Determinants of Familiarity and Experience with HIV Pre-Exposure Prophylaxis in Primary Care Providers in Ontario, Canada.

Background: Despite increased access to HIV pre-exposure prophylaxis (PrEP) in Canada, familiarity and experience among primary care providers (PCPs)-including family doctors and those working with key populations-remains limited. To understand the barriers and facilitators of PrEP familiarity and experience, we conducted a situational analysis in PCPs in sub-urban and rural Ontario.

Methods: We surveyed a non-probabilistic sample of PCPs using an online questionnaire, designed with the Consolidated Framework for Implementation Research (CFIR).

Syphilis Point of Care Rapid Test and Immediate Treatment Evaluation (SPRITE) study: a mixed-methods implementation science research protocol of eight public health units in Ontario, Canada.

Introduction: Urgent, tailored and equitable action is needed to address the alarming rise in syphilis rates in Canada. In the last decade, the rates of infectious syphilis have increased by 345% in Ontario, Canada. Underserved populations-people who use drugs, un(der)housed individuals and those living in rural and remote areas-face unique social and healthcare challenges that increase their vulnerability to syphilis infections and hinder their access to timely diagnosis and treatment.

Determinants of COVID-19 knowledge and self-action among African women: Evidence from Burkina Faso, the Democratic Republic of Congo, Kenya, and Nigeria.

Knowledge of infectious diseases and self-action are vital to disease control and prevention. Yet, little is known about the factors associated with knowledge of and self-action to prevent the coronavirus disease (COVID-19). This study accomplishes two objectives.

Sexually Transmitted Infections: Updates From the 2021 CDC Guidelines.

Sexually transmitted infection (STI) rates are increasing for most nationally notifiable disease categories in the United States. The 2021 Centers for Disease Control and Prevention STI guidelines provide several updated, evidence-based testing and treatment recommendations. The recommended treatment for gonorrhea is ceftriaxone monotherapy given intramuscularly, with dosing based on the patient's body weight.

The Use of Intracranial Vessel Wall Magnetic Resonance Imaging to Detect a Presumptive Syphilitic Brain Aneurysm.

Syphilitic intracranial aneurysm is a rare presentation of meningovascular syphilis in developed countries. In this case report, we discuss the utilization of the intracranial vessel wall magnetic resonance imaging in the management of a patient with a rare fusiform brain aneurysm, positive syphilis serologies, and inconclusive cerebrospinal fluid findings.

The Emerging Intersection Between Injection Drug Use and Early Syphilis in Nonurban Areas of Missouri, 2012-2018.

Background: The national rate of syphilis has increased among persons who inject drugs (PWID). Missouri is no exception, with increases in early syphilis (ES), congenital syphilis, and PWID, especially in nonurban counties.

Methods: Disease intervention specialist records for ES cases in Missouri (2012-2018) were examined.

Single and Repeated Use of the Emergency Department for Chlamydia and Gonorrhea Care.

Objective: Chlamydia and gonorrhea infection rates are rising in the United States, and the emergency department (ED) is increasingly a site where individuals seek care for these infections, sometimes more than once. This article investigates how individuals who use the ED more than once and receive chlamydia and gonorrhea care differ from individuals who are single users of the ED, as well as characteristics associated with being a repeat user of the ED.

Methods: We analyzed 46,964 visits made by individuals who attended 1 of 4 EDs from January 1, 2010, to May 31, 2016, and received a test for chlamydia and gonorrhea infection.

The National Network of Sexually Transmitted Disease Clinical Prevention Training Centers Turns 40-A Look Back, a Look Ahead.

Since 1979, the National Network of Sexually Transmitted Disease (STD) Clinical Prevention Training Centers (NNPTC) has provided state-of-the-art clinical and laboratory training for STD prevention across the United States. This article provides an overview of the history and activities of the NNPTC from its inception to present day, and emphasizes the important role the network continues to play in maintaining a high-quality STD clinical workforce. Over time, the NNPTC has responded to changing STD epidemiological patterns, technological advances, and increasing private-sector care-seeking for STDs.

Presenting to the Emergency Department Versus Clinic-Based Sexually Transmitted Disease Care Locations for Testing for Chlamydia and Gonorrhea: A Spatial Exploration.

Background: Rates of sexually transmitted diseases (STDs) including chlamydia and gonorrhea are increasing in the United States while public health funding for STD services is decreasing. Individuals seek care in various locations including the emergency department (ED). The objective of this study is to investigate whether there are more physically proximal clinic-based STD care locations available to individuals who present to the ED in a major metropolitan area.

The influence of race and sex on gonorrhea and chlamydia treatment in the emergency department.

Background: Emergency Departments (EDs) are a care source for patients with sexually transmitted diseases (STDs). St. Louis, MO reports among the highest rates of gonorrhea and chlamydia infection.

Existence, Distribution, and Characteristics of STD Clinics in the United States, 2017.

Objectives: Studies of sexually transmitted disease (STD) clinics have been limited by the lack of a national list for representative sampling. We sought to establish the number, type, and distribution of STD clinics and describe selected community characteristics associated with them.

Methods: We conducted a 2-phased, multilevel, online search from September 2014 through March 2015 and from May through October 2017 to identify STD clinics in all 50 US states and the District of Columbia.

Lymphogranuloma Venereum 2015: Clinical Presentation, Diagnosis, and Treatment.

Lymphogranuloma venereum (LGV) has emerged as an important cause of proctitis and proctocolitis in men who have sex with men; classical inguinal presentation is now increasingly uncommon. We report summary findings of an extensive literature review on LGV clinical presentation, diagnosis, and treatment that form the evidence base for the 2015 Centers for Disease Control and Prevention treatment guidelines for sexually transmitted diseases. Proctitis and proctocolitis are now the most commonly reported clinical manifestations of LGV, with symptoms resembling those of inflammatory bowel disease.

A mixed methods multiple case study of implementation as usual in children's social service organizations: study protocol.

Background: Improving quality in children's mental health and social service settings will require implementation strategies capable of moving effective treatments and other innovations (e.g., assessment tools) into routine care.

"Testing-only" visits: an assessment of missed diagnoses in clients attending sexually transmitted disease clinics.

Background: At sexually transmitted disease (STD) clinics, advances in testing technology coupled with increasing demands and diminishing resources have promoted the use of testing-only visits (clinic visits with testing for STDs but no full examination) to meet increasing demands for STD services.

Objectives: The aims of the present study were to estimate the prevalence of STD diagnoses that could become "missed diagnoses" if patients would use testing-only visits and to examine patient characteristics associated with these potential missed diagnoses.

Methods: We conducted a self-administered survey of STD-related symptoms and sexual risk behaviors in patients seeking routine clinical care at 3 STD clinics.

Risk behaviours by type of concurrency among young people in three STI clinics in the United States.

Background: Concurrent sexual partnerships can increase sexually transmissible infections (STI) transmission on a population level. However, different concurrency types may be associated with differential risks for transmission. To investigate this, we describe the prevalence and correlates of four specific concurrency types.

A prospective study of the psychosocial impact of a positive Chlamydia trachomatis laboratory test.

Background: Few data exist on potential harms of chlamydia screening. We assessed the psychosocial impact of receiving a positive Chlamydia trachomatis test result.

Methods: We prospectively studied women ≥16 years of age undergoing chlamydia testing in 2 Midwestern family planning clinics.

Use of home-obtained vaginal swabs to facilitate rescreening for Chlamydia trachomatis infections: two randomized controlled trials.

Objective: To determine whether the use of home-based, self-obtained vaginal swabs among women who were treated for Chlamydia infection can increase rescreening rates in comparison with clinic-based rescreening, and to identify subgroups in which rescreening could be enhanced using self-obtained vaginal swabs.

Methods: Two randomized trials were conducted: one with enrollment in sexually transmitted disease (STD) clinics and the other in family planning clinics. Study participants were recruited from STD (n = 880) and family planning clinics (n = 412) in three cities.

Screening methods for Chlamydia trachomatis and Neisseria gonorrhoeae infections in sexually transmitted infection clinics: what do patients prefer?

Objectives: To meet the need for services at sexually transmitted infection (STI) clinics, self-obtained vaginal (SOV) swabs or first-catch urine (FCU) samples collected at a clinic visit have been proposed as an alternative approach for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) screening. The purpose of this clinic-based survey was to determine if non-invasive clinic-based SOV swabs and FCU samples for CT and GC screening are acceptable replacements for a traditional provider visit.

Methods: Patients seen at STI clinics in three US cities completed a self-administered survey of preferences for methods of CT and GC screening under hypothetical circumstances.

The need and plan for global elimination of congenital syphilis.

In every society, congenital syphilis (CS) has significant medical, economic, societal and emotional burdens; these are poorly characterized but high. Inexplicably, the elimination of CS has failed to attract international attention. Yet, the cornerstones of programs to do this universally are in place, the recent development of new diagnostic tools offers the now-practical possibility of testing every pregnant woman, testing is cost-effective, and programs for the elimination of CS can be joined with other programs to enhance efficiency.