International Journal of STD & AIDS最新文献

BackgroundFemale sex workers (FSWs) face a disproportionately high risk of HIV acquisition, yet uptake of pre-exposure prophylaxis (PrEP) remains low in many settings. We examined PrEP awareness, utilization, and adherence, and identified predictors of uptake among FSWs engaged through One-Stop-Shop (OSS)-linked urban venues in Nigeria.MethodsA cross-sectional survey was conducted among 146 FSWs using venue-based time-location sampling. Structured, interviewer-administered questionnaires assessed socio-demographic characteristics, PrEP knowledge and use, and exposure to HIV prevention services. Multivariate logistic regression was used to identify independent predictors of PrEP uptake.ResultsPrEP awareness was high (76.7%), and among those aware, 92.0% had ever used PrEP. However, adherence was inconsistent: only 41.7% reported daily use, while the majority reported irregular or on-demand use. Peer educators and community-based HIV prevention workers were the most common information sources (69.6%). After adjusting for potential confounders, only participation in group sessions remained a significant independent predictor of PrEP uptake (adjusted Odds Ratio, aOR = 14.22; 95% confidence interval, CI: 1.44-31.61).ConclusionsFSWs linked to urban OSS platforms in Nigeria demonstrated high levels of PrEP awareness and use. The emergence of group HIV prevention sessions as an independent predictor of PrEP uptake reinforces the value of peer-led, community-based behavioral interventions in this setting.

We report a man in his thirties living with advanced HIV presenting with Pneumocystis pneumonia, cytomegalovirus colitis and HIV retinopathy. Initial HIV screening was positive, and immunochromatographic testing demonstrated simultaneous p24 antigen and antibody bands, an exceptionally rare finding outside the acute seroconversion phase. Despite profound immunosuppression (CD4 3 cells/µL), initiation of antiretroviral therapy led to rapid disappearance of the p24 antigen, while antibody positivity persisted. This case illustrates how severe cellular immune deficiency can allow concurrent antigen/antibody positivity, likely due to high viremia and impaired antibody responses. Clinicians should be aware that point-of-care HIV test results may vary depending on the stage of infection and the timing of therapeutic intervention.

BackgroundQuantitative HIV-1 DNA (qDNA) is a biomarker of the viral reservoir. We evaluated whether two-drug regimens (2DRs) maintain qDNA values comparable to those of three-drug therapies (3DRs).Materials and methodsWe collected data from people living with HIV (PLWH) undergoing qDNA testing. Total HIV-1 DNA was measured using the HIV-1 DNA Test PRO (Diatheva) on InGenius (ELITech) platform. Descriptive analyses and non-parametric tests were performed. Bivariate logistic regression was applied to identify predictors of qDNA levels ≥2.3 log copies/10⁶ in peripheral blood mononuclear cells (PBMC).Results263 PLWH receiving antiretroviral therapy (ART) were included; 118 (44.9%) had qDNA ≥2.3 log copies/10⁶ PBMC. Age (OR: 1.44 per 10-years increase, p = 0.008) and prior CDC C stage events (OR: 2.26, p = 0.025) were associated with qDNA >2.3 log copies/10⁶ PBMC. Years of treatment (OR: 0.71 per 5-years increase, p = 0.018) was associated to lower probability of qDNA >2.3 log copies/10⁶ PBMC. No association was found between ART type (2DR vs 3DR) and qDNA levels (p = 0.441).ConclusionThe impact of 2DRs on the viral reservoir assessed by mean of qDNA is not different from what observed with 3DRs and may be a viable option for PLWH at risk of disease progression.

BackgroundSexually transmitted infections (STIs) are increasing globally. To improve understanding of the epidemiology of STIs in key populations, we analysed sentinel surveillance data on STI test positivity among individuals tested using subsidised tests at anonymous walk-in clinics in North Rhine-Westphalia (NRW), Germany.MethodsThis was a cross-sectional analysis of sentinel surveillance data from all 53 local health authority anonymous walk-in clinics in NRW during 2021. Test positivity for HIV, syphilis, chlamydia, and gonorrhoea was analysed by key population group. We used univariable and multivariable logistic regression to examine factors associated with each infection.ResultsAmong 11,560 consultations, overall STI test positivity was 6.6%. Chlamydia was the most frequently detected (6.4%), followed by gonorrhoea (2.7%), syphilis (0.9%), and HIV (0.6%). We observed disparities in STI test positivity among key population groups. Men-who-have-sex-with-men (MSM) (aOR 1.93; 95%CI 1.38-2.68), sex work (aOR 2.77; 95%CI 1.9-3.96), and having an STI-positive partner (aOR 1.71; 95%CI 1.30-2.22) were associated with increased STI risk. Coinfections were rare (0.4%) and predominantly occurred among MSM.ConclusionsAnonymous walk-in clinics reach diverse high-risk populations with substantial STI burdens. Findings support targeted prevention strategies for key populations and highlight the importance of comprehensive STI screening in anonymous settings for surveillance and case detection.

BackgroundPrompt doxycycline use (200 mg taken 24-72 hours after sexual activity, i.e., post-exposure prophylaxis, Doxy-PEP), effectively reduces chlamydia and syphilis acquisition in men who have sex with men (MSM) and individuals experiencing recurrent STIs. Considering the IUSTI Europe position statement and recent guidelines from the CDC, this study investigated the use of doxycycline to prevent STIs among MSM attendees of an STI/HIV center in Rome, Italy.MethodsFrom June 2024 to February 2025, an anonymous self-administered questionnaire was used to collect data on sexual behaviors, HIV status, HIV pre-exposure prophylaxis (PrEP), STI history, recreational substances, and doxycycline PrEP/PEP use. Logistic regression analyzed associations between Doxy-PEP/PrEP use and behavioral/clinical factors.ResultsTwo hundred and ninety MSM were enrolled. Among them, 9.3% reported using Doxy-PEP/PrEP, with nearly half accessing it without medical supervision. Multivariable analysis showed significant associations between doxycycline use and having ≥20 sexual partners, erectile drug use, and condomless anal sex.ConclusionsWhile doxycycline remains an uncommon choice for STI prevention among our attendees, its usage is linked to individuals engaging in sex with multiple partners. These findings highlight the urgency of national guidelines to address informal prophylactic antibiotic use and ensure supervised STI prevention strategies among individuals at elevated risk for bacterial STIs.

BackgroundCondylomata acuminata (genital warts) are one of the most common sexually transmitted infections, mainly caused by human papillomavirus types 6 and 11. While vaccination programs have reduced the incidence in young women since 2006, the healthcare situation for men in Germany remains poorly studied. The aim of this study was to analyse the reality of care for men with condylomata acuminata in both outpatient and inpatient settings.MethodsA retrospective analysis was conducted on 239 male patients treated for condylomata acuminata between 2020 and 2024 at the Department of Dermatology, Venerology and Allergology, University Medical Center Leipzig. The data collected encompassed demographic information, comorbidities including immune status and sexually transmitted infections, prior medical consultations, the type of treatment provided (outpatient or inpatient), where applicable duration of hospitalization, our therapeutic approach, and the overall recurrences rate.ResultsThe mean age of the patients was 41.1 years. 83.3% were treated on an outpatient basis, while 16.7% received inpatient or short-term inpatient care. The average length of stay for inpatients was 4.03 days (standard deviation: 2.75). Prior diagnostics were documented in 15.1% of cases. Overall recurrences occurred in 22.2% of patients. Only 7.5% had a documented HPV vaccination status.ConclusionsThese results highlight the significant disease burden of condylomata acuminata among men in Germany, with the majority of cases managed on an outpatient basis. The insufficient vaccination rate and low rates of prior diagnostics indicate deficits in prevention and structured care. Intensifying vaccination programs and optimizing treatment pathways could reduce the disease burden and the need for inpatient care.

BackgroundDepression care in Kenya has limited access due to a shortage of specialists and inadequate finances for mental health services. This study aimed to determine the prevalence and barriers to accessing depression care among people living with HIV in Juja Sub-County, Kiambu County, Kenya.MethodsA quantitative analytical cross-sectional study was used. A total of 329 people living with HIV receiving comprehensive care at six public health facilities in Juja Sub-County were selected using a stratified sampling technique. Data were collected using interviewer-administered questionnaires after obtaining informed consent from each study participant. The prevalence of depression was assessed using the PHQ-9 scale. Data analysis was done using R. Descriptive statistics were computed. An ordinal logistic regression model was used to determine the factors associated with the prevalence of depression. A binary logistic regression model was used to determine the individual barriers to accessing depression care. Adjusted odds ratios (AORs) with a 95% confidence interval were used to measure the association, and a p-value of less than 0.05 was considered statistically significant.ResultsThe prevalence of depression was 27.4% (95% CI: 22.7-32.6), and 84.4% of affected participants did not access depression care. Depression was significantly associated with poor adherence to HIV medication (AOR = 2.42; 95% CI: 1.53-3.85), poor social support (AOR = 0.57, 95% CI: 0.33-0.99), and high perceived HIV stigma (AOR = 1.85; 95% CI: 1.18-2.93). Additionally, poor adherence to HIV medication (AOR = 0.21; 95% CI: 0.04-0.76) emerged as a significant barrier to accessing depression care.ConclusionsA severe treatment gap exists, with 84.4% of depressed people living with HIV not receiving needed care despite a high depression prevalence of 27.4%.

IntroductionAnal cancer, though rare in the general population, is increasing among men who have sex with men (MSM), particularly those living with HIV. In Algeria, no clinical data on anal HPV or precancerous lesions were available until now.ObjectiveTo determine the prevalence of anal HPV infection, identify circulating high-risk genotypes, and estimate the frequency of anal dysplasia among MSM with HIV in Setif, Algeria.MethodologyA cross-sectional study was conducted in 2024 among 57 MSM followed at the STI/HIV Reference Center in Setif. Anal HPV was detected by PCR (GeneXpert®), followed by high-resolution anoscopy with targeted biopsies. Histology was classified according to LAST (LSIL, HSIL).ResultsHPV infection was detected in 72% (41/57). HPV-16 and HPV-18 were the predominant genotypes, found in 42.1% and 35.1% of participants. Among the 41 biopsied patients, 85.4% had precancerous lesions, including 39% HSIL. Multiple HPV co-infections occurred in 24.3%. The main risk factors were condomless receptive anal intercourse, smoking, and chemsex.ConclusionThis first Algerian study reveals a high prevalence of anal HPV infection and precancerous lesions among MSM with HIV. Findings support the urgent need for targeted screening, HPV vaccination, and strengthened prevention.