Modifiable and non-modifiable factors related to HPV infection and cervical abnormalities in women at high risk: a cross-sectional analysis from the Valhidate Study

Abstract: Migrant women, and women infected with HIV, are at enhanced risk of cervical HPV infection and HPV-related cancers. We investigated factors that can reduce these risks through public health preventive and screening interventions. We compared prevalence and risk factors for cervical HPV infection/lesions in women with HIV-infection (HIW) and migrant women (RMW) with a control group of resident women (SPW) who were enrolled in the study for the eVALuation and monitoring of HPV Infections and relATEd cervical diseases in high-risk women (VALHIDATE). Among 3093 evaluable women, age-standardized HPV prevalence was 36.3% (95%CI: 28.1\u201344.4) in HIW, 21.6% (95%CI: 15.7\u201327.5) in RMW, and 14.3% (95%CI: 12.5\u201316.1) in SPW. Adjusted prevalence of HPV infection was 2.07 times higher among HIW (95%CI: 1.75\u20132.45), and 1.45 times higher among RMW (95%CI: 1.17\u20131.80) than in SPW. Prevalence-ratios of SIL and HG-SIL were 2.67 (95%CI: 2.06\u20133.45) and 2.82 (95%CI: 1.28\u20136.20), respectively, in HIW compared to controls. A multivariate log-binomial regression model showed modifiable risk factors associated with HPV infection/lesion to have different patterns among groups. Specific public-health intervention, including health and sexual-health education, safe-sex procedures, and improvements to screening programmes, could favorably affect these highly vulnerable women

Sexual Functioning and Opioid Maintenance Treatment in Women. Results From a Large Multicentre Study

Opioid maintenance treatment (OMT) is the most widespread therapy for both females and males opioid addicts. While many studies have evaluated the OMT impact on men’s sexuality, the data collected about the change in women’s sexual functioning is still limited despite the fact that it is now well-known that opioids - both endogenous and exogenous - affect the endocrine system and play an important role in sexual functioning. The present study aims to determine how OMT with buprenorphine (BUP) or methadone (MTD) affects sexual health in women; examining also any possible emerging correlation between sexual dysfunction (SD), type of opioid and patients’ mental health. This multi-center study case recruited 258 female volunteers attending Italian public Addiction Outpatients Centers that were stabilized with OMT for at least 3 months. SD was assessed with the Arizona Sexual Experience Scale. The twelve-item General Health Questionnaire was used to assess participants’ mental health conditions. The results show that 56.6% of women receiving OMT for at least 3 months presented SD without significant differences between MTD e BUP groups. The majority of the subjects with SD have a poorer quality of intimate relationships and worse mental health than the average. To the best of our knowledge, the present study is the largest report on the presence of SDs in women as a side effects of MTD and BUP used in OMT. Since SDs cause difficulties in intimate relationships, lower patients’ quality of life and interfere with OMT beneficial outcomes, we recommend that women undertaking an opioid therapy have routine screening for SD and we highlight the importance to better examine opioid-endocrine interactions in future studies in order to provide alternative potential treatments such as the choice of opioid, opioid dose reduction and hormone supplementation

Effects of SARS-CoV-2 pandemic on follow-up and pharmacological treatment of chronic diseases in undocumented migrants

Background All over the world, the COVID-19 pandemic, not unlikely other epidemics, has hit harder people in low socioeconomic conditions. In Western countries, undocumented migrants are a growing component of this disadvantaged segment of the population. Their health conditions are frequently burdened by a number of chronic conditions, and they experience many difficulties in accessing public health services. Frequently, the only medical assistance they can get is provided by non-governmental organisations. Methods We studied the medical records (including pharmacological treatments) of all patients attending the outpatient clinics of Opera San Francesco (OSF; a big charity in Milano, Italy), in the first 5 months of 2020. These comprise the outbreak of the pandemic and the lockdown period. The 1914 patients (1814 undocumented migrants and 100 Italians) seen during the lockdown were compared with those seen in the same period of 2019 and with those seen in the preceding months of 2020. We especially focused on three chronic conditions: cardiovascular diseases, diabetes and psychiatric disorders. Results The number of consultations during the first 5 months of 2020 was much smaller than that of the same period of 2019. During the lockdown, we found 4048 consultations for 1914 patients, while they were 8051 in the same period of 2019 and 5681 in the first 2 months of 2020. The quantity of medicines dispensed by OSF showed a marked decrease in the period of the study and mainly during the lockdown. The decrease in consultations and dispensation of medicines was most evident for psychiatric patients and almost not existent for patients with diabetes. Female patients suffered a more pronounced reduction. Conclusions Western countries need strategies to better assist the very poor during epidemics. Differences among different groups of disadvantaged persons should be taken into account when designing recovery plans

Chagas disease prevalence among migrants from El Salvador in Milan: a cross- sectional study of an often-overlooked population

BackgroundChagas disease (CD) is considered to be highly endemic in El Salvador, where its prevalence is estimated to be 1.3-3.7%. Although more than 40,000 migrants from El Salvador are currently living in Europe (particularly in Spain and Italy), there are few data regarding the prevalence of CD in this population. The aim of this study was to evaluate the prevalence of CD among Salvadorans living in Italy.MethodsA cross-sectional serological survey of CD among Salvadorans living in the metropolitan area of Milan was carried out between October 2017 and December 2019. The participants' blood samples were tested for Trypanosoma cruzi antibodies using two different serological assays. The collected demographic data included their biological sex, province of origin, the type of housing in their country of origin, and family history of CD.ResultsOf the 384 subjects who voluntarily participated in the study, five (1.3%, most coming from La Paz) were positive to both serological assays and therefore conclusively diagnosed as having CD. Five other subjects had discrepant serological results but were not positive to a third assay. Three of the five subjects with a diagnosis of CD completed medical staging, one of whom had chronic disease (digestive and cardiac involvement).ConclusionsThe prevalence of CD among Salvadorans living in Milan is similar to that estimated by the WHO in 2010. Although they are often overlooked in CD surveys, Salvadoran migrants should be included in CD control programs in countries in which the disease is not endemic

Modifiable and non-modifiable factors related to HPV infection and cervical abnormalities in women at high risk: a cross-sectional analysis from the Valhidate Study

Abstract: Migrant women, and women infected with HIV, are at enhanced risk of cervical HPV infection and HPV-related cancers. We investigated factors that can reduce these risks through public health preventive and screening interventions. We compared prevalence and risk factors for cervical HPV infection/lesions in women with HIV-infection (HIW) and migrant women (RMW) with a control group of resident women (SPW) who were enrolled in the study for the eVALuation and monitoring of HPV Infections and relATEd cervical diseases in high-risk women (VALHIDATE). Among 3093 evaluable women, age-standardized HPV prevalence was 36.3% (95%CI: 28.1–44.4) in HIW, 21.6% (95%CI: 15.7–27.5) in RMW, and 14.3% (95%CI: 12.5–16.1) in SPW. Adjusted prevalence of HPV infection was 2.07 times higher among HIW (95%CI: 1.75–2.45), and 1.45 times higher among RMW (95%CI: 1.17–1.80) than in SPW. Prevalence-ratios of SIL and HG-SIL were 2.67 (95%CI: 2.06–3.45) and 2.82 (95%CI: 1.28–6.20), respectively, in HIW compared to controls. A multivariate log-binomial regression model showed modifiable risk factors associated with HPV infection/lesion to have different patterns among groups. Specific public-health intervention, including health and sexual-health education, safe-sex procedures, and improvements to screening programmes, could favorably affect these highly vulnerable women