Sexually transmitted diseases最新文献

Background: For infants born to those with infectious syphilis during pregnancy, guidelines recommend monitoring nontreponemal titers every 2 to 3 months until non-reactive. The primary objective was to determine when nontreponemal titers become non-reactive in this setting.

Methods: This retrospective cohort study included infants born to mothers in Alberta with infectious syphilis during pregnancy from January 1, 2015 through December 31, 2021 who had at least one follow-up RPR beyond one month of age. Cumulative incidence curves for RPR, EIA and TPPA seroreversion were examined.

Results: For 228 infants (46% female), a diagnosis of probable, possible and less likely congenital syphilis was made in 13%, 32% and 55% respectively. Treatment with intravenous penicillin G was administered to 144 infants (63%) and 80 infants (38%) were not treated for congenital syphilis. A follow-up RPR performed at median 103 days of life (IQR 86-143) was nonreactive in 174 (76%) infants. RPR, EIA, and TPPA seroreversion were documented in 96%, 40%, and 51% of cases, respectively. RPR reactivity beyond 6 months of age was uncommon (1 of 80 untreated infants and 8 of 147 treated infants) and was associated with higher birth RPR.

Conclusion: Approximately three-quarters of infants born to persons with infectious syphilis during pregnancy will have RPR seroreversion by 3 months of age. A small percentage of treated and untreated infants will have a persistently reactive RPR at 6 months of age despite presumed adequate treatment.

Background: Bacterial sexually transmitted infections (STIs) remain prevalent among men who have sex with men (MSM) and transgender women (TGW) in Peru. Doxycycline postexposure prophylaxis (doxy-PEP) is a promising prevention strategy, but data from Latin America remain limited.

Methods: We conducted two online surveys in Lima, Peru (September-October 2024). One assessed willingness to use doxy-PEP among MSM and TGW; the other assessed willingness to recommend doxy-PEP among healthcare providers (HCPs). Logistic regression evaluated correlates of high willingness.

Results: Of 730 eligible MSM and TGW, 447 completed outcome measures. Overall, 82.1% expressed willingness to use doxy-PEP, 34.2% with high willingness. High willingness was associated with ≥5 anal sex partners in past three months (aOR 1.86; 95% CI 1.06-3.24), prior HIV preexposure prophylaxis (HIV-PrEP) use (aOR 2.56; 95% CI 1.40-4.71), living with HIV (aOR 2.74; 95% CI 1.44-5.24), and concern about needing a prescription (aOR 3.33; 95% CI 1.99-5.66). Concerns about side effects (aOR 0.55; 95% CI 0.31-0.98) and microbiome disruption (aOR 0.51; 95% CI 0.29-0.87) were negatively associated. Most participants preferred doxy-PEP over daily doxycycline (64.0% vs 28.6%). Among 132 HCPs, 54.5% were involved in HIV/STI care; 87.1% expressed willingness to recommend doxy-PEP, and 89.4% would do so if included in national guidelines. Limited diagnostic capacity and risk of unofficial use were most frequently endorsed concerns.

Conclusions: High willingness to use or recommend doxy-PEP was observed among clients and HCPs in Peru, providing evidence to guide integration into sexual health services in Latin America.

Background: This study examined human immunodeficiency virus (HIV) -related health literacy and prevention among students at a Southeastern Historical Black College and University (HBCU) using the Integrative Health Literacy Model and the Consolidated Framework for Implementation Research (CFIR).

Methods: Seven gender-specific focus groups (n = 20) were created between June and October 2023. The discussions explored health and HIV information-seeking behaviors, knowledge, prevention practices, and campus culture. Transcripts were analyzed using the domains of health literacy and CFIR.

Results: Participants primarily relied on social media and Google for health information, often passively encountering content rather than actively seeking it. While most have basic knowledge of HIV, misconceptions persist regarding HIV transmission, prevention, and curability. Condom use and testing were endorsed but inconsistently practiced, and knowledge of pre-exposure prophylaxis (PrEP) was minimal. Female groups emphasized relational decision making and negotiation, while male groups raised more factual questions. Campus culture-including gossip, "dirty/clean" narratives, and sexual activity around events like homecoming-shaped both stigma and prevention behaviors. Barriers included comfort concerns regarding condom use, privacy concerns, judgmental staff, and uneven sexual health education before college.

Conclusions: The students highlighted the need for private, affordable, and culturally resonant preventive strategies. The CFIR analysis identified opportunities for anonymous and bundled testing, peer-led education based on relationships and pleasure, and co-designed interventions that embed sexual health into campus life. Strengthening media literacy, promoting partner testing, improving awareness of PrEP and Rapid testing improve HIV prevention among HBCU students.

Abstract: Pregnancy is associated with false-positive treponemal and nontreponemal screening test results. We present five pregnant women who had reactive treponemal screening and nontreponemal tests but nonreactive Treponema pallidum-Particle Agglutination test. Reliance on treponemal screening tests may result in misdiagnosis and unnecessary treatment unless a specific treponemal test is performed.

Background: Chlamydia is the most diagnosed STI among young people in England. Repeat infections are common, and the risk of complications from chlamydia increase with the number of lifetime infections. National guidelines recommend re-testing three to six months following treatment; however, re-testing rates remain low at 10-14%. The objectives of this study were to explore barriers to, and identify potential interventions to improve, chlamydia re-testing among young people in England, using the behaviour change wheel (BCW).

Methods: Qualitative semi-structured interviews were conducted with twenty-two people aged 16-24 who had previously been diagnosed with chlamydia. Participants were recruited from sexual health services in London, the South West, and the North West of England. An inductive thematic analysis was conducted, followed by thematic categorisation to the BCW.

Results: Barriers to re-testing included low awareness and knowledge of the recommendation, and differences in how the term "re-test" was interpreted. Participants' experience of the initial test influenced their willingness or intention to re-test. Possible interventions to overcome barriers include routine discussions of re-testing at diagnosis and the rationale behind the recommendation, re-testing reminders from service providers, and opt-in self-sampling kits.

Conclusions: Lack of awareness, and varied interpretations of "re-test" present challenges to retesting. Interventions such as routine discussions, text reminders, opt-in self-sampling kits, and clear guidance could improve awareness and understanding, and streamline the process. Future strategies should be developed with stakeholders and patients, and assessed for acceptability, practicability, effectiveness, affordability, side-effects, and equity, to maximise their real-world implementation and public health impact.

Abstract: National surveillance data show that early syphilis cases among women increased during 2014-2023, regardless of the sex of their sex partners. Certain characteristics that could affect syphilis transmission-including incarceration history, sexual behaviors, and substance use-were most common among women who have sex with both women and men.

Objective: To characterize computed tomography (CT) findings in women with pelvic inflammatory disease (PID) due to PCR-confirmed Chlamydia trachomatis or Neisseria gonorrhoeae, and to identify imaging patterns that may assist diagnosis in the emergency setting.

Methods: We conducted a retrospective study of 44 female patients who underwent abdominal or pelvic CT in the gynecology emergency department and tested positive for C.trachomatis, N. gonorrhoeae, or both. CT images were re-evaluated by two radiologists for signs consistent with PID. Imaging findings were compared across three analyses: (1) cases correctly vs. incorrectly diagnosed in the original radiology report, (2) concordant vs. discordant interpretations between original and retrospective reads, and (3) differences between infections caused by C.trachomatis and N.gonorrhoeae.

Results: CT features consistent with PID were present in 77.3% of cases. The most frequent findings were fat stranding (86.4%), free pelvic fluid (79.5%), and peritoneal thickening (72.7%). Tubo-ovarian abscesses (TOAs) occurred in 36.4% and were always correctly identified. Subtle peritoneal thickening was more frequent in discordant interpretations (100% vs 63%, p = 0.01). Fallopian-tube thickening was more common in C. trachomatis than N. gonorrhoeae infection (49% vs 11%, p = 0.013).

Conclusion: CT often reveals characteristic features of PID even when the condition is not clinically suspected. Subtle radiologic findings-particularly peritoneal thickening or enhancement and pelvic fat stranding- are often overlooked during emergency evaluation. Increased awareness of these signs may facilitate earlier recognition and management.

Background: Individual food insecurity, defined as having limited or uncertain access to food of sufficient quality and quantity, is associated with increased sexual risk behavior and diagnosis of a sexually transmitted infection, even after accounting for measures of socioeconomic status. Little is known about how food stress at the community level may exacerbate sexual and social vulnerabilities, or its potential association to a higher rate of sexually transmitted infections at the county level.

Methods: An ecological analysis of the association between county-level reported rates of chlamydia, gonorrhea, and primary and secondary syphilis, with rates of food insecurity net of socioeconomic controls in the United States. The moderating effect of county-level estimates of the Supplemental Nutrition Assistance Program (SNAP) adequacy-the SNAP Meal Gap (SMG)-was assessed.

Results: The results show that food insecurity and the SNAP meal gap were both positively associated with bacterial STI burden at the county level, even after controlling for poverty and other sociodemographic characteristics. The association between food insecurity and STI rates is more pronounced in counties where the average SNAP allocation is inadequate to cover the cost of meals.

Conclusions: This study serves as a first step toward understanding how food insecurity may function as an additional stressor on communities struggling with high rates of STIs. These findings underscore the importance of considering food insecurity not only as an economic hardship but also as a potential contributor to community-level sexual health disparities. This study provides more evidence that food assistance programs may play a critical role in shaping population health outcomes.

Abstract: This study assesses doxycycline post-exposure prophylaxis (doxyPEP) awareness, perceptions, and concerns among bathhouse-affiliated individuals. Antimicrobial resistance, adverse effects, and accessibility were primary concerns. Partnerships with bathhouses present opportunities to address these barriers through targeted education, enhancing acceptance and promoting doxyPEP's effectiveness in preventing sexually transmitted bacterial infections.