Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-12 (of 12 Records) |
Query Trace: Berman SM [original query] |
---|
Centers for Disease Control and Prevention sexually transmitted disease treatment guidelines
Workowski KA , Berman SM . Clin Infect Dis 2011 53 S59-S63 Sexually transmitted diseases (STDs) constitute an epidemic of tremendous magnitude, with an estimated 18.9 million persons acquiring a new STD each year [1]. Reported disease rates underestimate the true burden of infection because the majority of STDs are asymptomatic and therefore go undetected, and also because of underreporting. STDs have far-reaching public health consequences on the sexual and reproductive health of individuals as well as the long-term health and health care costs of the community. | The accurate identification and effective clinical management of STDs represents a critical strategy for improving reproductive and sexual health and strengthening human immunodeficiency virus (HIV) prevention efforts. This is especially relevant to women, adolescents, and infants, as untreated infections frequently result in severe, long-term complications, including tubal infertility, adverse pregnancy outcomes, cancer, and facilitation of HIV infection. For more than 20 years, the Centers for Disease Control and Prevention’s (CDC) national guidelines for managing STDs has helped clinicians deliver optimal STD care. The CDC STD treatment guidelines are the most widely referenced and authoritative source of information on STD treatment and prevention strategies for clinicians who evaluate persons with STDs or those at risk for STDs. |
A prospective study of the psychosocial impact of a positive Chlamydia trachomatis laboratory test
Gottlieb SL , Stoner BP , Zaidi AA , Buckel C , Tran M , Leichliter JS , Berman SM , Markowitz LE . Sex Transm Dis 2011 38 (11) 1004-11 BACKGROUND: Few data exist on potential harms of chlamydia screening. We assessed the psychosocial impact of receiving a positive Chlamydia trachomatis test result. METHODS: We prospectively studied women ≥16 years of age undergoing chlamydia testing in 2 Midwestern family planning clinics. We surveyed women at baseline and about 1 month after receiving test results, using 9 validated psychosocial scales/subscales and chlamydia-specific questions. Changes in scale scores were calculated for each woman. Mean percent changes in scores for chlamydia-positive and -negative women were compared using a t test. RESULTS: We enrolled 1807 women (response rate, 84%). Of the 1688 women with test results, 149 (8.8%) tested positive. At follow-up, chlamydia-positive women (n = 71) had a 75% increase in anxiety about sexual aspects of their life on the Multidimensional Sexual Self-Concept Questionnaire (P < 0.001), significantly greater than the 26% increase among 280 randomly selected chlamydia-negative women (P = 0.02). There were no differences for the other 8 scales/subscales, including general measures of anxiety, depression, and self-esteem. Chlamydia-positive women were more likely than chlamydia-negative women to be "concerned about chlamydia" (80% vs. 40%, P < 0.001) and to report breaking up with a main partner (33% vs. 11%, P < 0.001) at follow-up. Women testing positive reported a range of chlamydia-specific concerns. CONCLUSIONS: Chlamydia-positive women had significant increases in anxiety about sex and concern about chlamydia, but did not have marked changes in more general measures of psychosocial well-being about 1 month after diagnosis. Chlamydia diagnoses were associated with some disruption of relationships with main partners. Chlamydia-specific concerns may guide counseling messages to minimize psychosocial impact. |
Danish health register study: a randomised trial with findings about the implementation of chlamydia screening, but not about its benefits
Soldan K , Berman SM . Sex Transm Infect 2011 87 (2) 86-7 Andersen et al1 report findings from 9 years' follow-up in one county in Denmark of 30 000 men and women aged 21–23 years, of whom 9000 (4000 women and 5000 men) were randomly selected in 1997 to receive a mailed invitation to provide a self-obtained specimen for chlamydia screening. That study has exploited the rare opportunity offered by Danish health registers to link longitudinal health records for a cohort of young people, which included men (a rarity). Using an intention-to-treat analysis, the authors conclude that a single postal invite for chlamydia testing, with a repeat offer to those found positive, did not reduce the long-term risk of reproductive complications.1 What do these data add to the evidence base concerning the effectiveness of chlamydia screening? What lessons should inform further studies? | Previous randomised controlled trials (RCTs) of a single chlamydia screen, with 1-year follow-up for the incidence of pelvic inflammatory disease (PID), have noted the limitation of evaluating the impact of a single round of chlamydia screening, because the risk of chlamydia infection is ongoing,2 as should the intervention be.3 The study by Andersen et al1 with its long follow-up for ectopic pregnancy and infertility increases the probability of the acquisition of chlamydia infections after (or before) the intervention and accentuates this bias to a null finding for these outcomes. |
Sexually transmitted diseases program performance measures: how are they performing?
Peterman TA , Newman DR , Collins DE , Doshi SR , Berman SM . Sex Transm Dis 2011 38 (7) 610-6 BACKGROUND: Performance measures were developed in order to improve the performance of sexually transmitted disease (STD) prevention programs. METHODS: A consultant worked with persons from STD programs and Centers for Disease Control and Prevention to identify possible measures. Measures were pilot tested for feasibility and relevance in several programs, then implemented nationwide in 2004. Data were collated and shared with programs and presented at national meetings. Site visits, webinars, and technical assistance focused on program improvement related to the measures. Reported data were analyzed to see if national performance improved on the activities measured. RESULTS: Some measures were dropped or revised, and quality of reported data improved over time. There was little evidence that overall program performance improved. CONCLUSIONS: Performance measures are one way to monitor performance, and might contribute to program improvement, but additional efforts are needed to improve performance. |
A paradox: overscreening of older women for chlamydia while too few younger women are being tested
Berman SM , Satterwhite CL . Sex Transm Dis 2010 38 (2) 130-2 In this issue, Bernstein et al. report on a structural intervention aimed at reducing chlamydia screening among women aged ≥26 years.1 This article, though brief, provides an opportunity to highlight several issues related to chlamydia screening and sexually transmitted disease (STD)/human immunodeficiency virus (HIV) prevention in general. | The importance of screening young women for chlamydia should be reemphasized. The United States Preventive Services Task Force (USPSTF) recommends annual chlamydia screening for all sexually active young women aged <25 years.2 This is an “A” recommendation, meaning there is good evidence that the benefits of screening outweigh the harms.3 Conversely, USPSTF recommends against routinely screening women aged ≥25 years, unless the individuals are at increased risk of infection (e.g., history of sexually transmitted infections, new or multiple sex partners, inconsistent condom use, exchanging sex for money or drugs). |
Screening and treatment to prevent sequelae in women with Chlamydia trachomatis genital infection: how much do we know?
Gottlieb SL , Berman SM , Low N . J Infect Dis 2010 201 Suppl 2 S156-67 BACKGROUND: An important question for chlamydia control programs is the extent to which finding and treating prevalent, asymptomatic Chlamydia trachomatis genital infection reduces reproductive sequelae in infected women. METHODS: We reviewed the literature to critically evaluate evidence on the effect of chlamydia screening on development of sequelae in infected women. RESULTS: Two randomized controlled trials of 1-time screening for chlamydial infection-in a Seattle-area health maintenance organization and a Danish school district-revealed that screening was associated with an approximately 50% reduction in the incidence of pelvic inflammatory disease over the following year. However, both of these trials had methodological issues that may have affected the magnitude of observed screening benefits and might limit generalizability to other populations. A large, nonrandomized cohort of chlamydia screening among US Army recruits, although limited by lack of outpatient data, did not find a benefit of similar magnitude to the randomized trials. Methodological limitations restrict valid conclusions about individual benefits of screening using data from historical cohorts and ecological studies. We identified no trials directly evaluating the effect of chlamydia screening on subclinical tubal inflammation or damage, ectopic pregnancy, or tubal factor infertility and no studies addressing the effects of >1 round of screening, the optimal frequency of screening, or the benefits of screening for repeat infections. CONCLUSIONS: Additional studies of the effectiveness of chlamydia screening would be valuable; feasible study designs may depend on the degree to which screening programs are already established. In addition, better natural history data on the timing of tubal inflammation and damage after C. trachomatis infection and development of more accurate, noninvasive tools to assess chlamydial sequelae are essential to informing chlamydia control efforts. |
Introduction: The natural history and immunobiology of Chlamydia trachomatis genital infection and implications for chlamydia control
Gottlieb SL , Brunham RC , Byrne GI , Martin DH , Xu F , Berman SM . J Infect Dis 2010 201 Suppl 2 S85-7 Chlamydia trachomatis genital infection is the most common bacterial sexually transmitted infection worldwide [1], and an estimated 3 million cases occur each year in the United States [2]. In women, C. trachomatis genital infection can lead to serious complications, including pelvic inflammatory disease, ectopic pregnancy, tubal infertility, and chronic pelvic pain [3]. Because of this, many countries have implemented chlamydia control efforts that have primarily emphasized enhanced detection and treatment of asymptomatic infection in young women and have achieved varying degrees of screening coverage [4–6]. Early reports from regions that were the first to implement chlamydia control activities (during the late 1980s and early 1990s) revealed that both chlamydia case rates and rates of associated complications were decreasing [7–9]. However, since the mid-1990s, in virtually all countries with substantial investment in chlamydia control, the number of C. trachomatis infection case reports has been increasing in the setting of ongoing control efforts [10–12]. In the United States, regions that had initially shown decreases in chlamydia test positivity (prevalence of chlamydia among tested women) have since shown stable or increasing test positivity [11]. Although there are limitations in using these types of surveillance data to assess burden of disease [13], the substantial and continuing decreases in rates of C. trachomatis infection that were expected after implementation of control programs have not been observed [14], and many chlamydia control programs are currently at a crossroads. |
A public health focus on infertility prevention, detection, and management
Macaluso M , Wright-Schnapp TJ , Chandra A , Johnson R , Satterwhite CL , Pulver A , Berman SM , Wang RY , Farr SL , Pollack LA . Fertil Steril 2010 93 (1) 16 e1-10 In 2002, 2 million American women of reproductive age were infertile. Infertility is also common among men. The Centers for Disease Control and Prevention (CDC) conducts surveillance and research on the causes of infertility, monitors the safety and efficacy of infertility treatment, and sponsors national prevention programs. A CDC-wide working group found that, despite this effort, considerable gaps and opportunities exist in surveillance, research, communication, and program and policy development. We intend to consult with other federal agencies, professional and consumer organizations, the scientific community, the health care community, industry, and other stakeholders, and participate in the development of a national public health plan for the prevention, detection, and management of infertility. |
Prevalence of sexually transmitted infections among female adolescents aged 14 to 19 in the United States
Forhan SE , Gottlieb SL , Sternberg MR , Xu F , Datta SD , McQuillan GM , Berman SM , Markowitz LE . Pediatrics 2009 124 (6) 1505-12 OBJECTIVE: Most young women initiate sexual activity during adolescence; risk for sexually transmitted infections (STIs) accompanies this initiation. In this study we estimated the prevalence of the most common STIs among a representative sample of female adolescents in the United States. METHODS: Data were analyzed from 838 females who were aged 14 to 19 and participating in the nationally representative National Health and Nutrition Examination Survey 2003-2004. After interview and examination, survey participants provided biological specimens for laboratory testing. The main outcome was weighted prevalence of at least 1 of 5 STIs: Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, herpes simplex virus type 2, and human papillomavirus (HPV) (any of 23 high-risk types or type 6 or 11). RESULTS: Prevalence of any of the 5 STIs was 24.1% among all and 37.7% among sexually experienced female adolescents. HPV (23 high-risk types or type 6 or 11) was the most common STI among all female adolescents (prevalence: 18.3%), followed by C trachomatis infection (prevalence: 3.9%). Prevalence of any of the STIs was 25.6% among those whose age was the same or 1 year greater than their age at sexual initiation and 19.7% among those who reported only 1 lifetime sex partner. CONCLUSIONS: The prevalence of STIs among female adolescents is substantial, and STIs begin to be acquired soon after sexual initiation and with few sex partners. These findings support early and comprehensive sex education, routine HPV vaccination at the age of 11 to 12 years, and C trachomatis screening of sexually active female adolescents. |
Dilemmas in the management of syphilis: a survey of infectious diseases experts
Dowell D , Polgreen PM , Beekmann SE , Workowski KA , Berman SM , Peterman TA . Clin Infect Dis 2009 49 (10) 1526-9 We surveyed infectious diseases consultants to determine how they manage syphilis when there are insufficient data to guide management or when guidelines cannot be followed because of a lack of available definitive diagnostic tests. Most providers did not have access to dark-field microscopy. We found variation in management of syphilis, especially for patients with human immunodeficiency virus infection. |
Screening for HSV-2 infection in STD clinics and beyond: a few answers but more questions
Douglas JM Jr , Berman SM . Sex Transm Dis 2009 36 (11) 729-31 Genital herpes simplex virus [HSV]-2 is considered the highest prevalence sexually transmitted infection in the United States, with an estimated 17% of all adolescents and adults infected.1 Although asymptomatic in most persons, HSV-2 causes a range of important problems, including recurrent genital ulcerations, devastating neonatal infection, and enhanced HIV transmission, with estimates that HSV-2 may account for 25% to 35% of HIV infections in sub-Saharan Africa.2 Conventional tools for prevention and control (e.g., curative therapy, vaccines) do not exist for HSV-2. However, strategies that do exist—serologic tests for diagnosis, disclosure to partners, the use of condoms,3,4 and antiviral therapy that suppresses symptoms and reduces transmission5—are analogous to those in use for HIV prevention, and, over the past decade, the magnitude of the population burden associated with HSV-2 has stimulated discussion about the value of initiating broad prevention programs.6–10 | The appropriate use and likely effect of these approaches, particularly the role of widespread serologic testing, has generated controversy. Since over 80% of infected persons are unaware of their diagnosis1 and most transmission is from individuals with unrecognized infection,11 identifying those who are infected is a logical starting point for prevention. Type-specific serologic tests for herpes, available over the past decade, represent a major improvement over the earlier, nonspecific, whole antigen tests.12 However, based on concerns over test performance in low-prevalence populations and lack of data about benefit of testing, screening has not been recommended in general populations, although there continues to be debate about its role in targeted populations such as those attending sexually transmitted disease [STD] clinics. |
Screening male prisoners for Chlamydia trachomatis: impact on test positivity among women from their neighborhoods who were tested in family planning clinics
Peterman TA , Newman DR , Goldberg M , Anschuetz GL , Salmon M , Satterwhite CL , Berman SM . Sex Transm Dis 2009 36 (7) 425-9 BACKGROUND: Chlamydia trachomatis screening test positivity among women in the United States has remained high, leading researchers to suggest that programs should also screen men. Men have been screened in Philadelphia prisons since 2002. Philadelphia prisons are similar to jails in other jurisdictions; in 2003 the median duration of incarceration was 17 days. We studied whether screening and treating men in prison influenced C. trachomatis infection among women living in their communities. METHODS: We divided the city into 2 areas: "high-treatment" (high percentage of men were treated for C. trachomatis detected in prison) and "low-treatment" (low percentage of men were treated for C. trachomatis detected in prison). We compared changes in test positivity among women from those areas, who were tested in family planning clinics during the 2 years before versus the 3 years after the male prison screening program began. RESULTS: In 2002 to 2004, prison screening led to treatment of 1054 infections among 23,203 men aged 20 to 24 years living in high-treatment areas and 98 infections among 21,057 men aged 20 to 24 years in low-treatment areas. Test positivity declined among 20- to 24-year-old women in both areas. In high-treatment areas, positivity decreased 9.1% per year from 1999 to 2001 and 4.9% per year from 2001 to 2004. In low-treatment areas, positivity decreased 13.2% per year from 1999 to 2001 and 7.5% per year from 2001 to 2004. CONCLUSION: C. trachomatis test positivity among 20- to 24-year-old women tested in family planning clinics continued to decrease after men were treated for C. trachomatis; however, we found no evidence that the continued decrease was due to the new prison screening program. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Sep 16, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure