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Sexually Transmitted Infections as a Challenge of Modern Society: Old...
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Sexually Transmitted Infections as a Challenge of Modern Society: Old Problems and Modern Solutions

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: 30 August 2025 | Viewed by 3765

Special Issue Editors

Dr. Mauro Zaccarelli

E-Mail Website
Guest Editor
STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elioi Chianes 53, 00144 Rome, Italy
Interests: infectious disease epidemiology; sexually transmitted infections; HIV infection; immunology of infectious diseases; viral infections; emerging infectious diseases; infectious disease surveillance; infectious disease transmission
Dr. Alessandra Latini

E-Mail Website
Guest Editor
STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Via Elio Chianesi 53, 00144 Rome, Italy
Interests: sexually transmitted infections; HIV infection; Kaposi sarcoma; human papillomavirus infection; cutaneous/mucosal infections; infection diseases epidemiology and prevention; dermatology

Special Issue Information

Dear Colleagues,

In recent years, a growing incidence in the literature of sexually transmitted infections (STIs) has been reported worldwide (syphilis, gonorrhea, and chlamydia infections), underscoring the continued relevance of these diseases in modern day society. The HIV epidemic continues to significantly influence STI prevalence, particularly more recently as a result of the wide spread use of PrEP (pre-exposure prophylaxis) playing a pivotal role in reducing HIV transmission but potentially affecting the patterns of other STIs. Concurrently, the management of HPV-related infections continues to present ongoing challenges, particularly in light of emerging concerns about vaccine coverage and the impact of vaccination programs.

The rising costs of STI management, alongside persistent issues of privacy, stigma, and counseling, further complicate the fight and prevention against these infections. The interplay between substance use, including chemsex, and STI risk also necessitates further investigation, as the evolution of these behaviors continues to shape transmission dynamics. Advances in therapeutic strategies, such as the use of doxycycline as post-exposure prophylaxis, offer new opportunities for managing bacterial STIs, yet raise concerns about resistance and long-term efficacy.

This collaboration seeks to address these issues, bringing together experts to explore both traditional and novel solutions, sharing best practices, and examining evolving approaches to STI prevention, diagnosis, and treatment.

Dr. Mauro Zaccarelli
Dr. Alessandra Latini
Guest Editors

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sexually transmitted infections (STIs)
  • human papilloma virus (HPV)
  • syphilis
  • gonorrhea
  • chlamydia trachomatis
  • HIV infection
  • PrEP
  • chemsex

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Published Papers (4 papers)

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Research

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13 pages, 617 KiB  
Article
Trends of Anogenital Warts: A 32-Year Retrospective Observational Study (Italy, 1991–2022)
by Eugenia Giuliani, Maria Gabriella Donà, Mauro Zaccarelli, Christof Stingone, Laura Gianserra, Stella Capodieci, Valentina Cafaro, Chiara Fulgenzio, Alessandra Latini and Massimo Giuliani
J. Clin. Med. 2025, 14(11), 3962; https://doi.org/10.3390/jcm14113962 - 4 Jun 2025
Viewed by 260
Abstract
Background: Anogenital warts (AGWs) represent the most common clinical manifestation of human papillomavirus (HPV) infection. The analysis of AGW time trends helps to investigate possible changes over time and monitor the impact of HPV vaccines on HPV-associated morbidity. Methods: AGWs diagnosed [...] Read more.
Background: Anogenital warts (AGWs) represent the most common clinical manifestation of human papillomavirus (HPV) infection. The analysis of AGW time trends helps to investigate possible changes over time and monitor the impact of HPV vaccines on HPV-associated morbidity. Methods: AGWs diagnosed from 1991 to 2022 at a centre belonging to the Italian STI Surveillance Network were analysed in terms of their numbers and the socio-behavioural characteristics of the patients and then compared over the course of three decades. The time trends, overall and by transmission category, were investigated by joinpoint analysis. Results: In total, 9781 AGWs were diagnosed [61.9% in men who have sex with women (MSW)]. Individuals aged 25–34 years (36.9%), those with one recent partner (52.0%), and those with no previous STIs (87.8%) accounted for the majority of diagnoses. The HIV prevalence among individuals tested for HIV was 136/3098 (4.4%, 95% CI: 3.7–5.2). AGW diagnoses showed a mild decrease from 1991 to 2004, followed by a significant increase up to 2013 (the highest peak over the entire study period) and a significant decline thereafter, until the most recent years. During 2011–2022, diagnoses in women who have sex with men (WSM) decreased for those aged up to 24 years—the age class that could potentially have included women vaccinated against HPV. Conclusions: AGWs have declined in recent years. The decrease in the proportion of diagnoses in young WSM may reflect the female immunisation campaign in Italy. Nonetheless, there is still a need to promote vaccine uptake to reduce the AGW burden. Full article
(This article belongs to the Special Issue Sexually Transmitted Infections as a Challenge of Modern Society: Old Problems and Modern Solutions)
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Review

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15 pages, 586 KiB  
Review
Hydrops Fetalis Caused by Congenital Syphilis: Case Series and a Comprehensive Review
by Yuri Yanase, Sirinart Sirilert, Phudit Jatavan, Mallika Pomrop, Krittaya Phirom and Theera Tongsong
J. Clin. Med. 2025, 14(11), 3671; https://doi.org/10.3390/jcm14113671 - 23 May 2025
Viewed by 328
Abstract
A total of 30 hydropic fetuses, including 25 cases from published reports and 5 from our own series, were reviewed, validated, and analyzed. This review yielded the following key findings: (1) Unlike most cases of nonimmune hydrops fetalis (NIHF), hydrops caused by syphilis [...] Read more.
A total of 30 hydropic fetuses, including 25 cases from published reports and 5 from our own series, were reviewed, validated, and analyzed. This review yielded the following key findings: (1) Unlike most cases of nonimmune hydrops fetalis (NIHF), hydrops caused by syphilis is not only preventable but also treatable, with complete resolution possible when appropriately managed. (2) Syphilis-associated hydrops carries a poor prognosis if timely and appropriate treatment is not administered. (3) Based on limited data, intravenous penicillin G is probably more effective than intramuscular benzathine penicillin in treating hydropic fetuses. (4) Middle cerebral artery peak systolic velocity (MCA-PSV) measurements are increasingly used as a reliable and noninvasive tool for assessing fetal anemia, determining the need for intrauterine transfusion (IUT), and monitoring treatment response. (5) A significant number of cases did not receive prenatal treatment due to false-negative serologic results caused by the prozone effect, as well as the omission of syphilis from the differential diagnosis of NIHF, leading to missed prenatal diagnoses. (6) IUT may help mitigate cellular damage in developing vital organs caused by anemic hypoxia, particularly while awaiting the effects of medical treatment. In conclusion, the modern approach to managing this ancient disease includes: (1) prioritizing intensive intravenous penicillin G therapy over conventional intramuscular benzathine penicillin G; (2) utilizing MCA-PSV in conjunction with other indicators of anemia to monitor its severity; and (3) implementing IUT to prevent anemic hypoxic injury in cases where the hematocrit falls below 30%. Full article
(This article belongs to the Special Issue Sexually Transmitted Infections as a Challenge of Modern Society: Old Problems and Modern Solutions)
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18 pages, 2539 KiB  
Review
HPV Infection in Children and Adolescents—A Comprehensive Review
by Paulina Tomecka, Anna Karwowska, Jacek Kuźnicki, Katarzyna Skinderowicz, Aleksandra Wojno, Kornelia Markut, Paulina Typek, Urszula Ciesielska, Julita Kulbacka and Małgorzata Drąg-Zalesińska
J. Clin. Med. 2025, 14(7), 2425; https://doi.org/10.3390/jcm14072425 - 2 Apr 2025
Cited by 1 | Viewed by 1654
Abstract
Background: Human Papillomavirus (HPV) is a predominant and clinically significant virus affecting individuals of all ages, including children and adolescents. Despite its well-documented role in adult health, particularly in cervical cancer, HPV’s impact on younger populations still remains underexplored. Methods: This review investigates [...] Read more.
Background: Human Papillomavirus (HPV) is a predominant and clinically significant virus affecting individuals of all ages, including children and adolescents. Despite its well-documented role in adult health, particularly in cervical cancer, HPV’s impact on younger populations still remains underexplored. Methods: This review investigates the epidemiology, clinical manifestations, transmission pathways, and historical context of HPV in children and adolescents. Results: The study demonstrates a significant prevalence of HPV DNA within paediatric populations, with diverse clinical manifestations such as verruca vulgaris, anogenital warts, and Juvenile Recurrent Respiratory Papillomatosis, alongside substantiating vertical transmission from mother to infant. We also highlight ground-breaking research milestones, including improvements in genetic studies, the development of HPV vaccines, and ongoing investigations into infection dynamics, and long-term health outcomes. Conclusions: By synthesising existing knowledge, this review aims to enhance clinical decision-making, improve management strategies, and pave the way for future research in HPV-related paediatric diseases. Full article
(This article belongs to the Special Issue Sexually Transmitted Infections as a Challenge of Modern Society: Old Problems and Modern Solutions)
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28 pages, 1462 KiB  
Review
Cervicovaginal Microbiome: Physiology, Age-Related Changes, and Protective Role Against Human Papillomavirus Infection
by Diana Alizhan, Talshyn Ukybassova, Gauri Bapayeva, Gulzhanat Aimagambetova, Kuralay Kongrtay, Nazira Kamzayeva and Milan Terzic
J. Clin. Med. 2025, 14(5), 1521; https://doi.org/10.3390/jcm14051521 - 24 Feb 2025
Cited by 1 | Viewed by 1235
Abstract
Background/Objectives: Persistent high-risk human papillomavirus (HPV) infections are the leading cause of cervical cancer. Developing evidence suggests that the cervicovaginal microbiome plays a significant role in modulating HPV persistence and progression to cervical neoplasia. This review synthesizes the current knowledge on the interplay [...] Read more.
Background/Objectives: Persistent high-risk human papillomavirus (HPV) infections are the leading cause of cervical cancer. Developing evidence suggests that the cervicovaginal microbiome plays a significant role in modulating HPV persistence and progression to cervical neoplasia. This review synthesizes the current knowledge on the interplay between the cervicovaginal microbiome and local immunity in HPV infections, emphasizing microbial diversity, immune responses, and potential therapeutic implications. Methods: A thorough review of the literature was performed using Embase, PubMed, Scopus, and Google Scholar, encompassing studies published between 2000 and 2024. Studies examining the composition of the microbiome, immune responses, and HPV-related outcomes were evaluated and synthesized into a comprehensive review. Results: A Lactobacillus-dominant microbiome, particularly with L. crispatus, creates a protective environment through lactic acid production, maintenance of low pH, and anti-inflammatory immune modulation, facilitating HPV clearance. Dysbiosis, often characterized by a dominance of L. iners and overgrowth of anaerobic bacteria, fosters chronic inflammation, cytokine imbalance, and a microenvironment conducive to HPV persistence and progression. Hormonal changes and menopause exacerbate these microbial shifts, increasing the risk of cervical lesions. Studies suggest that cytokine profiles and antimicrobial peptides significantly influence local immune responses, further modulating infection outcomes. Conclusions: The cervicovaginal microbiome is a critical determinant in HPV infection outcomes, with therapeutic potential for modulating the microbiome to enhance immune responses and prevent cervical cancer. Personalized microbiome-targeted therapies may offer a novel avenue for managing HPV and reducing cervical cancer incidence. Full article
(This article belongs to the Special Issue Sexually Transmitted Infections as a Challenge of Modern Society: Old Problems and Modern Solutions)
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