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Out staff of freelance writers includes over 120 experts proficient in Gonorrhea, therefore you can rest assured that your assignment will be handled by only top rated specialists. Order your Gonorrhea paper at affordable prices! There have been reports that increases in gonorrhea infections in homosexual men is associated with an increase in new HIV-1 infections.Craib et al. (15) state Our findings are consistent with previous studies reporting an association between HIV infection and
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non-ulcerative sexually transmitted diseases. Such a direct association might be explained by postulating that gonorrhoea results in inflamed rectal mucosa and compromised epithelial integrity, thereby predisposing an individual to subsequent HIV infection.Yet, in New York City, the rate of gonorrhea plummeted subsequent to 180, while the rates of HIV-1 and HHV-8 new infections were steeply increasing subsequent to 180 reaching a peak in 18 to 18. As concerns HIV-1 new infections, this increase and peak were similar to San Francisco homosexual men (J Acquir Immune Defic Syndr Hum Retrovirol 17; 1618-18) and to United States new infections (Stine Gerald J. (18). Acquired Immune Deficiency Syndrome Biological, Medical, Social, and Legal Issues, rd ed. New Jersey Prentice Hall, pp. -6).As concerns rates of gonorrhea in a Manhattan STD clinic, whose patients are primarily homosexual males, the CDC MMWR of 6/1/84 states This decrease is most evident in the area with the highest rates-- Manhattan --where reported rectal and pharyngeal gonorrhea rates declined from 485/100,000 in 180 to 01/100,000 in 18--a 5% decrease.Between 177 and 180, the rates of gonorrhea in Manhattan were flatlined at a rate of about 460 per 100,000 population.As concerns these major gonorrhea decreases among NYC homosexuals, the CDC editorializes The substantial and persistent declines in gonorrhea among homosexual males in New York City suggest that prevention efforts have succeeded in reducing the incidence of this short-incubation-period sexually transmitted infection. Further sustained efforts should help in reducing the incidence of AIDS among homosexual males.Strangely, while there were major gonorrhea decreases since 180 in NYC homosexuals, the homosexual HIV-1 and HHV-8 seroconversion rates in NYC were increasing subsequent to 180. OBrien et al. (1) state The patterns of seropositivity to HHV-8 and to HIV-1 were very similar in this cohort. For both viruses, seroprevalence was high in June 18 (0.4% for HHV-8 and 4.0% for HIV-1), and the estimated relative hazard of seroconversion peaked during 18. Hepatitis B vaccine trials in high risk and HBV-negative homosexual men took place in the late 170s and early 180s. The first NYC participant was inoculated in 11/78. HBV carriers, who provided the serum for the vaccine (HBsAg particles prior to 11/78), were New York City homosexuals attending bathhouses, venereal disease clinics, or other such meeting places. The NYC trial vaccine and subsequent NYC inoculations involved three 40 mcg intramuscular injections (Szmuness et al., 180), which was later changed to three 0 mcg injections. ===============================Declining rates of rectal and pharyngeal gonorrhea among males--New York City. MMWR Morb Mortal Wkly Rep 184 Jun 1;(1)5-7 http//www.cdc.gov/epo/mmwr/preview/mmwrhtml/0000048.htmThe rates of rectal and pharyngeal gonorrhea for New York City males aged 15-44 years has declined from 1 per 100,000 males in that age group in 180 to 74/100,000 in 18--the lowest level in the past 7 years. This decrease is most evident in the area with the highest rates--Manhattan--where reported rectal and pharyngeal gonorrhea rates declined from 485/100,000 in 180 to 01/100,000 in 18--a 5% decrease (Figure 1). In other areas of New York City, the rates of rectal and pharyngeal gonorrhea have declined slightly since 180, but the initial rates outside Manhattan were much lower. Gonorrhea rates for females 15-44 years old have risen over the same period from 587/100,000 females in that age group to 64/100,000 in 18 (Figure 1). The majority of New York City rectal and pharyngeal gonorrhea was reported from one New York City Department of Health sexually transmitted disease (STD) clinic in Manhattan, whose patients are primarily homosexual males. At this clinic, culture testing for pharyngeal and rectal gonorrhea is provided to all males identified as being at risk for contracting gonorrhea due to same-sex contact. Based on analyses of second- and fourth-quarter data from each year, the percentage of positive rectal cultures declined from 0. in 180 to 16.5 in 18, and the percentage of positive pharyngeal cultures declined from 6.8% in 180 to .4% in 18 (Table 4). First clinic visits by males decreased by 4.% from 18,44 in fiscal year 180 to 17,65 in fiscal year 18. Reported by S Schultz, MD, S Friedman, MD, A Kristal, DrPH, DJ Sencer, MD, New York City Dept of Health; Div of Sexually Transmitted Diseases, Center for Prevention Svs, AIDS Activity, Center for Infectious Diseases, CDC. Editorial NoteEditorial Note Since 180, reported pharyngeal and rectal gonorrhea rates among New York City males 15-44 years old have shown consistent annual decreases, while the reported rates of gonorrhea for females in the same age group have increased during the same period. In Manhattan, the greatest decreases in male pharyngeal and rectal gonorrhea rates occurred in 18 and 18. The percent decreases in infection were substantially greater than either the percent decreases in clinic attendance or total cultures taken. Hence, it is unlikely that changes in testing or clinic attendance account for a large portion of the declines. A similar decrease in gonorrhea incidence has been reported among homosexual males attending a public clinic in Denver, Colorado (1). The major gonorrhea decreases in 18 and 18 coincide with the period of heightened awareness and concern about the incidence of acquired immunodeficiency syndrome (AIDS) among homosexual males. U.S. Public Health Service recommendations stress the importance of reducing the numbers of sexual partners for preventing AIDS among homosexual males (). Similar recommendations have been developed and widely distributed by the American Association of Physicians for Human Rights and many local groups concerned with the health of homosexual males. Recently, a reduction of the number of sexual partners among homosexual males has been documented in Madison, Wisconsin (). The substantial and persistent declines in gonorrhea among homosexual males in New York City suggest that prevention efforts have succeeded in reducing the incidence of this short-incubation-period sexually transmitted infection. Further sustained efforts should help in reducing the incidence of AIDS among homosexual males. References 1. Judson FN. Fear of AIDS and gonorrhea rates in homosexual men (Letter). Lancet 18;II15-60. . CDC. Prevention of acquired immune deficiency syndrome (AIDS) report of inter-agency recommendations. MMWR 18;101-. . Golubjatnikov R, Pfister J, Tillotson T. Homosexual promiscuity and the fear of AIDS (Letter). Lancet 18;II681. 180 Census data. Disclaimer All MMWR HTML documents published before January 1 electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 040-71; telephone (0) 51-1800. Contact GPO for current prices.==============================Craib KJ, Meddings DR, Strathdee SA, Hogg RS, Montaner JS, OShaughnessy MV, Schechter MT. Rectal gonorrhoea as an independent risk factor for HIV infection in a cohort of homosexual men. Genitourin Med 15 Jun;71()150-4 Vancouver Lymphadenopathy-AIDS Study Group, BC Centre for Excellence in HIV/AIDS, St Pauls Hospital, Canada. Abstract OBJECTIVE--To determine whether certain sexually transmitted diseases are independent risk factors for HIV transmission in a cohort of homosexual men. METHODS--Eligible cases were identified as those who had seroconverted between November 18 and November 10. Two persistently HIV-seronegative control participants were randomly selected for each case from all participants who remained seronegative in November 10. For cases, risk factor data were taken from an index visit which was defined as the first seropositive visit, while for controls these data were obtained from a matched visit which occurred within two months of the index visit for the corresponding case. Mantel-Haenszel methods and logistic regression were used to compare differences in risk factors for seroconversion between cases and controls. RESULTS--A total of 15 cases and 50 controls were eligible for this study. Cases were significantly more likely to have had reported any gonorrhoea (17% versus 6%; OR = .4; 5% CI 1.51-5.7) or syphilis (7% versus %; OR = .78; 5% CI 1.-10.7) than controls during the seroconversion period. Multivariate logistic regression revealed rectal gonorrhoea to be independently associated with risk of seroconversion (odds ratio = .18; p = 0.044), whereas urethral gonorrhoea (p = 0.47) and pharyngeal gonorrhoea (p = 0.44) were not after inclusion of rectal gonorrhoea. In addition, the following variables were also shown to exert an independent effect on seroconversion frequency of anal intercourse, use of illicit drugs, number of male sexual partners, and lack of a post-secondary education. CONCLUSIONS--In this observational study, rectal gonorrhoea was found to be associated with HIV seroconversion after adjustment for a number of HIV risk factors. We cannot rule out that rectal gonorrhoea was not directly associated with HIV infection but rather with other residual lifestyle factors not fully adjusted for in the analysis. However, the relationship with gonococcal involvement of a specific anatomic site lends support to a biological association between gonorrhoea and HIV infection, rather than to alternative non-biologic explanations. Our findings are consistent with previous studies reporting an association between HIV infection and non-ulcerative sexually transmitted diseases. Such a direct association might be explained by postulating that gonorrhoea results in inflamed rectal mucosa and compromised epithelial integrity, thereby predisposing an individual to subsequent HIV infection. ==============================OBrien TR, Kedes D, Ganem D, Macrae DR, Rosenberg PS, Molden J, Goedert JJ. Evidence for Concurrent Epidemics of Human Herpesvirus 8 and Human Immunodeficiency Virus Type 1 in US Homosexual Men Rates, Risk Factors, and Relationship to Kaposis Sarcoma. J Infect Dis 1 Oct;180(4)1010-1017. Viral Epidemiology Branch, National Cancer Institute, EPS 8016, Rockville, MD 085, USA. obrient@exchange.nih.gov Abstract We examined human herpesvirus 8 (HHV-8) seroprevalence and seroincidence among 45 homosexual men from New York City (NYC) and Washington, DC (DC) who have been followed since 18. An immunofluorescence assay measured antibodies to a latent HHV-8 nuclear antigen. Seroprevalence was 0.4% in 18; seroincidence was approximately 15%/year during 18-18 but fell sharply thereafter. NYC men had a higher seroprevalence (odds ratio, .4; P.001) and seroincidence (rate ratio, .1; P=.01) than DC men. Risk of Kaposis sarcoma (KS) was increased in seropositive men (adjusted relative hazard, .58; P=.0). Among men who were seropositive for both human immunodeficiency virus type 1 and HHV-8, the 10-year cumulative risk of KS was %; time from coinfection to KS diagnosis ranged from 15 to 154 months (median, 6.5 months). This study shows an epidemic of HHV-8 among US homosexual men in the early 180s that was associated with a high risk of developing KS. ==============================Szmuness W, Stevens CE, Harley EJ, Zang EA, Oleszko WR, William DC, Sadovsky R, Morrison JM, Kellner A. Hepatitis B vaccine demonstration of efficacy in a controlled clinical trial in a high-risk population in the United States. N Engl J Med 180 Oct ;0(15)8-41. Abstract We assessed the efficacy of an inactivated hepatitis B vaccine in a placebo-controlled, randomized, double-blind trial in 108 homosexual men known to be at high risk for hepatitis B virus infection. The vaccine was found to be safe and the incidence of side effects was low. Within two months, 77% of the vaccinated persons had high levels of antibody against the hepatitis B surface antigen. This rate increased to 6% after the booster dose and remained essentially unchanged for the duration of the trial. For the first 18 months of follow-up, hepatitis B or subclinical infection developed in only 1.4 to .4% of the vaccine recipients as compared with 18 to 7% of placebo recipients (P 0.0001). The reduction of incidence in the vaccinees was as high as .%; none of the vaccinees with a detectable immune response to the vaccine had clinical hepatitis B or asymptomatic antigenemia. A significant reduction of incidence was already seen within 75 days after randomization; this observation suggests that the vaccine may be efficacious even when given after exposure.
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