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Canabarro APF, Eriksson M, Nielsen A, Zeebari Z, Salazar M. Cognitive social capital as a health-enabling factor for STI testing among young men in Stockholm, Sweden: A cross-sectional population-based study. Heliyon 2023; 9:e20812. [PMID: 37876418 PMCID: PMC10590937 DOI: 10.1016/j.heliyon.2023.e20812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 09/12/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Abstract
Objective To assess whether different forms of cognitive social capital increased the relative probability of testing for sexually transmitted infections (STIs) among young men living in Stockholm, Sweden. Methods A population-based cross-sectional study was conducted in 2017 with men aged 20-29 years living in Stockholm County, Sweden (n = 523). The main outcome was STI testing patterns (never tested, tested only within a12-monthperiod, tested only beyond a12-monthperiod, repeatedly tested). The main exposure were two forms of cognitive social capital: social support (having received help, having someone to share inner feelings with) and institutionalized trust (in school, healthcare, media). Data were analyzed using weighted multivariable multinomial logistic regression to obtain adjusted weighted relative probability ratio (aRPR). Results After adjusting for confounding factors, receiving help (aRPR: 5.2, 95% CI: 1.7-16.2) and having someone to share inner feelings with (aRPR: 3.1, 95% CI: 1.2-7.7) increased the relative probabilities of young men testing for STIs, but only for those testing beyond a 12-month period. Trust in media increased the relative probability of STI testing for those testing only within a 12-month period (aRPR: 2.6, 95% CI: 1.1-6.1) and for those testing repeatedly (aRPR: 3.6, 95% CI: 1.5-8.8). Conclusion Young men in Stockholm County exhibit distinct STI testing patterns. Social support and trust in media were factors that increased the probability of being tested for STIs, with this effect varying according to the young men's STI testing pattern. Further studies are required to explore how trust in media might promote STI testing in this population.
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Affiliation(s)
- Ana Paula Finatto Canabarro
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset, 171 77, Stockholm, Sweden
| | - Malin Eriksson
- Department of Social Work, Umeå University, 901 87, Umeå, Sweden
| | - Anna Nielsen
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset, 171 77, Stockholm, Sweden
| | - Zangin Zeebari
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset, 171 77, Stockholm, Sweden
- Jönköping International Business School, Jönköping University, Gjuterigatan 5, 553 18, Jönköping, Sweden
| | - Mariano Salazar
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18a, Widerströmska Huset, 171 77, Stockholm, Sweden
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Veličko I, Ploner A, Marions L, Sparén P, Herrmann B, Kühlmann-Berenzon S. Patterns of sexual behaviour associated with repeated chlamydia testing and infection in men and women: a latent class analysis. BMC Public Health 2022; 22:652. [PMID: 35382799 DOI: 10.1186/s12889-021-12394-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents and young adults are at higher risk of acquiring Chlamydia trachomatis infection (chlamydia), so testing is promoted in these populations. Studies have shown that re-testing for chlamydia is common amongst them. We investigated how sexual risk behaviour profiles are associated with repeated testing for chlamydia. METHODS We used baseline data from a cohort of 2814 individuals recruited at an urban STI -clinic. We applied latent class (LC) analysis using 9 manifest variables on sexual behaviour and substance use self-reported by the study participants. We fitted ordered logistic regression to investigate the association of LC membership with the outcomes repeated testing during the past 12 months and lifetime repeated testing for chlamydia. Models were fit separately for men and women. RESULTS We identified four LCs for men and three LCs for women with increasing gradient of risky sexual behaviour. The two classes with the highest risk among men were associated with lifetime repeated testing for chlamydia: adjOR = 2.26 (95%CI: 1.50-3.40) and adjOR = 3.03 (95%CI: 1.93-4.74) as compared with the class with lowest risk. In women, the class with the highest risk was associated with increased odds of repeated lifetime testing (adjOR =1.85 (95%CI: 1.24-2.76)) and repeated testing during past 12 months (adjOR = 1.72 (95%CI: 1.16-2.54)). An association with chlamydia positive test at the time of the study and during the participant's lifetime was only found in the male highest risk classes. CONCLUSION Prevention messages with regard to testing for chlamydia after unprotected sexual contact with new/casual partners seem to reach individuals in highest risk behaviour classes who are more likely to test repeatedly. Further prevention efforts should involve potentially more tailored sex-specific interventions taking into consideration risk behaviour patterns.
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Li A, Parent S, Kasmani A, Guan TH, Moore K. COVID-19 outbreak in a personal service setting in Kingston, Ontario, 2020. Can Commun Dis Rep 2021; 47:216-223. [PMID: 34035668 PMCID: PMC8127683 DOI: 10.14745/ccdr.v47i04a06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, Ontario created a three-phase reopening framework for the economy. Outbreaks were expected at each phase. One week after Phase Two of reopening in the provincial public health administration region of Kingston, Frontenac, Lennox and Addington (KFL&A), a positive case was reported after three weeks of zero new COVID-19 cases. The objective of this report is to describe this COVID-19 outbreak, linked to a personal service setting (PSS), and the public health response to contain the outbreak. METHODS The outbreak investigation included all COVID-19 cases in KFL&A between June 20, 2020 and July 3, 2020. Public health inspectors and nurses were rapidly deployed to inspect the PSS. A multimodal approach to high-volume testing involved fixed assessment centres, drive-through testing capacity and targeted testing at the outbreak site. Testing was conducted through a real-time polymerase chain reaction assay at the local Public Health Ontario laboratory. RESULTS Thirty-seven cases were associated with the outbreak: 38% through direct PSS exposure; 32% through household contact; and 30% through social and workplace contact. A superspreading event contributed to 38% of total cases. The majority of cases were in the low to mid-quintiles when analyzed for material deprivation. Testing rates increased four-fold compared to the prior baseline weeks in response to media attention and public health messaging, resulting in a low percent positivity. CONCLUSION The interplay of aggressive accessible testing, quick lab turnaround time, contact tracing within 24 hours of positive laboratory results as per provincial standards, frequent public communication, rapid inspections, mandatory self-isolation and face coverings were measures successful in halting the outbreak. Inspections or self-audits should be required at all PSSs prior to reopening and outbreak management must work with PSSs to reduce the possibility of superspreading events.
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Affiliation(s)
- Anthony Li
- Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON
- School of Medicine, Queen’s University, Kingston, ON
| | - Stéphanie Parent
- Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON
- School of Medicine, Queen’s University, Kingston, ON
| | - Azim Kasmani
- Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON
- Public Health and Preventive Medicine Residency Program, Queen’s University, Kingston, ON
| | - T Hugh Guan
- Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON
- Public Health and Preventive Medicine Residency Program, Queen’s University, Kingston, ON
| | - Kieran Moore
- Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health, Kingston, ON
- Public Health and Preventive Medicine Residency Program, Queen’s University, Kingston, ON
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van Wees DA, Heijne JCM, Basten M, Heijman T, de Wit J, Kretzschmar MEE, den Daas C. Longitudinal Patterns of Sexually Transmitted Infection Risk Based on Psychological Characteristics and Sexual Behavior in Heterosexual Sexually Transmitted Infection Clinic Visitors. Sex Transm Dis 2020; 47:171-6. [PMID: 31876886 DOI: 10.1097/OLQ.0000000000001110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We identified longitudinal patterns of STI risk based on psychological and behavioral characteristics, and these characteristics did not change over time in most participants, irrespective of sexually transmitted infection test results. Supplemental digital content is available in the text. 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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Affiliation(s)
- Stephen Foster
- Department of Psychology, Penn State York, York, PA, USA
| | | | - Jongwon Lee
- College of Nursing, University of New Mexico, Albuquerque, NM, USA
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Aung ET, Chow EP, Fairley CK, Hocking JS, Bradshaw CS, Williamson DA, Chen MY. International travel as risk factor for Chlamydia trachomatis infections among young heterosexuals attending a sexual health clinic in Melbourne, Australia, 2007 to 2017. ACTA ACUST UNITED AC 2020; 24. [PMID: 31690365 PMCID: PMC6836681 DOI: 10.2807/1560-7917.es.2019.24.44.1900219] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BackgroundInternational travel is considered a risk factor for acquiring Chlamydia trachomatis; however, there are little empirical data to support this.AimTo examine the prevalence and risk factors for Chlamydia trachomatis infections among heterosexual international travellers (n = 28,786) attending the Melbourne Sexual Health Centre (MSHC), Australia, compared to Australian residents (n = 20,614).MethodsWe conducted a repeated cross-sectional study and analysed sexual behaviours and chlamydia positivity among heterosexual males and females aged ≤ 30 attending MSHC for the first time between January 2007 and February 2017. 'Travellers' were defined as individuals born outside of Australia who had resided in the country < 2 years. Associations between patient characteristics and chlamydia positivity were examined.ResultsChlamydia positivity was higher among travellers (11.2%) compared with Australian residents (8.5%; p < 0.001). Male travellers had higher chlamydia positivity (12.1%) than Australian males (9.3%; p < 0.001), as did female travellers (10.4%) compared with Australian females (7.7%; p < 0.001). Travellers had a higher mean number of sexual partners than Australian residents among males (5.7 vs 4.7; p < 0.001) and females (3.6 vs 3.2; p < 0.001). Travellers from the United Kingdom, Europe, Ireland and New Zealand accounted for 29.6%, 21%, 8.5% and 5.8% of C. trachomatis infections, respectively. Chlamydia in males and females was associated with younger age (≤ 25), inconsistent condom use, a higher number of sexual partners (≥ 4 partners) and being a traveller (p < 0.001).ConclusionsWe found that international travel is an independent risk factor for chlamydia among young heterosexual travellers in Australia, who should therefore be a target group for chlamydia prevention.
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Affiliation(s)
- Ei T Aung
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Eric Pf Chow
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Christopher K Fairley
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Jane S Hocking
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Catriona S Bradshaw
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Deborah A Williamson
- Microbiological Diagnostic Unit Public Health Laboratory, Department of Microbiology and Immunology, The University of Melbourne at The Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Marcus Y Chen
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
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Abstract
OBJECTIVES The aim of the study was to investigate whether the use of dating apps is a risk factor for acquiring Chlamydia trachomatis (CT) infections. METHODS Patients attending the drop-in facility at the STI clinic at Umeå University Hospital between April 2016 and November 2017 were asked to fill in a survey about their sexual preferences and behaviors, including dating app use. RESULTS Of 943 participants, 80 (8.5%) received a CT diagnosis (34 women and 46 men). Dating app users did not seem to have an increased risk of CT infection. Having 3 or more sex partners within the last year was a risk factor for CT only among those not using a dating app. Alcohol use before sex and unprotected sex with a new partner were risk factors for CT infection in the univariate but not in the multivariate analysis. CONCLUSIONS Dating app users did not seem to have an increased risk of acquiring CT and for dating app users the seemingly well-established risk factor of having many partners was not valid.
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van Wees DA, den Daas C, Kretzschmar MEE, Heijne JCM. Double trouble: modelling the impact of low risk perception and high-risk sexual behaviour on chlamydia transmission. J R Soc Interface 2019; 15:rsif.2017.0847. [PMID: 29618527 DOI: 10.1098/rsif.2017.0847] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/09/2018] [Indexed: 12/11/2022] Open
Abstract
Risk perception plays an important role in testing behaviour for sexually transmitted infections, but is rarely included in mathematical models exploring the impact of testing. We explored the impact of incorporating sexual behaviour (SB), risk perception (RP) and differential testing uptake in SB-RP groups on prevalence, using chlamydia as an example. We developed a pair model with a susceptible-infected-susceptible structure representing heterosexuals aged 16-26 years. The effect of testing on chlamydia prevalence was compared between a model with only SB (SB model) and a model with SB and RP (SB-RP model). In the SB-RP model, a scenario without differential testing uptake in SB-RP groups was compared to scenarios with differential testing uptake in SB-RP groups. Introducing testing into the SB-RP model resulted in a slightly smaller reduction in chlamydia prevalence (-38.0%) as compared to the SB model (-40.4%). In the SB-RP model, the scenario without differential testing uptake in SB-RP groups overestimated the reduction in chlamydia prevalence (with 4.8%), especially in the group with high SB and low RP (19.8%). We conclude that mathematical models incorporating RP and differential testing uptake in SB-RP groups improve the impact assessment of testing and treatment on chlamydia prevalence.
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Affiliation(s)
- Daphne A van Wees
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Chantal den Daas
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
| | - Mirjam E E Kretzschmar
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Janneke C M Heijne
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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van Wees DA, Heijne JCM, Heijman T, Kampman KCJG, Westra K, de Vries A, de Wit J, Kretzschmar MEE, den Daas C. A Multidimensional Approach to Assessing Infectious Disease Risk: Identifying Risk Classes Based on Psychological Characteristics. Am J Epidemiol 2019; 188:1705-1712. [PMID: 31145447 PMCID: PMC6736114 DOI: 10.1093/aje/kwz140] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 05/24/2019] [Accepted: 05/24/2019] [Indexed: 01/05/2023] Open
Abstract
Prevention of infectious diseases depends on health-related behavior, which is often influenced by psychological characteristics. However, few studies assessing health-related behavior have examined psychological characteristics to identify risk groups, and this multidimensional approach might improve disease risk assessment. We aimed to characterize subgroups based on psychological characteristics and examine their influence on behavior and disease risk, using chlamydia as a case study. Selected participants (heterosexuals aged 18–24 years and females aged 18–24 years who had sex with both men and women) in a Dutch longitudinal cohort study (the Mathematical Models Incorporating Psychological Determinants: Control of Chlamydia Transmission (iMPaCT) Study) filled out a questionnaire and were tested for chlamydia (2016–2017). Latent class analysis was performed to identify risk classes using psychological predictors of chlamydia diagnosis. Two classes were identified: class 1 (n = 488; 9% chlamydia diagnosis) and class 2 (n = 325; 13% chlamydia diagnosis). The proportion of participants with high shame, high impulsiveness, and lower perceived importance of health was higher in class 2 than in class 1. Furthermore, persons in class 2 were more likely to be male and to report condomless sex compared with class 1, but the number of recent partners was comparable. Thus, risk classes might be distinguished from each other by psychological characteristics beyond sexual behavior. Therefore, the impact of the same intervention could differ, and tailoring interventions based on psychological characteristics might be necessary to reduce chlamydia prevalence most effectively.
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Affiliation(s)
- Daphne A van Wees
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Janneke C M Heijne
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Titia Heijman
- Public Health Service Amsterdam, Amsterdam, the Netherlands
| | | | - Karin Westra
- Public Health Service Hollands Noorden, Alkmaar, the Netherlands
| | - Anne de Vries
- Public Health Service Kennemerland, Haarlem, the Netherlands
| | - John de Wit
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, the Netherlands
| | - Mirjam E E Kretzschmar
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Chantal den Daas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, the Netherlands
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Morhason-Bello IO, Kabakama S, Baisley K, Francis SC, Watson-Jones D. Reported oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa: a systematic review. Reprod Health 2019; 16:48. [PMID: 31060573 PMCID: PMC6501425 DOI: 10.1186/s12978-019-0722-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 04/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral and anal sexual behaviours are increasingly reported among adolescents and adults reporting heterosexual sex in peer-reviewed journals in high income countries, but less is known about these behaviours in low and middle-income countries, especially in sub-Saharan Africa. The aim of this systematic review is to describe the prevalence of, and motivations for, oral and anal sex among adolescents and adults reporting heterosexual sex in sub-Saharan Africa. METHODS A systematic review of published articles that reported oral and or anal sex in sub-Saharan Africa was conducted from seven databases up to and including 30th August 2018. RESULTS Of 13,592 articles, 103 met the inclusion criteria. The prevalence of reporting ever practising oral sex among adolescents, university students and a combined population of adolescents/adults ranged from 1.7-26.6%, 5.0-46.4% and 3.0-47.2% respectively. Similarly, prevalences of reported ever practising anal sex ranged from 6.4-12.4% among adolescents, 0.3-46.5% among university students and 4.3-37.8% amongst combined population of adolescents and adults. Higher prevalences of oral and anal sex were reported among populations at high-risk for sexually transmitted infections and HIV and university students and, in most studies, both behaviours were more commonly reported by males than females. Heterosexual oral and anal sexual acts were associated with some high-risk behaviours such as inconsistent condom use and multiple sexual partners. CONCLUSION Reported oral and anal sex between men and women are prevalent behaviours in sub-Saharan Africa. Health professionals and policy makers should be aware of these behaviours and their potential associated health risks.
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Affiliation(s)
- Imran O. Morhason-Bello
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT UK
- Obstetrics and Gynaecology Department, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Severin Kabakama
- Mwanza Intervention Trials Unit, National Institute for Medical Research, PO Box 11936, Mwanza, Tanzania
| | - Kathy Baisley
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT UK
| | - Suzanna C. Francis
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT UK
| | - Deborah Watson-Jones
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT UK
- Mwanza Intervention Trials Unit, National Institute for Medical Research, PO Box 11936, Mwanza, Tanzania
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11
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van Wees DA, Heijne JCM, Heijman T, Kampman KCJG, Westra K, de Vries A, Kretzschmar MEE, den Daas C. Study protocol of the iMPaCT project: a longitudinal cohort study assessing psychological determinants, sexual behaviour and chlamydia (re)infections in heterosexual STI clinic visitors. BMC Infect Dis 2018; 18:559. [PMID: 30424737 PMCID: PMC6234675 DOI: 10.1186/s12879-018-3498-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 11/01/2018] [Indexed: 01/06/2023] Open
Abstract
Background Chlamydia trachomatis (chlamydia), the most commonly reported sexually transmitted infection (STI) in the Netherlands, can lead to severe reproductive complications. Reasons for the sustained chlamydia prevalence in young individuals, even in countries with chlamydia screening programs, might be the asymptomatic nature of chlamydia infections, and high reinfection rates after treatment. When individuals are unaware of their infection, preventive behaviour or health-care seeking behaviour mostly depends on psychological determinants, such as risk perception. Furthermore, behaviour change after a diagnosis might be vital to reduce reinfection rates. This makes the incorporation of psychological determinants and behaviour change in mathematical models estimating the impact of interventions on chlamydia transmission especially important. Therefore, quantitative real-life data to inform these models is needed. Methods A longitudinal cohort study will be conducted to explore the link between psychological and behavioural determinants and chlamydia (re)infection among heterosexual STI clinic visitors aged 18–24 years. Participants will be recruited at the STI clinics of the public health services of Amsterdam, Hollands Noorden, Kennemerland, and Twente. Participants are enrolled for a year, and questionnaires are administrated at four time points: baseline (before an STI consultation), three-week, six-month and at one-year follow-up. To be able to link psychological and behavioural determinants to (re)infections, participants will be tested for chlamydia at enrolment and at six-month follow-up. Data from the longitudinal cohort study will be used to develop mathematical models for curable STI incorporating these determinants to be able to better estimate the impact of interventions. Discussion This study will provide insights into the link between psychological and behavioural determinants, including short-term and long-term changes after diagnosis, and chlamydia (re)infections. Our mathematical model, informed by data from the longitudinal cohort study, will be able to estimate the impact of interventions on chlamydia prevalence, and identify and prioritise successful interventions for the future. These interventions could be implemented at STI clinics tailored to psychological and behavioural characteristics of individuals. Trial registration Dutch Trial Register NTR-6307. Retrospectively registered 11-nov-2016.
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Affiliation(s)
- Daphne A van Wees
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - Janneke C M Heijne
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Titia Heijman
- Public Health Service Amsterdam, Amsterdam, The Netherlands
| | | | - Karin Westra
- Public Health Service Hollands Noorden, Alkmaar, The Netherlands
| | - Anne de Vries
- Public Health Service Kennemerland, Haarlem, The Netherlands
| | - Mirjam E E Kretzschmar
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Chantal den Daas
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, The Netherlands
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12
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Luo ZZ, Li W, Wu QH, Zhang L, Tian LS, Liu LL, Ding Y, Yuan J, Chen ZW, Lan LN, Wu XB, Cai YM, Hong FC, Feng TJ, Zhang M, Chen XS. Population-based study of chlamydial and gonococcal infections among women in Shenzhen, China: Implications for programme planning. PLoS One 2018; 13:e0196516. [PMID: 29715319 PMCID: PMC5929501 DOI: 10.1371/journal.pone.0196516] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/14/2018] [Indexed: 01/04/2023] Open
Abstract
This study was aimed to estimate the prevalences of chlamydia (CT) and gonococcal (NG) infections and explore risk factors associated with the CT infection among women in Shenzhen, China. We collected socio-demographic and clinical data from women (aged 20–60) and determined positivity of CT or NG by nucleic acid amplification test (NAAT) with self-collected urine specimens. We estimated prevalence of CT and NG and determined risk factors associated with CT infection. Among 9,207 participants, 4.12% (95% confidence interval [CI], 3.71%-4.53%) tested positive for CT and 0.17% (95% CIs, 0.09%-0.25%) for NG. Factors significantly associated with CT infection included being an ethnic minority (ethnicity other than Han China) (Adjusted odds ratio [AOR], 1.9; 95% CI, 1.2–3.0), using methods other than condom for contraception (AOR, 1.5; 95% CI, 1.2–1.8), having a history of adverse pregnancy outcomes (AOR, 1.4; 95% CI, 1.1–1.8), and experiencing reproductive tract symptoms in the past three months (AOR, 1.3; 95% CI, 1.0–1.7). we found that CT infection is prevalent among women in Shenzhen, China and associated with both demographic and behavioral factors. A comprehensive CT screening, surveillance and treatment programme targeting this population is warranted.
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Affiliation(s)
- Zhen-Zhou Luo
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Wu Li
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Qiu-Hong Wu
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Li Zhang
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Li-Shan Tian
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Lan-Lan Liu
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Yi Ding
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Jun Yuan
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Zhong-Wei Chen
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China
| | - Li-Na Lan
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Xiao-Bing Wu
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Yu-Mao Cai
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Fu-Chang Hong
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Tie-Jian Feng
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Min Zhang
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
- * E-mail: (MZ); (XSC)
| | - Xiang-Sheng Chen
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Dermatology, Nanjing, China
- National Center for STD Control, Nanjing, China
- * E-mail: (MZ); (XSC)
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13
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Visser M, van Aar F, Koedijk FDH, Kampman CJG, Heijne JCM. Repeat Chlamydia trachomatis testing among heterosexual STI outpatient clinic visitors in the Netherlands: a longitudinal study. BMC Infect Dis 2017; 17:782. [PMID: 29262776 PMCID: PMC5738891 DOI: 10.1186/s12879-017-2871-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 11/30/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Chlamydia infections are common in both men and women, are often asymptomatic and can cause serious complications. Repeat testing in high-risk groups is therefore indicated. In the Netherlands, guidelines on repeat chlamydia testing differ between testing facilities, and knowledge on repeat testing behaviour is limited. Here, we analyse the current repeat testing behaviour of heterosexual STI clinic visitors, and aim to identify groups for which repeat testing advice could be advantageous. METHODS Longitudinal surveillance data from all Dutch STI outpatient clinics were used, which included all STI clinic consultations carried out among heterosexual men and women between June 2014 and December 2015. Repeat testing was defined as returning to the same STI clinic between 35 days and 12 months after initial consultation. We calculated chlamydia positivity at repeat test stratified by initial test result and time between consultations. Logistic regression analyses were used to identify predictors of repeat testing, and predictors of having a chlamydia positive repeat test. RESULTS In total, 140,486 consultations in 75,487 women and 46,286 men were available for analyses. Overall, 15.4% of women and 11.1% of men returned to the STI clinic within the study period. Highest chlamydia positivity at repeat test was seen 3-5 months after initial positive test. Among both women and men, repeat testing was associated with non-Western ethnicity, having had more than two sex partners in the past 6 months, reporting STI symptoms, having a history of STI, and having a chlamydia positive initial test. Among repeat testers, chlamydia positive repeat test was most strongly associated with younger age, followed by a chlamydia positive initial test. CONCLUSIONS Repeat testing most often resulted in a positive test result among young heterosexuals (<25) and heterosexuals of any age with a chlamydia infection at the initial consultation. Further efforts are needed to determine optimal repeat testing strategies.
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Affiliation(s)
- Maartje Visser
- National Institute for Public Health and the Environment, P.O. Box 1, 3720, BA, Bilthoven, the Netherlands.
| | - Fleur van Aar
- National Institute for Public Health and the Environment, P.O. Box 1, 3720, BA, Bilthoven, the Netherlands
| | - Femke D H Koedijk
- Public Health Service Twente, postbus 1400, 7500, BK, Enschede, the Netherlands
| | | | - Janneke C M Heijne
- National Institute for Public Health and the Environment, P.O. Box 1, 3720, BA, Bilthoven, the Netherlands
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14
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Babinská I, Halánová M, Kalinová Z, Čechová L, Čisláková L, Madarasová Gecková A. Prevalence of Chlamydia trachomatis Infection and Its Association with Sexual Behaviour and Alcohol Use in the Population Living in Separated and Segregated Roma Settlements in Eastern Slovakia. Int J Environ Res Public Health 2017; 14:E1579. [PMID: 29240704 PMCID: PMC5750997 DOI: 10.3390/ijerph14121579] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/04/2017] [Accepted: 12/11/2017] [Indexed: 12/14/2022]
Abstract
The aim of the study was to explore sexual behaviour and the occurrence of Chlamydia trachomatis (CT) infection in the population living in Roma settlements compared to the majority population in Slovakia and to assess the association between alcohol use and sexual behaviour within both populations. A cross-sectional population-based Hepa-Meta study was conducted in Slovakia in 2011. The final sample comprised 452 Roma and 403 non-Roma respondents. The occurrence of CT was detected by direct proof of the pathogen by PCR. The association between alcohol use and the prevalence of risky sexual behaviour were assessed using a logistic regression. First intercourse at age 15 or younger was reported by 27.9% of Roma (vs. 4.5% of non-Roma); 93.4% of Roma (vs. 77.9% of non-Roma) used condom inconsistently, 22.8% of Roma (vs. 43.9% of non-Roma) used a condom for protection from unwanted pregnancies and only 8.8% of Roma (vs. 21.8% of non-Roma) due to protection against infectious diseases. However, Roma reported having had five or more sexual partners less often compared to the majority (11.5% of Roma vs. 20.6% of non-Roma). Binge drinking at least once a month was associated with a higher number of sexual partners in both groups, but not with condom non-use. The prevalence of CT infection in the Roma population was higher (3.8%) compared to non-Roma (2.7%); however, the difference was not statistically significant. Our study found no differences in the prevalence of CT infection between Roma and non-Roma despite differences in sexual behaviour. Roma begin their sexual life earlier and have unprotected sex more often, but on the other hand, they seem to be much more restrained in terms of the number of sexual partners compared to the majority population.
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Affiliation(s)
- Ingrid Babinská
- Department of Epidemiology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 041 80 Košice, Slovakia.
| | - Monika Halánová
- Department of Epidemiology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 041 80 Košice, Slovakia.
| | - Zuzana Kalinová
- Department of Epidemiology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 041 80 Košice, Slovakia.
| | - Lenka Čechová
- Department of Epidemiology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 041 80 Košice, Slovakia.
| | - Lýdia Čisláková
- Department of Epidemiology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 041 80 Košice, Slovakia.
| | - Andrea Madarasová Gecková
- Department of Health Psychology, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 040 11 Košice, Slovakia.
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15
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Somayaji R, Naugler C, Guo M, Church DL. Examining sociodemographic risk factors for Chlamydia trachomatis infection: a population-based cohort study. Future Microbiol 2017; 12:1363-1370. [PMID: 29022366 DOI: 10.2217/fmb-2017-0078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AIM Chlamydia trachomatis is the most prevalent bacterial sexually transmitted infection in developed nations and is an important public health concern. We aimed to assess the factors associated with testing and positivity of C. trachomatis in a large population. METHODS A retrospective study of a large Canadian health region was undertaken using 2011 census and laboratory data. Demographic and socioeconomic data from the national household survey were linked to microbiologic data for C. trachomatis. Multivariable generalized estimating equation models were constructed to examine relative risk for C. trachomatis testing and positivity. RESULTS For testing and positivity, female sex and younger age groups were associated with increased risk. University education and South Asian ethnicity were associated with lower risk of positivity. CONCLUSION Incorporating socio-demographic factors will be critical to the success of future sexually transmitted infection public health programs.
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Affiliation(s)
- Ranjani Somayaji
- Department of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Christopher Naugler
- Calgary Laboratory Services, Calgary, AB, T2L 2K8, Canada.,Department of Pathology & Laboratory Medicine & Medicine, University of Calgary, Calgary, AB, T2L 2K8, Canada.,Department of Family Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada
| | - Maggie Guo
- Calgary Laboratory Services, Calgary, AB, T2L 2K8, Canada
| | - Deirdre L Church
- Department of Medicine, University of Calgary, Calgary, AB, T2N 1N4, Canada.,Calgary Laboratory Services, Calgary, AB, T2L 2K8, Canada.,Department of Pathology & Laboratory Medicine & Medicine, University of Calgary, Calgary, AB, T2L 2K8, Canada
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16
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Belozorov A, Fedets O, Chastii T, Milutina E, Sokol O, Grigorova R, Unuchko S. Chlamydia trachomatis infection positivity rates determined by nucleic acid amplification test in patients of hospitals in the northeastern region of Ukraine. Int J STD AIDS 2017; 28:1405-1409. [PMID: 28583015 DOI: 10.1177/0956462417709831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There are no accurate data regarding the prevalence of Chlamydia trachomatis infection in Ukraine. This study aims to estimate the prevalence in the northeastern region of the country through reviewing nucleic acid amplification test results in patients of medical institutions in the Kharkov region during 2014-2016. Samples from 6920 patients (5028 women and 1892 men) aged 12-76 years were tested. The overall positivity rate was 4.5% (95% CI 4.0-5.0): 3.9% (95% CI 3.4-4.5) in women and 6.1% (95% CI 5.1-7.3) in men. The highest prevalence was found in the 16-20 (8.5%, CI 6.3-11.4) and 21-25 (8.0%, CI 6.7-9.4) year age groups. The prevalence in men was higher than in women in all investigated groups. The results show the need for more attention to the prevention, diagnosis, and treatment of chlamydial infection in these age groups of women and men in this region.
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Affiliation(s)
- Alexei Belozorov
- 1 SE 'Institute of Dermatology and Venerology of the National Academy of Medical Sciences of Ukraine,' Kharkiv, Ukraine
| | - Olga Fedets
- 2 Medical Laboratory 'Analytica,' Institute of Hygiene and Professional Pathology, Kharkiv, Ukraine
| | - Tatjana Chastii
- 1 SE 'Institute of Dermatology and Venerology of the National Academy of Medical Sciences of Ukraine,' Kharkiv, Ukraine
| | - Elena Milutina
- 1 SE 'Institute of Dermatology and Venerology of the National Academy of Medical Sciences of Ukraine,' Kharkiv, Ukraine
| | - Oksana Sokol
- 1 SE 'Institute of Dermatology and Venerology of the National Academy of Medical Sciences of Ukraine,' Kharkiv, Ukraine
| | - Ritsa Grigorova
- 1 SE 'Institute of Dermatology and Venerology of the National Academy of Medical Sciences of Ukraine,' Kharkiv, Ukraine
| | - Sergey Unuchko
- 1 SE 'Institute of Dermatology and Venerology of the National Academy of Medical Sciences of Ukraine,' Kharkiv, Ukraine
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