Urban Transgender Females Likely To Get HIV Testing

MedicalResearch.com Interview with:

Adrian Juarez, PhD, RN Assistant Professor The State University of New York School of Nursing  Department of Family, Community and Health Systems Sciences Buffalo, New York 14214

Dr. Juarez

Adrian Juarez, PhD, RN
Assistant Professor
The State University of New York
School of Nursing
Department of Family, Community and Health Systems Sciences
Buffalo, New York 14214

 

 

MedicalResearch.com: What is the background for this study?

Response: HIV testing is considered the initial component of HIV eradication strategies such as “seek, test, treat, and retain.” This study examines the characteristics of an urban, transgender population in western New York when volunteering for an HIV test. The use of an intersectional lens was observed in order to determine the level of influence of sexual partnership types, previous HIV and STD testing, substance use, housing status referral source and racial/gender identification on HIV testing.

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Could Vaccine Against Meningococcus Help Protect Against Gonorrhea?

MedicalResearch.com Interview with:
Helen Petousis-Harris. BSc, PhD

Senior Lecturer, Dept General Practice and Primary Health Care
Academic Head, Immunisation Research and Vaccinology
Immunisation Advisory Centre
School of Population Health, Faculty of Medical and Health Sciences
University of Auckland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Early thinking came from two quarters. One, the observation that the NZ OMV vaccine appeared broadly protective – beyond the clone it was based on and two, the observation of graphs depicting annual number of cases from both Cuba and NZ. There is nothing to suggest other types of meningococcal vaccine have had any effect on gonorrhoea so we are interested in the OMV vaccines. This led to the hypothesis that as these two Neisseria species are related the meningococcal OMV in the form of a vaccine may offer some kind of cross protection.

To explore this possibility we conducted a case-control study that compared the vaccination status of cases (gonorrhoea) and controls (Clamydia). We found that the cases with gonorrhoea were less likely to be vaccinated than the controls and after we controlled for confounders – ethnicity, SE deprivation, age we found a vaccine effectiveness of 31%.

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Does HAART Treatment for HIV Contribute To Rapid Rise in Syphilis Infections?

MedicalResearch.com Interview with:

Michael Rekart, MD, DTM&H Clinical Professor, Medicine and Global Health The University of British Columbia .... On behalf of my co-authors

Dr. Michael Rekart

Michael Rekart, MD, DTM&H
Clinical Professor, Medicine and Global Health
The University of British Columbia
…. On behalf of my co-authors

MedicalResearch.com: What is the background for this study?

Response: The background for this study is the observation that new syphilis cases over the last decade in British Columbia, Canada, have been escalating more rapidly than anyone could have predicted and that syphilis incidence has outpaced the incidence of other sexually transmitted diseases (STDs), including gonorrhea and chlamydia. This unexpected increase in syphilis has been almost wholly concentrated in men who have sex with men (MSM). Most of these MSM are HIV-1 infected and many are taking highly active antiretroviral therapy (HAART). In fact, the expansion in HAART coverage in MSM parallels the growth in syphilis in the same population. In addition, my co-authors and I had serious doubts as to whether ‘treatment optimism’, the generally accepted explanation for this phenomenon, was robust enough to account for such a dramatic increase in new syphilis cases. Treatment optimism posits that HAART availability and effectiveness have led to the perception in both HIV-1-infected and HIV-1-uninfected individuals that HIV-1 transmission has become much less likely, and the effects of HIV-1 infection less deadly. This is expected to result in increased sexual risk-taking, especially unprotected anal intercourse, leading to more non-HIV-1 STDs, including gonorrhea, chlamydia and syphilis.

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Co-infection with HPV and Chlamydia Can Be Asymptomatic and Lead to Infertility

MedicalResearch.com Interview with:

Dejan R. Nonato, MD, PhD Institute of Tropical Pathology and Public Health School of Medicine Federal University of Goiás Goiânia, GO, Brazil

Dr. Dejan Nonato

Dejan R. Nonato, MD, PhD
Institute of Tropical Pathology and Public Health
School of Medicine
Federal University of Goiás
Goiânia, GO, Brazil

MedicalResearch.com: What is the background for this study?

Response: Human papillomavirus (HPV) and Chlamydia trachomatis (CT) share the same route of sexual transmission and possess similar risk factors, indicating that co-infection may act synergistically in the induction of epithelial cell abnormalities.

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Estradiol May Increase Resistance To Sexually Transmitted Diseases

MedicalResearch.com Interview with:

Charu Kaushic. PhD. Professor OHTN Applied HIV Research Chair Department of Pathology and Mol. Medicine McMaster Immunology Research Center, McMaster University

Dr. Charu Kaushic

Charu Kaushic. PhD.
Professor
OHTN Applied HIV Research Chair
Department of Pathology and Mol. Medicine
McMaster Immunology Research Center,
McMaster University

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Kaushic: Female sex hormones, estradiol and progesterone have been shown to regulate immune responses in many experimental and clinical studies. We and others have shown previously that these hormones also regulate susceptibility to and outcome of sexually transmitted infections (STIs), including Chlamydia, HSV-2, SIV and HIV-1. Most studies show that progesterone generally increases susceptibility while estradiol generally confers protection against STIs. This has recently gained much more widespread attention because of the controversy surrounding use of injectable hormonal contraceptives in geographical areas where there is high prevalence of HIV-1. The most frequently used injectable contraceptive uses a progestin-based formulation which has been correlated with 2-fold increase in HIV acquisition and transmission in epidemiological studies. Oral contraceptives that contain a combination of estradiol and progesterone do not show similar correlation with increased infection. This is currently a very important women’s health issue, which is being carefully monitored by many public health agencies, including WHO. Many researchers are focusing efforts in understanding how sex hormones can increase or decrease susceptibility of women to STIs.

We have published in this area for more than a decade, including a series of papers showing that in a mouse model, the outcome of genital herpes (HSV-2) infection can depend on which hormone we treat the mice with. A few years ago, we showed for the first time that mice that received an HSV-2 vaccine under the influence of estradiol were much better protected and showed less disease pathology (Bhavanam et al, Vaccine 2008). These results were reproduced a year later by another group, using an actual HSV-2 vaccine formulation. Since then, we have been working to understand at a cellular level, the underlying mechanism of estradiol-mediated enhanced protection. In this PLOS Pathogens paper, we report for the first time a cellular mechanism by which estradiol was seen to enhance immune protection against HSV-2 infection in mice.

The main findings are that estradiol primes dendritic cells in the vaginal tract to induce enhanced anti-viral T cell responses. Dendritic cells are key immune cells that decide what type of immune responses will be mounted against an infection. Under the influence of estradiol, the dendritic cells in the vaginal tract of mice induced Th17 cells which in turn helped enhance anti-viral T cell responses (Th1), resulting in better protection against genital HSV-2. This regulation of anti-viral immunity was seen only in the reproductive tract.

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Mycoplasma genitalium, a Sexually Transmitted Infection, identified in 1% of the British population

MedicalResearch.com Interview with:
Dr Pam Sonnenberg 

Reader in Infectious Disease Epidemiology
Research Department of Infection & Population Health
University College London
London

MedicalResearch: What is the background for this study? What are the main findings?

Dr. Sonnenberg:  This study strengthens growing evidence that Mycoplasma genitalium (MG) is a sexually transmitted infection (STI). Analyses of over 4500 of urine samples from Britain’s third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) showed that MG was prevalent in up to 1% of the general population aged 16-44, who had reported at least one sexual partner. Prevalence was much higher in those who had reported more than four sexual partners in the past year – 5.2% in men and 3.1% in women. Absence of the infection in over 200 16-17 year olds who had not had vaginal, anal, or oral sex provided further evidence that MG is transmitted sexually. The study also analysed risk factors for  Mycoplasma genitalium, such as ethnicity, number of partners, and areas of deprivation. There were strong associations with risky sexual behaviours, with similar behavioural risk factors to other known STIs. The authors found that men of Black ethnicity and those living in the most deprived areas were more likely to test positive for MG. Over 90% of Mycoplasma genitalium in men and over two-thirds of MG cases in women were in those aged 25–44 years; an age group who would not be included in STI prevention measures currently aimed at young people in Britain. Interestingly, the majority of participants who tested positive for MG did not report any STI symptoms in the last month. Over half of women did not report any symptoms, but among those who did, bleeding after sex was most common. Over 90% of MG positive men did not report any symptoms.

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Smartphone Medical Device Can Test For Three STDs in 15 Minutes

Smartphone dongles performed a point-of-care HIV and syphilis test from finger prick whole blood in 15 minutes, operated by health care workers trained on a software app. Credit: Samiksha Nayak, Columbia Engineering

Smartphone dongles performed a point-of-care HIV and syphilis test from finger prick whole blood in 15 minutes, operated by health care workers trained on a software app. Credit: Samiksha Nayak, Columbia Engineering

MedicalResearch.com Interview with:
Tassaneewan Laksanasopin
PhD Candidate
Molecular and Microscale Bioengineering Lab
Columbia University

Medical Research: What is the background for this study? What are the main findings?

Response: We miniaturized and integrated all components needed for blood test (similar to ELISA) to be run on a smartphone accessory for point-of-care testing of infectious diseases.  The device simultaneously detects three infectious disease markers for HIV, treponemal syphilis and nontreponemal syphilis from a finger prick of blood in just 15 minutes.  In a blinded experiment in three health clinics in Rwanda, local health care workers obtained diagnostic results from 96 patients enrolled in prevention of mother-to-child transmission and voluntary counseling programs.  The test performance from our triplexed test was 92-100% sensitivity and 79-92% specificity compared to the gold standard of lab-based HIV ELISA, Treponema pallidum haemagglutination and rapid plasma reagin.  Importantly, patient preference for the dongle was 97% compared to lab-based tests, with most pointing to the convenience of obtaining quick results with a single finger prick.  This work suggests coupling microfluidics with recent advances in consumer electronics can make certain lab-based diagnostics accessible to almost any population with access to smartphones.

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STDs Reduced in Young Girls Through Telephone Counseling

Dr. Ralph Joseph Diclemente PhD Behavoral Sciences & Health School Of Public Health Emory University Atlanta GeorgiaMedicalResearch.com Interview with:
Dr. Ralph Joseph Diclemente PhD
Behavoral Sciences & Health School Of Public Health
Emory University Atlanta Georgia

 

Medical Research: What are the main findings of the study? 

Dr. DiClemente: In our study of 701 African American girls we observed significant and durable reductions in laboratory-confirmed sexually transmitted infections (50% reduction in chlamydial infections and a 60% reduction in gonorrhea) among girls in our intervention group relative to the comparison condition over a 36-month follow-up period.  In addition, we observed significant increases in condom use during sex and reductions in sex while using drugs or alcohol.  The key finding is the durability of the results – 3 years in the life of an adolescent is a long period.

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