Sexually Transmitted Infections最新文献

{"title":"Interesting case of syphilis with atypical vegetative lesions.","authors":"Luca Pipitò, Roberta Gaudiano, Floriana Di Figlia, Edoardo Mandalà, Cinzia Calà, Giuseppina Capra, Antonio Cascio","doi":"10.1136/sextrans-2024-056367","DOIUrl":"10.1136/sextrans-2024-056367","url":null,"abstract":"<p><p>Syphilis is a re-emerging disease, and suspicion of syphilis infection should be considered in all cases with atypical skin manifestations, mainly when there is a history of unprotected sexual intercourse. Here, we describe a case of secondary syphilis in a woman aged 42 years, who presented with an atypical, painful and itchy skin rash with vegetative cerebriform lesions, which resolved after the administration of penicillin. Multiplex PCR targeting <i>Treponema pallidum</i> on vaginal and lesion swabs, along with syphilis serology, confirmed the diagnosis.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786935","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":"Differences in HIV risk factors between South African adolescents and adult women and their association with sexually transmitted infections.","authors":"Pamela Mkhize, Celia Mehou-Loko, Nokuthula Maphumulo, Nina Radzey, Andrea G Abrahams, Sengeziwe Sibeko, Rushil Harryparsad, Monalisa Manhanzva, Bahiah Meyer, Phumla Radebe, Lenine J P Liebenberg, Sinaye Ngcapu, Nadia Ahmed, Funeka Busakwe, Noluthando Mqaba, Derseree Archary, Aida Sivro, Natasha Samsunder, Disebo Potloane, William Horsnell, Christine Jordan, Quarraisha Abdool Karim, Linda-Gail Bekker, Jo-Ann Passmore, Heather Jaspan, Hilton Humphries, Lindi Masson","doi":"10.1136/sextrans-2024-056260","DOIUrl":"10.1136/sextrans-2024-056260","url":null,"abstract":"<p><strong>Objectives: </strong>In sub-Saharan Africa, approximately 86% of HIV infections in adolescents aged 15-19 years occur among girls. Their heightened susceptibility is likely influenced by converging sociobehavioural and biological factors, although the relative contributions remain unclear. To address this, we compared known and hypothesised risk factors for HIV between cisgender adolescent girls and adult women in South Africa and evaluated the relationships between these factors and sexually transmitted infection (STI) status.</p><p><strong>Methods: </strong>This cross-sectional observational study included adolescent (n=305; 14-19 years) and adult females (n=114; 25-35 years) in two South African provinces (Western Cape (WC), KwaZulu-Natal (KZN)). Demographic and sociobehavioural data were collected by questionnaire. Colposcopy was conducted to identify cervicovaginal abnormalities, and tests for bacterial vaginosis (BV), <i>Chlamydia trachomatis</i>, <i>Neisseria gonorrhoeae</i> and <i>Trichomonas vaginalis</i> were performed.</p><p><strong>Results: </strong>Adults reported higher risk sexual behaviour than adolescents across multiple variables, although adolescents were more likely to have STIs than adults (62.8% vs 34.0%, respectively, p=0.0010 for WC; 42.5% vs 16.4%, respectively, p=0.0002 for KZN). Adolescents did, however, report earlier sexual debut (16 years old vs 17 years old, p<0.0001 for both sites) and KZN adolescents were more likely to use intravaginal sexual enhancers than adults (34.6% vs 20.6%, respectively, p=0.0417). Numbers of sexual partners (β-coefficient: 0.34, SE: 0.12, p=0.0054) and sex acts within the previous 3 months (β-coefficient: 0.25, SE: 0.09, p=0.0062) were associated with STIs in adolescents and trended to significance for adults. Intravaginal sexual enhancer use (KZN only; β-coefficient: 0.95, SE: 0.38, p=0.0118) and biological risk factors, including BV Nugent score (β-coefficient: 0.09, SE: 0.04, p=0.0257) and signs of cervicovaginal injury/inflammation (β-coefficient: 1.07, SE: 0.45, p=0.0171), were associated with STIs in adolescents but not adults.</p><p><strong>Conclusions: </strong>Risk factors for STIs including HIV may differ between age groups of girls and women, and mitigation interventions may need to be tailored accordingly.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780976","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":"Syphilis prevalence among a large regional online postal self-sampling STI testing service (OPSS).","authors":"Sara Louise Day, Jessica Collins, Jonathan Spate, Sophie Jones, Efejiro Ashano, David Asboe","doi":"10.1136/sextrans-2024-056309","DOIUrl":"10.1136/sextrans-2024-056309","url":null,"abstract":"<p><strong>Objectives: </strong>In England, infectious syphilis diagnoses have reached the highest annual number since 1948. Fifty per cent of syphilis testing is now provided through online postal self-sampling sexually transmitted infection (STI) testing services (OPSS). To reduce the burden of syphilis, we need to understand the syphilis prevalence and transition to treatment rates among service users of OPSS. This report aims to estimate syphilis prevalence among people accessing Sexual Health London (SHL), a regional, National Health Service (NHS)-funded OPSS.</p><p><strong>Methods: </strong>Demographic, STI concurrency, sexual behaviour data and case outcomes were collected from SHL service users who received testing for syphilis between 8 March 2022 and 30 June 2023. Data were analysed to identify syphilis prevalence and transition to care rates.</p><p><strong>Results: </strong>458 520 syphilis tests were performed for 267 780 service users. 12 870 (2.8%) results were reactive. Their assigned case outcomes comprised: 10 048 (78.1%) past adequately treated syphilis; 971 (7.5%) treated for active syphilis; 1293 (10.1%) SHL results did not subsequently confirm and 558 (4.3%) had an unknown final outcome. Of unique users, 0.4% (940/267 780) received syphilis treatment at least once. They were: 89.3% aged ≥25 years, 87.3% male, 83.7% gay/bisexual. Co-infections identified were: chlamydia (14%), gonorrhoea (13.3%) and previously undiagnosed HIV (1.5%). 36.1% (339) took pre-exposure HIV prophylaxis, 30.1% engaged in sex parties/group sex and 26.8% had sex under the influence of drugs/alcohol. Individuals aged ≥35 years, of non-female gender, gay/bisexual, from indices of multiple deprivation (1-5) and from certain racially minoritised communities were statistically more likely to require treatment for syphilis than the overall testing population (p<0.05).</p><p><strong>Conclusion: </strong>Estimated syphilis prevalence (0.4%) was comparable to rates within national sexual health clinics and the demographic characteristics of those most affected by syphilis were also similar. Further work is required to improve the integration between NHS OPSS and sexual health clinics and to enable OPSS to more accurately input data on treatment and diagnoses towards national surveillance statistics.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781063","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":"Treatment of asymptomatic chlamydia and gonorrhoea drives antibiotic consumption in PrEP cohorts.","authors":"Thibaut Vanbaelen, Sheeba Santhini Manoharan-Basil, Chris Kenyon","doi":"10.1136/sextrans-2024-056381","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056381","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755448","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":"Mpox vaccination uptake in a UK community sample of gay, bisexual and other men who have sex with men (GBMSM) the year following the 2022 clade IIb mpox outbreak.","authors":"Dolores Mullen, Jessica Edney, Dawn Phillips, Ruth Wilkie, David Reid, Catherine M Lowndes, Erna Buitendam, Katy Sinka, Sema Mandal, Catherine H Mercer, John Saunders, Hamish Mohammed, Dana Ogaz","doi":"10.1136/sextrans-2024-056358","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056358","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682251","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 of sexually transmitted infection in pregnancy and their association with adverse birth outcomes: a case-control study at Queen Elizabeth Central Hospital, Blantyre, Malawi.","authors":"Charlotte van der Veer, Chifundo Kondoni, Annie Kuyere, Fatima Mtonga, Vita Nyasulu, George Shaba, Chelsea Morroni, Gladys Gadama, Luis Gadama, Kondwani Kawaza, Queen Dube, Neil French, David Lissauer, Bridget Freyne","doi":"10.1136/sextrans-2024-056130","DOIUrl":"10.1136/sextrans-2024-056130","url":null,"abstract":"<p><strong>Background: </strong>There are limited data on the epidemiology of sexually transmitted infections (STI) and their contribution to adverse birth outcomes (ABO) in sub-Saharan Africa (SSA). We performed a case-control study to assess the prevalence of STI and their association with ABO among women attending Queen Elizabeth Central Hospital, Blantyre, Malawi.</p><p><strong>Methods: </strong>A composite case definition for ABO included stillborn, preterm and low birthweight infants and infants admitted to neonatal intensive care unit within 24 hours of birth. Following recruitment of an infant with an ABO, the next born healthy infant was recruited as a control. Multiplex PCR for <i>Neisseria gonorrhoeae</i> (NG), <i>Chlamydia trachomatis</i> (CT) and <i>Trichomonas vaginalis</i> (TV) was performed on maternal vaginal swabs. HIV and syphilis status was determined on maternal and infant serum. For syphilis, we used combined treponemal/non-treponemal rapid point-of-care tests in parallel with rapid plasma reagin tests, PCR for <i>Treponema pallidum</i> and clinical parameters to diagnose and stage the infection. We compared STI positivity between cases and controls.</p><p><strong>Results: </strong>We included 259 cases and 251 controls. Maternal prevalence of STI was 3.1%, 2.7% and 17.1% for NG, CT and TV, respectively. Maternal prevalence of untreated syphilis was 2.0% and 6.1% for early stage and late/unknown stage, respectively; prevalence of treated syphilis was 2.7%. The HIV prevalence was 16.5%. HIV infection significantly increased the odds for ABO (OR=3.31; 95% CI 1.10 to 9.91) as did NG positivity (OR=4.30; 95% CI 1.16 to 15.99). We observed higher rates of ABO among women with untreated maternal syphilis (early: OR=7.13; 95% CI 0.87 to 58.39, late/unknown stage: OR=1.43; 95% CI 0.65 to 3.15). Maternal TV and CT infections were not associated with ABO.</p><p><strong>Conclusion: </strong>STI prevalence among pregnant women in Malawi is comparable to other SSA countries. HIV, NG and untreated syphilis prevalence was higher among women with ABO compared with women with healthy infants.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"517-523"},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752631","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":"Research news in clinical context.","authors":"Nadja A Vielot, Weiming Tang, Giovanni Villa","doi":"10.1136/sextrans-2023-056078","DOIUrl":"10.1136/sextrans-2023-056078","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":"100 8","pages":"545-546"},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669037","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":"Phagedenic chancres: a neglected diagnosis?","authors":"Giulia Ciccarese, Cristian Fidanzi, Agata Janowska, Gaetano Serviddio, Francesco Drago","doi":"10.1136/sextrans-2024-056161","DOIUrl":"10.1136/sextrans-2024-056161","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"540-541"},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459069","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":"Making sexual and reproductive healthcare environments safe and supportive for disclosure of sexual violence: interview findings from patients and healthcare professionals using a realist approach.","authors":"Rachel J Caswell, Jonathan Dc Ross, Caroline Bradbury-Jones","doi":"10.1136/sextrans-2024-056140","DOIUrl":"10.1136/sextrans-2024-056140","url":null,"abstract":"<p><strong>Objectives: </strong>Most people who have experienced sexual violence (SV) will disclose the event(s) to someone. Key recipients of disclosure are those working in healthcare. Telling someone in healthcare about experiences of SV can be an important step in accessing necessary medical care and being signposted to other services. While recognising healthcare settings are a key place for people to seek support, evidence is lacking about how best to create a safe environment for disclosure to take place, how services can make changes to better facilitate this experience and what changes matter most.</p><p><strong>Design: </strong>This study used a realist approach to identify mechanisms that facilitate safe and supported disclosure. Data were generated through three focus groups with Sexual and Reproductive Health Services healthcare professionals in the UK, and one-to-one interviews with survivors of SV who attended healthcare settings (n=18).</p><p><strong>Results: </strong>The analysis found that service users needed to feel empowered and recognised as appropriate candidates for care in the material used to promote sexual healthcare services after SV. This promotional material needs to address rape myths, stereotypes and silence surrounding SV, to ensure that all individuals and especially those from diverse groups are empowered to access care. Three fundamental mechanisms for safe and supported disclosure were identified: being listened to, being validated and having choice. Trauma-informed care was identified as being essential for implementing these mechanisms. Healthcare professionals who were confident and competent regarding enquiry about SV and response to disclosures of SV were key.</p><p><strong>Conclusions: </strong>The development of services that are conducive to the disclosure of SV is needed to provide better support for those who have experienced SV and are ready to seek support. Use of appropriate promotional material, specific staff training and a trauma-informed approach are key elements to improve services.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"492-496"},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318208","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":"Clinical spectrum of late symptomatic neurosyphilis in China: an 11-year retrospective study.","authors":"Yilan Yang, Xin Gu, Lin Zhu, Yuanyuan Cheng, Haikong Lu, Zhifang Guan, Mei Shi, Liyan Ni, Rui-Rui Peng, Wei Zhao, Juan Wu, Tengfei Qi, Fuquan Long, Zhe Chai, Weiming Gong, Meiping Ye, Pingyu Zhou","doi":"10.1136/sextrans-2024-056117","DOIUrl":"10.1136/sextrans-2024-056117","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to describe the clinical features of neurosyphilis in Chinese patients in an attempt to find clinical features that are helpful for the early identification of neurosyphilis.</p><p><strong>Methods: </strong>This retrospective study included people with syphilis who visited Shanghai Skin Disease Hospital between January 2010 and December 2020. Lumbar puncture was performed on those who met the inclusion and exclusion criteria. The diagnosis of neurosyphilis was based on clinical and laboratory findings. The parameters were analysed statistically.</p><p><strong>Results: </strong>Of the 3524 patients with neurosyphilis, 2111 (59.9%) and 1413 (40.1%) were asymptomatic and symptomatic neurosyphilis, respectively. General paresis was the most common type of symptomatic neurosyphilis (46.8%). The clinical manifestations of symptomatic neurosyphilis include psychiatric and neurotic symptoms, among which general paresis predominantly presented as psychiatric symptoms such as affective (66.7%) and memory disorder (72.9%). Tabes dorsalis is often presented as neurotic symptoms. One hundred fifty patients (10.6%) with symptomatic neurosyphilis presented candy signs, a rare and specific neurosyphilis symptom that is common in general paresis. Girdle sensation was presented in 13 patients, mainly with tabes dorsalis, which had not been reported in previous studies.</p><p><strong>Conclusions: </strong>Notably, the candy sign is identified as a specific symptom of general paresis, while girdle sensations are highlighted as a particular symptom of tabes dorsalis. This is the largest study describing the clinical spectrum of neurosyphilis since the onset of the penicillin era and could help doctors learn more about the disease. A comprehensive description of the possible clinical manifestations of late symptomatic neurosyphilis, particularly highlighting rare symptoms, can identify suspicious patients and prevent diagnostic delays.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":" ","pages":"477-483"},"PeriodicalIF":3.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432674","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}