International Journal of STD & AIDS最新文献

IntroductionDetectable plasma HIV viral loads remain a major public health concern due to its association with increased HIV transmission and disease progression. The aim of this study is to assess the factors associated with a detectable HIV viral load in People Living with HIV (PLHIV) aged between 15 and 60 at the Cité des Palmiers District Hospital in Cameroon.MethodologyThis is a cross-sectional study conducted between July 2023 and January 2024 using a non-probability convenience sampling method. Data were collected using a semi-structured questionnaire administered to PLHIV aged between 15 and 65 years (n = 309). Analyses were performed using logistic regression, with a p-value <0.05.ResultsOut of 511 patients recruited, 309 consented to participate, representing a participation rate of 60%. Among the participants, 17% had a detectable viral load. Analyses revealed that living in a rural area [aOR = 4.40, p-value = 0.040], having a primary education as the highest level attained [aOR = 4.82, p-value = 0.025], frequently forgetting to take medication [aOR = 5.67, p-value = 0.002], eating only one meal a day [aOR = 13.02, p-value = 0.007], and fearing that therapy would no longer be effective in the future [aOR = 4.45, p-value = 0.009] significantly increased the probability of having a detectable HIV viral load.ConclusionThese result provide insight into targeting adherence support for PLWH in Cameroon to reduce the community HIV viral load. By improving access to care and providing psychosocial support, it may be possible to reduce community viral load, and reducing HIV transmission.

BackgroundCondomless sexual behaviors and intimate interactions have increased co-infections of syphilis, Mpox, and HIV. The concurrent infections disrupt the natural course of syphilis, hindering timely diagnosis and the effective implementation of treatment strategies. This research investigates the clinical characteristics of individuals co-infected with Mpox, T. pallidum and HIV through case studies, aiming to enhance understanding and identify effective treatment strategies for syphilis to prevent disease progression.MethodsA retrospective study was conducted to assess the clinical characteristics and treatment strategies of two patients diagnosed with both syphilis and Mpox. Additionally, a thorough review of the existing literature was performed using the PubMed, Web of Science, and Medline databases.ResultsThe review identified 32 cases of syphilis co-infected with Mpox, with 75% of individuals also living with HIV and 25% newly diagnosed with HIV. Notably, 66% had a clearly defined stage of syphilis, and serological testing showed that 65% of patients had antibody titers of 1:16 or higher, while 35% had titers of 1:8 or lower.ConclusionsThis study emphasizes the importance of evaluating co-infections in individuals with anogenital ulcerative conditions. Timely identification and prompt intervention are crucial for effectively managing concurrent infections, especially when patients are facing multiple infections.

BackgroundArtificial Intelligence (AI) is an emerging approach in addressing sexual health including HIV and other sexually transmitted infections (STIs). The aim of this study was to explore facilitators and barriers of AI with a focus on underserved populations who are disproportionately impacted by sexual health disparities.MethodsIn 2025, individuals presenting to a safety-net sexual health clinic were asked to take part in a short, one-time anonymous survey to assess the acceptability of AI-based technology in sexual health promotion. Multiple linear regression analyses were conducted to examine the association between demographic factors and the preference for AI-based versus clinic-based counseling.ResultsOf 100 individuals who participated in this study, 17% were African American/Black, and 11% Hispanic/Latino. The majority self-identified as LGBTQ+ (84%) and reported that they had previously used AI (67%) such as ChatGPT, Google Bard, and/or Fandango for topics related to health information, school, or customer service. Fifteen percent of people reported using AI-technology an average of once a month, 14% once a week, and 11% daily. Demographic variables were not significantly associated with preference for sexual health promotion by AI versus clinic-based counseling (p = 0.21). However, 56% reported distrust regarding sharing personal information with AI technology.ConclusionsMany individuals are willing to consider AI technology use for sexual health promotion. However, issues related to trust and security should be addressed to optimize uptake.

Background: A syndromic approach likely underestimates prevalence of Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhea) infection among Filipino people living with HIV (PLHIV). We determined urine, rectal, and pharyngeal prevalence of chlamydia and gonorrhea infection using nucleic acid testing (NAAT) in this population.Methods: This is a single-center, cross-sectional study performed at Philippine General Hospital. Following ethical approval and informed consent, urine, rectal, and pharyngeal samples from treatment-naïve adult PLHIV were tested using GeneXpert® for chlamydia and gonorrhoea. Participants with recent antibiotic use with activity against chlamydia or gonorrhoea were excluded. Demographic and clinical data were collected.Results: We enrolled 60 participants with median age of 30 years, 85% were male, 78% identified as men who have sex with men, and 95% were asymptomatic. The overall prevalence of chlamydia or gonorrhoea was 32%. Site-specific testing showed that rectal chlamydia or gonorrhoea infections were most common at 16.7%, followed by multisite infections at 10.0%.Conclusion: The prevalence of chlamydia and gonorrhoea among newly diagnosed Filipino PLHIV is 32% with 95% being asymptomatic. This is sufficiently high to warrant routine NAAT screening.

BackgroundSexual health service (SHS) delivery in England shifted substantially with rapid expansion of online services during the COVID-19 pandemic. While digital services may improve reach, limited data exist on unmet need for in-person SHS in England, especially among men and gender-diverse individuals who have sex with men, key populations disproportionately affected by sexual health inequalities.MethodsWe analysed data from "Reducing inequalities in Sexual Health" (RiiSH) 2024 (Nov/Dec 2024), an online survey of UK-resident men and gender-diverse individuals having sex with men. We assessed in-person SHS access and unmet need (tried but failed to access a SHS in-person) over the past year. Bivariate and multivariable logistic regression was used to examine associations with unmet need.ResultsAmong 2404 participants living in England (median age 45 years, 88% White, 95% cisgender), 86% had ever accessed in-person SHS and 59% in the past year. Of those who tried to access in-person care in the past year, 12% (95% CI: 11%-14%) experienced unmet need, especially Outside London (15% vs 8% in London). Common barriers included unavailable (50%) or inconvenient (41%) appointment times. In adjusted multivariable analysis, unmet need continued to be lower among participants living in London (aOR: 0.64 [95% CI: 0.44-0.92]), those financially comfortable (aOR: 0.69 [0.49-0.97]), and those reporting ≥1 marker(s) of sexual risk (e.g. HIV-PrEP use in the last year and/or in the last 3-4 months, the report of a bacterial STI diagnosis, engaging in chemsex, having had ≥10 male physical sex partners; aOR: 0.14 [0.10-0.20]). Unmet need was higher among participants with limiting long-term physical health conditions (aOR: 1.61 [1.12-2.30]) and those who reported ever using online postal self-sampling services for STI testing (OPSS) (aOR: 1.50 [1.07-2.09]).ConclusionsDespite high SHS engagement, one-in-eight reported unmet need for in-person SHS. Local service delivery guided by joint strategic needs assessments could help address unmet need for SHS.

Transient detection of hepatitis B surface antigen (HBsAg) following hepatitis B vaccination is a rare but recognized phenomenon that may be misinterpreted as acute hepatitis B virus (HBV) infection. We report a case illustrating this diagnostic challenge in an HIV pre-exposure prophylaxis (PrEP) user. A 36-year-old man presented in October 2025 for PrEP initiation. He reported condomless sex with multiple male partners and occasional on-demand use of tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) obtained from a partner. Screening for sexually transmitted infections in August 2025 showed negative viral hepatitis serologies. Two days prior to the PrEP consultation, he received a combined hepatitis A/B vaccine in preparation for travel to Thailand.Routine baseline testing revealed isolated HBsAg positivity. The patient was asymptomatic and recalled for further evaluation. Repeat testing eight days later showed HBsAg negativity, newly positive anti-HBs antibodies, undetectable HBV DNA, negative hepatitis D serology, and normal liver enzymes. Follow-up serology fourteen days later confirmed sustained HBsAg negativity with isolated anti-HBs positivity. The rapid resolution of HBsAg in close temporal proximity to vaccination, together with the absence of hepatitis B core antibodies and undetectable HBV DNA, supported transient post-vaccination antigenemia rather than acute HBV infection.Transient HBsAg positivity after vaccination has previously been described, particularly among hemodialysis patients. Retrospective studies indicate that circulating recombinant HBsAg may be detected shortly after immunization, most commonly within five days but occasionally up to twenty days. To our knowledge, this is the first reported case of transient HBsAg positivity in a PrEP user. This is clinically relevant given the anti-HBV activity of TDF and evidence suggesting that TDF-based PrEP reduces HBV acquisition. As incident HBV infection during PrEP use is uncommon, isolated HBsAg positivity shortly after vaccination may create diagnostic uncertainty. Awareness of this phenomenon is essential to avoid misdiagnosis, unnecessary anxiety, and inappropriate interruption of PrEP.

BackgroundThis multicentre study evaluated the prevalence, distribution, and risk factors of cancer among people living with HIV (PLWH) in Turkey over two decades. Mortality rates and factors were also investigated.MethodsThis retrospective cohort study included 154 adults diagnosed with cancer and HIV between 2008 and 2024. Data were collected from the medical records. The demographics, clinical characteristics, cancer types, treatments, and outcomes were evaluated. The risk factors for ADCs and mortality were defined using multivariate logistic regression and Cox regression. The estimated survival time was determined using Kaplan-Meier analysis.ResultsAmong 8708 PLWH, cancer prevalence was 1.8% (95% CI:1.5-2). ADCs (66.9%) were twice as frequent as NADCs (33.1%). Most prevalent cancers were non-Hodgkin lymphoma (35.1%), Kaposi sarcoma (29.9%), and lung cancer (7.8%). Age ≤54 years, CD4 + T lymphocyte count ≤94/mm³, and HHV-8 co-infection were risk factors for ADCs. Mortality rate was 32%. Non-Hodgkin lymphoma and CD4 + T lymphocyte count ≤232/mm³ at treatment completion predicted mortality. The 3-years overall survival rate was 67.6%.ConclusionsThis study offers insights into cancer burden among PLWH in Turkey. High rates of ADCs and mortality highlight the importance of early HIV diagnosis and antiretroviral therapy access to reduce cancer burden in this population.

BackgroundNew HIV-1 infections continue to pose a major challenge to ending the HIV epidemic and may facilitate the transmission of drug-resistant strains. In this study, we aimed to determine the proportion of recent HIV-1 infections (RHI) among individuals initiating HIV care at a rural referral hospital in Tanzania and to assess the prevalence of pre-treatment HIV-1 drug resistance (PDR) and circulating subtypes among those with RHI.MethodsIn this cross-sectional analysis, RHI was identified using the Asante HIV-1 rapid recency assay on bio-banked samples from newly diagnosed adult people living with HIV (PLHIV) enrolled in the Kilombero and Ulanga Antiretroviral cohort between March 2019 and March 2022. Risk factors for recent HIV were evaluated using logistic regression analysis. Genotypic resistance testing (GRT) using Sanger sequencing was performed on samples from people with RHI.ResultsAmong 599 PLHIV, 24 (4%) were identified with RHI. No factors were found to be associated with RHI. Genotypic resistance testing was successful in 16 of the 24 (67%) participants, of whom 5 (31%) harbored HIV-1 drug resistance mutations: 4/16 (25%) for non-nucleoside reverse transcriptase inhibitors, 2/16 (13%) for nucleoside reverse transcriptase inhibitors, and 1/16 (6%) for protease inhibitors.ConclusionThe low prevalence of RHI in this hospital-based study suggests a high rate of late HIV diagnosis. Despite the limited sample size, the notable proportion of people with recent infection who had drug resistance highlights a serious public health concern.

BackgroundYoung women in South Africa experience a disproportionate burden of HIV transmission. Oral pre-exposure prophylaxis (PrEP) offers an additional HIV prevention option; however, its acceptability and use among young, female university students remain underexplored.MethodsThis qualitative study explored perceptions, awareness, and acceptability of oral PrEP among female university students in Durban, South Africa. Semi-structured, in-depth interviews were conducted with 12 female students aged 18-24 years. Data were thematically analysed to identify key factors shaping PrEP awareness, attitudes, and perceived barriers and facilitators to use.ResultsParticipants demonstrated varying levels of awareness of PrEP, often informed by informal sources such as peers, social media, and healthcare encounters. While PrEP was viewed as a potentially empowering HIV prevention option, misconceptions, fear of side effects, stigma associated with HIV-related medication, and concerns about partner reactions constrained acceptability and uptake. Structural barriers, including limited access to youth-friendly services, further influenced interest in PrEP.ConclusionThe findings highlight the complex social and structural contexts shaping PrEP acceptability among female university students and point to the need for targeted, youth-friendly communication and service delivery approaches.