Sexually Transmitted Infections Research Articles

Exploring the prevalence of chlamydial and gonorrheal infections in pregnant women: a multicenter study in Egypt

BackgroundChlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widespread, treatable sexually transmitted infections (STIs) of global significance, affecting millions annually. Left untreated, they pose significant risks, including pelvic inflammatory disease (PID), infertility, and complications during pregnancy. The U.S. Centers for Disease Control recommends annual chlamydial screening for sexually active women to address these risks. Responding to this global challenge, the World Health Organization (WHO) has formulated a global health sector strategy on sexually transmitted infections, outlining priority actions to strengthen STI responses in countries. However, STI epidemiological studies encounter challenges in developing nations like Egypt due to socio-cultural factors, poverty, and limited diagnostic facilities. In Egypt, STI diagnosis primarily relies on clinical presentations, lacking structured screening programs for CT and NG. This study’s main objective is to estimate the prevalence of Chlamydial and gonorrheal infections, advocating for supportive STI strategies in Egypt. Additionally, the study aims to provide a foundation for national prevalence estimates of CT and NG infections.MethodsA cross-sectional study encompassed five antenatal clinics in different regions of Egypt. A total of 1040 pregnant women attending these clinics were consecutively sampled. Data collection involved structured questionnaires, and urine samples were subjected to the GeneXpert CT/NG qualitative real-time PCR test.ResultsThe prevalence of CT infections was 0.29% (95% CI, 0.10–0.86%), with no detected NG infections. The three CT-positive cases were distributed across different recruitment centers, with no statistically significant differences observed between infected and non-infected participants. Notably, 40.3% of recruited women reported gynecological symptoms, primarily discharge. Additionally, 9.6% had undergone previous testing for sexually transmitted infections, with 8.2% receiving positive results.ConclusionsThis study provides valuable data on the prevalence of CT and NG infections among pregnant women attending ANC clinics in Egypt. The findings underscore the importance of ongoing surveillance, routine screening, and targeted interventions to ensure the reproductive health and well-being of pregnant women and their infants. Further research is warranted to explore the broader implications of STIs in different populations and to inform evidence-based guidelines for screening and management in diverse settings. Trial registration: IRB no.: 17,400,017; WHO ERC Protocol Id. A66005.

Screening for Sexually Transmitted Infections in Adolescents with Genitourinary Complaints: Is There a Still Role for Endocervical Gram Stains?

Study objective: Adolescent females are disproportionately affected by Sexually Transmitted Infections (STIs). Endocervical Gram stain smears taken during gynecological examination are inexpensive, relatively easy procedures to perform and interpret. The purpose of this study was to evaluate the performance characteristics of Gram smears in the diagnosis of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (GC) and Trichomonas vaginalis (TV) in a female adolescent population presenting to the Emergency Department (ED) with genitourinary complaints. Methods: This study was a retrospective, cohort analysis of consecutive females (ages 13 – 19) seen at three academic medical centers over a two-year study period. All patients underwent a pelvic exam with diagnostic testing for STIs. Positive criteria for a Gram stain included greater than ten white blood cells per high-power field, gram-negative intracellular/extracellular diplococci (suggesting GC), or direct visualization of TV organisms. Polymerase Chain Reaction (PCR) assays were used as the gold standard definition for CT/GC infection. Direct microscopic visualization of organisms on a separate wet mount prep was considered the gold standard for TV infection. Demographic information, clinical findings of cervicitis, and the results of diagnostic testing were obtained from ED records using standardized abstraction forms. Results: During the study period, 1303 adolescent females were evaluated for genitourinary complaints. A total of 181 adolescents (12.9%) had at least one documented STI. Overall, 298 patients (22.9%) had positive gram stains. The sensitivity, specificity, and positive likelihood ratio for Gram stain in the diagnosis of STI were 28.7% (95% CI, 22.2 to 35.9), 78.1% (95% CI, 75.5 to 80.5), and 1.31 (95% CI 1.0 to 1.7), respectively. The sensitivity of Gram stain to Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis were 35.9% (95% CI 26.8 to 45.8), 34.5% (95% CI 18.0 to 54.3), and 5.7% (95% CI 1.3 to 15.7), respectively. The consistency of the data recording was excellent, with a median kappa statistic of 0.89. Conclusions: The positive likelihood ratio of inflammation on endocervical Gram stain is too low to recommend its use to direct empiric treatment of adolescents at risk for sexually transmitted infections. Diagnostic uncertainty or treatment failures should prompt specific laboratory testing.

Sociodemographic characteristics, community engagement and stigma among Men who have Sex with Men (MSM) who attend MSM-led versus public sexual health clinics: A cross-sectional survey in China.

Community-based sexual health services are recommended to increase sexually transmitted disease (STD) testing among men who have sex with men (MSM). Pilot study data from multiple sites found that MSM in Guangzhou who use public STD clinics were found to have different sociodemographic characteristics, lower community engagement, and increased social cohesion, compared to MSM who use MSM-led clinics.

Seroprevalence of herpes simplex virus 2 infection among commercial sex workers in Colombo, Sri Lanka

Background: Herpes Simplex Virus Type 2 (HSV2) causes genital herpes, an incurable, lifelong sexually transmitted infection (STI). This study was conducted to describe the seroprevalence and associated factors of HSV2 infection in a cohort of Female Sex Workers (FSWs). Methods: A descriptive cross-sectional study was conducted on 136 FSWs who attended the central STD Clinic, in Colombo. They were assessed using an interviewer-administered questionnaire followed by serum sampling. Serum samples were tested for HSV2 IgG using an enzyme immunoassay specific for glycoprotein gG2 of HSV2. Results: HSV2 seroprevalence of FSW was 66.9% (91/136) of which only 14.3% (13/91) reported a history of genital infection. Age ≥35 years (OR 3.35, 95%CI 1.54-7.31, p=0.002), education ≥ grade 5 (OR 8.35, 95%CI 13.1- 64.7, p<0.001), lifetime sexual partners ≥ 200 (OR 5.33, 95% CI 2.3-12.36), p<0.001), duration of sex work ≥1 year (OR 4.5, 95% CI 2.09-9.65, p<0.001) and history of STI (OR 4.52, 95% CI 1.9-10.78, p<0.001) were statistically significant risk factors for high HSV2 prevalence. Consistent condom use by commercial partners in the last 3 months was not a significant protective factor in preventing HSV2 infection (OR 0.44, 95% CI 0.15-1.26, p = 0.12) in this cohort. Conclusions: The seroprevalence of HSV2 is high in this population and most of them did not report any genital infection. Multiple risk factors for higher prevalence were observed. Findings support the need for regular surveillance, monitoring of HSV-2 infection in high-risk populations, and expanding awareness of HSV-2 infection in the country.

Sexual and reproductive health challenges and service use among internally displaced persons in Benue and Kaduna states of Nigeria: a comparative study

This study investigates the sexual and reproductive health (SRH) challenges and access to SRH services among internally displaced persons (IDPs) in two Nigerian states: Benue (North-central) and Kaduna (Northwest). The research focuses on understanding how different contexts and variation in the management of displacement in these contexts influence SRH outcomes for IDPs and use of SRH services within and outside camp settings. We conducted face-to-face survey interviews with 581 sexually active IDPs residing in camps for at least 6 months. The questionnaire covered contraception, gender-based violence, sexually transmitted infection (STI) services, and SRH service utilization. Our findings reveal significant contextual differences between the two states. Benue reported higher rates of transactional sex, while Kaduna had higher rates of intimate partner violence and contraceptive use. SRH service use was generally higher in Benue than in Kaduna. We found statistically higher odds of SRH service use one camp in Benue (β = 2.7; p < 0.001) and significantly lower odds in a camp in Kaduna ((β = 0.1; p < 0.001) in comparison with a camp in Benue. By showing how different approaches may shape displaced persons’ access to SRH services within and outside camps, our study highlights the importance of understanding the nuances in humanitarian contexts in designing responses. This study provides valuable insights into the SRH needs and experiences of IDPs in different Nigerian contexts, informing targeted interventions and policies to improve service provision for displaced populations.

Assessing the Effectiveness of Wet Mount and PCR Methods in Diagnosing Trichomonas vaginalis Infections in Endocervical and Urine samples

Trichomonas vaginalis is the cause of trichomonas’s infection, which is referred to be the global sexually transmitted disease (STD) worldwide. This parasite primarily spreads through sexual activity, though it can also spread through intimate. Vaginal inflammation in females causes a variety of clinical symptoms, such as a profusion of greenish-yellow, frothy, foul-smelling discharge, valvar enlargement, itching, and punctate erythematous lesions of the cervix, commonly referred to as "strawberry cervix." There are numerous scenarios in which women may be sick but not exhibit any symptoms. The purpose of the current study is to compare the diagnostic efficacy of polymerase chain reaction (PCR) and wet mount preparation for detecting T. vaginalis in various sample types, including endocervical discharge, endocervical swabs, and urine, of 300 female patients (married and single), ages ranging from 15 to 62, who were referred to Dohuk Maternity Hospital, Shariya Camp, either inside or outside of Dohuk city. Based on the clinical symptoms of the patients, the diagnosis of parasite infection was validated by microscopically confirming the infection in the laboratory using two methods: PCR and direct wet mount preparation. The study findings demonstrated, out of 240 samples, 61 (25.4%) at Dohuk Maternity Hospital and 15 (25%) out of 60 samples in Shariya Camp were contaminated with T. vaginalis. Of the 300 samples, 74 (24.6%) had wet mount preparation infection, and 75 (25.0%) had PCR infection. In the current study, 42 single women had 10 (23.8%) and 258 married women had 66 (25.5%) infected. The age range of 15 to 25 had a higher infection rate (32.8%).

Extragenital self-collection testing for gonorrhea and chlamydia: A feasibility study for expanding STI screening in the Veterans Health Administration.

Rectal and pharyngeal infections with gonorrhea and chlamydia are of concern because they are associated with higher risk of HIV acquisition. Extragenital screening in asymptomatic persons at high risk may have the potential to reduce the incidence of these sexually transmitted infections (STIs). Several testing platforms are available for the testing of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) using nucleic acid amplification tests (NAATs). Self-collected extragenital samples are currently not approved by the US Food and Drug Administration in any NAAT platform. This study compares the analytical performance of self-collected extragenital specimens to that of clinician-collected specimens. We performed a multicenter/multiplatform validation study as a National Veterans Health Administration Pathology and Laboratory Medicine quality improvement project, with 9 different participating sites. Self-collected specimens were obtained at the same time as clinician-collected specimens. Clinician-collected specimens were used as the gold standard to evaluate the sensitivity and specificity of self-collection. A total of 2324 individual tests were analyzed (501 rectal and 661 oropharyngeal). The sensitivity was 94.44% for CT and 100% for NG for rectal specimens, whereas it was 100% for CT and 97.22% for NG for oral specimens. Specificity for oral specimens was 99.85% for CT and 99.36% for NG, whereas for rectal specimens, it was 99% for CT and NG. Self-collected specimens for extragenital CT/NG testing are highly sensitive and specific, with negative predictive values of 100%. Self-collection has the potential to overcome a major barrier for STI screening by providing an accessible, convenient, and patient-centered alternative.

Olax dissitiflora Oliv. (small-fruited olax): Current status and future prospects as medicinal plant

Olax dissitiflora Oliv. (O. dissitiflora) has several medicinal uses, some of them known since prehistoric times. The present review compiles existing knowledge of the chemical and pharmacological properties, current medicinal uses, and further use potential and applications of O. dissitiflora. Multiple searches on existing literature on the medicinal, phytochemistry and pharmacological properties of O. dissitiflora were conducted in online databases such as Scopus, JSTOR, PubMed, Google Scholar and Science Direct as well as using pre-electronic literature sources obtained from the university library. This study showed that the bark, leaves, roots and twigs of O. dissitiflora are used as aphrodisiac, emetic, mosquito repellent and purgative, and as traditional medicines against dental problems, gonorrhoea, hernia, venereal diseases and wounds. The phytochemical evaluation of the plant revealed that it contains reducing sugars, alkaloids, flavonoids, phenolic compounds, quinones, saponins, steroids, tannins, terpenoids, 21-epimachaerinic acid, oleanolic acid, hederagenin, oleanolic acid 3-O-glucuronide, amphotericin, santalbic acid, exocarpic acid and octadic-9,11-diynoic acid. The pharmacological assessments showed that the crude extracts and phytochemical compounds isolated from the species have antibacterial, antifungal, antiplasmodial, larvicidal and adulticidal activities. The collected ethnomedicinal and ethnopharmacological properties of O. dissitiflora documented in this review will assist to understand the therapeutic relevance and potential of the species as well as providing baseline data required for ethnopharmacological assessments required in the discovery of novel plant-based health products. There is also need for more studies focusing on phytochemistry, pharmacological properties and toxicological evaluations, in vivo and clinical research on O. dissitiflora to compliment and validate the ethnomedicinal properties of the species.

STI Rates Among High-Risk Youth Undeterred During Early COVID-19 In A HIV Care Clinic

Abstract Background In recent years, the United States has observed increasing rates of sexually transmitted infections (STIs). Rates are highest amongst the teen and young adult age groups. In addition to the immense healthcare costs associated with STIs, long-term sequelae can be severe on the individual level. The risk of infertility is particularly high for those with repeated or prolonged infection. Upon entering the COVID-19 pandemic, it was unclear if the widespread behavioral changes and disruptions in routine care practices to minimize the further spread of COVID-19 would cause an increase or decrease in the United States’ STI rates. This study sought to determine if there was a change in the incidence of STIs during the first year of the COVID-19 pandemic compared to the year prior in a population at high risk for STIs. Methods A retrospective chart review was performed for 330 patients aged 12 to 41 years (mean 20.2 years, median 20 years, standard deviation 3.75 years) with human immunodeficiency virus (HIV) or on pre-exposure prophylaxis (PrEP) to prevent the acquisition of HIV, who presented for preventative and acute care appointments at a multidisciplinary pediatric and young adult HIV Clinic in the year prior to and during the first year of the COVID-19 pandemic (March 22, 2019-March 21, 2021). Utilizing telehealth, rapid COVID-19 screening, and multimodal patient communication, increased efforts were made in this clinic during the pandemic to maintain appropriate STI screening, testing, treatment, and rescheduling of routine visits when appropriate to minimize COVID-19 exposure and spread. Comparisons were made between the two time periods, which evaluated the incidences of individual and overall STIs diagnosed per person-years, STIs per total tests performed, and time to treatment initiation. Results Between one year prior to and the first year during the COVID-19 pandemic, this clinic experienced no statistically significant rate changes of sexually transmitted infections. A non-significant decreased incidence of chlamydia (22 cases per 100 person-years and 18 cases per 100 person-years, respectively) and unchanged rates of gonorrhea (22 cases per 100 person-years and 22 cases per 100 person-years, respectively) and syphilis (16 cases per 100 person-years and 15 cases per 100 person-years, respectively) were observed. The median times to treatment remained largely unchanged. Conclusion This HIV care clinic experienced a decreased chlamydia infection rate, a trend similar to the CDC United States STI data during this time period. In contrast to the nationally reported increased rates of gonorrhea and syphilis, this clinic experienced unchanged rates. The lack of change in our cohort could reflect that the benefits of a multidisciplinary HIV care model persist despite a pandemic that disrupted routine medical care and behavior practices.

The effect of teach-back method training on the prevention behaviors of reproductive age women against sexually transmitted diseases

The aim of this research was to examine the effect of teach-back method-based training provided to reproductive-age women to protect them from sexually transmitted diseases (STDs) on their protective behaviors. Sexually transmitted diseases cause significant health problems for many women every year. The transmission of sexually transmitted diseases can be prevented through health education, which is among the preventive health services. Nurses are the leading health educators. Nurses should learn new education systems and models and use them in their practice. This study has a randomized controlled design. The teach-back method and face-to-face training were provided to women of reproductive age experimentally for protection from sexually transmitted diseases. In this research, the teach-back method in which there were 42 participants in each group, an identifying information form for women in three groups who were provided face-to-face training and not trained, the Behavioral Scale for Protection from Sexually Transmitted Diseases were applied pre-training, fifteen days and three months after the training. Participants’ socio-demographic data in the intervention and control groups were compared. The mean age of the teach-back group had been 30.64 ± 5.73, the average age of the face-to-face group had been 29.83 ± 5.49, and the mean age of the non-trained group had been 28.16 ± 5.09. These groups had displayed similar characteristics. The mean score of the Behavioral Scale for Protection from Sexually Transmitted Diseases was found to be 75.57 ± 12.78 pre-training, 82.54 ± 9.59 fifteen days after the training and 81.85 ± 9.28 three months after the training in women who were trained with the teach-back method; 76.92 ± 10.03 pre-training, 80.78 ± 8.72 fifteen days after the training and 80.21 ± 8.77 three months after the training in women who received face-to-face training, while it was found in women who did not receive face-to-face training to be 75.73 ± 6.14 pre-training, 75.61 ± 6.01 fifteen days after the training and 75.54 ± 6.09 three months after the training and there was a statistically significant relationship between them (F = 6.736; p < 0.001). As a result of the research, it was found that the training provided to women with the teach-back method had a positive effect on women’s behaviors and was more effective than face-to-face training.

Assessing a Couples-Based, Digital HIV Serostatus-Neutral Intervention (Para Ti, Para Mí, Para Nosotros) for Adult Cisgender Sexual Minority Male Couples in Lima, Peru: Protocol for a 6-Month Pilot Randomized Controlled Trial.

HIV disproportionately affects sexual minority men (SMM; eg, gay, bisexual, and other men who have sex with men) in Lima, Peru; epidemiological data estimate that 32% to 39% of new HIV infections occur among adult cisgender SMM within primary partnerships (ie, male couples). Most HIV prevention-care research in Lima, Peru, has focused on SMM as individuals and not couples. To help address this critical gap in prevention care, we developed Para Ti, Para Mí, Para Nosotros (P3): a couples-based, digital HIV serostatus-neutral intervention (DHI) for adult cisgender SMM couples in Lima, Peru. The P3 DHI is designed to facilitate couples with skill-building, communication, decision-making, and working together to form and adhere to a detailed prevention care plan that aligns with their explicit sexual agreement. The P3 DHI is theoretically informed, self-guided, directed, sequential, and fully automated. This pilot randomized controlled trial (RCT) aims to examine the preliminary effects of P3 on couples' formation and adherence to a detailed prevention care plan containing evidence-based strategies that also aligns with their explicit sexual agreement over time. In addition, the feasibility of enrollment and retention and couples' acceptability of P3 will be assessed. The research implements a prospective, 6-month pilot RCT with a 3-month delayed control condition. After baseline, 60 enrolled SMM couples will be randomized to 1 of 2 conditions. Couples randomized to the unmatched, delayed control condition will receive access to the P3 DHI to use during the last 3 months of the trial after the 3-month assessment. Couples randomized to the immediate intervention condition will immediately receive access to the P3 DHI for 6 months. Study assessments will occur at baseline and months 3 and 6. Descriptive, comparative, qualitative, and longitudinal analyses using generalized linear mixed-effect, multilevel, and actor-partner interdependence models will be conducted to address the specific aims. The 6-month pilot RCT is ongoing. Recruitment, enrollment, and data collection began in January 2023 and ended in April 2024. A total of 74 adult cisgender SMM couples met all inclusion criteria, provided consent, and were enrolled in the pilot RCT. Retention was 92% (68/74) at month 6. Data are currently being analyzed to address the 3 specific aims regarding feasibility, acceptability, and preliminary efficacy. Findings from this research will reveal whether couples deemed the P3 DHI to be acceptable. Findings will also highlight the preliminary efficacy of the P3 DHI on couples managing their vulnerability to HIV and other sexually transmitted infections (STIs) over time via alignment of their prevention-care plan and sexual agreement. Trial findings will help shape the future direction of the P3 DHI while addressing the existing gap in prevention and care services for couples in the local context. ClinicalTrials.gov NCT05873855; https://clinicaltrials.gov/study/NCT05873855. DERR1-10.2196/63106.

Barriers and enablers that influence the uptake of HIV testing among heterosexual migrants in the Netherlands.

Heterosexual migrant men and women in the Netherlands often face barriers to accessing health services, including HIV testing, that may lead to late-stage HIV diagnoses. This study explored factors of influence in the usage of HIV testing among heterosexual migrants. Qualitative evaluation with semi-structured interviews at the Amsterdam-based AIDS Healthcare Foundation (AHF) Checkpoint and one focus group discussion (FGD) conducted during June-July 2023 with 19 participants: interviews with 12 heterosexual migrants from low- or middle-income countries (LMICs) and FGD (n = 5) and interviews (n = 2) with 7 key informants from the (public) health sector. Recorded interviews were transcribed and thematically analyzed, using the framework of Andersen's Expanded Behavioral Model of Health Services Use. In total, 55 themes emerged from the interviews and the FGD. Examples include insufficient availability of information on HIV and testing services, and difficulty in accessing these services (e.g. the barrier of the online appointment system of the Centre for Sexual Health (CSH)). HIV test participants expressed free, rapid testing, no appointment required, and a positive experience during their HIV test as enablers to test in the future. Results from key informants showed that poor health literacy and lack of clarity on the healthcare system's guidelines were barriers for heterosexual migrants in accessing information on HIV and testing services. It also revealed past initiatives and interventions that were successful in reaching at-risk groups such as the integration of HIV testing into sexually transmitted infection (STI) testing, but that were subsequently discontinued due to financial constraints. Factors contributing to a low HIV test uptake were participants' perception of limited accessibility of CSH facilities, insufficient available information on HIV (testing) services, and low perception of HIV risk. Unclear policies on accessing HIV/STI testing services at CSHs, and potential missed opportunities for HIV testing at general practitioners were contributing factors identified by key informants.

Demographic, Behavioural, and Biological Factors Seen in Men Who Have Sex with Men with Salmonella spp.: A Systematic Review

Background: The sexual transmissibility of enteric pathogens, including Salmonella spp., has been described in men who have sex with men (MSM). However, the factors seen in MSM with Salmonella spp. are poorly understood. Method: We aimed to systematically review the literature to explore any factors seen in MSM with Salmonella spp. (MSM). We searched six databases—Medline, PubMed, CINAHL, Embase, Emcare, and Global Health—in April 2024 for manuscripts which contained primary peer-reviewed data in English and the measurement of any risk factors observed in MSM with Salmonella spp. This review was registered on PROSPERO (CRD42023472864). Results: Eleven manuscripts were included in the final review and highlighted demographic (living with HIV), behavioural (oral–anal sex, receptive and penetrative anal sex, hand licking to stimulate their partner, group sex, non-condom use), and biological (co-infection with CMV, Mycobacterium avium complex, Strongyloides stercoralis, Blastocystis hominis, Klebsiella spp. Herpes simplex virus, Cytomegalovirus, Cryptosporidium, Histoplasmosis, Shigella spp.; previous infection with Treponema pallidum, Neisseria gonorhoeae, Chlamydia trachomatis and hepatitis B; and antimicrobial treatment failure) factors seen in MSM with Salmonella spp. Conclusion: Despite a limited number of manuscripts and individuals, this review highlighted some potential demographic, behavioural, and biological factors implicated in the transmission of Salmonella spp. in MSM. These data will provide insights for future guidelines, public health control strategies, and research.

Gaps in HIV Pre-exposure Prophylaxis Acceptance: Findings from an Outpatient HIV Testing Service in Italy

Background: The aim of this study is to assess the acceptability of HIV pre-exposure prophylaxis (PrEP) among individuals eligible for prophylaxis. Setting: Retrospective study of individuals receiving their first HIV test at the Infectious Diseases Unit of IRCCS San Raffaele Scientific Institute, Milan, Italy. Methods: People i) who received their first HIV test (baseline date) between January 2018 (availability of PrEP in Italy) and December 2023 (data lock), ii) with an indication for PrEP based on condomless sex were included; those already on PrEP were excluded. Individuals with a negative HIV test result were offered PrEP counselling and prescription according to guidelines. Characteristics of people who accepted or declined HIV PrEP were compared using Mann-Whitney or Chi-square tests, as appropriate. Results: A total of 2627 people were tested for HIV: 175 (6.6%) were diagnosed with HIV. Of the 2452 people with negative HIV test results, 2165 (88.3%) were men; median age was 34.3 years (interquartile range, IQR=28.7-42.4). Sexually transmitted infections (STIs) were detected in 478/2452 (19.5%), most commonly gonorrhoea (206/2452, 8.4%). Overall, 982/2452 (40.0%) people accepted PrEP, including only three women. Non-acceptance was higher among women (p&lt;0.001) and non-Caucasians (p&lt;0.001). Of those who did not accept PrEP, 260 (17.7%) were diagnosed with at least one STI at the time of HIV testing. Conclusion: Low PrEP acceptance was observed, particularly among women and people of non-Caucasian origin. Non-acceptance of PrEP was also observed among individuals diagnosed with an STI.

Enabling a Learning Public Health System: Enhanced Surveillance of HIV and Other Sexually Transmitted Infections.

Sexually transmitted infections (STIs) continue to pose a substantial public health challenge in the United States (US). Surveillance, a cornerstone of disease control and prevention, can be strengthened to promote more timely, efficient, and equitable practices by incorporating health information exchange (HIE) and other large-scale health data sources into reporting. New York City patient-level electronic health record data between January 1, 2018 and June 30, 2023 were obtained from Healthix, the largest US public HIE. Healthix data were linked to neighborhood-level information from the American Community Survey. In this cross-sectional study, we compared patients who received a test or tested positive for chlamydia, gonorrhea, and/or HIV with patients who were untested or tested negative, respectively, using generalized estimating equations with logit function and robust standard errors. Among 1,519,121 tests performed for chlamydia, 1,574,772 for gonorrhea, and 1,200,560 for HIV, 2%, 0.6% and 0.3% were positive for chlamydia, gonorrhea, and HIV, respectively. Chlamydia and gonorrhea co-occurred in 1,854 cases (7% of chlamydia and 21% of gonorrhea total cases). Testing behavior was often incongruent with geographic and sociodemographic patterns of positive cases. For example, people living in areas with the highest levels of poverty were less likely to test for gonorrhea but almost twice as likely to test positive compared to those in low poverty areas. Regional HIE enabled review of testing and cases using granular and complementary data not typically available given existing reporting practices. Enhanced surveillance spotlights potential incongruencies between testing patterns and STI risk in certain populations, signaling potential under- and over-testing. These and future insights derived from HIE data may be used to continuously inform public health practice and drive further improvements in provision and evaluation of services and programs.

Manifestações dermatológicas da Monkeypox

Objective: This study aimed to identify the primary mucocutaneous manifestations secondary toMonkeypox infection and determine the prevalence of coinfection with other sexually transmittedinfections (STIs). Methods: Searches were conducted in the PubMed, LILACS, SciELO, Cochrane Library, andVirtual Health Library databases using the descriptors “monkeypox,” “dermatological,” “dermatology,”“cutaneous,” “skin,” and “mucocutaneous,” combined with the Boolean operators “and” and “or.” All articles published between January 2017 and October 2022 that addressed mucocutaneous manifestations secondary to Monkeypox infection, regardless of language, wereincluded. Technical notes from the Brazilian Ministry of Health and World Health Organization recommendations were also incorporated. The Joanna Briggs Institute (JBI) critical appraisal tool was used to assess the quality of the studies. Data were independently evaluated by three reviewers. Exclusion criteria included the absence of photographic records of the lesions, lack of laboratory confirmation of infection, “letter to the editor” publications, duplicates, and articles primarily focused on systemic manifestations without association with the integumentary system. Results: A total of 22 publications were included in this study. The most frequently affected anatomical sites were the genital and perianal regions, though lesions were also reported on the torso, face, oropharynx, limbs, palms, and soles. There is a possibility that the infection may present nonspecifically as a maculopapular rash. Lesions are typically multiple, with either localized orwidespread distribution. In the latter case, the progression is centrifugal, beginning on the face.The most prevalent characteristic of the elementary lesion is central umbilication, which eventuallydevelops a crusted appearance. Umbilicated papules are often associated with pain, which gradually transitions to varying degrees of pruritus. Coinfection with HIV and other STIs was particularly notable among men who have sex with other men and/or have multiple partners and who use condoms inconsistently.Conclusions: Monkeypox can present with various cutaneous manifestations, none of which arepathognomonic of the disease. The chronological evolution of the elementary lesions (papule, vesicle,pustule, crust) is not always precise, with multiple stages potentially coexisting in the same area of the body. The primary behavioral factor associated with infection is unprotected sexual activity, especially among men who have sex with other men. Coinfections with HIV, syphilis, gonorrhea, chlamydia, and/or herpes were observed in the majority of cases.

Epidemiological and clinical aspects of syphilis incidence in the Russian Federation and the Kyrgyz Republic: comparative analysis

The Soviet period of development of domestic dermatovenereology was characterized by scientific achievements and the creation of organizational forms of combating venereal and contagious skin diseases. After the collapse of the USSR, socio-economic changes occurred in the former Soviet republics that affected the medical sphere. In recent years, the integration of dermatovenereologists with representatives of related specialties has increased and cooperation in the exchange of experience between dermatovenereological services of Russia and other countries is actively developing, including in the field of prevention of the spread of STIs. In 2021 and 2022, a significant increase (by 69.7%) in the incidence of syphilis was registered in Russia for the first time compared to 2020, which is due to an increase in this indicator among migrants (from 2801 cases in 2020 to 12748 cases in 2022), of which 30% of syphilis cases were among citizens of Kyrgyzstan. The article presents the results of a retrospective comparative study of syphilis incidence rates among children aged 0 to 14 years, adolescents aged 15 to 17 years, and adults over 18 years in the Russian Federation and the Kyrgyz Republic, and analyzes regulatory documents governing syphilis testing and treatment. Despite significant similarities in approaches to laboratory diagnostics of syphilis, including neurosyphilis, uniform principles of prenatal examination of women and treatment of pregnant women, there are currently a number of significant differences, including shorter courses of therapy and low doses of drugs, shorter periods of clinical and serological monitoring in the Kyrgyz Republic.

Distribution of HPV genotypes in Mashhad, Iran: insights from a 2022–2023 study

BackgroundHuman papillomavirus (HPV), is one of the main causes of cervical cancer and also one of the most common sexually transmitted infections (STIs). HPV is responsible for almost all cases of cervical cancer and plays a principal role in causing other cancers including oropharynx, penis, larynx, oral cavity, anus, vulva, and vagina. The study aims to investigate the prevalence and distribution of HPV genotypes among patients referred to private laboratories in Mashhad, located in the northeast of Iran.Methods and materials428 samples including 382 females (89.3%) and 46 males (10.7%) between January 10, 2022, and February 11, 2023, in Mashhad, Iran were evaluated to detect HPV and determine its genotypes. Cervical swabs and urine samples were collected from females and males, respectively. Viral DNA was extracted by using a CedExtra purification kit (cedbio, Iran) and viral genotypes were identified with a High + Low Papillomastrip kit (Operon, Spain). Mann Whitney U test and Chi-square test were accomplished for statistical analysis.ResultFrom the total of 428 participants analyzed, the HPV test result was positive for 129 patients (30.1%) and negative for 299 people (69.9%). Among the participants, 115 female (30.1%) and 14 male (30.4%) were positive for HPV infection. The prevalence of HPV infection among the referring people was about 30%. The most common genotype identified was HPV-6 (10.3%), followed by HPV-16 (8.7%) and HPV-51 (7.7%), the second and third most common genotypes, respectively. Additionally, HPV-39 was detected at a frequency of 6.70%. HPV-11, HPV-61, HPV-91, and HPV-44 with a frequency of 1% were among the least genotypes identified among the patients.ConclusionIn line with the results of this study, the prevalence of HPV genotypes in both genders is 30%. The results likely reflect differences in the prevalence of high-risk HPV genotypes, that are less common. Also, HPV-6 and HPV-16 genotypes that are covered by the vaccine had a significant prevalence. On the other hand, with the prevalence of HPV-51 and HPV-39 genotypes in infected people who are not covered by the Gardasil (quadrivalent) vaccine, there is a risk of related cancers in the future.

Replication-Competent Oropouche Virus in Semen of Traveler Returning to Italy from Cuba, 2024.

A febrile man in Italy who had traveled to Cuba in July 2024 was diagnosed with Oropouche fever. Reverse transcription PCR detected prolonged shedding of Oropouche virus RNA in whole blood, serum, urine, and semen. Sixteen days after symptom onset, replication-competent virus was detected in semen, suggesting risk for sexual transmission.

'Monkeypox, where is your rage?': The racialization, sexualization, and securitization of global health

With the purposes of identifying the underlying challenges of global and public health governance of outbreaks, this paper explores three key themes that emerged in response to the 2022 mpox epidemic: the belated change of disease nomenclature from monkeypox to mpox; the classification of mpox as a sexually transmitted infection (STI); and the unpreparedness of health agencies to vaccinate impacted populations. The paper makes the case that, because of the global and public health tensions arising from racialized nomenclatures, sexualized classifications, biosecuritized borders, and monopolized vaccines, national and international agencies failed in providing an adequate and comprehensive response to the latest mpox pandemic, which contributed further to the pathologization of already vulnerable and stigmatized population groups.