Sexually Transmitted Infections最新文献

{"title":"Awareness, attitudes and early use of doxycycline prophylaxis among gbMSM in Ireland: findings from a 2025 community-based cross-sectional survey.","authors":"John Gilmore, David J Field, Helen Kelly, Robert Lawlor, Chris Noone, Michael Traeger, John White","doi":"10.1136/sextrans-2025-056745","DOIUrl":"10.1136/sextrans-2025-056745","url":null,"abstract":"<p><strong>Background: </strong>Bacterial sexually transmitted infections (STIs) remain a growing public health challenge globally, with gay, bisexual and other men who have sex with men (gbMSM) disproportionately affected. Doxycycline postexposure prophylaxis (DoxyPEP) has been shown in clinical trials to reduce syphilis and chlamydia, and has been incorporated into US and UK guidelines. However, community-level data in many European countries remain scarce. This study aimed to assess awareness, attitudes and early use of DoxyPEP among gbMSM in Ireland.</p><p><strong>Methods: </strong>An anonymous, cross-sectional online survey was conducted between May and June 2025. Eligible participants were aged ≥18 years, identified as male (cis or trans) or non-binary/gender diverse and reported sex with a man in the past 12 months. The questionnaire covered demographics, sexual behaviours, STI/HIV history, awareness and use of antibiotics for STI prevention and attitudinal measures. Descriptive statistics summarised findings, and logistic regression identified predictors of DoxyPEP use.</p><p><strong>Results: </strong>A total of 149 participants completed the survey, with a mean age of 36.4 years (range: 22-67); 92.6% were cisgender men and 86.6% identified as gay. Awareness of antibiotic STI prophylaxis was high (83.2%), and 69.1% expressed strong interest in future use. Over one-quarter (29.5%) reported DoxyPEP use in the past 12 months, almost exclusively at the recommended 200 mg dose. DoxyPEP use was associated with previous HIV PEP use (adjusted OR (AOR) 3.02 s, 95% CI 1.35 to 6.73) and group sex (AOR 3.27, 95% CI 1.26 to 8.59). Most participants reported sourcing antibiotics informally, including online or through friends. Antimicrobial resistance was the most common concern reported (69.8%).</p><p><strong>Conclusion: </strong>Despite the absence of national guidelines on the use of DoxyPEP for STI prevention, over one-quarter of participants reported using DoxyPEP, with high awareness and demand for structured access. These findings highlight the urgency for evidence-based, internationally aligned policies that ensure safe and equitable delivery, integrated within sexual health services and underpinned by antimicrobial stewardship.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"380-386"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985409","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":"Revisiting gonorrhoea prevention in the era of resistance and biomedical interventions.","authors":"Justyna D Kowalska, Jean-Michel Molina, Ismael Maatouk, Thibaut Vanbaelen, Angelo Roberto Raccagni, Giovanni Villa, Drieda Zace, Anna Maria Geretti","doi":"10.1136/sextrans-2025-056896","DOIUrl":"10.1136/sextrans-2025-056896","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"345-349"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988841","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":"From silos to synergies: harnessing the power of sexual health data sources in England to understand changing epidemiology and inform policy.","authors":"Dana Ogaz, Anika Knuppel, Emily Trickett, Soazig Clifton, Charles Beck, Magnus Unemo, Pam Sonnenberg, Hamish Mohammed, Catherine H Mercer, Kate Soldan, Katy M Turner, Nigel Field","doi":"10.1136/sextrans-2025-056754","DOIUrl":"10.1136/sextrans-2025-056754","url":null,"abstract":"<p><strong>Objectives: </strong>Following major changes to sexual health provision in England in the past decade, monitoring and evaluation of population-level interventions require re-examination to ensure quality and visibility of key communities. We make the case that sexual health data sources might be used synergistically to improve sexual health and tackle inequalities.</p><p><strong>Methods: </strong>We conducted a purposive narrative review to (1) describe national sexual health policy and provision changes in England in the past decade (2012 onwards), (2) map key sexual health data resources and (3) demonstrate how integrated data-driven approaches can be used to understand and evaluate population-level sexual health policy.</p><p><strong>Results: </strong>There have been major changes at a national and regional level in the availability, targeting and implementation of HIV and sexually transmitted infection (STI) interventions, including through high-level shifts in funding structures, expansion of online services and pathogen-focused policies. Synergistic use of the many data sources available takes advantage of their different features. For example, for HIV, integration of nationally representative behavioural surveys that include people not accessing care (eg, National Surveys of Sexual Attitudes and Lifestyles), targeted surveys (eg, Reducing inequalities in Sexual Health surveys for gay, bisexual and other men who have sex with men (GBMSM)) and national STI/HIV surveillance for people accessing care (eg, GUMCAD STI Surveillance System) can be used to inform progress towards HIV elimination in England through assessment of online and postal-based self-sampling and inequalities in HIV testing uptake in populations and key communities such as GBMSM.</p><p><strong>Conclusion: </strong>In the face of rapid change, approaches that integrate complementary data sources have the potential to harness the strengths of individual assets and mitigate limitations to form a more complete assessment of population-level interventions and should guide sexual health policy and practice in the decade to come. Effective data integration requires addressing a range of methods, mandates and challenges to strengthen contemporary research, monitoring and evaluation.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"401-408"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206000","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":"Diarrhoea as a frequent adverse event after intramuscular ertapenem treatment for uncomplicated <i>Neisseria gonorrhoeae</i>: a secondary analysis from the NABOGO trial.","authors":"Buhari Teker, Maarten Schim van der Loeff, Anders Boyd, Ron Mathot, Alje van Dam, Henry de Vries, Vita Willemijn Jongen","doi":"10.1136/sextrans-2025-056735","DOIUrl":"10.1136/sextrans-2025-056735","url":null,"abstract":"<p><strong>Objectives: </strong>The New AntiBiotic treatment Options for uncomplicated GOnorrhoea trial compared the efficacy of gentamicin, ertapenem and fosfomycin with ceftriaxone. Ertapenem was non-inferior to ceftriaxone for treating <i>Neisseria gonorrhoeae</i>, but participants receiving ertapenem commonly reported having diarrhoea. We assessed diarrhoea trajectories, estimated the probability of remaining with diarrhoea over time and identified determinants of diarrhoea.</p><p><strong>Methods: </strong>Participants were randomly assigned (1:1:1:1) to receive intramuscular 5 mg/kg gentamicin (maximum 400 mg), intramuscular 1000 mg ertapenem, oral 6 g fosfomycin or intramuscular 500 mg ceftriaxone (control group). Following antibiotic treatment, participants self-reported adverse events, including diarrhoea, in a paper diary until 30 days after treatment. In this secondary analysis, we assessed the frequency of diarrhoea in each study arm. Kaplan-Meier methods were used to estimate the probability of remaining with diarrhoea over time in each study arm. Determinants of diarrhoea in the ertapenem arm were assessed using relative risk regression.</p><p><strong>Results: </strong>Among 343 participants randomised, 2/102 (2.0%) in the gentamicin arm, 49/97 (50.5%) in the ertapenem arm, 32/37 (86.5%) in the fosfomycin arm and 11/103 (10.7%) in the ceftriaxone arm reported diarrhoea. Median duration of diarrhoea varied between 1 and 2 days across arms. In the ertapenem arm, only having an anal <i>N. gonorrhoeae</i> and/or anal <i>Chlamydia trachomatis</i> infection (prevalence ratio=2.29, 95% CI 1.04 to 5.02) was associated with increased diarrhoea risk.</p><p><strong>Conclusions: </strong>Ertapenem was associated with high frequency of diarrhoea, which was mostly short-lived. Continued evaluation of the tolerability of ertapenem could help increase acceptability of this potential second-line treatment against <i>N. gonorrhoeae</i>.</p><p><strong>Trial registration number: </strong>NCT03294395.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"394-397"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990617","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":"Inaction against HIV/AIDS remains a crime against humanity.","authors":"Julio S G Montaner, Reuben Granich, Brian Williams, Sindisiwe Shangase, Robert S Hogg","doi":"10.1136/sextrans-2025-056807","DOIUrl":"10.1136/sextrans-2025-056807","url":null,"abstract":"<p><p>HIV infection is 100% fatal; however, antiretroviral therapy prevents illness, death and transmission-delaying access to treatment is a death sentence while also leading to the spread of HIV. More recently, antiretroviral chemoprophylaxis (commonly known as pre-exposure prophylaxis or PrEP) has been shown to prevent HIV infection among individuals at high risk. In 2003, President George W Bush established the President's Emergency Plan for AIDS Relief (PEPFAR), the largest commitment by any nation to address a single disease. Over the last two decades, PEPFAR provided antiretroviral treatment to more than 20 million people, saved over 25 million lives, enabled more than 7 million babies to be born free of HIV and helped cut new HIV infections by half in the most impacted countries. Earlier last year, the US administration drastically cut overseas development funding, severely compromising PEPFAR's ability to deliver life-saving HIV services. UNAIDS modelling shows that if the funding permanently disappears, there could be an additional 6 million HIV infections and an additional 4 million AIDS-related deaths by 2029. We urge the US administration and the G7 leadership to reflect carefully on the likely and grave consequences of dismantling one of the most successful initiatives in the history of global health.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"398-400"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146066523","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":"Missed opportunities for anal cancer (AC) screening in women living with HIV: results from a survey across the European region.","authors":"Dagny Clea Krankowska, Maria Mazzitelli, Deborah Konopnicki, Eva Orviz, Hazal Albayrak Ucak, Konstantinos Protopapas, Harriet Mortimer, Elena Barzizza, Alessandro Fanesi, Yvonne Gilleece, Karoline Aebi-Popp","doi":"10.1136/sextrans-2025-056687","DOIUrl":"10.1136/sextrans-2025-056687","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of anal cancer (AC) is higher in women with HIV than in women without HIV due to immunosuppression and persistence of human papilloma virus (HPV). Since 2024, the International Anal Neoplasia Society's and European AIDS Clinical Society (EACS) guidelines recommend annual AC screening of cisgender women (CW) of ≥45 years old, transgender women (TW) of ≥35 years old and women with previous vulvar high-grade squamous intraepithelial lesion (HSIL)/cancer regardless of age. This study describes current clinical practices and protocols for AC screening in women with HIV within healthcare settings across WHO European Region (WER).</p><p><strong>Methods: </strong>Between November 2024 and January 2025, an anonymous online survey on AC screening and prevention in persons with HIV was disseminated among healthcare workers in the WER via the EACS website, social networks and e-mails.</p><p><strong>Results: </strong>Among the 240 participants, 28.1% declared following national AC screening guidelines. Of those, 43.3%, 20.9% and 19.4% stated that CW, TW and women with previous vulvar HSIL/cancer, respectively, were not included in AC screening guidelines. Of those who answered the question, 37.7% respondents routinely asked CW about AC symptoms; 12.5% and 25.0% of respondents performed digital anal rectal examination annually in cis and trans gender women, respectively.Anal cytology was not routinely available in 23.2% and HPV genotyping in 20.8% of clinical settings. High-resolution anoscopy was not accessible for 37.2% of respondents and was more available in Western (68.2%) than in Central/Eastern Europe (44.6%). 26.4% of respondents did not routinely suggest HPV vaccination to adult CW. Main barriers to AC screening among women were lack of resources (47.9%), integrated resources (47.5%) and guidelines (46.6%).</p><p><strong>Conclusion: </strong>Women with HIV are often omitted in national guidelines and practices for AC screening in Europe. Screening methods are often not accessible. More education of healthcare workers is needed about benefits of AC screening and HPV vaccination for women with HIV.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"350-355"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145564941","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":"Prevalence and co-occurrence of sexually transmitted infections among heterosexual couples in southern Uganda: a population-based study.","authors":"Michelle Anne Moffa, Austin D Peer, Aaron Tobian, Xinyi Feng, Josephine Mpagazi, Yukari Carol Manabe, Charlotte A Gaydos, Caitlin E Kennedy, Robert Ssekubugu, Steven Reynolds, Jade Jackson, Godfrey Kigozi, Larry W Chang, Thomas Quinn, Joseph Kagaayi, Mary K Grabowski, Ronald Moses Galiwango","doi":"10.1136/sextrans-2025-056709","DOIUrl":"10.1136/sextrans-2025-056709","url":null,"abstract":"<p><strong>Objective: </strong>Partner-level sexually transmitted infection (STI) data from eastern Africa are rare, despite high STI burden. To address this gap, we examined STI prevalence and clustering among cohabiting couples in two high HIV-burden Ugandan communities, representing the largest population-based, couple-level STI study in the region.</p><p><strong>Methods: </strong>We analysed data from the Sexually Transmitted Infection Prevalence Study (STIPS), a cross-sectional, population-based study in southern Uganda which tested participants for chlamydia, gonorrhoea, trichomonas, syphilis, high-titre syphilis and herpes simplex virus-2 (HSV-2). We restricted the present analysis to STIPS participants in a cohabiting sexual relationship. Poisson regression with robust standard errors was used to estimate prevalence ratios (PRs) and corresponding 95% confidence intervals (CIs) of all STIs by partner's infection status.</p><p><strong>Results: </strong>Among 423 cohabiting heterosexual couples, at least one partner tested positive for a curable STI (chlamydia, gonorrhoea, trichomonas or high-titre syphilis) in 37% of couples. STIs were strongly clustered within partner dyads. For example, female participants with male partners with gonorrhoea had increased prevalence of not only gonorrhoea (PR 10.4, 95% CI 6.4 to 16.8) but also HIV (PR 2.2, 95% CI 1.5 to 3.2), chlamydia (PR 2.5, 95% CI 1.1 to 5.7), trichomonas (PR 2.4, 95% CI 1.2 to 4.7) and HSV-2 (PR 1.3, 95% CI 1.1 to 1.7).</p><p><strong>Conclusion: </strong>Partners of individuals with an STI are more likely to have a curable STI, which may be the same or may be a different pathogen; broad screening of partners could be essential to curbing transmission and preventing reinfection. Comprehensive couple-based approaches, including partner notification, treatment and counselling strategies, are critical for reducing STI disease burden.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"387-390"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744123","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":"Research news in clinical context.","authors":"Angelo Roberto Raccagni, Marina Daskalopoulou, Rachel Herbert, Drieda Zace","doi":"10.1136/sextrans-2025-056819","DOIUrl":"https://doi.org/10.1136/sextrans-2025-056819","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":"102 6","pages":"411-412"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148797754","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":"Recommendations for developing asynchronous online consultations for chlamydia treatment for underserved populations: a Behaviour Change Wheel analysis.","authors":"Claudia S Estcourt, Julie McLeod, Paul Flowers, Jennifer MacDonald, Fiona Mapp, John Saunders, Melvina Woode Owusu, Amelia McInnes-Dean, Nuria Gallego Márquez, Ann Blandford, Pam Sonnenberg, Jo Gibbs","doi":"10.1136/sextrans-2025-056677","DOIUrl":"10.1136/sextrans-2025-056677","url":null,"abstract":"<p><strong>Introduction: </strong>People from underserved groups experience disproportionately poor sexual health and challenges accessing care. Asynchronous online consultations (a user completes a health questionnaire online, which is reviewed by a clinician) are being used within sexual healthcare to prescribe chlamydia treatment. Users require sufficient health and digital literacy to access online services and use them safely.</p><p><strong>Methods: </strong>We used the PROGRESS-Plus (PROGRESS: Place of Residence, Race/Ethnicity, Occupation, Gender/Sex, Religion, Education, Socio-economic Status, Social Network; Plus: e.g., Age, Sexual Orientation, Disability) framework to guide purposive recruitment of 35 participants from diverse underserved groups, from community settings and sexual health services in contrasting areas of the UK (15 October 2021-18 March 2022). We conducted qualitative semistructured interviews and thematic analyses to derive key barriers and facilitators to using asynchronous online consultations. We applied the Behaviour Change Wheel to specify recommendations to address them.</p><p><strong>Results: </strong>Over half of participants were from the most deprived areas and 40% were from minoritised ethnic groups. Key barriers included: lack of familiarity with online healthcare; perceived need to see a healthcare professional in person; privacy concerns; concerns about difficulty interpreting the questions; discomfort answering personal questions online. Key facilitators included: familiarity with online consultations; perceived low sexually transmitted infection risk; perceived increase in convenience, control and privacy; simple wording and design; and support while completing them. Recommendations included: increasing awareness and familiarity by promoting them offline and online and providing demonstrations and instructions on how to use them; encouraging people to choose them by highlighting available support, equivalence to in-person consultations and privacy and convenience; and reducing attrition by using simple wording and design, providing additional explanations and offering audio and visual alternatives to text.</p><p><strong>Conclusions: </strong>Incorporating these evidence-based, theoretically informed recommendations could widen access to underserved groups and increase the usability and safety of asynchronous online consultations for chlamydia treatment. Recommendations are likely to benefit all users and could be of use across health more broadly.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"372-379"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934946","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":"High prevalence and incidence of curable sexually transmitted infections among young women using oral HIV pre-exposure prophylaxis in sub-Saharan Africa: results from the INSIGHT Cohort study.","authors":"Irene Mukui, Sue Peacock, Deborah Donnell, Brenda Gati-Mirembe, Meighan Krows, Elizabeth A Bukusi, Loveness Imaan, Philip Kotze, Katherine Margaret Gill, Pippa Macdonald, Cheryl Louw, Manjeetha Jaggernath, Anita Marais, Remco P H Peters, Sinead Delany-Moretlwe, Amy Ward, Phillip du Preez, Margaret Kasaro, Monica Gandhi, Renee Heffron, Connie Celum","doi":"10.1136/sextrans-2025-056625","DOIUrl":"10.1136/sextrans-2025-056625","url":null,"abstract":"<p><strong>Background: </strong>HIV pre-exposure prophylaxis (PrEP) programmes in Africa reach young women at risk of sexually transmitted infections (STIs). We evaluated curable STI prevalence, incidence and risk factors among women initiating PrEP.</p><p><strong>Methods: </strong>From August to December 2022, sexually active women aged 16-30 years from 15 South African sites, and one site each in Eswatini, Kenya, Malawi, Uganda and Zambia were enrolled into the INSIGHT cohort and offered oral emtricitabine/tenofovir PrEP with follow-up at 1, 3 and 6 months. At each visit, STI symptoms were assessed and treatment provided based on syndromic management or diagnostic testing. Diagnostic tests included nucleic acid amplification for <i>Chlamydia trachomatis</i> and <i>Neisseria gonorrhoeae</i>, the rapid OSOM for <i>Trichomonas vaginalis</i> at enrolment and month 6, and serological testing for syphilis at enrolment using rapid plasma reagin with confirmatory <i>Treponema pallidum</i> particle agglutination. Prevalence and incidence of each STI were calculated, and predictors assessed using multivariable regression.</p><p><strong>Results: </strong>Of 3087 participants offered daily oral PrEP with a median age of 23 (IQR 21-27), 3011 had STI results and 30.9% had one or more STIs, with 15.7% reporting symptoms. The prevalence of <i>C. trachomatis</i>, <i>N. gonorrhoeae</i>, <i>T. vaginalis</i> and syphilis was 20.8%, 6.8%, 6.0% and 4.4%, respectively. The incidence of one or more STIs (<i>C. trachomatis</i>, <i>N. gonorrhoeae</i> or <i>T. vaginalis</i>) was 49.3/100 person-years (95% CI 45.3 to 53.4) with 12.7% reporting symptoms. The incidence of <i>C. trachomatis</i> was 30.6/100 person-years (95% CI 27.5 to 33.7), <i>N. gonorrhoeae</i> 10.8/100 person-years (95% CI 9.0 to 12.6) and <i>T. vaginalis</i> 11.5/100 person-years (95% CI 9.7 to 13.4). An incident STI diagnosis was associated with low alcohol use (adjusted incidence rate ratio (aIRR) 1.3; 95% CI 1.0 to 1.6) and moderate alcohol use (aIRR 1.4; 95% CI 1.1 to 1.8), and having an STI diagnosed at enrolment (aIRR 1.8; 95% CI 1.5 to 2.1).</p><p><strong>Conclusion: </strong>The high prevalence and incidence of STIs among African women initiating PrEP, most of whom did not report symptoms, highlights the need for aetiologic testing to detect STIs, guide treatment and reduce reproductive health sequelae and risk of transmission.</p><p><strong>Trial registration number: </strong>clinicaltrials.gov NCT05746065.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"364-371"},"PeriodicalIF":3.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834603","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}