Sexually Transmitted Infections 

About: Sexually Transmitted Infections is an academic journal published by BMJ. The journal publishes majorly in the area(s): Population & Acquired immunodeficiency syndrome (AIDS). It has an ISSN identifier of 1368-4973. Over the lifetime, 9446 publications have been published receiving 175541 citations. The journal is also known as: STI & STI online.

From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection.

Abstract: Objectives: To review the scientific data on the role of sexually transmitted diseases (STDs) in sexual transmission of HIV infection and discuss the implications of these findings for HIV and STD prevention policy and practice Methods: Articles were selected from a review of Medline, accessed with the OVID search engine The search covered articles from January 1987 to September 1998 and yielded 2101 arti- cles Methods used to uncover articles which might have been missed included searching for related articles by author, and combing literature reviews In addition, all abstracts under the cat- egory "sexually transmitted diseases" from the XI and XII International Conferences on AIDS (Vancouver 1996 and Geneva 1998) and other relevant scientific meetings were reviewed Efforts were made to locate journal articles which resulted from the research reported in the identified abstracts All original journal articles and abstracts which met one of the following criteria were included: (1) studies of the biological plausibility or mechanism of facilitation of HIV infectious- ness or susceptibility by STDs, (2) prospective cohort studies (longitudinal or nested case-control) which estimate the risk of HIV infection associated with specific STDs or STD syndromes, or (3) intervention studies which quantitate the eVect which STD treatment can have on HIV incidence Results: Strong evidence indicates that both ulcerative and non-ulcerative STDs promote HIV transmission by augmenting HIV infectiousness and HIV susceptibility via a variety of biological mechanisms These eVects are reflected in the risk estimates found in numerous prospective studies from four continents which range from 20 to 235, with most clustering between 2 and 5 The relative importance of ulcerative and non-ulcerative STDs appears to be complex Owing to the greater frequency of non-ulcerative STDs in many populations, these infections may be responsible for more HIV transmission than genital ulcers However, the limited reciprocal impact of HIV infection on non-ulcerative STDs and the evidence that non-ulcerative STDs may increase risk primarily for the receptive partner (rather than bidirectionally) may modulate the impact of these diseases The results of two community level randomised, controlled intervention trials conducted in Africa suggest that timely provision of STD services can substantially reduce HIV incidence, but raise additional questions about the optimal way to target and implement these services to achieve the greatest eVect on HIV transmission Conclusions: Available data leave little doubt that other STDs facilitate HIV transmission through direct, biological mechanisms and that early STD treatment should be part of a high quality, comprehensive HIV prevention strategy Policy makers, HIV prevention programme managers, and providers should focus initial implementation eVorts on three key areas: (i) improving access to and quality of STD clinical services; (ii) promoting early and eVective STD related healthcare behaviours; and (iii) establishing surveillance systems to monitor STD and HIV trends and their interrelations (Sex Transm Inf 1999;75:3-17)

HIV testing attitudes AIDS stigma and voluntary HIV counselling and testing in a black township in Cape Town South Africa.

Abstract: Objectives: A cornerstone of HIV prevention in South Africa is voluntary HIV antibody counselling and testing (VCT), but only one in five South Africans aware of VCT have been tested. This study examined the relation between HIV testing history, attitudes towards testing, and AIDS stigmas. Methods: Men (n = 224) and women (n = 276) living in a black township in Cape Town completed venue intercept surveys; 98% were black, 74% age 35 or younger. Results: 47% of participants had been tested for HIV. Risks for exposure to HIV were high and comparable among people tested and not tested. Comparisons on attitudes toward VCT, controlling for demographics and survey venue, showed that individuals who had not been tested for HIV and those tested but who did not know their results held significantly more negative testing attitudes than individuals who were tested, particularly people who knew their test results. Compared to people who had been tested, individuals who were not tested for HIV demonstrated significantly greater AIDS related stigmas; ascribing greater shame, guilt, and social disapproval to people living with HIV. Knowing test results among those tested was not related to stigmatising beliefs. Conclusions: Efforts to promote VCT in South Africa require education about the benefits of testing and, perhaps more important, reductions in stigmatising attitudes towards people living with AIDS. Structural and social marketing interventions that aim to reduce AIDS stigmas will probably decrease resistance to seeking VCT.

Measuring sexual behaviour: methodological challenges in survey research

Abstract: Series editors J M Stephenson, A Babiker The study of sexual behaviour lies at the heart of understanding the transmission dynamics of sexually transmitted infections (STIs). Academic investigation into sexual behaviour dates back to the 18th century and, over time, has employed a variety of approaches including the medical and psychiatric investigation of sexual disorders, anthropological investigations, and survey research based largely on volunteer samples. More recent studies, driven largely by the public health response to HIV/AIDS, have focused on large scale probability sample survey research.1–5 Key areas of inquiry have shifted towards describing population patterns of risk behaviours for STI/HIV transmission, understanding how epidemics of STIs are generated, and informing disease control strategies. Sexual behaviour is a largely private activity, subject to varying degrees of social, cultural, religious, moral and legal norms and constraints. A key challenge for all sex survey research is to generate unbiased and precise measures of individual and population behaviour patterns. Methods are needed to minimise measurement error which may be introduced by participation bias, recall and comprehension problems, and respondents' willingness to report sensitive and sometimes socially censured attitudes or behaviours.6, 7 This paper briefly considers the role of different types of study in understanding STI epidemiology. It then focuses on potential sources of measurement error in survey research and strategies for assessing and limiting them.Sex Transm Inf 2001;77:84–92 The type of study chosen will depend on the purpose of the investigation. However, studies generally fall into four main groups: general population surveys, studies on population subgroups, partner and network studies, ethnographic and qualitative studies. ### GENERAL POPULATION PROBABILITY SAMPLE SURVEYS Cross sectional population surveys aim to describe the overall distribution of behaviours in populations. By using probability sampling techniques and maximising response rates, large scale behavioural surveys can provide robust estimates of the prevalence …

Natural history of genital warts.

Abstract: Genital warts were known to the ancients, and many Greek and Roman writers referred to them. The early history of the disease has recently been reviewed by Bafverstedt (1967), who pointed out that some of the early synonyms for the lesions, particularly the words 'fig' and 'condyloma', have survived into modern times. In the Middle Ages, descriptions of diseases were less precise than in the ancient world, but some of the genital lesions described (Lanfranc, 1306) may have been warts. The outbreak of syphilis in Europe at the end of the 15th century led to renewed interest in genital diseases, but at this time most genital lesions were attributed to the 'venereal poison', and no causal distinction was made between the diseases now known as gonorrhoea, syphilis, and genital warts. Even Hunter (1786), who gave a clear description of genital warts, regarded them as a manifestation of syphilis, and did not differentiate them from condylomata lata. The important recognition that genital warts comprised a disease entity unrelated to syphilis was first made by Bell (1793), and his work was later confirmed by Jourdan (1826) and Ricord (1838). But, as the belief that genital warts were due to syphilis was gradually abandoned, the erroneous view developed that they were connected with gonorrhoea (Pirrie, 1852); indeed, in the 19th century, they were sometimes referred to as 'gonorrhoeal warts'. But Aime Martin (1872) pointed out that many patients with genital warts gave no history of gonorrhoea, and after the isolation of the gonococcus in 1879 it was realised that over half of the patients with genital warts showed no sign of it (Jadassohn, 1905). Many 19th century writers thought that genital warts were caused by irritation of the epidermis by various agents such as dirt, decomposed smegma, and genital discharges (Astley Cooper, 1835; Bumstead, 1864). This 'non-specific irritant' theory was widely accepted for many years; Cronquist (1912) strongly supported it, and it was reaffirmed well into the 20th century (Kaplan, 1942).