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  • Chlamydia Trachomatis
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  • 1
    In: Sex Transm Dis, 2001, Vol.28(5), pp.247-251
    Description: BACKGROUND: The temporal pattern of partners and sexual encounters may be key factors in the acquisition and transmission of sexually transmitted diseases (STDs). Behavior among adolescent women is of particular interest because they frequently have the highest prevalence and incidence of infection. GOAL: To examine coital diary data collected during a 7-month longitudinal study of young women at high risk of STDs and to describe their sexual behaviors, with particular attention to issues of partner sequence and overlap. STUDY DESIGN: A 7-month longitudinal study of young women infected with or having a sexual contact infected with Neisseria gonorrhoeae, Chlamydia trachomatis, or Trichomonas vaginalis attending the STD clinic or one of four neighborhood adolescent health clinics. Data were collected at enrollment and at 1, 3, 5, and 7-month follow-up visits. Coital diaries were kept between visits. RESULTS: The average frequency of coital events was 0.94 per week. The median number of sexual partners during the follow-up period was one, and overlapping of partnerships was an uncommon occurrence. The number of days between the last coital event of a current relationship and the first encounter of a new relationship differed for those choosing a new partner (mean, 20.6 days) and those who returned to a previous partner (mean, 7.9 days;P 〈 0.001). CONCLUSION: Although at high risk for STDs, high-risk behavior was not common among the study population. Partner choice and the behavior of these partners may be more important elements than personal high-risk behavior in accounting for the high prevalence of sexually transmitted infections among inner-city adolescent women.
    Keywords: Teenage Girls -- Sexual Behavior ; Sexually Transmitted Diseases -- Research;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 2
    Language: English
    In: PLoS ONE, 2012, Vol.7(5), p.e36298
    Description: Lactobacillus- dominated vaginal microbiotas are associated with reproductive health and STI resistance in women, whereas altered microbiotas are associated with bacterial vaginosis (BV), STI risk and poor reproductive outcomes. Putative vaginal taxa have been observed in male first-catch urine, urethral swab and coronal sulcus (CS) specimens but the significance of these observations is unclear. We used 16 S rRNA sequencing to characterize the microbiota of the CS and urine collected from 18 adolescent men over three consecutive months. CS microbiotas of most participants were more stable than their urine microbiotas and the composition of CS microbiotas were strongly influenced by circumcision. BV-associated taxa, including Atopobium , Megasphaera , Mobiluncus , Prevotella and Gemella , were detected in CS specimens from sexually experienced and inexperienced participants. In contrast, urine primarily contained taxa that were not abundant in CS specimens. Lactobacilllus and Streptococcus were major urine taxa but their abundance was inversely correlated. In contrast, Sneathia , Mycoplasma and Ureaplasma were only found in urine from sexually active participants. Thus, the CS and urine support stable and distinct bacterial communities. Finally, our results suggest that the penis and the urethra can be colonized by a variety of BV-associated taxa and that some of these colonizations result from partnered sexual activity.
    Keywords: Research Article ; Biology ; Medicine ; Public Health And Epidemiology ; Infectious Diseases ; Microbiology ; Urology
    E-ISSN: 1932-6203
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  • 3
    Language: English
    In: Pediatrics, February 2011, Vol.127(2), pp.e336-44
    Description: We assessed differences in chlamydia screening rates according to race/ethnicity, insurance status, age, and previous sexually transmitted infection (STI) or pregnancy. A retrospective cohort study was performed using electronic medical record and billing data for women 14 to 25 years of age in 2002-2007, assessing differences in the odds of a chlamydia test being performed at that visit. Adjusted odds of a chlamydia test being performed were lower among women 14 to 15 years of age (odds ratio: 0.83 [95% confidence interval: 0.70-1.00]) and 20 to 25 years of age (20-21 years, odds ratio: 0.78 [95% confidence interval: 0.70-0.89]; 22-23 years, odds ratio: 0.76 [95% confidence interval: 0.67-0.87]; 24-25 years, odds ratio: 0.64 [95% confidence interval: 0.57-0.73]), compared with women 18 to 19 years of age. Black women had 3 times increased odds (odds ratio: 2.96 [95% confidence interval: 2.66-3.28]) and Hispanic women nearly 13 times increased odds (odds ratio: 12.89 [95% confidence interval: 10.85-15.30]) of testing, compared with white women. Women with public (odds ratio: 1.74 [95% confidence interval: 1.58-1.91]) and public pending (odds ratio: 6.85 [95% confidence interval: 5.13-9.15]) insurance had increased odds of testing, compared with women with private insurance. After first STI diagnosis, differences according to race/ethnicity persisted but were smaller; after first pregnancy, differences persisted. Despite recommendations to screen all sexually active young women for chlamydia, providers screened women differently according to age, race/ethnicity, and insurance status, although differences were reduced after first STI or pregnancy.
    Keywords: Chlamydia Infections -- Diagnosis ; Health Personnel -- Standards ; Mass Screening -- Methods
    ISSN: 00314005
    E-ISSN: 1098-4275
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  • 4
    Language: English
    In: The Journal of infectious diseases, 01 January 2010, Vol.201(1), pp.42-51
    Description: Repeated Chlamydia trachomatis infections are common among young sexually active women. The relative frequency of reinfection and antibiotic treatment failure is undefined. Adolescent women enrolled in a longitudinal cohort had behavioral and sexually transmitted infection assessments performed every 3 months, including amplification tests for C. trachomatis, ompA genotyping, and interviews and diary entries to document sex partner-specific coitus and event-specific condom use. Repeated infections were classified as reinfection or treatment failure by use of an algorithm. All infections for which treatment outcomes were known were used to estimate the effectiveness of antibiotic use. We observed 478 episodes of infection among 210 study participants; 176 women remained uninfected. The incidence rate was 34 episodes/100 woman-years. Of the women who were infected, 121 experienced 1 repeated infections, forming 268 episode pairs; 183 pairs had complete data available and were classified using the algorithm. Of the repeated infections, 84.2% were definite, probable, or possible reinfections; 13.7% were probable or possible treatment failures; and 2.2% persisted without documented treatment. For 318 evaluable infections, we estimated 92.2% effectiveness of antibiotic use. Most repeated chlamydial infections in this high-incidence cohort were reinfections, but repeated infections resulting from treatment failures occurred as well. Our results have implications for male screening and partner notification programs and suggest the need for improved antibiotic therapies.
    Keywords: Anti-Bacterial Agents -- Therapeutic Use ; Azithromycin -- Therapeutic Use ; Chlamydia Infections -- Drug Therapy
    ISSN: 00221899
    E-ISSN: 1537-6613
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  • 5
    In: Journal of the Royal Statistical Society: Series A (Statistics in Society), October 2011, Vol.174(4), pp.975-989
    Description: Bacterium causes genital chlamydia infection. Yet little is known about the efficiency of transmission of this organism. Ethical constraint against exposing healthy subjects to infected partners precludes the possibility of quantifying the risk of transmission through controlled experiments. This research proposes an alternative strategy that relies on observational data. Specifically, we present a stochastic model that treats longitudinally observed states of infection in a group of young women as a Markov process. The model proposed explicitly accommodates the parameters of transmission, including per‐encounter sexually transmitted infection acquisition risks, with and without condom protection, and the probability of antibiotic treatment failure. The male‐to‐female transmission probability of is then estimated by combining the per‐encounter disease acquisition risk and the organism's prevalence in the male partner population. The model proposed is fitted in a Bayesian computational framework.
    Keywords: Bacterial Infection ; Binary Outcome ; Longitudinal Study ; Markov Chain Monte Carlo Methods ; Markov Model ; Observational Data ; Transmission Probability
    ISSN: 0964-1998
    E-ISSN: 1467-985X
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  • 6
    Language: English
    In: The Journal of Pediatrics, 1996, Vol.128(2), pp.288-295
    Description: To determine whether condom use among high-risk female adolescents could be increased by a behavioral intervention, with the use of infection with as a biomarker of condom practices. Prospective, randomized, controlled intervention. Urban family planning and sexually transmitted disease clinics. Two hundred nine female adolescents, aged 15 through 19 years, who were treated for genitourinary infection, were randomly assigned to standard (control) or experimental (behavioral intervention) groups. One hundred twelve subjects returned for follow-up 5 to 7 months after enrollment and comprise the study subjects. Subjects completed a multiinstrument questionnaire measuring sexual behavior, condom practices, attitudes and beliefs, cognitive complexity, sociodemographics, and motivation at enrollment and follow-up. Endourethral and endocervical sites were sampled for . Among the 112 subjects who returned for repeated examination, those who had received the experimental intervention reported increased use of condoms by their sexual partners for protection against sexually transmitted diseases (odds ratio = 2.4; = 0.02) and for vaginal intercourse (odds ratio = 3.1; = 0.005) at the 6-month follow-up. Multivariable logistic regression analysis controlling for condom use at enrollment demonstrated that the experimental intervention (odds ratio = 2.8; = 0.03) and the higher cognitive complexity (odds ratio = 4.6; = 0.02) independently contributed to greater condom use at follow-up. Despite greater use of condoms among the group who had received the intervention, use remained inconsistent and rates of reinfection with were not significantly different (26% vs 17%; = 0.3). Although a brief behavioral intervention among high-risk female adolescents can increase condom use by their sexual partners, incident infection does not appear to be reduced, because condom use remained inconsistent. (J P 1996;128:288-95 )
    Keywords: Medicine
    ISSN: 0022-3476
    E-ISSN: 1097-6833
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  • 7
    In: Sexually Transmitted Diseases, 2016, Vol.43(12), pp.741-749
    Description: BACKGROUND: Sexual transmission rates of Chlamydia trachomatis (Ct) cannot be measured directly; however, the study of concordance of Ct infection in sexual partnerships (dyads) can help to illuminate factors influencing Ct transmission. METHODS: Heterosexual men and women with Ct infection and their sex partners were enrolled and partner-specific coital and behavioral data collected for the prior 30 days. Microbiological data included Ct culture, and nucleic acid amplification testing (NAAT), quantitative Ct polymerase chain reaction, and ompA genotyping. We measured Ct concordance in dyads and factors (correlates) associated with concordance. RESULTS: One hundred twenty-one women and 125 men formed 128 dyads. Overall, 72.9% of male partners of NAAT-positive women and 68.6% of female partners of NAAT-positive men were Ct-infected. Concordance was more common in dyads with culture-positive members (78.6% of male partners, 77% of female partners). Partners of women and men who were NAAT-positive only had lower concordance (33.3%, 46.4%, respectively). Women in concordant dyads had significantly higher median endocervical quantitative Ct polymerase chain reaction values (3,032) compared with CT-infected women in discordant dyads (1013 inclusion forming units DNA equivalents per mL; P 〈 0.01). Among 54 Ct-concordant dyads with ompA genotype data for both members, 96.2% had identical genotypes. CONCLUSIONS: Higher organism load appears associated with concordance among women. Same-genotype chlamydial concordance was high in sexual partnerships. No behavioral factors were sufficiently discriminating to guide partner services activities. Findings may help model coitus-specific transmission probabilities.
    Keywords: Chlamydia Infections -- Genetic Aspects ; Chlamydia Infections -- Development And Progression ; Virulence (Microbiology) -- Genetic Aspects ; Genotypes -- Health Aspects ; Disease Susceptibility -- Genetic Aspects;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 8
    Language: English
    In: Statistics in Medicine, 1992, Vol.11(5), pp.565-577
    Description: Estimates of transmission probabilities for sexually transmitted diseases historically come from studies of uninfected individuals exposed to those with a high disease prevalence (for example, prostitutes). However, changes in sexual behaviour, much of which relates to concerns about AIDS, has made identification of populations suitable for such studies extremely difficult. This paper presents a method for estimating these probabilities that utilizes a deterministic model and routinely collected data available in many clinics. Variance estimates for the estimators are also derived. Data for chlamydial infection and sensitivity analyses for the input parameters and assumptions illustrate the method.
    Keywords: Chlamydia Trachomatis ; Models, Statistical ; Chlamydia Infections -- Transmission ; Sexually Transmitted Diseases, Bacterial -- Transmission;
    ISSN: 0277-6715
    E-ISSN: 1097-0258
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  • 9
    Language: English
    In: The Journal of Infectious Diseases, 1 April 1989, Vol.159(4), pp.661-669
    Description: To determine whether concurrent gonorrhea reactivates latent chlamydial infection, we studied 74 recurrent chlamydial infections and the effect of concurrent gonorrhea at the recurrent episode on the chlamydial serovar identified. Serotyping of 74 recurrent pairs of chlamydial isolates from patients attending a sexually transmitted diseases clinic indicated that 47.1% (16 of 34) with gonorrhea at the time of recurrence harbored chlamydiae of the same serovar as at the initial infection, while only 22.5% (9 of 40) without gonorrhea had the same serovar (P = .03). The proportion of recurrences by the same serovar in the group without gonorrhea did not differ from the proportion predicted by a random exposure model (22.2% vs. 18.4%, P = .46), while the proportion in the gonorrhea group did (47.1% vs. 19.8% P 〈 .0001). The possibility of reinfection did not appear more likely in the group with gonorrhea than in the group without. These observations support the hypothesis that concurrent gonorrhea can reactivate latent chlamydial infection.
    Keywords: Health sciences -- Medical conditions -- Infections ; Health sciences -- Medical conditions -- Infections ; Biological sciences -- Biology -- Microbiology ; Health sciences -- Medical sciences -- Immunology ; Health sciences -- Medical conditions -- Diseases ; Health sciences -- Medical sciences -- Immunology ; Health sciences -- Medical conditions -- Diseases ; Health sciences -- Medical conditions -- Infections ; Social sciences -- Population studies -- Human populations ; Biological sciences -- Biology -- Anatomy
    ISSN: 00221899
    E-ISSN: 15376613
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  • 10
    Language: English
    In: Statistics in Medicine, July 1988, Vol.7(7), pp.795-804
    Description: For a series of data points that follow a pattern due to natural ordering, I develop a modified runs test for continuous data to detect such a pattern. The test statistic is the number of runs in the series after having smoothed the data with use of a moving average. The testing procedure is based on permutations of the original data. My simulations indicate that the modified test is generally more powerful than the usual runs test.
    Keywords: Permutation Test ; Test For Randomness ; Simulation
    ISSN: 0277-6715
    E-ISSN: 1097-0258
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