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.

Sexual behaviour of young people in Northern Ireland: First sexual experience

Two National Surveys of Sexual Attitudes and Lifestyles in Britain (Natsal) were conducted, one in 1990 and one in 2000. Northern Ireland was excluded from both studies. Now, for the first time, comparable data about sexual attitudes and lifestyles of young people (14- to 25-year-olds) in Northern Ireland are available. Data were collected through self-administered questionnaires, one-to-one interviews and focus-group discussions. As in Natsal 1990 and 2000, young people were asked about their sexual attitudes towards sex, experiences of sex education, knowledge of sexually transmitted infections (STIs) and, if sexually active, about the circumstances in which sexual intercourse occurred. A total of 1013 young people in the target age group completed the self-administered questionnaire. Young people in Northern Ireland do not differ significantly from their counterparts in Britain in terms of sexual lifestyles and attitudes. Some 53.3% of all respondents reported that they had had sexual intercourse. Condom use at first sex was reported by 64% of sexually active respondents; 27.4% said they used no contraception; 26.7% of all respondents said they had sex before age 16. Respondents who first had sex when they were 15 or 16 years were more likely than other respondents to say that 'being drunk' was the main reason why intercourse occurred. Peer pressure to engage in sex was more prevalent among males than females. Young people in Northern Ireland regard friends as their most important source of sex education. School is the second most important source but most respondents wanted more sex education in school. It is important that it is needs focused and includes potentially sensitive and contentious information.

Bronzino’s allegory of ‘Venus and Cupid’: An exemplary image for contemporary sexual health promotion?

Recent sexual health promotion strategies have veered between a negative emphasis on the deleterious consequences of sexually transmitted infections, and a more positive, eroticized approach to safer sex. The differences in approach are starkly reflected in the images chosen to illustrate them. We note that there are problems with both approaches. The main purpose of this review is to demonstrate how this dichotomy was transcended by the sixteenth century Florentine Mannerist painter, Agnolo Bronzino, in his allegory on syphilis

Sex, drugs and STDs: Preliminary findings from the Belfast Youth Development Study

Young people's participation in sexual risk behaviours is commonly linked with participation in a range of other risky behaviours, and in particular with substance use behaviours. This cross-sectional analysis of the sixth sweep of the Belfast Youth Development Study aimed to examine associations between substance use and sexual activity and related risks among 17-19-year olds in Northern Ireland. Being sexual activity and participating in sexual risk behaviours was associated with the use of a range of licit and illicit substances particularly alcohol and ecstasy. Additionally, females were more likely to have been tested for a sexually transmitted disease (STD). The findings add to the existing research body suggesting that substance misuse and sexual risk behaviours tend to co-occur in adolescence and highlight a need to develop appropriate interventions and initiatives for school aged young people.

Beyond HIV microbicides: multipurpose prevention technology (MPT) products

Multi-purpose prevention technologies (MPTs) that aim to simultaneously prevent unintended pregnancy, human immunodeficiency virus type 1 (HIV-1) infection and other sexually transmitted infections (STIs) are among the most innovative and complex products currently in development within women’s sexual and reproductive healthcare. In this review article, MPTs are placed within the wider context of combination products, combination drug products and multi-indication products. The current MPT product landscape is mapped and assessed with reference to existing products for the corresponding single indications, before identifying the gaps in the current MPT product pipeline and highlighting priority products and challenges moving forward.

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.

Overconfidence, sexual health awareness and sexual health risk among young female users of sexual health clinics

This study explored the patterning of young people’s sexual health competence, and how this relates to sexual health outcomes. A survey of 381 young people attending two sexual health clinics in Northern Ireland was carried out between 2009 and 2010. Latent profile analysis of self-rated decision making, self-rated sexual health knowledge, and knowledge of sexually transmitted disease questionnaire scores was used to determine typologies of sexual health competence. Analysis revealed three categories of sexual health competence and explored their association with other behaviours and social characteristics. Young people’s subjective opinion of their sexual health competency, when not matched with a corresponding knowledge of sexual health, could place people at an increased risk of poor sexual health outcomes. Greater levels of peer pressure to have sex and early sexual debut were associated with poorer sexual health knowledge. This finding warrants further investigation, as the importance of self-perceived competence for sexual health screening and education programmes are considerable.

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.

Detecção do vírus do papiloma humano por PCR em tempo real : relevância para medicina legal

Tese de mestrado, Medicina Legal e Ciências Forenses, Faculdade de Medicina, Universidade de Lisboa, 2014

Pilot study of the utility and acceptability of tampon sampling for the diagnosis of Neisseria gonorrhoeae and Chlamydia trachomatis infections by duplex realtime polymerase chain reaction in United Kingdom sex workers

We aimed to evaluate the acceptability of self-collected tampon samples for the screening of female sex workers for sexually transmitted infections. We recruited 65 sex workers, and 63 agreed to provide tampon samples. The tampon samples were processed by realtime polymerase chain reaction (PCR) targeting Neisseria gonorrhoeae and Chlamydia trachomatis. Urethral and endocervical swabs were also obtained from 61 of 63 participants and tested using culture (N. gonorrhoeae) and the BD ProbeTec strand displacement amplification (SDA) (C. trachomatis) assay. Tampon sampling was preferred by 95% of the women and all favoured being tested away from genitourinary medicine clinics; the most common reasons cited were avoidance of embarrassment (40%) and convenience (30%). Besides near-universal acceptability of tampon sampling, the tampon sampling-PCR approach described in this study appeared to have enhanced sensitivity compared with conventional testing, suggesting the possibility of a residual hidden burden of N. gonorrhoeae and/or C. trachomatis genital infections in UK female sex workers.

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.