Posts filed under ‘Infecciones de transmision sexual’
Current Opinion in Infectious Diseases Feb 2013 V.26 N.1 P.80–85
Poynten, I. Marya; Grulich, Andrew E.a; Templeton, David J.a,b
aKirby Institute, University of New South Wales, Sydney
bRPA Sexual Health, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia
Correspondence to Dr Mary Poynten, Kirby Institute, The University of New South Wales, Sydney, NSW 2052, Australia. Tel: +61 2 93850937; fax: +61 2 93850920; e-mail: email@example.com
Purpose of review
People are living longer and healthier lives. In recent years, there has been a focus on recognition of ongoing sexual activity among older adults and leading from this, the potential for an increase in diagnoses of sexually transmitted infections (STIs). Data on STI rates, sexual behaviour and factors affecting susceptibility to STIs are discussed.
There is limited published literature in this field and few recent longitudinal studies of STI acquisition in people older than 50 years. Although there is evidence of an increase in incidence, STIs remain rare in older compared with younger populations. Compared with their heterosexual counterparts, older men who have sex with men are at higher risk of incident HIV and some other STIs. The HIV epidemic is ageing as a result of increasing life span and acquisition of HIV at older ages. Improved longevity, evolving societal norms and physiological changes may place older people at risk of HIV and other STIs.
Routine STI screening is not warranted in all older people. Education and prevention strategies for all people at greater risk of HIV, regardless of age are required. Age-appropriate interventions designed to impart knowledge and provide the requisite skills needed to reduce STI risk in older age would be beneficial.
PDF (CLIC PDF)
N Engl J of Medic Aug.14, 2014 V.371 P.667-667
IMAGES IN CLINICAL MEDICINE
- Cherniak and M. Silverman
A 45-year-old woman presented to an outreach clinic in rural Uganda with a 1-year history of a progressively enlarging ulcerated mass on the hard palate (Panel A). The mass had initially been painless but more recently had become painful and was causing difficulty in speaking and swallowing. She had received a diagnosis of cancer and was attempting to sell her home to pay for surgical resection. She had no history of syphilitic symptoms or treatment. The results on Treponema pallidum hemagglutination assay were positive for syphilis; nontreponemal testing was not locally available. Serologic analysis for human immunodeficiency virus was negative. Tertiary syphilis with an oral gumma was diagnosed. The patient was treated with three intramuscular injections of 2.4 million units of penicillin G benzathine at 1-week intervals. At follow-up 2 months after the end of treatment, there was resolution of the mass and symptoms (Panel B). In the oral cavity, gummas may occur as masses on the hard palate or tongue that frequently ulcerate….
Current Opinion in Infect. Dis Feb 2014 V.27 N.1 P.53–55
Sheffield Teaching Hospitals NHS Foundation Trust and Undergraduate Dean, University of Sheffield Medical School, Sheffield, UK
Correspondence to Karen Rogstad, Consultant in HIV and Sexual Health, Sheffield Teaching Hospitals, NHS Foundation Trust and Undergraduate Dean, University of Sheffield School of Medicine, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK. Tel: +44 114 271 1900; e-mail: Karen.firstname.lastname@example.org
The five review topics in this issue highlight some of the key controversies in sexually transmitted infections (STIs), and their control.
The authors are from all corners of the world and work in different healthcare systems, but all have an awareness of the internationality of STIs, which do not conform to national boundaries.
A problem in one country can rapidly spread to other continents, requiring a world view of STI treatment and control, and international collaboration and support.
There are some major areas of concern: in men who have sex with men (MSM), there is a resurgent syphilis epidemic, hepatitis C in HIV-positive men has an annual incidence of transmission of 2–4% , and there is no decrease in HIV incidence in MSM; gonorrhoea has increased globally by 21% over 3 years  and multidrug, extensively drug-resistant and potentially untreatable
PDF (CLIC on PDF)
MMWR My 9, 2014 V.63 N.18 P.402-406
Monica E. Patton, MD1, John R. Su, MD2, Robert Nelson, MPH2, Hillard Weinstock, MD2
1EIS officer, CDC; 2Division of Sexually Transmitted Disease Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC (Corresponding author: Monica Patton, email@example.com, 404-718-8648)
In 2013, based on data reported as of April 28, 2014, the rate of reported primary and secondary syphilis in the United States was 5.3 cases per 100,000 population, more than double the lowest-ever rate of 2.1 in 2000.
To characterize the recent epidemiology of syphilis in the United States, CDC analyzed data from the National Notifiable Diseases Surveillance System (NNDSS) for cases of primary and secondary syphilis diagnosed during 2005–2013 with a focus on states that reported the sex of sex partners during 2009–2012 to describe reported syphilis among gay, bisexual, and other men who have sex with men (collectively referred to as MSM).
During 2005–2013, primary and secondary syphilis rates increased among men of all ages and races/ethnicities across all regions of the United States.
Recent years have shown an accelerated increase in the number of cases, with the largest increases occurring among MSM. Among women, rates increased during 2005–2008 and decreased during 2009–2013, with different trends among different racial/ethnic groups.
Racial/ethnic disparities in reported syphilis persisted during 2005–2013, likely reflecting social determinants of health, such as socioeconomic status, that might contribute to the burden of syphilis in a community (1).
These findings underscore the need for continued syphilis prevention measures among MSM….
PDF (see p.402)
Emerging Infectious Diseases April 2014 V.20 N.4
Harrell W. ChessonComments to Author , Robert D. Kirkcaldy, Thomas L. Gift, Kwame Owusu-Edusei, and Hillard S. Weinstock
Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Antimicrobial drug resistance can hinder gonorrhea prevention and control efforts.
In this study, we analyzed historical ciprofloxacin resistance data and gonorrhea incidence data to examine the possible effect of antimicrobial drug resistance on gonorrhea incidence at the population level.
We analyzed data from the Gonococcal Isolate Surveillance Project and city-level gonorrhea incidence rates from surveillance data for 17 cities during 1991–2006.
We found a strong positive association between ciprofloxacin resistance and gonorrhea incidence rates at the city level during this period. Their association was consistent with predictions of mathematical models in which resistance to treatment can increase gonorrhea incidence rates through factors such as increased duration of infection.
These findings highlight the possibility of future increases in gonorrhea incidence caused by emerging cephalosporin resistance.