Sexually Transmitted Infections最新文献

{"title":"<i>Clostridioides difficile</i> infection following self-directed post-exposure antibiotic use for STI prevention.","authors":"Angelo Roberto Raccagni, Flavia Passini, Elena Bruzzesi, Flavia Badalucco Ciotta, Simona Bossolasco, Antonella Castagna, Silvia Nozza","doi":"10.1136/sextrans-2025-056479","DOIUrl":"https://doi.org/10.1136/sextrans-2025-056479","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625907","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>Mycoplasma genitalium</i> and antimicrobial resistance among the general female and male population in northern Spain.","authors":"Isabel Lara, Victor Hernandez-Ruiz, Miguel Fernández-Huerta, Jorge Rodriguez-Grande, Francisco Arnaiz De Las Revillas, Jesus Rodriguez-Lozano, Jorge Calvo-Montes, Alain Ocampo-Sosa, María Carmen Fariñas, Maria Pia Roiz Mesones, Sergio Garcia-Fernandez, Zaira Moure","doi":"10.1136/sextrans-2024-056374","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056374","url":null,"abstract":"<p><strong>Objectives: </strong><i>Mycoplasma genitalium</i> (MG) STIs represent a global concern, especially considering its rapid ability to acquire antimicrobial resistance. The objective of this study was to investigate the epidemiology of MG and antibiotic resistance among the general female and male populations in northern Spain.</p><p><strong>Methods: </strong>Between April 2019 and May 2023, individuals attending healthcare facilities for STI screening were tested for MG and macrolide and fluoroquinolone resistance mutations. Phylogenetic analysis was conducted using single-locus sequence-based typing of the <i>mgpB</i> gene and complemented by dual-locus sequence-based typing combining the <i>mgpB</i> and MG309 genes.</p><p><strong>Results: </strong>Of the 6350 people tested for MG during the study period, 5269 (83%) were women. Macrolide resistance mutations were identified in 25.4% of cases, with a higher prevalence in men (40% vs 17.14%) and coinfection with <i>Chlamydia trachomatis</i> was found predominantly in women (18.6% vs 7.5%). Phylogenetic analysis revealed two distinct epidemiological clades strongly correlated with gender. Clade A predominantly involved men with higher rates of HIV and syphilis history and detection of resistance mutations, while clade B exclusively comprised women, with only one case of macrolide resistance.</p><p><strong>Conclusions: </strong>The predominance of women in STI screening requests reflects local trends in screening patterns and underscores the importance of understanding MG infection in women in our region. The clear separation of clades suggests two independent sexual networks, with clade A representing a high-risk population and dense connectivity. This research provides a foundation for future studies on the prevalence, transmission dynamics and impact of MG infection, particularly among the female population, where understanding remains limited.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625909","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 a syndemic of STI symptoms, substance use and violence among incarcerated Peruvian women.","authors":"Elena Cyrus, Rodman Turpin, Typhanye Dyer, Elika Hashemi, Sobur Ali, Andrea Cornejo Bazo, Antonio Morgan-Lopez, Joy D Scheidell, Segundo R Leon, Michael Sciaudone, Frederick L Altice","doi":"10.1136/sextrans-2024-056371","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056371","url":null,"abstract":"<p><strong>Objectives: </strong>Despite parallel global trends of increasing incarceration rates and sexually transmitted infections (STIs) among women, STI epidemiological data for this vulnerable at-risk population are limited. The study objective was to characterise patterns of STI symptoms and explore covariates and drivers of indicating STI symptoms using syndemic theory among a population of incarcerated women in Peru.</p><p><strong>Methods: </strong>In a cross-sectional study, a sample of 249 incarcerated women responded to a questionnaire on substance use, depression, sexual behaviour, STI symptoms and violence, among other variables, between May and July 2015 in Santa Manica Prison (Lima, Peru). Univariate and bivariate analyses informed a latent profile analysis (LPA) and logistic regression.</p><p><strong>Results: </strong>Most women (93.5%) were Peruvian; 86.6% had prison sentences <5 years; the median age was 37 years (range 18-70 years); 2.6% were pregnant, 7.2% had children residing with them in prison; most women (78.7%) had a high school degree; >1/3 of the sample had ≥2 STI symptoms. The LPA analysis revealed that 39% of the sample had a 'syndemic' profile (co-occurrence of multiple STI symptoms, experiences of violence and substance use). Approximately 87% of women who were characterised by the syndemic profile were <50 years of age. The 'syndemic' profile was associated with double the prevalence of having multiple STI symptoms (≥2 symptoms: Prevalence Ratio (PR)=1.88 (95% CI 1.18, 2.99); ≥3 symptoms: PR=2.55 (95% CI 1.32, 4.93)).</p><p><strong>Conclusions: </strong>To address this syndemic, younger incarcerated women presenting with co-occurring STI symptoms (>2) can be clinically screened for diagnosis and treatment and assessed for substance use and risk of violence. Further research in this area may help stem and prevent deleterious health outcomes, including STIs, abuse and substance misuse, that can impact the individual and families.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625911","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":"Investigation of ceftriaxone-resistant <i>Neisseria gonorrhoeae</i> detected in Scotland, 2018-2024.","authors":"Martin P McHugh, Kirsty Aburajab, Alexandra Maxwell, John Anderson, Fraser Cairns, Seb Cotton, Andrew Gough, Brian Malloy, Katharine Mathers, Lynne Renwick, Jill Shepherd, Kate E Templeton","doi":"10.1136/sextrans-2024-056405","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056405","url":null,"abstract":"<p><strong>Objectives: </strong>Describe the clinical, phenotypic and genomic characteristics of ceftriaxone-resistant <i>Neisseria gonorrhoeae</i> from Scotland.</p><p><strong>Methods: </strong>Cases were identified in routine care from 2018 to 2024. Minimum inhibitory concentrations were determined for seven antimicrobial agents. Whole genome sequencing was performed with Illumina and Oxford Nanopore Technology instruments. A phylogeny containing global ceftriaxone-resistant genomes was generated with Parsnp. A collection of ST8780 genomes was also analysed to give further context using reference-based mapping with Snippy.</p><p><strong>Results: </strong>There were five cases of ceftriaxone-resistant <i>N. gonorrhoeae</i> detected. One case (multilocus sequencing typing (MLST) ST1903) clustered within the FC428 lineage in a returning traveller from an Asia-Pacific country. Two cases belonged to the recently described extensively drug-resistant MLST ST16406, a returning traveller from an Asia-Pacific country and a sexual contact within Scotland. The final two cases were a resident of an Asia-Pacific country and a sexual contact within Scotland, both belonged to MLST ST8780. These were distinct from other publicly available ST8780 genomes, suggesting a novel introduction of the mosaic <i>penA</i>-60.001 allele. All cases were initially treated with ceftriaxone-based regimes, four returned for test of cure and showed clearance of infection.</p><p><strong>Conclusions: </strong>As ceftriaxone resistance is increasingly identified, multiple public health interventions are required to reduce the impact of resistance on gonorrhoea treatment globally.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573723","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":"Lack of prenatal care in pregnancies complicated by syphilis: trend, risk factors and outcomes.","authors":"Han-Yang Chen, Irene A Stafford","doi":"10.1136/sextrans-2024-056453","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056453","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the temporal trend and risk factors associated with lack of prenatal care and the association between lack of prenatal care and adverse outcomes in pregnancies complicated by syphilis.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using US vital statistic data (2016-2022). We included non-anomalous, singleton live births delivered by pregnancies complicated by syphilis at 24-42 weeks of gestation in a hospital. The exposure variable was prenatal care (had care vs no care). We used Adequacy of Prenatal Care Utilization Index. Adverse outcomes were examined. The annual per cent change (APC) was calculated to assess the trend of lacking prenatal care. Multivariable Poisson regression models with robust error variance were used to examine the association. Adjusted relative risks (aRR) with 95% CIs were calculated.</p><p><strong>Results: </strong>Among the study population of 38 583 live births, 2417 (6.3%) lacked prenatal care. The rate of lacking prenatal care increased over time (APC=11.4; 95% CI 4.7 to 18.5). Maternal education, insurance, nulliparity, prepregnancy body mass index, prior preterm birth, smoking, diabetes, hepatitis C and year of delivery were associated with lacking prenatal care. Compared with individuals with prenatal care, those without care were associated with a higher risk of preterm birth <37 weeks (aRR 2.57; 95% CI 2.40 to 2.74) and <34 weeks (aRR 3.56; 95% CI 3.13 to 4.05). Compared with patients with adequate care, those without care were associated with a higher risk of preterm birth <37 weeks (aRR 5.07; 95% CI 4.59 to 5.60) and <34 weeks (aRR 6.42; 95% CI 5.32 to 7.75). Similar associations were shown in other adverse outcomes.</p><p><strong>Conclusions: </strong>Among pregnancies complicated by syphilis in the USA, there was an upward trend in lack of prenatal care from 2016 to 2022. Modifiable factors of lacking prenatal care were identified. The risks of adverse outcomes were higher among individuals without prenatal care.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573724","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":"What are we missing? Data from the Gonorrhoea Undetected Resistance Laboratory Study (GURLS).","authors":"Michelle Jayne Cole, Anna Vickers, Suzy Sun, Michaela Joanne Day, Ross Harris, Laura Burgess Tornaletti, Katie Thorley, Hussain Ahmed, Monica Rebec, Miriam O'Connor, Soma N'Jai-Ndimbalan, Alan Lord, Mark Hopkins, Paul Grant, Peter Muir, Kate Sibson, Hamish Mohammed, Katy Sinka, Rachel Pitt-Kendall, Helen Fifer","doi":"10.1136/sextrans-2024-056459","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056459","url":null,"abstract":"<p><strong>Objectives: </strong>Increasing ceftriaxone-resistant <i>Neisseria gonorrhoeae</i> is of public health concern. A cluster of ceftriaxone-resistant <i>N. gonorrhoeae</i> was identified in 2022, which was linked to heterosexuals from the Asia-Pacific region who were studying at UK universities. The possibility of further transmission within and beyond this network was of concern, particularly as not all gonococcal cases have a positive culture for antimicrobial susceptibility testing to be performed. We, therefore, undertook a case finding exercise using an <i>N. gonorrhoeae penA</i> real-time PCR to identify undetected transmission of ceftriaxone-resistant strains. The PCR detects <i>penA</i>-60.001, which is the most common gonococcal ceftriaxone-resistance mechanism. The aim of this Gonorrhoea Undetected Resistance Laboratory Study was to estimate the prevalence of undetected ceftriaxone-resistant <i>N. gonorrhoeae</i> in England.</p><p><strong>Methods: </strong>Sexually transmitted infection surveillance data (2017-2021) was combined with university data on student country of origin to identify sexual health services in English university towns with the highest number of gonorrhoea cases among those of Asian ethnicity born in selected countries of the Asia-Pacific region. Residual <i>N. gonorrhoeae</i>-positive molecular specimens from women (as a proxy for heterosexual behaviour) aged 18-30 years were sent to the UK Health Security Agency (UKHSA) for testing.</p><p><strong>Results: </strong>Between February 2023 and March 2024, 921 specimens meeting the inclusion criteria were received, of which 661 were reconfirmed as <i>N. gonorrhoeae</i>. Of these, one was positive on the <i>penA</i> PCR, indicating ceftriaxone resistance; this specimen came from a previously identified case, therefore no 'undetected' cases were identified.</p><p><strong>Conclusions: </strong>This case-finding exercise provided reassurance that ceftriaxone-resistant <i>N. gonorrhoeae</i> in England is currently adequately detected through the existing UKHSA-enhanced surveillance activities. The current <i>penA</i> PCR is a useful tool in the fight to keep gonorrhoea a treatable infection; however, it requires expansion as it does not currently detect all <i>penA</i> alleles responsible for ceftriaxone resistance.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568063","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":"Human papillomavirus vaccination uptake among men who have sex with men living with HIV.","authors":"Conor Moran, Jaime Garcia-Iglesias, Colm Kerr","doi":"10.1136/sextrans-2024-056361","DOIUrl":"10.1136/sextrans-2024-056361","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) is a very common sexually transmitted infection. Persistent infection with high-risk subtypes can lead to a variety of cancers. Men who have sex with men (MSM), particularly those who are living with HIV (MSMLWH), have a high prevalence of HPV infection and are at greatest risk of HPV-related diseases such as anal cancer. HPV vaccines are effective in preventing new infections, and many countries have implemented HPV vaccination for MSM.</p><p><strong>Methods: </strong>This systematic review aimed to examine HPV vaccine uptake among MSM and MSMLWH. Quantitative studies published between 2010 and 2022 were screened and included if they detailed HPV vaccination uptake data for MSM and MSMLWH. Identified studies were screened using Covidence, data were extracted from the final included studies and narratively synthesised, and risk of bias of studies was assessed using the Joanna Briggs Institute Checklist tool for prevalence studies.</p><p><strong>Results: </strong>There were 19 studies all from high-income countries, included in the final review. This review showed a wide variety of HPV vaccine uptake, ranging from 2.7% to 91.5% for HIV-negative MSM and among MSMLWH ranging from 5.6% to 90%. Although limited by the heterogeneity of studies and settings, there was evidence of a consistent, steady increase in HPV vaccination particularly among younger men. MSMLWH generally had higher rates of HPV vaccination, but overall HPV vaccine uptake remained suboptimal.</p><p><strong>Conclusion: </strong>MSMLWH are at high risk of HPV-related disease. Despite an available and efficacious vaccine in many countries, this review showed overall rates of HPV vaccination uptake remain inadequate. Further research and policy should aim to address and overcome barriers to HPV vaccination.PROSPERO registration numberCRD42023382251.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524305","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 incident infections during pre-exposure prophylaxis (PrEP) use in Wroclaw, Poland, 2017-2023: a real-life experience.","authors":"Bartosz Szetela, Karol Serwin, Mateusz Bozejko, Aleksander Zinczuk, Kamila Zielinska, Lukasz Lapinski, Aleksandra Szymczak, Anna Urbanska, Jacek Gąsiorowski, Miłosz Parczewski","doi":"10.1136/sextrans-2024-056329","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056329","url":null,"abstract":"<p><strong>Objectives: </strong>The efficacy of pre-exposure prophylaxis (PrEP) relies on adherence to effective regimens. As data on real-life PrEP roll-out and efficacy from Central and Eastern Europe are scarce, we explored the HIV incident infections among PrEP users in an observational cohort in Poland.</p><p><strong>Methods: </strong>A cohort of 887 men having sex with men (MSM) on generic emtricitabine/tenofovir disoproxil (FTC/TDF) were followed for a cumulative 2587 person years (PY). HIV infection was confirmed using molecular and immunoassays, with subtype and genotyping performed at diagnosis. For phylogenetic analysis, we used 2087 HIV-1 A6 partial <i>pol</i> sequences from Poland as background.</p><p><strong>Results: </strong>Nine (1%) PrEP users acquired HIV during the follow-up period. The estimated HIV incidence was 0.347 per 100 PY, with a relative risk reduction of 90.9%. All users who acquired HIV were cisgender white MSM of European origin (median age: 35.5 years). The majority (eight out of nine) used PrEP on demand (ie, 2-1-1 schedule), with one using PrEP only before receptive and not insertive sexual contacts and seven skipping the double dose. Infections occurred due to inadequate PrEP dosing. In five (55.6%) and four (44.4%) users, subtypes B and A6 were acquired, respectively, with no drug resistance. Each of the four A6 sub-subtypes belonged to distinct clusters. Three of them had distinct regional origins within Poland and one in Ukraine. Users were started on tenofovir alafenamide/emtricitabine/bictegravir at a median of 10.5 days from diagnosis and reached undetectable viral load (<50 copies/mL) at a median of 63 days.</p><p><strong>Conclusions: </strong>Overall, FTC/TDF PrEP was very effective, with failures occurring due to suboptimal adherence to on-demand dosing. Effective communication of HIV-related risks and clear instructions on how to use on-demand PrEP without missing doses should be provided to PrEP users. Despite the lack of transmitted drug resistance, we noted a higher number of infections with the A6 subtype and independent lineage introductions.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524303","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":"TESTATE STI project: an online chlamydia and gonorrhoea self-sampling strategy for gay, bisexual and other men who have sex with men and trans people in Catalonia (Spain).","authors":"Héctor Martínez-Riveros, Victoria Gonzalez Soler, Yesika Díaz, Marcos Montoro-Fernandez, Gema Fernandez-Rivas, Carles Pericas, David Palma, Marta Villar, Héctor Adell, Héctor Gonzalez Quiles, Javier Sotomayor Cortés, Silvia Gomez, Aida Ramirez Marinero, Pol Romano-de Gea, Esteve Muntada, Jordi Casabona, Cristina Agusti","doi":"10.1136/sextrans-2024-056394","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056394","url":null,"abstract":"<p><strong>Objectives: </strong>TESTATE STI is an online offer of self-sampling kits (SSKs) for the detection of <i>Chlamydia trachomatis</i> (CT) and <i>Neisseria gonorrhoeae</i> (NG) among gay, bisexual and other men who have sex with men (GBMSM) and transgender people (TG) in Catalonia. The aims of this study are: 1) to develop and evaluate the effectiveness, satisfaction and willingness of a pilot online intervention that includes the offer of SSKs for CT/NG screening with online consultation of subsequent results and (2) to analyse its potential as an effective strategy to encourage diagnosis, linkage to treatment and to describe contact notification by participants with a positive diagnosis.</p><p><strong>Methods: </strong>The distribution of SSKs, which included a urine collection tube, a pharyngeal and a rectal swab, was conducted through two recruitment strategies: autonomously via social media and GBMSM or TG leisure spaces, or accompanied by community-based organisations. Participants completed a socio-demographic, biobehavioural and satisfaction survey.</p><p><strong>Results: </strong>A total of 386 kits were tested in the laboratory. The estimated positivity rate for having at least one STI was 20.7%. TESTATE STI indicates that approximately 90.0% of positive participants were extragenital. 81.0% of positive cases were linked to the health system, and 96.9% of those were treated. We estimate that five kits must be performed to detect a positive CT/NG with the TESTATE STI intervention. Almost all participants (98.8%) would recommend taking the chlamydia and gonorrhoea self-sampling with TESTATE STI.</p><p><strong>Conclusion: </strong>The TESTATE STI project concluded that the deployment of SSKs for the detection of CT/NG is a viable and feasible strategy for GBMSM and TG in Catalonia. TESTATE STI is an effective strategy for encouraging diagnosis, treatment linkage and contact notification. Implementing TESTATE STI would increase access to confidential testing and promote early STI detection.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502152","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":"Systematic review exploring the burden of sexually transmissible infections and bloodborne viruses in refugees and asylum seekers: insights to inform policy and practice.","authors":"Wondimeneh Shiferaw, Beatris Mario Martin, Judith Ann Dean, Kenneth Koh, Deborah Mills, Colleen Lau, Luis Furuya-Kanamori","doi":"10.1136/sextrans-2024-056395","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056395","url":null,"abstract":"<p><strong>Background: </strong>In 2022, the number of refugees and asylum seekers (RAS) have reached an all-time high of 40.7 million globally. The surge in RAS, coupled with their limited access to healthcare (at their home and destination countries), has led to the risk of transmitting/acquiring sexually transmissible infections (STIs) and bloodborne viruses (BBVs). This situation threatens the health of RAS and poses a public health challenge to destination countries, potentially placing a burden on healthcare systems and resources. Healthcare recommendations for screening programmes for RAS vary between countries, leading to disparities in STI/BBV screening practices on arrival. These disparities can impact early detection and treatment of STIs/BBVs, increasing the risk of onward transmission and long-term negative sequelae. Therefore, this systematic review aims to investigate the prevalence and factors associated with STIs/BBVs among RAS.</p><p><strong>Methods: </strong>Six databases (ie, PubMed, Embase, Scopus, Cochrane Library, Web of Science and CINAHL) were searched for observational studies reporting STIs/BBVs prevalence and/or risk factors among RAS. The inverse variance heterogeneity model with double arcsine transformation was applied to prevalence meta-analysis of STIs/BBVs by region of origin of RAS. Narrative data synthesis was undertaken to summarise risk factors associated with STIs/BBVs.</p><p><strong>Results: </strong>A total of 21 studies (n=504 432 RAS) were included. Most studies were conducted among RAS arriving in Europe (n=14), followed by North America (n=5) and Australia (n=2). The highest prevalence of HIV (1.55%; 95% CI 0.53 to 3.04), syphilis (1.29%; 95% CI 0.59 to 2.24) and hepatitis B (6.50%; 95% CI 2.29 to 12.46) were observed among RAS from sub-Saharan Africa. The highest prevalence of hepatitis C was found in RAS from Southeast Asia (3.96%; 95% CI 2.74 to 5.38) and North Africa (3.59%; 95% CI 1.33 to 6.79). The highest prevalence of chlamydia was reported among RAS from the Middle East (1.48%; 95% CI 0.00 to 4.73) and Eastern Europe (1.40%; 95% CI 0.38 to 4.96). History of STIs, torture, blood transfusion and African origin were identified as factors associated with increased prevalence of STIs/BBVs.</p><p><strong>Conclusions: </strong>This study underscores the regional disparities in the burden of STIs/BBVs among RAS. These findings highlight the importance of targeted screening for STIs/BBVs based on the country/region of origin and individual risk factors, and implementation of mitigation measures (eg, improving healthcare access and raising awareness) tailored to their unique needs. Such measures are crucial for reducing the impact of STIs/BBVs in both RAS and host countries.</p><p><strong>Prospero registration number: </strong>CRD42024546750.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143503772","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}