Screening and Prevention of Sexually Transmitted Infections

Hunter, Paul; Dalby, Jessica; Marks, Jaime; Swain, Geoffrey; Schrager, Sarina

doi:10.1016/j.pop.2014.02.003

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…The development of effective treatments and a prophylactic agent for HIV infection may have shifted population risk perceptions. In addition, the emergence of social networking and dating app platforms has altered the landscape that defines sexual networks and sexual practices . Since adolescents and young adults have the highest rates of STI, research is needed to develop interventions addressing the current sexual, social, and interpersonal contexts that emerging adolescents and young adults will navigate.…”

Section: Discussionmentioning

confidence: 99%

Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections

Henderson

Senger

Henninger

et al. 2020

JAMA

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Increasing rates of preventable sexually transmitted infections (STIs) in the US pose substantial burdens to health and well-being. OBJECTIVE To update evidence for the US Preventive Services Task Force (USPSTF) on effectiveness of behavioral counseling interventions for preventing STIs. DATA SOURCES Studies from the previous USPSTF review (2014); literature published January 2013 through May 31, 2019, in MEDLINE, PubMed (for publisher-supplied records only), PsycINFO, and Cochrane Central Register of Controlled Trials. Ongoing surveillance through May 22, 2020. STUDY SELECTION Good-and fair-quality randomized and nonrandomized controlled intervention studies of behavioral counseling interventions for adolescents and adults conducted in primary care settings were included. Studies with active comparators only or limited to individuals requiring specialist care for STI risk-related comorbidities were excluded. DATA EXTRACTION AND SYNTHESIS Dual risk of bias assessment, with inconsistent ratings adjudicated by a third team member. Study data were abstracted into prespecified forms. Pooled odds ratios (ORs) were estimated using the DerSimonian and Laird method or the restricted maximum likelihood method with Knapp-Hartung adjustment. MAIN OUTCOMES AND MEASURES Differences in STI diagnoses, self-reported condom use, and self-reported unprotected sex at 3 months or more after baseline. RESULTS The review included 37 randomized trials and 2 nonrandomized controlled intervention studies (N = 65 888; 13 good-quality, 26 fair-quality) recruited from primary care settings in the US. Study populations were composed predominantly of heterosexual adolescents and young adults (12 to 25 years), females, and racial and ethnic minorities at increased risk for STIs. Nineteen trials (n = 52 072) reported STI diagnoses as outcomes (3 to 17 months' follow-up); intervention was associated with reduced STI incidence (OR, 0.66 [95% CI, 0.54-0.81; I 2 = 74%]). Absolute differences in STI acquisition between groups varied widely depending on baseline population STI risk and intervention effectiveness, ranging from 19% fewer to 4% more people acquiring STI. Thirty-four trials (n = 21 417) reported behavioral change outcomes. Interventions were associated with self-reported behavioral change (eg, increased condom use) that reduce STI risk (OR, 1.31 [95% CI, 1.10-1.56; I 2 = 40%, n = 5253). There was limited evidence on persistence of intervention effects beyond 1 year. No harms were identified in 7 studies (n = 3458) reporting adverse outcomes. CONCLUSIONS AND RELEVANCE Behavioral counseling interventions for individuals seeking primary health care were associated with reduced incidence of STIs. Group or individual counseling sessions lasting more than 2 hours were associated with larger reductions in STI incidence, and interventions of shorter duration also were associated with STI prevention, although evidence was limited on whether the STI reductions associated with these interventions persisted beyond 1 year.

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Section: Discussionmentioning

confidence: 99%

Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections

Henderson

Senger

Henninger

et al. 2020

JAMA

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“…It is crucial to reinforce STI training and develop training strategies for general physicians and PHC midwives. Como estrategias de prevención secundaria, se incluye el manejo de los pacientes con ITS y sus parejas, así como también, la detección temprana y tratamiento de infecciones asintomáticas mediante el tamizaje de éstas 3,5 .…”

Section: Discussionunclassified

Infecciones de transmisión sexual: Concordancia diagnóstica entre profesionales de atención primaria de la zona norte de Santiago y dermatólogos del Hospital San José

Pineda

Minuzzi

Gárate

et al. 2018

Rev. chil. dermatol

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Introducción: Las infecciones de transmisión sexual (ITS) son una prioridad en salud pública, por su alta prevalencia, impacto en la calidad de vida y repercusiones económicas. Actualmente, no existen publicaciones que analicen la concordancia diagnóstica de las ITS entre el nivel primario y el nivel secundario de atención.Objetivo: Analizar la concordancia diagnóstica entre profesionales de atención primaria de salud (APS) y especialistas en el diagnóstico de las ITS.Metodología: Se analizaron retrospectivamente las fichas de 627 pacientes derivados desde APS de la zona norte de Santiago a la UNACESS (Unidad de Atención y Control en Salud Sexual) del Hospital San José entre enero de 2015 y enero de 2016, según diagnóstico de referencia y contrarreferencia. Además, se analizó: el profesional derivador, sexo, edad y nacionalidad del paciente. El grado de concordancia diagnóstica se determinó mediante el coeficiente kappa de Cohen.Resultados: El 74% de las interconsultas desde APS fueron emitidas por matronas y el 26% por médicos. Los diagnósticos de referencia más prevalentes fueron: Condiloma acuminado (64.43%), molusco contagioso (8.13%), sífilis (7.34%), uretritis (7.02%) y herpes genital (3.67%). Los diagnósticos de contrarreferencia más prevalentes fueron: Condiloma acuminado (51.20%), sífilis (10.85%), molusco contagioso (10.37%), uretritis (6.86%) y herpes genital (3.51%). La concordancia diagnóstica global del estudio fue moderada (54%). Los médicos de APS lograron una concordancia sustancial (62%) y las matronas una concordancia moderada (49.19%) respecto a los diagnósticos realizados por el especialista.Conclusión: De los resultados, podemos concluir que existe una concordancia diagnóstica moderada entre los profesionales APS y los médicos especialistas. Es fundamental reforzar la formación en ITS y elaborar estrategias de capacitación dirigido a médicos generales y matronas de APS.

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“…Therefore, in case they are exposed to an STI, adolescents are more likely to get infected than adults, as the columnar epithelium does not have the immunological defense ability of epithelial cells 64,65 . The criteria for diagnosing and treating cervicitis for adolescents are the same in women in general 64 .…”

Section: Adolescentsmentioning

confidence: 99%

“…Adolescents are more likely to risky sexual behavior, such as simultaneous partners or sexual intercourses without condoms. Besides, adolescents present a lower probability of accessing and using sexual health services in comparison with adults 64 , 65 . Such factors lead to a higher chance of exposure and a lower likelihood of diagnostic and treatment.…”

Section: Adolescentsmentioning

confidence: 99%

“…From the biological point of view, female adolescents are particularly susceptible to STI due to the lower production of cervical mucus and increased cervical ectopy 66 . Therefore, in case they are exposed to an STI, adolescents are more likely to get infected than adults, as the columnar epithelium does not have the immunological defense ability of epithelial cells 64 , 65 . The criteria for diagnosing and treating cervicitis for adolescents are the same in women in general 64 .…”

Section: Adolescentsmentioning

confidence: 99%

See 1 more Smart Citation

Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis

Miranda

Silveira

Pinto³

et al. 2021

Rev. Soc. Bras. Med. Trop.

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Infections that cause cervicitis are a topic presented in the "Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections", published by the Brazilian Ministry of Health in 2020. The document was developed based on scientific evidence and validated in discussions with experts. This article presents epidemiological and clinical aspects of infections that cause cervicitis and recommendations on screening, diagnosis, and treatment of affected people and their sexual partnerships. Also, it discusses strategies for surveillance, prevention, and control of these infections for health professionals and health service managers involved in the programmatic and operational management of sexually transmitted infections. Expanding access to diagnostic tests and early treatment are crucial for controlling the spread of pathogens that cause cervicitis.

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Screening and Prevention of Sexually Transmitted Infections

Cited by 10 publications

References 30 publications

Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections

Behavioral Counseling Interventions to Prevent Sexually Transmitted Infections

Infecciones de transmisión sexual: Concordancia diagnóstica entre profesionales de atención primaria de la zona norte de Santiago y dermatólogos del Hospital San José

Brazilian Protocol for Sexually Transmitted Infections, 2020: infections that cause cervicitis

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