Sexually Transmitted Infections最新文献

{"title":"Italian infectious diseases centres' practices for <i>Mycoplasma genitalium</i> management: a nationwide PrIDE network survey.","authors":"Angelo Roberto Raccagni, Giulia Micheli, Riccardo Lolatto, Enrico Caruso, Annamaria Cattelan, Salvio Cecere, Francesco Maria Fusco, Maddalena Giglia, Leonardo Del Negro, Marianna Menozzi, Eugenio Milano, Marco Ridolfi, Roberto Rossotti, Lucia Taramasso, Daniele Tesoro, Serena Venturelli, Antonella Castagna, Andrea Antinori, Davide Moschese, Valentina Mazzotta, Massimo Cernuschi, Silvia Nozza","doi":"10.1136/sextrans-2026-057137","DOIUrl":"https://doi.org/10.1136/sextrans-2026-057137","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138179","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":"<i>Neisseria gonorrhoeae</i> antimicrobial resistance trends in Portugal over four decades, 1983-2025.","authors":"Miguel Pinto, Diogo Ramos, João Rodrigues, Rui Matias, Carolina Fonseca, Cristina Correia, Inês João, Dora Cordeiro, Teresa Carreira, Teresa Ramos, Maria José Borrego","doi":"10.1136/sextrans-2026-057131","DOIUrl":"https://doi.org/10.1136/sextrans-2026-057131","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138182","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":"Korean syphilis 'Surge' of 2024: a surveillance-artefact decomposition and its implications for the HIV-syphilis syndemic hypothesis.","authors":"Minsoo Jung","doi":"10.1136/sextrans-2026-057192","DOIUrl":"https://doi.org/10.1136/sextrans-2026-057192","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128634","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":"HIV breakthrough infection after 6 years of daily TDF/FTC oral PrEP with objectively documented optimal adherence.","authors":"Nicholas Brian Bana, Davide Moschese, Leonardo Francesco Rezzonico, Enrico Caruso, Camilla Muccini, Giulia Jole Burastero, Anna De Bona, Nicoletta Frattini, Federico D'Amico, Massimo Cernuschi, Elena Simoncini, Massimo Puoti, Roberto Rossotti","doi":"10.1136/sextrans-2026-057198","DOIUrl":"https://doi.org/10.1136/sextrans-2026-057198","url":null,"abstract":"<p><p>Oral Pre-Exposure Prophylaxis (PrEP) is highly effective for HIV prevention when adherence is optimal, with rare HIV breakthrough infections usually happening within 1-2 years since PrEP start. After 6 years of daily PrEP, routine HIV testing identified seroconversion in a 46-year-old Italian cisgender man. He reported high adherence, confirmed by pharmacy refill history and plasma tenofovir concentration. Genotypic resistance test identified a recombinant HIV-1 strain with M184V and K70E reverse transcriptase mutations. Immediate antiretroviral therapy with FTC/TAF/DRV/c+DTG was initiated, achieving rapid viral suppression. A hair sample was sent for therapeutic drug monitoring and results were consistent with correct daily tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) before the acquisition of HIV infection. This case represents a rare PrEP failure after the longest reported duration of daily TDF/FTC PrEP with confirmed optimal adherence. It highlights that breakthrough HIV infection can occur even after many years of successful PrEP use, underlying the importance of periodic HIV surveillance.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128545","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":"Predictors of positive culture in NAAT-confirmed rectal <i>N. gonorrhoeae</i> infection among men who have sex with men.","authors":"Flavia Passini, Angelo Roberto Raccagni, Riccardo Lolatto, Nicolò Capra, Maria Francesca Lucente, Caterina Candela, Camilla Muccini, Elena Bruzzesi, Marcella Negri, Antonella Castagna, Silvia Nozza","doi":"10.1136/sextrans-2025-056855","DOIUrl":"https://doi.org/10.1136/sextrans-2025-056855","url":null,"abstract":"<p><strong>Background: </strong><i>Gonorrhoea</i> is a common sexually transmitted infection (STI) among men who have sex with men (MSM). Nucleic acid amplification tests (NAATs) are the recommended diagnostic method; however, the interpretation of positive results in asymptomatic individuals remains uncertain. The aim of this study was to identify factors associated with positive culture results in NAAT-confirmed rectal gonorrhoea.</p><p><strong>Methods: </strong>This retrospective study included individuals receiving HIV care, pre-exposure prophylaxis or STI screening at the Infectious Diseases Unit of San Raffaele Hospital, Milan, Italy, between January 2021 and January 2025. Individuals with NAAT-confirmed rectal <i>Neisseria gonorrhoeae</i> who also underwent culture testing were included. Demographic and clinical data were collected. Group comparisons were performed between individuals with positive or negative cultures.</p><p><strong>Results: </strong>Among 556 individuals with NAAT-confirmed rectal <i>N. gonorrhoeae</i> (552 MSM and 4 women who have sex with men), 200 (35.3%) had a positive culture. The median age was 35.7 years (IQR=30.7-41.9). Individuals with a positive culture were younger (34.9 vs 36.4 years; p=0.013) and more frequently symptomatic (56.5% vs 16.6%; p<0.001), particularly reporting anal burning, gastrointestinal symptoms, tenesmus and anal discharge (all p<0.001).</p><p><strong>Conclusions: </strong>Gonococcal culture was positive in about one-third of NAAT-confirmed rectal infections. The presence of STI-related symptoms was associated with a positive culture. These findings corroborate the limited sensitivity of gonococcal culture and may help guide resistance surveillance strategies.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114676","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":"Longitudinal quantitative treponemal-specific immunoassay patterns in syphilis reinfection among MSM living with HIV.","authors":"Shaked Landman, Alon Shtrikman, Tal Zilberman-Daniels, Ravid Armon, Itzchak Levy, Sharon Amit","doi":"10.1136/sextrans-2026-057022","DOIUrl":"https://doi.org/10.1136/sextrans-2026-057022","url":null,"abstract":"<p><strong>Objectives: </strong>Syphilis reinfection is increasing among men who have sex with men (MSM) living with HIV and is frequently asymptomatic, complicating timely diagnosis and management. Current screening strategies rely on multistep serological algorithms that require confirmation with non-treponemal testing, often delaying clinical decision-making. The chemiluminescent microparticle immunoassay for <i>Treponema pallidum</i> (TP-CMIA) is widely used as an initial screening assay and provides quantitative signal-to-cut-off values; however, it is currently designated for qualitative interpretation. We aimed to evaluate whether longitudinal changes (ie, dynamics) in TP-CMIA values can serve as an early marker of syphilis reinfection and support initial clinical decision-making.</p><p><strong>Methods: </strong>We conducted a retrospective observational study including 179 MSM living with HIV who underwent routine syphilis screening between 2014 and 2024 and had at least two paired treponemal (TP-CMIA) and non-treponemal (rapid plasma reagin (RPR)) test results. Syphilis infection status was classified using an algorithm based on RPR dynamics and Centres for Disease Control guidelines. Absolute and relative changes were analysed between sequential tests. Diagnostic performance was assessed using receiver operating characteristic and precision-recall analyses.</p><p><strong>Results: </strong>Absolute changes in TP-CMIA values demonstrated good diagnostic performance for identifying reinfection, with a receiver operating characteristic area under the curve of 0.84. Performance improved to 0.90-0.95 for first reinfection episodes when prior TP-CMIA values were <21 signal-to-cut-off. Optimised thresholds yielded positive predictive values of 70%-75%, specificity of 99%, and negative predictive values exceeding 98%. Sensitivity increased from 47% overall to 60%-75% under refined conditions. Performance was independent of HIV viral load and CD4 count, while younger age was associated with higher false-positive rates.</p><p><strong>Conclusions: </strong>Longitudinal absolute changes in TP-CMIA values represent a robust early marker of syphilis reinfection among MSM living with HIV, although it is limited when baseline values are high. TP-CMIA dynamics may support earlier recognition of reinfection and inform initial clinical decision-making during serological follow-up.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114633","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":"Comparative histological specimen adequacy and tolerability of endoscopic versus Baby Tischler forceps for anal canal biopsy during high-resolution anoscopy in people with HIV.","authors":"Ivan Chivite, David García-Hernández, Richard D Cranston, Gemma Olmeda, Josep Riera, Emilia Sánchez, Irene Fuertes, José Luis Blanco","doi":"10.1136/sextrans-2026-057027","DOIUrl":"https://doi.org/10.1136/sextrans-2026-057027","url":null,"abstract":"<p><strong>Objectives: </strong>Anal canal cancer is strongly associated with high-risk human papillomavirus infection and occurs at increased incidence in people living with HIV. High-resolution anoscopy (HRA) with directed biopsy is the reference standard for diagnosing histological high-grade squamous intraepithelial lesions (HSIL). Comparative data on diagnostic performance and tolerability of different biopsy forceps are limited.</p><p><strong>Methods: </strong>We conducted an observational single-centre non-randomised study comparing endoscopic forceps (EF) and Baby Tischler forceps (BTF) for anal canal biopsy during HRA. Histological specimen adequacy was defined as the proportion of biopsies yielding adequate histopathological specimens. Tolerability was assessed using a visual analogue scale (VAS). Short-term adverse events were systematically recorded. Investigators also completed an exploratory structured poststudy assessment of procedural handling, bleeding control, feasibility of multiple biopsies and overall instrument preference.</p><p><strong>Results: </strong>A total of 244 participants underwent 365 biopsies (208 with EF and 157 with BTF). Overall, 348/365 biopsies (95.3%) yielded adequate specimens, with no significant difference between EF and BTF (96.6% vs 93.6%; p=0.272). HSIL was detected more frequently in biopsies obtained with BTF than EF (50.3% vs 26.4%; p<0.001). Clinically relevant pain (VAS score ≥5) was similar between groups (8.17% vs 8.28%; p=1.00). Any postbiopsy adverse event occurred in 42.3% of EF and 41.1% of BTF procedures (p=0.958), and all events were mild and self-limited. Investigator-reported assessment favoured EF, particularly regarding handling and bleeding control.</p><p><strong>Conclusions: </strong>EF and BTF demonstrated similarly high specimen adequacy and comparable short-term safety for anal canal biopsy during HRA. Clinically relevant pain did not differ between instruments. The higher HSIL detection rate observed with BTF should be interpreted cautiously given the non-randomised design and potential operator-related and procedural confounding. Further prospective studies are warranted.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114690","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":"Hepatitis C in a sexually transmitted infection clinic in Barcelona, Spain: analysis of the last decade.","authors":"Patricia Álvarez-López, Jorge Nestor García-Pérez, Ariadna Rando-Segura, Susana Bernalte Ruz, Adrián Najarro-Centeno, Mar Riveiro-Barciela, Arnau Monforte, Vicente Descalzo, Antonio Carrillo, Mateo Cerro Lillo, Jordi Arcarons-Martí, Sixto Navarro, Maider Arando","doi":"10.1136/sextrans-2025-056830","DOIUrl":"https://doi.org/10.1136/sextrans-2025-056830","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatitis C virus (HCV) remains a global health concern, particularly among gay, bisexual and other men who have sex with men (GBMSM) with HIV or receiving HIV pre-exposure prophylaxis (PrEP). This study describes the sociodemographic, clinical and behavioural characteristics of HCV cases diagnosed at our clinic over a 10-year period and explores potential transmission networks.</p><p><strong>Methods: </strong>Retrospective, descriptive, single-centre study including epidemiological, behavioural and clinical characteristics of HCV cases diagnosed at a Sexually Transmitted Infections (STI) Unit in Barcelona between January 2015 and December 2024. Data were summarised using descriptive statistics. Phylogenetic analysis was performed in HCV cases diagnosed between 2020 and 2024 with HCV RNA >1000 copies/mL and available blood samples to identify potential transmission networks.</p><p><strong>Results: </strong>During the study period, 15 456 people were screened, leading to 100 HCV cases (68 newly acquired hepatitis, 13 newly acquired reinfections, 16 chronic infections and 3 unclassifiable) in 98 individuals (0.63% positivity rate). Among individuals, 98% were cisgender men and 90.7% GBMSM. By the end of the study, 64.8% were people with HIV and 24.2% had been in PrEP at some point of the follow-up. No or infrequent condom use was common (89.9%) and 65.3% reported drug use the 3-4 months prior to diagnosis. Among HCV cases, 41.2% had an ulcerative STIs at diagnosis. Of those treated, 96.3% achieved sustained virological response. Genotype 1a was the most common (44.2%) and phylogenetic analysis revealed potential transmission clusters of HCV subtype 1a but also 2c.</p><p><strong>Conclusions: </strong>HCV remains frequent in our unit, particularly among GBMSM with HIV, GBMSM who use PrEP and those reporting condomless sex, drug use or concomitant STIs. Despite highly effective direct-acting antivirals, transmission within the GBMSM population persists. Enhanced prevention strategies, targeted education on safer sex and harm reduction strategies are essential.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081985","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":"Two for the price of one: should donovanosis and chancroid be targeted for eradication?","authors":"Jacques Pépin, Philippe Mayaud, John Richens, David Mabey","doi":"10.1136/sextrans-2026-056935","DOIUrl":"10.1136/sextrans-2026-056935","url":null,"abstract":"<p><p>Half a century after smallpox eradication, this feat has not been repeated, although there is hope for the Guinea worm. This article examines whether two uncommon genital ulcerative diseases, donovanosis and chancroid, should be targeted for eradication. Many think that their decline has been such that they might be heading towards spontaneous eradication, following more effective treatments, integration of sexually transmitted infection management in primary healthcare, enhanced condom use by sex workers and promotion of male circumcision. However, examples of syphilis and mpox suggest spontaneous eradication may be a fallacy.Donovanosis occurs sporadically in several countries, especially India. In other formerly endemic nations (eg, Papua New Guinea and the Papua region of Indonesia), the current epidemiological situation is unclear. Worldwide incidence might be a few hundred cases annually, perhaps a thousand. The availability of effective interventions, relatively easy clinical diagnosis, adequate laboratory tests and the absence of animal reservoirs suggest that eradication could be achieved through enhanced surveillance and a stronger contact tracing system with presumptive treatment of all sexual contacts, including sex workers.Chancroid's current annual caseload is unknown but likely in the hundreds of thousands of cases globally. Prior to eradication activities, a first phase should document its status in all previously endemic countries using molecular tests on patients presenting with genital ulcers in sentinel clinics. Additional research should investigate whether <i>Haemophilus ducreyi</i> in skin ulcers can cause genital infections. Chancroid is strongly associated with sex work: this is the tap that must be turned off. Where it remains endemic, sex workers' services should be supported to treat symptomatic cases, enhance condom use and deliver periodic presumptive treatment with azithromycin.Given their overlapping geographic distribution and the preponderant role of sex workers in transmission dynamics, an eradication programme could address both diseases simultaneously, with the same personnel.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064172","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":"Measuring sexual and reproductive health in Britain: changes in bias between the third and fourth National Surveys of Sexual Attitudes and Lifestyles (Natsal-3 and Natsal-4).","authors":"Luke Muschialli, Victoria L Parsons, Soazig Clifton, Elise Paul, Rebecca Light, Katharine Sadler, Claudia Gascoyne, Anika Knuppel, Emily Trickett, Nigel Field, Christopher Bonell, Wendy Macdowall, Kirstin R Mitchell, Catherine H Mercer, Pam Sonnenberg, Andrew Copas","doi":"10.1136/sextrans-2026-056955","DOIUrl":"https://doi.org/10.1136/sextrans-2026-056955","url":null,"abstract":"<p><strong>Objectives: </strong>The fourth National Survey of Sexual Attitudes and Lifestyles (Natsal-4; conducted 2022-2024) identified substantial changes in reported sexual and reproductive health (SRH) in Britain compared with Natsal-3 (2010-2012). Lower response rates in Natsal-4 necessitated mixed-mode adaptations, raising concerns that estimates of change over time could be biased by changes in who took part (participation bias) and how they answered questions (reporting and instrument bias).</p><p><strong>Methods: </strong>We identified two birth cohorts of participants eligible to be sampled in Natsal-3 and Natsal-4, enabling comparison of people of the same generation across the two surveys: those born 1964-1980 (ie, <i>Gen-X</i>) and 1981-1994 (ie, <i>Millennials</i>). If bias remained stable between surveys, we would expect consistent estimates from members of the same birth cohort when sampled in each survey for events occurring before Natsal-3 data collection (ie, before 2010) and for outcomes where prevalence can logically only increase or only decrease over time.</p><p><strong>Results: </strong>In Natsal-4 compared with Natsal-3, a higher proportion of Gen-X and Millennial cohorts reported having had same-sex sex before 2010; a lower proportion of men reported opposite-sex sex before 16 years old; and a lower proportion of women reported a first pregnancy outcome and live birth before 2010 (all of which should be stable across surveys). The largest change in bias was observed among women and men in the Gen-X cohort through their increased reporting of never having had a sexual experience and never having had sex, which logically should only decrease over time.</p><p><strong>Conclusions: </strong>Evidence of changing bias between Natsal-3 and Natsal-4 was observed in key SRH estimates, which may be due to changes in participation or reporting. Resulting overestimations or underestimations of the magnitude of change over time in cross-survey comparisons have implications for interpreting apparent population-level trends to inform SRH policy and practice.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064231","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}