Gentamicin/azithromycin and gemifloxacin/azithromycin were highly effective for treatment of urogenital gonorrhea. Gastrointestinal adverse events may limit routine use. These non-cephalosporin-based regimens may be useful alternative options for patients who cannot be treated with cephalosporin antimicrobials. Additional treatment options for gonorrhea are needed. Clinical Trials Registration. NCT00926796.

NCT01591447.

African American WSW/WSWM in this study were aware of their STI risk, more so with regard to men, and desired accurate information on safer sex options in their sexual relationships with women. Health care providers can assist these women by helping them apply their existing knowledge of heterosexual STI transmission to their female sexual partnerships.

African American WSW are not a homogeneous group, and their sexual health may be directly or indirectly influenced by male partners. A better understanding of the distinctions and differences between African American WSW and WSWM will enable health care providers to improve the quality of care provided.

Those providing sexual health services to WSW should be cautious in assuming that WSW have accurate information regarding barrier methods for safer sex. Sexual health services provided to WSW should include an accurate description of what barrier methods are, how to distinguish them from barrier methods more commonly used during heterosexual sex (female and male condoms), and how to use them correctly. Future studies are needed to address how effectively these measures reduce transmission of STIs among WSW.

This research examines individual and area level factors associated with maternal health care utilization in Pakistan. The 2012-2013 Pakistan Demographic and Health Surveys data was used to model five outcomes: prenatal care within the first trimester, four plus prenatal visits, birth attendance by a skilled attendant, birth in a medical facility, and receipt of postnatal care. Less than half of births were to mothers receiving prenatal care in the first trimester, and approximately 57 % had trained personnel at delivery. Over half were born to mothers who received postnatal care. Evidence was found to support the positive effect of individual level variables, education and wealth, on the utilization of maternal health care across all five measures. Although, this study did not find unilateral differences between women residing in rural and urban settings, rural women were found to have lower odds of utilizing prenatal services as compared to mothers in urban environments. Additionally, women who cited distance as a barrier, had lower odds of receiving postnatal health care, but still engaged in prenatal services and often had a skilled attendant present at delivery. The odds of utilizing prenatal care increased when women resided in an area where prenatal utilization was high, and this variability was found across measures across provinces. The results found in this paper highlight the uneven progress made around improving prenatal, delivery, and postnatal care in Pakistan; disparities persist which may be attributed to factors both at the individual and community level, but may be addressed through a consorted effort to change national policy around women's health which should include the promotion of evidence based interventions such as incentivizing health care workers, promoting girls' education, and improving transportation options for pregnant women and recent mothers with the intent of ultimately lowering the Maternal Mortality Rate as recommended in the U.N.'s Millennium Development Goal 5.

Women reporting multiple sex partners are an important minority among STD clinic attendees. Understanding the antecedents to high risk sexual behavior as determined by partner number is an important step in reducing STI's in this group.

Background CDC guidelines recommend azithromycin or doxycycline as treatments for chlamydial infection. Recently, one randomised trial comparing these therapies suggested doxycycline was superior, while another found the two therapies were equivalent. We examined the risk of persistent/recurrent chlamydial infection among patients treated with doxycycline or azithromycin. Methods We performed a secondary analysis of data from Project Aware, a randomised, controlled trial of a behavioural intervention. The trial enrolled patients aged ≥ 18 years without a prior HIV diagnosis in 9 U.S. STD clinics in 2010. At baseline, women with urogenital chlamydial infection and men with urethral and/or rectal chlamydial infections were treated with azithromycin or doxycycline, per clinic standard of care. Patients with a positive chlamydia test at 6-month follow-up were considered to have persistent/recurrent infection. Results Of 5012 participants, 492 (9.8%) tested positive for C. trachomatis at baseline. Of these, 338 (69%) were treated with doxycycline or azithromycin without a second drug active against C. trachomatis; 92% (76 of 83) and 88% (225 of 255), respectively, were re-tested at 6 months. Comparing doxycycline and azithromycin, overall 7 (9.2%) and 26 (11.6%), respectively, had persistent/ recurrent infection (RR = 0.80, 95% CI = 0.36-1.76). Among persons with urogenital infections, 6 (10.0%) of 60 and 18 (10.1%) of 179 (RR = 0.99, 95% CI = 0 0.41-2.39), respectively had persistent/recurrent infection. Among men with rectal infections, 2 (9.5%) of 21 and 8 (16.3%) of 49 who received doxycycline and azithromycin, respectively, had persistent/recurrent infection (RR = 0.58, 95% CI = 0.14-2.52). On multivariate analysis, persistent/recurrent infection was significantly associated with black (vs. white) race (aRR = 4.29, 95% CI = 1.14-16.16) and rectal (vs. urogenital) infection (aRR = 5.42, 95% CI = 0.99-29.55), but not treatment regimen. Conclusion There were no differences in persistent/recurrent urogenital chlamydia infections at six months by treatment type. Treatment failure of rectal infections among men may be more common with azithromycin and merits additional study. Objectives Emerging resistance to available treatment creates an urgent need for new therapies for uncomplicated gonorrhoea. Solithromycin, a new 4 th generation macrolide with 3 ribosomal targets, is highly active against most antibiotic-resistant strains of Neisseria gonorrhoeae. A Phase II, dose ranging study to evaluate the efficacy and safety of single-dose oral solithromycin for uncomplicated urogenital gonorrhoea was conducted. Methods Consenting participants with suspected Neisseria gonorrhoeae infection were cultured at the urethra/cervix, rectum, and pharynx at enrollment and Day 7. The primary outcome was bacterial eradication (conversion from positive baseline N. gonorrhoeae urethral/cervical culture to negative) at Day 7. Secondary outcomes included eradication of rectal or pharyngeal gonorrhoea and the eradication of gonococcal and ...