach provided a high level of safety (negative predictive values close to 1) for the price of a considerably number of false positives (positive predictive values < 0.01 for some subpopulations). When applying such a sensitivity-optimized screening as a “diagnostics as prevention” strategy, the advantages of excellent negative predictive values need to be cautiously balanced against potential undesirable consequences of low positive predictive values.

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Diversification of the Prevention of Sexually Transmitted Infections

Abstract: With a technically well evaluated diagnostics-as-prevention approach covering a broad spectrum of STIs, sexual risk-taking populations could greatly reduce their STI transmission risk. "

Cited by 9 publications

References 12 publications

Establishing a prediction model for recurrence of condyloma acuminatum

Establishing a prediction model for recurrence of condyloma acuminatum

Testing as Prevention of Resistance in Bacteria Causing Sexually Transmitted Infections—A Population-Based Model for Germany

Optimization of Case Definitions for Sensitivity as a Preventive Strategy—A Modelling Exemplified with Rapid Diagnostic Test-Based Prevention of Sexual HIV Transmission

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