Travel-Related Sexually Transmitted Infections

Sexually transmitted infections (STIs) are among the most common notifiable health problems worldwide, with particularly high rates in developing countries. 

Men and women with multiple sexual partners at home or a previous history of STIs are more likely to have casual sexual exposure (CSE) while travelling. Over the last several decades 5% to even 50% of short-term travellers engaged in CSE during foreign trips. It is estimated that only 50% of travellers use condoms during casual sex abroad. Sexual contact with commercial sex workers is an exceptionally high-risk behaviour. 

The common risk factor is also young age. Adolescents and young adults constitute 25% of the sexually active population, but represent almost 50% of all new acquired STIs. Many STIs are asymptomatic and therefore can be difficult to identify and control. 

The clinical manifestation of STIs can be grouped into a number of syndromes, such as genital ulcer or erosion, urethral or vaginal discharge, pelvic inflammatory disease. STIs are divided into curable infections caused by bacteria (gonorrhoea, chlamydiasis, syphilis, chancroid, lymphogranuloma venereum, granuloma inguinale) or protozoa (trichomoniasis) and incurable viral infections (genital herpes, genital warts, HIV). STIs are not only a cause of acute morbidity, but may result in complications including male and female infertility, ectopic pregnancy, cervical cancer, premature mortality or miscarriage.

Full article at:   https://goo.gl/1Kl7HF

By:  Korzeniewski K1, Juszczak D.

• 1Head of Department of Epidemiology and Tropical Medicine, Military Institute of Medicine, Warsaw, Poland. kktropmed@wp.pl 

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“Hey Everyone, I’m Drunk.” An Evaluation of Drinking-Related Twitter Chatter

Objective:

The promotion of drinking behaviors correlates with increased drinking behaviors and intent to drink, especially when peers are the promotion source. Similarly, online displays of peer drinking behaviors have been described as a potential type of peer pressure that might lead to alcohol misuse when the peers to whom individuals feel attached value such behaviors. Social media messages about drinking behaviors on Twitter (a popular social media platform among young people) are common but understudied. In response, and given that drinking alcohol is a widespread activity among young people, we examined Twitter chatter about drinking.

Method:

Tweets containing alcohol- or drinking-related keywords were collected from March 13 to April 11, 2014. We assessed a random sample (n = 5,000) of the most influential Tweets for sentiment, theme, and source.

Results:

Most alcohol-related Tweets reflected a positive sentiment toward alcohol use, with pro-alcohol Tweets outnumbering anti-alcohol Tweets by a factor of more than 10. The most common themes of pro-drinking Tweets included references to frequent or heavy drinking behaviors and wanting/needing/planning to drink alcohol. The most common sources of pro-alcohol Tweets were organic (i.e., noncommercial).

Conclusions:

Our findings highlight the need for online prevention messages about drinking to counter the strong pro-alcohol presence on Twitter. However, to enhance the impact of anti-drinking messages on Twitter, it may be prudent for such Tweets to be sent by individuals who are widely followed on Twitter and during times when heavy drinking is more likely to occur (i.e., weekends, holidays).

Purchase full article at:   http://goo.gl/kgO0kX

By:   Patricia A. Cavazos-Rehg, Ph.D.,^a,* Melissa J. Krauss, M.P.H.,^a Shaina J. Sowles, M.P.H.,^a & Laura J. Bierut, M.D.^a

Affiliations
^aDepartment of Psychiatry, Washington University School of Medicine, St. Louis, Missouri

*Correspondence may be sent to Patricia A. Cavazos-Rehg at the Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Box 8134, St. Louis, MO 63110, or via email at:rehgp@psychiatry.wustl.edu.

DOI: http://dx.doi.org/10.15288/jsad.2015.76.635 

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Antecedents of Young Women’s Sexual Risk Taking in Tourist Experiences

The purpose of this phenomenological exploration was to shed light on the constellation of factors anteceding young women’s sexual risk taking during their tourist experiences. 

A total of 15 in-depth interviews (1.5 to 2.5 hours each) with 13 women were conducted and analyzed through the lens of transcendental phenomenology. An analysis of antecedent factors revealed a confluence of sociopersonal characteristics (e.g., sexual definitions, attitudes, double standards, and age) and touristic attributes (e.g., the sense of temporariness/ephemerality, anonymity, and fun-oriented mentality depending on length, destination, and type of tourist experience) that underlie women’s proclivity for and perceptions of sexual risk taking in certain travel scenarios. 

These result in myriad effects on physical, sexual health, sociocultural, mental, and emotional aspects of women’s health and well-being. While the sociopersonal antecedents highlight the cross-pollination between sex-related perceptions in everyday life and touristic environments, the touristic antecedents emphasize the uniqueness of tourist experiences as the contexts for sexual risk taking. 

The findings address an under researched topic in sex and tourism scholarship and offer implications for health education and intervention programs, pointing to the value of constructing the context-specific and gender-sensitive sexual health messages underpinned by the ideas of women’s empowerment and sexual agency.

Purchase full article at: http://goo.gl/dyBj3X

By: Liza Berdychevsky^a*

^a Department of Recreation, Sport and Tourism, College of Applied Health Sciences, University of Illinois at Urbana–Champaign

 

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Epidemiology of Sexually Transmitted Infections in Visitors for the London 2012 Olympic Games: A Review of Attendees at Sexual Health Services

Mass gatherings and large sporting events, such as the Olympics, may potentially pose a risk of increased sexually transmitted infection (STI) transmission and increase burden on local STI services. The objectives of this analysis were to assess whether the STI profile of Olympic visitors differed from that of the local STI clinic population and to investigate what impact these visitors had on local STI services.

Self-administered questionnaires (completed by 29,292 patients) were used to determine the visitor status of patients attending 20 STI clinics, between July 20, 2012, and September 16, 2012, in the host cities, London and Weymouth. Using routine surveillance data from the Genitourinary Medicine Clinic Activity Dataset version 2, Olympic visitors were compared with usual attendees (local residents and non-Olympic visitors) in terms of their demographic characteristics, services utilized, and STIs diagnosed using univariate and multivariate methods.

Compared with usual attendees, Olympic visitors were more likely to be heterosexual males (56.0% vs. 34.9%, P = 0.001), aged between 15 and 24 years of age (47.1% vs. 34.0%, P = 0.001), of white ethnicity (81.9% vs. 66.4%, P = 0.001), and born in Australasia, Asia, North America, or South America (18.8% vs. 12.0%, P = 0.006). Olympic visitors constituted 1% of new clinic attendances and were less likely to be diagnosed as having a new STI (adjusted odds ratio, 0.69; 95% confidence interval, 0.48-0.98; P = 0.040).

In this first multisite study to examine the effect of Olympic visitors on local sexual health services, the 2012 Olympic Games was found to have minimal impact. This suggests that a "business as usual" approach would have been sufficient.

Purchase full article at:  http://goo.gl/AnKDvG

By:  Sile B1, Mohammed H, Crook P, Hughes G, Mercer C, Cassel J, Coyne K, Hartley A, Hall V, Brook G.

• 1From the *HIV/STI Department and †Field Epidemiology Services, Public Health England, London, UK; ‡University College London, London, UK; §Brighton and Sussex Medical School, Brighton, UK; ¶Public Health England, Kent, Surrey, UK; ∥Sussex PHE Centre, Horsham, UK; **Department of Sexual Health and HIV, Homerton University Hospital, London, UK; ††Infection and Immunity Department, Barts Health NHS Trust, London, UK; and ‡‡Department of Genitourinary Medicine, Central Middlesex Hospital, London, UK. 

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Seasons of Risk: Anticipated Behavior on Vacation and Interest in Episodic Antiretroviral Pre-exposure Prophylaxis (PrEP) among a Large National Sample of U.S. Men Who have Sex with Men (MSM)

The current analysis evaluates interest in and acceptability of daily PrEP during short episodes of anticipated increased risk (i.e. Epi-PrEP). 

In 2013, U.S. members of an internet-based MSM sexual networking site were invited to complete a survey about HIV prevention practices in the context of vacationing. 7305 MSM responded to the survey. Of respondents who had vacationed in the past year, 25.6 % reported condomless anal sex (CAS) with new male sex partners while vacationing. 

Most (92.6 %) respondents agreed that having to use PrEP every day was a barrier to PrEP use and 74.3 % indicated they would take PrEP if they knew it would be helpful for short periods of anticipated increased risk. MSM who reported increased CAS while on vacation in the past year were more likely to indicate that they would take PrEP if it were helpful when used for short periods than respondents who did not. 

Studies designed to evaluate uptake, adherence, and protective benefit of short PrEP courses are warranted.

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By: Elsesser SA1, Oldenburg CE1,2, Biello KB1,2, Mimiaga MJ1,2,3, Safren SA1,3,4, Egan JE5, Novak DS6, Krakower DS1,7, Stall R8, Mayer KH9,10,11.

• 1The Fenway Institute, Fenway Health, 8th floor, 1340 Boylston Street, Boston, MA, 02115, USA.
• 2Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA.
• 3Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
• 4Department of Medicine, Harvard Medical School, Boston, MA, USA.
• 5Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
• 6OLB Research Institute, Online Buddies, Inc., Cambridge, USA.
• 7Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
• 8Department of Behavioral and Social Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
• 9The Fenway Institute, Fenway Health, 8th floor, 1340 Boylston Street, Boston, MA, 02115, USA. kmayer@fenwayhealth.org.
• 10Department of Medicine, Harvard Medical School, Boston, MA, USA. kmayer@fenwayhealth.org.
• 11Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA. kmayer@fenwayhealth.org. 

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