1
|
Shi L, Luo J, Chen Y, Chen L, Hu H, Qiu T, Liu X, Xu X, Chen Y, Zhang Z, Zhou Y, Lu J, Fu G. Prevalence of syphilis and chlamydia trachomatis infection among female sex workers in Jiangsu, China: Results from a multicenter cross-sectional and venue-based study. Front Public Health 2022; 10:1018724. [PMID: 36388309 PMCID: PMC9659951 DOI: 10.3389/fpubh.2022.1018724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/14/2022] [Indexed: 01/28/2023] Open
Abstract
Background Female sex workers (FSWs) are considered highly vulnerable to sexually transmitted infections (STIs), but available data on the prevalence of STIs among FSWs in China is limited at a provincial level. This study aimed to evaluate the prevalence of STIs and risk factors among FSWs in Jiangsu, China. Methods We conducted a multicenter cross-sectional study in seven cities of Jiangsu to investigate the prevalence and risk factors associated with HIV and other STIs. Blood and urine were collected to test for HIV, syphilis, Hepatitis C (HCV), Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infections. Results We enrolled 3,580 FSWs. The overall prevalence of bacterial STIs was 6.2% (5.4%-7.0%). The prevalence of HIV, syphilis infection, HCV, NG and CT were 0.1% (95%CI, 0.0-0.2), 1.8% (95%CI, 1.4-2.3), 0.3% (95%CI, 0.1-0.5), 0.3% (95%CI, 0.2-0.5) and 4.3% (95%CI, 3.6-5.0), respectively. Most FSWs (85.6%) reported consistent condom use with clients in the past month. Only 10.6% of FSWs reported group sex, and 68.3% self-reported HIV testing in the previous year. According to the multivariable model, having group sex in the past year (aOR, 2.521, 95%CI: 1.366-4.651) and HIV infection (aOR, 26.260, 95%CI: 2.432-283.563) were associated with a higher risk of syphilis infection. Migrants (aOR, 1.669, 95%CI: 1.163-2.395), having a history of STIs in the past year (aOR, 4.601, 95%CI: 1.003-21.118), and NG infection (aOR, 38.549, 95%CI: 11.214-132.514) were associated with a higher risk of CT infection. On the contrary, FSWs aged older than 25 were associated with lower risk of syphilis infection (25-34: aOR, 0.339, 95%CI: 0.151-0.763) and CT infection (25-34: aOR, 0.503, 95%CI: 0.316-0.802; ≥35: aOR, 0.578, 95%CI: 0.362-0.925). Conclusion This study's prevalence rates of syphilis and CT infections show the need to promote comprehensive STIs control and prevention strategies, including behavioral intervention and STIs screening, especially in younger high-risk populations. With the increasing coverage of HIV testing, integrating other STIs screening with HIV testing may be a reasonable way to implement comprehensive STIs control and prevention.
Collapse
Affiliation(s)
- Lingen Shi
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China,Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China
| | - Jun Luo
- Department of Clinical Central Laboratory, Jiangsu Health Vocational College, Nanjing, China
| | - Yuheng Chen
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Liping Chen
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Haiyang Hu
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Tao Qiu
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiaoyan Liu
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiaoqin Xu
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yunting Chen
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zhi Zhang
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Ying Zhou
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jing Lu
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Gengfeng Fu
- Institute for STIs and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China,*Correspondence: Gengfeng Fu
| |
Collapse
|
2
|
KORUNMASIZ CİNSEL İLİŞKİ SONUCU ÜRETRİT TANISI ALAN SÜNNETLİ HASTALARDA ASEMPTOMATİK HIV, HEPATİT B, HEPATİT C VE SİFİLİZ GÖRÜLME SIKLIĞI. JOURNAL OF CONTEMPORARY MEDICINE 2022. [DOI: 10.16899/jcm.1030661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim: In this study, it was aimed to determine the frequency of asymptomatic Human Immunodeficiency Virus (HIV), Hepatitis B, Hepatitis C, and syphilis in circumcised patients diagnosed with urethritis transmitted by sexual intercourse because of unprotected sexual contact.
Material and Methods: We retrospectively investigated the serological results of HIV, Hepatitis B, Hepatitis C, and Syphilis diseases in 364 male patients diagnosed with urethritis, all of them were circumcised during childhood. The study included patients who applied to the urology outpatient clinic of secondary state hospital between January 2017 and December 2019 with symptoms or signs of urethritis. In the examination, only urethral discharge could be seen without symptoms. After the patients were examined, first void urine samples were taken. Also at the first examination, peripheral blood samples were tested for HIV, Hepatitis B, Hepatitis C, and syphilis antibodies.
Results: As a result of retrospective screening of the serological results of 364 male patients diagnosed with urethritis, Hepatitis B positivity was 1.09% with 4 cases, Hepatitis C positivity was found as 0.27% in 1 case and the Syphilis positivity rate was 1.92% with 7 cases in 364 patients. None of the patients had HIV positivity.
Conclusions: The fact that there was not any encounter of HIV-positive patients in patients diagnosed with urethritis because of unprotected sexual contact led to the thought that circumcision had a protective contribution in these patients with urethritis, who were all circumcised. Also, screening tests, especially syphilis, should be performed on all patients diagnosed with STI infection.
Collapse
|
3
|
Fu L, Sun Y, Han M, Wang B, Xiao F, Zhou Y, Gao Y, Fitzpatrick T, Yuan T, Li P, Zhan Y, Lu Y, Luo G, Duan J, Hong Z, Fairley CK, Zhang T, Zhao J, Zou H. Incidence Trends of Five Common Sexually Transmitted Infections Excluding HIV From 1990 to 2019 at the Global, Regional, and National Levels: Results From the Global Burden of Disease Study 2019. Front Med (Lausanne) 2022; 9:851635. [PMID: 35308518 PMCID: PMC8924524 DOI: 10.3389/fmed.2022.851635] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/31/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Sexually transmitted infections (STIs) are common worldwide and pose a challenge to public health. We conducted this study to assess the annual incidence of five common STIs, including syphilis, chlamydia, gonorrhea, trichomoniasis, and genital herpes at the global, regional, and national levels. Materials and Methods We obtained detailed data on STIs excluding HIV from 1990 to 2019 from the Global Burden of Disease (GBD) 2019 database. Estimated annual percentage change (EAPC) was calculated to quantify trends in age-standardized incidence rates (ASR) of STIs, stratified by gender, sociodemographic index (SDI) region, and pathogenic microorganism. Results Globally, incident cases of STIs increased by 58.15% from 486.77 million in 1990 to 769.85 million in 2019, but the annual change in ASR was only -0.04% (95% CI -0.09 to 0.01) per year. EAPC was 0.16 (0.06 to 0.26) for syphilis, 0.09 (0.05 to 0.13) for genital herpes, 0.06 (0.03 to 0.09) for trichomoniasis, -0.21 (-0.36 to -0.06) for chlamydia, and -0.14 (-0.19 to -0.08) for gonorrhea. High SDI regions reported significant increases in ASR of syphilis and chlamydia. Conclusions The burden of disease from STIs remains large, though control of STIs has contributed to the decreasing incidence in most regions, especially in the low-SDI regions. Globally, over the past 20 years, the ASR has remained stable for trichomoniasis and genital herpes decreased for chlamydia and gonorrhea, and increased for syphilis.
Collapse
Affiliation(s)
- Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yinghui Sun
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Min Han
- Department of Medical Administration, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Fei Xiao
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Yiguo Zhou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yanxiao Gao
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Thomas Fitzpatrick
- Department of Internal Medicine, University of Washington, Seattle, WA, United States
| | - Tanwei Yuan
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Peiyang Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yuewei Zhan
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Yong Lu
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Ganfeng Luo
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Junyi Duan
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Zhongsi Hong
- The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Christopher K. Fairley
- Central Clinical School, Monash University, Melbourne, VIC, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
| | - Tong Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Jin Zhao
- Department of HIV/AIDS Control and Prevention, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, China
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
4
|
Chico RM, Tsuboi M, Evans J, Davies EP, Rowley J, Korenromp EL, Clayton T, Mabey D, Taylor MM. Estimating burden of syphilis among men who have sex with men – Authors' reply. THE LANCET GLOBAL HEALTH 2021; 9:e1649. [PMID: 34798018 PMCID: PMC9128567 DOI: 10.1016/s2214-109x(21)00449-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022] Open
|
5
|
Wilson A, Wang YY, Chen R, Cen P, Wang Y, Yao X, Wang T, Li S, Yan H. A thematic analysis of experiences of HIV risks among female sex workers in the Yunnan-Vietnam Chinese border region. BMC WOMENS HEALTH 2021; 21:7. [PMID: 33407384 PMCID: PMC7789185 DOI: 10.1186/s12905-020-01143-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/07/2020] [Indexed: 12/29/2022]
Abstract
Background The Yunnan province is located near the “Golden Triangle” border region between China, Myanmar and Thailand, which has the highest HIV/AIDS prevalence in China. Female sex workers (FSWs) in the Yunnan province are highly vulnerable to HIV infection. The objective of this study was to examine the experiences of FSWs in the Yunnan to better understand the risk of infection and the potential for transmission of HIV. Methods Semi-structured interviews were conducted between May 2018 and June 2018 with 20 FSWs recruited in Hekou County, Yunnan Province, China. Thematic analysis was conducted to identify themes that highlighted increased exposure of FSWs to the risk of HIV infection and transmission. Results The findings showed that FSWs’ primary source for HIV information was gynecologists, with few visiting the local HIV charity Red Ribbon. FSWs reported infrequent visits for check-ups with some seeing a gynecologist once a year. FSWs felt that the onus was on them to prevent STI/HIV infection by using a condom during sex, regardless of their ability to negotiate use. FSWs were also reluctant to see a gynecologists for treatment. Instead, they resorted to douching as a way of preventing HIV/STIs and treating vaginal health problems, such as leucorrhea. Most FSWs worked without the influence of alcohol and drugs. A small number of FSWs reported heroin addiction and injecting drug use. Conclusion The findings suggest a need for innovative HIV prevention strategies among FSWs and their clients in the Chinese border region. Governmental agencies should continue to implement practical strategies in terms of HIV prevention education and condom use through tailored interventions that are localized. Such strategies should include localized tailored interventions that dispel myths about douching as a method of HIV/STI prevention and incorporate a mobile outreach approach, similar to the ‘roadside restaurant’ outreach that has been successful in rural China.
Collapse
Affiliation(s)
- Amanda Wilson
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Yuan Yuan Wang
- Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Runsen Chen
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ping Cen
- Center for Disease Control and Prevention of Nanning, Nanning, China
| | - Yuehui Wang
- School of Health Sciences, Wuhan University, Wuhan, China.,Center for Disease Control and Prevention of Yuzhong District of Chongqing, Chongqing, China
| | - Xing Yao
- Center for Disease Control and Prevention of Wuhan, Wuhan, China
| | - Tang Wang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Shiyue Li
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Hong Yan
- School of Health Sciences, Wuhan University, Wuhan, China.
| |
Collapse
|
6
|
Prevalence of syphilis, gonorrhoea and chlamydia in women in Fiji, the Federated States of Micronesia, Papua New Guinea and Samoa, 1995-2017: Spectrum-STI
model estimates. Western Pac Surveill Response J 2020; 11:29-40. [PMID: 32963889 PMCID: PMC7485516 DOI: 10.5365/wpsar.2019.10.2.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objective To estimate prevalence levels of and time trends for active syphilis, gonorrhoea and chlamydia in women aged 15-49 years in four countries in the Pacific (Fiji, the Federated States of Micronesia [FSM], Papua New Guinea [PNG] and Samoa) to inform surveillance and control strategies for sexually transmitted infections (STIs). Methods The Spectrum-STI model was fitted to data from prevalence surveys and screenings of adult female populations collected during 1995-2017 and adjusted for diagnostic test performance and to account for undersampled high-risk populations. For chlamydia and gonorrhoea, data were further adjusted for age and differences between urban and rural areas. Results Prevalence levels were estimated as a percentage (95% confidence interval). In 2017, active syphilis prevalence was estimated in Fiji at 3.89% (2.82 to 5.06), in FSM at 1.48% (0.93 to 2.16), in PNG at 3.91% (1.67 to 7.24) and in Samoa at 0.16% (0.07 to 0.37). For gonorrhoea, the prevalence in Fiji was 1.63% (0.50 to 3.87); in FSM it was 1.59% (0.49 to 3.58); in PNG it was 11.0% (7.25 to 16.1); and in Samoa it was 1.61% (1.17 to 2.19). The prevalence of chlamydia in Fiji was 24.1% (16.5 to 32.7); in FSM it was 23.9% (18.5 to 30.6); in PNG it was 14.8% (7.39 to 24.7); and in Samoa it was 30.6% (26.8 to 35.0). For each specific disease within each country, the 95% confidence intervals overlapped for 2000 and 2017, although in PNG the 2017 estimates for all three STIs were below the 2000 estimates. These patterns were robust in the sensitivity analyses. Discussion This study demonstrated a persistently high prevalence of three major bacterial STIs across four countries in WHO's Western Pacific Region during nearly two decades. Further strengthening of strategies to control and prevent STIs is warranted.
Collapse
|