Sexually Transmitted Infections最新文献

{"title":"Correspondence on 'Increasing awareness and surveillance of sexually transmitted infections among adolescents is an essential element of HIV epidemic control in sub-Saharan Africa' by Murewanhema <i>et al</i>.","authors":"Grant Murewanhema, Enos Moyo, Tafadzwa Dzinamarira","doi":"10.1136/sextrans-2024-056311","DOIUrl":"10.1136/sextrans-2024-056311","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"135"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age, sex and sexual orientation effects in the Safetxt trial: secondary data analysis of a randomised controlled trial.","authors":"Sima Berendes, Melissa J Palmer, Ford Colin Ian Hickson, Ellen Bradley, Ona L McCarthy, James R Carpenter, Caroline Free","doi":"10.1136/sextrans-2024-056285","DOIUrl":"10.1136/sextrans-2024-056285","url":null,"abstract":"<p><strong>Background: </strong>Increasing rates of sexually transmitted infections (STIs) and antimicrobial resistance among young people underscore the urgent need for preventative interventions. Interventions should be evidence-based and tailored to the unique risks and needs associated with varying age, sex and sexual orientation. We used data from the Safetxt trial to explore whether young people's age, sex and sexual orientation influence (1) their risk of STI reinfection and condom use and (2) the effect of the Safetxt intervention on STI reinfection and condom use.</p><p><strong>Methods: </strong>We conducted exploratory secondary analyses of data from the Safetxt trial that evaluated a theory-based digital sexual health intervention tailored according to sex and sexual orientation. We recruited 6248 young people with STIs from 92 UK sexual health clinics and assessed outcomes after 1 year, including the cumulative incidence of STI reinfection and condom use at last sex. We used adjusted logistic regression and margins plots to visualise effect modification.</p><p><strong>Results: </strong>There were differences in STI reinfection and condom use by age, sex and sexuality. Age was associated with STI reinfection (OR 0.90, 95% CI 0.87 to 0.94) with evidence for interaction between age and sexuality (p<0.001). Our findings suggest that the risk of STI reinfection decreases with age among young heterosexuals but increases among men-who-have-sex-with-men (MSM). Overall, MSM had the highest likelihood of reinfection (OR 3.53, 95% CI 2.66 to 4.68) despite being more likely to use condoms (OR 1.50, 95% CI 1.18 to 1.91).Among MSM, age modified the intervention effect on condom use at 1 year with highest benefits among participants aged 16-18, moderate to minor benefits among those aged 18-21 and no effect among participants aged 22-24 years.</p><p><strong>Conclusions: </strong>Future digital health interventions tailored for diverse sexuality groups need to target young people early enough to have an impact on sexual behaviour. Specific novel interventions are needed for older MSM.</p><p><strong>Trial registration number: </strong>ISRCTN64390461.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"94-100"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of antenatal <i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> screening on postdelivery prevalence and vertical transmission in Gaborone, Botswana: findings from an exploratory study.","authors":"Aamirah Mussa, Adriane Wynn, Rebecca Ryan, Chibuzor M Babalola, Emily Hansman, Selebaleng Simon, Bame Bame, Neo Moshashane, Maitumelo Masole, Melissa L Wilson, Jeffrey D Klausner, Chelsea Morroni","doi":"10.1136/sextrans-2023-055965","DOIUrl":"10.1136/sextrans-2023-055965","url":null,"abstract":"<p><strong>Objectives: </strong><i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i> are common sexually transmitted infections (STIs). Untreated infection in pregnancy can result in adverse neonatal outcomes, including vertical transmission. Screening for these infections is not routine in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>The Maduo Study was a non-randomised cluster crossover trial in Botswana to provide preliminary data on the effect of antenatal <i>C. trachomatis</i> and <i>N. gonorrhoeae</i> screening and treatment on postdelivery prevalence and vertical transmission to infants. Pregnant women asymptomatic for STIs were enrolled at four clinics (seven clusters). The intervention arm received <i>C. trachomatis</i> and <i>N. gonorrhoeae</i> screening at first antenatal care, third trimester and postdelivery. The standard-of-care arm received postdelivery screening only. Infants of women with a positive test postdelivery in both arms were screened. A cluster-level analysis was performed to compare the risk of postdelivery infection between intervention and standard-of-care arms.</p><p><strong>Results: </strong>The study enrolled 500 women; 206 (82.1%) and 187 (75.1%) were retained in the intervention and standard-of-care arms, respectively and screened ≤12 weeks postdelivery. <i>C. trachomatis</i> prevalence in the intervention arm reduced from 22.7% at first antenatal care to 1.0% postdelivery. <i>N. gonorrhoeae</i> prevalence reduced from 1.2% at first antenatal care to 0% postdelivery. The risk of <i>C. trachomatis</i> and/or <i>N. gonorrhoeae</i> was lower in the intervention arm postdelivery (0.6%) compared with the standard-of-care arm (15.7%); adjusted risk difference: -14.7% (95% CI -23.0%, -6.4%). Among 26 infants born to women with either infection postdelivery, 10 (38.5%) tested positive (<i>C. trachomatis</i>: 9; <i>N. gonorrhoeae</i>: 1).</p><p><strong>Conclusions: </strong>Postdelivery prevalence of <i>C. trachomatis</i> was significantly lower among pregnant women in Botswana who received diagnostic antenatal screening. Among women with <i>C. trachomatis</i> and/or <i>N. gonorrhoeae</i> postdelivery, more than one-third transmitted the infection to their infants. This exploratory study suggests antenatal STI screening has the potential to reduce infection in newborns in similar LMIC settings.</p><p><strong>Trial registration number: </strong>NCT04955717.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"81-87"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increase in disseminated gonococcal infections in Belgium in 2023: clinical and molecular characteristics.","authors":"Irith De Baetselier, Tessa de Block, Sheeba Santhini Manoharan-Basil, Amaryl Lecompte, Chris Kenyon, Dorien Van den Bossche","doi":"10.1136/sextrans-2024-056341","DOIUrl":"10.1136/sextrans-2024-056341","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"133-134"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In conversation with Dr Paddy Horner.","authors":"Daniel Richardson, Rachel J Caswell, Anna Maria Geretti","doi":"10.1136/sextrans-2023-055970","DOIUrl":"https://doi.org/10.1136/sextrans-2023-055970","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":"101 2","pages":"139-140"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of <i>Neisseria gonorrhoeae</i> strain differences in patients with multisite infection.","authors":"Victoria F Miari, Matthew R Blakiston, Priya Solanki, Ozan Gundogdu, Richard A Stabler","doi":"10.1136/sextrans-2024-056297","DOIUrl":"10.1136/sextrans-2024-056297","url":null,"abstract":"<p><strong>Background: </strong><i>Neisseria gonorrhoeae</i>, the aetiological agent of gonorrhoea, is an increasing global health priority due to high levels of antimicrobial resistance (AMR). It is estimated that up to 42% of patients are infected at multiple anatomical sites simultaneously. Previous studies identified that 7%-40% of those with multisite infection have different strains infecting different sites, with potentially different antimicrobial susceptibility profiles. This study aims to estimate the proportion of patients with multisite infection through differential antimicrobial susceptibility testing (AST) profiles and sequence-based molecular methods.</p><p><strong>Methods: </strong>This was a cross-sectional study of multisite gonococcal isolates provided by three National Health Service laboratories. Minimum inhibitory concentrations (MICs) for cefixime, ceftriaxone, azithromycin, ciprofloxacin, tetracycline and spectinomycin were determined. Possible multistrain infections were defined as isolates with a significant difference in MIC to at least one antimicrobial. Whole genome sequencing (WGS) was performed to determine multistrain infection through <i>N. gonorrhoeae</i> multiantigen sequence typing (<i>NG</i>-MAST), <i>N. gonorrhoeae</i> sequence typing for antimicrobial resistance (<i>NG</i>-STAR), multilocus sequencing typing (MLST) and single nucleotide polymorphism (SNP) phylogeny, and to compare AST profiles with identified AMR genes.</p><p><strong>Results: </strong>Ninety-one isolates were collected from 41 patients with multisite infections. Of these 41 patients, 6 (14.6%) had <i>N. gonorrhoeae</i> isolates with discordant MICs. WGS-based typing confirmed that four out of six patients were infected with different gonococcal strains. The relatedness of isolates with the same MLST across multiple patients was differentiated using SNP-based analysis, and this included the identification of a potential transmission event. WGS-based AMR prediction for all antimicrobials tested correlated well with the phenotypic data.</p><p><strong>Conclusion: </strong>This study demonstrates that potentially a significant proportion of patients with multisite infections are infected with multiple gonococcal strains, with differing AST profiles, at different anatomical sites. This has implications for patient sampling, susceptibility testing protocols, AMR surveillance and potentially appropriate antibiotic therapy.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"88-93"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oropharyngeal gonorrhoea among heterosexual men and women at a sexual health centre in Rotterdam, the Netherlands, 2023: reservoir for transmission?","authors":"Denise E Twisk, Corné Klaassen, Mireille van Westreenen, Hannelore M Götz","doi":"10.1136/sextrans-2024-056313","DOIUrl":"10.1136/sextrans-2024-056313","url":null,"abstract":"<p><strong>Background: </strong>Sexual health centres (SHCs) in the Netherlands report a surge in gonorrhoea, especially among young women (notably oropharyngeal) and men who have sex with women (MSW) since the second half of 2022. MSW are not routinely oropharyngeal tested, and women only when reporting oral sex. This cross-sectional study aimed to assess oropharyngeal gonorrhoea in MSW and women, and potential underdiagnosis.</p><p><strong>Methods: </strong>From 10 August to 10 November 2023, the SHC in Rotterdam, the Netherlands, extended its gonorrhoea testing protocol, requiring oropharyngeal tests for all MSW and women. Positive cobas nucleic acid amplification test (NAAT) results were followed by culture sampling. Oropharyngeal infections were confirmed with a second NAAT (opa gene-based PCR), and for discrepancies a third NAAT (GeneXpert CT/NG test) was employed. The impact of extended testing on detection rates, along with the corresponding 95% CIs, was analysed.</p><p><strong>Results: </strong>The overall gonorrhoea detection rate was 6.4% (95% CI 4.7% to 8.8%) among MSW and 6.0% (95% CI 4.8% to 7.6%) among women, compared with 3.6% (95% CI 2.3% to 5.4%) and 6.0% (95% CI 4.8% to 7.6%) without expanded testing. Oropharyngeal rates were 6.4% (95% CI 4.4% to 9.2%) for MSW and 4.3% (95% CI 3.2% to 5.7%) for women. Highest positivity was among individuals notified, <25 years, without migratory background, with lower educational levels and more sex partners. Oropharyngeal cultures confirmed viable gonorrhoea in 39.1% of MSW and 35.5% of women. False positives were 7.4% among MSW and 10.8% among women. Confirmed oropharyngeal gonorrhoea positivity rate was 5.9% (95% CI 4.0% to 8.6%) among MSW and 3.9% (95% CI 2.8% to 5.2%) among women.</p><p><strong>Conclusion: </strong>Oropharyngeal gonorrhoea is common and currently underdiagnosed among MSW. The impact of this underdiagnosis on transmission dynamics under the current testing policy remains unclear. Further research is needed to inform prevention and control strategies, especially given the recent surge in gonorrhoea.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"109-116"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doxycycline postexposure prophylaxis (doxyPEP): sexual health clinicians' knowledge and readiness.","authors":"Carys Phillips, Marisa Vinuesa, Clare Fowler, Suneeta Soni, Daniel Richardson","doi":"10.1136/sextrans-2024-056388","DOIUrl":"10.1136/sextrans-2024-056388","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"132"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do men who have sex with men recognise syphilis symptoms? A syphilis awareness campaign in Amsterdam, the Netherlands.","authors":"Silvia Achia Nieuwenburg, Arjan van Bijnen, Koenraad Vermey, Arjen Stam, Wim Zuilhof, Elske Hoornenborg, Maarten Franciscus Schim van der Loeff, Henry John Christiaan de Vries","doi":"10.1136/sextrans-2023-055925","DOIUrl":"10.1136/sextrans-2023-055925","url":null,"abstract":"<p><strong>Introduction: </strong>Syphilis incidence is rising among gay, bisexual and other men who have sex with men (GBMSM). To improve early health-seeking behaviour, we developed an online syphilis symptom score tool for GBMSM to self-identify a higher likelihood of infectious syphilis and promoted its use via an online and offline awareness campaign.</p><p><strong>Methods: </strong>From October 2018 through September 2019, a dedicated website on syphilis including the online symptom score tool was promoted. The reach of the campaign was measured by website metrics and the completion of the self-assessment tool. The impact of the campaign was assessed by comparing the monthly number of syphilis serology tests and the percentages of infectious syphilis diagnoses at the Centre for Sexual Health (CSH) in Amsterdam between three periods: 12 months preceding, 12 months during and 6 months after the campaign.</p><p><strong>Results: </strong>During the campaign, 20 341 visitors viewed the website. A total of 13 499 (66.4%) visitors started the self-assessment algorithm, and 11 626 (86.1%) completed it. Prior to the campaign, the mean number of syphilis tests per month was 1650 compared with 1806 per month during the campaign (p=0.02). In the 6 months after the campaign, the mean number of tests per month was 1798 (compared with the period of the campaign, p=0.94). Prior to the campaign, the percentage of infectious syphilis diagnoses was 2.5% compared with 3.0% during the campaign (p=0.009). The percentage of infectious syphilis diagnoses in the 6 months after the campaign was 2.2% (p<0.0001 compared with the period of the campaign, and p=0.045, compared with the period prior to the campaign).</p><p><strong>Conclusions: </strong>Although we did not find definite proof of a (sustained) effect, syphilis symptoms awareness campaigns deserve further evaluation and improvements to help those suspected of syphilis to get tested.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"118-120"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141767262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and opportunities for hepatitis B virus screening in people attending PrEP services: a retrospective prevalence study.","authors":"Bianca Monti, Roberto Rossotti, Fabiana D'Aloia, Daniele Calzavara, Laura Corsico, Massimo Cernuschi, Massimo Puoti, Paolo Bonfanti, Alessandro Soria","doi":"10.1136/sextrans-2024-056245","DOIUrl":"10.1136/sextrans-2024-056245","url":null,"abstract":"<p><strong>Objectives: </strong>Pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir to prevent HIV in individuals with hepatitis B virus (HBV) raises concerns about HBV reactivation when stopping event-driven PrEP or redundancy in HBV treatment for continuous PrEP (since tenofovir alone would be enough for HBV). Real-world data from PrEP services could provide useful epidemiological information on HBV prevalence in PrEP attendees in low-prevalence countries.</p><p><strong>Methods: </strong>A retrospective analysis on PrEP attendees of three services in northern Italy were conducted to assess HBV prevalence among PrEP attendees and the need for primary cycle/booster dose HBV vaccination despite previous vaccination during childhood (at birth or 12 years). Risk factors possibly associated with HBV exposure were evaluated with a binary logistic regression analysis, controlling for age, gender, place of birth (Italy vs abroad) and chemsex use (as a proxy of high-risk sexual behaviour for contracting sexually transmitted infections).</p><p><strong>Results: </strong>Among 10 hepatitis B surface antigen (HBsAg)-positive out of 2152 PrEP attendees (0.46%), PrEP was started in 7 subjects mainly with a daily schedule, 1 has declined after counselling, 2 were lost to follow-up. Around three-fourth of the 2152 PrEP attendees were born in Italy after 1979, thus were previously vaccinated during childhood. The probability of needing a booster for low-titre HBs antibodies was higher among those vaccinated at birth with respect to those vaccinated at 12 years (OR 2.30, 95% CI 1.80 to 2.96). The risk of previous HBV exposure (resulting in either HBsAg+ or antibodies against HBV core antigen [HBcAb]+) was higher for increasing age (OR 3.07, 95% CI 2.49 to 3.78 per 10 years more) and lower for being born in Italy (OR 0.23, 95% CI 0.14 to 0.36).</p><p><strong>Conclusions: </strong>Our real-world data on a large PrEP cohort suggest that, although uncommon, HBV infection in PrEP users in low-prevalence countries should be considered and managed. In addition, HBV screening offers the opportunity to expand prevention services through vaccination.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"121-124"},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142473878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}