Search Results (428)

The HIV epidemic in Romania started in the late eighties with a large cohort of children nosocomially infected with subtype F1 strains, in parallel with sexual transmission. The purpose of the present study was to investigate the transmitted drug resistance (TDR), subtype distribution, and transmission clusters among persons diagnosed with HIV between 2019 and 2022 in Romania. The prototype of a person recently diagnosed with HIV in Romania is male, 20–50 years old, a late presenter, infected with F1, B, or A subtype. The rate of TDR varied over time, from 5% in 2019 to 15% in 2022. TDR affected mainly the first generation of NNRTIs and the PI class. The rate of late presentation was almost 60%, with 35% of persons qualifying as very late presenters. Subtype F1 is still preponderant in Romania, whereas other subtypes (B, A) and recombinants account for a quarter of HIV-1 new cases. Several transmission networks were identified in the study population, two of them associated with TDR in subtypes F1 and A1. The largest cluster consisted of 26 sequences, originating from Western Romania and introduced around 2007. Molecular clock analysis indicated different origin time points for different clusters, with the most recent in subtypes A1 and B, and the oldest in subtype F1. In conclusion, the HIV-1 epidemic in Romania is currently driven by sexual transmission, with MSM contribution continuously rising in recent years; there are also increases in TDR and the circulation of HIV-1 strains other than F1 (subtype B, A, recombinants). Full article

Background: HIV is one of the deadliest viruses in the world and the leading cause of mortality and morbidity in the Sub-Saharan African countries, including Ethiopia. Millions of new HIV infections are reported every year among the population in the 15–24 age group. Particularly, adolescents are vulnerable to HIV infection due to a lack of adequate information and engagement in risky sexual practices. Thus, the assessment of knowledge, attitudes, and practices (KAPs) is one of the cornerstones in the fight against HIV/AIDS for designing appropriate prevention strategies. This study aimed to assess the KAPs regarding HIV/AIDS among high school students in Burayu town, Ethiopia. Methods: A cross-sectional study design was conducted on students from three higher secondary schools in Burayu town from February to June 2022. A total of 394 students were selected using a stratified proportional sampling technique. Data were collected using pre-tested and self-administered questionnaires and analyzed by SPSS version 26. Descriptive statistics were conducted, and logistic regression was used to determine the associations between variables. A p-value ≤ 0.05 was considered significant in all cases. Results: Out of the 394 students, the majority of respondents (70%) had sufficient knowledge about HIV/AIDS transmission and prevention, while only 61% demonstrated a positive attitude towards people living with HIV/AIDS (PLWHA). In bivariate analysis, a higher level of knowledge was significantly associated with a positive attitude towards PLWHA at OR 23.4, 95% CI, 2.9–185.5, p = 0.003, and not having had sexual practice at OR 4.1, 95% CI, 1.2–13.9, p = 0.025. In multivariate analysis, sexual practice was significantly (p ≤ 0.05) associated with the level of knowledge, age, gender, and places of residence at AORs values of 5.5, 9.7, 3.4, and 5.5, respectively. Conclusions: This study suggests that students with high levels of knowledge had a positive attitude towards PLWHA and less sexual practice compared to students with low levels of knowledge. Furthermore, students’ sexual practice was significantly associated with knowledge level, age, gender, and place of residence. This underscores the urgent need for targeted education to empower vulnerable groups, foster positive attitudes and practive, and curb HIV/AIDS transmission for improved health outcomes. Full article

Monkeypox (MPOX) is an emerging zoonotic disease caused by monkeypox virus (MPXV), an orthopoxvirus closely related to smallpox. Initially confined to endemic regions in Central and West Africa, MPOX has recently gained global significance with outbreaks reported across multiple continents. MPXV is maintained in animal reservoirs but is increasingly transmitted from person to person, facilitated by close contact, respiratory droplets, and, in some cases, sexual transmission. Clinically, MPOX presents with fever, lymphadenopathy, and a characteristic vesiculopustular rash, though atypical manifestations have been observed in recent outbreaks, complicating diagnosis. Laboratory confirmation relies on molecular testing, while differential diagnosis must consider varicella, herpes, and other vesicular illnesses. Therapeutic options remain limited; supportive care is the cornerstone of management, but antivirals such as tecovirimat and brincidofovir, as well as smallpox vaccines, have shown efficacy in mitigating disease severity and preventing infection. The unprecedented global outbreak has underscored the importance of surveillance, rapid diagnostics, and coordinated public health responses to contain transmission. This review provides an overview of epidemiology, virology, clinical manifestations, modes of transmission, available diagnostics, and prophylactic and therapeutic strategies against MPOX. We also discuss the role of animal reservoirs, viral evolution, and human-to-human transmission in shaping the dynamics of recent MPOX outbreaks. By summarizing the latest evidence, this review aims to inform clinicians, researchers, and policymakers about key aspects of MPOX biology, clinical management, and prevention, while identifying gaps that warrant future investigation for the control of this and potentially other emerging zoonotic-related pathogens with an impact on human health. Full article

Background: Human papillomavirus (HPV) is the leading cause of sexually transmitted infections (STIs). It is found in extragenital regions, including the oropharyngeal cavity. Its presence in this area is linked to the increased prevalence of oral and pharyngeal cancer cases in young individuals, which is associated with current sexual practices in the young population. Objective, the objective of this study was to estimate the prevalence of HPV infection in the oropharyngeal cavity and identify associated factors within the student community of the Engineering and Chemical Sciences Unit of the University of Veracruz. Methods: an observational, descriptive, and transversal study was conducted. The study included 136 sexually active students aged 18 to 25 without oropharyngeal infection. After obtaining informed consent from all participants, mouthwashes were collected from the oropharyngeal cavity for subsequent detection of viral DNA and HPV genotyping using the PCR-RFLP technique. Risk factors were further assessed through a private questionnaire. For statistical analysis, a bivariate analysis of the main risk factors was performed, and Odds Ratios (OR) and 95% Confidence Intervals (CI) were calculated. Results: The results showed that HPV was detected in 6 participants, resulting in a prevalence of 4.4% (95% CI, 0.92–7.91), with genotypes 11, 52 and 58 identified. Notably, participants with a sexual orientation other than heterosexual had a 7.5-fold higher association with HPV. Conclusions: these findings indicate that low- and high-risk HPV infection in the oropharyngeal cavity is associated with risky sexual behavior in young individuals. Therefore, understanding the specifics of sexual activities is necessary to better comprehend viral transmission and spread among HPV-positive students. Full article

Background: Human papillomavirus (HPV) is a highly prevalent sexually transmitted infection that can lead to cervical and other anogenital and oropharyngeal cancers. Despite available vaccines, vaccination coverage remains low in Bulgaria. This study aimes to assess the knowledge, attitudes, and practices of Medical University students in HPV prevention. Materials: A cross-sectional anonymous survey was conducted at the Medical University-Plovdiv, Bulgaria. Results: A total of 1485 students, primarily women (60.1%) with a median age of 22.78 years, participated. Four hundred fifty-two (30.4%) reported having received the HPV vaccine. Of the unvaccinated, 800 (77.8%) expressed willingness to receive the vaccine. Vaccinated respondents were more likely to report having had five or more sexual partners (37.1%) compared to unvaccinated respondents (21.1%) (χ² = 77.136, p < 0.001). Approximately one-third (36.4%) mistakenly believe condoms provide complete protection and that antibiotics effectively treat HPV. Students who opposed the assertion that vaccinating minors suggests early sexual activity is permissible were 1.89 times more likely to be vaccinated. Conclusions: Medical University students possess insufficient understanding of HPV transmission, health outcomes, and prevention. Their attitudes and practices require improvement. Enhancing the curriculum with comprehensive HPV information will better equip future healthcare providers and improve public health outcomes. Full article

Immunological non-response (INR) to antiretroviral therapy (ART) is a critical concern for PLHIV, characterized by inadequate CD4⁺ T-cell recovery despite virological suppression. This retrospective study analyzed medical records of virologically suppressed adult PLHIV on ART (2004–2024) at two hospitals in Surabaya, Indonesia, using four operational categories to identify clinical and demographic determinants of INR. Patients were classified as immunological responders (IRs) or non-responders (INRs) based on four definitions: INR1 (CD4⁺ gain < 100 cells/mm³), INR2 (CD4⁺ < 350 cells/mm³), INR3 (meeting of either criterion), and INR4 (meeting of both criteria). Of 464 patients, 382 were analyzed. Baseline CD4⁺ < 200 cells/mm³ strongly predicted INR2 (aOR = 5.60, 95% CI: 2.95–10.62) and INR3 (aOR = 4.46, 95% CI: 2.39–8.29), while anal sexual transmission was protective against INR2 (aOR = 0.42, 95% CI: 0.19–0.92) and INR3 (aOR = 0.41, 95% CI: 0.19–0.89). By month 12, IR groups had over 350 CD4⁺ cells/mm³, with faster recovery slopes in months 0–6 (IR: >20 vs. INR: <10 cells/mm³/month). INR1 and INR4 had flat or negative slopes at 12–24 months, while IR groups had positive slopes. Baseline CD4⁺ was the strongest INR predictor, suggesting the value of early ART and individualized care for Indonesian PLHIV. Full article

Background: Monkeypox (MPX), caused by the Monkeypox virus (MPOX) of the Orthopoxvirus genus, has re-emerged as a significant global health threat. Once confined to Central and West Africa, the 2022–2025 multi-country outbreaks, predominantly caused by Clade IIb, demonstrated sustained human-to-human transmission and global spread. Objective: This review summarizes current knowledge on MPX virology, epidemiology, clinical presentation, and diagnostic technologies, with a focus on innovations supporting rapid and field-deployable detection in resource-limited settings. Methods: The recent literature (2019–2025), including peer-reviewed studies, WHO and Africa CDC reports, and clinical guidelines, was critically reviewed. Data were synthesized to outline key developments in diagnostic methodologies and surveillance approaches. Results: MPX comprises two genetic clades: Clade I (Congo Basin) and Clade II (West African), which differ in virulence and transmission. Clade IIb is associated with sexual and close-contact transmission during recent outbreaks. Clinical manifestations have shifted from classic disseminated rash to localized anogenital lesions and atypical or subclinical infections. RT-PCR remains the diagnostic gold standard, while emerging assays such as loop-mediated isothermal amplification (LAMP), recombinase polymerase amplification (RPA), and CRISPR/Cas-based platforms show promise for rapid point-of-care (POC) testing. Complementary serological tools, including ELISA and lateral flow assays, enhance surveillance and immune profiling. Conclusions: The resurgence of MPX highlights the urgent need for accessible, sensitive, and specific diagnostic platforms to strengthen surveillance and outbreak control, especially in endemic and resource-constrained regions. Full article

This paper evaluates the Enhancing Mobile Populations’ Access to HIV and AIDS Services, Information and Support (EMPHASIS) programme implemented by CARE International across Bangladesh, India, and Nepal. Using individual-level data, we estimate the programme’s impact on HIV-related knowledge and preventive behaviours among migrant workers. Results show that participation in EMPHASIS significantly increased correct knowledge of HIV transmission, reduced misconceptions, and improved partner communication. These informational gains translated into higher condom use and fewer unsafe sexual practices, with stronger effects among women. The findings provide evidence that peer-led, information-based interventions can improve health behaviours among mobile populations. Integrating such approaches with gender empowerment and mobile health services offers a promising model for addressing HIV vulnerability in cross-border migration settings. Full article

Trypanosoma cruzi is the etiological agent of Chagas disease, traditionally transmitted by triatomine vectors. However, experimental and clinical evidence suggest a possibility that the parasite could also be transmitted sexually. In animal models, T. cruzi amastigotes and trypomastigotes have been identified in reproductive tissues and semen, and infection has been experimentally transmitted between mating partners. In humans, the presence of the parasite in menstrual blood, semen, and other genital secretions has been reported, raising the possibility of sexual transmission in both endemic and non-endemic settings. This potential route could contribute to the persistence of infection and the development of congenital cases. Here, we review the current evidence supporting the biological plausibility and experimental demonstration of sexual transmission of T. cruzi, and highlight key research priorities to clarify its clinical and epidemiological significance. Full article

Lymantria xylina is a major pest in coastal casuarina shelterbelts and a species subject to quarantine regulations by countries to which it is non-native. Phototaxis is fundamental to the insect’s surveillance and risk assessment analysis, and it exhibits pronounced sexual dimorphism in compound eye structure. This dimorphism was investigated using scanning and transmission electron microscopy. Males displayed significantly larger compound eyes, characterized by greater ommatidial areas and a higher total number of facets per eye compared to females. From the distal to proximal end, the ommatidium consists of the cornea, primary and secondary pigment cells, crystalline cones, retinula cells, a rhabdom bundle, and basal retinal cells (in a “7 + 1” arrangement). The internal ultrastructure of the ommatidia is similar in both sexes. However, males possess significantly thinner cornea and extremely elongated crystalline cones. Based on external morphology, both sexes generally exhibit a parallel-symmetrical compound eye form, minimizing optical asymmetry to optimize nocturnal vision. These differences are attributed to the distinct visual demands of males for mate-searching in low-light environments, while females, being more stationary, have reduced visual needs. Paraffin sections of Lymantria xylina compound eyes further revealed that, during dark adaptation, pigment granules aggregated within the crystalline cone region to enhance low-light capture. Conversely, following intense light stimulation, these granules translocated to the perinuclear region of photoreceptor cells, forming a light-shielding configuration. Full article

HSV-1 is associated with oral lesions and non-sexual transmission; HSV-2 is primarily transmitted through sexual contact and causes genital infections. Understanding the epidemiological dynamics of both viruses is essential for guiding targeted public-health responses. We conducted a retrospective analysis of 177,599 clinical specimens collected between September 2018 and December 2022 from patients with symptoms suggestive of sexually transmitted infections (STIs) at healthcare institutions across South Korea. HSV-1 and HSV-2 were identified using a real-time PCR assay; positivity rates were stratified by age, sex, specimen type, and year of testing. The overall positivity rate was 0.26% for HSV-1 and 1.60% for HSV-2. HSV-1 was most prevalent among individuals aged <19 years; HSV-2 showed the highest positivity in females aged 20–29 years, declining with age thereafter. HSV-2 positivity was significantly higher in females than in males. A significant decline in HSV-2 positivity was observed over the 5-year study period, while HSV-1 positivity remained stable. This nationwide PCR-based study reveals distinct age- and sex-related epidemiological patterns of HSV-1 and HSV-2. The findings support the need for age-specific and gender-specific STI screening strategies and health education programs. The declining trend in HSV-2 infection may reflect the impact of recent public-health initiatives. Full article

Oropouche virus (OROV), an emerging arbovirus of the Peribunyaviridae family, is responsible for acute febrile illness and, in some cases, neurological or hemorrhagic complications. Although traditionally confined to tropical areas of Central and South America, the 2024–2025 epidemic has signaled a major shift in its geographic and clinical profile, with sustained transmission in the Caribbean, over 15,000 confirmed cases, and the first imported infections reported in Europe and the United States. New clinical observations include fatalities in previously healthy adults, suspected vertical transmission with adverse fetal outcomes, and potential sexual transmission. Despite entomological data indicating low competence of European mosquito species and the absence of the main vector Culicoides paraensis, the increasing frequency of imported cases underscores the need for continued vigilance. Diagnostic limitations and clinical overlap with other arboviruses further complicate early detection. This review summarizes current knowledge on OROV’s epidemiology, transmission dynamics, and clinical features, and highlights the urgent need for integrated surveillance, diagnostic readiness, and coordinated research efforts. Emphasis is placed on Europe’s preparedness strategies, with Italy’s Jubilee 2025 offering a real-world case study for managing arboviral threats during mass gatherings. Full article

Bacterial vaginosis is more than a mild inconvenience for women and has been shown to be an important cause of morbidity and mortality in women through sexually transmitted infections, and in babies due to late miscarriage and preterm birth. The aetiology of bacterial vaginosis remains unclear but there is increasing evidence to support sexual transmission as a cause. Preterm birth is a major cause of neonatal and perinatal mortality and morbidity worldwide and a huge cost on healthcare. The earlier bacterial vaginosis is detected in pregnancy, the greater the risk of an adverse outcome like preterm birth. Bacteriophages influence the vaginal microbiome, resulting in a eubiotic or dysbiotic state that may have implications on the prediction and prevention of preterm birth. We have provided the evidence to link vaginal dysbiosis in the form of bacterial vaginosis with the prediction and prevention of preterm birth. We have also explored the role of bacteriophages in bacterial vaginosis and the possibility of therapeutic interventions. Bacteriophages play an important role in the aetiology of vaginal dysbiosis and novel therapeutic interventions may help in the prediction and prevention of preterm birth through achieving vaginal eubiosis. Full article

Objective: This study conducted a comprehensive analysis of molecular transmission networks and pretreatment drug resistance (PDR) in newly diagnosed HIV-1 infections in Taizhou, China. Methods: From 2021 to 2023, we collected 1126 plasma samples from newly diagnosed HIV patients in Taizhou. The HIV pol gene was amplified, and the obtained sequence was used to construct a maximum likelihood (ML) phylogenetic tree and molecular transmission network. PDR-related mutations were analyzed based on the Stanford University HIV Resistance Database. We conducted genotyping analysis and analysis of factors related to the larger clusters (≥10). Results: We successfully amplified and sequenced the pol region from 937 (83.2%, 937/1126) treatment-naïve HIV-1 patients, each with comprehensive epidemiological documentation. Phylogenetic characterization revealed significant subtype heterogeneity, with CRF07_BC (42.1%, 395/937), CRF01_AE (27.6%, 259/937) and CRF08_BC (22.1%, 209/937) being the most prevalent. Notably, 11.4% of the sequenced population (107/937) presented detectable PDR mutations. Univariate analysis revealed that larger clusters (≥10) are more inclined to be aged ≥60, divorced or widowed, have high or technical secondary school education, and have sexual contact with homosexuality. Multivariate analysis revealed that age ≥60 years and not having a PDR mutation (p < 0.05) were factors associated with larger clusters (≥10). Conclusions: Molecular transmission networks suggest that CRF08_BC is spreading rapidly among the older male population. Consequently, targeted interventions aimed at this population are crucial for halting the ongoing rapid dissemination of this subtype. Full article

Background: Monkeypox (Mpox) is a re-emerging zoonotic disease caused by the monkeypox virus (MPXV). Transmission occurs primarily through direct contact with lesions or contaminated materials, with sexual transmission playing a significant role in recent outbreaks. In 2022, Mpox triggered a major global outbreak and was declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO), prompting renewed interest in effective control strategies. Methods: This study developed a compartmental SEIR-based model to assess the epidemiological impact of key interventions, including vaccination and isolation, while incorporating critical epidemiological parameters. Sensitivity analyses were conducted to examine (1) disease dynamics in relation to the basic reproduction number, and (2) how different parameters influence the curve of symptomatic infections. Real-world continental-scale data were used to validate the model and identify the parameters that most significantly affect epidemic progression and potential control of Mpox. Results: Results showed that the basic reproduction number was most influenced by the recovery rate, vaccination rate, vaccine effectiveness, and transmission rates of symptomatic and asymptomatic individuals. In contrast, the progression of symptomatic cases was highly sensitive to the case fatality rate and incubation rate. Conclusions: These findings highlight the importance of integrated public health strategies combining vaccination, isolation, and early transmission control to mitigate future Mpox outbreaks. Full article