Sexually transmitted infections (STIs) are a common health problem in all populations; however, female adolescents are at increased risk for acquiring STIs and their complications. Their increased risk of acquiring STIs is due to their behavior, anatomy. and lack of knowledge about STIs. STIs have many complications in women. Some complications include: pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain, and infertility. The purpose of this integrative review is to identify current sexual behaviors of female adolescents, and to find strategies at preventing or reducing STIs within this population. Nurses and other health care providers need to know the current statistics of STIs in adolescent females, and need to understand their current sexual behaviors in order to implement effective preventative strategies.

Thesis (M.A. (Clinical Psychology)) -- University of Limpopo, 2022 / Sexually transmitted infections (STIs) remain a serious global health challenge, which if left untreated, may threaten an individual’s health. The challenge regarding the prevention of STI transmission is the asymptomatic nature of STIs during their early stages. Hence, STI testing is vital in tackling the devastating impact of STIs. The Health Belief Model (HBM) provided a lens through which to understand the study as it provides a basis upon which to predict health behaviours. The study employed a qualitative research method. The study aimed to explore University of Limpopo students’ perceptions towards STI testing. The objectives of the study were (1) to establish the perceptions of second-year Psychology students at the University of Limpopo towards STI testing, and (2) to determine the importance of testing for STIs among second-year Psychology students at the University of Limpopo. The study purposively sampled 15 second-year Psychology students at the University of Limpopo. It was found that the participants were knowledgeable about STI testing. The study revealed psychological effects associated with STI testing ranging from anxiety-related attacks, stress, depression, and insomnia, among others. It further revealed important aspects learned about STI testing, i.e. that some STIs are curable, early detection facilitate early treatment, and STIs are not a myth. The importance of STI testing was also determined. It was also noted that it is important to know one’s health status to prevent mother-to-child transmission and health consequences. The study further established the experiences of STI testing, such as anxiety, stress, feeling embarrassed, ashamed, and overwhelmed. In addition, it was found that students are reluctant to test for STIs because of low-risk perception of contracting STIs, the fear of receiving positive test results, lack of knowledge, stigma, and the judgemental attitude of health professionals. The findings also revealed that students consider testing to be a good health behaviour, although the majority of them rarely consult for STI testing. Constructive counselling is highly recommended for those who consult for STI testing. It is further recommended that future research should be conducted in other universities with broader sample size.

Due to wealth of advantages offered by short range ultra wideband (UWB) technology, such as capacity improvement, fading reduction and localization, it has gathered a considerable attention. Distinct UWB qualities also pose many system design challenges like difficulties in using digital processing, complex channel estimation and different propagation characteristics. The main objective of the thesis is to develop and evaluate efficient modulation and detection schemes for impulse radio (IR) UWB with a focus on wireless sensor networks characterized by low cost and low power consumption. The content of the thesis comprises of five parts. In Part I, a coherent RAKE and non-coherent energy detector (ED) and transmitted reference (TR) receivers are examined and their bit-error-rate (BER) performance is evaluated using channels measured in an industrial environment. In specific, selective RAKE (SRake) and partial RAKE (PRake) for both maximal ratio combining (MRC) and equal gain combining (EGC) are compared. Based on the analysis and simulation results, it is concluded the SRake with EGC is to be preferred, whereas the best complexity/performance trade-off is provided by the ED based receivers. Part II presents several signaling and detection schemes; the proposed schemes are recursive TR (R-TR), dual-doublet TR (DDTR), doublet-shift TR (DSTR) and binary pulse position modulation (BPPM)/DSTR. Analysis and simulations verify that the proposed schemes may be preferred over the conventional TR in terms of BER, energy efficiency and/or implementation complexity. Part III presents a non-coherent kurtosis detector (KD) and a fourth-order detector (FD), which can discriminate between Gaussian noise and non-Gaussian IR-UWB signals by directly estimating the fourth-order moment of the received signal. Empirical evaluations and simulations using channel measurements conducted in a corridor, an office and a laboratory environment verify that performance of the proposed FD receiver is slightly better than the ED in the low SNR region and its performance improves as the SNR increases. Part IV presents a robust weighted ED (WED) in which the weighting coefficients are estimated adaptively based on the received stochastic data. Simulation results confirm that performance of the proposed weight estimation method is close to that of a data-aided (DA) scheme. Finally, Part V focuses on a multi-user scenario and develops a weighted code-multiplexed TR (WCM-TR) receiver employing the robust adaptive weight estimation scheme. Secondly, a BPPM/CM-TR UWB system is presented to mitigate inter-frame interference (IFI) and multi-user interference (MUI) from other asynchronous users. The BPPM/CM-TR system is 3 dB energy-efficient and improves the BER performance by mitigating MUI/IFI in the high SNR region, while for the low SNR case and single-user scenario, a dual-mode BPPM/CM-TR system is suggested

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Chlamydia and gonorrhea are among the most frequently reported infectious diseases in the United States. These two diseases are easily treated with antibiotics; however, challenges exist in providing treatment to cases and their sexual partners. Maricopa County implemented a Field Delivered Therapy (FDT) protocol to treat chlamydia and gonorrhea cases and contacts in 2009. Ultimately, this project sought to inform other public health departments across the United States regarding the benefits of FDT program to treat gonorrhea and chlamydia and provide better insight on how to treat the two most commonly reported infectious diseases. Existing data was analyzed from April 1, 2011 to October 31, 2014 (42 months) for all patients that received FDT in Maricopa County utilizing pharmacy records and electronic health records (PRISM and eClinicalWorks). The following pieces of information were collected from these data sources: gender, age, race/ethnicity, diagnosis, number of partners, and time to treatment. The data were then divided into four FDT groups (FDT, expedited partner therapy via FDT, FDT attempted and FDT planned). There were 172 patients in this analysis; 140 diagnosed or in contact with chlamydia and 16 diagnosed or in contact with gonorrhea. There were 79 patients (45.9%) in the FDT group, 28 (16.3%) in the FDT EPT group, 28 (16.3%) in the FDT attempted and 37 (21.5%) in the FDT planned group. The median age of these patients was 23.8 (range 16.6‐31); 111 (64.5%) were female. The median time to treatment for these patients was 24.6 days (range 0‐64.5 days). Most patients (79.6%) lived outside of central Phoenix. The median number of sexual partners reported by these patients was 6.6 (range 1‐19.7 partners). A majority of the patients were <25 years old, except for in the FDT EPT group where 100% of patients were >25 years old. And the group with the largest <19‐year‐old population (32%) was in the FDT group. All the groups had a female majority, except in the FDT EPT group where 75% of the patients were male. Most patients in the FDT only group received testing at an outside hospital or outpatient clinic, while the FDT attempted and planned were more often tested at the STD clinic. Future Direction/Conclusion Many of the patients that received FDT are young women, some pregnant, that lived outside of Central Phoenix. However, a majority of the overall clients that received expedited partner therapy via FDT were male, a typically hard to reach population for treatment of potentially asymptomatic infections. This study demonstrates an effective method of delivering partner treatment to men. This study can be used to inform other public health departments about this novel practice and to help Maricopa County grow their FDT program to reach even more untreated patients.

Introduction: Youth (15-24) have the highest prevalence of sexual transmitted infections (STI) among all the age groups and this has been attributed to high sexual risk behaviour and low condom use in this group. The use of condoms by youth is negotiated through a complex array of personal and social factors. Aim: The aim of this study was to explore the perceptions of Swedish youth on the factors that affect their use of condoms to protect against STI.  Methodology: The data collection was done over a period of 3 months using semi-structured interviews and focus group discussions (FGD) and the collected data was analysed with thematic analysis. Findings: Participants perceived that different factors across intimate social circle, community and access to condoms influence the use of condoms by youth in Sweden. The lack of information from the media, embarrassment as a barrier to obtaining condoms and the influence of parents on condom use were prominent findings. Conclusion: Efforts to improve condom use by youth will benefit from exploring the different factors that inform youth’s perceptions on condom use. Opportunities for improvement identified in this study include the installation of condom vending machines, promoting condom use through the mass media and parents discussing condoms with their children.

Bartonella bacilliformis is a pathogen that is endemic in some areas of the Andean region of Peru, southern Ecuador and southern Colombia. This pathogen causes so-called Carrion's disease, a biphasic disease with acute and chronic phases (called Oroya fever and "Peruvian wart" respectively1-3). In the absence or delay of antibiotic treatment, the mortality rate in the acute phase is up to 88%1. The acute phase is characterised by fever and severe anaemia and may be followed, several weeks or months later, by the chronic eruptive phase due to endothelial cell proliferation2. No animal reservoir has been identified to date and it is considered that healthy carriers act as a pathogen reservoir in endemic areas

Student Number : 9813645X - PhD thesis - Faculty of Health Sciences / Epidemiological information on sexually transmitted infections (STIs) is necessary to assess the magnitude of the burden of infections, to identify vulnerable population groups, to mobilise resources for intervention activities and to monitor the impact of these activities. In addition, specific STI surveillance systems, such as studies on the relative prevalence of aetiological agents of STI syndromes and their antimicrobial susceptibility patterns, are aimed at improving patient care. The studies included in this thesis were designed and implemented to improve our understanding of the epidemiology of STIs and HIV infection in southern Africa. In all the study populations, we observed that high level STI epidemics preceded the explosive spread of HIV infection among high-risk individuals. The studies reported here also demonstrate the importance of triangulating data collected from different recommended STI surveillance components, using a tiered surveillance approach. The studies reported here also explored the bidirectional interactions of HIV and STIs. We observed that different STIs have shown different magnitudes of interaction with HIV infection. We found particularly strong interactions between genital herpes and HIV. At the individual level, HIV-seropositive patients with genital herpes were more frequently found to have atypical clinical presentations, delays in spontaneous healing, longer duration of HSV shedding and increased association with HIV shedding from ulcer and genital exudates. Mixed infections involving chancroid and genital herpes were found to be common, particularly in HIV-seropositive patients. The effectiveness of syndromic treatment targeting only bacterial causes of genital ulceration was significantly reduced due to persistent ulcerations as a result of co-infection with genital herpes. The successful treatment of herpes in men and women was found to be associated with a decline or cessation in HIV shedding into ulcer exudates or genital fluid. The studies have also shown that HIV plasma viral load is the main determinant for HIV shedding in both men and women presenting with STIs. As was the case with HSV infection, there was a strong association between HIV and HPV infection in both men and women. A higher prevalence of HPV infection was found among HIV-seropositive patients in our study population and this may reflect the higher frequency of recurrences and/or longer duration of infection (i.e. persistency). The studies also found that the biological false positive reactions in syphilis serology (i.e. RPR) are not a common occurrence in our HIV-seropositive study population. On the other hand, syphilis serology could be falsely negative in patients with PCR-confirmed primary syphilis who are co-infected with HIV and other aetiological agents causing GUD. In conclusion, the findings of our studies have supported the bidirectional nature of interactions between conventional STIs and HIV infection in southern Africa.

Abstract: Background: The global estimated adult and child deaths from HIV/AIDS in 2006 were 2.9 million and those living with HIV stood at 39.5 million. Of the HIV deaths, 72% (2.1 million) occurred in Sub-Saharan Africa (SSA). Two thirds (63%) of all adults and children with HIV globally live in, with its epicenter in Southern Africa. One third (32%) of all people with HIV globally live in Southern Africa and 34% of all deaths due to AIDS in 2006 occurred there. In South Africa, a total of 5.5 million people, including 240,000 children younger than 15 years, were living with HIV in 2005. HIV data gathered in the country’s antenatal clinic surveillance system suggest that HIV prevalence has not yet reached a plateau. There is a continuing trend nationally in HIV infection levels among pregnant women attending public antenatal clinics: from 22.4% in 1999 to 30.2% in 2005 (a 35% increase). Aim: The aim of this study was to assess sexual practices, the prevalence of condom usage and sexually transmitted diseases, and their associations among 930 men and women aged 15-60 years in Orange farm South Africa. Objectives: 1. To determine condom usage among males and females aged 15–60 year old. 2. To determine the number of new partners, short-term partners and unprotected sexual acts in this particular age group of men and women. 3. To assess the prevalence of sexually transmitted diseases in this age group. 4. To assess the relationship between sexual practices and sexually transmitted diseases in this community. Methods: The project was a secondary data analysis of a population-based, cross-sectional study was conducted in Orange Farm, South Africa in 2002. The original study involved 930 men and women respondents. A two-stage random sampling technique was used to select households. A self-weighting random sample of twenty households was chosen from clusters of 15 households. All men and women aged 15 to 60 years, who slept in the selected households the night before the study team’s visit, were eligible for inclusion in the study. The main focus of this secondary study was to analyze the baseline data collected for the level and risk factors for sexually transmitted diseases in this age group. All 930 men and women were included in the analysis. Results: The risk factor under consideration viz: condom usage was not optimal, and the prevalence of sexually transmitted disease is high in this population with HIV prevalence at 21.8%. Women in the age-group 15-24 years were disproportionately more affected by HIV in this community as compared to men. Among the HIV positive respondents, 61.8% had at least single or over 2 non-spousal partners in the last year. At the time of the interviews, 34.7% had never used condoms and 84.3% did not use condoms in any of the sexual episodes of the last month. Conclusion: An important goal is to practice partner reduction and to encourage especially those who are single to use condoms consistently. Further qualitative research on sexual behaviours involving focus group discussions, in-depth interviews or participant observation should be conducted in this community to complement the quantitative methods. They produce results that directly represent how people feel and provide information on behaviour through the observation of events and activities.

MSc (Med), Epidemiology and Biostatistics, University of the Witwatersrand / Introduction This secondary data analysis of a prospective cohort study set out to describe the association between the use of hormonal contraception and sexually transmitted infection (STI) acquisition in a cohort of 752 HIV negative women who were followed up for a year. Methods Outcome variables were measured by standard laboratory tests (PCR for Chlamydia trachomatis (CT) and Neiserria gonorrhoea (NG), culture for Trichomonas vaginalis (TV) and gram stain with Nugent score for Bacterial Vaginosis (BV). Exposure variable information was collected by structured interview. Basic descriptive statistics were applied to describe the characteristics of the cohort, including a comparison of women who used contraception and those who did not. A time series analysis including incidence rates for the outcomes (CT, NG, TV and BV), Kaplan Meier curves for time to event measurement and Cox regression models (univariate and multivariate), for the estimation of risk were applied. Results The analysis found no significant difference between women who use hormonal contraception and those who did not with respect to baseline demographic characteristics. Incidence rates per 100 women years to follow up with 95% confidence intervals were: CT 13 (7 to 17), NG 2 (1 to 4), TV 6 (4 to10), BV 72 (63 to 83). Kaplan Meier curves showed no significant difference in time to event between women who used contraception and those who did not. Adjusted hazard ratios for women who used contraception was 1.12 (0.69 to1.82) for CT, 0.47 (0.17 to 1.30) for NG, 1.06 (0.48 to 2.34) for TV and 0.27 (0.05 to 1.52) for BV. Conclusion This analysis did not reveal any significant associations between the use of hormonal contraception and the acquisition of STIs, however the trends in risks follow those reported in the literature.

Thesis (M.Pharm.)--University of the Witwatersrand, Faculty of Health Sciences, 2013. / Sexually transmitted infections (STIs) are a global concern and more specifically southern Africa has seen a tremendous upsurge in infection rates. KwaZulu-Natal is the province found to have the highest Human Immunodeficiency Virus and STI infection rates. From an ethnobotanical study conducted specifically in northern Maputaland (Mabibi, Tshongwe, Mseleni and Mbazwana), it was found that the lay people most often used plants in various combinations for the treatment of STI related symptoms. The use of these plant combinations were thus antimicrobially investigated and the toxicity properties determined. The dichloromethane: methanol (organic) and aqueous extracts were prepared for each plant in situ using collected ground dried plant material. The plants (individually and in combination) were investigated for toxic potential using the 3-[4,5-dimethyl-2-thiazol-yl]-2,5-diphenyl-2H-tetrazolium bromide (MTT) cellular viability assay on the human kidney epithelial (Graham) cell line. The antimicrobial activities for each sample, as well as for each combination, were then further investigated using the minimum inhibitory concentration (MIC) assay. The six STI pathogens investigated in this study were Candida albicans (ATCC 10321), Ureaplasma urealyticum (clinical strain), Oligella ureolytica (ATCC 43534), Gardnerella vaginalis (ATCC 14018), Trichomonas vaginalis (clinical strain) and Neisseria gonnorhoeae (ATCC 19424).