Search Results (87)

Background: High-risk human papillomavirus (HPV) is a leading cause of cervical cancer, particularly in settings with high-risk sexual behaviours and limited preventive care. HPV prevalence peaks in adolescence and early adulthood due to early sexual initiation, multiple partners, inconsistent condom use, anal intercourse, and oral–genital contact. To assess the prevalence and associated risk factors for high-risk HPV infections among female students in Benin City, Nigeria. A faith-based college in Benin City, Nigeria. Methods: A cross-sectional study was conducted among 133 female nursing students. Self-collected genital swabs were analysed using real-time fluorescence quantitative PCR to detect 14 high-risk HPV types. Participants completed a structured questionnaire on sexual behaviour, contraceptive use, and HPV knowledge. Results: The overall high-risk HPV prevalence was 45/133 (33.8%), with 39 (29.3%) presenting multiple infections. HPV66, 58, and 56 were the most common types detected. Significant associations were observed with oral contraceptive use (OR = 3.2, 95% CI = 1.01–9.97) and abnormal vaginal discharge (p = 0.028). Conclusions: The predominance of HPV66, HPV58, and HPV56 highlights the increasing importance of non-vaccine HPV genotypes and shows the need for targeted screening and vaccination. Associations with abnormal vaginal discharge and oral contraceptive use emphasize the importance of sexual health education and routine gynaecological care among young women. This study underscores the need for targeted HPV screening, vaccination, and sexual health education to reduce cervical cancer risk among young women in Nigeria. Full article

Sexually transmitted infections (STIs) remain a global health burden. Beyond classical pathogens, dermatophytes are increasingly identified within sexually linked transmission networks. Genital dermatophytosis is a superficial fungal infection of the genital area, primarily caused by anthropophilic and zoophilic dermatophytes. Recently, Trichophyton mentagrophytes genotype VII and Trichophyton indotineae have emerged as clinically significant dermatophytes, increasingly linked to human-to-human and sexually associated transmission within highly interconnected sexual networks. These infections are often marked by inflammatory, persistent, and treatment-refractory presentations, with prominent genital involvement and rising antifungal resistance—particularly to terbinafine—posing growing diagnostic and therapeutic challenges. Doxycycline post-exposure prophylaxis (Doxy-PEP) has recently emerged as a novel preventive strategy for bacterial STIs, involving the administration of 200 mg doxycycline within 24–72 h after activities associated with increased infection exposure, particularly among men who have sex with men (MSM) and transgender women. While effective in reducing infections such as syphilis and chlamydia, its broader implementation raises concerns regarding antimicrobial resistance. Chemsex is an increasingly prevalent behavioural phenomenon, defined as the intentional use of psychoactive substances during sexual activity to enhance or prolong the experience, particularly among MSM. It is associated with multiple adverse effects, including increased STI transmission, substance dependence, drug toxicity, psychological disturbances, and significant challenges in treatment adherence and healthcare engagement. This review aims to provide a comprehensive and clinically oriented overview of emerging trends in STIs, with a particular focus on dermatophyte infections as pathogens with potential sexually associated transmission, alongside evolving prevention strategies and behavioral factors influencing transmission. Full article

Background: Sexually transmitted infections (STIs) remain a major public health concern among adolescent girls and young women (AGYW) in sub-Saharan Africa (SSA). Although routine STI screening is essential for early diagnosis and prevention, uptake among AGYW is often suboptimal and influenced by multiple individual and contextual factors. This study assessed factors associated with STI screening uptake among AGYW enrolled in HIV prevention programs in Namibia. Methods: A secondary analysis of anonymized programmatic data was conducted among AGYW aged 15–24 years who received services through the DREAMS project and REACH PHN activity between 2018 and 2024. Descriptive statistics, Chi-square tests, and multivariable logistic regression analyses were performed to identify factors associated with STI screening uptake. Results: A total of 26,689 AGYW were included in the analysis, of whom 97.2% were screened for STIs. STI screening uptake was significantly associated with district of residence, year of enrolment, inconsistent or no condom use, perceived risk of HIV infection, use of family planning, and having had sex under the influence of alcohol or drugs. AGYW who perceived themselves to be at risk of HIV and those using family planning methods had higher odds of STI screening, while those who reported sex under the influence of alcohol or drugs were less likely to be screened. Significant geographic disparities in screening uptake were also observed across districts. Conclusions: STI screening uptake among AGYW enrolled in HIV prevention programs in Namibia was high. While this may reflect the effectiveness of integrated, community-based service delivery models, the results should be interpreted with caution, as they are based on a convenience sample. However, behavioural and geographic disparities persist. Strengthening integrated sexual and reproductive health services, addressing substance-related barriers, and implementing targeted district-level interventions may further improve equitable access to STI screening among AGYW. Full article

Sexually transmitted diseases (STDs) continue to represent a substantial burden on public health and society worldwide. With significant implications for social, economic, and public health, STDsare a major global health concern. Despite advances in treatment, the global control of STDs is increasingly threatened by high prevalence of asymptomatic infections, delayed diagnosis and the rapid emergence of antimicrobial resistance (AMR). This emergence includes the value of asymptomatic screeningand the ensuing collateral damage resulting from the overuse of our declining potent antimicrobial resources. This review article critically examines current trends in the epidemiology, clinical significance, and laboratory diagnosis of major sexually transmitted pathogens, including Treponema pallidum, Chlamydia trachomatis, Trichomonas vaginalis, human papillomavirus, herpes simplex virus, and emerging sexually transmissible infections. Major emphasis is focused on contemporary diagnostic technologies and strategies, with a major focus on nucleic acid-based and point-of-care testing and their applicability in routine testing. The review also highlights evolving AMR patterns, resistance-guided therapy, and the role of global and national surveillance systems in informing treatment guidelines, with the integration of diagnostic strategies with resistance-guided therapy and surveillance systems. Strengthening diagnostic capacity, antimicrobial stewardship, and integrated surveillance is essential to mitigate resistance, improve patient outcomes, and advance effective STD management in venereology practice. Full article

Background: In older people, syphilis diagnosis might be undervalued due to both clinical conditions and age-related changes that obscure symptom presentation and physician discomfort with sexual history-taking, creating a dual barrier to timely recognition. Methods: Case presentation with literature review. Results: An 80-year-old woman was referred to the Dermatology Department of Cagliari University by her oncologist, with a 2-month history of intermittent episodes of pruritus associated with papular–nodular skin lesion eruptions, accompanied with asthenia, night sweats, and unintentional weight loss, indicative of a paraneoplastic syndrome or an adverse drug reaction. Careful evaluation indicated the need to perform serological testing, which confirmed secondary syphilis (RPR 1:64 and TPHA 1:5120). Specific questioning regarding sexual behaviors pointed out oral and anal intercourse. The 83-year-old husband did not have active lesions at visit but reported a self-healing generalized skin rash, episodes of asthenia, arthralgia, and headache he had never suffered before. Blood tests showed positive RPR 1:64 and TPHA 1:5120. Targeted sexual history assessment disclosed patient’s engaging with commercial sex workers, clarifying the chain of transmission in this conjugal STI case. Treatment with Benzathine penicillin G 2.4 million units IM in a single dose resulted in complete recovery in both patients. Conclusions: The observation highlights the importance of maintaining a high index of suspicion for syphilis even at advanced age. Persistent stigma regarding elderly sexuality should be faced, and targeted interventions are necessary to improve the clinician’s ability to identify STIs in older adults, but also to reduce sexual stigma and taboo persistence in the general population. Full article

Background/Objectives: Human papillomaviruses (HPVs) are the most common sexually transmitted viruses worldwide and are strongly associated with multiple cancers, including cervical cancer. In France, HPV prevention relies on a combination of organized cervical cancer screening and prophylactic vaccination; however, coverage remains below international targets. Methods: This narrative review summarizes recent advances in HPV prevention in France, with a focus on screening strategies, including the integration of high-risk HPV testing and vaginal self-sampling, as well as vaccination policies that now include both girls and boys, notably through school-based programs. Results: International comparisons, particularly with Australia and several European countries, are used to highlight successful strategies and transferable lessons that could enhance the effectiveness of French prevention efforts. The review also discusses persistent barriers to uptake, including social, organizational, and cultural factors, and considers opportunities to reduce inequalities in access to prevention. Conclusions: Overall, this work provides a comprehensive overview of the current landscape of HPV prevention in France and situates national efforts within a global public health context, offering insights for policy development and future research directions. Full article

Background/Objectives: Early diagnosis of HIV remains a key objective of global health strategies; however, nearly half of HIV infections in Europe (47.0%) continue to be diagnosed at a late stage. Individuals with undiagnosed HIV infection frequently present initially to dermatology services with inflammatory or pruritic dermatoses. Indicator condition-guided (IC-guided) HIV testing has been reaffirmed by recent guidelines as a central pillar of differentiated testing services, with explicit recommendations to systematically offer testing when defined conditions are present. Methods: This narrative review compares current HIV testing and IC-guided testing recommendations with major dermatology guidelines. Results: This comparison highlights a persistent misalignment. Although certain conditions, such as herpes zoster in younger adults, crusted scabies and selected forms of chronic pruritus, carry clear recommendations to offer HIV testing, most dermatology guidelines for chronic inflammatory dermatoses do not include HIV testing as part of routine assessment. Observational data and implementation studies indicate that integrating IC-guided testing into dermatology pathways can identify previously undiagnosed HIV infections, often in patients without recognised risk factors. Conclusions: Our observations highlight the need to integrate HIV testing recommendations into dermatology clinical guidelines. Aligning these guidelines with IC-guided testing strategies is not only feasible but can also reduce late HIV diagnoses arising from dermatology services. Full article

Background: Epididymo-orchitis can be caused by sexually transmitted pathogens, including Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium, or entero-bacteria. The aim of this study was to explore the demographics, microbiological findings, and treatment outcomes of patients presenting to a tertiary sexual health clinic with epididymo-orchitis. Methods: We reviewed the clinical notes of 200 randomly selected patients seen in the clinic with a diagnosis of epididymo-orchitis between 2021 and 2025. We extracted data on demographics, microbiological findings, follow-up, and clinical response rate to treatment. Results: The median age was 33 years (Interquartile range (IQR) = 24–44), 97 (49%) identified as MSM, 11 (6%) were living with HIV (all MSM), and 55 out of the 86 HIV-negative MSM (64%) were using HIV pre-exposure prophylaxis. In total, 35 (18%, 95% confidence intervals = 12.5–23.5%) people were diagnosed with a causative organism: 17 (9%) C. trachomatis, 10 (5%) N. gonorrhoeae, 7 (4%) M. genitalium, 3 (2%) Escherichia coli. Overall, 91 out of 200 (46%) had a documented partner notification plan. Conclusions: A minority of men attending our sexually transmitted infection clinic with clinical epididymo-orchitis have positive microbiology, including M. genitalium. More work is needed to understand the clinical pathophysiology of epididymo-orchitis to streamline treatment algorithms. Full article

Objective: To explore healthcare professionals’ beliefs and concerns about doxyPEP by systematically reviewing the literature. Method: A systematic review of three bibliographical databases (CINAHL, EMBASE and MEDLINE) and MedRxiv in August 2024, updated in February 2026 explored healthcare professionals’ beliefs and concerns about doxyPEP. Three researchers independently reviewed full-text manuscripts for eligibility and narratively synthesized data. We used the Joanna Briggs Institute toolkit to assess risk of bias. This review was registered on PROSPERO (ID:CRD42024570646). Results: Eight manuscripts were included in the final review: five cross-sectional studies, two qualitative studies, and one mixed method study from the USA (n = 5), Australia (n = 1), Kenya (n = 1), and the UK (n = 1) published between 2020–2025 and including 1840 healthcare professionals. Healthcare professionals recognised the high burden of bacterial STIs and believed that doxyPEP should be made available to MSM. There was a strong willingness to provide doxyPEP to MSM with the support of national guidelines. Healthcare professionals suggest that implementing doxyPEP would be feasible with educational support, but were concerned about antimicrobial resistance, drug–drug interactions, pill burden, cost, implementation logistics and the effect on clinical service demands. They acknowledged the lack of research and access to doxyPEP for other groups, specifically trans people and cis-gendered women. They also highlighted the need for community involvement in the implementation of doxyPEP. Conclusions: This review highlights that healthcare professionals were willing and ready to provide doxyPEP; however, they have concerns including antimicrobial resistance, the effect on service capacity, and the lack of research on cis-gendered women and trans people. Patients and health professionals need to be involved in the implementation of doxyPEP. Full article

Background: Since the onset of the HIV epidemic, over 40 million individuals have died from AIDS-related illnesses, leading to nearly 14 million children aged 0–17 losing one or both parents to AIDS by 2022. In 2023, Namibia had 250,000 vulnerable children and 72,000 children aged 0–17 orphaned due to HIV and AIDS. Without parental support, orphaned and vulnerable children (OVC) face heightened risks, including neglect, distress, and compromised decision-making. These vulnerabilities can increase their susceptibility to risky behaviors, such as sexual experimentation. This study used data from the Project HOPE Namibia (PHN) OVC program to assess HIV testing rates and associated factors among OVC. Methods: This retrospective cross-sectional secondary analysis study used data from PHN’s OVC program implemented from 1 August 2023 to 30 November 2024. Data were analyzed using Chi-square tests and binomial and multinomial logistic regression. Results: Among the 16,995 participants included in this analysis, 15,014 (88.3%) participants had ever been tested for HIV (95% confidence interval (CI): 87.8–88.8%). Participants with an increased likelihood of having ever tested for HIV included those who had been in the program for 0–6 months (adjusted odds ratio (AOR) = 1.31, 95% CI (1.17–1.47)), and those from households experiencing little or moderate hunger (AOR = 1.29, 95% CI (1.12–1.50), AOR = 1.51, 95% CI (1.33–1.72), respectively. Conclusions: A multi-pronged approach involving all stakeholders is required to increase HIV testing among OVC. Such an approach should include community-based HIV testing, providing male-friendly healthcare services, and reducing household hunger through economically empowering vulnerable households. Full article

Background: The surveillance of antimicrobial-resistant (AMR) gonorrhea in the United States is conducted under the Gonococcal Isolate Surveillance Project (GISP). Its protocol involves the collection of urethral isolates from the symptomatic men diagnosed with urethral gonorrhea at designated surveillance sites and the estimation of the percentage of cases resistant to current and former gonorrhea antibiotics. A switch to a new antibiotic is typically made when this percentage for a current first-line drug reaches 5%. However, the cost-effectiveness of this surveillance strategy has never been assessed. Methods: We utilized our previously developed agent-based model of gonorrhea transmission among the US men who have sex with men (MSM) population and estimated the total number of gonorrhea cases, total number of discounted quality-adjusted life years (QALYs) and total discounted costs over 25 years under the current surveillance strategy and under a scenario with no surveillance. Results: The maintenance of the current surveillance strategy is projected to avert 104,108 (95% uncertainty interval: 9163, 213,238) gonorrhea cases, gain 192.9 (95% uncertainty interval: 6, 458.3) QALYs and save $38.6 million (95% uncertainty interval: $1 million, $68.2 million) in the simulated cohort of 10,000 US MSM over a 25-year period (2023–2048) when compared to a scenario with no surveillance. Conclusions: The current US surveillance strategy for AMR gonorrhea is cost-saving. However, the low-bound estimate indicates limited savings of $1 million, which is relatively modest at a national scale. Full article

Background/Objectives: Chemsex is defined as the intentional use of psychoactive substances to enhance or prolong sexual activity, predominantly observed among men who have sex with men. It has emerged as a notable behavioral and public health concern due to its association with high-risk sexual practices, psychiatric morbidity, and somatic complications. Despite increasing recognition, global prevalence estimates vary widely (3–52.5%) due to differences in study populations and methodology. Commonly used substances include synthetic cathinones, amphetamines/methamphetamines, MDMA, GHB/GBL, ketamine, alkyl nitrites, and PDE-5 inhibitors. Methods: A narrative review was conducted using PubMed through 11 December 2025. Search terms combined chemsex-related terminology, substance names, and health outcomes. Recent English-language publications (2020–2025) were prioritized. Evidence was synthesized thematically across epidemiology, health complications, motivations, and interventions. Results: Chemsex is strongly associated with unprotected sex, multipartner encounters, and prolonged intercourse, leading to significantly increased rates of HIV, syphilis, gonorrhoea, and chlamydia. Psychiatric complications include depression, anxiety, compulsive sexual behavior, and psychosis, with higher risks in individuals engaging in slamming or polysubstance use. Somatic complications vary by substance and include cardiovascular disease, hyponatremia, rhabdomyolysis, ulcerative cystitis, methemoglobinemia, and overdose. Motivational factors extend beyond sexual enhancement and include minority stress, internalized and externalized stigma, and maladaptive coping mechanisms. Integrated interventions combining harm reduction, cognitive–behavioral therapy, peer-led services, and pharmacotherapy, alongside digital health tools to support PrEP adherence and risk reduction, show promise in mitigating these harms. Conclusions: Chemsex represents a complex interplay of biological, psychological, and sociocultural factors that contribute to elevated STI risk and psychiatric and somatic morbidity. Addressing chemsex requires destigmatized, multidisciplinary approaches that integrate behavioral, pharmacological, and community-based interventions. Digital health innovations can further enhance engagement, risk reduction, and access to timely care. Full article

Background/Objectives: This study investigates the potential association between the sharp increase in syphilis cases in Japan and the growing popularity of dating apps, with a specific focus on the dynamics during the COVID-19 pandemic. Syphilis, a sexually transmitted infection (STIs) caused by Treponema pallidum, presents a significant global public health challenge despite being curable with antibiotics. In Japan, the incidence of syphilis has risen dramatically since 2013, surpassing 10,000 reported cases annually by 2022. Methods: To examine this trend, we analyzed the quarterly reported syphilis cases alongside active user data from three major dating apps (App1, App2, and App3) and conducted a stratified linear correlation analysis by gender and age group. Results: The results reveal that syphilis cases showed accelerated growth starting in the first quarter of 2021, and App 3 demonstrated the strongest positive correlation with new syphilis cases. The association was particularly significant among males aged 20–29 (R² = 0.70, p = 0.0007) and 30–39 (R² = 0.82, p < 0.0001). Conclusions: These findings suggest that the widespread use of dating apps may contribute to the rise in sexually transmitted infections, including syphilis, by facilitating extensive new sexual contacts. Notably, this trend became increasingly evident during the COVID-19 pandemic. Future STI prevention strategies should consider integrating dating apps as a potential medium for public health interventions. Additionally, strengthening sexual health services is essential to ensure that responses to global crises do not inadvertently undermine STI prevention and control efforts. Full article

Background/Objective: High-risk Human papillomavirus (hrHPV) is the leading cause of premalignant lesions and cervical cancer (CC), affecting disproportionally women living with HIV. Mozambique is among the countries with a heavy triple-burden of HIV, hrHPV infections and CC which accounts for more than 5300 new cases and 3800 deaths each year. In this study, we assessed the age-specific distribution and factors associated with hrHPV and cervical lesions among HIV-positive and -negative women from HPV-ISI (HPV Innovative Screening Initiative) study in Maputo, Mozambique. Methods: This cross-sectional study included 1248 non-pregnant women aged ≥18 years who attended CC screening at the DREAM Sant’Egídio Health Centre between July 2021 and April 2022. Screening involved visual inspection with acetic acid (VIA) and high-risk HPV DNA testing. Sociodemographic, lifestyle, and reproductive data were collected through a routine questionnaire. Logistic regression assessed associations between risk factors and hrHPV infection or cervical lesions. Age-specific hrHPV prevalence, partial HPV16/18 genotyping, and abnormal cytology rates were further analyzed by HIV status. Results: The mean age of participants was 43.0 ± 8.6 years. Overall hrHPV prevalence was 28.0%, being higher among HIV-positive women (46.8%) than HIV-negative women (23.8%). Non-16/18 hrHPV genotypes predominated across all age groups. VIA positivity was 11.1%, most frequently involving less than 75% of the cervical area and was more common among younger women (30–45 years) and those living with HIV. Increasing age was associated with lower odds of hrHPV infection (OR = 0.98, 95% CI: 0.97–1.00; p = 0.017), as was higher parity (≥3 deliveries vs. nulliparity: OR = 0.58, 95% CI: 0.36–0.94; p = 0.029). Contraceptive use (OR = 1.65, 95% CI: 1.15–2.38; p = 0.007) and a partially or non-visible squamocolumnar junction (SCJ) (OR = 2.88, 95% CI: 1.74–4.79; p < 0.001) were associated with higher odds of VIA positivity. Conclusions: hrHPV infection and cervical lesions were more frequent in younger and HIV-positive women, highlighting the need for strengthened targeted screening within HIV care services in Mozambique. Full article