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3. Evaluation of office-based intervention to improve prevention counseling for patients at risk for sexually acquired hepatitis B virus infection

Author

Margolis, Harold S., Handsfield, H.Hunter, Jacobs, R.Jake, and Gangid, Joseph E.

Subjects
Hepatitis B virus -- Health aspects, Sexually transmitted diseases -- Health aspects, Health
Abstract

Byline: Harold S. Margolis, H.Hunter Handsfield, R.Jake Jacobs, Joseph E. Gangid Keywords: Health education; hepatitis B vaccination; immunization; patient counseling; prevention; primary care Abstract: The aim of this study was to determine the effectiveness of tools to identify and counsel patients at risk for sexually transmitted hepatitis B virus infection. Physicians were randomly assigned to either an intervention group or a control group. The intervention group was provided with materials intended to encourage patients to return for counseling and to guide counseling concerning prevention of hepatitis B virus infection. Baseline data on 457 patients at risk for hepatitis B virus infection showed that 7% had received prevention counseling and 2% had begun hepatitis B vaccination. Counseling was least likely to occur in obstetric-gynecologic practices, among uninsured patients, and among patients whose only risk factor was a diagnosis of a sexually transmitted disease. After a 6-month intervention period 26% of the intervention group patients and 7% of the control group patients had been counseled (P < .01). Vaccination was more likely among intervention group patients (8% vs Author Affiliation: Atlanta, Georgia, Seattle, Washington, Alexandria, Virginia, and Rockville, Maryland From the Hepatitis Branch, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention,.sup.a the Seattle-King County Department of Public Health and Department of Medicine, University of Washington,.sup.b Capitol Outcomes Research, Inc,.sup.c and QSI Incorporated..sup.d Members of the Hepatitis B-WARE Study Group are listed at the end of the article Article Note: (footnote) [star] Funded in part by an educational grant from SmithKline Beecham Pharmaceuticals to QSI, Incorporated., [star][star] Reprint requests: Harold S. Margolis, MD, Hepatitis Branch (A-33), Centers for Disease Control and Prevention, Atlanta, GA 30333., a 6/1/98323

Published
2000

6. Prevalence of Sexually Transmitted Diseases and Risk Behaviors from the NIMH Collaborative HIV/STD Prevention Trial.

Author

Celentano, DavidD., Mayer, KennethH., Pequegnat, Willo, Abdala, Nadia, Green, AnnetteM., Handsfield, H.Hunter, Hartwell, TylerD., and National Institute of Mental Health Collaborative HIV/STD Prevention Trial Group*

Subjects
HIV prevention, CHI-squared test, COMPUTER software, CONFIDENCE intervals, FISHER exact test, INTERVIEWING, SEX work, RISK-taking behavior, SEXUALLY transmitted diseases, STATISTICS, LOGISTIC regression analysis, DATA analysis, RANDOMIZED controlled trials, DISEASE prevalence, CROSS-sectional method
Abstract

This cross-sectional study describes the baseline prevalence and correlates of common bacterial and viral sexually transmitted diseases (STDs) and risk behaviors among individuals at high risk for HIV recruited in five low- and middle-income countries. Correlations of risk behaviors and demographic factors with prevalent STDs and the association of STDs with HIV prevalence are examined. Between 2,212 and 5,543 participants were recruited in each of five countries (China, India, Peru, Russia, and Zimbabwe). Standard protocols were used to collect behavioral risk information and biological samples for STD testing. Risk factors for HIV/STD prevalence were evaluated using logistic regression models. STD prevalence was significantly higher for women than men in all countries, and the most prevalent STD was Herpes simplex virus-type 2 (HSV-2). HIV prevalence was generally low (below 5%) except in Zimbabwe (30% among women, 11.7% among men). Prevalence of bacterial STDs was generally low (below 5% for gonorrhea and under 7% for syphilis in all sites), with the exception of syphilis among female sex workers in India. Behavioral and demographic risks for STDs varied widely across the five study sites. Common risks for STDs included female gender, increasing number of recent sex partners, and in some sites, older age, particularly for chronic STDs (i.e., HSV-2 and HIV). Prevalence of HIV was not associated with STDs except in Zimbabwe, which showed a modest correlation between HIV and HSV-2 prevalence (Pearson coefficient = .55). These findings underscore the heterogeneity of global STD and HIV epidemics and suggest that local, focused interventions are needed to achieve significant declines in these infections. [ABSTRACT FROM AUTHOR]

Published
2010
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