We estimated vaccine effectiveness (VE) against severe COVID-19 during October 2021, using Slovenian surveillance data. For people fully vaccinated with any vaccine in age groups 18-49, 50-64, ≥ 65 ...years, VE was 86% (95% CI: 79-90), 89% (85-91), and 77% (74-81). Among ≥ 65 year-olds fully vaccinated with mRNA vaccines, VE decreased from 93% (95% CI: 88-96) in those vaccinated ≤ 3 months ago to 43% (95% CI: 30-54) in those vaccinated ≥ 6 months ago, suggesting the need for early boosters.
National testing strategy, including monitoring and evaluation, is critical in responding to HIV, sexually transmitted infections, and viral hepatitis. Community-based voluntary counselling and ...testing contributes to early HIV diagnoses among key populations. Countries providing community-based testing, should integrate some core data on testing and linkage to care in these services into national surveillance and monitoring and evaluation systems. This study aimed to support the integration of community-based voluntary counselling and testing data into respective national surveillance and M&E systems for those infections. Preliminary consensus on indicators for the integration of community-based voluntary counselling and testing data into respective national surveillance and monitoring and evaluation systems was reached. Pilot studies were conducted in Estonia, Poland, Serbia, Slovakia, Slovenia and Spain. After pilot activities were implemented, the final consensus on indicators was reached. An analysis of the facilitators and barriers faced during pilot studies was conducted to inform the final recommendations for implementation. The minimum set of six indicators to be integrated into national surveillance and monitoring and evaluation systems were: number of tests, number of clients tested, reactivity rate for tests and clients, positivity (active infection) rates for tests and clients, linkage to care rates for clients with reactive and/or positive test result, proportion of all new diagnoses in a country with first reactive test result at community-based voluntary counselling and testing service. Seven additional indicators were identified. Each indicator should be disaggregated by key population, sex and age group. A list of 10 recommendations for the collection and integration of community-based voluntary counselling and testing data into national surveillance and monitoring and evaluation systems for HIV, sexually transmitted infections and viral hepatitis was identified. Integration of some community-based voluntary counselling and testing monitoring and evaluation data into national surveillance and monitoring and evaluation systems in all pilot countries was achieved. The recommendations will support such integration in other European countries. European Centre for Prevention and Control of Diseases included questions from the minimum list of indicators into their Dublin Declaration questionnaire 2020 to contribute to evidence based community testing policies in European countries.
Community-based voluntary counselling and testing contributes to early HIV diagnoses among key populations. Testing data from such decentralized services is however often not standardized nor linked ...to national surveillance systems. This study aimed to support the integration of community testing data into respective national surveillance and monitoring and evaluation systems for those infections. We present results from three national pilots, focused on improved data collection and transfer.
Within the Joint Action INTEGRATE different pilot activities were planned and implemented according to the local context. In Slovakia, standardised data collection tools were implemented in three community testing services. The data generated was used to calculate the proposed indicators. In Poland, positive test results from the community testing database were linked to the national case-based surveillance database using confirmatory test number, to improve the completeness of behavioural data in the national database. In Serbia, voluntary counselling and testing forms were improved enabling identification of community-based testing. A system to generate unique client identifiers was initiated in the National registry of HIV cases to monitor linkage to care.
All three sites were able to estimate most of the agreed indicators. In Slovakia during the study period 675 people were tested for HIV, 410 for hepatitis C and 457 for syphilis, with reactivity rates of 0.4, 2.5 and 1.8%, respectively. For HIV, 66.7% of reactive cases were confirmed and linked to care. In Poland, 28.9% of the community testing sites' records were linked to the national surveillance database (and accounted for 14.3% of all new diagnoses registered here during 2017-2018). Reactivity rate ranged between 1.9% and 2.1%. In Serbia, 80 persons were tested at community sites, from which two had a reactive HIV test result. By linking unique client identifiers from voluntary counselling and testing and National Registry of HIV cases databases, linkage to care within a two-month period was observed for one of two people with reactive HIV test result.
Pilot activities in the three countries demonstrate that integration of community-based testing data into surveillance systems is feasible and can help improve national surveillance data by providing key information.
Globally, the HIV epidemic continues to represent a pressing public health issue in Europe and elsewhere. There is an emerging and progressively urgent need to harmonise HIV and STI behavioural ...surveillance among MSM across European countries through the adoption of common indicators, as well as the development of trend analysis in order to monitor the HIV-STI epidemic over time. The Sialon II project protocols have been elaborated for the purpose of implementing a large-scale bio-behavioural survey among MSM in Europe in line with a Second Generation Surveillance System (SGSS) approach.
Sialon II is a multi-centre biological and behavioural cross-sectional survey carried out across 13 European countries (Belgium, Bulgaria, Germany, Italy, Lithuania, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, and the UK) in community settings. A total of 4,966 MSM were enrolled in the study (3,661 participants in the TLS survey, 1,305 participants in the RDS survey). Three distinct components are foreseen in the study protocols: first, a preliminary formative research in each participating country. Second, collection of primary data using two sampling methods designed specifically for 'hard-to-reach' populations, namely Time Location Sampling (TLS) and Respondent Driven Sampling (RDS). Third, implementation of a targeted HIV/STI prevention campaign in the broader context of the data collection.
Through the implementation of combined and targeted prevention complemented by meaningful surveillance among MSM, Sialon II represents a unique opportunity to pilot a bio-behavioural survey in community settings in line with the SGSS approach in a large number of EU countries. Data generated through this survey will not only provide a valuable snapshot of the HIV epidemic in MSM but will also offer an important trend analysis of the epidemiology of HIV and other STIs over time across Europe. Therefore, the Sialon II protocol and findings are likely to contribute significantly to increasing the comparability of data in EU countries through the use of common indicators and in contributing to the development of effective public health strategies and policies in areas of high need.
Objectives were to estimate the lifetime prevalence of self-reported sexually transmitted infections (STIs) and describe STIs healthcare.
Data was collected in the period 2016-2017 from a probability ...sample of the general population, 18-49 years old, at respondents' homes by a combination of face-to-face interviews and self-administration of more sensitive questions. Statistical methods for complex survey data were used to account for stratification, clustered sampling, and weighting.
Approximately every tenth sexually experienced individual reported to have had genitourinary symptoms suggestive of STIs, but only a minority of them reported to have had those respective STIs diagnosed. The proportion of sexually experienced individuals that reported to have ever been diagnosed with an STI (excluding trichomoniasis, pubic lice for men and women, and pelvic inflammatory disease, vaginal thrush, bacterial vaginosis for women) was 2.4% for men and 6.7% for women (p<0.001). Independent risk factors associated with self-reported STIs in women included at least 10 lifetime sexual partners and having been forced into sex. The majority of the last STI episodes in women were treated by gynaecologists accessible at the primary healthcare level and in men by a dermatovenerologist, after referral by a general practitioner. Approximately half of STI patients were counselled for safer sex and majority reported to have notified their sexual contacts.
Our estimates for lifetime prevalence of self-reported STIs in a probability sample of Slovenian sexually experienced men and women, 18-49 years old, indicate a substantial national burden of STIs. The results will inform national STI prevention and control policies and strategies.
IntroductionAlthough sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes ...in many parts of the world. We propose sexual satisfaction as a useful indicator, as one of the proxy measures for sexual health and well-being and as a component of well-being in general.MethodsThe Sialon II project is a multicentre biological and behavioural cross-sectional community-based survey implemented across 13 European cities during 2013–2014 among men who have sex with men. Sexual satisfaction was explored using one single item: ‘How satisfied are you with your sex life?’ A multivariable multilevel logistic random-intercept model was estimated to identify factors associated with reporting positive sexual satisfaction versus negative sexual satisfaction.ResultsAge, the number of partners and self-reported HIV status were not significantly associated with sexual satisfaction in the multivariate model. Participants reporting an insertive role or reported both an insertive and receptive role during the last anal intercourse were more likely to be sexually satisfied, compared with a receptive role. Participants reporting anal intercourse with a condom were more likely to be satisfied than those declaring no anal intercourse in the last 6 months, but no significant association was found compared with anal intercourse without condom. Knowledge of HIV-serostatus concordance with the last sexual partner was positively correlated with sexual satisfaction. Having had sexual intercourse with non-steady partners only in the last 6 months was negatively correlated. The more positive participants perceived their work/school, parents and friends/acquaintances’ attitudes towards gay or bisexual persons, the higher the odds they were satisfied with their sexual life.ConclusionUsing a single item on sexual satisfaction in a bio-behavioural study, our analysis has shown that it is associated with individual, interpersonal and social/structural factors and has proven its usefulness as a sexual health indicator among men who have sex with men.
To consider whether a revision of the national chlamydia surveillance system is needed, the objectives were to estimate the proportion of laboratory confirmed cases at the Institute of Microbiology ...and Immunology (IMI) not reported to the National Institute of Public Health (NIPH), and to assess the completeness of reporting for individual data items.
The dataset with information about the cases diagnosed at the IMI during 2007-2010, and the national chlamydia surveillance data at the NIPH, were linked using SOUNDEX code and the date of birth as unique identifier. The proportion of unreported cases was calculated. The proportions of records with missing data for individual variables were estimated for all reported cases during the same period. Chlamydia testing and reported rates for the period 2002-2010 were presented.
Of 576 laboratory confirmed chlamydia cases at the IMI during 2007-2010, 201 were reported to the NIPH, corresponding to 65.1% of the overall underreporting (50.4% among dermatovenerologists, 90.1% among gynaecologist and 100% among other specialists). Item response was above 99% for demographic variables and from 69% to 81% for sexual behaviour variables. Higher testing rates corresponded to higher diagnosed rates.
Surveillance data underestimated diagnosed chlamydia infection rates. Mandatory reporting of cases by laboratories with less variables, including unique identifier, gender, date of diagnosis, and reporting physician specialty, together with numbers of tests performed (for estimating testing and positivity rates) would simplify the surveillance system and eliminate underreporting of laboratory confirmed cases, while still providing necessary information for public health policies.
The second Slovenian national healthcare-associated infections (HAIs) prevalence survey (SNHPS) was conducted in acute-care hospitals in 2011. The objective was to assess the sensitivity and ...specificity of the method used for the ascertainment of six types of HAIs (bloodstream infections, catheter-associated infections, lower respiratory tract infections, pneumoniae, surgical site infections, and urinary tract infections) in the University Medical Centre Ljubljana (UMCL).
A cross-sectional study was conducted in patients surveyed in the SNHPS in the UMCL using a retrospective medical chart review (RMCR) and European HAIs surveillance definitions. Sensitivity and specificity of the method used in the SNHPS using RMCR as a reference was computed for ascertainment of patients with any of the six selected types of HAIs and for individual types of HAIs. Agreement between the SNHPS and RMCR results was analyzed using Cohen's kappa coefficient.
1474 of 1742 (84.6%) patients surveyed in the SNHPS were included in RMCR. The sensitivity of the SNHPS method for detecting any of six HAIs was 90% (95% confidence interval (CI): 81%-95%) and specificity 99% (95% CI: 98%-99%). The sensitivity by type of HAI ranged from 63% (lower respiratory tract infections) to 92% (bloodstream infections). Specificity was at least 99% for all types of HAIs. Agreement between the two data collection approaches for HAIs overall was very good (κ=0.83).
The overall sensitivity of SNHPS collection method for ascertaining HAIs overall was high and the specificity was very high. This suggests that the estimated prevalence of HAIs in the SNHPS was credible.
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