Sexually Transmitted Infections[JOURNAL]
Sun
200 papers
Acceptability and use of doxyPEP among cisgender men who have sex with men, transgender women and non-binary persons assigned male sex at birth: results from a national online survey from the USA.
Gistand NL, Torres TS, Celum C … +3 more , Luetkemeyer A, Buchbinder S, Scott HM
Sex Transm Infect · 2026 Jul · PMID 42392875 · Publisher ↗
BACKGROUND: Sexually transmitted infections (STIs) have continued to rise in the USA, and doxycycline postexposure prophylaxis (doxyPEP) has shown prevention efficacy for bacterial STIs. We sought to evaluate doxyPEP int...
BACKGROUND: Sexually transmitted infections (STIs) have continued to rise in the USA, and doxycycline postexposure prophylaxis (doxyPEP) has shown prevention efficacy for bacterial STIs. We sought to evaluate doxyPEP interest, use and its associated factors among a national sample of eligible users. METHODS: Using national advertisements on a social networking application for men who have sex with men (MSM), we recruited participants to complete an anonymous cross-sectional online survey from 1 March to 30 April 2023. Analyses of doxyPEP user characteristics and factors associated with use were restricted to respondents assigned male sex at birth, residing in the USA and eligible for doxyPEP. Eligibility was defined as self-report of a bacterial STI in the past year following the US Centers for Disease Control and Prevention guidelines. A multivariate logistic regression model was used to evaluate the factors associated with doxyPEP use. RESULTS: Of 1428 respondents, only 9% reported ever using doxyPEP and 2.5% reported current use. Most respondents (88.3%) not currently on doxyPEP were interested in using it. Among the 471 eligible respondents included in the analysis, the median age was 37 years; the majority (93.6%) identified as cisgender MSM, 2.5% as transgender and 3.8% as non-binary. Most respondents were from the Southern United States (29.5%) and Western United States (37.6%). Among the eligible participants, 17.0% ever used doxyPEP. The majority received doxyPEP from their healthcare provider or STI clinic. Self-identifying as black race (adjusted OR (aOR) 3.08, 95% CI 1.31 to 7.16), reporting a higher number of sex partners (aOR 1.02, 95% CI 1.01 to 1.03), current pre-exposure prophylaxis use (aOR 3.61, 95% CI 1.55 to 9.74) and living with HIV (aOR 3.08, 95% CI 1.20 to 8.83) were associated with doxyPEP use in a multivariable model. CONCLUSION: A national online survey among cisgender MSM, transgender and non-binary persons showed high interest but low use of doxyPEP, which was expected as there were no national guidelines in place at the time. These findings provide baseline estimates to inform future monitoring of doxyPEP uptake.
Cervicovaginal inflammation and HIV target cell activation in adolescent girls and young women with infections.
Dabee S, Barnabas S, Kullin B … +14 more , Versteeg B, Mkhize N, Muller E, Maseko V, Lewis DA, Dietrich J, Gray G, Gill K, Bekker LG, Sinkala M, Martin DP, Bruisten SM, Jaspan HB, Passmore JS
Sex Transm Infect · 2026 Jul · PMID 42392874 · Publisher ↗
BACKGROUND: Adolescent girls and young women (AGYW) in sub-Saharan Africa are disproportionately affected by (CT) infections, a leading cause of pelvic inflammatory disease, infertility and increased HIV susceptibility....
BACKGROUND: Adolescent girls and young women (AGYW) in sub-Saharan Africa are disproportionately affected by (CT) infections, a leading cause of pelvic inflammatory disease, infertility and increased HIV susceptibility. CT-induced genital inflammation disrupts mucosal barriers and activates HIV target cells, compounding immunological risks. We investigated CT infection in AGYW from two South African regions, focusing on genital inflammation and immune activation. METHODS: An observational cohort of 298 sexually active AGYW (aged 16-22 years) from Cape Town and Johannesburg was enrolled. Participants in Johannesburg attended one visit, while those in Cape Town were followed longitudinally (6-8 months). Cytokine profiling of cervicovaginal samples assessed inflammatory responses, while cervical cytobrush-derived CD4+ T cells were analysed for CD38, Ki67 and C-C chemokine receptor type 5 expression. CT genotyping examined strain diversity. RESULTS: CT prevalence was 2.4-times higher in Cape Town (41.6%) than Johannesburg (17.4%). CT infection was associated with upregulated interleukin (IL)-1β, IL-6 and tumour necrosis factor (TNF)-α, with responses appearing stronger in Johannesburg, although low CT cases at this site limited regional comparisons. Genotyping suggested regional variation: genovar D, predominant in Cape Town, was associated with lower interferon (IFN)-γ concentrations, whereas genovar E, more common in Johannesburg, was associated with higher IFN-γ concentrations. AGYW with CT infection across multiple visits did not exhibit elevated genital tract cytokine levels compared with those infected at a single visit. However, they showed increased activated cervical CD4+ T cells. CONCLUSIONS: CT-associated immune responses in AGYW appear to reflect a combination of pathogen diversity, regional context and host immune history.
Cost-effectiveness of a decentralised molecular point-of-care testing programme for sexually transmitted infections in remote primary care health services in Australia.
Watts CG, Causer LM, Matthews SJ … +24 more , Smith K, Andrewartha K, Tangey A, Hui BB, Huang RL, Anderson D, Badman SG, Donovan B, Fairley CK, Gunathilake M, Hengel B, Kaldor J, Maher L, Mak DB, Persing D, Regan DG, Shephard MD, Speers D, Wand H, Ward J, Whiley D, White CS, Wiseman V, Guy RJ
Sex Transm Infect · 2026 Jun · PMID 42373317 · Publisher ↗
OBJECTIVES: In remote Australian First Nations communities, the burden of curable sexually transmitted infections (STIs) is highest for young women and men aged 16-29 years and for women is associated with two-fold highe...
OBJECTIVES: In remote Australian First Nations communities, the burden of curable sexually transmitted infections (STIs) is highest for young women and men aged 16-29 years and for women is associated with two-fold higher rates of hospitalisations for pelvic inflammatory disease (PID) than for non-First Nations women. Following a randomised trial, decentralised community-led molecular point-of-care (POC) testing for STIs has operated in remote primary care across Australia for more than 7 years, improving uptake and timeliness of treatment for chlamydia, gonorrhoea and trichomonas infections. However, cost-effectiveness remains unknown. METHODS: A decision analytic model was devised to compare costs and outcomes associated with a POC testing programme for chlamydia, gonorrhoea and trichomonas infections in women and men aged 16-29 years seeking care, compared with standard care (laboratory-based testing). The analysis used a government payer perspective and 10-year time horizon. The primary outcome was the cost ($A) per quality-adjusted life year (QALY) gained. Sensitivity analyses examined uncertainty around the results. RESULTS: Based on a combined testing positivity rate of 36% and 29% for chlamydia, gonorrhoea and trichomonas for women and men, respectively, the POC testing programme, compared with laboratory testing, produced an estimated incremental cost per QALY ratio (ICER) of $A19 714 (95% CIs $A19 608 to $A19 821) over 10 years. Among those with an STI, the POC testing programme was predicted to reduce diagnosed PID by 30% and preterm/low birth weight babies by 17%. Sensitivity analyses indicated that the ICER was most sensitive to the probability of infection and receiving treatment within 2 days, based on a willingness-to-pay threshold of $A50 000. CONCLUSION: This health economic evaluation indicates that a scaled molecular POC testing programme for the management of STIs in remote primary care settings is cost-effective compared with standard care. Sustained POC testing in this setting is likely to improve reproductive health outcomes.
Insights into sexual partners and partnerships among gay, bisexual and other men who have sex with men in the United Kingdom: results from the Reducing Inequalities in Sexual Health (RiiSH) behavioural survey.
Fearon E, Etoori D, Ogaz D … +6 more , Weil B, Nutland W, Reid D, Saunders J, Mohammed H, Mercer CH
Sex Transm Infect · 2026 Jun · PMID 42373316 · Publisher ↗
OBJECTIVES: Sexual decision-making and sexually transmitted infection (STI) prevention are influenced not only by individuals' characteristics but also by those of their partners and their relationship with each other. T...
OBJECTIVES: Sexual decision-making and sexually transmitted infection (STI) prevention are influenced not only by individuals' characteristics but also by those of their partners and their relationship with each other. To inform STI prevention and understand transmission dynamics, we aimed to understand sexual partnership demographic assortativity, sexual behaviour, communication and concurrency among UK-resident gay, bisexual and other men who have sex with men (GBMSM). METHODS: With community members and organisations, we codesigned a sexual partnerships module for an annual online cross-sectional community-based survey of UK-resident GBMSM (cisgender/trans/non-binary assigned-male-at-birth) undertaken November-December 2023. We collected data about ≤3 most recent male sex partners since August 2023 and analysed variations in relative demographic characteristics (age, ethnicity), sexual behaviours (practices, condom use, HIV-pre-exposure prophylaxis (HIV-PrEP use)) and sexual health communication by partner type (one-time, established, casual and uncertain). RESULTS: 1106 participants described 2342 partners: 12.5%, 20.4%, 9.9% and 57.1% reporting 0, 1, 2 and 3 partners, respectively, of varying combinations. Casual partner types were most reported (43.2%) versus one-time (36.1%), established (13.9%) and uncertain partnerships (6.8%). Concurrency was common with the mean number of ongoing partnerships >1 (1.23, 95% CI 1.17 to 1.30). Age-mixing varied by partner type, from median 2 (established partners) to 10 (one-time partners) years difference.Sexual health communication was highest among established partners. It was two times as common to be unaware of one-time partners' HIV status (66.8%) and not to have discussed sexual health (65.7%) compared with casual partners (30.0% and 27.2%, respectively). Condom use was low across partner types. HIV-PrEP was always used by HIV-negative participants in two times as many one-time, causal and uncertain partnerships (49.2%, 50.0%, 42.0%) compared with established partnerships (23.3%) involving condomless anal intercourse. DISCUSSION: UK-resident GBMSM have diverse types of male sexual partners, varying in their demographic mixing, sexual behaviour and communication, which should be reflected in sexual health promotion and transmission dynamics analyses.
Deep genomic characterisation of an extensively drug-resistant carrying bla in a sexually transmitted infection in an MSM patient in Spain.
Fraile Valcárcel N, Armas Luján BM, Fernández Vecilla D … +8 more , Urrutikoetxea-Gutiérrez M, Rodriguez-Grande J, Ruiz De Alegría Puig C, Labrador Descalzo S, Mesa Santana E, Riesco Alonso S, Ocampo-Sosa A, Roiz Mesones MP
Sex Transm Infect · 2026 Jun · PMID 42350269 · Publisher ↗
OBJECTIVES: We aimed to characterise the genomic features, resistance determinants, plasmid content and phylogenetic relatedness of an extensively drug-resistant (XDR) isolate carrying bla identified in northern Spain....
OBJECTIVES: We aimed to characterise the genomic features, resistance determinants, plasmid content and phylogenetic relatedness of an extensively drug-resistant (XDR) isolate carrying bla identified in northern Spain. METHODS: A 31-year-old man who has sex with men (MSM) living with HIV on antiretroviral therapy with a prior history of treated syphilis presented with 1 week of bloody diarrhoea and abdominal pain. He reported multiple recent sexual partners and use of mobile dating applications and had no symptoms suggestive of urethritis or proctitis. Whole-genome sequencing was conducted and phylogenetic relatedness to international bla strains were assessed using single nucleotide polymorphism (SNP) based analysis. RESULTS: As symptoms persisted, the patient re-attended the emergency department and was discharged after Infectious Diseases consultation while awaiting susceptibility results. Whole-genome sequencing assigned it to ST152 and exhibited resistance to third-generation cephalosporins, aminoglycosides, ciprofloxacin, trimethoprim-sulfamethoxazole and azithromycin while retaining susceptibility to amoxicillin-clavulanic acid, nitrofurantoin and fosfomycin. Oral fosfomycin 500 mg was subsequently prescribed in primary care. A follow-up stool culture 1 month later was negative. Phylogenetic analysis demonstrated that this isolate was genetically distinct from clusters reported in England and Los Angeles and only moderately related to Spanish strains from Bilbao, suggesting an independent acquisition event. CONCLUSIONS: We describe the second report in Spain of an XDR harbouring bla sexually transmitted in an MSM. The coexistence of multiple resistance genes on potentially conjugative plasmids highlights the capacity of this pathogen as vehicles for resistance gene dissemination, which underscores the public health threat posed by sexually transmitted XDR .
National prevalence estimates of chlamydia and gonorrhoea in the Netherlands (PECAN): comparison of two national cross-sectional surveys.
van Wees DA, Willemstein IJM, Bruisten SM … +5 more , de Graaf H, Vermey K, Hiemstra M, van Benthem BHB, Heijne JCM
Sex Transm Infect · 2026 Jun · PMID 42350268 · Publisher ↗
OBJECTIVES: National prevalence estimates of chlamydia and gonorrhoea are essential to inform public health strategies and support evidence-based policy development. The aim was to generate national prevalence chlamydia...
OBJECTIVES: National prevalence estimates of chlamydia and gonorrhoea are essential to inform public health strategies and support evidence-based policy development. The aim was to generate national prevalence chlamydia and gonorrhoea estimates in 2022/2023, identify associated risk factors and compare prevalence over time. METHODS: Five years after the first survey in 2016/2017, a second national cross-sectional probability sample survey about sexual health among men and women aged 16-34 years in the Netherlands was conducted between October 2022 and March 2023. Sexually active survey participants were invited to participate in the prevalence study and received a home-based sampling kit. Returned samples were tested for chlamydia and gonorrhoea in a laboratory (ie, nucleic acid amplification test). Weighting techniques were used to correct for selective non-response. Multivariable logistic regression analyses were performed to identify risk factors of infection. RESULTS: Of 6277 survey participants invited for the prevalence study, 1142 (18.2%) returned a specimen. The weighted overall chlamydia prevalence was 3.5% (95% CI 2.3% to 5.4%), and prevalence was higher in younger age groups (<25 vs ≥25 years). Due to low numbers in other groups, risk factor analysis was only possible among women aged 18-24 years, where risk factors for chlamydia included being <20 years, vocational education, no steady relationship and condomless sex. As in 2016/2017, no gonorrhoea cases were detected in 2022/2023. Chlamydia prevalence and associated risk factors did not change, except for higher prevalence among university-educated individuals in 2022/2023. DISCUSSION: Chlamydia prevalence among young sexually active men and women in the Netherlands remained stable between 2016/2017 and 2022/2023, with higher prevalence observed in younger age groups in both studies. Given recent changes in chlamydia testing guidelines in the Netherlands towards more restrictive testing of asymptomatic individuals, probability sample surveys with laboratory-confirmed STI testing are crucial for monitoring prevalence trends and evaluating public health policy.
STI-driven antibiotic exposure may shape macrolide and tetracycline resistance in nasal among MSM receiving HIV pre-exposure prophylaxis.
Gaspari V, Foschi C, Lazzarotto T … +3 more , Djusse ME, Marangoni A, Ambretti S
Sex Transm Infect · 2026 Jun · PMID 42342442 · Publisher ↗
BACKGROUND: HIV pre-exposure prophylaxis (PrEP) programmes are associated with intensified sexually transmitted infection (STI) screening and increased incidence of bacterial STIs, resulting in repeated antibiotic exposu...
BACKGROUND: HIV pre-exposure prophylaxis (PrEP) programmes are associated with intensified sexually transmitted infection (STI) screening and increased incidence of bacterial STIs, resulting in repeated antibiotic exposure. The ecological impact of STI-driven antimicrobial use on resistance in commensal bacteria remains insufficiently characterised, particularly in populations with high antimicrobial exposure such as men who have sex with men (MSM). OBJECTIVE: To evaluate differences in nasal antimicrobial resistance between MSM receiving PrEP and HIV-negative MSM not on PrEP and to explore behavioural and antibiotic exposure factors associated with resistance. METHODS: In this exploratory cross-sectional study, 153 HIV-negative MSM attending an STI clinic in Italy were enrolled (80 PrEP users; 73 controls). Participants underwent nasal swabbing for culture-based isolation and antimicrobial susceptibility testing of . Antibiotic exposure, behavioural variables and STI history were collected via structured questionnaire. RESULTS: PrEP users reported more sexual partners in the last 6 months (p=0.0009) and higher antibiotic use in the preceding year (p=0.004). Doxycycline postexposure prophylaxis (Doxy-PEP) use was more frequent among PrEP users (16% vs 7%; p=0.08). The cumulative 2-year STI burden was higher in the PrEP group (p<0.0001), driven by infections. colonisation prevalence did not differ significantly between groups (p=0.17). However, erythromycin (p=0.0008), clindamycin (p=0.004) and tetracycline resistance (p=0.03) were more frequent among PrEP users. Tetracycline exposure was independently associated with tetracycline resistance (p=0.03), whereas PrEP status was not. CONCLUSIONS: Among MSM, higher antimicrobial resistance in nasal may be associated with antibiotic exposure rather than PrEP use per se. These exploratory findings should be interpreted with caution given the limited sample size and lack of detailed exposure quantification but support the need to integrate antimicrobial stewardship into PrEP and Doxy-PEP implementation frameworks. Longitudinal studies are needed to better disentangle the roles of antimicrobial exposure and transmission dynamics.
Impact of decentralised, community-led molecular STI point-of-care testing on testing practices in remote First Nations communities in Australia.
Tangey A, Smith K, Hengel B … +20 more , Andrewartha K, Wand H, Saha A, Leonard J, Gunathilake M, Anderson L, Mak DB, Badman S, Persing D, Donovan B, Maher L, Matthews S, Fairley CK, Shephard M, Kaldor J, Huang RL, Ward J, Guy R, Causer L, TTANGO2 collaboration
Sex Transm Infect · 2026 Jun · PMID 42336645 · Publisher ↗
OBJECTIVE: In remote Australia, where there is a substantial burden of sexually transmitted infections (STIs) among First Nations peoples, testing and timely treatment are key to reducing prevalence. We evaluated the imp...
OBJECTIVE: In remote Australia, where there is a substantial burden of sexually transmitted infections (STIs) among First Nations peoples, testing and timely treatment are key to reducing prevalence. We evaluated the impact of introducing molecular point-of-care (POC) testing for chlamydia/gonorrhoea and later trichomonas on STI testing (including syphilis) and positive tests. METHODS: We conducted a retrospective interrupted time-series analysis of routinely collected data from First Nations peoples aged 15-54 years attending 20 remote/regional clinics participating in the Test, Treat and GO programme (2016-2019). We used segmented regression models to estimate the immediate level change (first month of POC) and after-period trends in monthly tests, positive tests and proportion of concurrent syphilis tests to assess sustainability. Before and after comparisons were estimated using linear regression models. RESULTS: There were 17 437 chlamydia/gonorrhoea and 14 173 trichomonas tests performed, mostly among women (69% and 64%) and individuals aged 15-34 years (72% and 68%). Following the introduction of molecular POC testing, there were immediate level increases in monthly tests: chlamydia/gonorrhoea by 26% (+154, p<0.001) and trichomonas by 21% (+116, p=0.004) and level increases of positive tests: gonorrhoea by 30% (+13, p=0.017) and trichomonas by 29% (+14, p=0.034); chlamydia was unchanged. The proportion of chlamydia/gonorrhoea tests with concurrent syphilis tests remained unchanged (-1.7%; -0.9%; p=0.531), while the proportion increased among positive chlamydia/gonorrhoea tests by 25% (+13%; p=0.013). Increased levels of testing were sustained for gonorrhoea/chlamydia (+2.7, p=0.118) and trichomonas (-3.5, p=0.400) and syphilis among those with positive chlamydia/gonorrhoea tests (-0.2%, p=0.593). CONCLUSION: Molecular POC testing led to immediate and sustained increases in STI testing and an immediate increase in positive tests in remote primary care. The use of POC testing is likely to result in earlier diagnosis and treatment and reduced onward transmission and sequelae, supporting a broader integration of POC testing in high-burden settings.
REPRIEVE in practice: a single-centre longitudinal service evaluation of implementing best-practice cardiovascular disease prevention in people living with HIV.
Goldwater Breheny C, Aowidah R, Karataraki AI … +2 more , Dell'Oro C, Smith J
Sex Transm Infect · 2026 Jun · PMID 42315337 · Publisher ↗
OBJECTIVES: To determine the number of eligible people living with HIV (PLWHIV) in a London tertiary care centre receiving statins and cardiovascular health lifestyle advice; to determine whether age, sex or QRISK3 cardi...
OBJECTIVES: To determine the number of eligible people living with HIV (PLWHIV) in a London tertiary care centre receiving statins and cardiovascular health lifestyle advice; to determine whether age, sex or QRISK3 cardiovascular risk score influences statin prescription; to identify barriers to statin access in the HIV clinic to General Practice pathway; and to determine whether statin prescriptions were continued after 6 months. METHODS: A retrospective review of clinic letters from consecutive patients attending specialist HIV clinic appointments in April 2024, and their 6-month follow-up appointments, was conducted via electronic patient records. RESULTS: Seven hundred and sixteen consultations were extracted, representing 358 participants, at two different time points: 195 (54%) patients were eligible for statin initiation at their initial appointment and 94 (48% of the eligible patients) had a recorded discussion around statin initiation in HIV clinic. Fifty (53% of patients who had a discussion) gave consent to begin statins. Only 28 (56% of consenting patients) were prescribed a statin. Smoking status was not up to date for 64 (33%) of PLWHIV eligible for statins and 141 (72%) did not have cardiovascular health lifestyle modification discussion. Multivariable regression found only QRISK3 score significantly affected statin discussion (OR: 1.137, 1.030 to 1.271) and initiation (OR: 1.244, 1.100 to 1.430). CONCLUSIONS: Many PLWHIV eligible for statins are not discussing this with their clinician; some willing patients are still not prescribed a statin. PLWHIV may be missing out on lifestyle advice for preventing cardiovascular disease. Further support for PLWHIV in both primary and secondary care would be useful to increase statin uptake.
User characteristics and use patterns in the STI-X STI test vending pilot.
Evans D, Cowen K, Colquhoun A … +4 more , Kelly AM, Tomnay J, Hocking JS, Ludwick T
Sex Transm Infect · 2026 Jun · PMID 42303569 · Publisher ↗
OBJECTIVES: Sexually transmitted infections (STI) testing is less frequently accessed in rural and regional Australian communities due to many barriers, including limited access to specialised services and stigma. To add...
OBJECTIVES: Sexually transmitted infections (STI) testing is less frequently accessed in rural and regional Australian communities due to many barriers, including limited access to specialised services and stigma. To address this, we sought to pilot the implementation of STI test kit dispensing vending machines and assess their acceptability and use. METHODS: We conducted a 12-month pilot, placing two free STI test kit vending machines in 4-month intervals across seven rural and regional towns/cities. We worked with each community to determine ideal placement locations and marketing strategies. We assessed utilisation rates, return rates, positive diagnosis rates and user satisfaction. RESULTS: The vending machines dispensed 176 STI test kits over a period of 836 days in situ across seven towns/cities. Users ranged from 17 years to 70 years of age-those over 30 years had a greater odds of travelling over 25 km to access a test compared with younger users (OR 0.53, 95%CI 0.28 to 1.01). A large number (43.9%) of users reported having never completed an STI test before. 32 users returned samples for analysis with 12.5% receiving a positive result. Of the users who rated the vending machine process, 94.0% (79/84) rated it as 'easy' or 'very easy' to use and 95.6% (86/90) rated the process as 'fast' or 'very fast'. CONCLUSION: Our pilot suggests that STI test kit vending machines are an acceptable testing option for a wide range of users in rural and regional communities. Further research is necessary to understand how to improve return rates in order to improve sustainability.
High prevalence of sexually transmitted infections among adolescent girls and young women seeking HIV testing in Entebbe, Uganda.
Watyaba B, Mugisha D, Mutesi B … +7 more , Kalutte H, Wanzira E, Kisitu D, Mukwano C, Nakanjako F, Kajumbula H, Kikaire B
Sex Transm Infect · 2026 Jun · PMID 42303568 · Publisher ↗
BACKGROUND: Adolescent girls and young women (AGYW) in Uganda experience a high burden of sexually transmitted infections (STIs), increasing vulnerability to HIV acquisition. Despite the WHO and Uganda's Ministry of Heal...
BACKGROUND: Adolescent girls and young women (AGYW) in Uganda experience a high burden of sexually transmitted infections (STIs), increasing vulnerability to HIV acquisition. Despite the WHO and Uganda's Ministry of Health recommendations, routine integration of STI screening into HIV testing services (HTS) remains limited. We assessed the prevalence of laboratory-confirmed STIs, associated factors and antimicrobial resistance among AGYW seeking HTS in Entebbe, Uganda. METHODS: We conducted a cross-sectional study among 321 AGYW aged 15-24 years attending HTS at the Uganda Virus Research Institute (UVRI) clinic. Endocervical swabs were tested for (culture and sensitivity), (wet microscopy) and bacterial vaginosis (BV; Nugent scoring). Syphilis was assessed using the haemagglutination assay. Modified Poisson regression was used to estimate adjusted prevalence ratios (aPR) for factors associated with any STI. RESULTS: Overall STI prevalence was 35.2% (n=113, 95% CI 30.0 to 40.5), with 41.6% (47/113) of infections occurring among asymptomatic individuals, driven largely by BV at 31.5% (100/318), followed by at 7.3% (23/316), syphilis at 5.0% (16/321) and at 1.3% (4/318). STI prevalence among AGYW who tested positive for HIV was 47.8% (11/23), while among those who tested negative was 34.2% (102/298). In multivariable analysis, having fewer sexual partners was associated with lower STI prevalence (one partner: aPR 0.07, 95% CI 0.03 to 0.14; 2-3 partners: aPR 0.73, 95% CI 0.58 to 0.90, compared with >3 partners); condom use was associated with lower STI prevalence (aPR 0.62, 95% CI 0.45 to 0.84), and intrauterine device use was associated with higher STI prevalence (aPR 1.61, 95% CI 1.24 to 2.08). Among four isolates, three showed resistance to ciprofloxacin, and all four were resistant to penicillin G; all were susceptible to cefotaxime. CONCLUSIONS: A high burden of STIs, including asymptomatic infections, was observed among AGYW seeking HTS in an urban Ugandan setting. These findings support the integration of diagnostic STI screening into HTS.
From silos to synergies: harnessing the power of sexual health data sources in England to understand changing epidemiology and inform policy.
Ogaz D, Knuppel A, Trickett E … +9 more , Clifton S, Beck C, Unemo M, Sonnenberg P, Mohammed H, Mercer CH, Soldan K, Turner KM, Field N
Sex Transm Infect · 2026 Jun · PMID 42259628 · Publisher ↗
OBJECTIVES: Following major changes to sexual health provision in England in the past decade, monitoring and evaluation of population-level interventions require re-examination to ensure quality and visibility of key com...
OBJECTIVES: Following major changes to sexual health provision in England in the past decade, monitoring and evaluation of population-level interventions require re-examination to ensure quality and visibility of key communities. We make the case that sexual health data sources might be used synergistically to improve sexual health and tackle inequalities. METHODS: We conducted a purposive narrative review to (1) describe national sexual health policy and provision changes in England in the past decade (2012 onwards), (2) map key sexual health data resources and (3) demonstrate how integrated data-driven approaches can be used to understand and evaluate population-level sexual health policy. RESULTS: There have been major changes at a national and regional level in the availability, targeting and implementation of HIV and sexually transmitted infection (STI) interventions, including through high-level shifts in funding structures, expansion of online services and pathogen-focused policies. Synergistic use of the many data sources available takes advantage of their different features. For example, for HIV, integration of nationally representative behavioural surveys that include people not accessing care (eg, National Surveys of Sexual Attitudes and Lifestyles), targeted surveys (eg, Reducing inequalities in Sexual Health surveys for gay, bisexual and other men who have sex with men (GBMSM)) and national STI/HIV surveillance for people accessing care (eg, GUMCAD STI Surveillance System) can be used to inform progress towards HIV elimination in England through assessment of online and postal-based self-sampling and inequalities in HIV testing uptake in populations and key communities such as GBMSM. CONCLUSION: In the face of rapid change, approaches that integrate complementary data sources have the potential to harness the strengths of individual assets and mitigate limitations to form a more complete assessment of population-level interventions and should guide sexual health policy and practice in the decade to come. Effective data integration requires addressing a range of methods, mandates and challenges to strengthen contemporary research, monitoring and evaluation.
Acute hepatitis C related to chemsex: insights from a Spanish cohort.
Asensi Díaz E, Álvarez Álvarez B, Castaño Núñez AL … +7 more , Prieto-Pérez L, López de Las Heras M, Carrillo-Acosta I, Waleed Al-Hayani A, Tellez Pérez R, Górgolas M, Cabello A
Sex Transm Infect · 2026 Jun · PMID 42259627 · Publisher ↗
BACKGROUND: Despite the transformative impact of direct-acting antivirals (DAAs) on hepatitis C control, acute/recent hepatitis C virus (HCV) infections continue to be diagnosed in contemporary clinical practice. We desc...
BACKGROUND: Despite the transformative impact of direct-acting antivirals (DAAs) on hepatitis C control, acute/recent hepatitis C virus (HCV) infections continue to be diagnosed in contemporary clinical practice. We describe acute/recent HCV cases diagnosed at a tertiary hospital in Madrid among men who have sex with men (MSM), including people living with HIV (PLHIV) and pre-exposure prophylaxis (PrEP) users. METHODS: We conducted a retrospective, single-centre descriptive study including acute/recent HCV cases reported between January 2023 and January 2025. Cases were defined by detectable HCV RNA following a previously negative HCV serology or after a cured HCV infection (reinfection). Chemsex was defined as intentional use of psychoactive substances in sexual contexts; slamsex as injecting drugs in sexual contexts. Patients initially managed with watchful waiting were reassessed at 12 weeks to assess spontaneous clearance. RESULTS: Ninety-two cases were included; median age was 43 years (IQR 36-52) and 24 (26.1%) were >50 years. In total, 91 out of 92 (98.9%) were MSM; 70 (76.1%) were PLHIV and 19 (20.7%) were PrEP users. Among 84 patients with genotype data, 55 (59.8%) had genotype 1a, 8 (8.7%) 1b, and 21 (22.8%) genotype 4. HCV RNA was >6 log in 41 (44.6%) and >7 log in 18 (19.6%). Chemsex was reported by 72 (78.3%); among them, 38 (52.8%) reported slamsex. Among those with available data, 17 out of 54 (31.5%) had another sexually transmitted infection. Watchful waiting was initially adopted in 73 (79.3%); 5 out of 73 (6.8%) achieved spontaneous clearance at 12 weeks. Of those observed, 68 (93.2%) initiated DAAs; 9 (9.8%) were treated at diagnosis. Ten (10.9%) were lost to follow-up before treatment initiation; sustained virological response was achieved in treated patients. CONCLUSIONS: Acute/recent HCV diagnoses occurred predominantly among MSM, including PLHIV and PrEP users, with frequent reporting of chemsex/slamsex. Low spontaneous clearance and losses before treatment initiation highlight the need for targeted HCV testing and linkage to care in HIV/PrEP and sexual health services, alongside harm reduction and substance use support.
Diagnosing established and acute HIV in the context of facility-based HIV testing services in rural Eswatini: a cross-sectional study.
Ciglenecki I, Kerschberger B, Mukooza E … +13 more , Lekelem S, Ntshalintshali N, Mavimbela M, Dlamini S, Dube L, Mabuza N, de Latour R, Haile M, Ellman T, Keiser O, Labhardt ND, Matse S, Calmy A
Sex Transm Infect · 2026 Jun · PMID 42248688 · Publisher ↗
INTRODUCTION: Acute HIV infection (AHI) is the brief period between viral acquisition and the appearance of HIV antibodies and cannot be detected by routinely used HIV rapid diagnostic tests (RDTs). Its role is likely to...
INTRODUCTION: Acute HIV infection (AHI) is the brief period between viral acquisition and the appearance of HIV antibodies and cannot be detected by routinely used HIV rapid diagnostic tests (RDTs). Its role is likely to become increasingly important in the rapidly changing context of HIV testing in high-burden countries. We describe the characteristics of individuals attending HIV testing services (HTS) in rural Eswatini and the prevalence of newly diagnosed HIV, including AHI. METHODS: Adults aged ≥18 years were enrolled at six routine HTS between June 2022 and April 2023. Participants completed detailed questionnaires. Routine HIV testing was conducted using the national serial RDT algorithm (Determine and Uni-Gold). HIV viral load (VL) analysis was performed on the Xpert platform (Xpert HIV-1 Viral Load, Cepheid) in the central laboratory. Newly diagnosed HIV was defined as a positive HIV RDT algorithm with detectable VL (established HIV), or negative or discordant HIV RDT together with VL ≥10 000 copies/mL (AHI). RESULTS: Of 1095 participants with a median age of 27 years (IQR 22-33), 684 (61.5%) were women. Risk factors for HIV acquisition were common: >1 sexual partner (332, 30.3%), condomless sex (452, 44.5%), not knowing main partner's HIV status (437, 42.8%). Symptoms consistent with AHI (713, 65.1%) and genito-urinary (660, 60.3%) infections were common. Overall, 41 participants (3.7%, 95% CI 2.7% to 5.0%) were diagnosed with HIV; 31 (2.8%, 95% CI 1.9% to 3.9%) with established HIV and 10 (0.9%, 95% CI 0.04% to 1.7%) with AHI, representing 24.4% (95% CI 12.4% to 40.3%) of new diagnoses. All participants diagnosed with AHI reported symptoms consistent with AHI. CONCLUSIONS: Our study among a general adult population attending HTS revealed a high overall HIV prevalence with a substantial proportion of AHI, highlighting the decreasing sensitivity of routine HTS to detect all HIV infections. To address AHI, accurate and accessible diagnostic tools and AHI testing guidance are needed.
Implementing STI point-of-care testing using a whole-system programme model: the ProSPiRO implementation research protocol.
Fuller SS, Padovese V, Sadiq ST … +2 more , Blondeel K, Toskin I
Sex Transm Infect · 2026 Jun · PMID 42248687 · Publisher ↗
OBJECTIVES: Sexually transmitted infections (STIs) continue to cause substantial global morbidity and mortality, compounded by reliance on syndromic management and limited access to laboratory diagnostics. Although point...
OBJECTIVES: Sexually transmitted infections (STIs) continue to cause substantial global morbidity and mortality, compounded by reliance on syndromic management and limited access to laboratory diagnostics. Although point-of-care tests (POCTs) can enable timely diagnosis and treatment, their adoption within health systems remains inconsistent. Here we present an implementation research protocol that aims to generate evidence on the acceptability, feasibility and suitability of a collaborative whole-system programme model to support implementation of STI POCTs and improve access to STI testing and treatment across diverse populations and settings. METHODS: This implementation research protocol describes a whole-system programme model for STI POCTs that can be locally adapted across multiple countries and is delivered through structured, interest-holder-led workshops. Participating sites will vary across sexual and reproductive health services, antenatal care and general practice. Sites will implement POCTs for , and/or HIV/syphilis for 1 year. A mixed-methods evaluation will assess patient clinical outcomes, health system capacity, economic costs and acceptability among patients, healthcare professionals and policymakers. Quantitative data will be collected before and after implementation alongside qualitative data from workshops, focus group discussions and interviews. A realist case-study comparison approach will examine mechanisms influencing implementation. Primary outcomes include changes in same-day diagnosis and appropriate treatment, patient and provider acceptability, service delivery capacity and incremental cost consequences compared with usual care. The evaluation will identify which components of the programme model are effective, for which services and under what circumstances, and will generate policy-relevant evidence on barriers and facilitators to POCT adoption. CONCLUSIONS: This study addresses a key evidence gap in how to integrate STI POCTs sustainably within health systems. By combining local co-design, structured knowledge exchange and rigorous evaluation, the programme model has the potential to support equitable scale-up of STI POCTs and inform national policy and service delivery.
Low HCV seroprevalence among PLWH: a large cross-sectional study of 6722 individuals.
Merdan S, Sarmış A, Aydoğan O … +1 more , Ekenoğlu-Merdan Y
Sex Transm Infect · 2026 Jun · PMID 42236159 · Publisher ↗
BACKGROUND: Hepatitis C virus (HCV) coinfection is a significant comorbidity and public health concern among people living with HIV (PLWH). This study aims to estimate HCV seroprevalence among PLWH in Istanbul, Türkiye,...
BACKGROUND: Hepatitis C virus (HCV) coinfection is a significant comorbidity and public health concern among people living with HIV (PLWH). This study aims to estimate HCV seroprevalence among PLWH in Istanbul, Türkiye, and compare it with the HIV-negative control group and assess age-related patterns in PLWH. METHODS: We performed a multicentre cross-sectional study including patients from nine distinct hospitals representing diverse districts of Istanbul between January 2022 and October 2025. Data were retrieved from the central laboratory system serving this hospital network. Anti-HCV was tested by third-generation electrochemiluminescence immunoassay (Elecsys Anti-HCV II, Roche). A total of 3361 PLWH and 3361 age-comparable and sex-comparable HIV-negative controls were included. Between-group differences were assessed with Fisher's exact test; within PLWH, age-group differences and trends were evaluated with χ and linear-by-linear association tests. RESULTS: HCV seroprevalence was 0.71% among PLWH (24/3361) and 0.39% in the control group (13/3361), with no significant between-group difference (p=0.098). When PLWH were compared with HIV-negative controls, the odds of HCV seropositivity were not significantly increased (OR 1.85; 95% CI 0.94 to 3.70). Among PLWH, HCV seropositivity differed by age group (p=0.007) and increased with age (p<0.001), with no seropositive cases in individuals younger than 30 years and the highest prevalence in those older than 70 years. Genotyping was available for eight PLWH; genotype 3 predominated (5/8, 62.5%), followed by genotype 1 (3/8, 37.5%; including subtypes 1a and 1b). CONCLUSION: HCV seroprevalence was low among PLWH in Türkiye and did not differ significantly from age-comparable and sex-comparable HIV-negative controls. The strong age gradient indicates that infections are concentrated in older cohorts and supports age-based screening for public health purposes in low-endemic settings.
Anal HPV type prevalence in gay, bisexual and other men who have sex with men following an opportunistic HPV vaccination programme in Scotland: a repeated cross-sectional study.
Cameron RL, Cuschieri K, Connor L … +1 more , Roy K
Sex Transm Infect · 2026 Jun · PMID 42236158 · Publisher ↗
BACKGROUND AND OBJECTIVES: Gay, bisexual and other men who have sex with men (GBMSM) are at increased risk of anal human papillomavirus (HPV) infection and subsequent development of anal cancer. An opportunistic HPV vacc...
BACKGROUND AND OBJECTIVES: Gay, bisexual and other men who have sex with men (GBMSM) are at increased risk of anal human papillomavirus (HPV) infection and subsequent development of anal cancer. An opportunistic HPV vaccination programme for GBMSM and those at similar risk for HPV infection was launched in Scotland in July 2017 using the quadrivalent vaccine. We aimed to evaluate the impact of the HPV vaccination programme for GBMSM by monitoring changes in the prevalence of HPV types. METHODS: A repeated cross-sectional study was undertaken collecting and HPV typing rectal swab samples from men in a city centre sexual health clinic. A baseline sample and three subsequent samples were taken for the 4 years following the introduction of the programme. RESULTS: Overall, HPV prevalence was high across all sample years, particularly in 2019/2020. Prevalence of quadrivalent vaccine targeted types decreased by 23% (PR 0.77, 95% CI 0.70 to 0.86, p<0.001) in the most recent sample taken in 2021 compared with the baseline. Other high-risk HPV types increased in each sample year and were 25% higher (PR 1.25, 95% CI 1.12 to 1.40, p<0.001) in the 2021 sample compared with baseline. CONCLUSIONS: Reductions in vaccine targeted types are encouraging and may reflect direct protection offered by the GBMSM vaccination programme or a combination of direct and modest indirect protection from the routine programme. These findings support HPV vaccination as an effective method of anal cancer prevention.
HIV testing in one London borough: do testing initiatives outside of sexual health persist after initial incentivised period?
Creighton S, Millett D, Johns B … +1 more , Portelli A
Sex Transm Infect · 2026 Jun · PMID 42236157 · Publisher ↗
Abstract loading — click title to view on PubMed.
Correspondence: the recommended resistance-guided treatment of infection in symptomatic individuals is not feasible in many Italian settings.
Rossotti R, Nava A, Tacconelli E … +1 more , Puoti M
Sex Transm Infect · 2026 Jun · PMID 42236156 · Publisher ↗
Abstract loading — click title to view on PubMed.
Sales of HIV self-tests (HIVST) and pharmacists' knowledge, attitudes and perceptions regarding the distribution of HIVST in community pharmacies in Belgium: a cross-sectional survey.
Rotsaert A, Beseran Valero E, Nöstlinger C … +7 more , Vanbaelen T, Van den Bossche D, Deblonde J, Scheerder G, Ravinetto R, Reyniers T, Hensen B
Sex Transm Infect · 2026 Jun · PMID 42236155 · Publisher ↗
OBJECTIVES: HIV self-testing (HIVST) through community pharmacies offers a complementary, confidential and convenient testing option. Despite the availability of HIVST kits in Belgian pharmacies since 2017, little is kno...
OBJECTIVES: HIV self-testing (HIVST) through community pharmacies offers a complementary, confidential and convenient testing option. Despite the availability of HIVST kits in Belgian pharmacies since 2017, little is known about sales and pharmacists' experiences. This study assessed HIVST sales and pharmacists' knowledge, attitudes and perceptions regarding its provision. METHODS: We conducted a cross-sectional web-based survey among all community pharmacies (~4700) in Belgium between 14 May and 31 July 2025. Participants were recruited via newsletters from national and regional pharmacists' associations and a pharmacy network. We analysed responses on HIVST sales and pharmacists' knowledge, attitudes and perceptions descriptively. Associations between sales and pharmacy or pharmacist characteristics were examined using χ, Fisher's exact or Mann-Whitney tests. RESULTS: Among 235 respondents, 33.2% (78/235) reported selling HIVST, of whom 69.2% (54/78) sold ≤2 kits annually. Most sold the finger-prick Autotest HIV (65/78, 83.3%). Retail prices ranged from €26 to €35 (58/78, 74.4%). Half procured kits on request (37/78, 47.4%), only 12.8% (10/78) displayed kits. Sales were associated with pharmacist age (p=0.04) and location, with Brussels pharmacies more likely to sell kits than those in Flanders or Wallonia (p<0.001). Selling ≥3 HIVST kits annually occurred in 90.0% (9/10) of respondents with kits visibly displayed, compared with 41.4% (12/29) for behind-the-counter storage and 5.4% (2/37) for on-request provision (p<0.001). While 76.6% (180/235) considered HIVST a valuable complement to facility-based testing, only 19.6% (46/235) actively recommended it. Only 15.3% (36/235) had attended HIVST training; 31.9% (75/235) reported discomfort advising clients due to limited experience (85.3%) or low knowledge (78.7%). CONCLUSIONS: The opportunity to purchase HIVST in community pharmacies remains underutilised in Belgium. Enhancing pharmacists' training, confidence, visibility of kits and affordability may increase uptake, strengthening the role of pharmacists as complementary providers of HIVST. Future research should include clients' perspectives on HIVST.
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