The vaginal microbiota has great significance in maintaining vaginal health and protecting the host from disease. Recent advances in molecular techniques and informatics allow researchers to explore ...microbial composition in detail and to compare the structure of vaginal microbial communities with behavior and health outcomes, particularly acquisition and transmission of sexually transmitted diseases (STDs) and poor birth outcomes. Vaginal flora have been found to cluster into a limited number of communities, although community structure is dynamic. Certain community types are more associated with poor reproductive outcomes and STDs; communities dominated by Lactobacillus species, particularly Lactobacillus crispatus, are most associated with vaginal health. Modifiable and nonmodifiable factors are strongly associated with community composition, including behavior, race or ethnicity, and hygiene. In this review, we describe the state of the science on the vaginal microbiome and its relationship to behavior, sexual health, and STDs, including determinants of the microbiome that go beyond an individual level.
BACKGROUND:Researchers have suggested that social media and online search data might be used to monitor and predict syphilis and other sexually transmitted diseases. Because people at risk for ...syphilis might seek sexual health and risk-related information on the internet, we investigated associations between internet state-level search query data (e.g., Google Trends) and reported weekly syphilis cases.
METHODS:We obtained weekly counts of reported primary and secondary syphilis for 50 states from 2012 to 2014 from the US Centers for Disease Control and Prevention. We collected weekly internet search query data regarding 25 risk-related keywords from 2012 to 2014 for 50 states using Google Trends. We joined 155 weeks of Google Trends data with 1-week lag to weekly syphilis data for a total of 7750 data points. Using the least absolute shrinkage and selection operator, we trained three linear mixed models on the first 10 weeks of each year. We validated models for 2012 and 2014 for the following 52 weeks and the 2014 model for the following 42 weeks.
RESULTS:The models, consisting of different sets of keyword predictors for each year, accurately predicted 144 weeks of primary and secondary syphilis counts for each state, with an overall average R of 0.9 and overall average root mean squared error of 4.9.
CONCLUSIONS:We used Google Trends search data from the prior week to predict cases of syphilis in the following weeks for each state. Further research could explore how search data could be integrated into public health monitoring systems.
Abstract
Pelvic inflammatory disease (PID) is a syndrome that causes substantial morbidity, including chronic pelvic pain, to women globally. While limited data are available from low- and ...middle-income countries, national databases from the United States and Europe suggest that PID incidence may be decreasing but the rate of decrease may differ by the etiologic cause. Recent studies of women with PID have reported that fewer than half of women receiving a diagnosis of PID have gonococcal or chlamydial infection, while Mycoplasma genitalium, respiratory pathogens, and the constellation of bacteria associated with bacterial vaginosis may account for a substantial fraction of PID cases. The clinical diagnosis of PID is nonspecific, creating an urgent need to develop noninvasive tests to diagnose PID. Advances in serologic testing for Chlamydia trachomatis and Neisseria gonorrhoeae could advance epidemiologic studies, while the development of vaccines against these sexually transmitted pathogens could affect incident PID and associated morbidity.
Knowledge generation, learning and monitoring are an integral part of programmes but what is often missing is an organized and systematic process of gathering, analysing and using this knowledge in a ...continual and iterative manner to not only inform and optimize programmes but also to generate new knowledge which is generalizable and transferable to other contexts, and which can move scientific knowledge forward. Programme Science is an approach to public health programming and research that aims to improve the design, implementation and monitoring of public health programmes through the systematic application of theoretical and empirical scientific knowledge that is generated through programme-embedded research and learning process 18, 19. Programme Science integrates key programmatic spheres of practice—strategic planning, programme implementation and evaluation—with complementary and evolving spheres of knowledge 21. 33 then illustrate the iterative nature of Programme Science through representation of the second and third spheres of Programme Science—programme implementation and programme monitoring and evaluation—with data then cycling back to inform programme strategy (first sphere).
Populations function as complex systems, and disease rates might result from the characteristics of individuals in the population, the interactions and interdependences between individuals, the ...effects of population-level factors on individual-level health outcomes, and the interplay between individual-level and population-level factors.1 This view of population health provides a best fit to understanding the importance of social determinants of disease and health within populations.4 Recent analyses in the USA demonstrate that reported sexual behaviour in terms of number of partners, practices, condom use, and other individual-level factors does not solely account for the observed racial and ethnic disparities in rates of HIV or other STIs.5 In most analyses, African American women have among the highest HIV and STI prevalence but do not have the highest levels of risk behaviours. Furthermore, the sex ratio of men to women is much lower among African Americans than all other ethnic groups as a result of high mortality rates among black men from disease and violence, and high rates of incarceration.1*17 These two social forces, poverty and the low sex ratio, are probably among the biggest determinants of sexual network patterns among black people in the USA.* Poverty and low sex ratios are associated with low marriage rates, and married people have lower rates of concurrent partnerships than unmarried people.18 Moreover, the shortage of black men promotes partner concurrency as well as partnering between women with low-risk behaviours and men with high-risk behaviours.
Telehealth offers one approach to improving access to sexually transmitted infection (STI) prevention and care services. Therefore, we described recent telehealth use among those providing ...STI-related care and identified opportunities for improving STI service delivery.
Using the DocStyles Web-based, panel survey conducted by Porter Novelli from September 14 to November 10, 2021, 1500 healthcare providers were asked about their current telehealth usage, demographics, and practice characteristics, and compared STI providers (≥10% of time spent on STI care and prevention) to non-STI providers.
Among those whose practice consisted of at least 10% STI visits (n = 597), 81.7% used telehealth compared with 75.7% for those whose practice consisted of less than 10% STI visits (n = 903). Among the providers with at least 10% STI visits in their practice, telehealth use was highest among obstetrics and gynecology specialists, those practicing in suburban areas, and those practicing in the South. Among providers whose practice consisted of at least 10% STI visits and who used telehealth (n = 488), the majority were female and obstetrics and gynecology specialists practicing in suburban areas of the South. After controlling for age, gender, provider specialty, and geographic location of their practice, providers whose practice consisted of at least 10% STI visits had increased odds (odds ratio, 1.51; 95% confidence interval, 1.16-1.97) of using telehealth compared with providers whose visits consisted of less than 10% STI visits.
Given the widespread use of telehealth, efforts to optimize delivery of STI care and prevention via telehealth are important to improve access to services and address STIs in the United States.
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