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Medicine in Malaysia: sexually transmitted diseases and AIDS

Rokiah I

Med J Malaysia, 1995 May;50 Suppl A:S42-5.
PMID: 10968014
Matched MeSH terms: Sexually Transmitted Diseases/diagnosis*
Fulltext Trichomoniasis in cosmopolitan Malaysia: is it under control or is it under diagnosed?

Amal RN, Aisah MY, Fatmah MS, Hayati MI

Southeast Asian J. Trop. Med. Public Health, 2010 Nov;41(6):1312-5.
PMID: 21329303

In a prospective, observational study, 380 women attending a family planning (LPPKN) clinic and Sexually Transmitted Diseases (STD) clinic in Kuala Lumpur between January 2008 and November 2008 were enrolled. Patient information was obtained from the medical records and patients voluntarily completed questionnaires. Three vaginal swabs from the posterior fornix were taken from each patient examined. Different staining methods and cultivation in Diamonds medium were performed on the collected samples. Study subjects recruited in this survey were mostly young, with a geometric mean ages of 37.31 years (LPPKN clinic) and 32.06 years (STD clinic). Malay, Chinese, Indians and others ethnic groups accounted for 91, 4, 2 and 3%, respectively, at the LPPKN clinic. At the STD clinic, almost all subjects were Chinese. The prevalence rate of trichomoniasis was 0.36% at the LPPKN clinic and 0.0% at the STD clinic. Our findings suggested no association between contraceptive methods used and trichomoniasis infection at the LPPKN clinic. At the STD clinic, it was found a high risk for STD acquisition was not associated with trichomoniasis positivity. The data demonstrated the prevalence of trichomoniasis was very low at LPPKN clinic and absent at STD clinic. The high prevalence rates of other STD among sex workers found in this survey suggest the need for more active interventions focused on this group.

Matched MeSH terms: Sexually Transmitted Diseases/diagnosis
Conventional versus molecular detection of Chlamydia trachomatis and Neisseria gonorrhoeae among males in a sexually transmitted infections clinic

Situ SF, Ding CH, Nawi S, Johar A, Ramli R

Malays J Pathol, 2017 Apr;39(1):25-31.
PMID: 28413202 MyJurnal

BACKGROUND: Chlamydia trachomatis and Neisseria gonorrhoeae are important bacterial pathogens of sexually transmitted infections (STIs) worldwide. This study sought to compare the analytical sensitivity and specificity of conventional methods against a rapid molecular method in detecting STIs caused by these bacteria.
METHODS: Ninety five first-time male attendees of the Genito-urinary Medicine Clinic in Hospital Kuala Lumpur were included in this cross-sectional study. The detection of C. trachomatis was achieved through direct fluorescence antibody (DFA) staining of urethral swabs and real-time polymerase chain reaction testing (Xpert® CT/NG assay) on urine specimens. N. gonorrhoeae was detected through Gram staining and culture of urethral swabs and Xpert® CT/ NG assay on urine specimens.
RESULTS: From the Xpert® CT/NG results, 11 (11.6%) attendees had chlamydia, 23 (24.2%) had gonorrhoea and 8 (8.4%) had both STIs. The sensitivity and specificity of DFA in detecting chlamydia compared to Xpert® CT/NG were 5.3% (95% CI: 0-28) and 94.7% (95% CI: 86-98), respectively. For gonorrhoea, the sensitivity and specificity of Gram staining were 90.3% (95% CI: 73-98) and 95.3% (86-99), respectively, whereas the sensitivity and specificity of culture compared to Xpert® CT/NG were 32.2% (95% CI: 17-51) and 100% (95% CI: 93-100), respectively.
CONCLUSION: Although Gram-stained urethral swab smears are sensitive enough to be retained as a screening tool for gonorrhoea, culture as well as DFA lack sensitivity and are poorly suited to screen for gonorrhoea and chlamydia, respectively. However, owing to their high specificity, conventional detection methods are still suitable as confirmatory tests for gonorrhoea and chlamydia.

Matched MeSH terms: Sexually Transmitted Diseases/diagnosis*
Fulltext What are the factors associated with human immunodeficiency virus/sexually transmitted infection screening behaviour among heterosexual men patronising entertainment establishments who engaged in casual or paid sex? - Results from a cross-sectional survey in an Asian urban setting

Lim RB, Tham DK, Cheung ON, Tai BC, Chan R, Wong ML

BMC Infect Dis, 2016 12 19;16(1):763.
PMID: 27993135 DOI: 10.1186/s12879-016-2088-8

BACKGROUND: Late presentation of human immunodeficiency virus (HIV) is associated with heterosexual transmission, particularly among heterosexual men in Asia. Although data on HIV/sexually transmitted infection (STI) testing behaviour is increasing, information is still lacking among heterosexual men who receive far lesser attention and are generally invisible in HIV/ STI prevention, particularly in the Asian urban setting. The aim of this study was to assess the prevalence of HIV/STI testing among heterosexual men patronising entertainment establishments (EEs) who engaged in casual or paid sex in Singapore, and the factors associated with this behaviour.

METHODS: This was a cross-sectional survey involving 604 participants using time location sampling between March and May 2015. For multivariable analysis, we used a mixed effects Poisson regression model with backward stepwise approach to account for clustering by venue and to obtain the adjusted prevalence ratio (aPR) for the association of various factors with HIV/STI testing.

RESULTS: Among 604 at-risk participants, only 163 (27.0%) had gone for HIV or STI testing in the past 6 months. Of this, 83.4% of them specifically underwent HIV testing. In multivariable analysis, HIV/STI testing increased with being non-Chinese (aPR 1.50; 95% CI: 1.08-2.06), having engaged in anal sex with casual or paid partner in the past 6 months (aPR 1.80; 95% CI: 1.27-2.57), number of partners in the past 6 months (aPR 1.03; 95% CI: 1.01-1.05) and HIV knowledge score (aPR 1.11; 95% CI: 1.05-1.16). Among those who reported non-consistent condom use with casual or paid partner, almost half of them (47.9%) perceived that they were at low risk for HIV/STI. Sigmatisation and discrimination was another common barrier for non-testing.

CONCLUSIONS: Despite being at risk of HIV/STI, the low prevalence of testing coupled with a high prevalence of risky sexual behaviour among this group of heterosexual men in Singapore calls for a need for HIV/STI prevention interventions in the EE setting. Other than promoting testing and safer sex, the interventions should address the discordance between perceived risk and actual sexual behaviour, in addition to the stigma and discrimination associated with testing for this group.

Matched MeSH terms: Sexually Transmitted Diseases/diagnosis