Positive Sexually Transmitted Infections Research Articles

Anal HPV prevalence in individuals with and without other concomitant sexually transmitted infections.

The association between human papillomavirus (HPV) and other sexually transmitted infections (STIs) in anal lesions still remains unclear. Aim of the study was to evaluate the prevalence of simultaneous infection of HPV and Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, and Trichomonas vaginalis in individuals screened for HPV anal infection. A total of 507 anal samples were tested for both anal HPV and STIs: 16% resulted positive for one or more non-HPV STIs. Specifically, C. trachomatis, M. genitalium, and N. gonorrhoeae were detected in 8%, 5%, and 4% of cases, respectively. Two groups were considered, including a positive STI group and a negative STI group. The prevalence of HPV was similar in patients in both groups: high risk (HR)-HPV and low risk (LR)-HPV were 67% and 53% versus 62% (p = 0.361) and 54% (p = 0.864) of patients, respectively. However, HPV 16, 18, 35, 51, 59, and 69 were significantly more frequent in patients tested positive for other STIs versus HPV infection alone (p < 0.05). No significant differences between the two groups were observed in vaccination coverage, 28% versus 32% (p = 0.463), and HIV status, 86% versus 84% (p = 0.658). The study shows that the overall HPV status is not directly correlated to other STIs in the investigated population, except for certain HPV types, including HR-HPV 16, reinforcing the urge for a greater vaccination coverage.

Using the Electronic Health Record to Implement Expedited Partner Therapy in the Pediatric Emergency Department.

Expedited partner therapy (EPT) is a partner treatment strategy for sexually transmitted infections (STIs) including gonorrhea and chlamydia as well as trichomoniasis in some states. The process allows healthcare providers to write prescriptions for STI treatment among partners of infected patients without a previous medical evaluation. The Centers for Disease Control (CDC) has recommended EPT as a useful option to facilitate partner treatment, particularly male partners of women with chlamydia or gonorrhea infections. Our institution implemented EPT in 2016 after Ohio legislation was passed to authorize its use. We aim to describe the implementation process and descriptive outcomes of EPT adoption in a pediatric emergency department. This study describes use of the electronic health record for implementation of EPT in our institution. We conducted a retrospective review of EPT utilization from implementation. Electronic records from the implementation date of January 1, 2017, through December 31, 2021, were reviewed. We describe basic demographics and overall uptake of the intervention. Fisher exact tests were used for categorical variables and two-sample t-tests for continuous variables. There was a total of 3275 positive test results and 739 EPT prescriptions written. Adolescent patients who received prescriptions for EPT were more likely to be female (78.7% of all EPT prescriptions, P = 0.007) and older than other patients (average age 17.7 vs 17.4 years, P = 0.004). There was no significant difference in race, insurance, or ethnicity among adolescent patients receiving and not receiving EPT. The percentage of positive STI tests associated with an EPT prescription ranged between 11.4% and 18.2%. Metronidazole was the most prescribed EPT medication. The use of the electronic health record provides a platform for implementation of EPT. Our study highlights a potential strategy for increasing treatments of STIs through EPT prescribing in the emergency department setting.

An Evaluation of the Performance, Patient Acceptability, and Feasibility of a Point-of-Care HIV-Syphilis Assay in an Urban Emergency Department.

Point-of-care (POC) tests for sexually transmitted infections (STIs) permit delivery of results during the patient's emergency department (ED) encounter. We evaluated performance, patient acceptability, and feasibility of a new duplex POC test, Chembio Dual Path Platform HIV-Syphilis Assay, in an urban ED setting. Convenience sampling approach prioritizing those considered at increased risk for an STI and/or with a history of HIV. For the performance evaluation, participants were tested for HIV/syphilis with the Chembio POC assay and the reference laboratory tests; sensitivity and specificity were determined. For the patient acceptability evaluation, participants completed pre- and post-user surveys. For the feasibility evaluation, ED clinical technicians completed a survey evaluating their perceptions regarding feasibility of use of this POC test. A total of 327 patients were consented and enrolled. The diagnostic sensitivity and specificity of the Chembio POC assay for HIV were 96.5% (95% confidence interval [CI], 90.1%-99.3%) and 99.6% (95% CI, 97.7%-100.0%), respectively, and for syphilis, the values were 93.9% (95% CI, 85.0%-98.3%) and 99.6% (95% CI, 97.9%-100.0%), respectively. Regarding patient acceptability, 87% trusted the result, and 93% reported that they were more likely to seek treatment if they received a positive STI test result in the ED rather than after the ED visit. Regarding feasibility, 90% of the technicians reported that they would recommend using the test in EDs. The Chembio Dual Path Platform HIV-Syphilis POC Assay had excellent performance characteristics when evaluated in an ED population, as well as high perceived acceptability from patients, and feasibility for ED use from clinical technicians. The test may have utility for HIV-syphilis screening among high-risk ED patients.

Alcohol Misuse and Sexually Transmitted Infections: Using the CAGE Questionnaire as a Screening Tool.

Background: While the connection between alcohol and risky behavior is well known, a clear correlation between alcohol misuse and contracting sexually transmitted infections (STIs) has not been determined. The 4-question CAGE questionnaire-the acronym stands for attitudes and activities related to alcohol use-is often administered at primary care annual visits to screen patients for alcohol abuse. This study assessed the relationship between CAGE scores and STI results to determine if the CAGE questionnaire could help determine the need for STI screening at annual visits. Methods: All patients who received a CAGE screening from 2015 to 2022 at a Gulf South health system were included in the analysis. The primary outcome of the study was the relationship between a positive CAGE score (a score ≥2) and a positive STI result. STIs included in the primary analysis were human immunodeficiency virus (HIV), hepatitis B, syphilis, chlamydia, gonorrhea, and trichomoniasis. The correlation between a positive CAGE score and hepatitis C was examined as a secondary outcome. Results: A total of 40,022 patients received a CAGE screening during the study period, and 757 (1.9%) scored ≥2 on the CAGE questionnaire. Significant associations were found between a positive CAGE score and hepatitis B (odds ratio [OR]=2.69, 95% CI 1.91, 3.80; P<0.001), gonorrhea (OR=5.43, 95% CI 1.80, 16.39; P=0.003), and hepatitis C (OR=2.10, 95% CI 1.57, 2.80; P<0.001). No associations were found between a positive CAGE score and HIV, chlamydia, or trichomoniasis. No patients with a CAGE score ≥2 had a syphilis diagnosis; therefore, no syphilis analysis was possible. Conclusion: Based on the results of this study, patients with a CAGE score ≥2 may benefit from screening for hepatitis B, hepatitis C, and gonorrhea at their primary care annual visit. Early STI detection could lead to prompt treatment and prevent further transmission and complications.

Point-of-care testing for sexually transmitted infections and HIV pre-exposure prophylaxis among pregnant women in South Africa, 2021–2022: randomised controlled trial

ObjectivePregnant and postpartum women (PPW) in Southern Africa are at increased risk of acquiring HIV and curable sexually transmitted infections (STIs). Oral pre-exposure prophylaxis (PrEP) is safe and effective to...

Bridging the Gaps in Women's Primary Care for Those Treated at a Residential Drug Treatment Facility in Southwest Ohio

Background: Patients with substance use disorders (SUD) have higher rates of sexually transmitted infections (STI) and limited utility of preventive and outpatient primary care. Women with SUD are a particularly vulnerable population requiring consistent primary and reproductive health care. This study evaluated the need for providing women’s primary health care to patients in a residential SUD treatment facility in rural southwest Ohio.Methods: A retrospective chart review was conducted using intakes at a female-only residential SUD treatment facility from 2021-2022. Variables recorded in this study were: 1) patient-reported substance use; 2) laboratory screenings for hepatitis B, hepatitis C, HIV, and STIs; 3) reproductive history (contraceptive, Papanicolaou (Pap) test, and pregnancy history); 4) patient-reported connection with a primary care provider (PCP); and 5) patient-reported mental health disorders. The analysis provided descriptive statistics to identify comorbidities and trends in women with SUD.Results: All completed intake charts were reviewed (n=159) without exclusions. No current PCP was reported in 59% of patients. Papanicolaou tests were needed in 50% of patients, and, of those completed, six (21%) had abnormal results. Almost 20% of patients were found with a positive STI, with highest prevalence of trichomoniasis (23%). Viral infection rate was 42%, the most common being hepatitis C (35% with active infection). Patient-reported comorbid psychiatric illness was 90%, the most common being generalized anxiety disorder (GAD) at 67.3%.Conclusion: This study supports the need for whole person primary care in residential SUD treatment facilities, particularly in respect to viral and sexually transmitted infections, and for overall women's health.

Chlamydia and Gonorrhea Testing Patterns Among Women with and Without Serious Mental Illness.

Rates of the sexually transmitted infections (STIs) Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) have risen in women by 13% and 40%, respectively, since 2015. Women with Serious Mental Illness (SMI) are at disproportionate risk for STIs. A retrospective chart review was performed at a safety-net healthcare system in the Southeastern United States (US) from 2014 to 2017. CT/GC positivity rates did not differ between the general and SMI populations (6.6% vs. 6.5% for CT and 1.8% vs. 2.2% for GC, respectively). Emergency Medicine accounted for more positive STI test results in SMI patients than the general population (25.2% vs. 19.1% for CT, 47.8% vs. 35.5% for GC, respectively). SMI patients received large portions of STI care in emergency settings, where follow-up is poor. Point of Care (POC) testing could improve care in this setting, and mental healthcare providers must address sexual health with patients who otherwise may not receive this care.

Evaluation of a Statewide Online, At-Home Sexually Transmitted Infection and Human Immunodeficiency Virus Screening Program.

Innovative approaches such as online, at-home programs may address important barriers to sexually transmitted infection (STI) and human immunodeficiency virus (HIV) screening in the United States. This study evaluated the first year of an online, at-home program offering HIV and triple-site (urogenital, rectal, and pharyngeal) gonorrhea (GC) and chlamydia (CT) testing in Colorado. Test Yourself Colorado (TYC) is an online, at-home program that provides free mailed HIV tests and/or GC/CT tests to Colorado adults. Program use and outcomes between 1 June 2021 and 31 May 2022 were analyzed. A total of 1790 unique clients utilized TYC. Of 1709 clients who ordered HIV tests, 508 (29.7%) were men who have sex with men (MSM), and 41.3% (210/508) of these clients reported having never been tested for HIV before or were not tested in the prior year. Hispanic clients had lower STI test return rates (37.1%; 134/361) compared with non-Hispanic clients (45.9%; 518/1128) (P = .003). Positive STI tests were identified in 9.6% (68/708) of clients. Positive STI tests were more common in MSM clients (15.7%; 34/216) compared with all other sexual orientations (6.9%; 34/492) (P < .001). STI treatment was confirmed in 80.9% (55/68) of clients. The TYC online, home testing portal is a scalable tool that reaches clients at risk of STIs and HIV and navigates those with positive STI tests to treatment. HIV/STI home testing programs need to further assess and address utilization and outcomes for disparities by race and ethnicity to assure programs equitably benefit all at-risk communities.

PrEP Access Affected by COVID-19 Is Associated With Increased Odds of HIV Seroconversion.

Black and Hispanic/Latino sexual minority men and gender diverse (SMMGD) individuals report lower uptake and adherence to pre-exposure prophylaxis (PrEP) compared with White SMMGD. For some, the COVID-19 pandemic has resulted in reduced access to PrEP prescriptions and related changes to PrEP use, yet little is known how pandemic-related changes to PrEP access and sexual activity might influence sexually transmitted infection (STI) status and HIV seroconversion among SMMGD of color. We used data from 4 waves of a national study of Black and Hispanic/Latino SMMGD's HIV, PrEP, and health experiences to assess whether self-reported changes to sexual activity were associated with STI status, and whether self-reported changes to PrEP access were associated with HIV seroconversion. Those who reported greater impact to their sexual activity during the pandemic [adjusted odds ratio (aOR) = 1.24; 95% confidence interval (CI): 1.10 to 1.40] and a greater number of sexual partners (aOR = 1.29; 95% CI: 1.21 to 1.38) were more likely to report a positive STI test. In addition, we found that compared with those who did not report pandemic-related changes to PrEP access, those who did report changes to PrEP access had significantly higher odds of HIV seroconversion during the study period (aOR = 2.80; 95% CI: 1.02 to 7.68). These findings have implications for HIV and STI prevention and highlight the importance of novel interventions to improve PrEP access among Black and Hispanic/Latino SMMGD. Importantly, these findings also demonstrate the need to stay focused on key populations at risk of HIV infection during emerging public health crises to avoid an increase in rates of new diagnoses.

Developing Sentinel Surveillance for Chlamydia and Gonorrhea Using Test Results From Routine Screening During Pregnancy.

Background Interpretation of case-based surveillance of chlamydia and gonorrhea is limited by the lack of negative tests for comparison. We sought to develop a sustainable electronic health record (EHR)-based approach to disease surveillance in a sentinel population of pregnant persons. Methods We conducted a 1-year assessment of sexually transmitted infections (STIs) in persons receiving at least 1 pregnancy-related visit within our university medical center. Data were obtained using EHR analytic structured query language code. Patients were categorized by whether they had an STI test during pregnancy and if screened, by the STI test results (positive or negative). We assessed screening and positivity by demographic using bivariate analyses. Predictors of a positive STI test were determined using logistic regression. Results We identified 4553 persons who received pregnancy care from January 1 to December 31, 2021. Seventy-six percent (n = 3483) of persons were screened for an STI during pregnancy. Those who identified as white or had private insurance were less likely to have a chlamydia test. Among persons screened, Trichomonas was the most commonly detected STI (5%, 141/2698) followed by chlamydia (4%, 135/3456), and gonorrhea (0.7% 24/3468). Predictors of a positive STI test during pregnancy were Black race (adjusted odds ratio [aOR], 6.0; 95% confidence interval [95% CI], 4.2–8.7), 25 years or younger (aOR, 2.5; 95% CI, 1.9–3.3), and public insurance (aOR, 1.6; 95% CI, 1.2–2.1). Conclusions We demonstrated that EHRs can be used to assess gonorrhea and chlamydia positivity. These methods could potentially be applied in other jurisdictions to improve the understanding of national STI surveillance.

Associations of Pediatric Symptom Checklist Scores with Sexual Activity and Sexually Transmitted Infections in Urban Adolescents.

To assess the association between the Youth Pediatric Symptom Checklist-17 (YPSC-17) and adolescents' reports of ever having sex and with having positive testing results for sexually transmitted infections (STIs). Analyzed electronic data from primary care clinics for 27,901 adolescents aged 13-17 years with responses to the YPSC-17 and urine screen results for gonorrhea/chlamydia. On the YPSC-17 in total 8.3% screened positive. Over one quarter (26%) reported ever having sex and 11% of sexually active youth had a positive STI test. Logistic regression analyses revealed increased odds of sexual activity among those positive on the YPSC-17 total (aOR 1.87, 95% CI 1.68-2.08) or any subscale (INT-aOR 1.43, 95% CI 1.32-1.55; EXT-aOR 1.62, 95% CI 1.40-1.88; ATT-aOR 1.67, 95% CI 1.47-1.90). In addition, sexually active youth with positive EXT (aOR 1.41 95% CI 1.00-1.98) scores were more likely to have STIs. The YPSC-17 can identify adolescents with heightened risks for STIs.

Impact of risk-based sexually transmitted infection screening inthe emergency department.

Sexually transmitted infections (STIs), including chlamydia, gonorrhea, and human immunodeficiency virus (HIV) pose a significant health burden in adolescents. Many adolescents receiving care in the emergency department (ED) are in need of testing, regardless of their chief complaint. Our objective was to determine whether an electronic, risk-based STI screening program in our ED was associated with an increase in STI testing among at-risk adolescents. We conducted a retrospective cohort analysis of patient outcomes in our pediatric ED after integrating an Audio-enhanced Computer-Assisted Self-Interview (ACASI) as standard of care. It obtained a focused sexual history and generated STI testing recommendations. Patient answers and testing recommendations were integrated in real-time into the electronic health record. Patients who tested positive received treatment according to our standard-of-care practices. All patients 15-21 years of age were asked to complete this on an opt-out basis, regardless of the reason for their ED visit. Exclusions included those unable to independently use a tablet, severe illness, sexual assault, or non-English speaking. Our primary outcome was to describe STI-testing recommendations and test results among ACASI participants. We also compared STI testing between ACASI participants and those who were eligible but did not use it. In the first 13 months, 28.9% (1788/6194) of eligible adolescents completed the ACASI and 44.2% (321/790) accepted recommended STI testing. The mean age of participants was 16.6±1.3 years, with 65.4% (1169) being female. Gonorrhea/chlamydia testing was significantly higher among participants vs. non-participants (20.1% [359/1788] vs 4.8% [212/4406]; p<0.0001). The proportion of positive STI tests was similar between the two groups: 24.8% (89/359) vs. 24.5% (52/212; p=0.94) were positive for chlamydia and/or gonorrhea, while 0.6% (2/354) participants vs. 0% non-participants (p>0.99) were positive for HIV. Among participants whose chief complaints were unlikely to be related to STIs but accepted recommended testing, 20.9% (37/177) were positive for gonorrhea or chlamydia. Our program facilitated STI testing in the ED and identified many adolescents with STIs, even when their ED complaint was for unrelated reasons. More rigorous implementation is needed to determine the impact of deployment of ACASI to all eligible adolescents and addressing barriers to accepting STI testing recommendations.

Hospital and Laboratory Practice in an Integrated Medical System for HIV Infection Prevention Interventions at a Veteran Affairs Medical Center.

The impact of sexually transmitted infection (STI) results on prompting clinicians to consider pre-exposure prophylaxis (PrEP) indication is sparse in the literature, particularly for veterans. A retrospective search from June 2018 to February 2020 was performed to identify all patients who were HIV-negative at a regional Veteran Affairs Medical Center with a positive STI test result and review the medical chart of these patients. We identified 220 veterans who were HIV-negative with a positive STI test result. Of these 220 veterans, 51 unique patients were identified by the clinicians. In a provider-initiated discussion, PrEP was discussed with all 51 patients. In the end, 27 of these 51 patients started PrEP after discussion with their clinical providers. Prior positive STI results successfully helped identify patients who may benefit from PrEP. Quality assurance studies on clinician reactions to test result reporting, particularly regarding highly effective preventive therapies, are important.

851. Rate of Sexually Transmitted Infections and Engagement in HIV Pre-Exposure Prophylaxis at the Veterans Affair Maryland Health System

BackgroundRates of sexually transmitted infections (STIs) and uptake of HIV pre-exposure prophylaxis (PrEP) during the 2020 coronavirus pandemic are unknown. We evaluated data from the Veterans Affair Maryland Health Care System (VAMHCS) data to determine rates of STI and PrEP linkage in our Veterans.MethodsWe extracted patient-level data on demographics, STI testing (chlamydia, gonorrhea, and syphilis), International Classification of Diseases (ICD) diagnosis codes and refills of TDF-FTC and TAF-FTC. We compared the ratio of positive STI tests in 2018, 2019 and 2020 using chi-square tests. Individuals eligible for PrEP were defined as patients with a newly positive STI result or an ICD diagnosis of: high risk sexual behavior; an STI mentioned above; or gender identity disorder. We excluded anyone with a positive HIV test or a creatinine >1.8. We identified patients initiated on PrEP through pharmacy refill data to define initiation of care. Finally, we used chi-square tests to compare differences of initiation of PrEP between years and demographics.ResultsThe STI positivity rate significantly increased (p< 0.01) from 44.2% (2018) and 42.9% (2019) to 61.6% (2020) [Table 1]. The median ages of those who had a positive STI test were 50 (2018), 44 (2019) and 44 (2020). In 2020, 17% of patients eligible for PrEP filled PrEP. Engagement was similar (p=0.33) in 2019 and 2018, where 14% and 11.6% of patients eligible for PrEP received a prescription (p-value=0.33) [Figure 1]. The median age of those refilling PrEP were: 44 (2018); 43 (2019) and 41 (2020)). In 2020, we observed a statistically significant difference (p< 0.01) in initiation of PrEP in care among Black patients with 11.7% of eligible patients filling PrEP as compared to white patients (26.2%) and other races (23.3%) [Figure 2]. Table 1. Rate of positive tests at VAMHCS from 2018-2020. Figure 1. PrEP Cascade at VAMHCS by year. Non-statistically significant (P=0.33) when comparing engagement in care between different years. Figure 2. Racial distribution of PrEP eligibility and initiation by year at the VAMHCS. ConclusionWhile during the coronavirus pandemic in 2020, fewer Veterans sought STI testing at the VAMHCS, the number of positive STI results remained steady, leading to a higher positivity rate. The rate of initiation of PrEP did not differ between 2020, 2019 and 2018. Racial inequities in initiation of PrEP increased in 2020.Disclosures All Authors: No reported disclosures

Sexualverhalten und Pr\xe4vention sexuell \xfcbertragbarer Infektionen unter Ber\xfccksichtigung der SARS-CoV-2-Pandemie. Daten aus einem Versorgungszentrum f\xfcr sexuelle Gesundheit und Medizin \u2013 WIR

ZusammenfassungHintergrundAnwendungsbezogene Daten zu sexueller Gesundheit und sexuellem Verhalten in unterschiedlich sexuell aktiven Populationen stehen nur begrenzt zur Verfügung, sind aber für Präventions- und Versorgungsstrategien sehr relevant. Das multisektorale Versorgungszentrum WIR – Walk In Ruhr hat aufgrund seiner Besucher*innenstruktur Zugang zu Daten aus diversen Lebenswelten.Ziel der ArbeitAus verschiedenen WIR-internen Datenquellen sollen populationsbezogene Erkenntnisse zu Alter, Geschlecht, sexueller Orientierung, Sexual- und Risikoverhalten gewonnen und Bedarfe für Prävention abgeleitet werden. Einflüsse der SARS-CoV-2-Pandemie auf das Sexualverhalten sollen durch den Vergleich verschiedener Zeiträume untersucht werden.MethodenAusgewertete Datenquellen sind der Onlinerisikotest für HIV und STI, die COWIR- und PrEP-Studie sowie die Immunologische Ambulanz und das Gesundheitsamt im WIR.ErgebnisSexuell übertragbare Infektionen (STI) sind von 2019 auf 2020 trotz Kontaktbeschränkungen gestiegen. Generell haben junge Menschen, Männer, die Sex mit Männern, und Frauen, die Sex mit Frauen haben, ein erhöhtes STI-Risiko aufgrund der gewählten Sexualpraktiken und der Anzahl sexueller Kontakte. Eine hohe Zahl bi- und transsexueller Kontakte ist festzustellen. SARS-CoV‑2 führte zu einer Reduzierung der Sexualkontakte. Sexualpraktiken wurden weiter gelebt. Die STI-Testquote und die Behandlungsrate stiegen an.DiskussionDie Daten aus dem WIR belegen, dass eine junge Klientel mit aktivem Sexualleben erreicht wird. Die Ergebnisse aus Fragebögen und dem Onlinerisikotest zeigen den Zusammenhang von erhöhten positiven STI-Tests mit Sexualverhalten und sexuellen Präferenzen, weshalb spezifische Strategien zu Sexualaufklärung, Prävention, Tests und Therapien erforderlich sind.

Direct and Indirect Cost Savings From Sexually Transmitted Infection Testing, Treatment, and Counseling Among Foster Youth.

Sexually transmitted infection (STI) prevention programs can decrease the economic burden of STIs. Foster youth have higher rates of STIs compared with their peers; however, information on direct costs and indirect costs averted by STI testing, treatment, and counseling among foster youth is lacking. This study used data from a comprehensive medical center for foster youth over a 3-year study period from July 2017 to June 2020. Direct and indirect costs averted by testing and treatment of chlamydia, gonorrhea, and syphilis, as well as HIV testing and counseling, were calculated based on formulas developed by the Centers for Disease Control and Prevention and adjusted for inflation. Among the 316 youth who received medical services during this time, 206 were sexually active and tested for STIs and/or HIV. Among 121 positive STI test results, 64.5% (n = 78) were positive for chlamydia, 30.6% (n = 37) were positive for gonorrhea, and 5.0% (n = 6) were positive for syphilis. Treatment was provided to all. Overall, $60,049.68 in direct medical costs and $73,956.36 in indirect costs were averted. Given the rates of STIs among this population and the economic benefit of STI treatment, it is imperative to continue to provide intensive and comprehensive, individualized sexual health care for foster youth. Traditional care management may miss the opportunity to prevent, identify, and treat STIs that comprehensive wraparound care can achieve. This study suggests that comprehensive wraparound care is a cost-effective way to identify, treat, and prevent STIs among foster youth.

Antibacterial Activity of Propolis Extracts from the Central Region of Romania against Neisseria gonorrhoeae.

(1) Background: Sexually transmitted infections (STIs) are among the most common infections worldwide, many of these being caused by Neisseria gonorrhoeae (NG). Increased antimicrobial NG resistance has been reported in recent decades, highlighting the need for new sources of natural compounds with valuable antimicrobial activity. This study aims to determine the effect of propolis extracts on NG strains, including antibiotic-resistant strains. (2) Methods: First void urine samples from presumed positive STI subjects were harvested. DNA was extracted, purified, and amplified via PCR for the simultaneous detection of 6 STIs. The presence of the dcmH, gyrA, and parC genes was checked in the DNA samples from NG-positive patients. The antimicrobial activity of 5 aqueous propolis extracts from central Romania was investigated in vitro against some isolated NG strains. ANOVA tests were employed to assess differences and interactions between the inhibition zone for NG strains and propolis extracts. (3) Results: 7.07% of the patients presented NG infections, some strains being resistant or intermediate-resistant to ciprofloxacin. All propolis samples exhibited an antibacterial effect, including on resistant strains. (4) Conclusions: Statistical analysis demonstrated that the diameter of the inhibition zone was influenced both by the NG strain type and the source of the propolis extracts.

Scaling Up CareKit: Lessons Learned from Expansion of a Centralized Home HIV and Sexually Transmitted Infection Testing Program.

Despite advances in implementing human immunodeficiency virus (HIV)/sexually transmitted infection (STI) services for men who have sex with men (MSM), many remain underserved because of barriers like stigma, low facility coverage, and provider competency. This article describes the implementation of centralized nationwide mailed HIV/STI home testing (CareKit). The Emory Center for AIDS Research developed CareKit for research study participants to request HIV self-test kits, STI specimen collection kits, and condom/lubricant packs to be shipped to any mailing address in the United States. Sexually transmitted infection kits were customized according to study needs and could include materials to collect whole blood, dried blood spots, urine sample, and rectal and pharyngeal swab samples for syphilis, gonorrhea, and chlamydia testing. Specimens were mailed back to a central Clinical Laboratory Improvement Amendments-approved laboratory for testing, and results were returned to participants. CareKit was used by 12 MSM studies and mailed 1132 STI kits to 775 participants between January 2018 and March 2020. Participants returned 507 (45%) STI kits, which included 1594 individual specimens. Eighty-one kits (16%) had at least one positive STI test result: pharyngeal chlamydia (n = 7), pharyngeal gonorrhea (n = 11), rectal chlamydia (n = 15), rectal gonorrhea (n = 12), genital chlamydia (n = 6), genital gonorrhea (n = 1), and syphilis (n = 54). In this same 2-year period, 741 HIV self-test kits were mailed to 643 MSM. CareKit successfully met studies' needs for home HIV/STI testing and diagnosed many STIs. These processes continue to be adapted for research and programs. The ability to mail home test kits has become increasingly important to reach those who may have limited access to health care services, particularly during the COVID-19 pandemic.

Lubrication Practices and Receptive Anal Sex: Implications for STI Transmission and Prevention.

IntroductionImplications of lubricant use in men having sex with men (MSM) are poorly characterized, particularly associations with sexual behavior and rectal sexually transmitted infection (STI) risk.AimWe sought to clarify covariates associated with lubrication type including differing sexual preferences and rectal STI prevalence.MethodsPrimary English-speaking individuals ≥18 years old visiting San Francisco City Clinic (SFCC) between April and May of 2018 who endorsed lubricant use during receptive anal sex within the last 3 months were studied. Associations between lubrication type used and collected covariates were assessed using Kruskal-Wallis analysis of variance for continuous variables and Chi-squared test for categorical variables. We used logistic regression to examine the association between lubrication type and rectal STI test result.Main Outcome MeasuresRectal STI test positivity.ResultsFrom all enrolled participants, 179 completed the survey and endorsed use of a lubricant during receptive anal sex within the last 3 months. Silicone lubricant users had the most sexual partners in the last 3 months (13 [mean] ± 30 [SD], P= .0003) and were most likely to have a history of gonorrhea. Oil-based lubricant users had the most partners with whom they had receptive anal sex in the last 3 months (7 ± 6, P= .03). Water-based lubricant users most commonly used a condom in their last sexual encounter and had the fewest sexual partners in the last 3 months (4 ± 4, P= .0003). Spit/saliva lubricant use was associated with positive rectal STI result.ConclusionSilicone and oil-based lubricant users were more likely to report condomless receptive anal sex and to have a history of gonorrhea while spit/saliva lubricant use associated with positive rectal STI acquisition. Lee A, Gaither TW, Langston ME, et al. Lubrication Practices and Receptive Anal Sex: Implications for STI Transmission and Prevention. Sex Med 2021;9:100341.

Mother-to-child transmission of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis in HIV-infected pregnant women in South Africa.

Sexually transmitted infections (STIs) can be transmitted from mother to neonate. We determined the frequency of mother-to-child transmission (MTCT) of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis to the newborn nasopharynx. This study was nested in a cohort study of etiologic testing versus syndromic management for STIs among pregnant women living with human immunodeficiency virus in South Africa. Mothers were tested for STIs using the GeneXpert platform within 60 days after delivery. Nasopharyngeal swabs were obtained from newborns of mothers with a positive STI test; these were then tested by Xpert® on the same day based on the maternal STI diagnosis. We tested nasopharyngeal swabs from 85 STI-exposed newborns; 74 (87%) were tested within 2 weeks after birth (median five; range 2-12days). MTCT frequency of any STI was 30/74 (41%); 43% (23/53) for C. trachomatis, 29% (2/7) for N. gonorrhoeae, and 24% (6/25) for T. vaginalis. Also, 4/11 (36%) swabs obtained between 14 and 60days after delivery tested positive for STI. There was a high frequency of MTCT of STIs to the nasopharynx of newborns in our setting. The impact of nasopharyngeal colonization and the benefits of STI testing on newborn health remain to be determined.