Pathways and progress to enhanced global sexually transmitted infection surveillance.
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ABSTRACT:
SUBMITTER: Taylor MM
PROVIDER: S-EPMC5486957 | biostudies-literature | 2017 Jun
REPOSITORIES: biostudies-literature
Publications
Pathways and progress to enhanced global sexually transmitted infection surveillance.
Taylor Melanie M MM Korenromp Eline E Wi Teodora T
PLoS medicine 20170627 6
Melanie Taylor and colleagues discuss global initiatives for surveillance of sexually transmitted diseases. ...[more]
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Project description:Sexually transmitted infections (STIs) continue to pose a substantial public health challenge in the United States (US). Surveillance, a cornerstone of disease control and prevention, can be strengthened to promote more timely, efficient, and equitable practices by incorporating health information exchange (HIE) and other large-scale health data sources into reporting. New York City patient-level electronic health record data between January 1, 2018 and June 30, 2023 were obtained from Healthix, the largest US public HIE. Healthix data were linked to neighborhood-level information from the American Community Survey. In this cross-sectional study, we compared patients who received a test or tested positive for chlamydia, gonorrhea, and/or HIV with patients who were untested or tested negative, respectively, using generalized estimating equations with logit function and robust standard errors. Among 1,519,121 tests performed for chlamydia, 1,574,772 for gonorrhea, and 1,200,560 for HIV, 2%, 0.6% and 0.3% were positive for chlamydia, gonorrhea, and HIV, respectively. Chlamydia and gonorrhea co-occurred in 1,854 cases (7% of chlamydia and 21% of gonorrhea total cases). Testing behavior was often incongruent with geographic and sociodemographic patterns of positive cases. For example, people living in areas with the highest levels of poverty were less likely to test for gonorrhea but almost twice as likely to test positive compared to those in low poverty areas. Regional HIE enabled review of testing and cases using granular and complementary data not typically available given existing reporting practices. Enhanced surveillance spotlights potential incongruencies between testing patterns and STI risk in certain populations, signaling potential under- and over-testing. These and future insights derived from HIE data may be used to continuously inform public health practice and drive further improvements in provision and evaluation of services and programs.
| S-EPMC11030475 | biostudies-literature
Project description:Purpose of reviewThe current study aimed to review how digital health has been used for sexually transmitted infection (STI)/HIV prevention, testing, and treatment.Recent findingsA scoping review was conducted by searching five databases for peer-reviewed literature published between March 2018 to August 2019. 23 out of 258 studies met the inclusion criteria and were assessed. Six studies used digital platform to enhance STI/HIV prevention messaging; four studies found that digital health can provide vivid promotional information and has been instrumental in increasing the accessibility and acceptability of STI/HIV testing; three studies reported digital health provides a channel to understand and interpret the discourses on preexposure prophylaxis (PrEP) and increase PrEP uptake; three studies focused on refining big data algorithms for surveillance; four studies reported on how digital interventions could be used to optimize clinical interventions; and four studies found digital interventions can be used to assist mental health services.SummaryDigital health is a powerful and versatile tool that can be utilized in the production of high-quality, innovative strategies on STIs and HIV services. Future studies should consider focusing on strategies and implementations that leverage digital platforms for network-based interventions, in addition to recognizing the norms of individual digital intervention platforms.
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Project description:Sexually transmitted infections (STIs) are widespread worldwide and negatively affect sexual and reproductive health. Gaps in evidence and in available tools have long hindered STI programmes and policies, particularly in resource-limited settings. In 2022, WHO initiated a research prioritisation process to identify the most important STI research areas to address the global public health need. Using an adapted Child Health and Nutrition Research Initiative methodology including two global stakeholder surveys, the process identified 40 priority STI research needs. The top priorities centred on developing and implementing affordable, feasible, rapid point-of-care STI diagnostic tests and new treatments, especially for gonorrhoea, chlamydia, and syphilis; designing new multipurpose prevention technologies and vaccines for STIs; and collecting improved STI epidemiologic data on both infection and disease outcomes. The priorities also included innovative programmatic approaches, such as new STI communication and partner management strategies. An additional six research areas related to mpox (formerly known as monkeypox) reflect the need for STI-related research during disease outbreaks where sexual transmission can have a key role. These STI research priorities provide a call to action for focus, investment, and innovation to address existing roadblocks in STI prevention, control, and management to advance sexual and reproductive health and wellbeing for all.
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Project description:The goal of the point-of-care (POC) sexually transmitted infection (STI) Diagnostics meeting was to review the state-of-the-art research and develop recommendations for the use of POC STI diagnostics. Experts from academia, government, nonprofit, and industry discussed POC diagnostics for STIs such as Chlamydia trachomatis, human papillomavirus, Neisseria gonorrhoeae, Trichomonas vaginalis, and Treponema pallidum. Key objectives included a review of current and emerging technologies, clinical and public health benefits, POC STI diagnostics in developing countries, regulatory considerations, and future areas of development. Key points of the meeting are as follows: (i) although some rapid point-of-care tests are affordable, sensitive, specific, easy to perform, and deliverable to those who need them for select sexually transmitted infections, implementation barriers exist at the device, patient, provider, and health system levels; (ii) further investment in research and development of point-of-care tests for sexually transmitted infections is needed, and new technologies can be used to improve diagnostic testing, test uptake, and treatment; (iii) efficient deployment of self-testing in supervised (ie, pharmacies, clinics, and so on) and/or unsupervised (ie, home, offices, and so on) settings could facilitate more screening and diagnosis that will reduce the burden of sexually transmitted infections; (iv) development of novel diagnostic technologies has outpaced the generation of guidance tools and documents issued by regulatory agencies; and (v) questions regarding quality management are emerging including the mechanism by which poor-performing diagnostics are removed from the market and quality assurance of self-testing is ensured.
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Project description:It is proposed that multiple sclerosis may be transmitted chiefly by sexual contact. Arguments favouring this include: migration studies that suggest a transmissible agent in adolescence; clusters of multiple sclerosis which have occurred in low prevalence areas following entry of young males; the similarity of multiple sclerosis to tropical spastic paraplegia, a known sexually transmitted infection with resemblance to primary progressive multiple sclerosis; an increased rate in drug misusers; a similar age of onset and sex pattern to that found in sexually transmitted disease; increased incidence of multiple sclerosis in those using oral contraceptives; low multiple sclerosis rates in societies with a strict moral code; longitudinal shifts in sex prevalence that show an increase in women after the sexual revolution of the 1960s; and important exceptions to the worldwide distribution corresponding to countries with permissive attitudes to sex. Family, conjugal pair, twin, and adoption studies are compatible with an infectious cause of multiple sclerosis if this is sexually transmitted. It is not proposed that sexual transmission is the only cause but that inherited factors create a susceptibility to a sexually transmitted neurotropic agent. It is hoped this hypothesis might encourage a new direction of neurological research.
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Project description:BACKGROUND:Great heterogeneity in sexually transmitted infections (STI) risk exists, and investigating individual-level characteristics related to changes in STI risk over time might facilitate the development and implementation of effective evidence-based behavior change interventions. The aim of this study was to identify longitudinal patterns of STI risk based on psychological and behavioral characteristics. METHODS:A longitudinal study was conducted among heterosexual STI clinic visitors aged 18 to 24 years. Latent classes based on behavioral and psychological characteristics at baseline, and transitions from 1 latent class to another at 3-week, 6-month, and 1-year follow-up, were identified using latent transition analysis. RESULTS:Four latent classes were identified that could be differentiated by psychological and behavioral characteristics and STI risk: overall low-risk (10%), insecure high-risk (21%), condom-users (38%), and confident high-risk (31%). Although the majority of the total study population did not move to another latent class over time, the size of the overall low-risk group increased from 10% at baseline to 30% after 1 year. This was mainly due to transitions from the insecure high-risk, condom-users, and confident high-risk class at 3-week follow-up to the overall low-risk class at 6-month follow-up. CONCLUSIONS:Distinct subgroups among heterosexual STI clinic visitors can be differentiated from each other by multiple psychological and behavioral characteristics, and these characteristics reflecting the risk of acquiring STI are consistent over the course of 1 year in most individuals. An integral approach, adapting behavioral interventions to match multiple psychological and behavioral characteristics of high-risk subgroups, might be more effective in controlling STI transmission.
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Project description:The selective forces shaping mating systems have long been of interest to biologists. One particular selective pressure that has received comparatively little attention is sexually transmitted infections (STIs). While it has been hypothesized that STIs could drive the evolutionary emergence of monogamy, there is little theoretical support. Here we use an evolutionary invasion analysis to determine what aspects of pathogen virulence and transmission are necessary for serial monogamy to evolve in a promiscuous population. We derive a biologically intuitive invasion condition in terms of population-specific quantities. From this condition, we obtain two main results. First, when pathogen virulence causes mortality rather than sterility, monogamy is more likely to evolve. Second, we find that at intermediate pathogen transmission rates, monogamy is the most selectively advantageous, whereas at high- and low-transmission rates, monogamy is generally selected against. As a result, it is possible for a pathogen to be highly virulent, yet for promiscuity to persist.
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Project description:There are many different sexually transmitted infections that can cause proctitis. Recognition of the common symptoms with anoscopic examination is crucial in accurate diagnosis of the pathogen. Clinicians should have a high index of suspicion of more than one inciting pathogen. Treatment should be prompt and extended to sexual partners who have been exposed to the disease. Effective treatment can alleviate the discomfort and potentially serious complications associated with sexually transmitted proctitides. This article illustrates and discusses the clinical presentations, diagnostic pearls, and treatments of sexually transmitted proctitides.
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Project description:ObjectiveTo determine the sexually transmitted infection (STI) vaccine research priorities of global leaders in STI vaccine research, development, and service provision.MethodsGlobal representatives attending the STI Vaccines: Opportunities for Research, Development, and Implementation symposium preceding the STI & HIV World Congress in 2019 were invited to complete an electronic survey. We asked participants to rank items by importance/priority for STI vaccine development for the following areas of focus: specific STIs (gonorrhea, chlamydia, syphilis, herpes, and trichomoniasis), broad research domains (basic science, funding, communication, program planning, and vaccine hesitancy), and specific research activities related to these domains. We calculated weighted value scores based on the ranking (e.g., first, second, third) and the total number of responses in order to produce a ranked list of the priorities.ResultsA total of 46 out of 97 (44%) symposium attendees responded to the survey. Gonorrhea was identified as the STI that should be prioritized for vaccine development, followed by syphilis with weighted value scores of 3.82 and 3.37, respectively, out of a maximum of five. Basic science (and vaccine development) was the domain ranked with the highest priority with a weighted value score of 4.78 out of six. Research activities related to basic science and vaccine development (including pre-clinical and clinical trials, and surveillance measures) and increased funding opportunities were the most highly ranked activities in the "STI vaccine development" and "research domains and activities" categories.ConclusionGlobal leaders in attendance at the STI Vaccines symposium prioritized continued scientific work in vaccine development and program planning. Gonorrhea was identified as the highest priority infection, followed by syphilis.
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