Sexually transmitted diseases最新文献

Abstract: We demonstrated no differences in susceptibility to penicillin G and ceftriaxone in three modern T. pallidum isolates (UW244B, UW249B, and UW330B), each carrying a variant of the penicillin-binding protein (PBP) Tp0705. This suggests that these polymorphisms should not be a reason for concern when β-lactams are prescribed for syphilis treatment.

Background: Individuals with multiple gonorrhea diagnoses (repeat-GC) may be a key group for STI prevention. We determined repeat-GC rates and associated characteristics by sexual orientation/gender identity within seven jurisdictions in the STI Surveillance Network.

Methods: We constructed a retrospective cohort of randomly-sampled, interviewed GC cases using enhanced surveillance data (01/01/2016-12/31/2021) and followed cases until the first repeat-GC date (diagnosis > 30 days after the interview-associated diagnosis) or 12/31/2022. We applied design weights with post-stratification adjustment for non-response by sex and age and calculated repeat-GC rates. We performed Poisson regression adjusted for follow-up time accrued during the COVID-19 pandemic to assess differences across characteristics.

Results: Among 21,743 interviewed individuals representing 577,719 gonorrhea diagnoses, 46.8% were men-who-have-sex-with-men (MSM), 21.6% men-not-reporting-male-partners, 30.9% women, and 0.7% transgender/gender-diverse persons (TG/GD). Repeat-GC rates per 1,000 person-years were: MSM: 182.3 (95% Confidence Interval (CI):173.8-191.0); men-not-reporting-male-partners: 64.5 (CI:58.2-71.7); women: 47.7 (CI:43.4-52.6) and TG/GD: 73.3 (CI:46.3-115.8). Repeat-GC was associated with prior gonorrhea diagnosis (past 12 m) [aIRR MSM: 1.58 (CI:1.42-1.75); men-not-reporting-male-partners: 1.37 (CI:1.01-1.84); women: 1.59 (1.24-2.02)]. Among MSM, repeat-GC was associated with an initial rectal [aIRR: 1.24 (CI:1.12-1.36)] or pharyngeal [aIRR: 1.14 (CI:1.04-1.25)] infection (versus other infection sites). Men-not-reporting-male-partners [aIRR: 1.57 (CI:1.18-2.12)] and women [aIRR: 1.92 (CI:1.11-3.30)] living with HIV (versus not) had higher rates.

Conclusions: Characteristics associated with repeat-GC (prior gonorrhea diagnosis, HIV status, anatomic site of infection) are available through routine STI surveillance and could be used to prioritize individuals for routine follow-up services and/or novel interventions to prevent repeat-GC.

Abstract: A nine-year retrospective study from a North Indian STI reference centre observed 10% (5/50) azithromycin-resistant gonococcal isolates, including one HLR-AZM (MIC 256 μg/mL) strain. WGS of resistant isolates revealed 23S rRNA mutations (A2059G, C2611T, and C2597T), multiple resistance determinants, and MLST ST-7363/NG-STAR ST-6332 lineages, underscoring the need for continued molecular surveillance.

Abstract: Utilizing aggregated, United States electronic medical record data at the state level, we found that increased mpox incidence was associated with increased bacterial STI rates in men for the same month as well as higher STI rates after the second mpox vaccination. Those seeking vaccination or testing for mpox should be screened for other STIs.

Abstract: We analyzed 162,397 de-identified HSV Western Blot results performed at the University of Washington Virology Laboratory from 1999 to 2020. HSV-1 seroprevalence declined by 0.53% per year, while indeterminate HSV-1 results increased by 0.08% annually. Similarly, HSV-2 seroprevalence decreased by 0.72% and indeterminate results increased by 0.16% each year.

Background: We sought to determine real-world effectiveness of doxycycline postexposure prophylaxis (doxy PEP) in reducing sexually transmitted infections (STIs) among men who have sex with men attending an HIV preexposure prophylaxis (HIV PrEP) clinic in Philadelphia.

Methods: Data from eligible HIV PrEP patients who did and did not receive doxy PEP from September 1, 2019, to December 31, 2023, were analyzed. We used a cohort study design and Cox models to estimate the associations between doxy PEP receipt and incident gonorrhea (GC), chlamydia (CT), and/or syphilis. We also used a crossover design and Poisson models to estimate incidence rate ratios (IRRs) for any STI and each STI separately among individuals in the year before and after doxy PEP initiation.

Results: Among the 508 eligible men, most were young men of color, and 416 (82%) opted to receive doxy PEP. Receiving doxy PEP was associated with a reduction in any incident STI (hazard ratio, 0.61; 95% confidence interval [CI], 0.40-0.93) and any incident CT (hazard ratio, 0.40; 95% CI, 0.21-0.78). Participants experienced a 62% relative reduction in STI rates while taking doxy PEP (IRR, 0.38; 95% CI, 0.29-0.50), including a reduction in CT (IRR, 0.28; 95% CI, 0.20-0.39) and GC (IRR, 0.49; 95% CI, 0.37-0.65).

Conclusions: We observed a significant reduction in any STI and CT in both analytic arms, suggesting that doxy PEP is effective in real-world settings. Enhancing doxy PEP implementation would likely reduce community STI transmission.

Background: Arizona has had one of the highest rates of congenital syphilis in the nation in recent years. The purpose of this study was to evaluate compliance with mandated 3 time-point syphilis testing for pregnant women attending prenatal care, describe access to benzathine penicillin G (BPG) treatment, and assess receipt and use of Think Syphilis campaign materials in Maricopa County, AZ.

Methods: A facility-level cross-sectional survey was performed among prenatal care providers and clinical staff in 2022 to 2023. Responses from individual participants were applied to their facilities, including respective satellite offices within their corporations.

Results: Responses from 42 distinct health care facilities were included, representing 104 outpatient obstetrician-gynecologist clinical settings. These facilities represented 232 delivering providers accounting for 33,196 live births, approximately 68.0% of all reported live births in Maricopa County for 2021. Of the 42, 41 (97.6%) reported use of syphilis screening policies for pregnant women. Reported compliance with performing prenatal syphilis testing was 78.6% (33 of 42) for syphilis at first prenatal care visit and 73.8% (31 of 42) during the third trimester. Among providers with first-hand knowledge of hospital-based screening practices, 76.5% (13 of 17) reported syphilis screening at delivery. Only 11.9% (5 of 42) reported on-site clinic-based administration of BPG; 71.4% (30 of 42) reported referring syphilis patients to an external site for treatment with BPG. Barriers to on-site treatment included cost and perception of syphilis as rare. The Maricopa County STI Clinic was the most reported treatment referral site by 90.5% (19 of 21) of respondents. Regarding the Think Syphilis campaign, 21.4% (9 of 42) confirmed receipt of campaign materials, and of these 77.8% (7 of 9) shared materials with office staff.

Conclusions: Reported performance of 3 time point syphilis testing for pregnant women attending prenatal care in Maricopa County is substantial. However, clinic-based barriers to on-site BPG administration exist. This survey afforded an opportunity to educate providers and clinic staff on maternal syphilis testing and treatment using the Think Syphilis campaign.

Background: Changes in travelers' sexual behaviors, driven by opportunities during travel, contribute to the acquisition of sexually transmissible infections (STIs). However, research on travelers' risk perception, intentions regarding new sexual partners, and engagement in behaviors that may place them at potential risk of STI acquisition remains limited. This study aims to assess the risk perception and intended sexual behaviors associated with STI acquisition among Australian travelers.

Methods: A cross-sectional online survey was conducted from July 2023 to August 2024 among Australian residents (aged ≥18 years) planning to travel overseas within 6 months. The survey was distributed in 5 Travel Medicine Alliance clinics and at the Gladstone Road Medical Centre clinic. Sociodemographics, travel plans, sexual intentions, STI risk perception, and patterns of intended sexual behaviors were collected. Subgroup analysis was performed on participants traveling without a partner to estimate their intention to engage in new sexual encounters.

Results: Of the 205 respondents, 172 (83.9%) attended the Travel Medicine Alliance clinics and 33 (16.1%) the Gladstone Road Medical Centre clinic. The median age was 42.5 years (interquartile range, 28-56 years); 51% (n = 105) were female. Nearly a quarter (22.7% [n = 29]) intended to engage in sexual activity with new partners while traveling. Among these, 72.4% perceived their risk of contracting STIs as low, despite reporting intended sexual behaviors linked to STI acquisition risk such as no intention to use condoms (28.0%), intention to engage in sexual relationships with sex workers (24.1%), and plans to undergo posttravel STI testing (34.6%). Nearly half (41.4%) identified a need for better STI-related pretravel information.

Conclusions: A substantial proportion of surveyed travelers intended to engage in sexual activity with a new sexual partner while traveling, with many underestimating their STI risk and demonstrating intended sexual behaviors that increase their likelihood of STI acquisition. These findings underscore the need for comprehensive sexual health counseling during pretravel consultations, with a focus on STI risk awareness, preventive strategies, and posttravel STI screening.