Sexually Transmitted Infections最新文献

Objective: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most commonly reported sexually transmitted infections globally. Anorectal CT/NG detection among men who have sex with men (MSM) and coinfections is common. Epidemiological studies suggest that CT/NG coinfections might result in greater bacterial load and transmissibility than single infection. The purpose of this study was to compare bacterial load and symptoms between CT/NG single and coinfections in MSM.

Methods: MSM positive for CT or NG on a triple swab (throat, urethra and rectal locations combined) were enrolled. Before treatment, they self-collected anorectal swabs. Bacterial loads for CT/NG were calculated using real-time PCR and compared between single or coinfected individuals, with or without rectal symptoms.

Results: We enrolled 382 MSM from December 2021 to December 2024. Among all samples: total CT (n=114), total NG (n=125), CT/NG coinfection 29/382 (7.6%). The bacterial loads in single and coinfected samples were comparable. The mean difference between CT alone and CT/NG was 0.40 target copies/mL (95% CI (-0.09 to 0.89), p value=0.107). The mean difference for NG alone and CT/NG was 0.24 copies/mL (95% CI (-0.49 to 0.99), p value=0.498). Among 382 MSM, 15.4% (n=59/382) experienced anorectal symptoms. There was no statistical difference in bacterial burdens between symptomatic and asymptomatic (CT difference of the means 0.52 copies/mL, 95% CI (-0.51 to 1.55); p value=0.313) (NG difference of the means 0.63, CI (0.01 to 1.28); p value=0.05).

Conclusions: In contrast to prior research, we found similar bacterial burdens in anorectal MSM samples with single CT/NG versus coinfection. Further research is needed to understand the clinical implications of CT/NG coinfections. Future studies should investigate factors influencing anorectal CT/NG bacterial burden, transmissibility and susceptibility, including the function of pre-exposure prophylaxis and the rectal microbiota.

HIV cases in the Philippines have surged dramatically, with 5101 new diagnoses reported in the first quarter of 2025-a 57% increase from the same period in 2024. Young individuals aged 15 to 34 years are the most affected, with 96% of new infections linked to sexual transmission. Alarmingly, there has also been a 12% rise in advanced HIV cases, reflecting delays in diagnosis and limited access to care. The country remains far from achieving UNAIDS 95-95-95 targets, with only 55% of people diagnosed, 66% on treatment and 40% achieving viral suppression. This letter calls for urgent public health action, including expanded testing, awareness campaigns, improved access to treatment and pre-exposure prophylaxis, and stronger surveillance systems. International collaboration is essential, and support from global health organisations is critical to reversing this trend and preventing wider regional consequences.

Injectable long-acting cabotegravir plus rilpivirine (CAB+RPV LA) is an effective treatment option for people living with HIV. Unlike regimens containing tenofovir with lamivudine (3TC) or emtricitabine (FTC), it lacks therapeutic activity against the hepatitis B virus, and hepatitis B vaccination is recommended for non-immune individuals. We present a case of acute hepatitis B after switching to CAB+RPV LA in a previously vaccinated individual.

Objective: This qualitative analysis aimed to explore the experiences of men who have sex with men (MSM) providing self-taken oropharyngeal, rectal, meatal and urine specimens, and pooling genital and extragenital specimens for Neisseria gonorrhoeae and Chlamydia trachomatis nucleic acid amplification testing (NAAT).

Method: MSM participants from the MYSTIC study consented to participate in an online focus group. They were encouraged to share and discuss their experiences of self-taken oropharyngeal, rectal, meatal and urine specimens, and the pooling of specimens. The focus group was recorded and transcribed. Thematic analysis, using a framework approach, generated themes and highlighted their experiences.

Results: Seven MSM, with experience of providing self-taken specimens for gonorrhoea and chlamydia testing, consented and contributed to a focus group in April 2024. They described difficulties they experienced in producing and handling urine specimens. They had concerns about urine spilling, but believed it was more accurate than meatal specimens. They described learning how to take oropharyngeal specimens, including being shown by clinicians and using a mirror. They were unsure how deep, and for how long, to take rectal specimens, and whether the swab should be twisted. They described feeling embarrassed at providing faecally contaminated specimens. They found the meatal specimens easy to perform but were concerned whether they were taking the specimen correctly. Overall, MSM preferred meatal specimens over urine and were willing to compensate some test accuracy for meatal specimens rather than urine. Some found the pooling complicated and were concerned about having an adequate environment to do this in correctly; conversely, some found this easy and quicker.

Conclusion: These data provide insight into the experiences of MSM providing self-taken samples and pooling them for gonorrhoea and chlamydia testing. Interestingly, MSM preferred self-taken meatal swabs to urine and would accept a slight reduction in diagnostic sensitivity with this specimen.

Objectives: This study investigated the acceptability by gay men, bisexual men and other men who have sex with men (GBMSM) of French public health information and prevention measures implemented during the 2022 Mpox outbreak.

Methods: ANRS-MPX-SHS "Mpox: perception of risks, health measures and vaccination" is a cross-sectional survey conducted in GBMSM between July and September 2022. Online questionnaires collected information about Mpox-related awareness, perceptions and prevention behaviours. Multiple correspondence analysis identified participant profiles according to their level of acceptability of the information and prevention measures implemented during the 2022 outbreak. The study outcome was a variable grouping participants into three profiles: 'strong endorsers', 'uninformed hesitant endorsers' and 'indifferent objectors'. Multinomial logistic regression was used to estimate factors associated with each profile.

Results: Of the 5688 participants, 5320 (93.5%) had available data for the outcome. The latter were mostly cisgender men (98%), aged between 35 and 54 years (54.5%), with tertiary education (82%); 44% were living in the Greater Paris region. Strong endorsers, uninformed hesitant endorsers and indifferent objectors accounted for 77.8%, 14.4% and 7.8% of the sample, respectively. Participants with tertiary education, those who had sex exclusively with men, those taking pre-exposure prophylaxis (ie, HIV-negative participants), HIV-positive participants and individuals living in the Greater Paris region, were all less likely to be uninformed hesitant endorsers or indifferent objectors. Participants with no lifetime HIV/sexually transmitted infection (STI) screening and those with infrequent screening were, respectively, more likely to belong to these two profiles.

Conclusions: Participants' acceptability of the information and prevention measures implemented during the 2022 Mpox outbreak in France depended on the perceived capability of public health authorities to effectively diversify information targets, representations and communication channels. In order to prevent the transmission of Mpox (and other STIs) in the general population in future outbreaks, information and measures adopted must take into account the needs, perceptions and experiences of persons never or not regularly screened for HIV/STIs.

Objectives: Trauma-an event or circumstance causing an individual physical and/or emotional harm-is associated with adverse sexual and reproductive health outcomes, including a higher prevalence of sexually transmitted infections. Trauma-informed care (TIC) is a systematic framework that recognises and addresses the impact of trauma through an organisation's policies, practices and environment. Online delivery of sexual health services has rapidly become a standard of care in England; therefore, our research aims to provide valuable insights for implementing TIC in digital platforms.

Methods: We performed a secondary analysis of qualitative data from two mixed methods studies that conducted semi-structured interviews with n=100 and n=25 sexual health service users following purposive sampling. A sample of 11 transcripts was included, and an inductive-deductive approach was used to analyse the data.

Results: Our findings highlight six key themes of TIC: (1) Safety, (2) Trust and Transparency, (3) Peer Support and Self-Help, (4) Collaboration and Choice and (5) Cultural, Historical and Gender Issues. Participants reported that online postal self-sampling offered more privacy, comfort and control than in-person testing. They appreciated the use of gender-inclusive language and identified online postal self-sampling as a 'safer option' for individuals who fear being misgendered in clinical settings. However, some were concerned about providing sensitive information online, such as information about sexual partners or gender identity. There was limited evidence of peer support, and participants recommended improved signposting to sexual assault reporting and other trauma-related resources.

Conclusions: This is the first known qualitative study exploring the intersection between TIC and digital sexual health interventions. Our study provides insight into how current online postal self-sampling practices facilitate the principles of TIC and which gaps remain. Future research should explore how these principles can be adapted to make digital sexual health services more trauma-informed.

Objectives: African and Caribbean heritage (ACH) communities in the UK face disproportionately high rates of HIV and often experience delayed diagnoses, worsening health inequities. Increasing HIV testing in these communities is essential to address these disparities and support the UK's HIV reduction targets. This study examines barriers and facilitators to HIV testing among Bristol's ACH community, a high-prevalence area with significant rates of late diagnoses, filling a critical gap in context-specific data.

Methods: Using a mixed-methods approach, this study combined 29 in-depth interviews and 41 online surveys, capturing ACH community members' views on HIV stigma, healthcare trust and testing experiences. Data were thematically analysed and mapped to the Social Ecological Model (SEM) framework, with community researchers conducting data collection and analysis to enhance participants' engagement and trust and contribute to a deeper contextual analytical understanding.

Results: Findings highlight significant barriers across SEM levels: individual-level knowledge gaps and stigma, interpersonal confidentiality concerns within tight knit communities, community-level taboos and distrust and organisational barriers, such as discriminatory healthcare experiences. Effective facilitators included culturally specific services, flexible testing options, community-driven outreach and increased healthcare representation, all of which fostered greater trust and engagement in testing.

Conclusion: The study underscores the importance of culturally aligned interventions, including representation within and training in cultural competence for healthcare providers and community co-production in service design. Implementing such strategies could reduce late diagnoses and support the normalisation of routine HIV testing in ACH communities, ultimately contributing to health equity. Future research should explore gender and age-specific barriers, while assessing the long-term impact of community-led interventions to inform national HIV policy and public health strategies for marginalised communities in the UK.