Partial protection against chlamydial reproductive tract infection by a recombinant major outer membrane protein/CpG/cholera toxin intranasal vaccine in the guinea pig Chlamydia cavaie model

Chlamydia trachomatis is a major cause of sexually transmitted diseases worldwide. There currently is no vaccine to protect against chlamydial infection of the female reproductive tract. Vaccine development has predominantly involved using the murine model, however infection of female guinea pigs with Chlamydia caviae more closely resembles chlamydial infection of the human female reproductive tract, and presents a better model to assess potential human chlamydial vaccines. We immunised female guinea pigs intranasally with recombinant major outer membrane protein (r-MOMP) combined with CpG-10109 and cholera toxin adjuvants. Both systemic and mucosal immune responses were elicited in immunised animals. MOMP-specific IgG and IgA were present in the vaginal mucosae, and high levels of MOMP-specific IgG were detected in the serum of immunised animals. Antibodies from the vaginal mucosae were also shown to be capable of neutralising C. caviae in vitro. Following immunisation, animals were challenged intravaginally with a live C. caviae infection of 102 inclusion forming units. We observed a decrease in duration of infection and a significant (p<0.025) reduction in infection load in r-MOMP immunised animals, compared to animals immunised with adjuvant only. Importantly, we also observed a marked reduction in upper reproductive tract (URT) pathology in r-MOMP immunised animals. Intranasal immunisation of female guinea pigs with r-MOMP was able to provide partial protection against C. caviae infection, not only by reducing chlamydial burden but also URT pathology. This data demonstrates the value of using the guinea pig model to evaluate potential chlamydial vaccines for protection against infection and disease pathology caused by C. trachomatis in the female reproductive tract.

Chlamydia

Chlamydial infections of humans can cause blindness and infertility as a result of diseases such as keratoconjunctivitis (trachoma), urethritis and cervicitis. However, in greater than half of all chlamydial diseases in males and females there are no signs or symptoms of infection. Chlamydia trachomatis is the causative bacterial organism responsible for the global estimate of 40.6 million people currently suffering with active trachoma and for the five million new cases of sexually transmitted infections each year in the United States of America. Even though antibiotics are available to treat Chlamydia, the incidence of each of these primarily asymptomatic infections continues to increase. In this Chapter we review the current knowledge of C.trachomatis including clinicial diseases and sequelae, the chlamydial developmental cycle in vivo, immunobiology and immune responses to infections, chlamydial genomics and vaccine development.

Relationships and sexual health promotion project for QUT international students

International students may experience a variety of sexual health problems which include unplanned pregnancies, abortions and sexually transmitted diseases. These are often because of limited knowledge of sexual health matters and lack of sexual health education and/or access to health services in their home country. A study was undertaken to identify the concerns of international students and how to provide culturally appropriate promotion of sexual health for international students at Queensland University of Technology (QUT). The project included consultations with stakeholders, interviews with key informants, an online survey and focus group discussions with international students. The project found that sexual health is a concern for international students, particularly in developing relationships and when becoming sexually active in Australia, and there is a perceived lack of access to health services and insufficient knowledge on sexual health matters. Preferred methods of dissemination of sexual health information included use of student mentors, web-based online resources, brochures and confidential on-line advice.

Intranasal immunization with C. muridarum major outer membrane protein (MOMP) and cholera toxin elicits local production of neutralising IgA in the prostate

Successful control of sexually transmitted diseases (STDs) through vaccination will require the development of vaccine strategies that target protective immunity to both the female and male reproductive tracts (MRT). In the male, the immune privileged nature of the male reproductive tract provides a barrier to entry of serum immunoglobulins into the male reproductive ducts, thereby preventing the induction of protective immunity using conventional injectable vaccination techniques. In this study we investigated the potential of intranasal (IN) immunization to elicit anti-chlamydial immunity in BALB/c male mice. Intranasal immunization with Chlamydia muridarum major outer membrane protein (MOMP) admixed with cholera toxin (CT) resulted in high levels of MOMP-specific IgA in prostatic fluids (PF) and MOMP-specific IgA-secreting cells in the prostate. Prostatic fluid IgA inhibited in vitro infection of McCoy cells with C. muridarum. Using RT-PCR we also show that mRNA for the polymeric immunoglobulin receptor (PIgR), which transports IgA across mucosal epithelia, is expressed only in the prostate but not in other regions of the male reproductive ducts upstream of the prostate. These data suggest that using intranasal immunization to target IgA to the prostate may protect males against STDs while at the same time maintaining the state of immune privilege within the MRT.

Serosorting may increase the risk of HIV acquisition among men who have sex with men

Background: Serosorting, the practice of seeking to engage in unprotected anal intercourse with partners of the same HIV status as oneself, has been increasing among men who have sex with men. However, the effectiveness of serosorting as a strategy to reduce HIV risk is unclear, especially since it depends on the frequency of HIV testing. Methods: We estimated the relative risk of HIV acquisition associated with serosorting compared with not serosorting by using a mathematical model, informed by detailed behavioral data from a highly studied cohort of gay men. Results: We demonstrate that serosorting is unlikely to be highly beneficial in many populations of men who have sex with men, especially where the prevalence of undiagnosed HIV infections is relatively high. We find that serosorting is only beneficial in reducing the relative risk of HIV transmission if the prevalence of undiagnosed HIV infections is less than ∼20% and ∼40%, in populations of high (70%) and low (20%) treatment rates, respectively, even though treatment reduces the absolute risk of HIV transmission. Serosorting can be expected to lead to increased risk of HIV acquisition in many settings. In settings with low HIV testing rates serosorting can more than double the risk of HIV acquisition. Conclusions: Therefore caution should be taken before endorsing the practice of serosorting. It is very important to continue promotion of frequent HIV testing and condom use, particularly among people at high risk.

The management of venereal disease in New South Wales, 1871 to 1916

Practical techniques to manage the dangers associated with sexually transmitted diseases have varied considerably both cross culturally and historically. Adopting a Foucauldian perspective, this article examines sociohistorical aspects of the governance of venereal disease in New South Wales between 1871 and 1916. Public debates and official documents are analysed to identify strategic shifts in practices associated with venereal disease management , especially in relation to prostitution. Particular attention is paid to the development of contagious disease legislation and its role in the regulation of venereal disease . It is argued that during the period in question, two distinct governmental regimes of disease control can be identified. In the first, medical policing managed venereal disease through the mobilisation of repressive controls, requiring the isolation and detention of polluting bodies. In the second, liberal governance adopted pedagogic practices to train populations perceived as either healthy or unhealthy. It is further argued that as liberal strategies of governance came to dominate the management of venereal disease , the association of prostitution with venereal disease began to weaken. Instead, authorities became increasingly concerned with populations whose behaviour was not traditionally linked with venereal disease , such as the young and the sexually inexperienced.

A representação social do ser homem para homens heterossexuais e a vulnerabilidade para o HIV/AIDS

Introdução: A Política Nacional de Atenção Integral à Saúde do Homem surge para compreender a singularidade masculina nos seus diversos contextos socioculturais. A política trás, como um dos objetivos, promover, na população masculina, conjuntamente com o Programa Nacional de DST/AIDS, a prevenção e o controle das doenças sexualmente transmissíveis e da infecção pelo HIV. A pesquisa em tela tem por objetivo: Identificar a representação social do ser homem para homens que se referem como heterossexuais; Descrever as práticas sociais e culturais que podem levar o homem a se expor ao HIV; e Analisar a representação social do ser homem e sua relação com a vulnerabilidade para a infecção pelo HIV. Metodologia: Trata-se de uma pesquisa qualitativa, pautada na Teoria das Representações Sociais, realizada no CTA em São Gonçalo, Rio de Janeiro, com a participação de 08 sujeitos, com os quais foram desenvolvidas entrevistas semiestruturadas. Os dados foram analisados através da análise de conteúdo. Resultado: Da análise dos dados surgiram quatro categorias, quais sejam, a representação social do ser homem: imagens, comportamentos e compromissos; O homem ideal e o romantizado: caráter, sucesso, herói e imagem; o homem real: individualismo, apego às máquinas, o jeitinho masculino e a vida sexual; e o universo reificado da aids e a construção do preconceito. A ideia do homem ideal aparece para os sujeitos como aquele que pratica o que é politicamente correto e que, por sua vez, segue as normas da sociedade vigente. Para eles a masculinidade tem como desdobramento a virilidade e o homem é, por natureza, considerado como ser insaciável sexualmente. Os entrevistados apontaram para uma dimensão avaliativa do homem real, como um sujeito individualista e com práticas hedonistas e com uma prática sexual desenfreada. Contudo, a proteção pela infecção ao HIV é representada através da fidelidade conjugal, onde o comportamento sexual considerado adequado serve como imunização contra a infecção. Os sujeitos apresentaram o homem ideal como um ser romantizado, rompendo com o estereótipo que se tem do homem na sociedade, como sujeito duro, infiel e dominador. A partir do estudo constatou-se que os entrevistados possuem uma visão reificada sobre a doença e representam a aids como a doença do outro. Conclusão/Contribuições para enfermagem: A compreensão do homem na atualidade pode nos trazer novas discussões no que diz respeito à construção social do mesmo, assim como suas implicações diante das vulnerabilidades existentes para a infecção pelo HIV/AIDS, a fim de desconstruir mitos e tabus que permeiam a questão cultural do que é ser masculino, para assim, entender esse sujeito no âmbito dos serviços de saúde e trabalhar práticas sociais e sexuais masculinas saudáveis.

Consumo de álcool e exposição ao HIV entre universitários: associação dos conhecimentos sobre HIV e práticas sexuais

O objetivo deste estudo é discutir a associação entre padrão de consumo de álcool e dimensões de risco à exposição ao HIV, desdobradas em conhecimento sobre HIV e práticas sexuais entre universitários. Trata-se de uma pesquisa transversal com abordagem quantitativa, realizada com 416 universitários de 14 cursos distintos. Os dados foram coletados através de dois instrumentos e tratados através de estatística descritiva com o software SPSS 21.0. A pesquisa foi autorizada pelo Comitê de Ética em Pesquisa da Universidade do Estado do Rio de Janeiro, sob n 003.3.2012. A população de estudo é predominantemente do sexo masculino (59,6%), com faixa etária entre 19 a 22 anos (54,3%), de cor branca (57,5%), sem companheiros (69,2%) ou filhos (92,3%) e com maior percentual de católicos (31,3%) e daqueles que não possuem religião (33,7%). Destaca-se, ainda, que são possuidores de computador ou eletrônicos portáteis (98,8%) com fácil acesso à internet (96,8%). Os principais achados apontam que a maioria faz uso de álcool (60%), com a proporção de 7 homens para cada 3 mulheres. Relacionado ao AUDIT, foi identificado predomínio das zonas I (abstinência ou baixo risco-73,8%) e II (uso nocivo-20,4%). Sobre as relações sexuais, a maioria afirmou ter experiência sexual (69,5%), com idade da primeira relação entre 16 e 18 anos (54%), no entanto, mais homens (54,3%) afirmaram manter relações sexuais após o consumo de álcool do que mulheres (45,7%). Apesar do conhecimento sobre HIV/aids e álcool ser considerado como fator protetor pela literatura vigente, constatou-se que não há associação deste conhecimento com a prática sexual mais segura. Independente do padrão de consumo de bebidas alcoólicas, os universitários apresentam o mesmo tipo de prática sexual, muitas vezes se expondo à infecção ao HIV e outras doenças sexualmente transmissíveis. Dentre os dados analisados, um dos motivos de exposição ao HIV/Aids são as relações sexuais após a ingestão de bebida alcoólicas e o não uso de preservativos nestas situações. O consumo exagerado de bebidas alcoólicas está ligado ao sexo masculino e este grupo apresenta práticas sexuais de maior risco. Sugere-se que novos estudos possam analisar a relação de causa e efeito para verificar quais fatores podem influenciar de fato a exposição ao HIV de estudantes usuários de álcool. Estas informações são relevantes para conhecermos a atual demanda desse grupo e focar nas reais necessidades que são imperiosas para a prevenção dos futuros danos nocivos à saúde individual e coletiva. Torna-se necessário compreender qual é a demanda dos jovens em se expor a diversos riscos à saúde adotando práticas não seguras e, principalmente, o que de fato modula estas condutas.

Transport of anti-sperm monoclonal IGA and IGC into murine male and female genital tracts from blood - Effect of sex hormones

Ab levels in the genital tract may be important in fertility and in preventing sexually transmitted diseases, In this study, I-125-labeled polymer or monomer mAb IgA (C4pIgA or C4mIgA) and IgC2b (C4IgC) to murine lactate dehydrogenase C4 and a polymer mAb IgA (npIgA) not cross-reacting with mouse sperm were intravenously injected into BALB/c mice, and the relative distribution of these Abs was determined. Polymer IgA was transported much more efficiently into the genital tract, trachea, and duodenum of both sexes than C4IgG and C4 mIgA (p < 0.01), The transport of polymer IgA (C4pIgA and npIgA) into the male genital tract greatly increased following orchiectomy (p < 0.01); this change was not affected by testosterone, suggesting that the unknown regulatory factor(s) from the testis may suppress polymer IgA transport, However, the transport of polymer IgA into female genital tissues was significantly decreased by ovariectomy (p < 0.01); this decline can be rectified by P-estradiol but not progesterone treatment, suggesting that estradiol may stimulate polymer IgA transport, Furthermore, the transport of C4IgG into tissues of the Fallopian tubes and the uterus was significantly decreased by treatment with progesterone (p < 0.01). Together, these findings indicate that serum polymer IgA can be transported selectively into the genital tracts of both sexes, that this transport is strongly under the control of gonads, and that transport of Ige into the Fallopian tubes and uterus is downregulated by progesterone.

In vitro release of nonoxynol-9 from silicone matrix intravaginal rings

The controlled-release characteristics of matrix silicone intravaginal rings loaded with between 100 and 971 mg of nonoxynol-9 have been investigated with a view to developing a ring that may offer a new female-controlled method for the prevention of transmission of sexually transmitted diseases, particularly HIV. Intravaginal rings containing 253, 487 and 971 mg of nonoxynol-9 provided a daily release of 2 mg or more over the 8-day release period, the minimal amount of nonoxynol-9 considered to provide an effective vaginal concentration for the prevention of HIV. Furthermore, the maximum daily release of N9 was about 6 mg, an amount significantly smaller than that observed for other nonoxynol-9 products whose large daily doses may in fact increase the occurrence of HIV by causing epithelial damage to the vaginal tissue. The release mechanism of the liquid nonoxynol-9 from the intravaginal rings has also been investigated and compared to models describing the release of solid drugs from the rings. It has been demonstrated through release studies and surface microscopy that a drug depletion zone is not established in such liquid-loaded intravaginal ring systems, with implications for the release kinetics. (C) 2003 Elsevier B.V. All rights reserved.

Development of a Temperature-Recording Vaginal Ring for Monitoring User Adherence

Background: Vaginal ring devices are being actively developed for controlled delivery of HIV microbicides and as multi-purpose prevention technology (MPT) products combining hormonal contraception with prevention of HIV and other sexually transmitted diseases. Presently, there is no reliable method for monitoring user adherence in HIV vaginal ring trials; previous acceptability studies have included some type of participant self-reporting mechanism, which have often been unreliable. More objective, quantitative and accurate methods for assessing adherence are needed.
Methods: A silicone elastomer vaginal ring containing an encapsulated miniature temperature recording device has been developed that can capture and store real-time temperature data during the period of designated use. Devices were tested in both simulated vaginal environments and following vaginal placement in cynomolgus macaques. Various use protocols and data sampling rates were tested to simulate typical patient usage scenarios. Results: The temperature logging devices accurately recorded vaginal temperature in macaques, clearly showing the regular diurnal temperature cycle. When environmental temperature and vaginal temperature was significantly different, the device was able to accurately pinpoint the insertion and removal times. Based on the data collected it was possible to infer removal periods as short as 5 min when the external environmental temperature was 25 °C. Accuracy increased with data sampling rate. Conclusions: This work provides proof-of-concept for monitoring adherence using a vaginal ring device containing an encapsulated temperature logger. The addition of one or more active agents into the ring body is not anticipated to affect the temperature monitoring function. A clinical study to compare self- reported user adherence data with that obtained by the device would be highly informative.

Evaluation of a partnership between primary and secondary care providing an accessible Level 1 sexual health service in the community

Comprehensive testing for asymptomatic sexually transmitted infections in Northern Ireland has traditionally been provided by genitourinary medicine clinics. As patient demand for services has increased while budgets have remained limited, there has been increasing difficulty in accommodating this demand. In May 2013, the newly commissioned specialist Sexual Health service in the South Eastern Trust sought to pilot a new model of care working alongside a GP partnership of 12 practices. A training programme to enable GPs and practice nurses to deliver Level 1 sexual health care to heterosexual patients aged >16 years, in accordance with the standards of BASHH, was developed. A comprehensive care pathway and dedicated community health advisor supported this new model with close liaison between primary and secondary care. Testing for Chlamydia, gonorrhoea, HIV and syphilis was offered. The aims of the pilot were achieved, namely to provide accessible, cost-effective sexual health care within a framework of robust clinical governance. Furthermore, it uncovered a high positivity rate for Chlamydia, especially in young men attending their general practice, and demonstrated a high level of patient satisfaction. Moreover the capacity of secondary care to deliver Levels 2 and 3 services was increased.

Educação sexual em contexto escolar: uma intervenção contra a vulnerabilidade na vivência da sexualidade adolescente

A sexualidade estando presente desde o nascimento, na adolescência assume novo significado. Descobre-se o primeiro amor através de uma relação de intimidade e partilha de afectos, o corpo adquire um novo sentido, o grupo torna-se importante enquanto fonte de suporte, partilha de angústias e confiança, contribuindo para o desenvolvimento do adolescente. Na adolescência, perscrutam alguns factores de risco, nomeadamente a vivência da sexualidade de forma não informada e responsável, com repercussões para a saúde física e psicológica, pelo que é imperioso intervir através de programas formativos no âmbito da sexualidade que promovam vivência desta de forma responsável. São objectivos do estudo: Promover um modelo de intervenção formativa baseado no debate e reflexão crítica sobre sexualidade em contexto de sala de aula; Construir e validar instrumentos que permitam avaliar as atitudes face à sexualidade e ainda os conhecimentos dos adolescentes sobre reprodução, planeamento familiar e infecções de transmissão sexual; Testar a eficácia de um programa de intervenção formativo a nível dos conhecimentos sobre planeamento familiar, infecções de transmissão sexual, reprodução e atitudes face à sexualidade; Testar a efectividade do programa de intervenção formativo numa amostra alargada de adolescentes, analisando também o papel das variáveis sociodemográficas, sociopsicológicas e sexuais. O trabalho de campo desenvolveu-se em três estudos distintos, no primeiro e terceiro participaram 840 adolescentes e no segundo 90. No primeiro estudo construímos e validamos os instrumentos para colheita de dados, no segundo, experimental de campo, validamos o modelo da intervenção formativa no âmbito da sexualidade e no terceiro, descritivo e correlacional, testamos a efectividade de um programa de intervenção numa amostra mais alargada. O protocolo de recolha de informação incluiu quatro escalas construídas para o efeito com o intuito de avaliar as atitudes face à sexualidade, os conhecimentos sobre planeamento familiar, infecções de transmissão sexual e reprodução e ainda a escala de insatisfação com a imagem corporal em adolescentes e a escala de satisfação com o suporte social. As raparigas e residentes na zona urbana são as que têm mais conhecimentos sobre planeamento familiar e possuem atitudes face à sexualidade mais favoráveis. Os interlocutores preferenciais sobre sexualidade são os amigos, seguidos da mãe. São os adolescentes com pouca ou moderada prática religiosa que já iniciaram a actividade sexual. São as raparigas que têm maior satisfação com o suporte social nas dimensões, satisfação com as amizades, intimidade, actividades sociais e suporte social total. Os adolescentes que já iniciaram a actividade sexual, revelam maior percepção de suporte social na dimensão satisfação com a amizade. O modelo de formação construído e aplicado influenciou as atitudes face à sexualidade, conhecimentos sobre reprodução, sobre infecções de transmissão sexual e sobre planeamento familiar. Do nosso ponto de vista, pensamos ser urgente a aplicação de programas de intervenção formativos em contexto escolar, ou outro, que integrem de uma forma harmoniosa as várias facetas da sexualidade humana, promovendo a aquisição de uma postura responsável, flexível e gratificante nos adolescentes enquanto seres sexuados.

¿Cómo le Informa a sus Parejas que Estuvieron Expuestas al VIH?

This paper written in Spanish gives information for couples who have been exposed to HIV and other sexually transmitted diseases.

Impacto do fator emocional quando da recuperação de informação da home page do Departamento de Doenças Sexualmente Transmissíveis, AIDS e Hepatites Virais da Secretaria de Vigilância em Saúde do Ministério da Saúde/

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciência da Informação, Programa de Pós-Graduação em Ciência da Informação, 2016.