Heterosexual men who purchase sex and attended an STI clinic in Israel: characteristics and sexual behavior

Abstract Background Commercial sex shares a role in HIV and sexually transmitted infections (STI) transmission. Men who pay for sex (MPS) may transmit HIV/STI to other populations which are low-risk. This study aimed to test our hypothesis that MPS engage in high-risk sexual behaviors associated with HIV/STI transmission more so than non-MPS. Methods This cross-sectional study included heterosexual men who attended an STI clinic between 2003 and 2010. Demographic, clinical, behavioral and laboratory data were compared between MPS and non-MPS to identify factors associated with high-risk sexual behavior and STI-burden. Results Of the first visits of 6156 heterosexual men who attended the STI-clinic during the study period, 1649 (26.7%) were MPS. MPS were more commonly older, married and non-Israeli born compared with non-MPS. MPS were more likely to engage in risk-behaviors associated with HIV/STI-transmission, including a greater number of lifetime sexual partners, substance use and previous STI diagnoses. Determinants associated with STI-diagnoses at the current visit included being non-Israeli born, presenting with STI symptoms, reporting a greater number of lifetime sexual partners and having sexual encounters with non-Israeli individuals. Conclusions Approximately 25% of all men who attended the clinic were MPS. They were more likely to engage in risk-behaviors associated with HIV/STI transmission compared to non-MPS. These findings highlight the need to establish interventions for MPS that both continue to encourage condom use and address the potential perils pertaining to risky sexual behaviors

Growth, developmental achievements and vaccines timeliness of undocumented migrant children from Eritrea compared with Israelis.

Israel has absorbed >40,000 Eritrean undocumented migrants since 2007, while the majority live in the southern neighborhoods of Tel-Aviv. As non-citizens and citizens infants in Israel receive free preventive treatment at the mother and child health clinics (MCHC), this study aimed to compare development and growth achievements between children of Eritrean mothers (CE) to children of Israeli mothers (CI), and assess their compliance to routine follow-up and vaccination-timeliness.This cohort study included all Israeli-born CE between 2009 and 2011, compared with a random sample of CI and treated at the same MCHC and followed-up to the age of 30-months. Dependent outcomes included anthropometric measurements, developmental achievements and adherence to immunization schedule.Of all 271 CE who were compared with 293 CI, no statistically significant differences were found in birth anthropometric measurements. Yet, CE had increased weight and length than CI after reaching one year of age (p<0.05). CE were more likely to fail in tests assessing fine-motor skills, linguistic and socio-emotional domains than CI, while no statistical difference was found in gross-motor achievements. At the end of follow-up, 203 (74.9%) of the CE and 271 (74.1%) of the CI completed the vaccination schedule, p = 0.9.CE had greater anthropometric measurements than CI after one year of age, and showed higher impairments in fine motor, linguistic and socio-emotional domains. Adherence to vaccination was similar. The inequalities in child health should be responded in the MCTC, and Eritrean mothers should be trained with the current recommendations for child well-being

Head circumference development curves of migrant and Israeli children, birth until 2 years.

<p>Head circumference development curves of migrant and Israeli children, birth until 2 years.</p

Comparison of children who failed in at least one test which examines developmental milestones to those succeed in all test in all visits.

<p>Comparison of children who failed in at least one test which examines developmental milestones to those succeed in all test in all visits.</p

Multivariate analysis associating maternal characteristics with infants’ achievements in developmental tests.

<p>Multivariate analysis associating maternal characteristics with infants’ achievements in developmental tests.</p

Comparison between Eritrean and Israeli children treated in south Tel Aviv mother and child health clinics, 2009–2011.

<p>Comparison between Eritrean and Israeli children treated in south Tel Aviv mother and child health clinics, 2009–2011.</p

Weight development curves of migrant and Israeli children, birth until 2 years.

<p>Weight development curves of migrant and Israeli children, birth until 2 years.</p

Length development curves of migrant and Israeli children, birth until 2 years.

<p>Length development curves of migrant and Israeli children, birth until 2 years.</p

The role of children in the spread of COVID-19: Using household data from Bnei Brak, Israel, to estimate the relative susceptibility and infectivity of children.

One of the significant unanswered questions about COVID-19 epidemiology relates to the role of children in transmission. This study uses data on infections within households in order to estimate the susceptibility and infectivity of children compared to those of adults. The data were collected from households in the city of Bnei Brak, Israel, in which all household members were tested for COVID-19 using PCR (637 households, average household size of 5.3). In addition, serological tests were performed on a subset of the individuals in the study. Inspection of the PCR data shows that children are less likely to be tested positive compared to adults (25% of children positive over all households, 44% of adults positive over all households, excluding index cases), and the chance of being positive increases with age. Analysis of joint PCR/serological data shows that there is under-detection of infections in the PCR testing, which is more substantial in children. However, the differences in detection rates are not sufficient to account for the differences in PCR positive rates in the two age groups. To estimate relative transmission parameters, we employ a discrete stochastic model of the spread of infection within a household, allowing for susceptibility and infectivity parameters to differ among children and adults. The model is fitted to the household data using a simulated maximum likelihood approach. To adjust parameter estimates for under-detection of infections in the PCR results, we employ a multiple imputation procedure using estimates of under-detection in children and adults, based on the available serological data. We estimate that the susceptibility of children (under 20 years old) is 43% (95% CI: [31%, 55%]) of the susceptibility of adults. The infectivity of children was estimated to be 63% (95% CI: [37%, 88%]) relative to that of adults