Search Results (242)

Direct-acting antiviral therapies can cure most people with hepatitis C virus (HCV) infection with little need for testing or monitoring. A major challenge to eliminating HCV is ensuring patients complete all steps of care, including confirmation of cure. We assessed the concordance of sustained virologic response (SVR) at 4 weeks (SVR4) and 12 weeks (SVR12) post-treatment to evaluate the viability of SVR4 as a predictor of cure in patients treated with sofosbuvir (SOF)/velpatasvir (VEL). We conducted a retrospective analysis of patients from the Phase 3 ASTRAL-1, -2, and -3 programs and a historical cohort from the Louisiana Department of Health Sexually Transmitted Infection (STI)/HIV/Hepatitis Program claims database. Concordance analyses were performed for patients with both SVR4 and SVR12 data. The concordance analysis in the ASTRAL studies included 1015 patients; 1005 and 1002 achieved SVR4 and SVR12, respectively. Among SVR4 achievers, 3 failed to maintain SVR12, while all (10/10) patients who did not achieve SVR4 also failed SVR12. In the real-world cohort, 479/509 (94%) patients achieved SVR4 and 485/509 (95%) achieved SVR12. Of those with SVR4, 7 failed SVR12; 17 of 30 patients who did not achieve SVR4 also failed SVR12. High concordance between SVR4 and SVR12 was observed in both ASTRAL and the real-world dataset, supporting the use of SVR4 as a predictor of long-term SVR in patients with HCV infection treated with SOF/VEL. Streamlining cure confirmation by shifting SVR determination from week 12 to week 4 post-treatment may reduce patient loss to follow-up. Full article

Despite widespread support for comprehensive sex education (CSE), abstinence-focused education is the legally mandated standard in Florida public schools. Using a cross-sectional survey design, this study examined the relationship between sex education content and sexual knowledge, attitudes, and behaviors among 117 college students aged 18 to 25 attending predominantly one large Florida public university. Participants completed an anonymous online survey assessing demographics, sex education history, HIV/STI knowledge, sexual attitudes, and condom use. Contrary to expectations and some prior findings, there were no significant differences in HIV/STI knowledge, sexual attitudes, or condom use between students who reported receiving predominantly abstinence-only education (AOE) and those who reported receiving predominantly CSE. While challenging assumptions about the long-term effectiveness of CSE compared to AOE, the data suggest, in part, that the CSE label may be secondary to local implementation, personal experiences, and broader sociopolitical context, in influencing outcomes. Given Florida’s restrictive sex education and reproductive health policies, findings highlight the urgent need for more nuanced, context-sensitive research. Findings also emphasize the importance of evaluating not only the stated content but also the delivery, quality, and accessibility of sex education programs to better support youth sexual health. 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

This study aims to explore characteristics and clinical predictors of Lymphogranuloma venereum (LGV) and non-LGV Chlamydia trachomatis (Ct) serovars. We conducted a retrospective study on men who have sex with men (MSM) diagnosed with rectal or urethral Ct between 2015 and 2022 at the Infectious Diseases Unit of San Raffaele Scientific Institute, Milan, Italy. Nucleic acid amplification test with sequencing was used for Ct serovar determination. Individuals’ characteristics were described by median (interquartile, IQR) or frequency (%) and compared using Kruskal–Wallis or Chi-Square tests, as appropriate. Logistic regression model was used to identify predictors of LGV; multinomial logistic regression model, with LGV group as reference category, investigated factors associated with the LGV group (serovars L1, L2B, L2C), specific highly prevalent non-LGV serovars (D, E, G) or the non-amplifiable group. Overall, 211 MSM were included: 29.8% with LGV, 50.2% non-LGV and 19.9% non-amplifiable. Symptomatic cases were 46% of which 48% LGV; rectal infection was the most common (86%), followed by urethral (10%) and both sites (4%). People living with HIV were 91.5%; 31.3% had ≥1 concomitant STI and 65.4% ≥1 previous one. According to logistic regression analysis, after adjustment for the diagnosis of ≥1 concomitant and previous STI, LGV serovars were significantly associated with symptomatic infections (adjusted odds ratio, aOR = 6.05; 95%CI = 2.92, 13.13; p < 0.001) and anorectal site (aOR = 17.12; 95%CI = 3.17–319.17, p = 0.007) compared to non-LGV. Among MSM, almost 30% of Ct infections were due to LGV serovars. Presence of symptoms and anorectal site involvement, identified as clinical predictors of LGV, should guide clinicians during diagnosis. Full article

Background: Sexually transmitted infections (STIs) represent a significant public health problem due to their impact. Knowledge about them, perceptions of the risk of contracting them, and adherence to prevention strategies such as HPV vaccination are, at various levels, key factors in preventing the spread of STIs. The study therefore aimed to investigate and evaluate, in a group of young Italians, the level of knowledge, perception of risk and propensity to adhere to preventive strategies, including vaccination against papillomavirus. Methods: A cross-sectional study was conducted by administering a questionnaire to young people aged between 16 and 30, residing in four macro-geographical areas, collecting socio-demographic, behavioral and knowledge data. Levels of knowledge about STIs and HPV were classified into four categories (low, medium without awareness, medium with awareness, high). Risk perception was assessed on a scale of 1 to 10. Results: A total of 2576 questionnaires were collected, revealing that general knowledge about STIs is limited: only 12.5% of participants demonstrated a high level of knowledge, while 27.1% demonstrated a low level; with regard to HPV, 41.3% of the sample demonstrated a low level of knowledge. The perception of the risk of contracting HIV and HPV was low in most subjects (average score of approximately 2.9 out of 10), with no significant differences related to levels of knowledge about HPV. Potential adherence to HPV vaccination was high (83.0% considered vaccination useful), but among unvaccinated subjects, almost half expressed concerns about vaccination, related to poor knowledge and mistrust of vaccines in general. Factors associated with a higher frequency of self-reported STIs included older age, transgender identity, non-heterosexual orientation, and risky sexual behavior. Conclusions: The results emerging from the study highlight the urgent need to strengthen educational and preventive interventions aimed at young people. Raising awareness of the risk of contracting STIs and the importance of vaccination are key targets for health promotion interventions. Full article

Background: Men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) experience a high burden of human papillomavirus (HPV) infection and related diseases, yet data on HPV vaccination among this group in Brazil remain limited. Aims: The aims of this study were to estimate the prevalence of complete HPV vaccination and to identify factors associated with vaccination completion among MSM using PrEP in Brazil. Methods: We conducted a cross-sectional online survey between May and September 2025 among MSM aged ≥18 years, residing in Brazil and currently using oral PrEP. Participants were recruited through virtual snowball sampling and targeted advertisements on social media and a gay geosocial networking application. Data were collected using a structured, self-administered questionnaire hosted on REDCap^®. Complete HPV vaccination was defined as self-reported receipt of all doses recommended according to the participant’s age and clinical condition. Sociodemographic characteristics, relationship patterns, sexual behaviors, lubricant use during sexual activity, and history of sexually transmitted infections (STIs) were assessed. Adjusted prevalence ratios (aPRs) and 95% confidence intervals (95% CIs) were estimated using Poisson regression with robust (sandwich) variance. Results: A total of 872 MSM using PrEP were included, of whom 59.4% reported complete HPV vaccination. In adjusted analyses, complete vaccination was more frequent among participants reporting both steady and casual partners (aPR = 1.90; 95% CI: 1.36–2.65) or only casual partners (aPR = 1.72; 95% CI: 1.24–2.39), those reporting lubricant use during sexual activity (aPR = 1.41; 95% CI: 1.23–1.61), and those with a diagnosis of chlamydia and/or gonorrhea in the previous 12 months (aPR = 1.22; 95% CI: 1.08–1.36). Conclusions: Although HPV vaccination coverage among MSM using PrEP in Brazil is higher than that reported for MSM in general, it remains incomplete in a population with regular contact with specialized health services. Integrating systematic assessment and delivery of HPV vaccination into PrEP care may help increase vaccination completion and reduce missed opportunities for prevention. Full article

Objective: The aim of this study was to systematically map evidence to inform best practices for sexual and reproductive healthcare delivered via telehealth (TeleSRH) in United States-based Title X-funded clinics. Methods: We searched three databases (2017–2025) for studies evaluating effectiveness, harms, patient and provider experiences, barriers/facilitators, and engagement strategies encompassing TeleSRH for sexually transmitted infections (STIs), contraceptive care/family planning (CC/FP), and sexual wellness, in countries with a human development index of ≥0.8. Results: From 5963 references and 436 articles, we included 142 eligible publications. TeleSRH use declined since the COVID-19 pandemic’s peak but remains higher than pre-pandemic. Evidence comes mostly from poor-quality studies. TeleSRH increases access and adherence to STI prevention (e.g., pre-exposure prophylaxis for HIV). Tele-follow-up may safely facilitate HIV care continuity. For CC/FP, TeleSRH is comparable to in-person care for patient satisfaction and uptake; patients are less likely to select long-acting reversible contraception but post-initiation tele-follow-up may increase its continuation rates. Vasectomy completion rates may be similar between pre-procedural counseling via telehealth versus in-person. TeleSRH’s potential benefits might include reduced travel time, wait times, no-show rates, and clinic human resource burden (via tele-triaging) and increased preventative screening rates for STIs and non-communicable diseases, prescription refill rates, ability to receive confidential care in preferred settings, and rural/marginalized community outreach. Implementation challenges span technological and capital constraints, provider availability, staff capability building, restrictive policies, language incompatibility, and patient mistrust. Supplementing synchronous TeleSRH with asynchronous communication (e.g., mobile application) may improve continued patient engagement. Conclusions: Preventive, diagnostic, and therapeutic TeleSRH can be effective, with high patient acceptability; however, effectiveness and adoption hinge on contextual factors outlined in this review. Full article

Despite antiretroviral therapy, HIV proteins, such as Tat, persist in tissues, driving chronic inflammation. Cervical inflammation in females not only accelerates HIV progression but also increases the risk of other STIs; hence, understanding the underlying factors/regulators is vital. However, Tat-induced cervical inflammation and its regulation are hitherto poorly understood, which we investigated using TZM-bl cells. Tat stimulation in these cervical epithelial cells significantly increased the expression of various inflammatory mediators, including cytokines (IL-1β, TNF-α, IL-6, IL-17a, GM-CSF), chemokines (MIP-1α, MIP-1β), adhesion molecules (ICAM-1, P-Selectin, E-Selectin), and ROS. Further upregulation of inflammatory mediators (NF-κB, IRAK-4) along with TLR7 was observed in Tat-stimulated cells. Interestingly, Tat stimulation decreased miR-204-5p expression in these cells, suggesting a role in regulating Tat-mediated inflammatory processes. Using a gain-of-function approach, we further observed that the overexpression of miR-204-5p reduced the expression of IL-1β, TNF-α, IL-6, MIP-1α, MIP-1β, ICAM-1, P-Selectin, and ROS in the Tat-stimulated TZM-bl cells, along with NF-κB, IRAK-1, and IRAK-4. Using Western blotting and luciferase assays, miR-204-5p was further shown to directly target NF-κB. Here, we report that HIV-1 Tat stimulation in cervical epithelial cells downregulates hsa-miR-204-5p, thereby activating the pro-inflammatory TLR7/NF-κB axis, highlighting its relevance to understanding mechanisms underlying cervical inflammation. Full article

Background/Objectives: The integration of artificial intelligence (AI) into primary health care (PHC) holds significant potential to enhance efficiency, equity, and clinical decision-making. However, its implementation remains uneven across contexts. This study aimed to identify the systemic, contextual, and governance-related determinants influencing AI readiness in PHC, comparing two distinct health systems, Quebec (Canada) and Iran. Methods: A qualitative, comparative design was employed. Data were collected through semi-structured interviews and focus group discussions with key informants in both settings. A framework-guided content analysis was conducted based on the four Primary Care Evaluation Tool (PCET): stewardship, financing, resource generation, and service delivery. The analysis explored shared context-specific challenges and requirements for AI implementation in PHC. Results: Analysis revealed that AI readiness is shaped more by systemic coherence rather than technological availability alone. Across both contexts, governance- and financing-related challenges were reported by the majority of participants, alongside limited data interoperability. In Quebec, challenges were more commonly articulated around operational and ethical concerns, including workflow integration, transparency, and professional trust. In contrast, participants in Iran emphasized foundational deficiencies in governance stability, financing mechanisms, and digital infrastructure as primary barriers. Across both settings, adaptive governance, sustainable investment, data standardization, and workforce capacity-building consistently emerged as key requirements for AI integration in PHC. Conclusions: AI readiness in PHC is a multidimensional process, in which implementation priorities must align with system maturity. This comparative analysis underscores that while high-resource systems must prioritize ethical integration and workflow alignment, middle-resource settings require foundational investments in governance and infrastructure. This reinforces that AI readiness is a context-dependent and phased process rather than a one-size-fits-all endeavor. Full article

Co-infection by human papillomavirus (HPV) and human immunodeficiency virus (HIV) facilitates cervical carcinogenesis, and additional cofactors such as other sexually transmitted infections (STI) further aggravate this scenario. This study aimed to validate a molecular detection strategy for Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae and to assess the association of these infections with cervical lesions in HPV-positive women living with HIV in Northeastern Brazil. In total, 155 samples were collected from CRIST/AIDS. After microorganism detection by conventional PCR, a multiplex PCR was standardized and validated. A prevalence of 9.03% was observed for C. trachomatis and 6.45% for T. vaginalis, with 0.64% co-infection. In addition, infection with both STIs showed a prevalence of 0.64%. Among HPV-positive women, high-risk genotypes accounted for 70.9% of cases, with HPV-16 being the most prevalent (35.5%). Overall, 18.2% of women presented cervical lesions, and 13.2% of those with co-detection of C. trachomatis and T. vaginalis were associated with high-grade squamous intraepithelial lesions (HSIL). These findings highlight the clinical relevance of screening for multiple STIs in HPV-positive women living with HIV and support the incorporation of multiplex molecular testing into public health strategies to improve early detection and targeted management. Full article

Background: Men who have sex with men (MSM) in Brazil remain disproportionately affected by HIV. Combination prevention strategies, including Pre-Exposure Prophylaxis (PrEP), are critical, yet adherence remains a challenge. This study aimed to identify factors associated with the simultaneous practice of condomless anal sex and non-use of PrEP among Brazilian MSM. Methods: A national cross-sectional study was conducted in 2020 via an online questionnaire disseminated on social media and dating apps. The outcome was defined as reporting condomless anal sex and no PrEP use in the previous year. Bivariate and multivariate logistic regression analyses were performed. Results: Among 1357 MSM participants, a high proportion (69.4%) reported condomless anal sex without PrEP use. Factors significantly associated with this behavior included being younger (18–28 years; AOR: 2.59), identifying as homosexual (AOR: 6.04), bisexual (AOR: 5.30), or pansexual (AOR: 8.67), having a steady partner (AOR: 4.57), engaging primarily in receptive or insertive anal sex, and having a prior STI diagnosis (AOR: 1.49). Conclusions: The confluence of condomless sex and PrEP non-use reveals a significant vulnerability profile among young MSM in Brazil, even within steady relationships. These findings highlight the originality of examining this combined behavioral outcome and underscore the urgent need for targeted, culturally sensitive prevention strategies that address risk perception and enhance PrEP uptake to meet the UNAIDS 2030 goals. Full article

Background/Objectives: The prevalence of Hepatitis C Virus (HCV) among men who have sex with men (MSM) is not negligible; however, data from Italy—especially regarding MSM who are not infected with Human Immunodeficiency Virus (HIV)—are limited. We report data from an HCV screening programme targeted at MSM in Rome, starting in 2019 in two hospital settings and in four urban community-based (CB) settings run by non-governmental organizations (NGOs). Methods: Adult MSM (>18 years old) who presented for HIV or sexually transmitted infection testing, or who attended CB activities, were invited to undergo a free-of-charge rapid HCV antibody test (OraQuick HCV^®), after providing informed consent. For all participants, demographic, clinical and behavioural data were collected using an anonymous questionnaire for all participants. Free confirmatory standard serology tests were offered for those found reactive at a rapid HCV test. Individuals with confirmed chronic HCV infection were referred through a dedicated “fast track” pathway for further clinical and laboratory assessment and direct-acting antiviral agents (DAAs) treatment according to the national treatment guidelines. Results: Between July 2019 and July 2023, 2714 MSM agreed to be screened for HCV infection. The median age was 36 years (interquartile range, IQR = 29–46), 91.0% were Italians, 58.0% enrolled in the two clinical centres and 10.7% reported living with HIV (people living with HIV, PLWH). Overall, 9 (0.33%) MSM tested reactive for HCV-specific antibodies using a rapid test. Eight MSM were retested and seven were confirmed to have chronic HCV infection (HCV viremia range: 8 × 10³–23 × 10⁶ IU/mL). The prevalence of confirmed cases was 0.26% (7/2714; 95%CI: 0.10–0.53) and was higher in PLWH compared to those not reporting HIV infection (1.04% vs. 0.17, p = 0.03). Four of seven confirmed HCV cases attended the STI clinic. All confirmed HCV cases reported high-risk behaviours for HCV infection and/or history of sexual transmitted infection (STI). Bening a PLWH (OR = 6.30) and current/former IDU (O = 17.02) resulted in being significantly associated with HCV infection. Other risk factors such as fisting, groupsex, chemsex and condomless anal intercourse were more common in the HCV case (OR > 2), but lacked statistical significance, likely due to small sample size. All seven individuals were linked to care, clinically assessed and started on DAAs treatment, achieving sustained viral response (SVR) in all cases. Conclusions: These data suggest the feasibility and potential effectiveness of a preventive programme targeting MSM living in Rome, combining HCV screening, case finding and prompt linkage to care. HCV prevalence in the screened population was lower than anticipated, although it is significantly higher in PLWH and in those with high-risk behaviours. Considering this condition of low prevalence of HCV infection among MSM in Italy, a targeted screening in PLWH and in individuals with high-risk behaviours may be more effective to achieve HCV eradication than universal screening in MSM. Full article

In developing countries, adolescent girls and young women (AGYW) continue to experience high rates of unintended pregnancy and sexually transmitted infections (STIs), including Human Immunodeficiency Virus (HIV). Several healthcare services are available at the primary level of healthcare to address the sexual and reproductive needs of adolescents in South Africa. Healthcare providers often face challenges such as limited resources, inadequate funds, and inadequate training, which hinder their ability to provide integrated care. Furthermore, cultural stigma and a lack of privacy prevent adolescents from seeking care. In response to increasing international calls for developing and implementing integrated person-centered care, which addresses both quality and access to care, this paper aims to develop and validate an integrated HIV/STI, and pregnancy prevention program for adolescent girls and young women in the Vhembe District of Limpopo. Multiphase mixed methods were employed in this study. This study consisted of three interconnected phases. As part of phase 1 of this study, a comprehensive literature review was conducted. In phase 2, an empirical study conducted using a concurrent triangulation strategy to collect and analyze both qualitative and quantitative data as a form of confirmation, dis-confirmation, cross-validation or corroboration of the findings. Consequently, a conceptual framework was developed using qualitative and quantitative analysis by merging, comparing, and interpreting the results. The findings of phase 2 interface were analyzed using the Political, Environmental, Social, and Technological (PEST) and Strength, Weakness, Opportunity, and Threat (SWOT) analyses. Additionally, the outcomes of the Logical Framework Analyses (LFA) informed the development of an integrated programme aimed at preventing HIV, STIs, and teenage pregnancy. Several stakeholders and experts (n = 35) were consulted as part of the Reduce the Risk (RTR) Coalition to validate the proposed integrated programme with an average of 94.3% on acceptability, feasibility, and appropriateness. In the Vhembe District of Limpopo province, there has been no published study that has developed an integrated HIV, STIs, and pregnancy prevention programme to improve the sexual health outcomes of adolescent girls and young women. Full article

Background: Meningococcal B (MenB) vaccination offers protection against invasive meningococcal disease and moderate cross-protection against gonorrhea. However, little is known about coverage and behavioral correlates among men who have sex with men (MSM) in China. This study assessed self-reported MenB vaccination uptake and its associations with sociodemographic and behavioral factors. Methods: We conducted a nationwide cross-sectional survey among 1022 MSM recruited via community-based organizations and online platforms. Vaccination status and recent sexual behaviors were self-reported. Logistic regression identified correlates of uptake, and latent class analysis (LCA) examined behavioral profiles. Results: Participants had a mean age of 29.6 years; most were unmarried (87.7%) and nearly 90% had a college degree or above. Overall, 21.7% reported receiving MenB vaccination. Uptake was positively associated with condomless anal intercourse (aOR = 1.57, 95% CI: 1.08–2.31), group sex (occasionally: aOR = 1.63, 95% CI: 1.01–2.64; frequently: aOR = 3.86, 95% CI: 1.85–8.04), and female partners in the past six months (aOR = 3.69, 95% CI: 2.25–6.10). MSM with multiple casual male partners were less likely to be vaccinated (aOR = 0.55, 95% CI: 0.32–0.93). LCA identified heterogeneous subgroups; notably, the “multi-partner and proactive” group, with high pre-exposure prophylaxis against HIV infection awareness and frequent STI testing, showed low uptake (13.4%). Conclusions: MenB vaccination coverage among MSM in China remained suboptimal. Uptake differed across behavioral subgroups, underscoring the need for stratified, context-specific strategies to inform future vaccine introduction. Full article

Background: Sexually transmitted infections (STIs) are common globally, posing significant public health challenges and financial strain, especially in low- and middle-income countries. Sub-Saharan Africa (SSA) accounts for 40% of global STI prevalence, with South Africa having the highest rates of curable STIs and human immunodeficiency virus (HIV), both of which are closely linked to increasing HIV transmission risk and other STIs. Genital ulcer disease (GUD), primarily caused by HSV-1, HSV-2, and Treponema pallidum, and less frequently by Haemophilus ducreyi, Klebsiella granulomatis, and Chlamydia trachomatis, exemplifies the complex interplay of STIs. Methods: This study analyzed GUD and co-infection with HIV, testing patterns, and co-occurrence trends among public clinic attendees in Mthatha, South Africa, to identify demographic, behavioral, and occupational disparities. Results: Sex-specific analysis revealed higher HIV prevalence among female attendees (47.00%) compared to male attendees (22.00%), alongside notable testing gaps and disparities in diseases such as syphilis, genital herpes, and lymphogranuloma venereum (LGV). Age-specific trends indicated the highest HIV prevalence in individuals aged 30–49, with peaks at 66.67% (30–39) and 76.47% (40–49). Treponema pallidum and HSV-2 prevalence were most pronounced in younger age groups (<20 and 20–29), while older demographics (50+) exhibited significant diagnostic gaps. Occupation-based analysis highlighted elevated HIV (65.91%) and HSV-2 (19.61%) prevalence among unemployed individuals, reflecting socioeconomic vulnerabilities. Co-occurrence analysis revealed notable overlaps, such as HIV and HSV-2 (6.67%) and Chlamydia trachomatis with HSV-1 (5.71%) and HSV-2 (4.76%), driven by shared risk factors. Correlation analysis identified strong links between HSV-1 and Haemophilus ducreyi (0.64) and between Chlamydia trachomatis and HSV-1 (0.56), underscoring the potential for integrated diagnostic strategies. Conclusion: These findings emphasize the need for targeted public health interventions addressing sex, age, and occupational disparities while improving diagnostic coverage and prevention efforts for co-occurring infections. Full article