Objectives: Persistent anal high-risk human papillomavirus (HR-HPV) infection is a major risk factor for anal cancer among MSM and transgender women (TGW). We aimed to estimate incidence, clearance, and persistence of anal HR-HPV in HIV-positive and HIV-negative MSM and TGW, and to assess factors for HR-HPV persistence. Design: Prospective cohort study. Methods: MSM and TGW aged at least 18 years, were enrolled from Indonesia, Malaysia, and Thailand, then followed up 6-monthly for 12 months. Anal swabs were collected at every visit for HR-HPV genotypes to define anal HR-HPV incidence, clearance, and persistence. Logistic regression was used to evaluate factors associated with HR-HPV persistence. Results: Three hundred and twenty-five MSM and TGW were included in this study, of whom 72.3% were HIV-positive. The incidence of anal HR-HPV persistence was higher in HIV-positive than HIV-negative MSM participants (28.4/1000 vs. 13.9/1000 person-months). HIV-positive participants had HR-HPV lower clearance rate than HIV-negative participants (OR 0.3; 95% CI 0.1–0.7). The overall persistence of HR-HPV was 39.9% in HIV-positive and 22.8% HIV-negative participants. HPV-16 was the most persistent HR-HPV in both HIV-positive and HIV-negative participants. HIV infection (aOR 2.87; 95% CI 1.47–5.61), living in Kuala Lumpur (aOR 4.99; 95% CI 2.22–11.19) and Bali (aOR 3.39; 95% CI 1.07–10.75), being employed/freelance (aOR 3.99; 95% CI 1.48–10.77), and not being circumcised (aOR 2.29; 95% CI 1.07–4.88) were independently associated with anal HR-HPV persistence. Conclusion: HIV-positive MSM and TGW had higher risk of persistent anal HR-HPV infection. Prevention program should be made available and prioritized for HIV-positive MSM and TGW where resources are limited.

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To evaluate the efficacy and safety of 1% and 5% 5-fluorouracil (5-FU) creams compared with 90% trichloroacetic acid (TCA) for the treatment of anogenital warts. we conducted a randomised controlled study in 72 subjects allocated to three groups: 1% 5-FU, 90% TCA and 5% 5-FU; 90% TCA was administered once a week, whereas 5-FU cream was applied three times a week. Response to therapy and side-effects were evaluated weekly for seven weeks. Evaluation at week 7 demonstrated that there was no significant difference in the efficacy between 1% 5-FU cream and 90% TCA ( p =  0.763) or between 5% 5-FU cream and 90% TCA ( p =  0.274). Subjective side-effects with 1% 5-FU were significantly milder than 90% TCA; however, significantly milder objective side-effects were observed only at weeks 2, 6 and 7. The subjective side-effects with 5% 5-FU were also significantly milder than 90% TCA; however, significantly milder objective side-effects were observed only at week 2. 5-FU may become an alternative topical therapy as it offers the benefit of self-application; furthermore, a concentration of 1% 5-FU cream is recommended due to milder side-effects.

Background: Dermatotherapy is an important topic in Dermatology and Venereology module. The time allocated for dermatotherapy topic is limited, so that the development of learning method is needed to achieve the learning objectives. Blended learning is a combination of e-learning and face to face lecture session. This method is often used when there is less time available for lecturing and limited number of teachers. This learning method is expected to be more effective and efficient for the students and also the teachers. This study was conducted to examine the effectiveness of blended learning method used in dermatotherapy topic, and to identify the obstacle of using this method. Methods: This study is a cross sectional study, using quantitative and qualitative approach, involving 22 fifth-year medical students of Faculty of Medicine Universitas Indonesia who enrolled in dermatology and venereology module. We collected data from questionnaire, pre and post-test, and feedback from the students. Comparison of pre-test and post-test results were analysed using paired T test, and followed by bivariate test of students’ characteristic, gadget usage and e-learning activities associated with the increased post-test score.Results: An increased in post-test score was found to be statistically significant (p<0.05). Approximately 95,4% of students passed the final exam on the dermatotherapy subject. Bivariate analysis revealed that the number of gadgets owned, digital usage and e- learning activities did not have a significant effect on the post-test score. Based on the students’ feedback, blended learning had a positive impact on helping their learning process; however, the materials of e-learning must be interactive, informative and comprehensive. Face-to-face lecture is still an important component in learning hence it is irreplaceable. Conclusion: Blended learning is an effective method of learning and should be considered if there is limitation of lecture time and number of teachers available. By using this method, medical students are more flexible in their study and it can be adjusted to their own learning style hence heling them understand better. Further development and improvement are needed for this method as to achieve the learning objectives.  Keywords: blended learning, dermatotherapy, medical students

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Background Difficulty in diagnosing Chlamydia trachomatis infections, including chlamydial cervicitis, is a notable challenge in managing sexually transmitted infections in Indonesia. Gram staining is usually done to make a presumptive diagnosis despite its low sensitivity and specificity. Polymerase chain reaction (PCR) is considered the gold standard, but it is costly, technically demanding, and difficult to be performed in low-resource settings. Thus, rapid point-of-care tests with high sensitivity and specificity are needed to diagnose chlamydial cervicitis. Methods This cross-sectional study included symptomatic and asymptomatic high-risk women in the Mulya Jaya Sex Workers Rehabilitation Center in June to July 2020. Endocervical swabs from each participant were taken for QuickStripe™ chlamydia rapid test (CRT), Gram staining, and real-time PCR. Results A total of 41 participants were enrolled. The sensitivity and specificity for QuickStripe™ CRT were 73.6% (95% CI: 48.80%–90.85%) and 81.82% (95% CI: 59.72%–94.81%). Positive and negative predictive values were 77.78% (95% CI: 58.09%–89.84%) and 78.05% (95% CI: 62.39%–89.44%). Proportion of chlamydial cervicitis in study participants based on real-time PCR was 46.3%. Conclusions We concluded that QuickStripe™ CRT can be recommended as an alternative diagnostic test for high-risk populations in Jakarta.