Correlates of Trichomonas vaginalis among Middle Age and Older Adults Who Use Drugs

BACKGROUND:

Recent studies have reported high rates of Trichomonas vaginalis among middle age and older adults. Though trichomoniasis risk factors in this age cohort remain largely unknown, illicit drug use has been associated with increased incidence of sexually transmitted infections (STIs). The number of mid-older adults using illicit drugs has increased significantly in recent years suggesting the need to understand the relationship between drug use and STIs in this age cohort.

OBJECTIVES:

This study examined the relationship between drug use, sexual-risk behaviors, and biologically confirmed T. vaginalis in a sample of mid-older and younger adults who reported recent drug use.

METHODS:

The cross-sectional design examined the relationship between past 6-month drug use, sexual risk-behaviors, and PCR-confirmed T. vaginalis in 264 adults age 18-64 who were recruited from Baltimore, Maryland. These relationships were also explored in the age-stratified sample among those 18-44 years ("younger") and individuals 45+ years ("mid-older").

RESULTS:

Trichomoniasis prevalence did not differ significantly between younger (18.8%) and mid-older (19.1%) adults. Mid-older adults that tested positive for T. vaginalis were more likely to have used marijuana and crack in the past 6 months. Among younger adults, there were no associations between trichomoniasis and past 6-month drug use and sexual-risk behavior.

CONCLUSIONS/IMPORTANCE:

Age- and drug-related immune decline is hypothesized to contribute to increase susceptibility to T. vaginalis in mid-older adults. Broad screening for trichomoniasis, particularly among older adults who are often not regarded as at risk for STIs, is needed to control this often asymptomatic infection.

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By:  Hearn LE1, Whitehead NE1, Dunne EM1, Latimer WW2.

• 1 Clinical and Health Psychology , University of Florida , Gainesville , Florida , USA.
• 2 School of Health Sciences , Human Services and Nursing, Lehman College , CUNY , Bronx, New York , USA.

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Risky Business or Not? FIFOs, Sexual Risk Taking and The Australian Mining Industry

Issue addressed: The fly-in, fly-out (FIFO) and drive-in, drive-out (DIDO) models of mining in Australia have led to concerns about adverse health and psychosocial impacts. Despite speculation that increased levels of sexually transmitted infections (STIs) in Australia, including HIV, are associated with FIFO/DIDO work, we know little about sexual risk-taking behaviours in mining populations. This study explores differences in sexual risk taking and perceptions of risk between FIFO/DIDO miners and residential miners.

Methods: A cross-sectional survey was administered to a sample (n = 444) of male miners working in Queensland, Australia. The self-completed survey contained 49 questions relating to knowledge, attitudes and behaviour and included demographic information and specific items related to sex and relationships.

Results: FIFO/DIDO status was not associated with any differential sexual risk-taking behaviours, except for an increased probability of reporting 'ever being diagnosed with an STI'; 10.8% of FIFO/DIDO respondents versus 3.6% of others (x2 (1) = 4.43, P = 0.35).

Conclusions: Our results appear to counter anecdotal evidence that FIFO/DIDO miners engage in higher sexual risk behaviours when compared with residential miners.

So what?: Anecdotal evidence linking the rise of sexually transmitted infections with the FIFO/DIDO mining workforce could drive costly and unnecessary approaches to prevention. Further research, surveillance and monitoring are required to inform health promotion interventions.

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By:  Cathy O’Mullan ^A C, Joseph Debattista ^B and Matthew Browne ^A 

^A School of Human, Health and Social Sciences, Central Queensland University, Locked Bag 3333, Bundaberg, Qld 4670, Australia. 
^B Metro North Public Health Unit, Locked Bag 2, Stafford, Qld 4053, Australia. 
^C Corresponding author. Email: c.omullan@cqu.edu.au 

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Modeling the Community-Level Effects of Male Incarceration on the Sexual Partnerships of Men & Women

Men who have been incarcerated experience substantial changes in their sexual behavior after release from jail and prison, and high rates of incarceration may change sexual relationship patterns at a community level. Few studies, however, address how rates of incarceration affect community patterns of sexual behavior, and the implications of those patterns for HIV and STD risk. 

We describe a "proof of principle" computational model that tests whether rates of male incarceration could, in part, explain observed population-level differences in patterns of sexual behavior between communities with high rates of incarceration and those without. This validated agent-based model of sexual partnership among 20-25 year old heterosexual urban residents in the United States uses an algorithm that incarcerates male agents and then releases them back into the agent community. 

The results from these model experiments suggest that at rates of incarceration similar to those observed for urban African American men, incarceration can cause an increase in the number of partners at the community level. 

The results suggest that reducing incarceration and creating a more open criminal justice system that supports the maintenance of inmates' relationships to reduce instability of partnerships for men who are incarcerated may have important sexual health and public health implications. Incarceration is one of many social forces that affect sexual decision-making, and incarceration rates may have substantial effects on community-level HIV and STD risks.

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By:  Knittel AK1, Snow RC2, Riolo RL3, Griffith DM4, Morenoff J5.

• 1Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; University of Michigan Medical School, 1137 Catherine Street, Ann Arbor, MI 48109, USA. Electronic address: aknittel@umich.edu.
• 2Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA. Electronic address: rsnow@unfpa.org.
• 3Center for the Study of Complex Systems, University of Michigan, 1085 S. University Ave., Ann Arbor, MI 48109, USA. Electronic address: rlriolo@umich.edu.
• 4Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA. Electronic address: derek.griffith@vanderbilt.edu.
• 5Department of Sociology, University of Michigan, 500 S State St #3001, Ann Arbor, MI 48109, USA. Electronic address: morenoff@isr.umich.edu. 

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The Role of Dyad-Level Factors in Shaping Sexual & Drug-Related HIV/STI Risks among Sex Workers with Intimate Partners

BACKGROUND:

Despite high HIV burden among sex workers (SWs) globally, and relatively high prevalence of client condom use, research on potential HIV/STI risk pathways of intimate partnerships is limited. This study investigated partner/dyad-level factors associated with inconsistent condom use among SWs with intimate partners in Vancouver, Canada.

METHODS:

Baseline data (2010-2013) were drawn from a community-based prospective cohort of women SWs. Multivariable generalized estimating equations logistic regression examined dyad-level factors associated with inconsistent condom use (<100% in last six months) with up to three male intimate partners per SW. Adjusted odds ratios and 95% confidence intervals were reported (AOR[95%CI]).

RESULTS:

Overall, 369 SWs reported having at least one intimate partner, with 70.1% reporting inconsistent condom use. Median length of partnerships was 1.8 years, with longer duration linked to inconsistent condom use. In multivariable analysis, dyad factors significantly associated with increased odds of inconsistent condom use included: having a cohabiting (5.43[2.53-11.66]) or non-cohabiting intimate partner (2.15[1.11-4.19]) (versus casual partner), providing drugs (3.04[1.47-6.30]) or financial support to an intimate partner (2.46[1.05-5.74]), physical intimate partner violence (2.20[1.17-4.12]), and an intimate partner providing physical safety (2.08[1.11-3.91]); non-injection drug use was associated with a 68% reduced odds (0.32[0.17-0.60]).

CONCLUSIONS:

Our study highlights the complex role of dyad-level factors in shaping sexual and drug-related HIV/STI risk pathways for SWs from intimate partners. Couple and gender-focused interventions efforts are needed to reduce HIV/STI risks to SWs through intimate partnerships. This research supports further calls for integrated violence and HIV prevention within broader sexual/reproductive health efforts for SWs.

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By:  Argento E1, Shannon K2, Nguyen P3, Dobrer S3, Chettiar J2, Deering KN4.

• 1Gender & Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6.
• 2Gender & Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; Department of Medicine, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, Canada V6T 1Z3.
• 3Gender & Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; Urban Health Research Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6.
• 4Gender & Sexual Health Initiative, BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6; Department of Medicine, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, Canada V6T 1Z3. Electronic address: kdeering@cfenet.ubc.ca. 

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The Impact of Meeting Locations for Men Having Sex with Men on the Risk for Bacterial Sexually Transmitted Infections: Analyses from a Cross-Sectional Online Survey

Opportunities for men having sex with men (MSM) to meet each other have very much improved by new communication technologies. Meeting venue-based characteristics can impact how many partners are met and how much sexual risk is taken. We analysed the association between physical and virtual venues and the risk for bacterial sexually transmitted infections (bSTIs) among participants in an MSM online survey.

Data were collected during 2013/2014 with a survey targeting MSM living in Germany. The impact of the meeting place with the last non-steady anal sex partner on diagnosis with a bSTI in the previous year was analysed using bivariate and multivariate regression analysis, taking into account self-reported HIV status, serostatus communication, condom use, partner number, age and city size.

The study sample consisted of 8878 respondents (7799 not diagnosed with HIV; 1079 diagnosed with HIV). Meeting partners online was most common (62% HIV-/51% HIV+), followed by sex venues (11% HIV-/25% HIV+); other venues were each reported by 2-6% of the respondents. Venue-dependent proportions reporting bSTIs in the recent year were 2-4 folds higher among men diagnosed with HIV. In multivariate analysis, HIV status was the strongest predictor for bSTIs. Compared with meeting partners online, sex and social venues were associated with increased bSTI risk for men not diagnosed with HIV, but the risk when meeting partners by smartphone apps was only of borderline significance. For men diagnosed with HIV, bSTI risk increased for sex venues, and was lower for non-gay/other venues.

Venues are connected to social-behavioural facets of corresponding sexual encounters, and may be important arenas for differential HIV and STI education, treatment and prevention.

Below:  Proportion of survey participants reporting no condom use during last anal intercourse with a non-steady partner stratified by partner knowledge (first time, repeated) and reported HIV seroconcordance*, German MSM online survey 2013.

Full article at:  http://goo.gl/k5ufWp

By:  Marcus U1, An der Heiden M1, Gassowski M1, Kruspe M2, Drewes J2.

• 1Department of Infectious Disease Epidemiology, Robert Koch-Institut, Berlin, Germany.
• 2Department of Public Health, Free University, Berlin, Germany. 

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HIV, STI and Behavioral Risk among Men Who have Sex with Men in a Setting of Elevated HIV Prevalence Along Ecuador's Pacific Coast

We assessed HIV and STI prevalence, risk behaviors and factors associated with HIV infection in men who have sex with men (MSM) in Guayaquil, Ecuador. Respondent-driven sampling was used to recruit 400 MSM in 2011-2012. Participants completed a computer-assisted self-interview and provided blood samples. Statistical analysis accounted for differential probability of selection and for recruitment patterns. 

• HIV prevalence was 11.3 %, 
• HSV-2 30.2 %, 
• active syphilis 6.9 % and 
• hepatitis B 1.2 %. 

In the previous 12 months, 

• 84 % of MSM reported casual male sex partners and 
• 25 % sex work. 
• Only 48 % of MSM consistently used condoms with male partners and 
• 54 % had ever been tested for HIV. 
• Of 17 % of MSM reporting a female partner, consistent condom use was 6 %. 
• HIV infection was associated with age 25 or older, active syphilis and homosexual self-identification. 

Findings suggest continuing HIV risk and a need to strengthen prevention and testing among MSM.

Via:  http://goo.gl/68XFz5 Purchase full article at: http://goo.gl/TkFCWF

By: Sánchez-Gómez A1, Jacobson JO, Montoya O, Magallanes D, Bajaña W, Aviles O, Esparza T, Soria E, González MA, Morales-Miranda S, Tobar R, Riera C.

1Pan American Health Organization, Quito, Ecuador,

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