| 1. |
- Andersson, Nirina, et al.
(författare)
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Gender differences in the well-being of patients diagnosed with Chlamydia trachomatis : a cross-sectional study
- 2018
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Ingår i: Sexually Transmitted Infections. - : BMJ Publishing Group Ltd. - 1368-4973 .- 1472-3263. ; 94:6, s. 401-405
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We aimed to investigate how an infection with Chlamydia trachomatis (CT) influenced patients' well-being and whether there were differences due to gender, age or relationship status, in an effort to strengthen preventive measures and provide better healthcare for patients with CT.Methods: Patients diagnosed with CT in the county of Västerbotten, Sweden, were asked to fill out a questionnaire about their feelings, thoughts and actions after CT diagnosis. The patients were also asked to fill in the validated questionnaires Hospital Anxiety and Depression Scale and Alcohol Use Disorder Identification Test. Between February 2015 and January 2017, 128 patients (74 women and 54 men) were included in the study.Results: After being diagnosed with CT, men were generally less worried than women (P<0.001). Women worried more about not being able to have children (P<0.001) and about having other STIs (P=0.001) than men did. Men felt less angry (P=0.001), less bad (P<0.001), less dirty (P<0.001) and less embarrassed (P=0.011) than women did. Nineteen per cent of men and 48% of women reported symptoms of anxiety. The majority of both men (60%) and women (72%) had a risk consumption of alcohol.Conclusion: Women and men reacted differently when diagnosed with CT. Women worried more about complications and more often blamed themselves for being infected. Being aware of these gender differences may be important when planning preventive measures and during counselling of CT-infected patients. Persons working with patients with CT must also be aware of the high frequency of harmful alcohol consumption among their patients.
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| 2. |
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| 3. |
- Carré, Helena, 1979-, et al.
(författare)
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[Contact tracing a year back is worthwhile. Follow the Vasterbottens example to prevent Chlamydia transmission in Sweden!]
- 2005
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 102:7, s. 468-71
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Tidskriftsartikel (refereegranskat)abstract
- Contact tracing is proved to be a good way to prevent asymptomatic sexually transmitted infections, such as Chlamydia trachomatis, from spreading. According to the Swedish law a physician has to report all cases of genital C. trachomatis to the County Medical Officer of Health and to the National institute for Infectious Disease Control and perform contact tracing. An evaluation of the sexual history 6 months back in time is recommended and standard in most of the country. The county of Västerbotten has one of the lowest incidenses of C. trachomatis in Sweden though the population is younger than the Swedish average. During year 2002 the contact tracing in Västerbotten was evaluated by sending a questionnaire to everyone who reported a case of genital C. trachomatis. We recived 534 (98%) out of 544 questionnaires. The patients reported 1360 partners, 2.5 on average, 1129 were identified. 761 had a known test result and 497 of them were positive, 0.9 on average. 72% of the contact tracers evaluated the sexual history > or = 12 months back in time. 78% of the contact tracings were performed by four social workers. Their patients reported 2.5 partners on average and 80% evaluated > or = 12 months back in time. 14 persons did only one contact tracing, 1.3 partners/index on average, 40% evaluated > or = 12 months back in time. 82% of the partners had sex with the infected patient 0-6 months before the patients was diagnosed with C. trachomatis, 75% out of those with a known test result were infected, 16% had sex 7-12 months before diagnosis, 30% infected. (The C. trachomatis prevalence in Sweden is estimated to be 2.7-4.9% among young women.) Conclusion: A few experienced persons tracing for at least 12 month back in time is probably two important reasons why Västerbotten has such a small C. trachomatis incidence.
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| 4. |
- Carré, Helena, 1979-, et al.
(författare)
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High prevalence of anxiety and hazardous alcohol consumption among patients attending an STI-clinic in northern Sweden
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Depression and hazardous alcohol consumption is associated to high-risk sexual behaviours among adolescents and young adults. Is the same true among grownups? The impact of anxiety on sexual risk behaviour is not thoroughly investigated. Our aim was to evaluate the correlation between hazardous alcohol consumption, depression and anxiety to sexual risk taking including Chlamydia infections, among patients attending an STI reception. Method: Patients attending an urban STI reception in Sweden were consecutively included and received questionnaires; screening- and demographic information, Alcohol Use Disorder Identification Test (AUDIT) and Hospital Anxiety and Depression scale (HAD). All patients also had a test for Chlamydia trachomatis taken. Results: 539 patients were included in the study, mean age 28 years. 152 (30%) had signs of anxiety and 37 (7%) of depression, of which 30 had also anxiety. Neither anxiety nor depression was correlated to sexual risk behaviour. >50% had hazardous alcohol consumption and it was independently linked to sexual risk behaviours and anxiety. Conclusion: Depression is not associated to sexual risk behaviours among adult STI-patients. Health care staff and must consider the high frequency of anxiety and hazardous alcohol consumption at their treatment of STI-clinic patients and in the preventive work. The society must work with lowering the stigmatization that still seems to be connected to STIs.
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| 5. |
- Carré, Helena, 1979-, et al.
(författare)
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Improved contact tracing for Chlamydia trachomatis with experienced tracers, tracing for one year back in time and interviewing by phone in remote areas
- 2008
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Ingår i: Sexually Transmitted Infections. - : BMJ publishing. - 1368-4973 .- 1472-3263. ; 84:3, s. 239-242
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To evaluate the Swedish model for contact tracing and especiallythe "Västerbotten model" with centralised, extended contactinterview periods, sometimes by telephone.Methods: Using questionnaires, the contact tracing and interview procedurewas evaluated during 2002, followed by an evaluation of contactinterviewing by phone in 2005–6.Results: Patients with diagnosed Chlamydia trachomatis infection reportedon average 2.5 sexual contacts, 3.0 contacts when contact interviewingwas performed at the clinic, and 2.3 contacts when performedby phone. 65% of the sexual contacts with a known test resultwere infected.Conclusion: Centralised contact tracing, exploring the sexual history forat least 12 months back in time, shows good results. Combinedwith screening of certain risk groups it is probably one effectiveway of preventing C trachomatis infections. Preventing C trachomatisby primary prevention such as information and counselling is,however, still of great importance.
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| 6. |
- Carré, Helena, 1979-
(författare)
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Who's at risk of catching Chlamydia trachomatis? Identifying factors associated with increased risk of infection to enable individualized care and intervention
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chlamydia trachomatis (CT) can cause infertility and is the most common sexually transmitted infection (STI) of bacterial origin in Europe. Surveys in seven countries estimated a population prevalence of 1.4-3.0 % in people 18 to 44 years. Approximately 87% of those diagnosed in Sweden are 15-29 years. Since 1997, with the exception of 2009-2010, despite all efforts, CT has increased steadily in many European countries including Sweden. That made us investigate risk factors associated with catching STIs, especially CT. In Sweden partner notification is mandatory by law when a patient is diagnosed with CT. Centralised partner notification, performed by a few experienced counsellors, and evaluation of the sexual history for at least 12 months back in time, shows superior results compared to other studies. Phone-interviews are a good option in remote areas. “The Västerbotten model” for partner notification fulfils these criteria and our evaluation has functioned as a model for changing recommendations of partner notification in Sweden. Preventing CT by primary prevention such as information and counselling is, however, still of great importance. We investigated whether it was necessary to test for CT in the throat. We found that patients testing positive for pharyngeal CT neither had more symptoms or signs nor a sexual history that differed from others. We therefore believe that we will find most or all of these patients by conventional testing of urine and cervical/vaginal samples. We wanted to further identify risk factors among patients attending a clinic for sexually transmitted infections to enable individualized care depending on risk. None or inconsistent use of condoms with new/temporary partners in combination with having at least one new/temporary partner within the past 6 months could identify persons with risk behaviour and at increased risk of CT (re)infection. Additional information about whether the condom was used during the whole intercourse did not add any risk of infection. A drop-in reception is a good contribution to an opportunistic screening approach. The rate of CT infected is high and the clinic attracts men and individuals ≥25 years old at risk of infection, groups which usually have a reduced test rate. The mean age was 28 years and 58% of the patients were men. The figure of correct condom usage is very low indicating the need for risk reducing counselling also in this grown-population. Among adult STI patients anxiety was common and depression uncommon. Neither was linked to high risk sexual behaviour nor ongoing CT infection. Hazardous alcohol consumption, however, was common and linked to anxiety and high risk sex. We conclude that preventive work can not only focus on STI prevention, but must consider the high frequency of hazardous alcohol consumption, which probably is contributing to sexual risk behaviour.
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| 7. |
- Englund-Ögge, Linda, et al.
(författare)
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Maternal characteristics and pregnancy outcomes in the NICE birth cohort: an assessment of self-selection bias
- 2022
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Ingår i: Journal of Maternal-Fetal and Neonatal Medicine. - : Informa UK Limited. - 1476-7058 .- 1476-4954. ; 35:25, s. 9014-9022
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prospective birth cohorts are essential for identifying associations between exposures and outcomes. However, voluntary participation introduces a potential bias due to self selection since the persons that chose to participate may differ in background characteristics and behaviors. Objectives: To investigate potential bias due to self-selection in the Nutritional impact onImmunological maturation duringChildhood in relation to theEnvironment (NICE) birth cohort in northern Sweden. Methods: Women in the NICE birth cohort (N = 621) were compared to nonparticipating pregnant women in Norrbotten County in northern Sweden who were eligible for participation (N = 4976) regarding maternal characteristics and lifestyle. Maternal characteristics and pregnancy outcomes were compared between the groups and associations between exposures (smoking, folic acid, BMI, parity, education) and pregnancy outcomes (birth weight and gestational age) were analyzed by linear regression analyses, examining any interaction with the group. Results: NICE participants were more highly educated, older and more likely to cohabit than the non-participants. They more often took folic acid and multivitamin supplements and less often smoked during early pregnancy. Pregnancy outcomes (mode of delivery, gestational age at delivery, birth weight and APGAR score) did, however, not differ significantly between participants and non-participants. Smoking, BMI, education and parity affected gestational age and birth weight, but the associations were of similar magnitude in participants and non-participants, with no significant effect on the group. Conclusion: Self-selection to the NICE study was evident in some factors related to lifestyle and socioeconomic characteristics but did not appear to skew pregnancy outcomes or alter well-known effects of certain lifestyle parameters on pregnancy outcomes.
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