International Journal of STD & AIDS最新文献

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.

BackgroundTopical antiviral agents, particularly acyclovir, are standard over-the-counter treatments for minor herpes simplex infections. However, natural products such as propolis and honey have drawn attention for their potential antiviral and wound healing-promoting properties. This meta-analysis aimed to systematically evaluate and compare the efficacy and safety profiles of propolis and/or honey with 5% topical acyclovir in the management of labial and genital herpes.MethodsA systematic search of PubMed, Scopus, Europe PMC, and the Cochrane Library was performed to identify studies comparing topical propolis and/or honey with 5% acyclovir for herpes simplex lesions. Clinical outcomes were synthesized using random-effects models, with outcomes reported as mean difference (MD) and odds ratio (OR).ResultsSeven studies were included in the analysis. Treatment with propolis and/or honey was associated with quicker lesion resolution (MD: -1.87 days; 95% CI: -2.73 to -1.01; p < 0.0001) and higher healing rates by day 7 (OR: 4.71; 95% CI: 2.70-8.25; p < 0.00001). No significant difference was observed in the number of aborted attacks (p = 0.66). Propolis and/or honey also reported reduced pain duration (MD: -0.96 days; p = 0.03) and pain intensity (MD: -6.53; p = 0.0002), with more patients reporting being symptom-free by day 3. No significant difference was observed in adverse events (AEs) rates between the natural therapy and acyclovir groups.ConclusionsPropolis and/or honey demonstrated superior lesion healing and pain relief compared to 5% acyclovir, with comparable safety, supporting their potential as safe and effective alternatives to conventional antiviral therapy.

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.

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.

BackgroundChlamydia trachomatis and Neisseria gonorrhoeae infections impose a significant burden to the military. In previous studies, women service members had higher rates of both these infections as compared to men for unclear reasons. This study evaluated if sex-based differences in infection rates for chlamydia and gonorrhea were due to sex-based differences in testing practices.MethodsA retrospective chart review was conducted on military service members who underwent testing for chlamydia and gonorrhea at Joint Base San Antonio between June 1, 2023 and September 31, 2023. The local electronic health record database was queried to determine patient demographics, clinical setting, indications for testing, and positivity rates.ResultsA total of 1620 (43%) patients were included for analysis. The cohort was predominantly women (67.5%) and enlisted (84.2%) with a median age of 27 years [IQR: 23-32]. Men were more likely to be tested for patient driven factors, such as symptoms (41.2%) or patient request (24.5%). Women were most frequently tested due to clinical algorithm (53.0%). Men were more likely to test positive for both chlamydia (8.7% vs 3.9%, p = <0.001) and gonorrhea (2.8% vs 0.4%, p = <0.001).ConclusionsAlthough women were more frequently tested for chlamydia and gonorrhea infections, men had significantly higher positivity rates, with more patient-driven indications for testing. The result of this study implies that sex-based testing practice differences in our study population might partially account for the higher rates in men. Importantly, it supports the need for future studies to evaluate the effectiveness of screening men in military settings.

BackgroundMen sex with men (MSM) are accepted as a hidden key population in the dissemination of HIV in Turkey. Understanding sexual behaviours and Sexually Transmitted Infections (STI) frequency in MSM living with HIV is important to provide appropriate health and control policies.MethodsSexual anamnesis including 5Ps were taken with triple-site (urine, pharyngeal and rectal swab) screening tests, which were performed according to the recommendations in the HIV follow up guidelines, from 45 MSM living with HIV, who were followed and consecutively attended to their control visit Marmara University Pendik Education and Training Hospital, in Istanbul, in 2018.Results24.4 % and 26.7 % of participants tested positive for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), respectively. This ratio decreased to 6.7% if urine was the only sample taken to be tested. Syphilis seropositivity increased from 18% to 34% during the HIV diagnosis to triple testing time, which is a median period of 28 months.ConclusionThe data obtained emphasizes the screening and reimbursement of triple testing in key population groups.

BackgroundWe aimed to determine antiretroviral therapy (ART) initiation timing and outcomes in people living with HIV (PLHIV) receiving tuberculosis treatment in KwaZulu-Natal, South Africa.MethodsWe performed a retrospective cohort analysis of routinely collected de-identified data from 62 clinics including PLHIV not already receiving ART aged ≥16 years, starting tuberculosis treatment between October 2016-November 2019. Multivariable Poisson regression models with robust standard errors evaluated associations between timing of ART initiation (after starting tuberculosis treatment) and successful tuberculosis treatment, and 6-month HIV viral load (VL) < 50 copies/mL.ResultsAmong 5,548 PLHIV with tuberculosis, 29.8% initiated ART within 15 days ("early"), 36.2% in 16-56 days, 8.7% in 57-210 days, with 25.3% not initiating ART by 7 months. Proportions with successful tuberculosis treatment were similar comparing 16-56 and 57-210 days to early initiation, with a lower likelihood of successful tuberculosis outcome with no ART within 7 months (adjusted risk ratio [aRR] 0.81 [0.77-0.86], p < 0.001). In those with a known VL 6 months post-ART initiation (n = 2,658), initiation within 57-210 days had a lower likelihood of viral suppression (aRR 0.90 [0.82-0.99], p < 0.03).ConclusionAlthough <30% of PLHIV with tuberculosis initiated ART early, this was associated with better tuberculosis outcomes and VL suppression.

Sclerosing lymphangitis of the penis (SLP) is a rare, benign condition typically presenting as a cord-like swelling. We report an unusual case of SLP in a 75-year-old circumcised man with marked penile edema and deep ulcerations. STI screening was negative. After 2 weeks of sexual abstinence and local care, the ulcerations healed, revealing the characteristic SLP cord. The penile swelling resolved completely after 2 months. This presentation is unique due to the patient's age and the prominent edema and ulcerations, suggesting these features may indicate a severe clinical form of SLP that only manifests its typical appearance after the initial acute phase resolves.

We report a 49-year-old woman living with HIV who stopped her antiretroviral treatment for several weeks. One month after resuming treatment with dolutegravir and lamivudine (Dovato^®), she presented with myalgia, physical weakness and rhabdomyolysis. As we suspected a drug-related cause, Dovato^® was changed for tenofovir disoproxil fumarate, lamivudine and doravirine (Delstrigo^®) without improvement. Second line assessment led to a diagnosis of dermatomyositis, with presence of anti-Mi-2 antibodies, typical MRI findings and pathological analysis of muscle biopsy. The outcome was favorable after treatment with corticosteroids followed by methotrexate. Dovato^® was subsequently re-prescribed without recurrence of symptoms or rhabdomyolysis.