Showing papers by "Myron S. Cohen published in 1996"

Successful Eradication of Sexually Transmitted Diseases in the People'S Republic of China: Implications for the 21st Century

Abstract: The global control of sexually transmitted diseases (STDs) represents a daunting task, and there have been very few examples of success. The scope of the STD problem in China before the formation of the People's Republic and the effects of a governmental STD control program were reviewed. In major cities, 10% of the population had syphilis, reaching 50% prevalence in some rural minorities. By 1964, STDs in China were virtually eliminated through a program that destigmatized STDs, provided an infrastructure for case finding and therapy, and eliminated prostitution. The People's Republic of China demonstrated the possibility of eliminating STDs, at least for some period of time. Although the Chinese approach may not be ideal for Western democracies, understanding some features of the Chinese program may help in designing a strategy for the eradication of human immunodeficiency virus when or if treatment becomes available.

HIV-1 shedding and chlamydial urethritis.

Abstract: To the Editor. —Drs Schmid and Fontanarosa1thoroughly discussed the causes and management of nongonococcal urethritis. However, they did not emphasize the link between treatment of sexually transmitted diseases and prevention of human immunodeficiency virus (HIV).2We collected ejaculate from a 32-year-old white man with HIV-1 disease and a CD4 cell count of 0.11×109/L who was taking no antiretroviral therapy. The patient had chlamydial urethritis at the time the sample was obtained, with dysuria but without discharge. We performed quantitative HIV-1 culture on his seminal cell fraction, using a modification of the AIDS Clinical Trials Group quantitative cell culture protocol. We had previously performed 32 quantitative cultures for HIV-1 using seminal cells from 25 HIV-1—infected individuals; the range of excretion was

Introduction of partner referral and treatment for control of sexually transmitted diseases in a poor Haitian community.

Abstract: Focus group discussions were held with women attending slum-based antenatal clinics and with male partners of pregnant women separately to evaluate knowledge and attitudes regarding sexually transmitted diseases (STDs) and acceptability of a proposed antenatal STD screening and treatment programme, including partner management Subsequently, antenatal women found to have a STD were asked to refer their partner(s) for STD treatment The institution's routine procedure of internal referral to the curative center was evaluated for loss to follow-up Focus group participants described common STD syndromes, knew that a pregnant woman could transmit a STD to her child, and knew that all sex partners needed to be treated for STDs Discussion participants disagreed on the possibility of asymptomatic STDs and mentioned other ways of contracting STDs beside sexual transmission The response to the proposed programme was positive Of 331 male partners named by antenatal women who were found to have at least one STD, 101 (30%) presented at the clinic through index referral, and an additional 38 (115%) presented because of health worker referral Of the 59 men sent to the curative center for care, only 26 (44%) received treatment The study demonstrated that in Haiti, partners of antenatal STD patients can be treated without apparent adverse effects However, internal referrals to separate treatment centres should be avoided Following this study, education efforts have emphasized the curable nature of STDs, the threat of vertical transmission, and frequent asymptomatic presentation of STDs to promote prevention and treat more partners of STD patients