PubMed Health

Pregnant women with gonorrhoea who take penicillin, spectinomycin or ceftriaxone are much less likely to show signs of infection.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

This review compared the diagnostic accuracy of three nucleic acid amplification tests (using urine samples) for Chlamydia trachomatis and Neisseria gonorrhoeae. The authors concluded that accuracy results in tests for the first condition equate favourably to traditional sampling methods. More research is needed for the second condition. Limitations in the review process mean that the reliability of the authors' conclusions is unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

This review compares the effects of various sexually transmitted disease (STD) partner notification strategies. It updates previous reviews, and addresses some of their methodological limitations. It includes 11 randomised controlled trials (RCTs) comparing two or more strategies, including 8014 participants. Only two trials were conducted in developing countries, and only two trials were conducted among HIV positive patients. The review found moderately strong evidence that: 1. provider referral alone, or the choice between patient and provider referral, when compared with patient referral among patients with HIV or any STD, increases the rate of partners presenting for medical evaluation; 2. contract referral, when compared with patient referral among patients with gonorrhoea, results in more partners presenting for medical evaluation; 3. verbal, nurse‐given health education together with patient‐centred counselling by lay workers, when compared with standard care among patients with any STD, results in small increases in the rate of partners treated. The review concludes that there is a need for evaluations of interventions combining provider training and patient education, for evaluations conducted in developing countries, and for the measurement of potential harmful effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Community‐ or population‐based sexually transmitted infection control does not appear to be an effective HIV prevention strategy in most settings. In the early 1990s, improved STI treatment services were shown to reduce HIV incidence in northern Tanzania, in an environment characterised by an emerging HIV epidemic, where STI treatment services were poor and where STIs were highly prevalent. Subsequent trials, however, failed to confirm these findings and also failed to show a substantial benefit for community‐wide presumptive treatment for STIs. This is likely due to the endemic nature of HIV and relatively low incidence of STIs in these populations. There are, however, other good reasons as to why STI treatment services should be strengthened and the available evidence suggests that when an intervention is applied and accepted in a community, it can improve the quality of services provided. The trial in Masaka District, Uganda showed an increase in the use of condoms, a marker for less risky sexual behaviours, although a newer study by Gregson conducted in Zimbabwe suggested no effect. With the last three trials having shown disappointing results with respect to HIV prevention, it is unlikely that further community trials will be conducted, let alone yield different results. Future trials of biomedical interventions that involve individual randomisation, however, may represent an opportunity to reexamine presumptive treatment of STIs. Such trials should also aim to measure a range of factors that include health‐seeking behaviour and quality of treatment, as well as HIV, STI and other biological endpoints.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

To update a 2004 systematic review of health care service use and health outcomes related to differences in health literacy level and interventions designed to improve these outcomes for individuals with low health literacy. Disparities in health outcomes and effectiveness of interventions among different sociodemographic groups were also examined.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

Contraception can be divided into two broad categories: hormonal and nonhormonal. There are two categories of hormonal contraception: combined oestrogen and progestogen and progestogen-only. Long-acting reversible contraception (LARC) is defined in this guideline as methods that require administering less than once per cycle or month.

NICE Clinical Guidelines - National Collaborating Centre for Women’s and Children’s Health (UK).

Despite advances in prevention and treatment, sexually transmitted infections (STIs) remain a significant cause of morbidity and mortality in the United States. There are an estimated 19 million new infections each year in the US costing about $13 billion.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Since its inception, the USPSTF has made and maintained recommendations on more than 100 clinical preventive services that are intended to prevent or reduce the risk for heart disease, cancer, infectious diseases, and other conditions and events that impact the health of children, adolescents, adults, and pregnant women. The Guide to Clinical Preventive Services 2012 includes new or updated recommendations on 64 clinical preventive services released from 2002–2012 in a brief, easily usable format meant for use at the point of patient care. Recommendations that were being updated while this edition of the Guide was being compiled, as well as the complete USPSTF recommendation statements, are available along with their supporting scientific evidence at www.USPreventiveServicesTaskForce.org.

Agency for Healthcare Research and Quality (US).

In preparing this review, the US Preventive Services Task Force (USPSTF) began by considering what type of evidence would be necessary to require revision of the 2001 systematic review of the evidence on screening for chlamydial infection. For example, since the USPSTF in 2001 found insufficient evidence to conclude that screening men could lead to a decreased incidence of infection in women, new evidence concerning this question might lead to a revision of the USPSTF recommendation for screening men. Additionally, changes in the epidemiology of chlamydial infection might lead to a revision of the categorization of increased risk.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

BACKGROUND: In many countries, the prevalence of bacterial sexually transmitted infections (STIs) among men who have sex with men (MSM) is high. We undertook a systematic review to identify clinic-based strategies for increasing screening and detection of bacterial STIs among MSM.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

INTRODUCTION: Around 92 million urogenital infections are caused yearly by Chlamydia trachomatis worldwide [1].The overall incidence of sexually transmitted diseases is increasing, as shown by the increases in the number of reported cases of syphilis and gonorrhea [2]. Chlamydia trachomatis infections are associated with various serious diseases in women, men and newborns, which could be, at least partially, avoided by means of early diagnosis and therapy. The Federal Joint Committee - responsible for decision-making concerning the benefit package of the German Social Health Insurance - has publicly announced the starting of deliberations on the issue of screening for Chlamydia trachomatis.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Concerns exist as to whether the insertion of copper and levonorgestrel-releasing intrauterine devices (IUDs) increases the risk of pelvic inflammatory disease (PID) among women with sexually transmitted infection (STI). We searched the MEDLINE database for all articles published between January 1966 and March 2005 that included evidence relevant to IUDs and STIs and PID. None of the studies that examined women with STIs compared the risk of PID between those with insertion or use of an IUD and those who had not received an IUD. We reviewed indirect evidence from six prospective studies that examined women with insertion of a copper IUD and compared risk of PID between those with STIs at the time of insertion with those with no STIs. These studies suggested that women with chlamydial infection or gonorrhea at the time of IUD insertion were at an increased risk of PID relative to women without infection. The absolute risk of PID was low for both groups (0-5% for those with STIs and 0-2% for those without).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).