International Journal of STD & AIDS最新文献

BackgroundSexual minority men (SMM) in China continue to face a disproportionately high burden of HIV. Yet, little is known about the differences in HIV prevention service utilization including HIV testing and pre-exposure prophylaxis (PrEP) by relationship status and sexual agreements among this population. The study aimed to explore the associations between relationship status and sexual agreements and HIV testing behaviors, PrEP willingness, and PrEP uptake among sexually active SMM in China.MethodsWe surveyed 1,379 sexually active SMM in China on a geosocial networking app and conducted multivariable regression to examine differences in HIV testing and PrEP-related outcomes.ResultsOver one-third of Chinese SMM (36%) were in a relationship (e.g., having a boyfriend or partner) and among these, 44% had a monogamous sexual agreement and 24.6% were having an open relationship agreement. In adjusted models, partnered Chinese SMM were more likely to have received a recent HIV test (AOR = 1.47, 95%CI: 1.14-1.91). Bisexual men were less likely to have tested for HIV (AOR = 0.71, 95% CI: 0.53-0.96) or ever used PrEP compared to gay men (AOR = 0.56, 95% CI: 0.30-0.98). Among partnered SMM, those with an open relationship agreement were less likely to have tested for HIV in the past 6 months (AOR = 0.51, 95% CI: 0.28-0.94) and more willing to use PrEP for HIV prevention (AOR = 1.96, 95% CI: 1.19-3.22), compared to SMM in monogamous relationships.ConclusionsThese findings provided quantitative evidence and insights into the differences in HIV prevention service utilizations among SMM in China and suggest the need for tailored interventions for targeted sub-groups to address the unique sexual health needs of Chinese SMM.

Topical imiquimod is widely used for the treatment of external anogenital warts due to its potent immunomodulatory effects. Although local skin reactions are common, systemic side effects are rare and under-recognized. We describe the case of a 23-year-old male who developed recurrent, cytokine-mediated systemic symptoms-including fever, myalgias, and malaise-within hours of each application of imiquimod 5% cream to condylomata acuminata on the glans penis and inner prepuce. The lesions were located on non-keratinized, highly vascular mucosal surfaces, likely facilitating enhanced percutaneous absorption and systemic immune activation through Toll-like receptor 7 pathways. Symptoms resolved promptly with discontinuation of therapy and did not recur with alternative treatment using podophyllin resin. This case underscores the importance of recognizing systemic adverse reactions to topical immunotherapies, particularly when applied to mucosal surfaces, and highlights the need for appropriate patient counseling and individualized treatment approaches.

BackgroundFilipino adolescents and young adults are at higher risk for acquiring human immunodeficiency virus (HIV) than any other age groups; 46% of new HIV infections in 2022 were in people aged 15 - 24 years. However, little is known about the prevalence and associated factors of HIV sexual risk behavior (SRB) among this vulnerable population in the Philippines.MethodsThis is a secondary analysis of a cross-sectional study from the 2021 Young Adult Fertility and Sexuality Study (YAFS5). 3120 sexually experienced Filipinos aged 15 - 24 were included in the analysis. Binary logistic regression and Poisson regression were used to test the relationship between the proposed independent variables and HIV SRB.ResultsApproximately two-thirds (n = 2101, 65.5%) of Filipino youth engage in HIV SRB, and this is significantly higher among males (n = 1212, 74.9%, p < .001). Factors associated with HIV SRB include ever married/cohabited (AOR: 0.25, 95% CI: 0.20 - 0.32), have had sex with a virtual partner (AOR: 2.44, 95% CI: 1.25 - 4.78), currently smoking (AOR: 1.35, 95% CI: 1.04 - 1.76), lifetime drug use (AOR: 4.30, 95% CI: 2.15, 8.59), and suicidal ideation (AOR: 1.51, 95% CI: 1.17, 1.96). Differences between males and females were also noted.ConclusionsThis study highlights the vulnerabilities and co-occurring health risk behaviors among young Filipinos that may increase their risk of HIV transmission. Findings underscore the need for integrated, youth-focused programs-such as comprehensive sexual and reproductive education and improved service access-while acknowledging sociocultural challenges in a deeply religious context.

BackgroundSeveral antiretroviral regimens have been used for prevention of mother to child transmission (MTCT) of HIV, with maternal dolutegravir-based regimens (e.g. tenofovir/lamivudine/dolutegravir - TLD) being the latest, initiated in last 3-4 years. There is a need for assessment of effectiveness of this new regimen as compared to earlier efavirenz-based (tenofovir/lamivudine/efavirenz - TLE) and other regimens in program settings.MethodWe conducted this retrospective cohort study to determine effectiveness of the TLD regimen in preventing antenatal, intranatal and postnatal MTCT compared to earlier regimens. 1905 HIV-exposed infants in West Bengal, India from April 2017 to March 2023 with available polymerase chain reaction for HIV at 314 Integrated Counselling and Testing Centres were considered. Duration of antenatal antiretroviral treatment and infant feeding practices types were also analyzed.ResultsAmong all mothers, 666 (35%) received TLD and 1194 (63%) TLE. With TLD, MTCT rate was significantly lower (2% vs 6.5%) [Adjusted Odds Ratio (AOR) = 0.28; 0.15-0.52] than all other regimens. Duration of maternal antiretroviral therapy (weeks) (AOR = 0.96; 0.95-0.98) and infant feeding practices (AOR = 0.09; 0.03-0.25) showed significant association with reduced MTCT rate.ConclusionDolutegravir-based ART is more effective than earlier regimens and promises to achieve the elimination of pediatric HIV.

Syphilitic proctitis is a rare presentation of syphilis that can mimic IBD, posing a diagnostic challenge, especially in immunocompromised patients. We report the case of a 28-year-old transgender woman with a past medical history of ulcerative colitis, HIV, and syphilis, initially misdiagnosed with ulcerative colitis. Sigmoidoscopy showed a rectal ulcer; histology and positive syphilis serologies confirmed syphilitic proctitis. This case highlights the need to consider infectious causes in atypical or treatment-resistant proctitis, emphasising the value of a thorough history and targeted testing.

IntroductionHuman Immunodeficiency Virus (HIV) infection remains a global public health concern due to its high morbidity and mortality rates, as well as the significant costs associated with treatment and healthcare services.ObjectiveTo determine the incidence of HIV and its associated factors among blood donors in the city of Medellín, Colombia.MethodsA longitudinal study was conducted using secondary data from 23,122 repeat blood donors at a blood bank in Medellín. The cumulative incidence was estimated along with its 95% confidence interval. Pearson's chi-square test, Fisher's exact test, and relative risk calculations were used to identify associated factors.ResultsThe HIV incidence was 9.1 per 10,000 donors (95% CI: 5.0-13.2). Subgroups with the highest incidence per 10,000 donors included those recruited through mobile blood drives (12.3), individuals under 40 years of age (12.0), men (11.3), and altruistic donors (10.6).ConclusionA relatively low number of new HIV cases was found among repeat donors. However, the identification of subgroups with higher incidence is critical for developing targeted strategies to ensure the safety of these priority populations and to enhance active epidemiological surveillance systems for HIV in the general population.

Angiokeratoma of Fordyce is a benign vascular lesion characterized by the dilation of blood vessels within the papillary dermis, accompanied by epidermal acanthosis and hyperkeratosis. This report presents two clinical cases: a 22-year-old woman with a solitary, prominent nodular lesion on the clitoris and a 26-year-old man with asymptomatic violaceous papules on the glans penis. Both cases underscore the clinical presentation, differential diagnoses, and histopathological findings associated with angiokeratoma. The first case was diagnosed through excisional biopsy, revealing orthohyperkeratosis, parakeratosis, and dilated vascular channels, while the second case was confirmed via punch biopsy. Although angiokeratomas are typically asymptomatic, they may occasionally present with bleeding, highlighting the necessity for clinical vigilance. The rarity of these lesions in the genital region emphasizes the importance of accurate diagnosis and management, as they can mimic more serious conditions, including melanoma.

Urethritis is a frequent lower urinary tract infection often linked to sexually transmitted infections (STIs). While Neisseria gonorrhoeae and Chlamydia trachomatis are the main pathogens, other microorganisms such as Mycoplasma genitalium, Trichomonas vaginalis, and Ureaplasma urealyticum may also be involved. In over half of non-gonococcal urethritis (NGU) cases, no causative agent is identified. We present the case of a 37-year-old man with scrotal pain, painful ejaculation, dysuria, and urethral discharge following a single unprotected sexual encounter. Initial STI PCR was positive for Ureaplasma urealyticum, and azithromycin was prescribed. Symptoms persisted, and a urethral culture revealed Streptococcus urinalis, confirmed by MALDI-TOF MS and 16S rRNA sequencing. Gram staining showed numerous leukocytes and Gram-positive cocci in chains. A second urethral swab yielded the same organism. The isolate was fully susceptible to all tested antibiotics. Although S. urinalis has been described in urinary tract infections and sepsis, to our knowledge, this is the first reported case suggesting a possible role in male urethritis. While prostatitis or epididymitis cannot be ruled out, the repeated isolation of S. urinalis and persistent symptoms support its potential pathogenicity. This case adds to growing evidence implicating S. urinalis in genitourinary tract infections.