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      Risk factors associated with sexually transmitted infections and HIV among adolescents in a reference clinic in Madrid

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          Abstract

          Introduction

          Adolescents have a higher incidence of sexually transmitted infections (STIs) than persons of older age groups. The WHO emphasises the need to adopt specific and comprehensive prevention programmes aimed at this age group. The objective of this work was to analyse the prevalence of HIV/STIs among adolescents and to identify the sociodemographic, clinical and behavioural markers associated with these infections, in order to promote specific preventive strategies.

          Methodology

          Retrospective descriptive study of adolescents, aged 10–19 years, who were attended to for the first consultation between 2016 and 2018 in a reference STI clinic in Madrid. All adolescents were given a structured epidemiological questionnaire where information on sociodemographic, clinical and behavioural characteristics was collected. They were screened for human inmmunodeficiency virus (HIV) and other sexually transmitted infections (STIs). The processing and analysis of the data was done using the STATA 15.0 statistical package.

          Results

          The frequency of HIV/STIs detected among all adolescents was: gonorrhoea 21.7%, chlamydia 17.1%, syphilis 4.8% and HIV 2.4%. After conducting a multivariate analysis, the independent and statistically significant variables related to the presence of an STI were having first sexual relations at a young age and having a history of STIs. Latin American origin was just below the level of statistical significance (p = 0.066).

          Discussion/Conclusions

          Adolescents who begin sexual relations at an early age or those who have a history of HIV/STIs are at higher risk of acquiring STIs. Comprehensive prevention programmes aimed specifically at adolescents should be implemented, especially before the age of 13 years.

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          Most cited references15

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          Impact of text and email messaging on the sexual health of young people: a randomised controlled trial.

          Christopher Fairley, M E Hellard, Megan Lim … (2011)
          To carry out a randomised controlled trial on the effect of a new method of health promotion-email and mobile phone text messages (short messaging service (SMS))-on young people's sexual health. 994 people aged 16-29 were recruited at a music festival to a non-blinded randomised controlled trial. Participants were randomised to either receive sexual health promotion messages (n=507) or the control group (n=487). The 12-month intervention included SMS (catchy sexually transmissible infections prevention slogans) and emails. Participants completed questionnaires at the festival at baseline and online after 3, 6 and 12 months. Outcomes were differences between the control and intervention groups in health-seeking behaviour, condom use with risky partners (new or casual partners or two or more partners within 12 months) and STI knowledge. 337 (34%) completed all three follow-up questionnaires and 387 (39%) completed the final questionnaire. At 12 months, STI knowledge was higher in the intervention group for both male (OR=3.19 95% CI 1.52 to 6.69) and female subjects (OR=2.36 95% CI 1.27 to 4.37). Women (but not men) in the intervention group were more likely to have had an STI test (OR=2.51, 95% CI 1.11 to 5.69), or discuss sexual health with a clinician (OR=2.92, 95% CI 1.66 to 5.15) than their control counterparts. There was no significant impact on condom use. Opinions of the messages were favourable. This simple intervention improved STI knowledge in both sexes and STI testing in women, but had no impact on condom use. SMS and email are low cost, popular and convenient, and have considerable potential for health promotion. Australian Clinical Trials Registry - ACTRN12605000760673.
          Article 0 comments Cited 69 times – based on 0 reviews     Review now
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            Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions

            Elizabeth C Tilson, Victoria Sánchez, Chandra L Ford … (2004)
            Background Sexually transmitted diseases (STDs) are a major public health problem among young people and can lead to the spread of HIV. Previous studies have primarily addressed barriers to STD care for symptomatic patients. The purpose of our study was to identify perceptions about existing barriers to and ideal services for STDs, especially asymptomatic screening, among young people in a southeastern community. Methods Eight focus group discussions including 53 White, African American, and Latino youth (age 14–24) were conducted. Results Perceived barriers to care included lack of knowledge of STDs and available services, cost, shame associated with seeking services, long clinic waiting times, discrimination, and urethral specimen collection methods. Perceived features of ideal STD services included locations close to familiar places, extended hours, and urine-based screening. Television was perceived as the most effective route of disseminating STD information. Conclusions Further research is warranted to evaluate improving convenience, efficiency, and privacy of existing services; adding urine-based screening and new services closer to neighborhoods; and using mass media to disseminate STD information as strategies to increase STD screening.
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              High human immunodeficiency virus incidence in a cohort of Rwandan female sex workers.

              Chantal Ingabire, Lambert Mwamarangwe, Evelyne Kestelyn … (2011)
              Measurement of human immunodeficiency virus(HIV) incidence among female sex workers in Rwanda is a key part of preparing for HIV prevention trials. HIV-negative, nonpregnant female sex workers (N =397) were tested for HIV-1, sexually transmitted infections, and pregnancy quarterly for 12 months, and again at a 1-time year 2 visit. Additional women (N=156) were tested for HIV at baseline and 6 to 12 months thereafter in a parallel study. A total of 19 participants seroconverted during follow-up,with 13 in the first 12 months. The 12-month HIV incidence rate (IR)was 3.5 (95% confidence interval: 1.6, 5.4) per 100 person-years (PY).There was a nonsignificant downward trend from 4.6/100 PY (1.6, 7.7)in the first 6 months to 2.2 (0.1, 4.4) in the second 6 months (IR ratio:2.1 [95% confidence interval: 0.7, 7.8]). The year 2 IR was 2.1 (0.4,3.7), and the HIV IR in the parallel study (in the absence of frequent study visits) was 3.3/100 PY (0, 7.0). HIV testing history, lifetime pregnancies, recent initiation of sex work, gonorrhea, syphilis, and change in reproductive intentions were associated with incident HIV infection. Incidence of pregnancy, herpes simplex virus-type 2,trichomoniasis, gonorrhea, chlamydia, and syphilis per 100 PY were as follows: 26.3 (21.9, 30.7), 8.7 (4.0, 13.4), 16.9 (12.7, 21.1), 12.1 (8.2,15.9), 8.1 (5.1, 11.2), and 6.2 (3.7, 8.7). The HIV/sexually transmitted infections burden int his group was high. HIV IR was highest in the first 6 months of the cohort, and in the parallel study in which there were no risk-reduction procedures. HIV prevention and family planning interventions are needed.
              Article 0 comments Cited 38 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Oskar Ayerdi Aguirrebengoa:
                ORCID: http://orcid.org/0000-0002-9441-8031
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Mar Vera Garcia: Role: ConceptualizationRole: Data curationRole: Visualization
                Montserrat Rueda Sanchez: Role: Data curationRole: Formal analysisRole: Writing – original draft
                Giovanna D´Elia: Role: Data curationRole: Formal analysisRole: Writing – original draft
                Belén Chavero Méndez: Role: Data curationRole: Formal analysisRole: Writing – original draft
                María Alvargonzalez Arrancudiaga: Role: Data curationRole: Formal analysisRole: Writing – original draft
                Sandra Bello León: Role: Data curationRole: Formal analysisRole: Writing – original draft
                Teresa Puerta López: Role: Data curationRole: SupervisionRole: Writing – review & editing
                Petunia Clavo Escribano: Role: Data curationRole: SupervisionRole: Writing – review & editing
                Juan Ballesteros Martín: Role: Data curationRole: SupervisionRole: Writing – original draft
                Blanca Menendez Prieto: Role: Data curation
                Manuel Enrique Fuentes: Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Writing – review & editing
                Mónica García Lotero: Role: Data curationRole: Project administration
                Montserrat Raposo Utrilla: Role: Data curationRole: Formal analysisRole: MethodologyRole: Project administration
                Carmen Rodríguez Martín: Role: ConceptualizationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Jorge Del Romero Guerrero: Role: ConceptualizationRole: Data curationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Remco PH Peters: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 16 March 2020
                Publication date Collection: 2020
                Volume: 15
                Issue: 3
                Electronic Location Identifier: e0228998
                Affiliations
                [1 ] Centro Sanitario Sandoval, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
                [2 ] Hospital Fundación Jiménez Díaz, Madrid, Spain
                [3 ] Servicio Estadística, Hospital Clínico San Carlos, Madrid, Spain
                University of Pretoria, SOUTH AFRICA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-9441-8031
                Article
                Publisher ID: PONE-D-19-33032
                DOI: 10.1371/journal.pone.0228998
                PMC ID: 7075699
                PubMed ID: 32176884
                SO-VID: 500bcd9d-d41e-4b8a-87ad-d05cd7597b35
                Copyright © © 2020 Aguirrebengoa et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 2 December 2019
                Date accepted : 27 January 2020
                Page count
                Figures: 1, Tables: 3, Pages: 10
                Funding
                There was no funding for this study.
                Categories
                Subject: Research Article
                Subject: People and Places
                Subject: Population Groupings
                Subject: Age Groups
                Subject: Children
                Subject: Adolescents
                Subject: People and Places
                Subject: Population Groupings
                Subject: Families
                Subject: Children
                Subject: Adolescents
                Subject: Medicine and health sciences
                Subject: Epidemiology
                Subject: HIV epidemiology
                Subject: People and Places
                Subject: Population Groupings
                Subject: Sexuality Groupings
                Subject: Men WHO Have Sex with Men
                Subject: Medicine and Health Sciences
                Subject: Infectious Diseases
                Subject: Sexually Transmitted Diseases
                Subject: Medicine and Health Sciences
                Subject: Infectious Diseases
                Subject: Sexually Transmitted Diseases
                Subject: Chlamydia Infection
                Subject: Biology and Life Sciences
                Subject: Psychology
                Subject: Behavior
                Subject: Human Sexual Behavior
                Subject: Social Sciences
                Subject: Psychology
                Subject: Behavior
                Subject: Human Sexual Behavior
                Subject: Biology and Life Sciences
                Subject: Organisms
                Subject: Bacteria
                Subject: Chlamydia
                Subject: Medicine and Health Sciences
                Subject: Urology
                Subject: Genitourinary Infections
                Subject: Syphilis
                Subject: Medicine and Health Sciences
                Subject: Infectious Diseases
                Subject: Sexually Transmitted Diseases
                Subject: Syphilis
                Subject: Medicine and Health Sciences
                Subject: Infectious Diseases
                Subject: Bacterial Diseases
                Subject: Treponematoses
                Subject: Syphilis
                Subject: Medicine and Health Sciences
                Subject: Tropical Diseases
                Subject: Neglected Tropical Diseases
                Subject: Treponematoses
                Subject: Syphilis
                Custom metadata
                Data Availability All relevant data are within the manuscript and its Supporting Information files.

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

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