Toward Understanding COVID-19 Recovery: National Institutes of Health Workshop on Postacute COVID-19.

Over the past year, the SARS-CoV-2 pandemic has swept the globe, resulting in an enormous worldwide burden of infection and mortality. However, the additional toll resulting from long-term consequences of the pandemic has yet to be tallied. Heterogeneous disease manifestations and syndromes are now recognized among some persons after their initial recovery from SARS-CoV-2 infection, representing in the broadest sense a failure to return to a baseline state of health after acute SARS-CoV-2 infection.

A Universal Influenza Vaccine: The Strategic Plan for the National Institute of Allergy and Infectious Diseases.

A priority for the National Institute of Allergy and Infectious Diseases is development of a universal influenza vaccine providing durable protection against multiple influenza strains. NIAID will use this strategic plan as a foundation for future investments in influenza research.

Integrating behavioral and biomedical research in HIV interventions: challenges and opportunities.

Recent clinical trials have demonstrated overwhelming success of biomedical tools to prevent the spread of HIV infection. However, the complex and somewhat disparate results of some of these trials have highlighted the need for effective integration of biomedical and behavioral sciences in the design and implementation of any future intervention trial. Integrating behavioral and biomedical sciences will require appropriate behavioral theories that can be used in the context of biomedical clinical trials and multidisciplinary teams working together from the earliest stages of trial design through to completion.

Changes in fluoroquinolone use for gonorrhea following publication of revised treatment guidelines.

Objectives: We evaluated the impact of revised national treatment recommendations on fluoroquinolone use for gonorrhea in selected states.

Methods: We evaluated gonorrhea cases reported through the Sexually Transmitted Disease Surveillance Network as treated between July 1, 2006 and May 31, 2008, using interrupted time series analysis. Outcomes were fluoroquinolone treatment overall, by area, and by practice setting.

Treatment of syphilis in HIV-infected subjects: a systematic review of the literature.

Background: The optimal antimicrobial regimen to treat syphilis in HIV-infected subjects remains controversial.

Objective: To systematically assess the literature for studies evaluating syphilis treatment regimens in this population.

Methods: Two reviewers independently assessed studies published between 1980 and June 2008 in electronic databases, trial registries and bibliographies (with no language restrictions) for content and quality.

Sexually transmitted infections and adverse pregnancy outcomes among women attending inner city public sexually transmitted diseases clinics.

Background: Studies in antenatal care clinics suggest that lower genital tract infections (LGTI) may be associated with adverse pregnancy outcomes (APO). We sought to characterize antenatal care patterns and determine whether LGTI are independently associated with preterm birth and/or low-birth weight among a high-risk public sexually transmitted diseases (STD) clinic population.

Methods: Electronic STD clinic medical records and state birth records were matched for 730 pregnant women age 13 to 49 tested for 5 treatable LGTI (bacterial vaginosis, chlamydia, gonorrhea, early syphilis, and trichomoniasis) in a case-control analysis.

Digital divide: variation in internet and cellular phone use among women attending an urban sexually transmitted infections clinic.

We sought to describe: (1) the prevalence of internet, cellular phone, and text message use among women attending an urban sexually transmitted infections (STI) clinic, (2) the acceptability of health advice by each mode of information and communication technology (ICT), and (3) demographic characteristics associated with ICT use. This study is a cross-sectional survey of 200 English-speaking women presenting to a Baltimore City STI clinic with STI complaints. Participants completed a self-administered survey querying ICT use and demographic characteristics.

Sexually transmitted infection prevalence and behavioral risk factors among Latino and non-Latino patients attending the Baltimore City STD clinics.

Background: Many studies have evaluated factors influencing sexually transmitted diseases (STD)/HIV disparities between black and white populations, but fewer have explicitly included Latinos for comparison.

Methods: We analyzed demographic and behavioral data captured in electronic medical records of patients first seen by a clinician in 1 of 2 Baltimore City public STD clinics between 2004 and 2007. Records from white, black, and Latino patients were included in the analysis.

Hormonal contraception and risk of bacterial vaginosis diagnosis in an observational study of women attending STD clinics in Baltimore, MD.

Background: The protective effect of hormonal contraception may offer a potential intervention against bacterial vaginosis (BV).

Study Design: Three hundred thirty reproductive-age women enrolled in a contraceptive program from April 2005 to October 2006 at two sexually transmitted diseases clinics in Baltimore, MD. Participants were supplied with hormonal contraceptives of their choice and followed prospectively.

Lumbar puncture in HIV-infected patients with syphilis and no neurologic symptoms.

Background: The decision to perform lumbar puncture in patients with asymptomatic human immunodeficiency virus (HIV) infection and syphilis is controversial. The Centers for Disease Control and Prevention recommend certain criteria that warrant lumbar puncture. Here, we assess the performance of these criteria for detecting asymptomatic neurosyphilis (ANS).

Male circumcision and risk of HIV infection among heterosexual African American men attending Baltimore sexually transmitted disease clinics.

Background: Male circumcision has received international attention as an intervention for reducing HIV infection among high-risk heterosexual men; however, few US studies have evaluated its association with the risk of HIV infection.

Methods: We analyzed visit records for heterosexual African American men who underwent HIV testing while attending sexually transmitted disease (STD) clinics in Baltimore, Maryland, from 1993 to 2000. We used multivariable binomial regression to evaluate associations between circumcision and the risk of HIV infection among visits by patients with known and unknown HIV exposure.

The relationship between recent alcohol use and sexual behaviors: gender differences among sexually transmitted disease clinic patients.

Background: Binge drinking is associated with risky sexual behaviors and sexually transmitted diseases (STDs). Few studies have investigated this by gender or in an STD clinic. This cross-sectional study examined the association between binge drinking and risky sexual behaviors/STDs among patients attending an urban STD clinic.

Antiretroviral therapy is associated with reduced serologic failure rates for syphilis among HIV-infected patients.

Background: Syphilis and human immunodeficiency virus (HIV) frequently coexist in patients, but the effects of immunosuppression on the course of syphilis are unknown. Our goal was to determine whether the degree of HIV-mediated immunosuppression and the use of highly active antiretroviral therapy impact syphilis serologic responses.

Methods: We assessed all cases of syphilis with positive serologic test results from 1990 through 2006 in a prospective, observational clinical cohort of HIV-infected patients.

Neurosyphilis in a clinical cohort of HIV-1-infected patients.

Objectives: To describe the risk factors, clinical presentation, and long-term follow up of patients enrolled in a clinical cohort of HIV-infected patients who were diagnosed and treated for neurosyphilis.

Methods: Comprehensive demographic, clinical, and therapeutic data were collected prospectively on all patients between 1990 and 2006. Patients were diagnosed with neurosyphilis if they had positive syphilis serologies and any of the following: (a) one or more cerebrospinal fluid abnormalities on lumbar puncture [white blood cells >10/microl; protein >50 mg/dl; reactive venereal diseases research laboratory], (b) an otherwise unexplained neurological finding.

Sexually transmitted diseases and risk behaviors among pregnant women attending inner city public sexually transmitted diseases clinics in Baltimore, MD, 1996-2002.

Objective: To determine the prevalence of sexually transmitted diseases (STDs) and characterize behavioral correlates among pregnant women attending inner city public STD clinics.

Study Design: A retrospective study of 2303 pregnant women frequency matched by clinic and year of visit to 2303 nonpregnant women seeking services during years 1996 to 2002 at public STD clinics in Baltimore, MD.

Results: On average, 329 pregnant women attended Baltimore City STD clinics each year during 1996 to 2002.

Findings associated with recurrence of bacterial vaginosis among adolescents attending sexually transmitted diseases clinics.

Study Objective: Bacterial vaginosis (BV) is a common infection and has been associated with adverse health outcomes, including preterm birth, pelvic inflammatory disease (PID), and acquisition of HIV. There are limited data on recurrent BV in adolescents. A relationship between the frequency of BV recurrence and specific risk factors might shed light on the pathophysiology of BV and lead to targeted interventions.

Sexually transmitted infections during pregnancy.

Two million of the 15 million (13.3%) new cases of sexually transmitted infections (STIs) among persons 15 to 49 years old occur in pregnant women. Access to care and a provider's ability to assess risk, screen, and treat STIs are critical factors in preventing adverse pregnancy outcomes.

Provider-delivered, theory-based, individualized prevention interventions for HIV positive adults receiving HIV comprehensive care.

HIV prevention efforts are often difficult to emphasize in settings delivering comprehensive HIV care due to factors such as time constraints and differing priorities about the use of clinical time. To assist clinicians within dedicated HIV clinics to offer prevention strategies, investigators at two universities in the United States (Johns Hopkins University and the University of Alabama at Birmingham) have developed and implemented similar, audio-computerized-assisted, self-interviewing systems that have been programmed to assess individual patient risk factors and identify based on the patient's self-assessment, the patient's behavioral stage or, readiness for changing, each identified target behavior. Following the assessment, the systems provide printouts of key elements of this information along with individualized, theory-based intervention strategies to the medical provider.

The role of speculum and bimanual examinations when evaluating attendees at a sexually transmitted diseases clinic.

Background: With the advent of molecular techniques, self-collected specimens without a clinician's examination are often adequate to detect common genital infections.

Objective: To evaluate the additional information that speculum and bimanual examinations provides clinicians in the routine evaluation of genital infections among attendees of a sexually transmitted disease (STD) clinic.

Methods: Cross-sectional study from a database of all visit records to two STD clinics in Baltimore between 1996 and 2002.

HIV seroconversion among public sexually transmitted disease clinic patients: analysis of risks to facilitate early identification.

Objectives: We identified risks for HIV seroconversion among public sexually transmitted disease (STD) clinic patients.

Design: This was a retrospective cohort study conducted January 1993 through October 2002 of STD clinic attendees aged > or =12 years in Baltimore, Maryland.

Methods: A negative HIV enzyme immunoassay (EIA) test was required for staggered cohort entry.

Cost-effectiveness of screening strategies for Gonorrhea among females in private sector care.

Objective: To identify the optimal screening algorithm for gonorrhea infection among females in private sector care, using cost-effectiveness analysis.

Methods: We compared 6 strategies using decision analysis for urine nucleic acid amplification testing for gonorrhea testing in a theoretical cohort of 10,000 females aged 15-35 years: 1) screen women aged younger than 25 years; 2) screen women aged younger than 30 years; 3) screen women aged younger than 25 years who report any risk (pregnant, drug use, new sexual partner < 30 days); 4) screen women aged younger than 30 years who report any risk; 5) screen women aged younger than 25 years or those who report any risk; and 6) screen women aged younger than 30 years or those who report any risk. Infection prevalence and sensitivity and specificity were by direct observation from a retrospective cohort of females attending the Baltimore City Sexually Transmitted Disease Clinics between 1999 and 2002.