Date of Award

Fall 12-21-2018

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Dr Gerardo Chowell

Second Advisor

Dr Egide Louis

Abstract

Background: Sexually transmitted diseases (STDs) and HIV are still a significant public health burden globally. According to the World Health Organization (WHO), globally there are more than 1 million cases of sexually transmitted diseases and HIV infections acquired on a daily basis. In 2016, there was an estimated 97,000 new HIV infections that occurred in Latin America. There is little to no information regarding the trends over time of sexually transmitted diseases and HIV infections in multiple Latin American countries, especially Chile which is considered a developing country.

Objective: The purpose of this study is to determine the patterns of sexually transmitted diseases and HIV using hospital discharges from 2001 to 2010 across all regions of Chile. We seek to 1) assess the pattern in hospital discharges due to STDs across all regions, 2) examine the association between the outcome (STDs) and predictor variables (age, gender, region) separately 3) examine the association between the outcome (STDs) and predictor variables (age, gender, region) controlling for region.

Methods: Data for this study was derived from the Chilean Department of Health Statistics and Information (DEIS). Using SAS Software (SAS 9.4, Cary NC), descriptive analyses were performed to determine the frequency distribution of the demographic data. Bivariate and multivariate logistic regression analysis were performed to examine the association between the outcome (STDs) and the predictor variables (Age, Gender and Region).

Results: The number of females with STDs were 50883 (79%) and males 13836 (22%). 54% of the STD cases arose from patients aged between 25-44 years, followed by patients aged 45-64 years which accounted for 22% of the STD cases. The region with the highest number of STD cases is Santiago accounting for 39% of the total number of cases. Pelvic inflammatory disease (PID), which only affects women, accounted for 66% (43085) of the STD cases among females. When compared to other STDs, the prevalence of PID occurred more in females than in males. For HIV, the results revealed that the odds of female patients being diagnosed with HIV were (AOR 0.02, 95% CI:0.02-0.09) when compared to male patients. For chlamydia, the odds of a female patient being diagnosed was (AOR 1.03 95% CI 0.85-1.25) when compared to male patients. The adjusted odds of females having syphilis is 0.31, (95% CI: 0.28-0.34) times less than the odds of males having syphilis. Therefore, there was no statistically significant difference between males and females for the outcomes of HIV, chlamydia and syphilis.

Conclusion: This study shows us an overall decrease in STD diagnoses from private hospital discharges. In the year 2002, there was a slight increase, and then it decreased and plateaued until 2010. Patients aged 25-44 years had the highest cases of all STDs followed by patients aged 5-24 year which is consistent with major studies. There was no statistically significant association between STDs and gender; females had a reduced odds of being diagnosed with HIV, Syphilis, Herpes and Other STDs when compared to males. Among female patients, PID cases were the highest for all STDs.

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