Determinants of frequent and infrequent STI testing and STI diagnosis related to test frequency among men who have sex with men in the eastern part of the Netherlands: a 6-year retrospective study.

Men who have sex with men (MSM) remain vulnerable to sexually transmitted infections (STIs) and are advised to be tested at least twice a year. The aim of this study was to assess the determinants of test frequency and their associations with an STI diagnosis

The role of schools in the spread of mumps among unvaccinated children: a retrospective cohort study

Contains fulltext : 98461.pdf (publisher's version ) (Open Access)BACKGROUND: In the Netherlands, epidemics of vaccine preventable diseases are largely confined to an orthodox protestant minority with religious objections to vaccination. The clustering of unvaccinated children in orthodox protestant schools can foster the spread of epidemics. School closure has nevertheless not been practiced up until now. A mumps epidemic in 2007-2008 gave us an opportunity to study the role of schools in the spread of a vaccine preventable disease in a village with low vaccination coverage. METHODS: A retrospective cohort study was conducted among the students in four elementary schools and their siblings. The following information was collected for each child: having had the mumps or not and when, school, age, MMR vaccination status, household size, presence of high school students in the household, religious denomination, and home village. The spread of mumps among unvaccinated children was compared for the four schools in a Kaplan-Meier analysis using a log-rank test. Cox proportional hazard analyses were performed to test for the influence of other factors. To correct for confounding, a univariate Cox regression model with only school included as a determinant was compared to a multivariate regression model containing all possible confounders. RESULTS: Out of 650 households with children at the schools, 54% completed a questionnaire, which provided information on 1191 children. For the unvaccinated children (N = 769), the Kaplan-Meier curves showed significant differences among the schools in their cumulative attack rates. After correction for confounding, the Cox regression analysis showed the hazard of mumps to be higher in one orthodox protestant school compared to the other (hazard ratio 1.43, p < 0.001). Household size independently influenced the hazard of mumps (hazard ratio 1.44, p < 0.005) with children in larger households running a greater risk. CONCLUSION: If and when unvaccinated children got mumps was determined by the particular school the children and their siblings attended, and by the household size. This finding suggests that school closure can influence the spread of an epidemic among orthodox protestant populations, provided that social distancing is adhered to as well. Further research on the effects of school closure on the final attack rate is nevertheless recommended

Intention to Accept Pertussis Vaccination for Cocooning: A Qualitative Study of the Determinants.

CONTEXT:Several countries have reported a resurgence of pertussis in the last decades. This puts infants (especially <6 months) at risk of severe complications, because they are too young to be fully protected by vaccination. The global pertussis initiative has proposed pertussis vaccination of young infants' close contacts, in order to reduce pertussis transmission and the burden of the disease on infants. Our aim is to explore the perceived determinants (barriers and facilitators) of intention to accept vaccination among the possible target groups of pertussis vaccination for cocooning. Consideration of these determinants is necessary to optimise the uptake of the vaccination. METHODS:We conducted 13 focus groups and six individual semi-structured interviews with members of possible target groups for pertussis cocooning (i.e. parents, maternity assistants, midwives, and paediatric nurses) in the Netherlands. Here, both maternal pertussis vaccination as well as pertussis cocooning has not been implemented. The topic list was based on a literature review and a barrier framework. All interviews were transcribed verbatim and two researchers performed thematic content analysis. FINDINGS:The participants' risk perception, outcome expectations, general vaccination beliefs, moral norms, opinion of others, perceived autonomy, anticipated regret, decisional uncertainty, and perceived organisational barriers were all factors that influenced the intention to accept pertussis vaccination for cocooning. DISCUSSION:This study has identified nine perceived determinants that influence the intention to accept pertussis cocooning vaccination. We add the following determinants to the literature: perceived cost-effectiveness (as a concept of outcome expectations), justice (as a concept of moral norms), anticipated regret, and decisional uncertainty. We recommend considering these determinants in vaccination programmes for pertussis cocooning vaccination. Experience, information and trust emerged as predominant themes within these determinants. These themes require particular attention in future research on vaccination acceptance, especially with regard to their role in use and implementation in policy and practice

Sexual behaviour and STI testing among Dutch swingers:A cross-sectional internet based survey performed in 2011 and 2018

BackgroundSwingers, heterosexuals who, as couples, practice mate swapping or group sex with other couples or heterosexual singles, are at risk for sexually transmitted infections (STIs). Therefore, the aim of this study was to assess changes in sexual behaviour and STI testing behaviour, as well as predictors of STI testing.MethodsTwo cross-sectional studies were performed, using the same internet survey in 2011 and 2018. For trend analysis, sexual behaviour and STI testing behaviour were used. Socio-demographics, swinger characteristics, sexual behaviour, and psycho-social variables were used to assess predictors of STI testing in the past year, using multivariable regression analysis.ResultsA total of 1173 participants completed the survey in 2011, and 1005 in 2018. Condom use decreased for vaginal (73% vs. 60%), oral (5% vs. 2%), and anal sex (85% vs. 75%). STI positivity was reported in 23% and 30% of the participants, respectively, although testing for STI was comparable between both years (~65%). The following predictors of STI testing were significant: being female (OR = 1.9, 95%CI: 1.2-2.9), having a high swinging frequency (>12 times a year, OR = 3.7, 95%CI: 1.9-7.3), swinging at home (OR = 1.6, 95%CI: 1.0-2.7), receiving a partner notification (OR = 1.7, 95%CI: 1.2-2.6), considering STI testing important (OR = 4.3, 95%CI: 2.2-8.5), experiencing no pressure from a partner to test (OR = 0.6, 95%CI: 0.3-0.9), partners test for STI regularly (OR = 10.0, 95%CI: 6.2-15.9), perceiving STI testing as an obligation (OR = 2.1, 95%CI: 1.3-3.5), experiencing no barriers such as being afraid of testing (OR = 1.9, 95%CI: 1.2-3.1), limited opening hours (OR = 1.6, 95%CI: 1.0-2.4), and forgetting to plan appointments (OR = 3.0, 95%CI: 2.0-4.6).ConclusionsSwingers exhibit self-selection for STI testing based on their sexual behaviour. However, STI prevention efforts are still important considering the increasing numbers of reported STIs, the decreased use of condom use, and the one-third of swingers who were not tested in the previous year

Positional map of determinants and overarching themes of parental intention to accept pertussis cocooning vaccination.

<p>Positional map of determinants and overarching themes of parental intention to accept pertussis cocooning vaccination.</p

Sexual behaviour and STI testing among Dutch swingers: A cross-sectional internet based survey performed in 2011 and 2018

Background Swingers, heterosexuals who, as couples, practice mate swapping or group sex with other couples or heterosexual singles, are at risk for sexually transmitted infections (STIs). Therefore, the aim of this study was to assess changes in sexual behaviour and STI testing behaviour, as well as predictors of STI testing. Methods Two cross-sectional studies were performed, using the same internet survey in 2011 and 2018. For trend analysis, sexual behaviour and STI testing behaviour were used. Socio-demographics, swinger characteristics, sexual behaviour, and psycho-social variables were used to assess predictors of STI testing in the past year, using multivariable regression analysis. Results A total of 1173 participants completed the survey in 2011, and 1005 in 2018. Condom use decreased for vaginal (73% vs. 60%), oral (5% vs. 2%), and anal sex (85% vs. 75%). STI positivity was reported in 23% and 30% of the participants, respectively, although testing for STI was comparable between both years (similar to 65%). The following predictors of STI testing were significant: being female (OR = 1.9, 95%CI: 1.2-2.9), having a high swinging frequency (>12 times a year, OR = 3.7, 95%CI: 1.9-7.3), swinging at home (OR = 1.6, 95%CI: 1.0-2.7), receiving a partner notification (OR = 1.7, 95%CI: 1.2-2.6), considering STI testing important (OR = 4.3, 95%CI: 2.2-8.5), experiencing no pressure from a partner to test (OR = 0.6, 95%CI: 0.3-0.9), partners test for STI regularly (OR = 10.0, 95%CI: 6.2-15.9), perceiving STI testing as an obligation (OR = 2.1, 95% CI: 1.3-3.5), experiencing no barriers such as being afraid of testing (OR = 1.9, 95%CI: 1.2-3.1), limited opening hours (OR = 1.6, 95%CI: 1.0-2.4), and forgetting to plan appointments (OR = 3.0, 95%CI: 2.0-4.6). Conclusions Swingers exhibit self-selection for STI testing based on their sexual behaviour. However, STI prevention efforts are still important considering the increasing numbers of reported STIs, the decreased use of condom use, and the one-third of swingers who were not tested in the previous year