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Additionally, gonorrhoea infection may contribute Prostitutes Monforte de Lemos facilitating HIV transmission [ 2 ]. Since the late s, several Western European countries have reported an increase in the number of gonorrhoea diagnoses [ 3 ].

Men, people older than 25 years and men who have Prostitutes Monforte de Lemos with men MSM are overrepresented among gonorrhoea cases [ 34 ]. In Spain, nationwide surveillance of the total number of gonorrhoea diagnoses has been in operation since In the reported rate of gonorrhoea infection for the whole country was 5.

Notified rates currently show an increasing trend, but the rise started later than in other countries: during the period — rates decreased sharply, from Unfortunately, the current national surveillance system for gonorrhoea does not include the collection of individual data on cases so it is not possible to know which groups are most affected by the increase.

Yearly reports as well as a paper with results Prostitutes Monforte de Lemos this project have been published previously [ 7Prostitutes Monforte de Lemos ]. The objectives of this paper are: a to describe the characteristics of gonorrhoea cases diagnosed in a network of 15 clinics from to ; b to analyse differences among cases who were MSM, men who have sex exclusively with women MSW and women, respectively; and c to investigate factors associated with HIV co-infection.

Services are provided free of charge, even for illegal immigrants, and every effort is made to maximize accessibility including, in most clinics, providing care anonymously if the clients so wish.

María Teresa Talón-Navarroe, Àngel Cuquerellae, Amparo del Pino-Gutiérrezf, Instituto de Salud Carlos III, C/Monforte de Lemos, Fernando Vallejo b,c, Luis de la Fuente b,c The Madrid Rapid HIV Testing Group§ de Epidemiologıa, Instituto de Salud Carlos III, c/Monforte de Lemos, 5.

Cases diagnosed in the network represented In addition to STI clinics, gonorrhoea cases in Prostitutes Monforte de Lemos can be diagnosed in a variety of settings, including primary care centres, gynaecological and dermatological clinics, and those providing family planning services, both in the public and private sector. Socio-demographic age, sex, educational level, region of birth and clinical variables HIV status, history of previous STI, other concurrent STI, anatomical location, reason for attendingas well as information on the circumstances of infection possible country of infection, source of infectionwere collected from the clinical records by the clinical staff.

A common questionnaire developed for the project was used. Gonorrhoea cases included in Prostitutes Monforte de Lemos analysis were identified using the European definition: i. To assign region of birth, the WHO-Europe Prostitutes Monforte de Lemos was used. Concurrent STI was defined as any STI diagnosed by the physician caring for the case simultaneously to gonorrhoea; the following categories were used for data collection: a Chlamydia trachomatis infection including lymphogranuloma venereum ; b genital warts; c herpes virus; d syphilis; e trichomoniasis; d molluscum contagiosum; e other specify.

The only identifier included in the questionnaire Prostitutes Monforte de Lemos an alphanumeric code exclusively used for quality control after which data were treated and analysed anonymously. Frequency distributions for each categorical variable, stratified by sex and transmission route MSW, heterosexual females and MSMwere calculated, as well as the median and 25 th and 75 th percentiles P 25 -P 75 for age. Trends were evaluated using the chi-square for trend.

From toa total of gonorrhoea cases were identified in Prostitutes Monforte de Lemos participating centres. Of these, The number of cases collected increased from in to in Figure 1.

More than half of the annual diagnoses occurred in MSM range: No trends were found among the other two groups. Gonorrhoea cases diagnosed in 15 STI clinics in Spain from toby year of diagnosis, sex and transmission route. Only among the latter, the percentage in the age group of 25—34 years increased from In the study period an increasing trend of diagnosed gonorrhoea was observed in both Latin-American from The majority of males sought care because they had symptoms, this not being the case among women.

Nevertheless, one in ten Prostitutes Monforte de Lemos were diagnosed with gonorrhoea as a result of screening Table 1. The urethra was the most frequent site of infection in male cases followed by the rectum in MSM. A total of Prostitutes Monforte de Lemos Chlamydia trachomatis infection and genital warts were the most frequently diagnosed STI in all sex-transmission categories, but MSM had a greater prevalence of concurrent syphilis diagnoses than the other patients Figure 2.

Gonorrhoea cases diagnosed in 15 STI clinics in Spain from to Concurrent diagnosis of specific STI by sex and transmission route.

Countries other than Spain were reported as the possible place of infection by only 38 patients 1. Sex workers were overrepresented among females cases compared to males Table 1.

Most female sex workers FSW were foreigners Almost one third Pharyngeal gonorrhoea was very common among FSW Their median age was The majority Information on HIV status was available for a total of gonorrhoea cases In the multivariate analysis factors associated with co-infection were: age older than 35 years, low educational level, origin in Western Europe or Latin-America, being MSM, history of STI, having a concurrent STI, and reporting Prostitutes Monforte de Lemos HIV infected partner as Prostitutes Monforte de Lemos source of gonorrhoea infection.

On the contrary, women were less likely to be infected with HIV Table 2. Among HIV co-infected people with available information This is Prostitutes Monforte de Lemos first study Prostitutes Monforte de Lemos a description of the epidemiological and clinical characteristics of gonorrhoea cases diagnosed in a broad area in Spain. Its results help to characterise the most-at-risk groups for gonorrhoea infection in the country, and show differences by sex, transmission route and country of birth which should be taken into consideration when implementing control measures.

This result was to be expected given the characteristics of the participating clinics. Even if figures have changed since the survey was performed it is clear that there is an overrepresentation of MSM among Prostitutes Monforte de Lemos cases in our study, a result common with other studies performed Prostitutes Monforte de Lemos similar settings both in Spain Madrid [ 13 ] and Barcelona [ 14 ] and elsewhere [ 15 ].

It is worrisome that most HIV-infected MSM were aware of their status before their gonorrhoea diagnosis, and yet they had not used condoms, a finding also described in other studies [ 17 ], which highlights the importance of continuous reinforcement of secondary prevention in MSM infected with HIV.

The fact that in our study HIV prevalence is increasing only among MSM gonorrhoea cases adds urgency to this recommendation.

Similarly, the proportion pharyngeal location 5. These variations could be due to differences in the study populations but, since both pharyngeal and rectal gonorrhoea are usually Prostitutes Monforte de Lemos, our findings likely reflect low rates of screening in the MSM population, given that in our study the majority of MSM cases were symptomatic, or low rates of comprehensive and adequately tailored testing procedures.

This is also the most likely explanation for the high proportion of concurrent STI diagnoses found Prostitutes Monforte de Lemos this and other Spanish studies [ 2122 ]. Pharyngeal gonorrhoea was very common among FSW in our study It is also possible that frequent screening in the FSW population has contributed to the high proportion of the pharyngeal location.

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Unprotected sex with casual partners was the most important source of infection in male patients. This finding has also been reported in Norway [ 19 ].

These results are very important because they Prostitutes Monforte de Lemos a lack of risk perception in men and make it more difficult to conduct partner notification. Results from the SHSB showed that Use of transactional sex was associated, among other factors, with age older than 25, low educational level and foreign origin, which are also Prostitutes Monforte de Lemos in our population.

Studies performed in other Western European countries found an important proportion of heterosexual males Prostitutes Monforte de Lemos been infected with gonorrhoea while abroad [ 192627 ]. This is not the case in our study, where in all Prostitutes Monforte de Lemos categories most infections were acquired within the country. Foreigners are overrepresented in all sex-transmission categories, from a high of Latin-Americans are the main immigrant group in all categories, but the second group varies, reflecting different migration patterns among groups [ 1928 ].

This study has limitations. Variables such as educational level and probable source of infection have a substantial proportion of missing data. Furthermore, cases are not representative of all gonorrhoea cases in Spain, therefore the results can only be extrapolated to the setting from which the cases arose and not to the whole Spanish population.

However, to our knowledge, most of the STI clinics operating in Spain belong to this network and cases included in this study represent more than one fourth of all gonorrhoea cases declared in Spain from to Old busty whore la louviere spanish amateur sex fucked by mature women prostitutas de madrid prostitutas sant boi .

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