Background 
Nongonococcal urethritis (NGU) is the most common male reproductive tract syndrome. Ureaplasmas spp. including U. urealyticum and U. parvum, have been increasingly reported to be implicated in NGU. However, there are still many contradictions about their pathogenic role in NGU.


Aims 
The goals of this study were to evaluate the association of Ureaplasmas spp. with NGU, and to compare the prevalence of Ureaplasmas spp. infection in China relative to the world average.


Methods 
A systematic review and meta-analysis was conducted following standard guidelines for meta-analysis. The quality of included studies was assessed by Newcastle-Ottawa scale.


Results 
A total of seven studies involving 1,507 NGU patients and 1,223 controls were eligible for meta-analysis. There was no significant difference in the Ureaplasma spp. positive rate between the NGU and control groups. However, the U. urealyticum positive rate was significantly higher in NGU patients compared to controls; the U. parvum positive rate was significantly higher in controls compared to NGU patients. Furthermore, within the NGU patient group, the positive rate of U. urealyticum was significantly higher than that of U. parvum, whereas within the control group, the opposite trend was observed. Compared to the world average, a significantly higher positive rate of Ureaplasma spp. was observed in both the NGU and control groups in China.


Conclusions 
Our analysis supports that U. urealyticum, but not U. parvum, is an etiological agent in NGU. More detailed studies of these two species in China and the world could contribute to a better understanding of the epidemiology and pathogenesis, and facilitate the development of better strategies for treatment and prevention of NGU.

/pdf/are-ureaplasma-spp-a-cause-of-nongonococcal-urethritis-a-1oypeh4p07.pdf

Are Ureaplasma spp. a cause of nongonococcal urethritis? A systematic review and meta-analysis.

The 1980’s economic boom has been associated with a rapid expansion of China’s sex industry over the past three decades. Consequently, the spread of sexually transmitted infections (STIs) and hepatitis infections among female sex workers (FSW) has become an important public health issue in China. This study identifies prevalence and risks of hepatitis and STIs in Chinese FSWs. Four electronic databases were searched for Chinese and English language peer-reviewed studies conducted between 01/2000-12/2011 that reported prevalence of hepatitis and STIs (excluding HIV) among Chinese FSW. Following the PRISMA guidelines, meta-analysis was used to estimate pooled prevalence and 95 % confidence intervals for each infection. Three hundred and thirty nine articles (34 in English and 305 in Chinese) investigating 603,647 FSWs in 29 Chinese provinces were included in this review. Over the period 2000–2011, the seroprevalence of active hepatitis B and hepatitis C among FSW were 10.7 % (7.3–15.5 %) and 1.0 % (0.7–1.3 %), respectively. The most prevalent STI was human papillomavirus (HPV, 27.0 % [10.1–55.1 %]), followed by herpes simplex virus-2 (HSV-2, 15.8 % [11.7–20.9 %]), chlamydia (13.7 % [12.1–15.4 %]), gonorrhoea (6.1 % [5.3–7.0 %]), syphilis (5.2 % [4.8–5.7 %]), genital warts (3.3 % [2.5–4.2 %]) and Trichomonas vaginitis (2.1 % [1.5–24.2 %]). Disease burden of both hepatitis and STI among FSW were concentrated in South Central and Southwest China. In particular, chlamydia and syphilis demonstrated a significant declining trend during the studied period (P < 0.05). Compared with the general Chinese population, FSW had significantly higher prevalence of all STIs except Trichomonas vaginitis. Further, compared to the general FSW population, HIV-positive FSW had significantly higher prevalence of syphilis, chlamydia, HSV-2 and Trichomonas vaginitis. Prevalence of hepatitis and STIs remained high and mostly stable among Chinese FSW over the period of 2000–2011. Targeted STI and hepatitis surveillance and interventions should be strengthened among Chinese FSWs, especially those who are HIV-positive.

https://cdr.lib.unc.edu/downloads/05741v106

Sustained high prevalence of viral hepatitis and sexually transmissible infections among female sex workers in China: a systematic review and meta-analysis

This study describes the current situation and projects dynamic trends for HIV prevalence in a highly endemic area of China, Liangshan Prefecture, Sichuan Province. Epidemiological, behavioral, and population census data from multiple sources were analyzed to extract input for an Asian Epidemic Model (AEM). Fitting curves to historical trends in HIV prevalence were used as a baseline, and future intervention scenarios were explored using the AEM. For 2007, modeled data suggested approximately 0.5% adult HIV prevalence in Liangshan, with an estimated 17,450 people living with HIV/AIDS and 3,400 new infections. With current high risk behaviors, the model predicts that adult prevalence will rise to 1.5% by 2020. Increased condom use and clean needle exchange among injection drug users (IDUs) have slowed the epidemic. The source of new HIV infections will change from a preponderance of IDU-related infections in 2007 (65.9%) to a mixed epidemic in 2020 (general population heterosexuals 45.2%, IDU 38.6%, homosexual transmission between men 12.7%, female sex workers and their clients 3.5%). We anticipate rising prevalence, stable incidence, and higher representation of sexual transmission over time. Prevention investments should target specific interventions toward sub-groups at highest risk, given that both IDUs and men who have sex with men will likely represent a majority of cases and serve as a bridge population.

/pdf/projecting-dynamic-trends-for-hiv-aids-in-a-highly-endemic-27k5fw93yf.pdf

Projecting dynamic trends for HIV/AIDS in a highly endemic area of China: Estimation models for Liangshan Prefecture, Sichuan Province

Background
Previous studies suggested a high prevalence of STDs including HIV among female sex workers and men who have sex with men in China, but little was known about the prevalence in male patients attending public STD clinics. The aim of this study was to investigate STD patterns and HIV prevalence among male STD clinic attendees in different areas in China and the associated risk factors. The feasibility of Provider-initiated HIV testing and counseling (PITC) was evaluated as well.

/pdf/hiv-std-pattern-and-its-associated-risk-factors-among-male-q1u4bpglqu.pdf

HIV/STD pattern and its associated risk factors among male STD clinic attendees in China: a foci for HIV intervention.

We assessed the types of drugs, the prevalence of HIV, syphilis, and its correlates among Shandong's drug users in China. Two consecutive cross-sectional surveys in 2009 and 2010 provided demographics, types of drugs, sexual and drug-use behaviors, and HIV-related services. Of the 1320 unique, eligible participants, 81.1% were male, two-thirds <35 years of age, 13.0% non-Shandong residents; in the past year, majority (96.4%) reported ever using methamphetamine, 3.4% using heroin, 8.6% using ≥2 types of these drugs and 8.0% injecting drugs, 63.8% having commercial sex. HIV and syphilis prevalence were 0.2% and 8.3%, respectively. In multivariable logistic regression analysis, syphilis was independently associated with female, non-Shandong residents, higher levels of education, and 2010. Synthetic drugs, especially methamphetamine, have become the predominant sources of drug addiction. The emerging epidemic of syphilis potentially driven by methamphetamine use underscored the urgency to implement an effective sex and substance use-related intervention.

Dual epidemics of syphilis and methamphetamine use among drug users in Shandong Province of China

To assess the risk factors for casual sex and infections among the sexually transmitted disease (STD) clinic attendees in two disparate Chinese cities, an STD clinic-based cross-sectional study was conducted to provide demographic and sexual behaviour information Participants were recruited from nine STD clinics selected by mapping strategy STD prevalence was 694% (686% of men and 652% of women) The most common diagnoses were non-gonococcal urethritis (222%), genital warts (132%), syphilis (116%), gonorrhoea (84%), chlamydia (63%) and herpes simplex virus type 2 (HSV-2) (58%) Of 536 participants, 225% reported having casual sex in the last three months, younger age, less education, unawareness of transmission routes and having had casual sex in the last three months were independent risk factors for acquisition of an STD Single or separated marital status, non-local residency and STD diagnoses were independently associated with having had casual sex After decades of exceedingly low STD rates in China, a full panoply of STD diagnoses are now evident Both for reproductive health concerns and for stemming the expansion of HIV spread, STD control and prevention must be revitalized as a priority for China's public health and medical institutions Effective training is a priority, given the dearth of STD-experienced health-care workers

/pdf/predictors-for-casual-sex-and-or-infection-among-sexually-298h9yukkv.pdf

Predictors for casual sex and/or infection among sexually transmitted disease clinic attendees in China

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Predictors for casual sex and/or infection among sexually transmitted disease clinic attendees in China