Journal of the International AIDS Society最新文献

{"title":"From Awareness to Action Study: Improving Human Papillomavirus Knowledge, Screening and Vaccine Uptake Among Mother-Adolescent Pairs in the HOMINY Study in Nigeria: A Longitudinal Study","authors":"Oluwaseun Peter, Elohor Oborevwori, Esosa Osagie, Paul Akhigbe, Nosakhare L. Idemudia, Ozoemene Obuekwe, Fidelis E. Eki-Udoko, Nicholas Schlecht, Yana Bromberg, Praise O. Okoh-Aihe, Nosayaba Osazuwa-Peters, Modupe O. Coker, HOMINY Study Group","doi":"10.1002/jia2.70164","DOIUrl":"10.1002/jia2.70164","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Persistent cervical infection with high-risk human papillomavirus (HPV) in women is a leading cause of cervical cancer, and its co-infection among people living with HIV increases the risk of other HPV-associated cancers, including oropharyngeal and anogenital cancers. In sub-Saharan Africa, awareness of HPV is limited, screening and vaccine adoption are critically low, undermining efforts towards sexually transmitted infection (STI) elimination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p><b>F</b>rom <b>A</b>wareness to A<b>CT</b>ion (FACT) study assessed HPV knowledge, screening and vaccine uptake among adolescent−mother pairs participating in the HOMINY (<b>H</b>PV, Human Immunodeficiency Virus, and <b>O</b>ral <b>M</b>icrobiota <b>I</b>nterplay in <b>N</b>igerian <b>Y</b>ouths) prospective cohort study. Participants were enrolled, including adolescents aged 9–18 years (<i>N</i> = 636) and mothers aged 29–59 years (<i>N</i> = 385). FACT was conducted at the University of Benin Teaching Hospital, Nigeria, between April 2024 and July 2025, with adolescents and mothers grouped by HIV serostatus. In line with the national immunization programme protecting girls in Nigeria, sensitization programmes were integrated into the research study to promote awareness and adoption of screening and vaccination practices. Knowledge and attitudes regarding HPV and its vaccination benefits were assessed through thematic discussions, interactive sessions and questionnaires administered over the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HPV awareness was initially low, particularly among adolescents, but increased following sensitization, rising from 34.5% to 64.4% among mothers and from 1.4% to 19.0% among adolescents. Vaccination uptake rose from 0% to 5.4% (<i>p</i> < 0.0001) in adolescents aged 9–14 years. Among adolescents with perinatally acquired HIV, uptake increased from 1.9% to 4% over time (<i>p</i> = 0.003), and the proportion of mothers who underwent HPV-related screening increased from 38.7% pre-sensitization to 52.4% 12-month post-sensitization (<i>p</i> < 0.0001). Barriers to the adoption of preventive services included misconceptions, healthcare provider gaps, myths, misinformation, mistrust, scepticism and limited access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HPV awareness programmes significantly improved knowledge, vaccination uptake and screening practices in this vulnerable population. As part of comprehensive STI elimination strategies, integrating HPV education an","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccination Coverage and Prevention Counselling for Vaccine-Preventable STIs Among HIV PrEP Users in São Paulo, Brazil: A Retrospective Cohort Study","authors":"Marjorie Marini Rapozo,&nbsp;Amanda Nazareth Lara,&nbsp;Victor Cabelho Passarelli,&nbsp;Laísa Rivas Dapousa Ramos,&nbsp;Patricia Silva Montes,&nbsp;Camila de Melo Picone,&nbsp;Angela Carvalho Freitas","doi":"10.1002/jia2.70152","DOIUrl":"10.1002/jia2.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>HIV pre-exposure prophylaxis (PrEP) users may be disproportionately vulnerable to sexually transmitted infections (STIs) in general, including several that are vaccine-preventable. Understanding immunization patterns in this population is, therefore, crucial. However, data on vaccination coverage among Brazilian PrEP users remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective single-centre study of adults using HIV PrEP at an STI clinic in São Paulo, Brazil, between 2017 and 2024, to assess vaccination adequacy for vaccine-preventable STIs among PrEP users, as well as other STI prevention measures during follow-up. Demographic characteristics, substance use, STI history and vaccination status for hepatitis A (HAV), hepatitis B (HBV), human papillomavirus (HPV) and MPox were extracted from medical records, immunization registries and laboratory results, and descriptive analyses were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 190 participants (median age: 36 years), 89.5% were gay or other men who have sex with men (MSM). Over a mean follow-up period of 45 months, complete vaccination coverage was observed in 97.7% for HBV, 49.5% for HAV, 24.2% for HPV and 1.6% for MPox. Despite documented prior vaccination, a proportion of participants remained susceptible to HAV (16.3%) and HBV (2.3%). Furthermore, a substantial proportion of participants (32.1% for HAV, 53.7% for HPV and 81.0% for MPox) had neither a documented vaccination status nor a provider recommendation for vaccination recorded in their medical charts. HPV- and MPox-related clinical lesions were documented in 17.9% and 2.1% of participants, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Notable gaps in immunization against preventable STIs were observed in this PrEP cohort in São Paulo, Brazil. While HBV coverage was high, uptake of HAV, HPV and MPox vaccines was low. Addressing these gaps in our cohort requires transitioning from mere provider recommendations to structural public health policies. Implementing on-site vaccine administration within PrEP services, integrating immunization into STI screening, expanding free access and addressing key vulnerabilities are critical steps to eliminate structural barriers and reduce the STI burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining the Efficacy of Meningococcal B Vaccines Against Gonococcal Acquisition: The Current Landscape","authors":"Kate L. Seib,&nbsp;Andrew E. Grulich","doi":"10.1002/jia2.70153","DOIUrl":"10.1002/jia2.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Gonorrhoea is a major global sexually transmitted infection, with rising incidence and increasing antimicrobial resistance threatening current control strategies. If untreated, <i>Neisseria gonorrhoeae</i> can lead to severe reproductive health sequelae. Gonorrhoea is also linked to increased HIV acquisition and transmission. There is currently no vaccine licensed to prevent gonorrhoea. However, observational evidence suggests that outer membrane vesicle–based serogroup B meningococcal vaccines, including the four-component meningococcal B (4CMenB) vaccine, confer partial cross-protection against gonorrhoea. We discuss observational studies and randomized controlled trials (RCTs) focused on defining the efficacy of 4CMenB against gonorrhoea.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Observational studies from multiple settings have reported an association between receipt of 4CMenB vaccine and reduced gonorrhoea risk, with a meta-analysis estimating a 38% reduction in risk. <i>Neisseria meningitidis</i> and <i>N. gonorrhoeae</i> are closely related bacteria that share numerous antigens, making cross-protection biologically plausible. Based on observational data, 4CMenB immunization programmes have been implemented in two countries with the aim of preventing gonorrhoea. However, three RCTs have recently shown that 4CMenB is not effective in preventing gonorrhoea in gay, bisexual and other men at high risk of acquisition. Several RCTs are ongoing, looking at efficacy in different populations, including women and people at lower risk of acquisition. The different outcomes between the observational studies and RCTs may be due to a range of known and unknown confounding factors, and differences in the populations considered in the different studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Current evidence from RCTs does not support the use of 4CMenB to prevent gonorrhoea in gay and bisexual men at high risk of acquisition. Results from ongoing RCTs will be critical to determine whether vaccine efficacy varies by population or epidemiological context and to inform future gonorrhoea vaccine policy and development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Impact of Catch-Up HPV Vaccination on HPV Prevalence and Cervical Cancer Incidence Among Women Living With HIV in South Africa: Results From Two Mathematical Models","authors":"Carla M. Doyle,&nbsp;Minttu M. Rönn,&nbsp;Cari van Schalkwyk,&nbsp;Marc Brisson,&nbsp;Nirali Soni,&nbsp;Marie-Claude Boily,&nbsp;Mathieu Maheu-Giroux","doi":"10.1002/jia2.70149","DOIUrl":"10.1002/jia2.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Women living with HIV (WLHIV) face an increased risk of cervical cancer (CC). With inequitable human papillomavirus (HPV) vaccine access globally and a programmatic focus on girls-only school-based delivery, many WLHIV in high HIV prevalence countries remain vulnerable to HPV and CC. We assessed the incremental impact of adding catch-up vaccination for WLHIV in South Africa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used two independently developed HPV/CC and HIV transmission models to predict the incremental impact of catch-up HPV vaccination for WLHIV compared to routine-only vaccination of girls aged 9−14 (90% cohort coverage) from 2020 onwards using a nonavalent vaccine (lifelong 100% protection). We assessed catch-up scenarios vaccinating WLHIV aged 15−24 or ≥15 (attaining 90% cohort coverage), maintaining baseline CC screening. We report the predicted median annual prevalence of vaccine-type high-risk HPV (VT HR-HPV), CC incidence and cumulative fraction of CC cases averted compared to routine-only vaccination among WLHIV overall (age-standardized) and by age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>With routine-only vaccination, overall coverage among all WLHIV remained substantially (&gt;50%) lower than in all women for 35−40 years, with gaps persisting even after 80 years. Adding catch-up vaccination for WLHIV aged 15−24 increased coverage and benefits mainly among young WLHIV, with the largest annual reductions (relative to routine-only vaccination) in VT HR-HPV prevalence and CC incidence for WLHIV &lt;30 years, reaching up to 36%–52% across models within 15 years and 38%–100% after 15−25 years, respectively. If catch-up included WLHIV aged ≥15, overall vaccination coverage among WLHIV would immediately increase to 90%, extending benefits to older WLHIV—reducing peak annual relative reductions in CC incidence among WLHIV ≥50 by an extra 19% points compared to catch-up vaccination of WLHIV aged 15−24, and shifting the peak 25 years earlier. Over 55−60 years, catch-up vaccination of WLHIV aged 15−24 and ≥15 could avert up to 3%–8% and 14% of CC cases among WLHIV, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Catch-up vaccination of WLHIV can reduce their CC burden in the short to medium term, even in the presence of girls-only routine vaccination programmes with high cohort coverage. To maximize impact, vaccines should be offered to WLHIV of all ages, not only younger women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Decade of the Global STI Vaccine Roadmap: Progress, Gaps and Challenges","authors":"Remco P. H. Peters,&nbsp;Sinead Delany-Moretlwe,&nbsp;Kate L. Seib,&nbsp;Birgitte Giersing,&nbsp;Sami L. Gottlieb","doi":"10.1002/jia2.70142","DOIUrl":"10.1002/jia2.70142","url":null,"abstract":"&lt;p&gt;Progress in sexually transmitted infection (STI) control has remained limited over the past decades, reflecting chronic under-investment, persistent structural and social barriers, high levels of asymptomatic infection and limited integration of STI services within broader healthcare systems [&lt;span&gt;1&lt;/span&gt;]. In this context, the development and deployment of effective STI vaccines is essential and recognized by the World Health Organization (WHO) as a global research priority [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;&lt;i&gt;The global STI vaccine roadmap&lt;/i&gt; was developed by WHO, the U.S. National Institutes of Health and international partners in 2014 and updated in 2016 [&lt;span&gt;3&lt;/span&gt;]. It outlines a coordinated strategy to accelerate the development, evaluation and introduction of new STI vaccines across three domains: assessing the public health value, advancing research and development, and defining preferred attributes and use cases for implementation (Figure 1a). More than a decade later, substantial progress has been made in several key areas, though major gaps and challenges remain.&lt;/p&gt;&lt;p&gt;&lt;i&gt;Public health value assessments&lt;/i&gt; underpin all other efforts to catalyse STI vaccine development. Advances are most marked for HSV vaccines, with updated estimates for global HSV-2 prevalence (∼520 million people aged 15−49 years), burden of disease (∼188 million cases of genital ulcer disease and 14,000 neonatal herpes cases annually), and economic burden ($35 billion in 2016) [&lt;span&gt;4&lt;/span&gt;]. Mathematical modelling suggests that both prophylactic and therapeutic HSV-2 vaccines could have important population-level impacts on HSV-2 incidence and genital ulcer disease, as well as indirect effects in reducing HIV risk [&lt;span&gt;5&lt;/span&gt;&lt;sup&gt;,&lt;/sup&gt; &lt;span&gt;6&lt;/span&gt;]. In contrast, the public health value assessment for chlamydia and gonorrhoea vaccines is constrained by limited data on disease outcomes. Although annual burdens of chlamydia (129 million new cases) and gonorrhoea (82 million new cases) are high, attribution to clinical disease, reproductive tract complications and healthcare utilization is poorly quantified. Mathematical modelling suggests that even partially protective vaccines (25%–50% vaccine effectiveness) could reduce &lt;i&gt;N. gonorrhoeae&lt;/i&gt; incidence or prevalence [&lt;span&gt;7&lt;/span&gt;&lt;sup&gt;,&lt;/sup&gt; &lt;span&gt;8&lt;/span&gt;], and could delay antimicrobial resistance development [&lt;span&gt;9&lt;/span&gt;]. Vaccine modelling for syphilis has been limited due to the nascent stage of vaccine development.&lt;/p&gt;&lt;p&gt;&lt;i&gt;Research and development pathways&lt;/i&gt; for STI vaccines have been dynamic, with several candidates now under clinical evaluation (Figure 1b). Unexpectedly—given the landscape at the time the STI roadmap was developed—the greatest progress has occurred in gonorrhoea vaccine development. The feasibility of &lt;i&gt;N. gonorrhoeae&lt;/i&gt; vaccines is driven by observational evidence of cross-protection from outer membrane vesicle (OMV)-based meningococcal B (MenB) vaccines. Pooled data fr","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards Elimination of Sexually Transmitted Infections: Research Developments and Vaccine Uptake","authors":"Jeanne Marrazzo,&nbsp;Nelly R. Mugo,&nbsp;Yves Levy","doi":"10.1002/jia2.70173","DOIUrl":"10.1002/jia2.70173","url":null,"abstract":"&lt;p&gt;At first glance, we should be living in a golden age for the potential of immunization against sexually transmitted infections (STIs). Vaccination against oncogenic human papillomavirus (HPV) has demonstrated that we can eliminate cervical cancer [&lt;span&gt;1&lt;/span&gt;]. We have developed new platforms that can rapidly adapt to emerging threats, notably mRNA technology, which underwent proof-of-concept trials during the COVID-19 pandemic [&lt;span&gt;2&lt;/span&gt;]. Monoclonal antibodies have been rapidly developed and wielded to fight deadly viruses, like Ebola and Marburg, and played a pivotal role in prevention and therapy for SARS-CoV-2. Cutting-edge approaches to immunogen design have harnessed the power of increasingly sophisticated structural biology techniques to target hidden immunogenic sites, and artificial intelligence is helping to direct approaches to subvert ever-evolving pathogenic defences.&lt;/p&gt;&lt;p&gt;Unfortunately, the STI field has not yet benefited fully from these advances despite the critical need for STI-focused prevention innovations. Western countries are experiencing some of the highest incidence rates ever of &lt;i&gt;Neisseria gonorrhoeae&lt;/i&gt; (gonorrhoea)&lt;i&gt;, Treponema pallidum&lt;/i&gt; (syphilis) and &lt;i&gt;Chlamydia trachomatis&lt;/i&gt; (chlamydia) since these epidemics were first tracked. Congenital syphilis cases have reached record numbers in several countries, undermining the successful elimination efforts of over 20 countries [&lt;span&gt;3&lt;/span&gt;]. These rising secular trends have been attributed to condomless sex in high socio-demographic index regions and increased numbers of people in the age bands with highest disease burden, among other factors.&lt;/p&gt;&lt;p&gt;Nearly one-third of sexually acquired HIV cases are attributable to genital infection with herpes simplex virus type-2 (HSV-2) [&lt;span&gt;4&lt;/span&gt;]. With concern for sustaining pre-PEPFAR levels of antiretroviral-mediated viral suppression and pre-exposure prophylaxis in an era of constrained resources, this proportion may increase. We continue to encounter outbreaks of “new” STIs, notably Mpox, dermatophytosis caused by &lt;i&gt;Trichophyton mentagrophytes&lt;/i&gt; Genotype VII and folliculitis caused by &lt;i&gt;Klebsiella aerogenes&lt;/i&gt; [&lt;span&gt;5&lt;/span&gt;]. The role of &lt;i&gt;Mycoplasma genitalium&lt;/i&gt; in potentiating HIV acquisition or transmission remains unclear, but this pathogen can be extremely challenging to treat and likely increase risk of female upper reproductive tract inflammation.&lt;/p&gt;&lt;p&gt;In this supplement of the &lt;i&gt;JIAS&lt;/i&gt;, we address several of these challenges with perspectives from investigators across the globe. Perhaps the most broadly relevant is the paper by Firth and Hodgson that discusses the role of stigma in confounding any intervention aimed at controlling STIs, especially vaccines. For STI vaccines to have adequate uptake, one of two conditions must occur. Either people are vaccinated prior to sexual debut—the ideal approach taken with HPV vaccination at the population level—or they must elect to be vacc","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moralized, Marginalized and Sanitized: How Stigma Shapes STI Vaccination Development, Policy and Uptake","authors":"Charlie Firth,&nbsp;Susanne H. Hodgson","doi":"10.1002/jia2.70138","DOIUrl":"10.1002/jia2.70138","url":null,"abstract":"&lt;p&gt;Vaccination has the potential to transform the prevention of sexually transmitted infections (STIs). In the current global context of rising incidence of STIs, growing antimicrobial resistance and limited resources for diagnosis and treatment of STIs in many global settings, vaccines for STIs could be a cost-effective and impactful public health intervention.&lt;/p&gt;&lt;p&gt;For many infectious diseases, evidence of safety, efficacy and cost-effectiveness is sufficient to support vaccine introduction in most settings. However, for STIs, the factors influencing vaccine development and implementation are more complex and nuanced. Stigma, societal perceptions, political priorities and moral frameworks exert a greater influence over STI vaccines than those targeting infectious diseases with less stigmatized transmission routes.&lt;/p&gt;&lt;p&gt;Stigma is multifaceted, comprising of labelling, stereotyping, separation, status loss and discrimination, which operate within wider systems of power [&lt;span&gt;1&lt;/span&gt;]. It manifests through micro-level mechanisms, such as perceived or experienced discrimination, as well as macro and structural-level processes, where stigma shapes the unequal distribution of resources across sectors, including healthcare, housing and employment [&lt;span&gt;2, 3&lt;/span&gt;]. In the context of STIs, this includes moralizing assumptions about sexual behaviour, blame and risk, and use of emotive terminology (“dirty” vs. “clean”). This stigma often manifests as delayed testing, non-disclosure to partners, and reduced engagement with prevention and treatment services due to fear of judgement and social repercussions [&lt;span&gt;4&lt;/span&gt;]. Stigma reinforces social and health disparities and influences prioritization of vaccine development, immunization policy and an individual's likelihood of seeking vaccination.&lt;/p&gt;&lt;p&gt;Vaccine hesitancy represents a growing challenge that limits the impact of even highly efficacious vaccines. The uptake of vaccines depends not only on individuals’ willingness but also on collective acceptance within families and communities. STI vaccines inherit the stigma associated with the infections they target, the communities they aim to protect, and the institutions promoting and delivering vaccination [&lt;span&gt;5&lt;/span&gt;]. In contexts where sex is stigmatized or discussing it is taboo, vaccination could be interpreted as condoning or pre-empting sexual behaviour, generating resistance even when the health benefits are clear [&lt;span&gt;6&lt;/span&gt;]. Such dynamics of stigma are evident in practice, as illustrated by the differing ways HIV, human papillomavirus (HPV) and Mpox interventions have been framed, prioritized and funded within public health responses.&lt;/p&gt;&lt;p&gt;Stigma was central to the early moralization of HIV, as the disease was associated with already marginalized groups and framed as a consequence of their “deviant” behaviour. Terms such as “gay plague” and “gay cancer” legitimized and justified the discriminatory responses against those living","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durability of the Humoral Response to MPXV Infection","authors":"Tara N. Palmore","doi":"10.1002/jia2.70165","DOIUrl":"10.1002/jia2.70165","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Mpox virus (MPXV) re-emerged in endemic countries in recent decades, resulting in large outbreaks in central and western Africa and a worldwide epidemic of clade IIb MPXV starting in 2022. Mpox cases in vaccinated persons, and a few documented reinfections, have raised questions about the durability of MPXV humoral immunity. Longitudinal studies conducted during the clade IIb global outbreak have enriched our understanding of immune responses during and after mpox. This commentary aims to summarize current knowledge about the durability of humoral immunity against MPXV and limitations in the available evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Studies following convalescent individuals show vigorous neutralizing antibody titres that peak within weeks after symptom onset and remain detectable for up to 2 years following acquisition. Binding IgG and IgA antibodies directed against MPXV antigens peak and wane more rapidly. Immunodominant epitopes, such as A35R, elicit robust responses. Older individuals who received historical replicating smallpox vaccines and acquired mpox had higher neutralizing and binding antibody titres than younger people, with no apparent difference in durability of humoral immune markers. In some studies, people living with HIV had less vigorous early antibody responses than people without HIV but without an observed difference in durability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Long-term protection following mpox involves both humoral and cellular immunity. There is no identified correlate of protection for mpox. The current evidence primarily includes studies of mild to moderate clade IIb infection among cohorts largely comprising men in non-endemic countries. Research involving additional viral clades and cohorts with greater breadth of geography, age, gender, race, ethnicity and severity of disease is needed to more fully explore durability of the MPXV immune response. A more complete understanding of this complex picture would likely inform development of improved vaccines and therapeutics for mpox.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mpox Vaccination and Diagnosis Among Sexual and Gender Diverse Populations in Brazil: Results From a Large Nationwide Online Survey","authors":"Mayara Secco Torres Silva,&nbsp;Paula Mendes Luz,&nbsp;Carolina Coutinho,&nbsp;Brenda Hoagland,&nbsp;Emilia Moreira Jalil,&nbsp;Cristina Pimenta,&nbsp;Marcos Benedetti,&nbsp;Sandra Wagner Cardoso,&nbsp;Valdilea Gonçalves Veloso,&nbsp;Beatriz Grinsztejn,&nbsp;Thiago Silva Torres","doi":"10.1002/jia2.70143","DOIUrl":"10.1002/jia2.70143","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Since the onset of the 2022 multinational mpox outbreak, Brazil has reported one of the highest case burdens globally, disproportionately affecting sexual and gender diverse populations. Mpox vaccination efforts in Brazil have been limited by delayed procurement, restricted eligibility criteria and structural access barriers. Understanding vaccination use, correlates of uptake and characteristics of individuals previously diagnosed with mpox is essential to guide equitable prevention strategies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted an online cross-sectional survey between August and December 2024 among individuals recruited through social media and dating apps. Eligible participants were aged ≥18 years, identified as a sexual and gender diverse person, and residing in Brazil. Primary outcomes were previous mpox vaccination and mpox diagnosis. Sociodemographic, behavioural, internalized LGBTQIAPN+phobia and HIV/sexually transmitted infections (STIs) variables were collected. Adjusted logistic regression models identified independent factors associated with both outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of 9546 respondents, most were cisgender men (91.8%), aged &gt;30 years (81.5%) and residing in capital cities (77.2%). Overall, mpox vaccination coverage was 4.9%; nearly half received only one dose, and one quarter were vaccinated outside Brazil. Previous mpox diagnosis was reported by 2.1% of respondents, with 76.5% seeking healthcare and 7.0% requiring hospitalization. Factors associated with previous mpox vaccination were self-identification as White (aOR = 1.36; 95% CI: 1.10−1.69), more than five sex partners (aOR = 1.29; 95% CI: 1.03–1.62), living with HIV (aOR = 3.40; 95% CI: 2.59–4.47), current/prior HIV pre-exposure prophylaxis (PrEP) use (aOR = 1.88; 95% CI: 1.41–2.53) and internalized LGBTQIAPN+phobia score (aOR = 0.80; 95% CI: 0.71−0.90). Factors associated with previous mpox diagnosis were living in capital cities (aOR = 1.88; 95% CI: 1.17–3.20), more than five sex partners (aOR = 1.93; 95% CI: 1.35−2.79), stimulant drug use (aOR = 1.61; 95% CI: 1.14–2.25), any STI diagnosis (aOR = 2.41; 95% CI: 1.74–3.33), living with HIV (aOR = 3.73; 95% CI: 2.31–6.25) and current/prior PrEP use (aOR = 2.35; 95% CI: 1.43−4.01).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Mpox vaccination among sexual and gender diverse populations in Brazil remains critically low. Findings highlight structural barriers, including vaccine scarcity, delayed rollout and stigma, that hinder","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioural and Structural Determinants of Mpox Vaccine Awareness and Uptake Among People With HIV in the Dominican Republic: A Cross-Sectional Study","authors":"Robert Paulino-Ramirez,&nbsp;Wilfredo R. Matias,&nbsp;Alexandre Chaumette,&nbsp;Hector Lora-Rodríguez,&nbsp;Monica Thormann-Peynado,&nbsp;Lucia Vargas","doi":"10.1002/jia2.70128","DOIUrl":"10.1002/jia2.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Mpox disproportionately affects people with HIV (PWH), yet little is known about mpox vaccine awareness and uptake in low- and middle-income countries. We evaluated mpox-related knowledge, attitudes and practices (KAP) among PWH in the Dominican Republic to identify determinants of vaccine awareness and uptake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional online survey of 98 PWH recruited through HIV clinics, community-based organizations and social networks (January−May 2025). The questionnaire assessed sociodemographic characteristics, mpox-related KAP, structural barriers and vaccination status. Univariable and multivariable logistic regression were used to examine factors associated with mpox vaccine awareness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Half of the participants (49/98) were aware of the mpox vaccine. Individuals aged 31–40 years had significantly lower odds of awareness compared with those aged 21–30 years. Despite high levels of formal education, 79% rated their mpox knowledge as low, and most perceived minimal personal risk. Among participants aware of the vaccine, 71% had been vaccinated. Structural barriers, including inconvenient site locations and logistical challenges, were frequently reported, even among vaccinated individuals, indicating that access limitations rather than hesitancy were the dominant constraints. Trust in vaccinating organizations was high overall, and healthcare providers and community organizations were the primary sources of vaccine information. Peer and community influence emerged as notable facilitators of uptake, while lack of reliable information and concerns about vaccine safety contributed to hesitancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Mpox vaccine awareness among PWH in the Dominican Republic was low, but willingness to vaccinate was high when individuals were informed and able to access services. Strengthening mpox preparedness will require expanding accessible vaccination sites, improving disease-specific health literacy, and leveraging trusted community and clinical networks. Integrating mpox vaccination into routine HIV care delivery and enhancing community-led outreach may substantially improve uptake in this and similar low-middle income countries (LMIC) settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":201,"journal":{"name":"Journal of the International AIDS Society","volume":"29 S2","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}