Journal of Preventive Medicine

Abstract

Porter Novelli's DocStyles survey, a US nationally representative semi-annual web-based survey of healthcare providers, included a number of questions in fall 2020 to gauge healthcare providers' awareness of the Nucleic acid amplification tests (NAATs) for chlamydia and gonorrhea that use extragenital specimens were approved by the Food and Drug Administration (FDA) in 2019.This study included 1502 respondents, including 251 obstetricians/gynecologists (OBs/GYNs), 1000 family practitioners/internists (PCPs), and 251 nurse practitioners/physician assistants (NP/PAs). Awareness of this FDA approval varied significantly by provider specialty, reaching 34.3% overall. 45.0 percent for OB/GYN and 23.5 percent for NP/PA, p 0.01. Compared to the other providers (ranging from 46.2% for NP/PA to 60.7% for PCP), the OB/GYN had the lowest rate of ordering any extragenital gonorrhea or chlamydia tests in the previous year (31.6%). If respondents had ordered extragenital chlamydia or gonorrhea testing for men who have sex with men (MSM), they were more likely to be aware of the FDA approval (72.3% vs. 43.7%, p 0.01) than respondents who did not order the tests for MSM. Lack of reimbursement as a barrier to ordering extragenital tests for chlamydia and gonorrhea was mentioned the most (16.6%) of the time among the 1502 respondents, and it did not significantly differ by provider's specialty. Healthcare providers need to be made aware of the changes to the FDA's approval for testing for chlamydia and extragenital gonorrhea through additional outreach. This will help them provide comprehensive care to their patients and reduce the risk of developing antimicrobial resistance. Sexually Transmitted Infections (STIs) are a persistent problem for global health that causes a lot of illness and death. According to Rowley et al., each day, nearly 1 million new curable STIs are diagnosed worldwide. 2019). 127.2 million new cases of Chlamydia trachomatis, 86.9 million new cases of Neisseria gonorrhoeae, 156 million new cases of Trichomonas vaginalis, and 6.3 million new cases of syphilis were reported in the United States alone in. An estimated half of new infections in adolescents and young adults in the United States occur between the ages of 15 and 25.

High Prevalence

This chapter focuses on youth ages 13 to 24 and the STIs most prevalent in this age group because of the high prevalence of these STIs among adolescents and young adults: Syphilis, N. gonorrhoeae (gonorrhea), C. trachomatis (chlamydia), Trichomonas vaginalis (trichomonas), and Genital Herpes Simplex Virus (HSV; herpes). The following is a discussion of numerous biological, psychological/behavioral, social, and risk factors for STIs in youth. Although the Human Immunodeficiency Virus (HIV) will not be discussed in this chapter, it is important to note that both bacterial and viral Sexually Transmitted Infections (STIs) increase HIV transmission and acquisition (CDC, 2021). An optimal control analysis-based model of Chlamydia Trachomatis (CT) and Gonorrhea codynamics is studied and analyzed to determine the effect of targeted treatment for each disease on their co-infections in a population. When the associated reproduction number is less than one, the gonorrhea-only sub-model reveals the existence of a stable Disease Free Equilibrium (DFE) and a stable Endemic Equilibrium (EE). When the reproduction number is lower than one, it is demonstrated that the DFE of the gonorrhea-only sub-model is globally asymptotically stable in the absence of re-infection. When there is more than one reproduction, it is also shown that the endemic equilibrium of the gonorrhea-only submodel is globally asymptotically stable. The entire model is shown to undergo backward bifurcation when the associated reproduction number is less than unity by applying the Centre Manifold Theory. The Pontryagin's Maximum Principle is utilized in the process of establishing the optimality system for the co-infection model. The total number of females and males co-infected with CT and gonorrhea decreases when male gonorrhea treatment is implemented. Additionally, the total number of females and males co-infected with CT and gonorrhea decreases when female gonorrhea treatment is implemented. Additionally, carrying out female CT treatment and male gonorrhea treatment deflects the most elevated co-tainted cases, in examination with all the mediation procedures. Retesting for Chlamydia Trachomatis/Neisseria Gonorrhea (CT/NG) three months after diagnosis is a strategy that is recommended by the guideline to find new infections. The U.S. Sexually Transmitted Infections National Strategic Plan prioritizes adolescents and young adults, but CT/NG retesting research has not been conducted on these populations. This study examines the relationship between patient-level factors and CT/NG retesting among adolescents and young adults treated at Title X and non-Title X clinics following a CT/NG diagnosis. Retesting for Chlamydia Trachomatis/Neisseria Gonorrhea (CT/NG) three months after diagnosis is a strategy that is recommended by the guideline to find new infections. The U.S. Sexually Transmitted Infections National Strategic Plan prioritizes adolescents and young adults, but CT/NG retesting research has not been conducted on these populations.

Genitourinary Medicine

Using surveillance data from the Genitourinary Medicine Clinic Activity Dataset and the Gonococcal Resistance to Antimicrobials Surveillance Programme on men who have sex with men (MSM) in England, we developed an integrated transmission-dynamic health-economic model and calibrated it using Bayesian methods. We compared three realistic approaches to targeting and looked at MSM vaccination from the perspective of sexual health clinics, both with and without vaccination offered to all adolescents in schools (vaccination before entry, or VbE). vaccination at the time of testing (VoA); vaccination following gonorrhea diagnosis (VoD); or a vaccination based on risk (VaR), given to people who have been diagnosed with gonorrhea and to people who test negative but say they have more than five sexual partners a year. In a conservative baseline scenario in which time-varying behavioral parameters (such as sexual risk behavior and screening rates) stabilize, the impact of vaccination was compared to the absence of vaccination for the primary analysis. The averted costs of testing and treatment were added to the monetary value of quality-adjusted life-year (QALY) gains, with a QALY valued at £20,000, to determine the value of vaccination per dose administered. The costs were in GB£ for the 2018–19 period, and both the costs and the QALYs were discounted by 3•5% annually. We looked at how vaccine uptake (five, one, and two times HPV vaccine uptake by MSM in England's sexual health clinics), vaccine efficacy (one to one hundred percent), duration of protection (one to twenty years), and the time horizon considered had an impact. We also used assumed vaccine prices to calculate incremental cost-effectiveness ratios for the use of 4CMenB. Oropharyngeal gonorrhea transmission and prevalence in heterosexuals are poorly documented. In August 2017, the Melbourne Sexual Health Centre (MSHC) began testing heterosexuals with untreated urogenital gonorrhoea for oropharyngeal gonorrhoea. The purpose of this study is to determine whether heterosexual MSHC patients with urogenital gonorrhea who were diagnosed between August 2017 and May 2020 have oropharyngeal gonorrhea. This study examines the relationship between patient-level factors and CT/NG retesting among adolescents and young adults treated at Title X and non-Title X clinics following a CT/NG diagnosis.