MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'International Journal of STD and AIDS' source. Thu, 09 Feb 2012 07:35:56 +0100 http://www.medworm.com/index.php?rid=5510249&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F768%3Frss%3D1 We report the case of an HIV-positive Nigerian man on antiretroviral therapy (ART) with an undetectable viral load who presented with rigors, fever and back pain after returning to the UK from a three-week trip to Nigeria. Infection with Plasmodium falciparum malaria was confirmed and treatment with quinine commenced together with amoxicillin/clavulanic acid and clarithromycin for possible respiratory infection. At the time of admission the patient could not remember the names of his ART medications. After 24 hours his parasitaemia had increased from 1% to 2.5% and his clinical condition had deteriorated. At this point, his ART was identified as abacavir, lamivudine and nevirapine. The Liverpool HIV-drug interactions website was checked for drug interactions. It recommends caution in the c... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510249 Thu, 15 Dec 2011 05:00:00 +0100 5510249 http://www.medworm.com/index.php?rid=5510248&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F766%3Frss%3D1 We report the case of a 23-year-old man with persistent genital ulceration; all microbiological examinations from the ulcers were negative. HIV-1/2 antibodies were positive, but the HIV-1 Western blot (WB) was indeterminate and HIV-1 p24 antigen was persistently negative, with a low HIV-1 RNA level. One month later, the genital ulcerations disappeared and the WB test showed complete seroconversion; nonetheless HIV p24 antigen remained negative and HIV-RNA was persistently low. HIV-1 proviral DNA was detected by nested polymerase chain reaction (PCR) from the initial ulcers swabs. This case was notable due to genital ulceration being the only sign of primary HIV infection. Furthermore, the serological pattern was unusual, and HIV-RNA was unexpectedly low. This underlines the importance of s... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510248 Thu, 15 Dec 2011 05:00:00 +0100 5510248 http://www.medworm.com/index.php?rid=5510247&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F764%3Frss%3D1 When counselling patients for postexposure prophylaxis after sexual exposure, we may need to inform them that the efficacy may be low, especially if the patient also had risks prior to the 72 hours between exposure and treatment. The use of a point-of-care test, as well as fourth generation HIV tests and HIV RNA in combination, can still miss seroconversion in the ‘eclipse’ phase of the infection as these tests are not designed to detect the earliest phase of infection. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510247 Thu, 15 Dec 2011 05:00:00 +0100 5510247 http://www.medworm.com/index.php?rid=5510246&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F759%3Frss%3D1 Plasmablastic lymphoma (PBL) is a distinct disease entity of the diffuse large B-cell lymphoma, which often occurs in HIV-positive patients. The immunophenotype of this lymphoid neoplasm is characterized by the presence of plasma cell-associated markers VS38c and CD138 antigens and the absence of B-cell markers such as CD20 and CD45. The most frequent site of involvement is the oral cavity and the jaw, while several reports describe the development of PBL in extra-oral sites including the lymph nodes, the anal canal, the soft tissue, the skin and the gastrointestinal tract as less frequent. Epstein–Barr virus is often associated with PBL pathogenesis and the neoplastic cells contain this virus genome. Here we review the epidemiological, clinical, immunological, histopathological and ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510246 Thu, 15 Dec 2011 05:00:00 +0100 5510246 http://www.medworm.com/index.php?rid=5510245&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F757%3Frss%3D1 To strengthen HIV screening in the French West Indies (FWI), we evaluated the feasibility of rapid tests in sexually transmitted infection (STI) testing centres. Rapid testing was offered to each user ahead of the standard screening tests. Between October 2007 and December 2008, 847 users had HIV rapid testing, and 1724 users did not have rapid testing. The results of rapid testing were returned to 99.1% of testers. However, clients who underwent rapid testing were significantly more likely than others to have not returned to get the results of their standard screening tests (for HIV and other STIs): 27.4% versus 14.0% with a relative risk of 1.96 (95% confidence interval [CI] 1.67–2.30, P < 0.0001). Rapid HIV testing has the capacity to reduce the return rates for confirmatory re... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510245 Thu, 15 Dec 2011 05:00:00 +0100 5510245 http://www.medworm.com/index.php?rid=5510244&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F755%3Frss%3D1 A proportion of funding for the South Yorkshire HIV Network is dependant on meeting the targets of the Commissioning for Quality and Innovation (CQUIN) payment framework. This states that 85% of patients with a CD4 count below 350 should be on antiretroviral therapy (ART). We also audited how many patients we started on treatment within six weeks. We found 88% of the 243 patients were on ART at the end of the audit, but significantly less had been started on treatment within six weeks of their CD4 count falling below 350. Although the target was achieved, there were patients who should be excluded as shown by other clinical guidelines, for example patients on treatment for tuberculosis. If these patients were excluded and the threshold level increased, it would help emphasize the at-risk p... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510244 Thu, 15 Dec 2011 05:00:00 +0100 5510244 http://www.medworm.com/index.php?rid=5510243&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F753%3Frss%3D1 Following the publication of the UK national guidelines for HIV testing 2008, we carried out a local audit to determine the level of awareness of these guidelines among doctors working in Sunderland Royal Hospital, Sunderland, UK. An email questionnaire was distributed. Over two-thirds of respondents were unaware of the publication of the guidelines. Only 36% of respondents felt comfortable in offering a patient testing for HIV. The majority of doctors who responded lacked knowledge and confidence in issues surrounding HIV management and diagnosis, suggesting that better dissemination of information and training is still needed. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510243 Thu, 15 Dec 2011 05:00:00 +0100 5510243 http://www.medworm.com/index.php?rid=5510242&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F751%3Frss%3D1 In an audit of HIV post-exposure prophylaxis (PEP) programmes in Blantyre, Malawi, and Liverpool, UK, a striking common deficiency was poor attendance of follow-up visits and of HIV testing to determine efficacy of PEP. Causes of poor follow-up after PEP need to be explored in both settings. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510242 Thu, 15 Dec 2011 05:00:00 +0100 5510242 http://www.medworm.com/index.php?rid=5510241&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F748%3Frss%3D1 This study underlines the importance of continued efforts to minimize the significant gaps in HIV testing rates in TB services. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510241 Thu, 15 Dec 2011 05:00:00 +0100 5510241 http://www.medworm.com/index.php?rid=5510240&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F742%3Frss%3D1 Worldwide elimination of HIV transmission from mother-to-child is theoretically achievable. In Cambodia, antenatal care (ANC) prevalence has dropped from 1.6% (2003) to 0.71% (2009). However, success in minimizing vertical transmission has been limited by low testing uptake at ANC and delivery. We trained midwives in counselling and performance of an HIV rapid test, incorporated point-of-care testing into routine antenatal and maternity services and determined acceptability, feasibility, accuracy, cost and yield after one year. In all, 97.3% of ANC clients and 73.0% of maternity admissions had unknown HIV status. Testing was offered to 97.6% and 95.0% of untested ANC and maternity clients, respectively. Acceptance rates were 95.5% and 99.4%. Partner testing rate was 38.6%. HIV was diagnose... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510240 Thu, 15 Dec 2011 05:00:00 +0100 5510240 http://www.medworm.com/index.php?rid=5510239&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F738%3Frss%3D1 Pre-exposure prophylaxis (PrEP) is a promising strategy whereby HIV-uninfected people could take antiretroviral (ARV) medications to reduce their risk of HIV acquisition. Reports suggest that unsupervised PrEP use has been occurring in gay communities of USA cities before human safety and efficacy data became available. We administered a 20-item questionnaire to men undergoing HIV testing at Hassle Free Clinic, a sexual health clinic in the gay village of Toronto. Questionnaire items enquired about demographics, sexual partners, substance use and awareness of, usage of and willingness to use PrEP. Logistic regression was used to identify characteristics associated with PrEP-related outcomes. Of 256 participants, 11.7% were aware of PrEP, with more men who have sex with men (MSM) aware (14.... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510239 Thu, 15 Dec 2011 05:00:00 +0100 5510239 http://www.medworm.com/index.php?rid=5510238&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F734%3Frss%3D1 Our objectives were to use foundational pilot findings to guide the implementation of an HIV rapid testing (RT) intervention at one Veterans Affairs outpatient clinic and to evaluate the success and sustainability of this intervention over the course of one year. Policy modifications were drafted and adopted to enable nurses to order, administer, interpret and document HIV RTs. Staff enrolled in a two-part training sessions designed to teach pre- and post-test counselling techniques and the mechanics of administering, interpreting and coding test results in the patients’ medical records. They were subsequently evaluated on their efforts at: (1) increasing HIV RT, (2) sustaining this effort one year post-launch. Enabling nurses to carry out HIV RT resulted in a significant increase in... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510238 Thu, 15 Dec 2011 05:00:00 +0100 5510238 http://www.medworm.com/index.php?rid=5510237&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F730%3Frss%3D1 This study suggests that more HIV tests could be performed, for example, in acute medicine, and training might increase the number of tests offered in some settings. The most effective way of increasing testing appears to be opt-out testing. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510237 Thu, 15 Dec 2011 05:00:00 +0100 5510237 http://www.medworm.com/index.php?rid=5510236&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F727%3Frss%3D1 High HIV testing coverage of high-risk populations is required to reduce the number of HIV-infected individuals unaware of their status. The aim of this study was to determine HIV testing rates among men who have sex with men (MSM) attending a sexual health service, including the impact of the treating clinician on HIV testing rates. Factors associated with HIV testing of MSM attending the Melbourne Sexual Health Centre for the first time between 2003 and 2009 were determined, including testing rates for individual treating clinicians. Overall, 78% of 4425 men were tested for HIV. Clinician HIV testing rates were higher among nurses (median 89%; range 77–95%) than doctors (median 73%; range 45–88%) with significant differences between individual physicians (P < 0.001). Lower... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510236 Thu, 15 Dec 2011 05:00:00 +0100 5510236 http://www.medworm.com/index.php?rid=5510235&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F722%3Frss%3D1 Little is known about the HIV testing behaviours among Caribbean youth. The purpose of this study was to determine the prevalence of and the factors associated with HIV testing in Caribbean youth. Data were used from population-based surveys in three Caribbean countries: Guyana, Haiti and the Dominican Republic. Chi-square tests and multiple logistic regression models were fitted to examine the associations between independent correlates and ever being tested of HIV. The proportion of youth reporting HIV testing ranged from 17% in Haiti to 48% in the Dominican Republic. Across all countries increased odds of ever being tested for HIV was associated with ever being married, having five or more lifetime partners, and knowing someone who was living with or had died from HIV. Male gender and r... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510235 Thu, 15 Dec 2011 05:00:00 +0100 5510235 http://www.medworm.com/index.php?rid=5510234&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F719%3Frss%3D1 In this study, the performance of an ultrasensitive p24 antigen assay on dried blood spots was evaluated under field conditions in rural Tanzania. Specimens were stored and shipped at tropical room temperature, and analysed within six weeks. In total, 27 consecutive children aged <18 months and exposed to vertical HIV transmission were enrolled. Overall sensitivity and specificity was 100% (95% confidence interval [CI], 47.8–100) and 95.5% (95% CI, 77.2–99.9), respectively. Our findings suggest that detection of p24 antigen on dried blood spots can be a reliable and feasible diagnostic tool for infant HIV infection in rural resource-limited settings. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510234 Thu, 15 Dec 2011 05:00:00 +0100 5510234 http://www.medworm.com/index.php?rid=5510233&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F714%3Frss%3D1 We describe a cohort of NPEP individuals from the commencement of the service to 31 December 2009. During this time, 1864 individuals presented for NPEP on 2396 occasions. The majority (85%) were men who have sex with men (MSM) presenting after receptive anal intercourse (56.1%). Repeat NPEP presentations were high (17.5%) and follow-up testing at week 12 post-NPEP was low (34%). Twenty-two patients (1.2%) tested positive for HIV at baseline presentation and six patients seroconverted to HIV during follow-up. The VNPEPS has initiated strategies to encourage behaviour change for those who re-present for NPEP, and to improve rates of week 12 follow-up. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510233 Thu, 15 Dec 2011 05:00:00 +0100 5510233 http://www.medworm.com/index.php?rid=5510232&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F709%3Frss%3D1 This study examined whether social vulnerability is associated with HIV testing among South African men who have sex with men (MSM). A community-based survey was conducted with 300 MSM in Pretoria in 2008. The sample was stratified by age, race and residential status. Social vulnerability was assessed using measures of demographic characteristics, psychosocial determinants and indicators of sexual minority stress. Being black, living in a township and lacking HIV knowledge reduced MSM's likelihood of ever having tested for HIV. Among those who had tested, lower income and not self-identifying as gay reduced men's likelihood of having tested more than once. Lower income and internalized homophobia reduced men's likelihood of having tested recently. Overall, MSM in socially vulnerable positi... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510232 Thu, 15 Dec 2011 05:00:00 +0100 5510232 http://www.medworm.com/index.php?rid=5510231&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F695%3Frss%3D1 We present the updated British Association for Sexual Health and HIV (BASHH) guidelines for post-exposure prophylaxis (PEPSE) to HIV. This document includes a review of the current data to support the use of PEPSE, considers how to calculate the risks of infection after a potential exposure, and provides recommendations on when PEPSE would and would not be considered. We review which agents to use for PEPSE including the potential for drug-drug interactions and make recommendations for monitoring individuals receiving PEPSE. Other areas included are the possible impact on sexual behaviour, cost-effectiveness and issues relating to service provision. Throughout the document, consideration is given to the place of PEPSE within the broader context of HIV prevention strategies and sexual healt... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510231 Thu, 15 Dec 2011 05:00:00 +0100 5510231 http://www.medworm.com/index.php?rid=5510230&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F12%2F693%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5510230 Thu, 15 Dec 2011 05:00:00 +0100 5510230 http://www.medworm.com/index.php?rid=5426648&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F690%3Frss%3D1 Although a vast majority of HIV-1-positive patients in the UK are infected with clade B virus, a large number of newly diagnosed cases of heterosexually transmitted HIV-1 are acquired abroad, in countries where non-B clade HIV-1 predominates. Since the development of the viral load assay in 1988, assessment of HIV-1 plasma viraemia has become an integral part of HIV clinical care; however, the contemporary viral load assay was developed and optimized for clade B HIV-1. Here we report the underquantification of viraemia in an individual infected with clade A virus, and the consequent initial classification of the patient as an HIV controller (HIC). Immunological investigations of interferon (IFN)- and lymphoproliferative responses to HIV-1 clade B antigens and peptides, in parallel with mit... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426648 Thu, 17 Nov 2011 05:00:00 +0100 5426648 http://www.medworm.com/index.php?rid=5426647&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F688%3Frss%3D1 We present a case of intrafamilial transmission of acute hepatitis B virus (HBV) following failure to self-disclose status to family members. Complex confidentiality issues can arise following a diagnosis of HBV infection. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426647 Thu, 17 Nov 2011 05:00:00 +0100 5426647 http://www.medworm.com/index.php?rid=5426646&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F686%3Frss%3D1 Previous studies have reported high HIV prevalence among transgender sex workers (TSWs). We performed a retrospective case-note review of known TSWs attending our unit. In all, 16/24 (66.7%) of patients were diagnosed with at least one sexually transmitted infection (STI) and 7/24 (29.2%) reported intentional unprotected anal or vaginal intercourse, which may explain the high prevalence of HIV in our cohort (37.5%). TSWs disclosed high rates of substance misuse, violence and sexual assault, which may also contribute to the increased prevalence of STI in this group. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426646 Thu, 17 Nov 2011 05:00:00 +0100 5426646 http://www.medworm.com/index.php?rid=5426645&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F684%3Frss%3D1 Audit of reliability of data collected by genitourinary (GU) medicine reception staff in north Cumbria for Department of Health mandatory returns suggests that receptionist-logged presence or absence of symptoms does not concur well with subsequent symptom disclosure to clinicians during consultations, even after the use of patient-completed symptom-specific questionnaires. Triage or fast-tracking based upon symptoms in order to select those at risk of sexually transmitted infection (STI) is likely to fail for a significant proportion of patients. Department of Health symptoms data need to be interpreted with caution. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426645 Thu, 17 Nov 2011 05:00:00 +0100 5426645 http://www.medworm.com/index.php?rid=5426644&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F682%3Frss%3D1 The new National Institute for Health and Clinical Excellence (NICE) guidance cites genitourinary (GU) medicine clinics as one setting where screening for alcohol-use disorders should be part of routine clinical practice. Northumberland GU medicine service has routinely used the Fast Alcohol Screening Tool (FAST) since June 2009. An audit of all first attendees to the service in April 2010 (n = 256) was carried out. This audit found that the FAST questionnaire was acceptable to both patients and staff (uptake of 95.7%). Statistically significant associations between excessive alcohol and higher rates of unprotected sex (P < 0.01), an increased number of sexual partners (P < 0.01) and higher rates of sexually transmitted infection (STI) diagnosis (P < 0.05) were also demonstrated. ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426644 Thu, 17 Nov 2011 05:00:00 +0100 5426644 http://www.medworm.com/index.php?rid=5426643&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F680%3Frss%3D1 We reviewed microscopy results for symptomatic male patients in order to identify clinical correlates of urethritis as diagnosed by same-day microscopy. Higher polymorph counts were found in patients presenting with discharge, or discharge together with dysuria, but dysuria without discharge was strongly associated with negative urethral microscopy. Symptoms were strongly linked to microscopy outcome but partnerships were not linked to either symptoms or outcome. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426643 Thu, 17 Nov 2011 05:00:00 +0100 5426643 http://www.medworm.com/index.php?rid=5426642&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F674%3Frss%3D1 We examined the relationship between HIV prevention beliefs related to male circumcision and sexual behaviour/sexually transmitted infection (STI) acquisition among traditionally circumcised men in Cape Town, South Africa. HIV-negative men (n = 304), circumcised for cultural/religious reasons, attending a health clinic in Cape Town, South Africa, completed cross-sectional surveys. Generalized linear models were used to analyse the relationships between unprotected vaginal sex acts, number of female sexual partners, STI diagnoses and male circumcision-related beliefs and risk perceptions. Men who were aware that circumcision offers protection against HIV (relative risk [RR] = 1.19, 95% confidence interval [CI] = 1.06–1.32, P < 0.01), endorsed risk compensation related to male circu... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426642 Thu, 17 Nov 2011 05:00:00 +0100 5426642 http://www.medworm.com/index.php?rid=5426641&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F671%3Frss%3D1 Roll-out of combination antiretroviral therapy (cART) in South Africa should impact on AIDS-associated Kaposi's sarcoma (KS). Government provision began in 2003, with 23% coverage for World Health Organization (WHO) stage IV AIDS in 2006. To assess the effect of cART availability on KS management, we evaluated records from 701 KS patients seen at a tertiary oncology centre in KwaZulu-Natal, South Africa, from 1995 to 2006. Associations between cART use and measures of KS care were evaluated. cART availability was 0% prior to 2001, 9.6% (2001–2003) and 44% (2004–2006). Documentation of HIV status increased incrementally from 65% to 92%. cART was associated with chemotherapy administration: 56% on cART versus 17% not on cART (P < 0.001); and less loss to follow-up, 13% on cART... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426641 Thu, 17 Nov 2011 05:00:00 +0100 5426641 http://www.medworm.com/index.php?rid=5426640&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F665%3Frss%3D1 The aim of this study was to identify baseline prognostic factors for poor clinical outcome of HIV-associated cryptococcal meningitis. We conducted a trial in Thailand and the USA comparing low- and high-dose concomitant use of amphotericin B and fluconazole for HIV-associated cryptococcal meningitis to amphotericin B followed by fluconazole. Subjects who were either alive and cerebrospinal fluid (CSF) culture-positive or dead were considered to have a poor outcome. At day 14, baseline characteristics associated with poor outcome included: low weight, high CSF cryptococcal antigen (CrAg) titre and low CSF white blood cell (WBC) count. At day 70, the associated baseline characteristics included: CSF CrAg titre >1:1024 and low Karnofsky performance status. Overall, consistent with publish... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426640 Thu, 17 Nov 2011 05:00:00 +0100 5426640 http://www.medworm.com/index.php?rid=5426639&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F659%3Frss%3D1 The objective of our study was to investigate factors associated with virological failure in 100 consecutive HIV-1 infected Vietnamese adults who initiated antiretroviral therapy (ART) from June 2007 to June 2008. Data were collected from medical records, and a structured questionnaire was used in individual interviews to investigate factors associated with adherence to ART. Plasma HIV viral load was measured at the time of the interview. The median age was 35 years, 35% were women and heterosexual intercourse was the most common mode of HIV transmission (61%). After a median of 14 months since starting ART, 23% had detectable HIV-1 viral load (≥400 copies/mL). Patients who had developed a World Health Organization (WHO) clinical stage 4 condition at the time of initiation of ART were m... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426639 Thu, 17 Nov 2011 05:00:00 +0100 5426639 http://www.medworm.com/index.php?rid=5426638&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F655%3Frss%3D1 Few data exist on oral human papillomavirus (HPV) prevalence in female sex workers (FSWs). Information regarding oral sex practices of 185 Peruvian FSWs, 18–26 years of age, was obtained via survey and compared with HPV testing results of oral rinse samples. Oral HPV prevalence was 14/185 (7.6%); four (28.9%) HPV genotypes were carcinogenic. One hundred and eighty-two participants reported having had oral sex; 95% reported condom use during oral sex with clients and 9.5% with partners. Women who had oral sex more than three times with their partners in the past month were more likely to have oral HPV than women who had oral sex three times or less (P = 0.06). Ten (71.4%) women with oral HPV were HPV-positive at the cervix; conversely 8.3% of women with cervical HPV were HPV-positive ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426638 Thu, 17 Nov 2011 05:00:00 +0100 5426638 http://www.medworm.com/index.php?rid=5426637&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F653%3Frss%3D1 Patients with HIV infection have a higher propensity for infectious, inflammatory, neoplastic and metabolic disorders. The link with psoriasis vulgaris is explained by well-known pathophysiological phenomena and can be observed at any stage of infection. The aim of our study was to characterize the clinical spectrum of psoriasis in a group of 50 patients with HIV. Our findings showed particular clinical presentations of psoriasis in those patients, suggesting a predilection for scalp lesions, palmoplantar keratoderma and flexural involvement, as well as a trend towards severe immunodeficiency. Psoriasis, a frequent reason for consultation, allows earlier suspicion and diagnosis of HIV in the presence of these particular patterns. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426637 Thu, 17 Nov 2011 05:00:00 +0100 5426637 http://www.medworm.com/index.php?rid=5426636&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F645%3Frss%3D1 To review a quality control and quality assurance (QC/QA) model established to ensure the validity and reliability of collection, storage and analysis of biological outcome data, and to promote good laboratory practices (GLPs) and sustained operational improvements in international clinical laboratories, we conducted a two-arm randomized community-level HIV behavioural intervention trial in five countries: China, India, Peru, Russia and Zimbabwe. The trial was based on diffusion theory utilizing a Community Popular Opinion Leaders (CPOLs) intervention model with behavioural and biological outcomes. The QC/QA model was established by the Biological Outcome Workgroup, which collaborated with the Data Coordinating Center and John Hopkins University Reference Laboratory. Five international lab... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426636 Thu, 17 Nov 2011 05:00:00 +0100 5426636 http://www.medworm.com/index.php?rid=5426635&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F640%3Frss%3D1 To identify factors associated with repeat visits among patients attending a clinic for sexually transmitted infections (STIs) in Kisumu, Kenya, we examined records of clinic visits from March 2009 to May 2010. Multivariable logistic regression identified factors associated with repeat visits occurring >30 days after the initial visit. Among 1473 clients (1296 single-visit individuals versus 177 individuals with repeat visits), the median age was 24 years, 67% were men and 8.6% self-reported being HIV-positive. In adjusted analyses, men with repeat visits were more likely to report ≥2 recent sexual partners (adjusted odds ratio [aOR] = 1.60) and being HIV-positive (aOR = 2.35). They were less likely to have been referred from other health facilities (aOR = 0.14) and more likely to ha... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426635 Thu, 17 Nov 2011 05:00:00 +0100 5426635 http://www.medworm.com/index.php?rid=5426634&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F635%3Frss%3D1 We investigated how young adults aged 18–29 years would like to be notified of chlamydia screening test results, and, when they test positive, their willingness and preferred mechanism for informing their partners. We conducted a cross-sectional survey of 6085 young adults and found that a call to their mobile phone was their preferred way of receiving positive test results (selected by 50%), followed by email. Text messages (short message service [SMS]) and calls to landline phones were unpopular options, selected by between 5 and 10%. Over 75% of respondents stated they would inform their current partner of a positive chlamydia diagnosis, and 50% would inform their previous partners. Most were willing to receive yearly reminders to go for a chlamydia test. Young adults preference f... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426634 Thu, 17 Nov 2011 05:00:00 +0100 5426634 http://www.medworm.com/index.php?rid=5426633&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F628%3Frss%3D1 A prognostic scoring tool (PST) was created to aid prediction of outcome from HIV-associated Pneumocystis jirovecii pneumonia (PCP) using data obtained from 577 episodes of PCP among 540 patients presenting to a specialist HIV treatment centre in London, UK. It used risk factors identifiable at/soon after hospitalization, previously identified as being associated with mortality: repeat episode of PCP, patient's age, haemoglobin (Hb) and oxygen partial pressure (PaO2) on admission, presence of medical co-morbidity (Comorb) and of pulmonary Kaposi sarcoma (PKS). The derived PST was 25.5+(age in years/10) + 2 (if a repeat episode of PCP) + 3 (if Comorb present) + 4 (if PKS detected) – PaO2 (kPa) – Hb (g/dL), and produced scores that ranged between 0 and 19. Patients were divided i... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426633 Thu, 17 Nov 2011 05:00:00 +0100 5426633 http://www.medworm.com/index.php?rid=5426632&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F621%3Frss%3D1 Many countries in sub-Saharan Africa have made antiretroviral therapy (ART) available in urban settings, but the progress of treatment expansion into rural Africa has been slower. We analysed routine data for patients enrolled in a rural HIV treatment programme in Zambézia Province, Mozambique (1 June 2006 through 30 March 2009). There were 12,218 patients who were ≥15 years old enrolled (69% women). Median age was 25 years for women and 31 years for men. Older age and higher level of education were strongly predictive of ART initiation (P < 0.001). Patients with a CD4+ count of 350 cells/μL versus 50 cells/μL were less likely to begin ART (odds ratio [OR]: 0.19, 95% confidence interval [CI]: 0.16–0.23). In rural sub-Saharan Africa, HIV testing, linkage to care, lo... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426632 Thu, 17 Nov 2011 05:00:00 +0100 5426632 http://www.medworm.com/index.php?rid=5426631&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F11%2F617%3Frss%3D1 Ritonavir-boosted tipranavir (TPV/r) and darunavir (DRV/r) have been approved in patients with virological resistance to multiple protease inhibitors (PIs). Whether the HIV-1 from these patients with virological failure to first-generation PIs remains susceptible to TPV/r or DRV/r is questionable. The susceptibilities of HIV-1 isolates to second-generation PIs in patients who experienced virological failure in three time periods were analysed: 9-2006 to 4-2007 (period 1), 5-2007 to 12-2007 (period 2) and 1-2008 to 8-2008 (period 3). A total of 53 subjects were enrolled, and 51 subject isolates (96.2%) were resistant to ≥1 PIs. The mutation scores for TPV and DRV, and the percentage of isolates with resistance to TPV or DRV, increased significantly from period 1 to period 3. Our data rev... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5426631 Thu, 17 Nov 2011 05:00:00 +0100 5426631 http://www.medworm.com/index.php?rid=5319791&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F616%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319791 Thu, 13 Oct 2011 04:00:00 +0100 5319791 http://www.medworm.com/index.php?rid=5319790&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F615-b%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319790 Thu, 13 Oct 2011 04:00:00 +0100 5319790 http://www.medworm.com/index.php?rid=5319789&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F615-a%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319789 Thu, 13 Oct 2011 04:00:00 +0100 5319789 http://www.medworm.com/index.php?rid=5319788&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F614%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319788 Thu, 13 Oct 2011 04:00:00 +0100 5319788 http://www.medworm.com/index.php?rid=5319787&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F613-b%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319787 Thu, 13 Oct 2011 04:00:00 +0100 5319787 http://www.medworm.com/index.php?rid=5319786&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F613-a%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319786 Thu, 13 Oct 2011 04:00:00 +0100 5319786 http://www.medworm.com/index.php?rid=5319785&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F610%3Frss%3D1 Pneumonia caused by Panton–Valentine leukocidin-producing Staphylococcus aureus is associated with a high fatality rate. There have been few reported cases in HIV-1-co-infected patients. Here we report a fatal case of severe community-acquired pneumonia caused by Panton–Valentine leukocidin-producing S. aureus in a 45-year-old woman with HIV-2 infection. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319785 Thu, 13 Oct 2011 04:00:00 +0100 5319785 http://www.medworm.com/index.php?rid=5319784&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F608%3Frss%3D1 There is increasing concern that HIV treatment failure may result from inadequate central nervous system (CNS) penetration of antiretroviral drugs, allowing compartmentalized viral replication and development of resistance. We discuss a patient who maintained a suppressed plasma viral load for four years on antiretroviral therapy (ART) before developing HIV encephalitis with a cerebrospinal fluid (CSF) HIV viral load of 861 copies/mL and newly detectable plasma viral load of 68 copies/mL. Identification of major resistance mutations to his combination therapy supported concerns that resistant HIV had developed within the CNS. His ART was changed to optimize CNS penetration, leading to maintained clinical improvement. Imaging presented demonstrates corresponding radiological improvement. Th... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319784 Thu, 13 Oct 2011 04:00:00 +0100 5319784 http://www.medworm.com/index.php?rid=5319783&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F604%3Frss%3D1 Local service quality indicators (SQIs) for both genitourinary (GU) medicine and HIV were drawn up using patient and public involvement (PPI). Our clinic's performance was audited against these SQIs. All measures were achieved, almost achieved or probably achieved. SQIs need to be challenging yet achievable and it is difficult to judge precisely where standards should be set. This paper provides a first estimate for our service after PPI. We hope other services may wish to audit performance against these SQIs. If such data were to be pooled, there would be valuable evidence for setting ‘SMART’ (specific, measurable, attainable, relevant and time-based) SQIs that are challenging yet achievable for the majority of clinics. If the bar were to be set correctly, the actual performan... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319783 Thu, 13 Oct 2011 04:00:00 +0100 5319783 http://www.medworm.com/index.php?rid=5319782&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F600%3Frss%3D1 The study objectives were to ascertain behavioural, access-related, health-seeking factors and sexually transmitted infection (STI) prevalence in young men (<25 years) attending genitourinary (GU) medicine clinics and compare them with older men (≥25 years) and young women (<25 years). Between October 2004 and March 2005, 4600 new attendees at seven sociodemographically and geographically contrasting GU medicine clinics across England completed questionnaires, which were linked to routine clinical data. Young men waited significantly less time to be seen in clinic compared with older men and young women. They were less likely to report symptoms than older men (P = 0.021) yet more likely to be diagnosed with chlamydia (P = 0.001) and gonorrhoea (P = 0.007). They were also more like... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319782 Thu, 13 Oct 2011 04:00:00 +0100 5319782 http://www.medworm.com/index.php?rid=5319781&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F596%3Frss%3D1 Life-expectancy increased in patients infected with HIV/AIDS with the advent of highly active antiretroviral therapy (ART). Facial lipoatrophy is a common complication in these patients, eventually leading to stigma, segregation and a negative impact in quality of life (QOL). We measured the impact of the treatment of facial lipoatrophy with polymethyl methacrylate (PMMA) in the QOL of patients with HIV/AIDS by using four questionnaires that address QOL. Forty consecutive patients on ART referred for facial lipoatrophy treatment were enrolled in this study. The first 20 were allocated to the intervention group and were treated with tissue augmentation with PMMA. The other 20 were allocated to the control group, which received treatment only after six months. At baseline, four questionnaire... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319781 Thu, 13 Oct 2011 04:00:00 +0100 5319781 http://www.medworm.com/index.php?rid=5319780&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F590%3Frss%3D1 The goal of this study was to assess condom use and related behaviour in young women in Vitória, Brazil. From March to December 2006, a cross-sectional sample of women aged 18–29 years was recruited into a population-based study. Risk behaviours for HIV and sexually transmitted infections (STIs) were surveyed. Condom use at last intercourse was assessed as a principal outcome describing protective sexual behaviour. Of 1200 eligible women identified, 1029 (85.8%) enrolled. Among them, 904 (87.9%) reported a history of sexual activity. Only 36.6% reported condom use at last intercourse; those who did were more likely to report commercial sex work (odds ratio [OR] 9.01 [1.46–55.55]), to state that STI prevention was a primary reason for using condoms (OR = 6.84 [4.81–... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319780 Thu, 13 Oct 2011 04:00:00 +0100 5319780 http://www.medworm.com/index.php?rid=5319779&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F585%3Frss%3D1 We measured plasma human herpesvirus 8 (HHV8) DNA load in consecutive patients presenting with HIV-associated multicentric Castleman disease (MCD) and in contemporaneous patients who had Kaposi sarcoma (KS), lymphoma or other diagnoses. All 11 patients with MCD had detectable plasma HHV8 DNA compared with 18 (72%) of 25 patients with KS, none with lymphoma and one of 38 patients with other diagnoses. Detectable plasma HHV8 DNA levels were higher among MCD patients, median (interquartile range [IQR]) = 43,500 (5200–150,000) copies/mL, when compared with those with KS, median (IQR) = 320 (167–822) copies/mL and those with lymphoma and other diagnoses (one-way analysis of variance; P = 0.0303). Using receiver operating characteristic analysis, a cut-off of >1000 copies HHV8 DNA... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319779 Thu, 13 Oct 2011 04:00:00 +0100 5319779 http://www.medworm.com/index.php?rid=5319778&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F581%3Frss%3D1 Research on management of Chlamydia trachomatis (CT) among men has largely been neglected. Findings from an audit of 284 CT-infected men from 2004 to 2005 attending a young men's clinic primarily serving Latino men in New York City, NY, USA, are presented. Ninety-nine percent received treatment, with 81% treated within 14 days of a positive test. Three percent reported no partner in the last three months, 17% were referred by a CT-positive partner and 24% were missing partner information. Among the rest, 18% received expedited partner therapy, 4% directly observed therapy, 12% partner referral and 65% did not receive documented partner management. Of the 34% who had a post-treatment visit at least three months after their index visit, only 36% received a test for re-infection. Among primar... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319778 Thu, 13 Oct 2011 04:00:00 +0100 5319778 http://www.medworm.com/index.php?rid=5319777&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F577%3Frss%3D1 Antiretroviral treatment (ART) has been available in the private sector in Namibia since 1998. National guidelines were developed by the Ministry of Health and clinicians of the public and private sector in 2003 and launched at the start of the public sector ART programme by the Ministry of Health. The Namibian HIV Clinicians Society was established around this period to promote adherence to the national guidelines and to provide comprehensive training for health professionals. To monitor adherence to national ART guidelines, in 2003, the Society requested access to anonymized data on ART dispensing from the medical insurance industry. Dispensing data from all Namibian medical insurance companies were obtained. ART regimens were categorized as recommended (non-nucleoside reverse transcript... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319777 Thu, 13 Oct 2011 04:00:00 +0100 5319777 http://www.medworm.com/index.php?rid=5319776&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F571%3Frss%3D1 Hepatitis C virus (HCV) is a major cause of liver disease in HIV-infected patients. The HCV treatment outcomes and barriers to HCV referral were examined in a centre with a HIV/HCV co-infection clinic. Patients who were antibody positive for both HIV and HCV between 1987 and January 2009 were identified. A retrospective chart review was undertaken. Multivariate analysis was performed to assess predictors of HCV clinic referral. Data were collected on 386 HIV/HCV patients; 202/386 had been referred to the co-infection clinic and 107/202 had HCV treatment. In addition, 29/202 were undergoing pretreatment work-up. Overall sustained virologic response (SVR) was 44%; SVR was equivalent in those who acquired HIV/HCV infection from intravenous drug use (IDU) and others. On multivariate analysis, ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319776 Thu, 13 Oct 2011 04:00:00 +0100 5319776 http://www.medworm.com/index.php?rid=5319775&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F568%3Frss%3D1 We measured the prevalence of international travel, the demographic and risk profile of international travellers and risk and preventive behaviours of travellers among HIV-negative and HIV-positive men who have sex with men (MSM), based in San Francisco, CA, USA, through the addition of questions to the local implementation of the National HIV Behavioral Surveillance survey in 2008. Of 270 MSM participating in the survey, slightly more than one-quarter (26.3%) had travelled internationally in the last year. Those with a history of international travel were more likely to be foreign born, of a higher socioeconomic status and HIV uninfected. Of eight HIV-positive MSM who travelled internationally (11.3% of HIV-positive MSM), all were on antiretroviral therapy and only three recalled being va... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319775 Thu, 13 Oct 2011 04:00:00 +0100 5319775 http://www.medworm.com/index.php?rid=5319774&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F558%3Frss%3D1 We estimated the effectiveness and cost-effectiveness of changes in concurrent sexual partnerships in reducing the spread of HIV in sub-Saharan Africa. Using data from Swaziland, Tanzania, Uganda and Zambia, we estimated country-specific concurrency behaviour from sexual behaviour survey data on the number of partners in the past 12 months, and we developed a network model to compare the impact of three behaviour changes on the HIV epidemic: (1) changes in concurrent partnership patterns to strict monogamy; (2) partnership reduction among those with the greatest number of partners; and (3) partnership reduction among all individuals. We estimated the number of new HIV infections over 10 years and the cost per infection averted. Given our assumptions and model structure, we find that reduci... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319774 Thu, 13 Oct 2011 04:00:00 +0100 5319774 http://www.medworm.com/index.php?rid=5319773&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F552%3Frss%3D1 We evaluated whether use of a short- or longer-term recall period for condom use was superior for assessing risk of acquisition of incident sexually transmitted infection (STI). Female sex workers (n = 1000) in Madagascar took part in a randomized trial comparing counselling strategies for male and female condom promotion. We explored associations between women's self-reported condom use with clients and non-paying partners and incident STI, examining both short-term recall (last sex act) and longer-term recall (over the past month and year). Self-reported condom use was generally not associated with reduced STI risk, whether measured at the last act or over longer time periods; with clients or non-paying partners; and through unadjusted and adjusted modelling. No condom use measure (short... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319773 Thu, 13 Oct 2011 04:00:00 +0100 5319773 http://www.medworm.com/index.php?rid=5319772&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F548%3Frss%3D1 In conclusion, the results of the present study concerning sexual behaviour, HIV status and clinical signs highlight the need for further evaluations that may shape future partner notification strategies in order to reduce the chlamydial disease burden. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319772 Thu, 13 Oct 2011 04:00:00 +0100 5319772 http://www.medworm.com/index.php?rid=5319771&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F10%2F541%3Frss%3D1 The British Association for Sexual Health and HIV (BASHH) UK gonorrhoea guideline has been updated in 2011. It offers advice on diagnosis, treatment and health promotion for anogenital and pharyngeal gonorrhoea. Nucleic acid amplification tests (NAATs) are now being used more for diagnosis and are increasing detection rates in the pharynx and rectum. First line treatment using ceftriaxone with azithromycin is now advised, along with routine test of cure (TOC). The aim is to slow the spread of resistant gonorrhoea now that fewer antibiotics remain effective. A patient information leaflet has been developed. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5319771 Thu, 13 Oct 2011 04:00:00 +0100 5319771 http://www.medworm.com/index.php?rid=5189413&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F538%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189413 Thu, 01 Sep 2011 23:00:00 +0100 5189413 http://www.medworm.com/index.php?rid=5189412&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F536%3Frss%3D1 A subset of HIV-infected patients who receive antiretroviral therapy (ART) develop immune restoration syndrome. A case of immune restoration Klebsiella lymphadenitis is described. Fine needle aspiration cytology remains a useful investigative tool in the post-ART era, particularly in the diagnosis of persistent generalized lymphadenopathy, infection and malignancy of the lymph nodes. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189412 Thu, 01 Sep 2011 23:00:00 +0100 5189412 http://www.medworm.com/index.php?rid=5189411&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F534%3Frss%3D1 We present an atypical case of a vaginal wart presenting as a single pedunculated mass protruding outside the vagina in a pregnant woman in labour. On examination of the vulva, a soft, pink papilliferous growth of 6 x 4 cm size was seen hanging outside the vaginal introitus. Speculum examination revealed that the growth was attached to the posterior and lateral vaginal wall near the fornix. Genital warts can proliferate during pregnancy due to altered immunity and increased blood supply, as seen in this case. Vaginal warts can also cause problems during delivery, since they prevent the vagina from stretching appropriately. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189411 Thu, 01 Sep 2011 23:00:00 +0100 5189411 http://www.medworm.com/index.php?rid=5189410&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F531%3Frss%3D1 A 47-year-old man presented to his general practitioner (GP) with painful swelling of his right testis. He was diagnosed with epididymo-orchitis and a two-week course of erythromycin 500 mg four times daily was prescribed by his GP. Despite initial improvement, his symptoms persisted and he was referred to the local urology department. His sexual history revealed one lifetime sexual contact. A midstream urine sample grew non-lactose fermenting coliforms sensitive to ciprofloxacin and a two-week course of ciprofloxacin 500 mg two times daily was prescribed. Despite clinical improvement, a persistent suspicious abnormality on the ultrasound scan of his right testis prompted a right radical inguinal orchidectomy to exclude malignancy. Further diagnostic tests including histopathology excluded... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189410 Thu, 01 Sep 2011 23:00:00 +0100 5189410 http://www.medworm.com/index.php?rid=5189409&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F529%3Frss%3D1 We present the first reported case of primary and secondary syphilis with negative Treponema pallidum enzyme immunoassay-IgM and Venereal Disease Research Laboratory tests in a man with common variable immunodeficiency. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189409 Thu, 01 Sep 2011 23:00:00 +0100 5189409 http://www.medworm.com/index.php?rid=5189408&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F527%3Frss%3D1 A 27-year-old man who has sex with men presented with a painful lesion at the urethral meatus. A diagnosis of genital herpes was suspected, and initial tests for sexually transmitted infections (STIs), including syphilis serology, were negative. However, a polymerase chain reaction (PCR) swab for Treponema pallidum from the lesion was positive, and a diagnosis of chancre of primary syphilis at the meatus was made. Subsequently, the patient required urological surgery due to the formation of a urethral stricture. Chancre at the meatus and development of stricture are unusual complications of syphilis that may become more common in the future with increasing case numbers. We also discuss the development of PCR as a useful test for early primary syphilis. (Source: International Journal of STD... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189408 Thu, 01 Sep 2011 23:00:00 +0100 5189408 http://www.medworm.com/index.php?rid=5189407&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F525%3Frss%3D1 Our genitourinary medicine service implemented an automated telephone results system in 2010. This system is used in other services but few are able to upload negative results automatically from laboratory software. The use of this system reduced unanswered calls to a telephone results line and also the number of calls that had to be connected to clinical staff. Patients have better access to their results in a timely manner, as per the requirements of the recent Standards for the Management of Sexually Transmitted Infections document. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189407 Thu, 01 Sep 2011 23:00:00 +0100 5189407 http://www.medworm.com/index.php?rid=5189406&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F523%3Frss%3D1 Escalating notifications of chlamydia in Western Australia (WA) prompted an audit of the compliance of general practitioners (GPs) with the current guidelines for management. The audit consisted of a telephone survey of GPs known to have treated a case of chlamydia. GPs generally performed opportunistic screening well and complied with the guidelines for testing and treatment. Only 8% of GPs took a comprehensive sexual history from symptomatic cases, 53% routinely tested for blood-borne sexually transmitted infections and 29% recorded a discussion of partner notification in the medical records. The results of the audit form part of the review of the current edition of the guidelines, and will be noted in the plans for promotion and dissemination of the next edition. (Source: International ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189406 Thu, 01 Sep 2011 23:00:00 +0100 5189406 http://www.medworm.com/index.php?rid=5189405&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F521%3Frss%3D1 A cluster of five (3 primary and 2 early latent) cases of syphilis were identified in young heterosexuals in the east of England. Three were symptomatic at presentation. No further cases linked to this cluster have been diagnosed since June 2010. Effective partner notification is key to the identification and treatment of infected contacts. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189405 Thu, 01 Sep 2011 23:00:00 +0100 5189405 http://www.medworm.com/index.php?rid=5189404&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F519%3Frss%3D1 We describe a recent outbreak of syphilis in young heterosexuals in the north west of England. A cluster of 12 cases of syphilis (7 primary and 5 early latent) was identified in Rochdale in heterosexuals aged 20 or under. Nine were women. Five were asymptomatic at presentation. This outbreak occurred in a group not usually associated with syphilis transmission in the north west. Not all the identified cases could be linked, and so potentially this outbreak is a sentinel of a larger problem. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189404 Thu, 01 Sep 2011 23:00:00 +0100 5189404 http://www.medworm.com/index.php?rid=5189403&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F517%3Frss%3D1 A local outbreak of infectious syphilis among heterosexual men and women was noted among residents of a National Health Services board in central Scotland in 2009. This is the first, and remains the only, such outbreak in Scotland reporting transmission in the heterosexual population. It was characterized by the young age of those infected. This highlights the need for increasing knowledge and awareness of syphilis infection among this group. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189403 Thu, 01 Sep 2011 23:00:00 +0100 5189403 http://www.medworm.com/index.php?rid=5189402&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F514%3Frss%3D1 Prior to 2006, diagnoses of heterosexually acquired syphilis were rare in Teesside (an area in the north east of England, UK). Since 2006, there has been an increase in such cases, with 24 cases diagnosed in 2006 and 22 in 2007. There was a marked reduction in cases in 2008 with six cases reported, but a large increase in diagnoses in 2009 (34 cases). There have been 14 cases to date in 2010. Of concern is the increase noted in women and younger age groups. Geographical mapping of cases shows a wide dispersion across Teesside although some clusters were identified, mostly in areas of high deprivation. Little detailed information is available to help identify social and sexual networks widely and target intervention. A multiagency outbreak control team is addressing this problem, based on t... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189402 Thu, 01 Sep 2011 23:00:00 +0100 5189402 http://www.medworm.com/index.php?rid=5189401&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F512%3Frss%3D1 A small cluster of infectious syphilis among young heterosexuals aged under 25 years in south-east Hampshire has highlighted the limitations of effective partner notification, the challenges of providing effective awareness raising and the need for increased accessibility to genitourinary (GU) medicine services. Evaluation of awareness raising to both the target age group and health care professionals indicated that the strategies employed did not increase testing and had limited impact on young people in terms of seeking further information. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189401 Thu, 01 Sep 2011 23:00:00 +0100 5189401 http://www.medworm.com/index.php?rid=5189400&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F505%3Frss%3D1 A new system for monitoring HIV voluntary counselling and testing (VCT) outcomes was established in 2007 at seven VCT clinics in Jakarta and Bali, Indonesia. Counsellors collected demographic and risk information from VCT clients. Logistic regression was used to determine factors associated with HIV infection. In 15 months, HIV prevalence in 5569 new clients without HIV symptoms was 63.3% in injecting drug users (IDUs) (n = 783), 7.7% in female sex workers (n = 1437), 31.6% among transgender people (n = 395), 9.3% in men who have sex with men (n = 268), 13.5% in clients of sex workers (n = 643), 21.1% in people with high-risk partners (n = 569) and 3.2% in other VCT clients (n = 822). Among IDUs, being older, tested though outreach, tested due to being ‘at risk’ and having inje... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189400 Thu, 01 Sep 2011 23:00:00 +0100 5189400 http://www.medworm.com/index.php?rid=5189399&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F498%3Frss%3D1 We retrospectively studied outcomes for HIV-infected patients admitted to the intensive care unit (ICU) between January 1999 and June 2009. Patient demographics, receipt of highly active antiretroviral therapy (HAART), reason for ICU admission and survival to ICU and hospital discharge were recorded. Comparison was made against outcomes for general medical patients contemporaneously admitted to the same ICU. One hundred and ninety-two HIV-infected patients had 222 ICU admissions; 116 patients required mechanical ventilation (MV) and 43 required renal replacement therapy. ICU admission was due to an HIV-associated diagnosis in 113 patients; 37 had Pneumocystis pneumonia. Survival to ICU discharge and hospital discharge for HIV-infected patients was 78% and 70%, respectively, and was 75% and... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189399 Thu, 01 Sep 2011 23:00:00 +0100 5189399 http://www.medworm.com/index.php?rid=5189398&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F493%3Frss%3D1 A large outbreak of syphilis was reported in Dublin, Ireland, in 2001. The mean age of patients in 2001 was 35 years and 22.5% of patients were HIV-positive. The number of new cases decreased from 2003 on, however, new diagnoses have again increased. All positive syphilis serology results from 2007–09 were identified. Patients were included if they had a newly positive syphilis serology or, in the case of patients with previously treated syphilis, had a four-fold rise in rapid plasma reagin titre. Four hundred and thirty-nine new diagnoses of syphilis were made. The mean age of patients at diagnosis was 35.7 years (range 17–73 years). Four hundred and twelve (93.8%) cases occurred in men. Three hundred and eighty-one (86.8%) cases occurred in men who have sex with men (MSM). Th... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189398 Thu, 01 Sep 2011 23:00:00 +0100 5189398 http://www.medworm.com/index.php?rid=5189397&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F488%3Frss%3D1 During the 1990s, cases of infectious syphilis were uncommon in Wales. In 2002, an outbreak occurred in a sexual network of men who have sex with men (MSM) attending a sauna. A multidisciplinary outbreak control team was convened to raise awareness of the outbreak among MSM and health professionals, assess the extent of outbreak, and initiate surveillance measures. It is likely that early intensive control efforts dampened the epidemic curve. However, since 2006 the number of cases has increased steadily to a peak of four cases per 100,000 population in 2008. The majority of cases continue to occur in MSM (81% in 2009) and in those attending genitourinary (GU) medicine clinics in south east Wales (76%). Traditional sexual networks such as saunas, bars/clubs and cruising grounds remain freq... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189397 Thu, 01 Sep 2011 23:00:00 +0100 5189397 http://www.medworm.com/index.php?rid=5189396&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F483%3Frss%3D1 Male patients can present with a genital skin burning sensation that bears similarities to vulvodynia. The classification of vulvodynia by International Society for the Study of Vulvovaginal Disease of vulvodynia provides a blueprint for nomenclature and classification of Dysaesthetic penoscrotodynia (DPSD). Recognizing DPSD as generalized, localized, provoked, unprovoked and mixed will enable precise and objective communication between practitioners. Learning from research on the aetiology and management of vulvodynia can improve the care of patients suffering with DPSD. Scope remains for better acknowledgement of DPSD within the medical profession and improvement in its public profile in order to enhance patient care. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189396 Thu, 01 Sep 2011 23:00:00 +0100 5189396 http://www.medworm.com/index.php?rid=5189395&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F9%2F481%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5189395 Thu, 01 Sep 2011 23:00:00 +0100 5189395 http://www.medworm.com/index.php?rid=5074717&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F478%3Frss%3D1 Rectal chlamydia is a common sexually transmissible infection (STI) in men who have sex with men (MSM) that is predominantly asymptomatic. The recommended treatment of azithromycin 1 g as a single oral dose has not been subject to randomized trials and so its efficacy is unknown. We conducted a retrospective case-note review of all MSM diagnosed at the Sydney Sexual Health Centre with asymptomatic rectal chlamydia in 2009. We identified 116 MSM who received azithromycin; 85 (73%) attended for the recommended re-test at varying times (median 78 days, range 21–372 days). Of the men who returned, 11 (13%) had a persistently positive result; we reviewed behavioural data to classify these men as probable re-infections (6/11) or possible treatment failures (5/11), suggesting an efficacy of... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074717 Tue, 26 Jul 2011 23:00:00 +0100 5074717 http://www.medworm.com/index.php?rid=5074716&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F474%3Frss%3D1 There are no evidence-based guidelines for the specific management of rectal Chlamydia trachomatis (CT) infection. All men who have sex with men (MSM) diagnosed with asymptomatic rectal CT by nucleic acid amplification test (NAAT) at a large London genitourinary (GU) medicine clinic between September 2006 and September 2009 were offered oral doxycycline 100 mg twice daily for seven days and invited for a test of cure (TOC) by CT NAAT four weeks after treatment. A total of 487 asymptomatic rectal CT infections were diagnosed and analysis was restricted to 165 TOCs from men whose only treatment had been doxycycline for seven days. The median time post-treatment for TOC was 45 days (interquartile range [IQR], 34–88). Only two patients tested CT-positive at follow-up. One had taken doxyc... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074716 Tue, 26 Jul 2011 23:00:00 +0100 5074716 http://www.medworm.com/index.php?rid=5074715&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F471%3Frss%3D1 We describe the use of a new molecular assay for Trichomonas vaginalis (TV), the Gen-Probe Aptima TV (ATV) in female attendees at community clinics, a genitourinary (GU) medicine clinic and a prison GU medicine service. Positivity rates at community clinics and GU medicine were 0/382 (0%) and 3/358 (0.8%, 95% confidence interval [CI] 0–1.7%), respectively. Positivity was significantly higher, 29/269 (10.8%, 95% CI 7.1–14.5%), odds ratio (OR) 14.3 (4.11 < OR < 59.55), in those tested at the prison. A questionnaire survey of English GU medicine clinics and data from the UK Health Protection Agency (HPA) for England both demonstrated the large variation in case rates by region and testing methods employed. Higher rates were seen in women, in prison GU medicine services and i... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074715 Tue, 26 Jul 2011 23:00:00 +0100 5074715 http://www.medworm.com/index.php?rid=5074714&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F465%3Frss%3D1 In order to determine inpatient hospital mortality rates, causes of mortality and characteristics of inpatients at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi, we conducted a prospective observational study of all patients admitted to KCH medical ward from 20 September 2008 to April 2, 2009. All admission diagnoses, HIV status and antiretroviral therapy (ART) use were recorded. Patients' vital status was determined at discharge. A descriptive analysis and two logistic regression models were used for the analysis. Of the 1895 enrolled patients, the overall hospital mortality rate was 14.6%, substantially higher among known HIV-infected patients (24.2% versus 10.8%, P = 0.0009) and men (17.1% versus 12%, P = 0.033). Patients with multiple diagnoses had significantly higher mortality (o... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074714 Tue, 26 Jul 2011 23:00:00 +0100 5074714 http://www.medworm.com/index.php?rid=5074713&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F463%3Frss%3D1 Herpes simplex virus type 2 (HSV-2) HIV co-infection is common and associated with increased risk of HIV transmission. HSV-2 seroprevalence was assessed on stored samples from baseline and one year follow-up from 81 patients identified with acute HIV infection and 81 age-matched chronically infected men. HSV-2 seroprevalence at baseline was lower for those with acute rather than chronic HIV-infection, 51.9 versus 71.6% (P = 0.01); relative risk 0.72 (95% confidence interval [CI] 0.57–0.92). Since HSV-2 seroprevalence is lower in those newly HIV-infected, the diagnosis of early HIV infection may allow for counselling to reduce subsequent HSV-2 acquisition. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074713 Tue, 26 Jul 2011 23:00:00 +0100 5074713 http://www.medworm.com/index.php?rid=5074712&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F457%3Frss%3D1 We determined the prevalence of renal impairment and possible HIV-associated nephropathy (HIVAN) in adults with World Health Organization (WHO) stages I or II HIV, presenting to the antiretroviral therapy (ART) clinic in a central hospital in Malawi. We enrolled 526 ART-naïve subjects, 67% women, median age 34 (17–73) years and mean CD4 count 305 (3–993) cells/µL. Blood pressure, weight, urine dipstick and microscopy, CD4 cell count and serum creatinine were measured. Creatinine clearance (CrCL) was estimated using the Cockcroft–Gault equation. Possible HIVAN was diagnosed based on levels of proteinuria and CrCl. In all, 23.3% had proteinuria (≥1+). 57.4% had reduced CrCl (<90 mL/minute): 18.8% had moderate (CrCl 30–59 mL/minute) and 2.2% severe (Cr... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074712 Tue, 26 Jul 2011 23:00:00 +0100 5074712 http://www.medworm.com/index.php?rid=5074711&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F453%3Frss%3D1 This cross-sectional study aimed to compare growth, nutritional status and body composition outcomes between a group of 94 HIV-infected children and adolescents on antiretroviral therapy (ART) and 364 healthy controls, and to evaluate their association with clinical and lifestyle variables within the HIV-infected group. When compared with the control group, HIV patients had higher risk of stunting (odds ratio [OR] 5.33, 95% confidence interval [CI]: 2.83–10.04) and thinness (OR 4.7, 95% CI: 2.44–9.06), higher waist-to-hip ratios (medians 0.89 versus 0.82 for boys and 0.90 versus 0.77 for girls, P < 0.001), and lower prevalence of overweight or obesity (OR 0.33, 95% CI: 0.14–0.78). Protease inhibitor usage was associated with thinness (OR 3.51, 95% CI 1.07–11.44) ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074711 Tue, 26 Jul 2011 23:00:00 +0100 5074711 http://www.medworm.com/index.php?rid=5074710&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F449%3Frss%3D1 Expedited partner therapy (EPT) is the practice of providing an extra dose or prescription of antibiotic to patients diagnosed with chlamydia or gonorrhoea to deliver to their sexual partner(s). Obstetrical providers who delivered more than 20 infants in Maricopa County, Arizona, USA, during the year 2008 were surveyed by telephone regarding their use of EPT. A total of 142 eligible respondents completed the survey, representing 34% (142/421) of the delivering providers, 67 (47%) of whom reported the use of EPT in their clinics. Having received information about EPT was significantly associated with its use (67% versus 41%) (P = 0.008). The most common reasons for not using EPT included the inability to obtain allergy history in partners (24%) and concern for liability (11%). Additional ed... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074710 Tue, 26 Jul 2011 23:00:00 +0100 5074710 http://www.medworm.com/index.php?rid=5074709&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F442%3Frss%3D1 This study examined sex toy use within this population to describe the extent to which using toys is incorporated into their sexual repertoires as a risk reduction practice. Data regarding sociodemographics, sexual/health-related behaviours and sex toy use were collected from 2275 MSM using an online survey. Most participants reported being sexually active (88.5%), and the majority (70.2%) of participants reported sex toy use within the previous year. Sex toy users were more likely to be white, in sexual relationships with others, and reported higher levels of sexual satisfaction. Given that sex toy use is common among this population, room for discussion exists about sex toys as tools to enhance pleasure and reduce HIV/sexually transmitted infection (STI) transmission. (Source: Internatio... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074709 Tue, 26 Jul 2011 23:00:00 +0100 5074709 http://www.medworm.com/index.php?rid=5074708&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F436%3Frss%3D1 Chlamydia trachomatis (CT) infection has been a target for both selective and national screening programmes, and Sweden has an opportunistic approach. A national plan of action states that risk groups should be identified and offered risk reduction counselling. Patients attending a drop-in sexually transmitted infection (STI) clinic reception at the University Hospital, Umeå, Sweden, were invited to complete a questionnaire regarding sociodemographic characteristics, symptoms and sexual risk behaviour; all had a CT test taken. A total of 1305 patients were included, 58% men, mean age 27.8 years. CT prevalence was 11%; 51% of those with CT were ≥25 years old. Only 5% used a condom during the entire sexual intercourse with their last new/temporary partner. Sexually active inconsiste... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074708 Tue, 26 Jul 2011 23:00:00 +0100 5074708 http://www.medworm.com/index.php?rid=5074707&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F430%3Frss%3D1 This review sought to establish the themes and approaches used in the measurement of patient satisfaction regarded by HIV service users as crucial to improving service quality. It also investigated how feedback has been measured previously and whether a gold standard instrument exists that is generalizable across HIV inpatient and clinic settings. Twelve databases and other sources yielded 1474 titles. Using a clinically-focused question and pre-defined inclusion and exclusion criteria, 32 articles were retrieved and reviewed for quality using a quality appraisal checklist. Two reviewers used a data extraction form to identify and verify key patient experiences. Thematic analysis revealed that clinic staffs' current knowledge of HIV was an essential factor in positive feedback. Treating pa... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074707 Tue, 26 Jul 2011 23:00:00 +0100 5074707 http://www.medworm.com/index.php?rid=5074706&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F8%2F421%3Frss%3D1 Three common infections are associated with vaginal discharge: bacterial vaginosis, trichomoniasis and candidiasis, of which trichomoniasis is a sexually transmitted infection (STI). This guideline covers the presentation and clinical findings of these infections and outlines the differential diagnoses. Recommendations for investigation and management based on currently available evidence are made, including the management of persistent and recurrent infections. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5074706 Tue, 26 Jul 2011 23:00:00 +0100 5074706 http://www.medworm.com/index.php?rid=5004380&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F419-b%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004380 Mon, 04 Jul 2011 23:00:00 +0100 5004380 http://www.medworm.com/index.php?rid=5004379&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F419-a%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004379 Mon, 04 Jul 2011 23:00:00 +0100 5004379 http://www.medworm.com/index.php?rid=5004378&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F418%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004378 Mon, 04 Jul 2011 23:00:00 +0100 5004378 http://www.medworm.com/index.php?rid=5004377&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F417%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004377 Mon, 04 Jul 2011 23:00:00 +0100 5004377 http://www.medworm.com/index.php?rid=5004376&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F416%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004376 Mon, 04 Jul 2011 23:00:00 +0100 5004376 http://www.medworm.com/index.php?rid=5004375&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F415-b%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004375 Mon, 04 Jul 2011 23:00:00 +0100 5004375 http://www.medworm.com/index.php?rid=5004374&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F415-a%3Frss%3D1 (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004374 Mon, 04 Jul 2011 23:00:00 +0100 5004374 http://www.medworm.com/index.php?rid=5004373&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F413%3Frss%3D1 We present an interesting case of an HIV-positive woman on antiretroviral therapy having tubal pregnancies on two separate occasions with Implanon in place. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004373 Mon, 04 Jul 2011 23:00:00 +0100 5004373 http://www.medworm.com/index.php?rid=5004372&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F411%3Frss%3D1 We describe a case of rhabdomyolysis associated with trimethoprim-sulphamethoxazole (TMP-SMZ) in a HIV-infected patient. A 33-year-old African American man with newly diagnosed AIDS initially presented with persistent, high-grade fevers suspected to be TMP-SMZ-related drug fever. The antibiotic was discontinued while in the hospital, but the patient was restarted on TMP-SMZ following discharge. Two days later, he returned to the hospital with severe muscle pain, acute renal failure and a significantly elevated creatine phosphokinase consistent with rhabdomyolysis. The patient gradually improved following discontinuation of TMP-SMZ. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004372 Mon, 04 Jul 2011 23:00:00 +0100 5004372 http://www.medworm.com/index.php?rid=5004371&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F409%3Frss%3D1 We report a case in which early diffuse large B-cell lymphoma regressed completely after ART alone, raising the possibility that this may be sufficient therapy in selected cases. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004371 Mon, 04 Jul 2011 23:00:00 +0100 5004371 http://www.medworm.com/index.php?rid=5004370&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F407%3Frss%3D1 An audit of 72 patients presenting for post-exposure prophylaxis following sexual exposure (PEPSE) to HIV (68 genitourinary medicine and 4 accident & emergency) was conducted from 2003 to 2009. The principal indications for PEPSE included 27 (38%) unprotected intercourse (15/27 vaginal and 12/27 anal) with a known HIV-positive partner, 20 (28%) unprotected receptive anal sex with male partner of unknown status, 17 (24%) following sexual assault and three (4%) unprotected sex with a partner from an endemic country. Of those who commenced PEPSE, 92% did so within the recommended 72 hours. Concurrent sexually transmitted infection (STI) was diagnosed in 8.3% patients (6.9% non-gonococcal urethritis and 1.4% rectal chlamydia). Fifty (69%) patients attended for follow-up and only 8% of thes... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004370 Mon, 04 Jul 2011 23:00:00 +0100 5004370 http://www.medworm.com/index.php?rid=5004369&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F405%3Frss%3D1 Practice related to hepatitis B vaccination of HIV outpatients in a London teaching hospital was audited against the British HIV Association (BHIVA) immunization guidelines 2004 and 2008, both before and after the implementation of a vaccination record sheet in the patients' notes. Adherence to the guidelines in the original audit was poor – only 67% of patients requiring vaccination for hepatitis B received a full course of vaccination. Following the introduction of the vaccination record sheet, this vaccination completion rate increased to 79% (BHIVA target 95%). Overall the percentage of patients managed according to BHIVA guidelines, including those who did not require vaccination, improved from 33% in the original audit to 61% in the re-audit. Introduction of a simple hepatitis ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004369 Mon, 04 Jul 2011 23:00:00 +0100 5004369 http://www.medworm.com/index.php?rid=5004368&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F400%3Frss%3D1 It is important to assess uptake of a new vaccine. The present survey estimated the uptake of the recently introduced human papillomavirus vaccine (HPVV) in the emirate of Abu Dhabi and also explored barriers to uptake. A questionnaire survey was conducted in secondary schools, enrolling 334 girls. The uptake percentage was estimated and factors associated with uptake were assessed with multilevel logistic regression. Crude vaccination uptake was 53%. Factors positively associated with uptake were, among others, having knowledge on human papillomavirus (vaccine) and having United Arab Emirates (UAE) nationality. The HPVV uptake of just over 50% could probably be improved by educating the target group and their parents before offering the HPVV and by making it free of costs for everyone. (S... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004368 Mon, 04 Jul 2011 23:00:00 +0100 5004368 http://www.medworm.com/index.php?rid=5004367&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F398%3Frss%3D1 Little information is available on the prevalence of Neisseria gonorrhoeae (GC) infections outside genitourinary (GU) medicine clinics. A number of National Chlamydia Screening Programme areas now carry out simultaneous testing for Chlamydia trachomatis (CT) and GC in a single sample using nucleic acid amplification tests (NAATs). The aim of this study was to gather together data on dual testing from community settings. Information was collected from five programme areas. A total of 219,412 results were recorded with 18,370 CT positives, 1226 GC positives and among these 554 were with dual CT/GC infection. These figures highlight the fact that substantial numbers of positive GC NAAT results are found outside GU settings. An assessment of both the prevalence of GC and the proportion of extr... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004367 Mon, 04 Jul 2011 23:00:00 +0100 5004367 http://www.medworm.com/index.php?rid=5004366&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F391%3Frss%3D1 The main objectives of this study were to identify the determinants of condom use among HIV-positive men having anal sex with HIV-negative men or men of unknown HIV status and moderators of the intention–behaviour relationship. A cohort of 237 sexually active HIV-positive men having sex with men was followed over a period of six months. The cognitive variables measured were guided by an extended version of the theory of planned behaviour. Results indicated that past behaviour (odds ratio [OR] = 9.75; 95% confidence interval [CI]: 4.48–21.26), intention (OR = 3.13; 95% CI: 1.25–7.81), self-efficacy (OR = 3.62; 95% CI: 1.40–9.37) and use of sex drugs (OR = 0.16; 95% CI: 0.06–0.45) contributed to the prediction of 100% condom use. Self-efficacy also interacted wi... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004366 Mon, 04 Jul 2011 23:00:00 +0100 5004366 http://www.medworm.com/index.php?rid=5004365&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F387%3Frss%3D1 To examine the seroprevalence of herpes simplex virus type 2 (HSV-2) among Hispanics in the USA, we used the cross-sectional, nationally representative National Health and Nutrition Examination Survey to compare the seroprevalence of HSV-2 between Hispanic persons of Mexican heritage and non-Mexican heritage aged 14–44 years, from survey years 2007–2008. The overall HSV-2 seroprevalence among Hispanics aged 14–44 years was 17.5% (95% confidence interval [CI], 15.2, 20.1) in the USA. HSV-2 seroprevalence was significantly lower among Mexican Americans than among other Hispanics (11.7% vs. 27.8%, P < 0.01). Prevalence of HSV-2 was also significantly associated with gender and age. The significant difference in HSV-2 seroprevalence between Hispanic persons of Mexican heri... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004365 Mon, 04 Jul 2011 23:00:00 +0100 5004365 http://www.medworm.com/index.php?rid=5004364&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F381%3Frss%3D1 The World Health Organization (WHO) has identified a failure to provide education for vulnerable populations such as prisoners as a contributing factor to the epidemic of sexually transmissible infections (STIs). Despite this recognition, little is known about prisoners' level of knowledge of STIs compared with the general population. Using computer-assisted telephone interviews, we compared a representative sample of 2289 Australian prisoners, aged 18–59 years from New South Wales and Queensland prisons with a representative community sample of 3536 participants from these two states. Prisoners had significantly better knowledge than the general community of chlamydia-related questions, while knowledge of herpes (genital and oral) was slightly better in the community sample. Prisone... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004364 Mon, 04 Jul 2011 23:00:00 +0100 5004364 http://www.medworm.com/index.php?rid=5004363&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F376%3Frss%3D1 The aim of this study was to describe the knowledge and health-seeking behaviour related to sexually transmitted infections (STIs) and abortion among women selling sex in Lahore, Pakistan. This was a cross-sectional, community-based, quantitative study. A total of 730 women selling sex were recruited by respondent-driven sampling. A pretested structured questionnaire was administered through face-to-face interviews. The median age of the participants was 30 years. Thirteen percent of the participants said it was common for them to have an abnormal vaginal discharge. Seventy-five percent of the participants recognized STIs as either leucorrhoea or AIDS. Sixty-five percent of the participants complained of having suffered from STI(s) in the six months preceding the survey, of whom 28% sought... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004363 Mon, 04 Jul 2011 23:00:00 +0100 5004363 http://www.medworm.com/index.php?rid=5004362&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F373%3Frss%3D1 The need for viral load (VL) monitoring of HIV patients receiving antiretroviral therapy (ART) in resource-limited settings (RLS) has become apparent with studies showing the limitations of immunological monitoring. We compared the Abbott m2000 Real-Time (Abbott) HIV-1 assay with the Roche AMPLICOR Monitor v1.5 (Roche) HIV-1 assay over a range of VL concentrations. Three hundred and eleven plasma samples were tested, including 164 samples from patients on ART ≥ six months and 147 from ART-naïve patients. The Roche assay detected ≥400 copies/mL in 158 (50.8%) samples. Of these, Abbott produced 145 (91.8%) detectable results ≥400 copies/mL; 13 (8.2%) samples produced discrepant results. Concordance between the assays for detecting HIV-1 RNA ≥400 copies/mL was 95.8% (298/311)... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004362 Mon, 04 Jul 2011 23:00:00 +0100 5004362 http://www.medworm.com/index.php?rid=5004361&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F368%3Frss%3D1 The expanding services of antiretroviral treatment (ART) in sub-Saharan Africa provide unique opportunities to reduce HIV/AIDS-related morbidity and mortality. In these settings, HIV prevalence among antenatal women remains high and treating eligible pregnant or breastfeeding women with antiretrovirals can substantially reduce transmission of HIV from the mother to her infant. However, identification of women eligible for treatment and ensuring access to ART services is challenging. In this analysis, we used data from a large clinical trial (the PEPI-Malawi study, 2004–09) to prevent mother-to-child transmission of HIV through extended antiretroviral prophylaxis of infants to examine barriers for wider coverage with highly active antiretroviral treatment (HAART) of postpartum women. ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004361 Mon, 04 Jul 2011 23:00:00 +0100 5004361 http://www.medworm.com/index.php?rid=5004360&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F366%3Frss%3D1 Measurement of health-care quality in the UK is no longer restricted to evaluating the effectiveness of treatments or the cost efficiency of services. There is a drive towards a patient-based agenda which enables them to make a clear contribution to the way services are shaped by expressing their values and sharing experiences. Positive engagement with HIV care has proven benefits to patients and the mandatory use of standardized reported outcome measures provides an opportunity to include HIV patients in the process of creating and refining an evaluation tool which places emphasis on aspects of care that are significant to them. Ultimately, this will provide services users with a stronger voice to guide appropriate service change and support the continuing improvement of HIV care. (Source... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004360 Mon, 04 Jul 2011 23:00:00 +0100 5004360 http://www.medworm.com/index.php?rid=5004359&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F7%2F361%3Frss%3D1 The BASHH UK guideline for the management of epididymo-orchitis has been updated in 2010. Consideration should be made of the changing potential aetiologies of epididymo-orchitis – mumps in non-immune individuals and tuberculosis in the immunocompromised and men from countries of high prevalence. The treatment of sexually acquired epididymo-orchitis has changed given the high levels of quinolone-resistant gonorrhoea such that ceftriaxone and doxycycline are recommended in those at high risk of gonorrhoea and doxycycline or ofloxacin in those patients where gonorrhoea is considered unlikely (negative microscopy for Gram-negative intracellular diplococci and no risk factors for gonorrhoea identified). A clinical care pathway has also been produced to simplify the management of epididym... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=5004359 Mon, 04 Jul 2011 23:00:00 +0100 5004359 http://www.medworm.com/index.php?rid=4929857&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F358%3Frss%3D1 We report a small case series of five women receiving raltegravir as part of their antiretroviral regimen during pregnancy. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929857 Wed, 15 Jun 2011 23:00:00 +0100 4929857 http://www.medworm.com/index.php?rid=4929856&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F356%3Frss%3D1 We report a case of a new diagnosis of hereditary angioedema (HAE) presenting with genital swelling to a genitourinary (GU) medicine clinic. There is often a significant delay in diagnosing HAE, but it commonly presents with genital swelling before manifesting as potentially life-threatening visceral attacks. This case highlights the fact that HAE should be considered as an important differential diagnosis of genital oedema, as early recognition may help to prevent more serious future visceral episodes. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929856 Wed, 15 Jun 2011 23:00:00 +0100 4929856 http://www.medworm.com/index.php?rid=4929855&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F353%3Frss%3D1 We report a case of a 62-year-old man who presented with one-month acute pain in the left leg. Treponema pallidum particle agglutination test was positive, and radiography showed a pathological fracture of the left tibiofibula. Surgical debridement and biopsy of the bone marrow were performed and a pathological diagnosis of syphilis osteomyelitis was entertained. The patient's symptoms resolved completely after a six-week course of penicillin. We identified 17 previously published cases of bone lesions of syphilis, eight of which had syphilitic osteomyelitis, seven were syphilitic osteitis and two had syphilitic periostitis. We suggest that bone lesions such as osteomyelitis caused by syphilis can be the only manifestation of late latent syphilis. (Source: International Journal of STD and ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929855 Wed, 15 Jun 2011 23:00:00 +0100 4929855 http://www.medworm.com/index.php?rid=4929854&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F351%3Frss%3D1 This retrospective study assessed whether Quality Improvement Scotland national standards for the sexual health care offered to HIV-positive individuals are being met by the Edinburgh genitourinary (GU) medicine clinic; specifically whether HIV-positive patients are offered: (a) sexually transmitted infection (STI) screening annually and (b) syphilis testing six-monthly. The study also reviewed what factors were associated with a clinician's offer of STI screening and syphilis testing. Of the 509 patients seen within the study period, case notes documented that 64% were offered STI screens, and 69% were offered syphilis testing, results consistent with audits of services elsewhere. Sexual orientation (P < 0.0005), relationship status (P = 0.007) and receipt of antiretrovirals (P = 0.001... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929854 Wed, 15 Jun 2011 23:00:00 +0100 4929854 http://www.medworm.com/index.php?rid=4929853&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F348%3Frss%3D1 We aimed to establish current practice regarding the testing of children of HIV-positive women in two centres in the South Yorkshire HIV Network, UK. Notes were reviewed from 59 women who attended clinic over a three-month period from 01 September 2009 to 30 November 2009. In our sample, only 29 of 52 (56%) children living in the UK who required testing had been HIV tested. Testing rates were high in preschool children (15/15) and fell with age to 2/11 (18%) in the 16–20 years age group. Uptake of testing for children of HIV-positive parents could potentially be improved if testing was incorporated into routine clinic practice as part of the package of care offered to a newly diagnosed individual. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929853 Wed, 15 Jun 2011 23:00:00 +0100 4929853 http://www.medworm.com/index.php?rid=4929852&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F345%3Frss%3D1 Patient-initiated partner notification of sexually transmitted infection (STI), i.e. patients informing their sexual partners of a diagnosis, is a cornerstone of STI prevention. Growing evidence suggests that women exposed to intimate partner violence (IPV) may fear such notification, or face negative consequences in response to STI disclosure. The current study assessed associations of IPV with fear of partner notification, and experiences of partner notification, among adolescent and young adult female family planning clinic patients. Women aged 16–29 years attending five family planning clinics in Northern California, USA (n = 1282) participated in a cross-sectional survey. A history of physical or sexual IPV was associated with fear of partner notification. Moreover, participants... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929852 Wed, 15 Jun 2011 23:00:00 +0100 4929852 http://www.medworm.com/index.php?rid=4929851&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F342%3Frss%3D1 This study evaluated Euroline WB for the detection of HSV-2 antibodies compared with University of Washington Western blot in three geographically different regions: Baltimore, MD, USA; Rakai, Uganda; and Kunming, China. Among the 135 American men attending a STI clinic in Baltimore, MD, 72% (n = 97) were HSV-2-positive by Euroline WB, showing a sensitivity of 97.8% and a specificity of 81.8%. Among the 273 commercial sex workers in Kunming, 62.3% were HSV-2-positive by Euroline WB (sensitivity 96.9%, specificity 89.1%). Among the 437 Ugandans in Rakai, 67.3% were HSV-2-positive by Euroline WB (sensitivity 98.7%, specificity 65.4%). The Euroline WB has a consistently high sensitivity, but specificity varied significantly among the different locations. (Source: International Journal of STD ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929851 Wed, 15 Jun 2011 23:00:00 +0100 4929851 http://www.medworm.com/index.php?rid=4929850&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F338%3Frss%3D1 Opinions are divided on whether to screen asymptomatic men for non-chlamydial non-gonococcal urethritis (NCNGU). We systematically reviewed the literature to determine whether male asymptomatic NCNGU is associated with significant clinical outcomes for men and/or their sexual partners. We searched electronic databases and reference lists from retrieved articles and reviews. No studies reporting clinical outcomes in men with asymptomatic NCNGU were identified. Two eligible studies report rates of sexually transmitted infections (STIs) in female partners of men with asymptomatic NCNGU; Chlamydia trachomatis was detected in 2.4% and 8.3% of these women. The evidence available is insufficient in quality and breadth to enable us to conclude whether asymptomatic NCNGU is associated with signific... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929850 Wed, 15 Jun 2011 23:00:00 +0100 4929850 http://www.medworm.com/index.php?rid=4929849&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F335%3Frss%3D1 We describe trends in MSM attendances, STI testing and diagnostic yield from 1996 to 2007 at a Sydney public sexual clinic. Aggregate data were extracted from the clinic database. There was a 76% increase in the number of individual MSM attending, more than three-fold increase in the number of STI tests performed and the proportion of MSM tested. The increase in testing was greatest for rectal infections. The positive yield increased for rectal chlamydia and infectious syphilis; remained stable for pharyngeal gonorrhoea; and decreased for urethral gonorrhoea, rectal gonorrhoea and urethral chlamydia. Our results demonstrate successful service reorientation in response to a local STI epidemic. Differing trends suggest evolving transmission dynamics for different STIs in the context of incre... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929849 Wed, 15 Jun 2011 23:00:00 +0100 4929849 http://www.medworm.com/index.php?rid=4929848&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F332%3Frss%3D1 We aimed to determine whether the type of outcome expectation, stemming from HPV vaccination, would have any effect on young men's HPV vaccine intent. We recruited young men (18–24 years of age) from two university campuses (n = 150). After answering a series of questions they were randomly assigned to one of three information conditions (all delivered by computer): (1) how women may benefit from men's HPV vaccination, (2) preventing genital warts and (3) preventing head and neck cancers. Intent to be vaccinated against HPV in the next 12 months was assessed before and after receiving the informational session corresponding to the assigned condition. A repeated-measures t-test indicated that a significant increase in young men's intent to be vaccinated after they received the assigne... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929848 Wed, 15 Jun 2011 23:00:00 +0100 4929848 http://www.medworm.com/index.php?rid=4929847&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F329%3Frss%3D1 We evaluated the acceptability of a community-based herpes simplex virus type 2 (HSV-2) screening programme for at-risk women and assessed factors related to uptake of point of care HSV-2 testing. One hundred recently arrested women (median age 34 years) were recruited from a community court handling lower-level misdemeanour cases in Indianapolis, Indiana. Individuals completed a survey assessing factors related to HSV-2 screening intentions and were offered point of care HSV-2 testing. Rates of HSV-2 infection in this population are high; 61.1% of women tested were positive. The majority (81%) accepted a prescription for suppressive therapy. Women in this sample indicated that HSV-2 screening is an important component of health care but were unwilling to pay the US$10 it cost to be tested... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929847 Wed, 15 Jun 2011 23:00:00 +0100 4929847 http://www.medworm.com/index.php?rid=4929846&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F324%3Frss%3D1 Non-cirrhotic portal hypertension (NCPH) has been associated with didanosine (ddI) exposure. We aimed to determine the number of individuals with NCPH within our cohort and define their characteristics. We identified individuals within our cohort with NCPH and performed a retrospective case note review. Cumulative antiretroviral therapy (ART) use was calculated and a statistical analysis performed to compare exposure to the rest of the clinic cohort for the same time period. Where available, data was collated on FibroScan®, echocardiography and coagulation profile. Seventeen patients were identified. Upper gastrointestinal bleeding was the most common presenting feature. Liver biopsy showed mild portal or periportal fibrosis in 13 (81%) and four with features of nodular regenerative hy... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929846 Wed, 15 Jun 2011 23:00:00 +0100 4929846 http://www.medworm.com/index.php?rid=4929845&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F315%3Frss%3D1 To make feasible future clinical trials with new-generation human papillomavirus (HPV) vaccines, novel virological surrogate endpoints of progressive disease have been proposed, including high-risk HPV (HR-HPV) persistence for six months (6M+) or 12 months (12M+). The risk estimates (relative risks [RRs]) of these ‘virological endpoints’ are influenced by several variables, not yet validated adequately. We compared the impact of three referent groups: (i) HPV-negative, (ii) HPV-transient, (iii) HPV-mixed outcome on the risk estimates for 6M+ or 12M+ HR-HPV persistence as predictors of progressive disease. Generalized estimating equation models were used to estimate the strength of 6M+ and 12M+ HR-HPV persistence with disease progression to squamous intraepithelial lesions (SILs... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929845 Wed, 15 Jun 2011 23:00:00 +0100 4929845 http://www.medworm.com/index.php?rid=4929844&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F310%3Frss%3D1 In conclusion, when compared with RT-PCR for patients infected with non-B subtypes, the Up24 demonstrated limited sensitivity especially at low viral loads. Moreover, the Up24 was positive in 33% of samples deemed undetectable by RT-PCR, which may limit the use of the Up24 to detect viral suppression. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929844 Wed, 15 Jun 2011 23:00:00 +0100 4929844 http://www.medworm.com/index.php?rid=4929843&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F308%3Frss%3D1 The performance characteristics of HIV rapid diagnostic tests (RDTs) vary by test and by population. We assessed five commercial RDTs in Uganda where all but one RDT (Determine; Abbott Laboratories, Germany) performed close to manufacturer's expectations. Determine had low specificity (85.2%, positive predictive value 67.3%) due to false-positive results with weak-positive bands. Properly trained staff, good quality control programmes and validation of RDTs with laboratories having confirmatory testing capacity may be warranted to assure accuracy in each setting. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929843 Wed, 15 Jun 2011 23:00:00 +0100 4929843 http://www.medworm.com/index.php?rid=4929842&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F306%3Frss%3D1 Benign recurrent aseptic meningitis is a rare disorder described by Mollaret in 1944. When initially described, this form of aseptic meningitis had no identifiable infecting agent. New sophisticated diagnostic tools have now identified herpes simplex type 2 virus as the most commonly isolated agent. Antiviral treatment has been used successfully for prophylaxis and treatment. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929842 Wed, 15 Jun 2011 23:00:00 +0100 4929842 http://www.medworm.com/index.php?rid=4929841&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F304%3Frss%3D1 Transmission of the crab louse Phthirus pubis generally occurs by close body contact. Diagnosis is usually clinical and screening for other sexually transmitted infections (STIs) is indicated. While most evidence is extrapolated from studies of head lice treatments, topical pediculicides are recommended and treatment of sexual contacts is indicated. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929841 Wed, 15 Jun 2011 23:00:00 +0100 4929841 http://www.medworm.com/index.php?rid=4929840&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F6%2F301%3Frss%3D1 Transmission of the mite Sarcoptes scabiei generally occurs by protracted direct body contact; although in crusted scabies, transmission also occurs via infected clothing or bedding. Diagnosis is usually clinical and topical antiscabietics are the mainstay of treatment. Oral ivermectin is not licensed in most countries, but may have a role in certain patients. Treatment of sexual contacts is indicated. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4929840 Wed, 15 Jun 2011 23:00:00 +0100 4929840 http://www.medworm.com/index.php?rid=4818323&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F298%3Frss%3D1 We present a 34-year-old man with HIV infection who developed multiple atypical cutaneous ulcerations, leonine facies, a scleral nodule and keratitis with visual loss. The diagnosis of malignant syphilis was delayed due to the insidious presentation, but was confirmed via immunohistochemical (IHC) staining with anti-Treponema antibodies of a skin biopsy. Significant clinical improvement was observed following a 15-day course of penicillin and tigecycline therapy. In advanced HIV disease, cutaneous manifestations are often difficult to identify and present a challenge for the clinician. Clinical manifestations of secondary syphilis vary greatly, earning the epigram of ‘the great imitator’. It is important to recognize atypical presentations of syphilis, especially among HIV-infe... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818323 Thu, 12 May 2011 23:00:00 +0100 4818323 http://www.medworm.com/index.php?rid=4818322&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F296%3Frss%3D1 A 40-year-old man who has sex with men (MSM) with urethral gonorrhoea failed to respond to treatment with 400 mg cefixime orally. Laboratory isolation of the post-treatment strain showed a minimum inhibitory concentration of ≥0.25 mg/L, which is a level of tolerance to cefixime that has not been previously documented in the UK. This case illustrates the importance of assessing all patients after treatment for gonorrhoea so that treatment failure and antibiotic resistance can be identified. It is vital that gonorrhoea culture continues to be attempted from all infected individuals to enable accurate diagnosis and antibiotic sensitivities. We also recommend that laboratories test for cefixime sensitivity routinely, given that it is one of the most commonly prescribed treatments for gonorr... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818322 Thu, 12 May 2011 23:00:00 +0100 4818322 http://www.medworm.com/index.php?rid=4818321&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F294%3Frss%3D1 The data on the use of tipranavir and enfuvirtide in pregnancy are very limited. We performed a pharmacokinetic profile in a pregnant woman with multidrug-resistant HIV-1 infection at 37 weeks gestation. Tipranavir levels were in the therapeutic range and the cord blood concentration at delivery was relatively high when compared with other protease inhibitors. No enfuvirtide was detected in the fetal compartment. Tipranavir and enfuvirtide were successfully used in pregnancy, but possible toxicities must be kept in mind. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818321 Thu, 12 May 2011 23:00:00 +0100 4818321 http://www.medworm.com/index.php?rid=4818320&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F292%3Frss%3D1 We report a case of a chronic non-healing penile ulcer due to repeated topical application of crushed paracetamol tablets. To our knowledge, there are no such reports in the literature. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818320 Thu, 12 May 2011 23:00:00 +0100 4818320 http://www.medworm.com/index.php?rid=4818319&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F290%3Frss%3D1 In conclusion, our department performed well against BASHH auditable outcome targets. The introduction of the TIC proforma greatly facilitated the ease of audit and is a valuable tool within our clinic setting, which may have positively influenced our audit outcomes. Further action is required to highlight the importance of follow-up VDRLs to patients. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818319 Thu, 12 May 2011 23:00:00 +0100 4818319 http://www.medworm.com/index.php?rid=4818318&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F288%3Frss%3D1 An audit of contraception service offered to teenagers attending Scottish genitourinary (GU) medicine clinics in 2007 was carried out by collecting data from each main clinic of 11 Scottish health boards. The case notes of 579 women aged under 18 years were reviewed. In 553 (95.5%) cases, sufficient data were available to make an assessment regarding whether the women needed any advice on having a reliable method of contraception. Of these 553 women, 280 (50.6%) were assessed as requiring contraceptive advice. Of the 280 women who needed advice, 156 (56%) received it. Currently, there are some gaps in the provision of contraception services offered to teenagers attending GU medicine clinics, which could be improved by increasing awareness among staff and providing adequate resources. (Sour... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818318 Thu, 12 May 2011 23:00:00 +0100 4818318 http://www.medworm.com/index.php?rid=4818317&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F286%3Frss%3D1 An audit of all patients presenting to an inner city sexual health clinic post-sexual assault over a four-year period was undertaken to evaluate the overall management of these patients. Sixty-five cases were identified; 22.6% had a pre-existing vulnerability factor and 21.0% a sexually transmitted infection (STI). Recommendations from the audit included: to offer non-invasive methods of testing for STIs to patients presenting at less than one week, improve documentation by completing the specific clinic template and ensure all patients are offered emotional support when they first attend. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818317 Thu, 12 May 2011 23:00:00 +0100 4818317 http://www.medworm.com/index.php?rid=4818316&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F281%3Frss%3D1 When treating contacts of patients with sexually transmitted infections (STIs), health professionals may face conflicting ethical imperatives. We surveyed middle grade doctors in genitourinary (GU) medicine and asked how they would manage a hypothetical clinical scenario. This was analysed on the basis of principles of respect for autonomy and beneficence/non-maleficence to assess how they weigh up duties of informed consent (autonomy of patient), partner confidentiality (autonomy of partner) and the need to achieve a good medical outcome. Responses indicated that the strategies that they employ in practice – what they actually say to patients (and what they leave unsaid) – balance the conflicting requirements of these ethical principles in quite different ways, some of which a... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818316 Thu, 12 May 2011 23:00:00 +0100 4818316 http://www.medworm.com/index.php?rid=4818315&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F278%3Frss%3D1 The present study estimates the prevalence and risk factors of human papillomavirus (HPV) infection among female sex workers (FSWs) in Bulgaria. HPV DNA was detected by polymerase chain reaction (PCR) in 43.4% of FSWs. HPV16 was the most common type, found in 17.0% of samples, followed by HPV31 (9.4%). Age and smoking were associated with a significantly greater risk of being infected. The results of this study indicate that FSWs in Bulgaria are at increased risk for cervical cancer and represent an important source of HPV infection for the general population in the country. They should be considered as a priority group in cervical cancer control programmes. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818315 Thu, 12 May 2011 23:00:00 +0100 4818315 http://www.medworm.com/index.php?rid=4818314&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F273%3Frss%3D1 This study provides genital HSV-2 DNA titre as a quantitative and symptom- and sign-based measures as qualitative predictors of HSV-2 shedding from the lower genital tract among HIV-infected women. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818314 Thu, 12 May 2011 23:00:00 +0100 4818314 http://www.medworm.com/index.php?rid=4818313&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F263%3Frss%3D1 In addition to oncogenic ‘high-risk’ human papillomaviruses (HR-HPV), several co-factors are needed in cervical carcinogenesis, but it is poorly understood whether these HPV co-factors associated with incident cervical intraepithelial neoplasia (CIN) grade 1 are different from those required for progression to CIN2 and CIN3. To gain further insights into the true biological differences between CIN1, CIN2 and CIN3, we assessed HPV co-factors increasing the risk of incident CIN1, CIN2 and CIN3. Data from the New Independent States of the Former Soviet Union (NIS) Cohort (n = 3187) and the Latin American Screening (LAMS) Study (n = 12,114) were combined, and co-factors associated with progression to CIN1, CIN2 and CIN3 were analysed using multinomial logistic regression models wit... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818313 Thu, 12 May 2011 23:00:00 +0100 4818313 http://www.medworm.com/index.php?rid=4818312&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F256%3Frss%3D1 This study examined pre-exposure prophylaxis (PrEP) acceptability among female sex workers, male-to-female transgendered persons and men who have sex with men in Lima, Peru. Focus groups explored social issues associated with PrEP acceptability and conjoint analysis assessed preferences among eight hypothetical PrEP scenarios with varying attribute profiles and their relative impact on acceptability. Conjoint analysis revealed that PrEP acceptability ranged from 19.8 to 82.5 out of a possible score of 100 across the eight hypothetical PrEP scenarios. Out-of-pocket cost had the greatest impact on PrEP acceptability (25.2, P < 0.001), followed by efficacy (21.4, P < 0.001) and potential side-effects (14.7, P < 0.001). Focus group data supported these findings, and also revealed that... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818312 Thu, 12 May 2011 23:00:00 +0100 4818312 http://www.medworm.com/index.php?rid=4818311&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F251%3Frss%3D1 This study aimed to address behavioural attributes and identify the sources of NG infection. Of 1234 NG cases in men reported between 2000 and 2004, 379 (31%) were interviewed. Most were single, heterosexual and Israeli-born. Insertive oral sex (OS) was reported by 77% patients and vaginal intercourse by 69%, where condoms were used by 4% and 40% for these practices, respectively. Unprotected OS was performed by 95% of the 151 men involved in protected vaginal sex. OS was the most common practice among the younger age group, and in sexual contacts with casual partners or commercial sex workers (CSWs): behaviours that were reported by 37% and 36% of patients, respectively. Unprotected OS is a common route for NG transmission, and it is suggested that the rise in NG may be attributed to unpr... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818311 Thu, 12 May 2011 23:00:00 +0100 4818311 http://www.medworm.com/index.php?rid=4818310&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F245%3Frss%3D1 Concurrent partnerships have been recognized as a determinant for the spread of HIV and sexually transmitted infections (STIs). We studied the association of concurrent partnerships with sexual behaviour among heterosexual Caribbean and African migrants, who account for a disproportionate burden of STIs and HIV in the Netherlands. Of 1792 migrants, 15% reported concurrent sexual partners in the previous six months. In multivariate multinomial analyses, women were less likely to have concurrent partners than men and they were less likely than men to use condoms with concurrent partners. We could not identify an association with the observed HIV prevalence; however, migrants with concurrent partners were less likely to be tested for HIV. Of migrants tested for STIs, one in three migrants wit... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818310 Thu, 12 May 2011 23:00:00 +0100 4818310 http://www.medworm.com/index.php?rid=4818309&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F5%2F241%3Frss%3D1 Chancroid is a sexually acquired disease caused by Haemophilus ducreyi. The infection is characterized by one or more genital ulcers, which are soft and painful, and regional lymphadenitis which may develop into buboes. The infection may easily be misidentified due to its rare occurrence in Europe and difficulties in detecting the causative pathogen. H. ducreyi is difficult to culture. Polymerase chain reaction (PCR) can demonstrate the bacterium in suspected cases. Antibiotics will usually be efficient for curing chancroid. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4818309 Thu, 12 May 2011 23:00:00 +0100 4818309 http://www.medworm.com/index.php?rid=4740369&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F4%2F238%3Frss%3D1 This report describes a rare case of perianal condylomata acuminata complicated with myiasis due to Chrysomya bezziana, seen in the presence of poor hygiene in a tropical country with a high fly population. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4740369 Thu, 21 Apr 2011 23:00:00 +0100 4740369 http://www.medworm.com/index.php?rid=4740368&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F4%2F236%3Frss%3D1 We present a case of acute limbic encephalitis secondary to HIV seroconversion. The patient made a gradual neurological recovery following treatment with antiretroviral therapy, steroids and intravenous immunoglobulin. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4740368 Thu, 21 Apr 2011 23:00:00 +0100 4740368 http://www.medworm.com/index.php?rid=4740367&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F4%2F234%3Frss%3D1 We report the case of a 44-year-old man infected with HIV and HCV with a high CD4 cell count who developed acute respiratory distress syndrome associated with influenza virus A/H1N1v infection. The patient recovered completely after oseltamivir therapy and mechanical ventilation. (Source: International Journal of STD and AIDS) International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4740367 Thu, 21 Apr 2011 23:00:00 +0100 4740367 http://www.medworm.com/index.php?rid=4740366&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F4%2F231%3Frss%3D1 We aimed to test the hypothesis that a short anovaginal distance may increase the risk of bacterial vaginosis (BV) due to faecal contamination and disruption of the vaginal microbiota. Women attending two sexually transmitted infection (STI) clinics in Baltimore, Maryland, USA, who complained of a vaginal discharge were asked to participate in a study to measure mucosal immune responses. In this pilot study of all enrolled women, a small plastic ruler was used to measure the anatomic distance from the posterior fourchette to the anus with the participant in the lithotomy position. Cases of BV, defined by Amsel's clinical criteria (n = 62), were compared with controls (n = 31) without BV. We used linear and logistic regression models to adjust for potential confounders. A total of 93 women ... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4740366 Thu, 21 Apr 2011 23:00:00 +0100 4740366 http://www.medworm.com/index.php?rid=4740365&cid=s_37239_46_f&fid=37239&url=http%3A%2F%2Fijsa.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F22%2F4%2F228%3Frss%3D1 We retrospectively evaluated the durability and reasons for discontinuation of nevirapine (NVP) in combination with a tenofovir (TDF) and emtricitabine (FTC) or lamivudine (3TC)-containing antiretroviral therapy (ART) regimen in an Australian outpatient setting. Between January 2003 and June 2009, 64 patients (29 naïve and 35 treatment-experienced) received NVP/TDF-based regimens. The median exposure was 13.0 months (interquartile range [IQR] 6.0–20.0 months). The two- and three-year probability of continuing a NVP/TDF with FTC or 3TC regimen was 76% and 70%, respectively. Thirteen (20.3%) patients discontinued their regimen during the observation period. Reasons for discontinuation included virological failure in four (6.3%), rash in three (4.7%), lost to follow-up in three (4.... International Journal of STD and AIDS journals http://www.medworm.com/rss/comments.php?id=4740365 Thu, 21 Apr 2011 23:00:00 +0100 4740365