Sexually transmitted diseases最新文献

{"title":"The Impacts and Consequences of Sexually Transmitted Infections in the United States.","authors":"Lao-Tzu Allan-Blitz, Jeffrey D Klausner","doi":"10.1097/OLQ.0000000000002126","DOIUrl":"10.1097/OLQ.0000000000002126","url":null,"abstract":"<p><strong>Abstract: </strong>Millions of people in the United States are affected by sexually transmitted infections (STIs) every year, with profound consequences for the individual, their community, and society at large. In this review, we aim to summarize the epidemiology of 4 STIs: Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, and herpes simplex virus, and to highlight the consequences of those infections among individuals and the healthcare system. Untreated N. gonorrhoeae, C. trachomatis, T. pallidum, or herpes simplex virus infection can result in female infertility, stillbirth, premature birth, and low birth weight. As many as 10% of incident HIV infections among men who have sex with men in the United States have been attributed to either N. gonorrhoeae or C. trachomatis infection. In 1 year in the United States, incident C. trachomatis infection resulted in $824 million lifetime medical costs and a loss of 1,541 lifetime quality-adjusted life years (QALYs) among men and 111,872 among women, while incident N. gonorrhoeae infection led to $323 million in lifetime medical costs, and a loss of 386 QALYs among women and 12,112 among men. Incident T. pallidum infection in 1 year resulted in $206 million in medical costs and a loss of 13,349 QALYs among both men and women, while genital herpes led to $107 million in medical costs and a loss of 33,100 QALYs. STI-attributable infertility alone resulted in more than $135 million in direct medical costs. Cumulatively, STIs lead to substantial financial costs to individuals and the health system, as well as long-term reductions in quality of life.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"285-289"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fannyhessea vaginae and Clearance of Lactobacillus iners Are Associated With Incident Nonchlamydial Non- Mycoplasma genitalium Urethritis in Men Who Have Sex With Women.","authors":"Caitlin M Drover, Sujatha Srinivasan, Kenneth A Tapia, Matthew Munch, Emily Rowlinson, Laura C Chambers, Tina L Fiedler, M Sylvan Lowens, Christine M Khosropour, Lisa E Manhart, David N Fredricks","doi":"10.1097/OLQ.0000000000002129","DOIUrl":"10.1097/OLQ.0000000000002129","url":null,"abstract":"<p><strong>Background: </strong>The etiology of nongonococcal urethritis (NGU) is incompletely understood. We sought to determine if genitourinary bacterial diversity or specific taxa were associated with incident NGU.</p><p><strong>Methods: </strong>From August 2014 to July 2018, men who have sex with women attending a sexual health clinic were clinically evaluated, including Mycoplasma genitalium (MG) and Chlamydia trachomatis (CT) testing, at enrollment and 6 monthly visits. New cases of NGU (≥5 polymorphonuclear leukocytes per high-power field in urethral exudates plus either symptoms or visible discharge) and their visit preceding NGU diagnosis were matched 1:1 to 2 sequential visits without NGU (controls). We determined associations with incident NGU and applied broad-range 16S rRNA gene polymerase chain reaction and sequencing to urine samples from each visit. We used conditional logistic regression to evaluate the association of Shannon Diversity Index, species richness, Haemophilus influenzae , Fannyhessea vaginae, Lactobacillus iners, and Streptococcus mitis group with incident non-CT-non-MG-NGU (NCNM-NGU).</p><p><strong>Results: </strong>Of 62 matched case-control pairs, median age was 32 years. Higher Shannon Diversity Index the previous month was associated with higher odds of incident NCNM-NGU (adjusted odds ratio [aOR], 2.8 per unit increase; 95% confidence interval [CI], 1.03-7.47), as was F. vaginae at NGU diagnosis (aOR, 5.1; 95% CI, 1.28-20.15), F. vaginae acquisition (aOR, 13.8; 95% CI, 1.96-97.33), and consistent carriage of F. vaginae (aOR, 16.1; 95% CI, 1.66-156.29). Odds of NCNM-NGU were higher when L. iners cleared between visits (aOR, 18.0; 95% CI, 1.08-299.24). Neither the H. influenzae nor S. mitis group was associated with incident NCNM-NGU.</p><p><strong>Conclusions: </strong>F. vaginae acquisition/detection and L. iners clearance were associated with urethritis. This merits investigation in larger longitudinal studies using species-specific detection methods.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"317-324"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Never Tested for HIV Among Men Who Have Sex With Men, Hanoi, Vietnam: Correlates and Missed Opportunities.","authors":"Hoang Thi Hai Van, Thi Huong Dang, Thi Thu Hong Nguyen, Willi McFarland, Bich Diep Vu, Lung Bich Ngoc, Le Minh Giang","doi":"10.1097/OLQ.0000000000002123","DOIUrl":"10.1097/OLQ.0000000000002123","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding levels of human immunodeficiency virus (HIV) testing among populations at risk for acquisition is essential to meeting the goal of the United Nations that 95% of individuals living with HIV know their status. This study assessed HIV testing prevalence among men who had sex with men (MSM), characteristics of MSM who have never tested for HIV, and missed testing opportunities in Hanoi, Vietnam.</p><p><strong>Methods: </strong>We measured the prevalence of never testing for HIV and missed opportunities for testing in the baseline data of a cohort study of MSM recruited in 2017 to 2019 in Hanoi. Logistic regression analysis characterized MSM who had never tested before cohort participation.</p><p><strong>Results: </strong>Of 1893 MSM enrolled in the cohort, 39.4% had never previously tested for HIV. Men who had sex with men with children (adjusted odds ratio, 1.75; 95% confidence interval, 1.09-2.82) and those who did not know or remember having a male partner living with HIV (adjusted odds ratio, 1.41; 95% confidence interval, 1.07-1.84) were more likely to have never tested. Older age, university education, higher income, and having a male partner living with HIV were associated with a lower likelihood of never having been tested. The most common missed testing opportunities to test MSM who had never been tested were when receiving free condoms from health educators (35.3%), testing for other sexually transmitted infections (STIs) (23.3%), reporting their MSM status to health care workers (16.4%), and receiving an STI diagnosis (13.0%). The most common barriers identified by MSM who had never tested were fear of seeking health care due to their sexual orientation (82.7%) and having been refused health care due to their sexual orientation (76.2%).</p><p><strong>Conclusions: </strong>Facilitating provider-initiated HIV testing in STI clinics and other health care services, community-based testing, and HIV self-test kits should enhance HIV testing options for young MSM, especially those with lower education and income.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"310-316"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Using a Standardized Questionnaire on Sexual History Documentation and Testing to Diagnose Gonorrhea and Chlamydia Among Men Who Have Sex With Men With Human Immunodeficiency Virus.","authors":"Danielle deMontigny Avila, Brooke Rabe, Arunmozhi Aravagiri, Martin Joseph, James Ray M Lim, Maryam Naveed, Raina Rappel, Berna Villanueva, Maithili Khandekar, Atehkeng Zinkeng, Sarah Yates, Lori E Fantry","doi":"10.1097/OLQ.0000000000002119","DOIUrl":"10.1097/OLQ.0000000000002119","url":null,"abstract":"<p><strong>Background: </strong>Most Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT) infections in men who have sex with men (MSM) are diagnosed at extragenital sites. However, testing at these sites is often lacking. The purpose of this study was to determine if a standardized questionnaire administered by physicians and clinical assistants improves documentation of sex activity and increases extragenital testing and diagnoses of GC and CT among MSM.</p><p><strong>Methods: </strong>A standardized sexual history questionnaire was implemented on 11/1/2022. Electronic medical records of 664 MSM with human immunodeficiency virus, including 1064 encounters, were reviewed to compare preimplementation and postimplementation sexual history documentation, adequacy of documentation, extragenital GC and CT testing, and GC and CT diagnoses. Analysis included χ 2 and exact tests and logistic regression adjusting for physician cluster effects.</p><p><strong>Results: </strong>The standardized questionnaire was used by 53.7% of physicians and 85.9% of coordinators. Documentation of whether sexual activity occurred increased from 79.3% (95% confidence interval [CI], 0.758-0.828) in the preintervention pre-COVID-19 period to 95.2% (95% CI, 0.925-0.970) in the postintervention period with an adjusted odds ratio of 4.7 (95% CI, 2.7-8.8). Specific questions about anal and oral sex increased from 42.0% to 88.1% ( P < 0.001) and 23.7% to 88.7% ( P < 0.001), respectively. Anal and pharyngeal testing increased from 14.4% to 20.2% ( P = 0.040) and 17.2% to 23.3% ( P = 0.045), respectively.</p><p><strong>Conclusions: </strong>This study demonstrates that using a standardized questionnaire during clinical encounters can improve documentation of sexual activity and testing for GC and CT at extragenital sites.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"290-294"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"STI Testing and Rates of STI Diagnoses Before and During the COVID-19 Pandemic in a US HIV Cohort.","authors":"Gina M Simoncini, Carl Armon, Kate Buchacz, Jonathan Mahnken, Qingjiang Hou, Kalliope Chagaris, Jack Fuhrer, Cynthia Mayer, Cynthia Firnhaber, Marcus D Durham, Alexander C Ewing, Kimberly Carlson, Jun Li","doi":"10.1097/OLQ.0000000000002124","DOIUrl":"10.1097/OLQ.0000000000002124","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic affected sexually transmitted infection (STI) testing and diagnosis rates in the United States, but these patterns have not been well characterized among people with HIV.</p><p><strong>Methods: </strong>We analyzed medical records data of HIV Outpatient Study (HOPS) participants seen for HIV care from January 2019 to March 2021, with ≥1 CD4+ cell count and viral load test results recorded. We used Poisson regression models to estimate rate ratio (RR) and 95% confidence interval (CI) to compare STI testing and diagnoses rates on/after versus before March 1, 2020 (early COVID-19 pandemic [pandemic] vs. prepandemic).</p><p><strong>Results: </strong>Of 2311 eligible patients, STI tests (STI cases, primarily defined as test results that were positive) were as follows during the analysis time frame: 4991 gonorrhea (157), 4978 chlamydia (135), and 4216 syphilis (114). Comparing pandemic versus prepandemic periods, STI testing RRs were 0.78 for both gonorrhea (95% CI, 0.73-0.82) and chlamydia (95% CI, 0.73-0.83), and 0.93 for syphilis (95% CI, 0.88-0.99); diagnosis rates were not statistically different. Multivariable models showed reduced testing for gonorrhea (adjusted RR, 0.79; 95% CI, 0.72-0.87) and chlamydia (adjusted RR, 0.78; 95% CI, 0.71-0.86) for men who have sex with men, but not for other HIV transmission groups.</p><p><strong>Conclusions: </strong>The fallout of the COVID-19 pandemic on sexual health may not be seen for some time. Despite reduced STI testing, rates of STI diagnoses did not decrease. It will take a return to more routine screening and improved access to sexual health care to uncover the true impact of undetected or untreated STIs.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"304-309"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pair of Hearts: Two Cases of Mitral Valve Gonococcal Endocarditis.","authors":"Carolyn F Pearce, Kelly A Johnson, Nessa Meshkaty, Eric C Tang","doi":"10.1097/OLQ.0000000000002092","DOIUrl":"10.1097/OLQ.0000000000002092","url":null,"abstract":"<p><strong>Abstract: </strong>Gonorrhea is a sexually transmitted infection. Manifestations include asymptomatic infection and disseminated, life-threatening disease. We present two cases of mitral valve gonococcal endocarditis and discuss epidemiologic trends in disseminated gonococcal infection, acknowledging antimicrobial resistance, genetic variability in gonococcal strains, and contextual factors related to the COVID-19 pandemic and sexually transmitted infection control.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"e15-e17"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syphilis Screening During Pregnancy in 18- to 49-Year-Old Women in Commercially Insured Claims Data, 2022.","authors":"Brian Emerson, Guoyu Tao, Kaitlin Hufstetler, Ryan Cramer, William S Pearson","doi":"10.1097/OLQ.0000000000002089","DOIUrl":"10.1097/OLQ.0000000000002089","url":null,"abstract":"<p><strong>Background: </strong>Syphilis cases continue to climb in the United States, with a 159% increase among women between 2018 and 2022. Congenital syphilis (CS) cases continued along the same trajectory, with a 183% increase over the same time frame. Adherence to the screening guidelines may assist in reducing this trend. Our analysis aimed to determine the proportion of commercially insured women receiving syphilis screening during pregnancy.</p><p><strong>Materials and methods: </strong>We analyzed the 2022 Merative MarketScan Database containing commercially insured medical claims to determine syphilis screening rates among insured pregnant women aged 18 to 49 years, insured for 8 months before childbirth. Screening events were classified into 3 categories: first (1-13 weeks), second (14-27 weeks), and third (28+ weeks). Percentages and odds ratios were calculated for pregnancy categories by age category, trimester, Centers for Medicare & Medicaid Services regions, employment, and type of health insurance.</p><p><strong>Results: </strong>Of the 170,005 pregnant women in the sample, 79.6% were screened for syphilis at least once, and 95.1% resided in a state requiring syphilis testing during pregnancy. The highest percentage of pregnant women was screened during the third trimester, and the majority of those screened received at least 2 tests during pregnancy. Women in states with laws had 14% greater odds for receiving any screening during pregnancy.</p><p><strong>Discussion: </strong>Despite Centers for Disease Control and Prevention syphilis screening recommendations, only 79.6% received screening among this insured population. Effective communication on the importance of syphilis screening for all medical providers and their patients may increase the screening rates and decrease the incidence of CS.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"295-303"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Doxycycline as Postexposure Prophylaxis to Prevent Neisseria gonorrhoeae and Treponema pallidum Infection: An Updated Meta-Analysis.","authors":"Matheus Negri Boschiero, Camila Vantini Capasso Palamim, Fernando Augusto Lima Marson","doi":"10.1097/OLQ.0000000000002112","DOIUrl":"10.1097/OLQ.0000000000002112","url":null,"abstract":"","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":"e13-e14"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142732710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient portal accessing of sexually transmitted infection test results among adolescent and young adult patients.","authors":"Kevon-Mark Jackman, Laura Prichett, Yong Zeng, B Aletta Nonyane, Kevin B Johnson, Harold Lehmann, Maria Trent","doi":"10.1097/OLQ.0000000000002174","DOIUrl":"https://doi.org/10.1097/OLQ.0000000000002174","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine factors associated with patient portal accessing of sexually transmitted infection (STI) test results among adolescents and young adults (AYA) at a large urban hospital.</p><p><strong>Methods: </strong>We analyzed 12-month retrospective electronic health record (EHR) patient portal data among 15,396 patients aged 15 to 25 who received STI testing. Multinomial logistic regression measured relationships of patient characteristics to accessing STI test results, (defined as the time from when STI test results were released to the portal, to when AYA patients logged into their portal to view test results). Accessing results was categorized as, (a) not accessed, (b) accessed after 4 days, and (c) accessed within 4 days.</p><p><strong>Results: </strong>63.5% (9,775) of patients accessed their STI test results within 4 days, while 26.1% (4,019) did not access results. Being <18 years-old, male, Black or Hispanic/Latino, and living in a low socioeconomic status neighborhood were associated with higher relative risk of not accessing results.</p><p><strong>Discussion: </strong>Findings highlight AYA disparities in accessing STI results while suggesting a promising future for innovative STI interventions that leverage portals for engaging AYA in accessing STI test results.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Syphilis in pregnant women and congenital syphilis in Japan, 2022-2023: a warning for other countries.","authors":"Ayu Kasamatsu, Takuri Takahashi, Yuzo Arima, Hanae Ito, Maki Masutani, Shimpei Murai, Natsuko Nakamura, Ayano Orime, Masami Kitaoka, Yukihiro Akeda, Motoi Suzuki, Takuya Yamagishi","doi":"10.1097/OLQ.0000000000002173","DOIUrl":"10.1097/OLQ.0000000000002173","url":null,"abstract":"<p><strong>Abstract: </strong>Following a brief decline, syphilis case counts among pregnant women reported through Japan's national surveillance doubled from 2021 to 2023; congenital syphilis case counts/100,000 live births also doubled to >5. The unprecedented trends in Japan highlight the current heterosexual syphilis epidemic's relentlessness, with important implications for other countries.</p>","PeriodicalId":21837,"journal":{"name":"Sexually transmitted diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}