Sexually Transmitted Infections Testing Research Articles

Self-Collected Testing for Sexually Transmitted Infections: A National Text Message Survey of Adolescents and Young Adults

We aimed to analyze adolescent and young adults' (AYAs) perspectives on using sexually transmitted infection (STI) self-collection kits to help guide the provision and implementation of accessible and confidential reproductive health-care services for those who experience the burden of STIs and STI-related morbidity. We utilized MyVoice, a nationwide text message survey of AYAs, to pose 6 open-ended questions on their perceptions and use of STI self-collection kits. Two independent reviewers used inductive content analysis to develop a codebook and analyze responses, and a third settled any coding discrepancies through discussion to reach consensus. Code frequencies and demographic data were summarized using descriptive statistics. We collected responses from 763 participants. Individuals who answered at least one question were included in the sample. Responses indicated that most (n= 695, 91.1%) participants would use free STI self-collection kits. Participants who would not use an STI self-collection kit (n= 45, 5.9%) cited concerns about test result accuracy and discomfort with specimen collection. Survey respondents were amenable to using free, STI self-collection kits; however, some were concerned about accuracy. There is an urgent need to prioritize and increase the accessibility of STI testing among youth. STI self-collection kits are an effective and accessible option that addresses barriers to reproductive health-care services-stigma, inconvenience, and lack of privacy. A social media campaign focusing on AYAs may increase knowledge and use of STI self-collection kits through dissemination of accurate information, stigma reduction, and provision of accessible resources that empower AYAs to prioritize their sexual health.

Feasibility of providing Sexually Transmitted Infection and Blood Borne Virus testing in a UK probation setting: findings from a service evaluation

BackgroundEarly diagnosis and treatment of Sexually Transmitted Infections (STIs) and Blood Borne Viruses (BBVs) remain strategic priorities for health services in the UK. Reaching those at high risk, including people in contact with the justice system, remains a key challenge in the diagnosis and treatment of STIs and BBVs. One setting that is yet to be used in the UK to identify STIs and BBVs is probation. Our objective was to examine whether a probation site (PS) is an acceptable and accessible setting for the provision of STI and BBV tests.MethodsIntervention. Testing for STIs and BBVs was offered to probation users attending a local probation setting in Wales, UK. Testing was offered via three methods: a finger-prick dried blood spot test, Rapid POCT oral swab, or finger-prick PCR micro-capillary finger prick test.Evaluation. Semi-structured interviews were used to provide insights from the testing team and probation staff who delivered and supported the testing service.ResultsThe programme was offered to all service users attending the PS over 18 working days. In total, 439 people were tested, 56% of whom had no previous record of being screened in Wales. Nine infections were identified and the majority of these were in people who appeared not to have previously accessed testing. Nine factors that affected uptake were identified. These included PS staff buy in, the location of the services, consistency, and empathy. Treatment uptake and completion rates were high for all infections.ConclusionsThis pilot study demonstrated that probation is an effective and acceptable setting to provide STI and BBV testing. The programme reached many people who had not previously accessed testing. It also showed that treatment completion rates were high amongst those who tested positive.

Interrelationship between chemsex engagement and PrEP (pre-exposure prophylaxis) experience in men who have sex with men: a community-based cross-sectional study

BackgroundChemsex engagement is known to be associated with higher-risk sexual behaviour, HIV and sexually transmitted infection (STI). To reduce HIV infection risk, pre-exposure prophylaxis (PrEP) is increasingly used in the...

Doxycycline Postexposure Prophylaxis and Bacterial Sexually Transmitted Infections Among Individuals Using HIV Preexposure Prophylaxis

Doxycycline postexposure prophylaxis (doxyPEP) has been shown to decrease the incidence of bacterial sexually transmitted infections (STIs) among people assigned male sex at birth in clinical trials, but data from clinical practice are limited. To describe early uptake of doxyPEP and evaluate changes in STI incidence following doxyPEP initiation. This retrospective cohort study of adults (aged ≥18 years) dispensed HIV preexposure prophylaxis (PrEP) at Kaiser Permanente Northern California during November 1, 2022, to December 31, 2023, examined electronic health record data to compare HIV PrEP users dispensed and not dispensed doxyPEP and rates of bacterial STIs before and after starting doxyPEP. Individuals were followed up from their first recorded STI test on or after November 1, 2020, until December 31, 2023, or discontinuation of health plan membership. Pharmacy dispensing data were used to define doxyPEP recipients. Demographic and clinical characteristics were compared between individuals dispensed and not dispensed doxyPEP. Primary outcomes were incident chlamydia, gonorrhea, or infectious syphilis measured as quarterly STI positivity (proportion of individuals testing positive at least once per quarter). Among doxyPEP recipients, rate ratios (RRs) compared mean quarterly STI positivity from 24 months before to 12 months after starting doxyPEP. In an exploratory analysis, STI trends were evaluated for the full cohort, stratified by receipt of doxyPEP. Among 11 551 HIV PrEP users (mean [SD] age, 39.9 [12.1] years; 95.1% male), 2253 (19.5%) were dispensed doxyPEP, of whom 2228 (98.9%) were male and 1096 (48.6%) had an STI in the year before starting doxyPEP. Compared with individuals not dispensed doxyPEP, doxyPEP recipients were older (mean [SD] age, 40.4 [10.8] vs 39.8 [12.4] years; P = .04) and had used HIV PrEP longer (mean [SD], 4.2 [2.8] vs 3.4 [2.6] years; P < .001), and a higher proportion were commercially insured (2091 [92.8%] vs 8270 [88.9%]; P < .001). Among doxyPEP recipients, quarterly chlamydia positivity decreased from 9.6% (95% CI, 9.0%-10.3%) before starting doxyPEP to 2.0% (95% CI, 1.5%-2.6%) after starting doxyPEP (RR, 0.21; 95% CI, 0.16-0.27; P < .001), with significant declines for each anatomic site of infection. Quarterly gonorrhea positivity decreased from 10.2% (95% CI, 9.6%-10.9%) before starting doxyPEP to 9.0% (95% CI, 8.0%-10.1%) after starting doxyPEP (RR, 0.88; 95% CI, 0.77-1.00; P = .048); site-specific declines were significant for rectal (RR, 0.81; 95% CI, 0.67-0.97; P = .02) and urethral (RR, 0.56; 95% CI, 0.40-0.79; P = .001) gonorrhea, but not pharyngeal gonorrhea. Quarterly syphilis positivity decreased from 1.7% (95% CI, 1.4%-1.9%) before starting doxyPEP to 0.3% (95% CI, 0.2%-0.6%) after starting doxyPEP (RR, 0.20; 95% CI, 0.11-0.37; P < .001). Positivity for STIs remained stable in individuals not dispensed doxyPEP. This study found that receipt of doxyPEP was associated with substantial declines in chlamydia and syphilis incidence and modest declines in urethral and rectal gonorrhea incidence among individuals using HIV PrEP. These findings suggest that doxyPEP may offer substantial benefits for reducing population-level STI transmission with broader implementation.

Factors associated with HIV self-testing and PrEP use among Nigerian youth: Baseline outcomes of a pragmatic, stepped-wedge, cluster-randomized controlled trial

IntroductionAdolescents and young adults (AYA, 14–24 years) bear a disproportionate burden of new HIV infections in Nigeria and are more likely to have worse HIV outcomes compared to other age groups. However, little is known about their access to recommended sexual health care services, including HIV self-testing (HIVST), sexually transmitted infections (STI) testing, sexual behavior patterns, awareness and or access to pre-exposure prophylaxis (PrEP), and overall risk for HIV. MethodsWe present a baseline analysis of the 4 Youth by Youth randomized controlled trial aimed to evaluate the uptake and sustainability of crowdsourced HIVST strategies led by and for young people across 14 states in Nigeria. None of the participants had received intervention at the time of completing this self-reported behavioral survey. We conducted a descriptive analysis to summarize participants' characteristics, sexual behavior, HIV testing, STI testing, and knowledge of PrEP and use across the study sample of the AYAs. We conducted a chi-square test, and the level of significance was set at ≤0.05. ResultsA total of 1551 participants completed the baseline survey comprising males (777, 50.1 %) and females (774, 49.9 %). The majority (77 %) of the participants were students at enrollment. Very few of the participants had ever tested for syphilis, 47 (3.1 %), gonorrhea, 49 (3.2 %), chlamydia, 31 (2.0 %), and hepatitis B, 106 (6.9 %). 678 (43.8 %) of the participants reported to be sexually active at the time of enrolment into the study, of which about 38 % of them engaged in condomless sex. Paying for sex, alcohol use, and drug use are all significant sexual behaviors (p < 0.01). Only 14 (1 %) have ever used PrEP. 481 (31.4 %) have ever tested for HIV, and 104 (6.8 %) have ever used an HIV self-testing kit at baseline. 457 (38.6 %) were eligible for PrEP. ConclusionsHIVST and STI uptake were low at baseline among the AYA in this study. Most AYAs also do not receive recommended sexual health care services, including STI testing services. This underlines the need for interventions to increase the uptake of HIV/STI prevention services among Nigerian AYA.

Rates of screening for sexually transmitted infections in adolescents with and without disabilities.

Individuals with disabilities experience a higher prevalence of sexually transmitted infections (STIs) compared to their counterparts without disabilities; however, there is limited data on whether they are screened for STIs at the same rate. The aim of this study was to determine whether adolescents and young adults with disabilities undergo routine screening for STIs at lower rates than individuals without disabilities. We performed a retrospective cohort study of female patients aged 16-21 years who were seen between July 2021 and August 2023 by pediatrics, internal medicine/pediatrics, or family medicine at a single institution. Disability status was determined via ICD-10 codes. STI testing information was obtained by chart review. Data were analyzed using multiple logistic regression, and adjusted odds ratios were reported for race, ethnicity, age, and disability. Among 6906 eligible patients, 90 (1.3%) had a disability. Individuals with disabilities underwent STI screening at lower rates (60% vs 77.2%, p<.001). There were lower odds of STI screening for individuals with any disability (aOR 0.38, 95% CI 0.24-0.61, p<.001), a physical disability (aOR 0.26, 95% CI 0.09-0.72, p=.008), or an intellectual disability (aOR 0.37, 95% CI 0.21-0.64, p<.001) when adjusting for race, ethnicity, and age. The rate of STI screening among adolescents and young adults with disabilities was lower compared to those without disabilities. Universal testing may help normalize STI screening so that individuals with a higher risk of STIs are not missed. Further research is indicated to identify and mitigate factors that lead to lower rates of screening.

Community pharmacies: Key players in point-of-care diagnostics for STI screening in Africa.

Sexually Transmitted Infections (STIs) rank in the top 5 disease categories for which adults in developing countries seek healthcare services. Community pharmacies offer clients convenience, proximity, extended opening hours, privacy, and efficiency, which could make them desirable locations for HIV and STI screening and treatment. We examined the feasibility of using point-of-care (POC) STI tests for screening HIV and other STIs at community pharmacies. We conducted a prospective cohort study of persons seeking medication and other services at 18 purposively selected community pharmacies in Kampala, Uganda. Study participants comprised two broad categories: i) Symptomatic persons aged 18 years who presented with at least one STI sign or symptom and were purchasing treatment for themselves; ii) persons presenting with no STI symptom who had come to purchase any other medication, including family planning services such as emergency contraception. POC tests were used to test HIV, Chlamydia trachomatis (Ct), Neisseria gonorrhoeae (Ng), Trichomonas vaginalis (Tv), and Syphilis. Test results were returned on-site or via telephone within 48 to 72 hours. Descriptive statistics were used to estimate the prevalence of STIs. Of the 450 participants enrolled, 235 (52.2%) were symptomatic, 215 (47.8%) were asymptomatic, and 280 (62.2%) were females. STI testing was feasible, with an acceptability rate of 99.8%. 135 (30%) of participants had at least one STI; HIV prevalence was 39 (8.7%), Syphilis prevalence was 14 (3.1%), 50 (11.1%) tested positive for Ng, 39 (8.7%) were positive for Ct while. The prevalence of Tv was 25 (8.9%) (tested among women). A total of 107 (23.8%) participants had used an antibiotic in the preceding month. Our research underscores the potentially pivotal role of community pharmacies in deploying POC diagnostics for STIs and antimicrobial stewardship by decreasing unnecessary antibiotic dispensation across Africa.

Incidence of Sexually Transmitted Infections and Pregnancy Among Adolescents Experiencing Sex Trafficking

Objective There is a lack of data regarding the incidence of sexually transmitted infections (STIs) and pregnancy among adolescents experiencing sex trafficking. This study aimed to determine the incidence proportion of STIs and pregnancy among adolescents evaluated for sex trafficking at an urban tertiary children's hospital compared to the community adolescent population. Methods This retrospective, cross-sectional study looked at adolescents aged 11 to 21 years experiencing sex trafficking from March 2019 to March 2022. Data were abstracted from the hospital's human trafficking advocacy team database and the electronic medical record (EMR), including demographics, type and setting of trafficking, presenting complaints, and STI and pregnancy test results. Using Fisher's exact test, the incidence of STIs and pregnancy among adolescents experiencing sex trafficking was compared to adolescents in the community using local county health department data. Results Fifty-four patients met the eligibility criteria. Females comprised 93% (n = 50) of the group. The average age was 16 years. The racial demographics most represented were African American at 56% (n = 30) and White at 30% (n = 16). History of abuse prior to trafficking was found in 78% (n = 42). Incidence proportions of STIs, compared to county health data, are as follows: 64.8% for Chlamydia trachomatis (CT) versus 7.8% (OR, 22; 95% CI, 12–40), 51.9% for Neisseria gonorrhoeae (GC) versus 2.2% (OR, 47; 95% CI, 26–83), 9.3% for syphilis versus 0.1% (OR, 111; 95% CI, 34–283), and 5.6% for HIV versus 0.1% (OR, 83; 95% CI, 16–261). There was a high individual cumulative incidence of STIs among patients over time, and patients presented with a variety of presenting complaints. The incidence proportion for pregnancy was 11.1% compared to 1.3% (OR, 10; 95% CI, 3–22). Conclusions Adolescents experiencing sex trafficking have a significantly higher rate of STIs and pregnancy than the community adolescent population.

Preferences for online or in-person STI testing vary by where a person lives and their cultural background: a survey of young Australians

ObjectivesThe objectives are to explore the acceptability of online sexually transmitted infection (STI) testing services among young Australians (16–29 years) and how this may vary between sociodemographic populations.MethodsA cross-sectional, online...

Preferences and Acceptability of Testing for Sexually Transmitted Infections in an HIV Pre-Exposure Prophylaxis clinic in Hanoi, Vietnam.

Men who have sex with men (MSM) using HIV Pre-Exposure Prophylaxis (PrEP) are a vulnerable population with a high prevalence of sexually transmitted infections (STIs). Self-collection of specimens could improve STI testing, yet implementation in low-resource settings is limited. The study aimed to assess the feasibility and acceptability of self-collection for STI testing and to understand STI testing preferences among PrEP clients in Hanoi, Vietnam. From January to December 2022 MSM aged 16 and older, participating in a clinic-based HIV PrEP program were enrolled. Participants self-collected pharyngeal, anal, and urine samples for Chlamydia trachomatis and Neisseria gonorrhoeae testing. Testing preferences were assessed through conjoint analysis using eight hypothetical testing profiles across five testing attributes; each profile was rated on a Likert scale (0-5) to create an impact score. Differences between attributes were assessed using a two-sided, one-sample t-test of the impact score. There were 529 participants enrolled; all were male. Specimens from three sites were provided by 97.9% (518/529). Mean satisfaction with self-collection was 4.3 (SD: 1.0), 99.4% reported they would perform again. In conjoint analysis, cost (free vs. $17USD) had the highest impact on testing preference (Impact Score: 25.2; p = <0.001). A one-week time to test result notification was preferred to 90 minutes (Impact Score: -0.8; p = 0.03). We found high acceptability of self-collection for STI testing among HIV PrEP clients in Vietnam. Cost was the most important factor affecting testing uptake. Expanding self-collection and lowering costs could improve STI testing in HIV PrEP programs.

Low sexually transmitted infection (STI) screening and presumptive treatment and high STI positivity among United States females visiting the emergency department after sexual assault.

The Centers for Disease Control and Prevention sexually transmitted infection (STI) treatment guidelines state that the decision to provide STI/human immunodeficiency virus (HIV) testing and presumptive treatment after sexual assault (SA) should be made on an individual basis to minimize retraumatization of the patient. However, little is known about STI screening, presumptive treatment, and positivity in the emergency department (ED) setting. The objective of this study was to evaluate STI testing rates and positivity, presumptive gonorrhea and chlamydia treatment, pregnancy testing, and emergency contraception offered to SA survivors in the ED in the United States. The Premier Healthcare Database, a national administrative data set containing health care information from inpatient and hospital-based outpatient encounters, was used. Approximately 30% of encounters have available laboratory test results. ED visits for SA (identified by ICD-10-CM codes) among female patients aged 15-44 years between 2019 and 2023 were included. For patients presenting multiple times to the ED, only the first ED visit after SA was included. Of 49,047 total visits where females ages 15-44 years presented to the ED for SA, chlamydia, gonorrhea, syphilis, and HIV tests were conducted in 18.6%, 18.6%, 13.4%, and 16.9%, respectively, and pregnancy tests in 33.1% of visits. Presumptive gonorrhea and chlamydia treatment was provided in 53.7% and 52.2%, respectively, and emergency contraception in 27.2% of visits. Approximately 40% of patients were neither tested nor treated for either chlamydia or gonorrhea. Of patients with available laboratory test results, chlamydia, gonorrhea, and syphilis positivity rates were 10.0%, 3.8%, and 1.0%, respectively. Low STI testing and treatment rates and high STI positivity identified in this study suggest that an important opportunity exists for improving STI screening and presumptive treatment for female patients presenting to the ED after SA.

Increasing awareness of sexually transmitted infections (STI) testing and addressing stigma may improve STI testing in Aboriginal and Torres Strait Islander youth: Evidence from the Next Generation Youth Wellbeing Study

ObjectiveTo quantify the prevalence of sexually transmitted infections (STI) testing in relation to sociodemographic, behavioural, and health related factors, and patterns in sexual health service (SHS) use and non-use among Aboriginal and Torres Strait Islander (hereafter Aboriginal) youth. MethodsThe analyses included N=198 sexually active 16-24-year-olds from Central Australia, Western Australia, and New South Wales participating in the Next Generation Youth Wellbeing Study. Modified Poisson regression estimated age-sex-adjusted prevalence ratios (PRs) for ever testing for STIs. ResultsApproximately 55% of the participants ever tested for STIs. Over 44% of the participants ever accessed SHS; perceived irrelevance (50%) and embarrassment (15%) were the main reasons for not accessing SHS. STI testing was higher among: 21–24-year-olds (68.75% vs 37.04% among 16–17-year-olds, PR: 1.82; confidence interval 1.23–2.67); those with high/very-high psychological distress (63.39% vs 44.55% among low/moderate group, 1.50;1.16–1.94); and those who lived in ≥3 houses in the past five years (65.43% vs 48.11% among those who lived in 1–2 houses, 1.33;1.04–1.70). ConclusionsSTI testing should be offered to sexually active Aboriginal youth at every opportunity. Implications for public healthSexual health messages should further promote the benefit of regular STI testing and where to access free SHS among Aboriginal youth.

High Prevalence of Sexually Transmitted Infections and Poor Sensitivity and Specificity of Screening Algorithms for Chlamydia and Gonorrhea Among Female Sex Workers in Zimbabwe: Analysis of Respondent-Driven Sampling Surveys in 3 Communities.

Effective strategies to reduce sexually transmitted infection burden and transmission among female sex workers (FSWs) and their networks are needed. We report sexually transmitted infection prevalence among FSWs in Zimbabwe and investigate the performance of screening algorithms. Respondent-driven sampling (RDS) surveys, including blood sampling for syphilis serology, were conducted among FSWs in 3 communities in Zimbabwe in 2017. In addition, a random sample of one-third of participants were offered genital examination and sexually transmitted infection (STI) testing. Data on symptoms and clinical signs were analyzed to determine the proportion of asymptomatic and clinically inapparent STIs by HIV status, and the sensitivity, specificity, and predictive values of syndromic, clinical, and hybrid screening algorithms for chlamydia and gonorrhea. Analyses were RDS-II weighted. Overall, 2507 women were included in the RDS surveys, and 661 of 836 (79.1%) of those randomly offered genital examination and STI testing accepted. The prevalence of STI by site ranged from 15.7% to 20.0% for syphilis (rapid plasma reagin + Treponema pallidum hemagglutination assay), 6.8% to 14.3% for gonorrhea, 8.4% to 10.1% for chlamydia, 26.6% to 35.5% for trichomonas, and 37.0% to 47.6% for any high-risk human papilloma virus. A high proportion of infections were both asymptomatic and clinically undetectable (gonorrhea: 41.2%, chlamydia: 51.7%, trichomonas: 62.8%). Screening algorithms performed poorly whether based on symptoms only (sensitivity: 53.3% gonorrhea, 43.3% chlamydia) or either symptoms or clinical signs (sensitivity: 58.7% gonorrhea, 48.3% chlamydia). Sexually transmitted infection burden is high among FSWs in Zimbabwe. The low sensitivity and specificity of screening algorithms used to guide syndromic management mean that more effective approaches are required to strengthen STI control. As access to HIV-specific prevention methods like preexposure prophylaxis increases, support for consistent condom use needs to be strengthened.

Teen Secure Messaging is Associated With Use of Sexual and Reproductive Health Services in One Health System

PurposePatient portal use may improve access to or use of sexual and reproductive health (SRH) services for adolescents. We examined the association between adolescent secure messaging on a portal and use of SRH services in one health system. MethodsWe conducted a retrospective cohort study using electronic health records of adolescents aged 13–17 at Kaiser Permanente Washington from 2019 to 2021. Using month of observation as our unit of analysis, we estimated unadjusted and adjusted odds ratios and 95% confidence intervals (CIs) for associations between secure messages sent and 3 outcomes: (1) sexually transmitted infection (STI) tests ordered in the observed month, and among pregnancy-capable individuals; (2) pregnancy tests; and (3) prescription contraceptive methods ordered. ResultsThirty-seven thousand eight hundred eighteen unique individuals contributed 667,678 months of individual observation. Among observed months with STI testing, 6.1% sent secure messages compared to 1.1% in months with no STI testing. Observed months with secure messaging had significantly greater odds of STI tests ordered than months without messaging, after adjusting for covariates (adjusted odds ratio (aOR) 3.5, 95% CI 2.9–4.3). Among observed months with prescription contraceptive orders, 5.0% sent a portal message compared to 1.4% without prescription contraceptive orders. Observed months with secure messaging among pregnancy-capable individuals had significantly greater odds of pregnancy tests (aOR 2.6, 95% CI 2.2–3.1) and prescription contraceptive orders (aOR 1.9, 95% CI 1.7–2.2) than months without messaging. DiscussionThe use of secure messaging by adolescents was more common among those with concurrent SRH care needs.

Acceptability of multi-level sexual health interventions and sexually transmitted infection screening and testing among persons with HIV across three clinical sites in Florida.

The US state of Florida has the third highest rate of HIV as well as high rates of sexually transmitted infections (STIs) indicating critical HIV and STI prevention needs remain unmet. To address gaps in the STI care continuum in people with HIV (PWH), evidence-based interventions were implemented across three Ryan White HIV/AIDS Program (RWHAP) funded clinics in Florida between August 2020-August 2021. Interventions included comprehensive sexual health history (SHH) taking using audio computer-assisted self-interview (ACASI) software, self-collected extragenital gonorrhea and chlamydia testing, and the introduction of a lesbian, gay, bisexual, transgender, and queer (LGBTQ+) welcoming environment. We 1) assessed the acceptability of these interventions and examined if acceptability differed among youth and sexual, racial and ethnic minorities, 2) determined the proportion of appropriate STI testing completed based on the SHH assessment, 3) examined whether STI at-risk individuals underwent STI screening 3-6 months after initial evaluation, and 4) determined the proportion of positive STI test results among priority intervention groups in Florida. Acceptability of all interventions was high. Youth, lesbian, gay, and bisexual, and Hispanic individuals were significantly more likely to notice and like LGTBQ+ welcoming measures. The proportion of recommended tests completed was high, although only a subset of at-risk individuals completed re-screening. 11.9% of rectal samples were positive for chlamydia and 6.5% of pharyngeal samples were positive for gonorrhea. Our study highlights the importance of incorporating comprehensive sexual health care protocols, including extragenital STI testing, into the overall care of PWH.

Sexually transmitted infections in sexually abused children: an audit project to implement PCR tests in a child advocacy center in Türkiye.

Sexual abuse in children can sometimes result in sexually transmitted infections (STIs), which can serve as crucial forensic evidence. Although PCR methods are now accepted as the gold standard for STI screening, they have not yet widely replaced traditional culture methods in Türkiye. This study aims to assess the necessity of implementing PCR-based STI testing at Child Advocacy Centers in Türkiye, where such testing is not routinely available. Conducted between February and November 2023, this study included children who presented to the Child Advocacy Center of Marmara University Pendik Training and Research Hospital. High-risk victims were identified based on criteria including a history of penetrative sexual abuse and factors such as multiple perpetrators or significant age disparity. Serological tests and genital swabs were collected and analyzed using both bacterial culture methods and a comprehensive STI PCR panel. The study included 20 victims, with a median age of 16 years. STI PCR testing detected pathogens in 19 out of 21 samples, including Chlamydia trachomatis (20%) and Neisseria gonorrhoeae (5%). In contrast, culture methods identified no sexually transmitted pathogens. PCR testing demonstrated significantly higher sensitivity for detecting STIs compared to traditional bacterial culture methods, as expected. Implementing PCR-based STI testing in Child Advocacy Centers is an urgent and essential need for providing an accurate diagnosis and robust forensic evidence, enhancing the care and legal protection of sexually abused children.

Perceptions, experiences and concerns with sexually transmitted infections among current and former PrEP users: a longitudinal qualitative study of gay, bisexual and queer men in Canada.

Background Pre-exposure prophylaxis (PrEP) use has been attributed to heightened rates of sexually transmitted infections (STIs), ostensibly due to increased condomless anal sex (CAS) and greater frequency of STI testing. Few qualitative studies have assessed how gay, bisexual and queer men (GBQM) who use PrEP perceive STIs and how these attitudes have evolved post-PrEP uptake. We investigated the perspectives of current and former PrEP users on STIs. Methods Annual, in-depth longitudinal interviews were conducted with 38 current and former PrEP users in Ontario (n =18) and British Columbia (n =20), Canada, as part of a mixed-methods implementation science study (2020-2022). Over 3years, 109 interviews were conducted. Data analysis included reflexive thematic coding and longitudinal recurrent cross-sectional analysis using NVivo 12. Results Four STI-related themes emerged: (1) lack of STI-related concerns due to treatment and prevention optimism, (2) stigma-related concerns, (3) perceived risk among other PrEP users due to increased CAS, and (4) inconsistent testing concerns among non-PrEP users. Over time, some STI-related anxieties decreased with increased knowledge and reduced stigma. However, concerns persisted for other participants due to perceived risky sexual behaviours among other PrEP users and non-PrEP users. Both current and former PrEP users who expressed STI-related apprehensions consistently indicated adopting risk-reduction strategies, including condom use and having fewer sexual partners throughout the study. Conclusions Findings show how varied STI perceptions and experiences among current and former PrEP users shaped sexual decision-making over time. Providers, public health experts, and policymakers should develop a more comprehensive strategy to address STI concerns among GBQM.

Viral hepatitis knowledge and vaccination awareness among men who have sex with men (MSM) in 43 countries of the WHO European Region: results from the European MSM Internet Survey, EMIS-2017.

BackgroundRecent hepatitis A virus outbreaks in Europe affecting men who have sex with men (MSM) and ongoing hepatitis B virus transmission among MSM underscore the ongoing need for viral hepatitis prevention in this population.AimTo describe viral hepatitis knowledge and associated factors among MSM in the WHO European Region to inform targeted prevention.MethodsIn the European MSM Internet Survey (EMIS-2017), basic knowledge was defined as correctly identifying at least 4 of 5 statements about viral hepatitis and vaccination. We described basic knowledge by country. In a multilevel logistic regression model, we estimated adjusted odds ratios (aOR) with 95% confidence intervals (CI) for having basic knowledge and explanatory variables: sociodemographic characteristics, history of hepatitis C and/or HIV diagnosis, sexual orientation disclosure at last sexually transmitted infections (STI) test and outness.ResultsOf 113,884 participants across 43 WHO European Region countries, 68% demonstrated basic knowledge, ranging from 50% in Israel to 80% in the Netherlands. Basic knowledge was significantly associated with older age (≥ 40 years vs < 25 years, aOR: 2.9, 95% CI: 2.7-3.0), a history of hepatitis C and/or HIV diagnosis (aOR: 1.8, 95% CI: 1.7-1.9) and sexual orientation disclosure at last STI test (aOR: 1.3, 95% CI: 1.2-1.3), among other factors.ConclusionsWe found a knowledge disparity regarding viral hepatitis and hepatitis vaccination awareness among MSM across Europe, highlighting a need to address these gaps. A non-judgemental, accepting climate that allows individuals attending medical services to safely disclose their sexual orientation is fundamental to enable healthcare professionals to target information and preventative measures more effectively.

Sexual health care barriers and HIV/STI prevention for transgender people in Japan.

Primary care and sexual health services for transgender people in Japan are lacking. We surveyed 233 transgender patients (57 [24.5%] assigned male at birth [AMABs] and 176 [75.5%] assigned female at birth [AFABs]) at the Personal Health Clinic to collect data on sexually transmitted infections (STI) and human immunodeficiency virus (HIV) risk, as well as lifestyle, stigma, and health literacy. Among respondents, 55% reported a sexual intercourse history, and 7.6% noted a previous STI. Only 62.2% underwent free STI testing. Current smoking rates were 19.3% higher in AFABs. Hospital visit hesitation was reported by 59.6%, and 83.3% experienced daily mental struggles. Awareness of post-exposure prophylaxis and pre-exposure prophylaxis was low. Our findings highlight the urgent need for improved primary care and sexual health services for transgender people in Japan, emphasizing the necessity to increase sexual health care facilities, reduce primary care access barriers, and improve knowledge among health care providers.

The use of digital technologies to promote sexual health in young adults: a narrative review

Abstract Background New technologies have the potential to play an important role in promoting sexual health, especially among young people, who are the biggest users and those at greatest risk of contracting Sexually Transmitted Infections (STI). The risk behavior assumed by young people today highlights this vulnerability in several contexts, such as individual, social, economic, and family. In this sense, it becomes relevant to approach sex education in schools using digital technologies. Objectives To identify the evidence in the literature on the use of digital technologies to promote the sexual health of young adults. Methods Narrative literature review. Three independent reviewers extracted, analyzed and synthesized the articles and results. Results Through the selection process, four studies were included. The articles show that the use of digital technologies (mobile phones/applications) leads to increased knowledge, improved attitudes and sexual behavior among young adults. The interventions studied in the studies were based on Short Message Service, electronic mail interventions and the MyPEEPS mobile application, with the following main focuses: Increased knowledge, attitudes, and behaviors of young adults. Considering the results of the studies, all interventions proved to be effective as facilitators of sexual health promotion. Conclusions The use of digital technologies allowed an increase in the promotion of the sexual health of the participants, since there was an increase in the level of knowledge with the use of digital technologies such as SMS, emails and mobile applications when comparing the experimental and control groups. The use of these digital technologies also allowed for a change in attitudes and behaviors, such as a significant increase in serological testing for STIs and an increase in health care seeking. Key messages • The use of digital technology promotes the sexual health of young adults, so these strategies should be implemented by health professionals. • The dissemination of these digital strategies will have an impact on Public Health, specifically regarding the sexual health of young adults.