Utility of antimicrobial susceptibility testing in Trichomonas vaginalis-infected women with clinical treatment failure.

Background: Antimicrobial resistance is one of the causes of treatment failure in women after standard nitroimidazole therapy for Trichomonas vaginalis infections. The Centers for Disease Control and Prevention provides drug susceptibility testing and guidance for treatment failures but the efficacy of the alternate recommendations has not been assessed.

Methods: T.

Protecting HIV information in countries scaling up HIV services: a baseline study.

Background: Individual-level data are needed to optimize clinical care and monitor and evaluate HIV services. Confidentiality and security of such data must be safeguarded to avoid stigmatization and discrimination of people living with HIV. We set out to assess the extent that countries scaling up HIV services have developed and implemented guidelines to protect the confidentiality and security of HIV information.

Repeat infection with Chlamydia and gonorrhea among females: a systematic review of the literature.

Determining the magnitude of chlamydia and gonorrhea reinfection is critical to inform evidence-based clinical practice guidelines related to retesting after treatment. PubMed was used to identify peer-reviewed English language studies published in the past 30 years that estimated reinfection rates among females treated for chlamydia or gonorrhea. Included in this analysis were original studies conducted in the United States and other industrialized countries that reported data on chlamydia or gonorrhea reinfection in females.

Gonococcal, chlamydia, and syphilis infection positivity among MSM attending a large primary care clinic, Boston, 2003 to 2004.

Background: In the past decade, increases in syphilis and rectal gonorrhea have been reported among men who have sex with men (MSM) in the United States; however, limited sexually transmitted disease (STD) positivity data are available on MSM who receive their healthcare from primary care or general medical clinics. The current study sought to elucidate STD positivity in asymptomatic MSM seen at the largest primary care clinic for MSM in New England and to describe STD test positivity by reason for STD testing.

Methods: As part of the Centers for Disease Control and Prevention's MSM Prevalence Monitoring Project, all medical visits between 2003 and 2004 (n = 21,927) among MSM attending Fenway Community Health (Boston) were reviewed.

Risk factors for prevalent and incident Trichomonas vaginalis among women attending three sexually transmitted disease clinics.

Goal: Trichomonas vaginalis is the most common nonviral sexually transmitted infection in the United States and may be associated with adverse birth outcomes and may also increase susceptibility to or transmissibility of human immunodeficiency virus. The purpose of this analysis is to describe the epidemiology of T. vaginalis in Sexually Transmitted Disease clinics and characterize the risk factors associated with prevalent and incident T.

Management of trichomonas vaginalis in women with suspected metronidazole hypersensitivity.

Background/objective: Standard treatment for Trichomonas vaginalis is metronidazole or tinidazole. Hypersensitivity to these drugs has been documented but is poorly understood. Desensitization is an option described in limited reports of women with hypersensitivity to nitroimidazoles.

An ongoing burden: chlamydial infections among young American Indian women.

Objectives: Studies conducted in the 1980s, when there was limited chlamydia screening, showed high positivity, 23%-30%, among American Indian women. In the 1990 s, chlamydia screening and treatment programs were implemented in a variety of settings serving American Indian women including Indian Health Service (IHS) clinics. Yet, a 2000-2001 national survey documented a chlamydia prevalence of 13.

Increasing chlamydia positivity in women screened in family planning clinics: do we know why?

Objective: Following a 9-year 60% decline, chlamydia positivity increased 46% from 1997 through 2004 among young sexually active women screened in Region X family planning clinics. The objective of this analysis was to systematically examine the influences of risk factors, changing laboratory test methods, and interclinic variability on chlamydia positivity during this period.

Study Design: We analyzed data from 520,512 chlamydia tests from women aged 15 to 24 years screened in 125 family planning clinics.

Within the hidden epidemic: sexually transmitted diseases and HIV/AIDS among American Indians and Alaska Natives.

Objectives: To review the epidemiology, research, and prevention programs for sexually transmitted diseases in American Indians and Alaska Natives (AI/ANs).

Study Design: We reviewed the current national and regional trends in sexually transmitted diseases (STDs) for AI/ANs from 1998-2004, peer-reviewed studies from January 1996, through May 2006, and reports, unpublished documents, and electronic resources addressing AI/AN STD prevention and control.

Results: STD prevalence among AI/ANs remains high.

Assessing a web-based approach to collect complex and sensitive surveillance data: the sexually transmitted diseases- laboratory tests methods survey.

The Centers for Disease Control and Prevention (CDC) is looking for improved ways to collect complex, and highly sensitive, public health surveillance data. The Sexually Transmitted Diseases - Laboratory Test Methods Survey (STD-LMS) was developed to replace the traditional STD mail survey. The web-based STD-LMS offered distinct advantages over the traditional mail survey technique including,reduced time and cost of conducting the survey and avoiding the often error prone and tedious task of data entry.

Testing for sexually transmitted diseases in U.S. Public health laboratories in 2004.

Objective: Appropriate laboratory testing practices are a critical part of sexually transmitted disease (STD) control.

Goal: The goal of this study was to describe the type and volume of STD tests performed in public health laboratories in the United States in 2004.

Study Design: A web-based survey was made available to 144 members of the Association of Public Health Laboratories.

Prevalence of Chlamydia in young men in the United States from newly implemented universal screening in a national job training program.

Objective: The objective of this study was to examine chlamydia prevalence and its risk factors from the first universal screening in socioeconomically disadvantaged young men.

Goal: The goal of this study was to evaluate the need for universal screening in young men.

Study Design: We calculated chlamydia prevalence by demographic and geographic characteristics from 51,478 men aged 16 to 24 years who were screened from July 2003 to December 2004.

Prevalence trends in chlamydial infections among young women entering the national job training program, 1998-2004.

Objectives: To assess the trends and risk factors of chlamydial infections in disadvantaged women aged 16 to 24 years entering a national job training program.

Goal: To assess the impact of chlamydia screening program on chlamydia trend.

Study Design: The authors calculated the prevalence of chlamydia by demographic and geographic characteristics from 106,377 women who were screened from 1998 through 2004.

Chlamydial infections among female adolescents screened in juvenile detention centers in Washington State, 1998-2002.

Objective: The objective of this study was to assess trends in Chlamydia trachomatis positivity and associated risk factors among detained female adolescents.

Goal: The goal of this study was to determine trends in prevalence of chlamydia among detained female adolescents.

Study Design: We retrospectively reviewed risk factor data and chlamydia results collected by providers during 1998-2002 at four large juvenile detention centers in Washington State that routinely screen female adolescents for C.

Chlamydia trachomatis and Neisseria gonorrhoeae prevalence and coinfection in adolescents entering selected US juvenile detention centers, 1997-2002.

Background: Juvenile detention centers offer public health practitioners an opportunity to gain access to large numbers of adolescents at risk for chlamydia and gonorrhea.

Goal: To describe the prevalence and coinfection of chlamydia and gonorrhea among adolescents in 14 US juvenile detention centers from 1997 to 2002.

Study: We calculated the prevalence of chlamydia and gonorrhea in males and females, stratified by race/ethnicity, age group, and site.

Indirect estimation of Chlamydia screening coverage using public health surveillance data.

Although routine screening of all sexually active adolescent females for Chlamydia trachomatis infection is recommended at least annually in the United States, no national or state-specific population-based estimates of chlamydia screening coverage are known to exist. Conclusions regarding screening coverage have often been based on surveys of health care provider or facility screening practices, but such surveys do not consider persons who do not seek care at these facilities or who seek care at more than one facility. The authors developed a method to estimate the proportion of sexually active females aged 15-19 years screened for chlamydia in 45 states and the District of Columbia by using national data on chlamydia positivity, estimates of sexual activity from the National Survey of Family Growth, and chlamydial infections reported to the Centers for Disease Control and Prevention.

Laboratory tests used in US public health laboratories for sexually transmitted diseases, 2000.

Background And Objectives: Public health laboratories are a critical component of sexually transmitted disease (STD) control in the United States.

Goal: The goal of this study was to describe the types and volume of STD tests performed in U.S.

Gonorrhea prevalence and coinfection with chlamydia in women in the United States, 2000.

Background: No recent national data address the prevalence of gonorrhea.

Goal: The goal was to describe gonorrhea prevalence and chlamydial coinfection among women aged 15 to 24 years.

Study Design: Data were analyzed from tests for chlamydia and gonorrhea at family planning, STD, and prenatal clinics in 2000.

Prevalence of metronidazole-resistant Trichomonas vaginalis in a gynecology clinic.

Objective: To determine the prevalence of in vitro resistance to metronidazole among unselected isolates of Trichomonas vaginalis and correlate in vitro findings with response to metronidazole therapy.

Study Design: Vaginal fluid from women attending a gynecology clinic at an urban hospital was cultured, isolates were tested for in vitro resistance to metronidazole, and these results were correlated with therapeutic outcome.

Results: Among 911 women, T vaginalis was detected by culture in 82 (9.

Impact of switching laboratory tests on reported trends in Chlamydia trachomatis infections.

Improvements in the sensitivity and specificity of laboratory testing methods for Chlamydia trachomatis infections in recent years have created potential problems with interpreting data on chlamydia prevalence trends. A switch to a more sensitive test can result in an increase in chlamydia positivity even with no increase in the true disease prevalence. To examine the impact of switching laboratory testing methods on chlamydia positivity trends among women, the authors analyzed data from chlamydia screening programs in family planning clinics in two geographic areas of the United States.

Chlamydia positivity versus prevalence. What's the difference?

Background: Data on chlamydia screening collected as part of Regional Infertility Prevention Projects often do not include personal identifiers, therefore repeat tests for patients during a year cannot be identified. Consequently, positivity is calculated and used to monitor chlamydia prevalence.

Goals: To assess how well positivity can estimate prevalence in family planning and sexually transmitted disease (STD) clinic settings.

Screening women for gonorrhea: demographic screening criteria for general clinical use.

Objectives: The purpose of this analysis was to derive potential gonorrhea screening criteria for women.

Methods: Data corresponding to 44,366 gonorrhea cultures from women 15 through 44 years of age in Columbus, Ohio, were analyzed.

Results: Characteristics that were associated with gonococcal infection and were suitable for screening decisions included patient's age and marital status and previous prevalence of gonorrhea at provider site.

Trends in the prevalence of chlamydial infections. The impact of community-wide testing.

Background: Evaluation of existing testing programs should guide the national effort to expand programs for the prevention of chlamydial infections. The Columbus (Ohio) Health Department instituted community-wide testing for Chlamydia trachomatis in 1988.

Goals: To assess trends in the prevalence of chlamydial infection, the coverage of screening, and concurrent trends in the prevalence of gonorrhea.

Genital Chlamydia infections in sexually active female adolescents: do we really need to screen everyone?

Purpose: To evaluate current Chlamydia trachomatis screening guidelines, which recommend that all sexually active female adolescents undergoing a pelvic examination be tested for chlamydial infection, and determine if instead providers should target particular subpopulations of these adolescents.

Methods: Data were collected from 148,650 sexually active females, ages 15-19 years, tested by direct immunofluorescent antibody in 160 family planning clinics from 1988-92. Trends in chlamydia prevalence by demographic, behavioral, and clinical risk factors were analyzed.

Predictors of Chlamydia trachomatis infection among female adolescents: a longitudinal analysis.

Screening guidelines recommend testing all sexually active female adolescents for Chlamydia trachomatis during a pelvic examination at each clinic visit. Such criteria have been based on cross-sectional studies; new evaluations should take into account multiple clinic visits and assess whether criteria are appropriate when a prior test is negative and risk factors are absent. Because repeated observations on an individual may be correlated, the authors used the generalized estimating equation method.