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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sexually transmitted infections (STIs) are poorly recognised and inadequately treated in Nigeria in spite of the fact that it constitutes a major risk for HIV transmission. This study was carried out to ascertain STI/HIV co-infection rate and to obtain relevant socio-demographic and reproductive health data associated with STIs. This information is urgently needed for designing STI/HIV control strategies. All consenting patients with history suggestive of STI, who attended STI clinic at the University College Hospital, Ibadan, between March and November 2001 were enrolled in the study. Of the 210 patients seen, 98 (46.7%) were males while 112 (53.3%) were females (p > 0.05). One hundred and fifty six (74.3%) of them were aged 20-39 years while only 10 (5.1%) were adolescents. Twenty (9.5%) had laboratory diagnosis of STIs, out of which 6 (30%) were also HIV positive. Among those with STIs, 8 (40%) had gonorrhoea, 8 (40%) had candidiasis, while 4 (25%) were positive for Trichomonas vaginalis. None of the patients' sera was positive for Treponema palladium antibody HIV prevalence rate in the study was 21.9%. Highest rate was found in patients aged 20-29 years while no adolescent and no one over 50 years old was HIV positive. Five (62.5%) of the patients with gonorrhoea were also HIV positive, a lower percentage (25%) of those with trichomoniasis were positive for HIV, while none of those infected with candidiasis was HIV positive. STI/HIV co-infection rate was 30%. This study reveals a high STI/HIV co-infection rate, indicating that there is a need for proper management of STIs as a way of reducing the spread of HIV infection in Nigeria.
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PMID:STI/HIV co-infections in UCH, Ibadan, Nigeria. 1610 54

The practice guideline on STD consultations from the Dutch College of General Practitioners sets out guidelines for the diagnosis and treatment of Chlamydia-infection, gonorrhoea, syphilis, trichomoniasis, genital herpes condylomata acuminata, hepatitis B, HIV-infection and pubic lice. Testing for Chlamydia-infection is always indicated if an STD is suspected but the necessity of also testing for gonorrhoea, syphilis, hepatitis B or HIV-infection depends on the likely risk. For the diagnosis of Chlamydia in a symptomatic woman it advises taking material from the cervix and urethra. In an asymptomatic woman Chlamydia infection is excluded by means of a urine test. In men a urethral swab of the first part of the urinary stream can be used for diagnosis. The first choice of treatment for gonorrhoea is a single 1 g intramuscular dose ofcefotaxime. The practice guidelines also examine other aspects of treatment for STDs including counselling and telling partners.
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PMID:[Summary of the practice guideline 'The STD consultation' from the Dutch College of General Practitioners]. 1635 25

Between July 2002 and July 2004, all male patients (n=307) presenting to a sexually transmitted disease (STD) clinic who reported unprotected sex were enrolled in the study. Of these, 63 (20.5%), 19 (6.2%) and one (0.3%) were infected with one, two and three pathogens, respectively. The prevalences of chlamydial infection, gonorrhoea, syphilis, human immunodeficiency virus infection and trichomoniasis were 14.3%, 10.1%, 6.8%, 2.2% and 0%, respectively. The sensitivities of urethral discharge syndrome for detection of chlamydial, gonococcal, and combined forms of infection were 31.8%, 58.5% and 70.0%, respectively, with specificities of 93.5%, 97.1% and 93.9%, respectively. Positive predictive values (PPVs) were 56.0%, 68.0% and 28.0% for chlamydial and gonococcal infections and combinations of the two forms, respectively. In contrast, the sensitivity of genital ulceration syndrome for syphilis detection was only 38.0%, although the specificity was 82.5%, and the PPV was 32.0%. To reduce the number of false-positive results for STD patients who practise unprotected sex, incorporation of risk assessment and rapid diagnostic tests are recommended.
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PMID:Aetiology of sexually transmitted disease (STD) and comparison of STD syndromes and aetiological diagnosis in Taipei, Taiwan. 1621 8

Trichomoniasis is a common but less well known sexually transmitted infection affecting men and women. In men it is often asymptomatic and goes undetected. In women it can produce a profuse, frothy, unpleasant-smelling vaginal discharge with pruritus and soreness which is sometimes confused with vulvo-vaginal candidiasis (thrush) and bacterial vaginosis. Women often mistakenly treat themselves for thrush with no result. Diagnosis is by laboratory culture and treatment is with metronidazole. Partner notification and treatment should be undertaken. Trichomoniasis often coexists with chlamydia and gonorrhoea. It can have consequences for reproduction, including low birth weight and preterm labour, and has been found to be a co-factor in the transmission of HIV. It is therefore mandatory to ensure prompt and appropriate treatment for all patients diagnosed with trichomoniasis.
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PMID:Dealing with trichomoniasis. 1713 77

We conducted a prospective study among women in Mombasa, Kenya, to determine whether Trichomonas vaginalis infection was associated with an increased risk of human immunodeficiency virus type 1 (HIV-1) infection. At monthly follow-up visits, laboratory screening for HIV-1 and genital tract infections was conducted. Among 1335 HIV-1-seronegative women monitored for a median of 566 days, there were 806 incident T. vaginalis infections (23.6/100 person-years), and 265 women seroconverted to HIV-1 (7.7/100 person-years). Trichomoniasis was associated with a 1.52-fold (95% confidence interval, 1.04-2.24-fold) increased risk of HIV-1 acquisition after adjustment for potential confounding factors. Treatment and prevention of T. vaginalis infection could reduce HIV-1 risk in women.
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PMID:Infection with Trichomonas vaginalis increases the risk of HIV-1 acquisition. 1726 12

Many sexually transmitted infections are associated with adverse pregnancy outcomes. The Centers for Disease Control and Prevention recommends screening all pregnant women for human immunodeficiency virus infection as early as possible. Treatment with highly active antiretroviral therapy can reduce transmission to the fetus. Chlamydia screening is recommended for all women at the onset of prenatal care, and again in the third trimester for women who are younger than 25 years or at increased risk. Azithromycin has been shown to be safe in pregnant women and is recommended as the treatment of choice for chlamydia during pregnancy. Screening for gonorrhea is recommended in early pregnancy for those who are at risk or who live in a high-prevalence area, and again in the third trimester for patients who continue to be at risk. The recommended treatment for gonorrhea is ceftriaxone 125 mg intramuscularly or cefixime 400 mg orally. Hepatitis B surface antigen and serology for syphilis should be checked at the first prenatal visit. Benzathine penicillin G remains the treatment for syphilis. Screening for genital herpes simplex virus infection is by history and examination for lesions, with diagnosis of new cases by culture or polymerase chain reaction assay from active lesions. Routine serology is not recommended for screening. The oral antivirals acyclovir and valacyclovir can be used in pregnancy. Suppressive therapy from 36 weeks' gestation reduces viral shedding at the time of delivery in patients at risk of active lesions. Screening for trichomoniasis or bacterial vaginosis is not recommended for asymptomatic women because current evidence indicates that treatment does not improve pregnancy outcomes.
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PMID:Screening and treatment for sexually transmitted infections in pregnancy. 1769 74

The aim of this study was to examine the prevalence rates and risk factors for reproductive tract infections (RTIs) among married women of reproductive age in a rural area of Shandong Province in China. A population-based cohort of 4,039 married women of reproductive age was cluster-randomly selected from the local birth control registry. All subjects underwent clinical and microbiological tests and an interview in the form of a standardized questionnaire. The prevalences of trichomoniasis, bacterial vaginosis (BV), and candidiasis as diagnosed by clinical tests were 2.8, 5.9, and 3.1%, respectively. The infection rates of Trichomonas, BV, and Candida were 2.9, 6.6, and 3.9%, respectively. The infection rates of gonorrhea and syphilis were low and no cases of HIV infection were found. After adjustment for confounding factors the risk factors for trichomoniasis were income higher than $200, lack of knowledge about sexually transmitted diseases, and marriage to a businessmen. For candidiasis the risk factors were three or more abortions, income higher than $200, age of 30-39 years, and women with extramarital sex partner(s). For BV the risk factors were three or more abortions and age of 30-39 years. The prevalence of RTI/sexually transmitted infection (STI) and the risk behavior observed in this study indicate a need for primary programs to prevent the increase of RTI/STI and HIV infections in rural areas.
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PMID:Prevalence and risk factors of trichomoniasis, bacterial vaginosis, and candidiasis for married women of child-bearing age in rural Shandong. 1788 63

The objective of this study was to describe trends over time in HIV prevalence, sexually transmitted infections (STIs) and sexual behaviour among women in Moshi urban, Tanzania. Two cross-sectional studies were conducted in 1999 and in 2002-04 among women attending three primary health-care clinics. They were interviewed and screened for HIV and STIs. There was a significant decrease in HIV prevalence (11.5-6.9%). The decline was greatest among women aged 15-24 years. Syphilis, trichomoniasis, bacterial vaginosis, genital ulcers and reported STI symptoms also decreased significantly over the three-year inter-survey period. The proportion of women reporting casual sex decreased and knowledge of STI symptoms and health-care seeking behaviour improved. Herpes simplex virus type 2, genital warts, age at sexual debut, age at first pregnancy and condom use remained unchanged. In conclusion, decline in curable STIs and casual sex partners may partly explain the observed decline in HIV seroprevalence. Both STIs and sexual behaviour should be monitored in HIV sentinel surveillance. There remains a gap between knowledge of preventive behaviour and actual preventive practices.
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PMID:Decline in HIV prevalence among women of childbearing age in Moshi urban, Tanzania. 1794 46

The present review assesses the protection that condoms offer against sexually transmissible infections (STI) and the impact that social, political and religious opinion in the USA has had in the past 8 years on promoting condoms for safer sex. Condoms offer protection against most STI. However, the degree of protection depends on correct and consistent use, the type of sexual activity and the biological characteristics of different infections. Cross-sectional and case-control studies and other observational data provide the majority of evidence for STI prevention. Condoms provide a high level of protection against those infections that are transmitted mainly via infected secretions, including HIV, gonorrhoea, chlamydia and trichomoniasis. Protection against those infections transmitted via skin and mucous membrane contact, including Herpes simplex virus infection and human papilloma virus, appears to be less. The Bush administration, driven by conservative political, social and religious elements in the USA, has mounted a concerted campaign to undermine the role of the condom in health-promotion activities in the USA and overseas by undervaluing and misrepresenting scientific data, and through a sustained and well-funded promotion of abstinence-only education. However, this has lead to considerable controversy and disillusionment with abstinence-only education, both at home and abroad, and there is now incontrovertible evidence that abstinence-only programs are ineffectual.
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PMID:Condoms for sexually transmissible infection prevention: politics versus science. 1836 48

Trichomonas vaginalis causes the most common non-viral sexually transmitted infection linked to increased risk of premature birth, cervical cancer and HIV. This study defines molecular domains of the parasite surface glycoconjugate lipophosphoglycan (LPG) with distinct functions in the host immunoinflammatory response. The ceramide phospho-inositol glycan core (CPI-GC) released by mild acid had Mr of approximately 8,700 Da determined by MALDI-TOF MS. Rha, GlcN, Gal and Xyl and small amounts of GalN and Glc were found in CPI-GC. N-acetyllactosamine repeats were identified by endo-beta-galactosidase treatment followed by MALDI-MS and MS/MS and capLC/ESI-MS/MS analyses. Mild acid hydrolysis led to products rich in internal deoxyhexose residues. The CPI-GC induced chemokine production, NF-kappaB and extracellular signal-regulated kinase (ERK)1/2 activation in human cervicovaginal epithelial cells, but neither the released saccharide components nor the lipid-devoid LPG showed these activities. These results suggest a dominant role for CPI-GC in the pathogenic epithelial response to trichomoniasis.
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PMID:Structural details and composition of Trichomonas vaginalis lipophosphoglycan in relevance to the epithelial immune function. 2779 65


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