Primary and secondary syphilis latino-

Records from white, African-American, and Latino patients were included in the analysis. English-proficient Latina female patients reported higher rates of infection and behavioral risk factors than Spanish-speaking Latina patients. After adjustment for gender and behavioral risk factors, Spanish-speaking Latinas also had significantly less risk of sexually transmitted infections than did English-speaking Latinas. Future studies on sexual risk behavior among specific Latino populations characterized by country of origin, level of acculturation, and years in the U. Latinos in the U.

Primary and secondary syphilis latino

Primary and secondary syphilis latino

Primary and secondary syphilis latino

ErbeldingM. Use of procalcitonin and a respiratory polymerase chain reaction panel to reduce antibiotic use via an EMR alert. Latino English-proficient. Many other diseases [1]. The revelation in of study failures by a whistleblowerPeter Buxtunled to major changes in U. Canadian Medical Association Journal.

Dbz game hentai. Sexually Transmitted Diseases (STD)

It appears at the original infection site, usually the mouth, anus, or genitals. Last updated on June 7th, by Samuel Peterson. This problem can be overcome by repeating the VDRL test using a higher serum dilution. Int Ophthalmol Clin. The notes of patients with primary and with secondary syphilis were retrospectively reviewed. If you are allergic to some medications which contain penicillin, other alternatives secodnary available to treat syphilis. Retrieved 2 October Larry K. The RPR test is important for pregnant women, as undiagnosed syphilis can Male celebrity list penis passed on to their unborn child, and could be life-threatening for the baby. Information on sexually transmitted infections latibo for women. New Haven: Yale University Press. Categories : Bacterial diseases Bacterium-related cutaneous conditions Infectious diseases Infectious diseases with eradication efforts Infections with a predominantly sexual mode Primary and secondary syphilis latino transmission Sexually transmitted Primarh and infections Spirochaetes Syphilis.

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum.

  • Syphilis is a sexually transmitted infection STI.
  • A bacterial infection caused by an organism called spirochete.
  • The Case: A year-old homosexual man was referred to a dermatologist for evaluation of a nonpruritic skin rash.
  • Please note: An erratum has been published for this article.

Records from white, African-American, and Latino patients were included in the analysis. English-proficient Latina female patients reported higher rates of infection and behavioral risk factors than Spanish-speaking Latina patients. After adjustment for gender and behavioral risk factors, Spanish-speaking Latinas also had significantly less risk of sexually transmitted infections than did English-speaking Latinas.

Future studies on sexual risk behavior among specific Latino populations characterized by country of origin, level of acculturation, and years in the U.

Latinos in the U. Among Latinos specifically, there is evidence that country of origin impacts HIV risk behaviors. Acculturated individuals may place less value on the traditional family and gender roles that protect against multiple partnerships and early sexual initiation.

Greater acculturation as measured by less ethnic self-identification may be related to discordant partnerships, [ 17 ] which are in turn associated with an increased risk of STD infection. Clinic location and hours of operation did not change over this time period. We selected the first clinical record from each patient. Demographic variables of interest included race, language spoken, sex, and age.

Only data from white, African-American, and Latino patients were used for this analysis. Acculturation status among Latinos was based on English language use, which was presumed to be English unless patients requested Spanish-language intake forms. Clinical and behavioral factors such as sexual preference, condom use at last sexual encounter, contraceptive use, drug use, and partner risk factors were elicited during the clinical interview.

Multivariate models were stratified by gender, and adjusted for age as a continuous variable and for year of visit. Multivariate models were restricted to patients reporting heterosexual intercourse due to the small number of patients reporting same-sex partners. These variables allowed for comparisons between English-proficient and Spanish-speaking Latino patients as well as English-proficient Latinos and non-Latino patients within the same multivariate model.

Fit statistics helped to determine the variables included in the final models. Latino patients were significantly younger than African-American or white patients, with a mean age of Overall, Latino patients reported fewer behavioral risk factors than white or African-American patients.

Both Latino males and females were less likely to report substance risk and multiple partnerships in the past 30 days. Latina females were less likely than white or African-American patients to report sex in exchange for drugs or money. To examine the impact of acculturation, we examined behavioral risk factors among Latino patients by English language proficiency. English-speaking Latina females were at increased risk of alcohol use before sex and multiple partners in the past 30 days, with a prevalence of these behaviors similar to non-Latina patients.

The prevalence of gonorrhea and syphilis were comparable, while the prevalence of HIV and chlamydia were much lower. Latina female patients were significantly less likely than white females to have chlamydia, and less likely than white and African-American females to have gonorrhea. Acculturation status was also associated with specific infections among Latino patients Table 4.

Among male Latino patients, English language proficiency was not significantly associated with higher prevalence of gonorrhea, syphilis, or HIV compared with Spanish-speakers, but English proficient Latinos had significantly higher rates of chlamydia and syphilis and significantly lower rates of gonorrhea compared with non-Latinos. However, English-proficient Latina patients had significantly higher rates of gonorrhea than Spanish-speaking Latinas, while English-speakers had a prevalence of gonorrhea infection similar to non-Latina patients.

English proficient Latina patients had marginally higher rates of syphilis compared with Spanish-speakers and significantly higher rates than non-Latina patients. ORs were adjusted for age as a continuous variable and for year of visit — Different patterns emerged for the impact of acculturation when models were restricted to specific infections.

Spanish-speaking Latinas were non-significantly less likely to have gonorrhea than English-proficient Latinas. Multivariate analysis of factors associated with chlamydia and HIV was not performed due to insufficient number of cases. We found differences in the prevalence of specific infections, with Latinos having a higher prevalence of syphilis among Latinos and lower prevalence of gonorrhea than non-Latino patients.

We also found associations among Latinas between sexual risk behaviors, sexually transmitted infections, and marginal associations with level of acculturation, as measured by self-reported language proficiency. Based on the prevalence of sexual risk factors among Latino patients, we would have expected to see lower prevalence of all sexually transmitted infections for both males and females.

The discrepancy that we observed between reported behavioral risk factors and infection prevalence among Latino patients compared to non-Latino patients has several possible explanations, including reporting bias, differences in natural history of infection, and differences in sexual networks. One concern is that Latino patients under-reported behavioral risk factors. Cultural factors can impact disclosure of risk behavior, and fear of deportation could be an obstacle to full disclosure of illicit activities such as injection drug use or relations with commercial sex workers, especially among undocumented immigrants.

Communication barriers can complicate the assessment of risk behavior, even when conducted by an experienced STD clinician fluent in Spanish. However, the English speakers also had a higher prevalence of STDs than Spanish speakers, suggesting that at least some of the reported differences in risk behavior are accurate.

The natural history of the infections may provide some explanation; gonorrhea has a short 2— day infectious period which reflects recent high-risk behavior [ 27 ], while syphilis is a chronic infection which may go undetected for years [ 28 ]. The disparity in infection prevalence by racial and ethnic group is also consistent with our earlier hypothesis that partner selection patterns are influenced by ethnicity, contributing to an increased risk of syphilis among Latinos choosing Latino partners.

We found that patients who did not report risk behaviors e. In addition to measuring disparities in infection and behavior prevalence, this study also adds to the growing body of literature on the impact of acculturation on sexual behavioral and sexually transmitted infection risk among Latinos.

Interestingly, English language proficiency was significantly associated in multivariate models with sexual risk behaviors and infection among female but not male Latino patients, suggesting that acculturation has differential impact on these outcomes by gender.

Other studies have found that gender may modify the association between acculturation and risk behavior. This study has several limitations. Our study sample was drawn from public STD clinics, so our findings are not representative of the general U. STD clinic patients are not a representative sample of the general population, tending to be poor, uninsured, and people of color. The impact of acculturation may be meaningful only for foreign-born Latino populations, and immigrant status was not assessed as part of the clinical record.

In conclusion, this study showed that despite lower reported risk behavior, Latino patients had a higher prevalence of syphilis than non-Latino patients. English-speaking Latinas had the highest risk of syphilis compared to non-Latina and Spanish-speaking Latinas, suggesting that acculturation plays an important role in the risk of syphilis, at least among females in this population. In contrast, prevalence of gonorrhea was lowest in Latinos compared to African-Americans and whites.

Future studies on partnership selection among specific Latino populations characterized by country of origin, level of acculturation, and years in the U.

Latinos had higher syphilis rates but lower gonorrhea rates. Acculturation is explored as a factor. National Center for Biotechnology Information , U. Sex Transm Dis.

Author manuscript; available in PMC Mar 1. Renee M. Gindi , M. Erbelding , M. Page , M. Author information Copyright and License information Disclaimer.

Gindi, ude. Copyright notice. The publisher's final edited version of this article is available at Sex Transm Dis. See other articles in PMC that cite the published article. Study Measures Demographic variables of interest included race, language spoken, sex, and age. Open in a separate window.

Latino English-proficient 0. Centers for Disease Control and Prevention. Atlanta, GA: U. Sexually Transmitted Disease Surveillance, Department of Health and Human Services; Washington, DC: Fertility, contraception, and fatherhood: data on men and women from cycle 6 of the National Survey of Family Growth. Vital Health Stat. Fertility, family planning, and reproductive health of U. MMWR Morb. Public Health. Aral SO. Sexual network patterns as determinants of STD rates: paradigm shift in the behavioral epidemiology of STDs made visible.

Sexually transmitted diseases. Dana RH. Assessment of Acculturation in Hispanic Populations. Hispanic Journal of Behavioral Sciences. Journal of acquired immune deficiency syndromes ; 49 1 — Journal of acquired immune deficiency syndromes ; 36 5 — Acculturation and the sexual and reproductive health of Latino youth in the United States: a literature review. Loue S. Laumann EO. The social organization of sexuality: sexual practices in the United States. Chicago: University of Chicago Press; Processes of Hispanic and Black Spatial Assimilation.

The American Journal of Sociology. Discord, discordance, and concurrency: comparing individual and partnership-level analyses of new partnerships of young adults at risk of sexually transmitted infections.

Categories : Bacterial diseases Bacterium-related cutaneous conditions Infectious diseases Infectious diseases with eradication efforts Infections with a predominantly sexual mode of transmission Sexually transmitted diseases and infections Spirochaetes Syphilis. Public Health Agency of Canada. Sexually Transmitted Diseases. How is syphilis contracted? Archived from the original on 9 August

Primary and secondary syphilis latino

Primary and secondary syphilis latino. REFERENCES

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Guidelines recommend that sexually active men who have sex with men MSM including human immunodeficiency virus HIV -positive MSM be tested at least annually for syphilis, with testing every 3—6 months for MSM at elevated risk. Using data from the Medical Monitoring Project, a population-based HIV surveillance system, we evaluated the proportion of MSM who had documentation of being tested for syphilis by their HIV care provider in the past 3, 6, and 12 months.

The rate of diagnoses of human immunodeficiency virus HIV infection in the United States has decreased between and [ 1 ]. Although there has been a decreasing trend in the number of diagnoses of HIV infection, marked the third consecutive year of increases in other reportable sexually transmitted diseases STDs —chlamydia, gonorrhea, and syphilis—in the United States [ 2 ].

Syphilis has been associated with an increased risk of HIV acquisition and transmission [ 5 , 6 ], whereas HIV-positive persons who become infected with syphilis may be at an increased risk of developing complications including neurologic or ocular complications [ 7 ]. Current guidelines recommend that sexually active HIV-positive MSM be screened for syphilis upon initiation of care and at least annually thereafter [ 8 , 9 ].

Population-based information on syphilis testing among HIV-positive MSM, particularly the frequency of syphilis screening among MSM at elevated risk, is lacking and of particular importance given the increasing trend in syphilis diagnoses. The objective of this analysis was to examine the proportion of sexually active HIV-positive MSM currently in care tested for syphilis in the past 3, 6, and 12 months by their HIV care provider.

MMP methods, including sampling, weighting procedures, and response rates, have been described in detail elsewhere [ 13 , 14 ]. In the and cycles, a total of 23 project areas were funded to conduct data collection—16 states, 1 territory, and 5 separately funded cities. In , eligible facilities were sampled in the 23 project areas, and in , facilities were sampled in 23 project areas. Data were collected from June through May using face-to-face or telephone interviews and medical record abstractions.

During the MMP — cycles, medical record data from 24 months prior to interview were abstracted. Data were weighted on the basis of known probabilities of selection at state or territory, facilities, and patient levels [ 14 ]. In addition, predictors of nonresponse were determined from analysis of data from sampled facilities and patients, and data were weighted to adjust for nonresponse following established methods [ 15 , 16 ].

In accordance with the federal human subjects protection regulations [ 17 ] and guidelines for defining public health research [ 18 ], MMP was determined to be a nonresearch, public health surveillance activity used for disease control program or policy purposes. Participating states or territories and facilities obtained local institutional review board approval to be part of MMP if required locally.

Informed consent was obtained from all interviewed participants. We used abstracted medical record data to estimate the prevalence of syphilis testing by an HIV care provider in the 3, 6, and 12 months prior to the interview. Syphilis testing was defined as a result from a non-treponemal or treponemal syphilis test, antibody test, or dark-field microscopy. MSM were defined as men who had sex with men only or with men and women during the past 12 months.

Bivariate logistic regression was used to generate prevalence ratios. All analyses accounted for the complex sample design and weights. Hispanic or Latino MSM had a higher proportion with documentation of syphilis testing in the past 12 months Table 1 compared to white non-Hispanics, and MSM with only RWP coverage had a higher proportion with documentation of syphilis testing in the past 12 months Table 1 compared to MSM with traditional sources of health insurance.

Note : Sexual behavior categories are not mutually exclusive. Frequent syphilis screening has the potential to ensure early detection and treatment, stemming ongoing disease transmission and development of disease sequelae [ 5—7 ]. There was variation in the proportion tested for syphilis across subgroups. The higher prevalence of syphilis testing among older compared to younger MSM has been reported before [ 12 ] and may be reflecting age group disparities in retention in continuous HIV care.

Studies have shown lower levels of retention in continuous HIV care among HIV-positive adolescent and young adults [ 19—21 ]. The lower prevalence of syphilis testing among younger MSM, despite increasing syphilis diagnoses among this population indicates a misalignment between screening practices and the current syphilis epidemiology and could result in missed opportunities to recognize and treat syphilis cases, particularly early, asymptomatic cases.

It is also a practical and inexpensive endeavor to screen for syphilis among HIV-positive MSM in care because these patients undergo routine blood draws and tests for viral load and CD4 count monitoring [ 26 ]. This speaks to the importance of routinely obtaining sexual histories from patients. When an HIV-positive person is diagnosed with syphilis, it is a marker for condomless sex and can be used as an opportunity to engage in behavioral counseling because reducing risk is important for reducing both HIV transmission and the acquisition of other STDs.

This analysis has a number of limitations. First, we only examined data collected from the medical record of HIV-positive men at their primary HIV care provider. Any syphilis testing occurring outside of this setting may have been missed, so we are likely underestimating syphilis testing rates. A recent analysis looking at local MMP data in San Francisco examining the proportion of sexually active persons screened for STDs at a place other than their primary HIV care provider reported that 8.

Second, we limited our analysis to sexually active MSM based on self-reported sexual behavior. We could therefore be excluding men who did not feel comfortable reporting sexual behaviors including risk behaviors and same-sex sexual behavior.

Although our findings suggest a continuation of the previously documented increasing trend in syphilis testing among sexually active HIV-positive MSM in care, nearly one-third of MSM did not have any documentation of syphilis testing by their primary HIV care provider in the past 12 months.

A lack of timely and regular syphilis screening represents a missed opportunity to identify early, asymptomatic infections, which when adequately treated could have a significant impact on stemming the transmission of syphilis.

Given the potentially serious complications that can result from HIV and syphilis coinfection, our findings suggest that improved efforts may be warranted to increase syphilis screening among sexually active HIV-positive MSM.

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC. Potential conflicts of interest. The authors declare no conflicts of interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Oxford University Press is a department of the University of Oxford.

It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide. Sign In or Create an Account. Sign In. Advanced Search. Article Navigation. Close mobile search navigation Article Navigation. Volume Article Contents. Correspondence: A. Oxford Academic. Google Scholar. Kyle T Bernstein. Heather Bradley. Robert D Kirkcaldy. Yunfeng Tie. R Luke Shouse. Cite Citation. Permissions Icon Permissions.

Abstract Background. Table 1. Open in new tab. Open in new tab Download slide. Table 2. Abbreviations: CI, confidence interval; PR, prevalence ratio.

Centers for Disease Control and Prevention. HIV surveillance report. Sexually transmitted disease surveillance Rates of primary and secondary syphilis among white and black non-Hispanic men who have sex with men MSM , United States, Search ADS.

From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Bacterial sexually transmitted infections among HIV-infected patients in the United States: estimates from the medical monitoring project.

Increased sexually transmitted disease testing among sexually active persons receiving medical care for human immunodeficiency virus infection in the United States, — Syphilis screening and diagnosis among men who have sex with men, , 20 U. Design and weighting methods for a nationally representative sample of HIV-infected adults receiving medical care in the United States-Medical Monitoring Project. Google Preview. Distinguishing public health research and public health nonresearch.

The adolescent and young adult HIV cascade of care in the United States: exaggerated health disparities. Using mathematical models to inform syphilis control strategies. Cost-effectiveness of enhanced syphilis screening among HIV-positive men who have sex with men: a microsimulation model.

Increased syphilis testing of men who have sex with men: greater detection of asymptomatic early syphilis and relative reduction in secondary syphilis. Use of a computer alert increases detection of early, asymptomatic syphilis among higher-risk men who have sex with men. Interventions to improve sexually transmitted disease screening in clinic-based settings.

Evidence of sexually transmitted disease testing outside of primary human immunodeficiency virus care for people living with human immunodeficiency virus in San Francisco, California. Issue Section:. Download all figures.

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Primary and secondary syphilis latino

Primary and secondary syphilis latino

Primary and secondary syphilis latino