Research news in clinical context
Published in STI: Self-start HIV postexposure prophylaxis after sexual exposure to reduce time to first dose The efficacy of HIV post-exposure prophylaxis (PEP) increases with a shorter time to treatment initiation. This randomised, prospective, open-label study among men who have sex with men (MSM) in the UK assigned 139 participants to either a 5-day PEP starter pack of emtricitabine/tenofovir disoproxil fumarate/maraviroc, or to the standard of care (SOC) PEP access through sexual health clinics or accident and emergency units. There was a significant reduction in time from sex to first PEP dose in the starter pack arm ...
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Tan, R. K. J., Herbert, R., Vielot, N. A. Tags: Perspective Source Type: research
BASHH feedback from the 2023 IUSTI-Europe conference in Malta
There is a growing relationship between BASHH and IUSTI.1 In 2023, several BASHH scholars were invited to give feedback on the IUSTI conference in Malta. Asymptomatic STI screening: Chris Kenyon, (Belgium) Despite good evidence for HIV and syphilis screening in asymptomatic patients, evidence is lacking for other STIs, for example, Neisseria gonorrhoeae and Chlamydia trachomatis. Kenyon et al2 highlighted the potential harms of widespread screening for asymptomatic STIs, particularly in HIV-pre-exposure prophylaxis (HIV-PrEP) cohorts, namely increased antimicrobial consumption and antimicrobial resistance (AMR). In Belgium...
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Richardson, D., Butler, M., Bull Olozabal, O., Gupta, N., Naser, F., Sultan, B., Caswell, R. J. Tags: BASHH column Source Type: research
Performing Trichomonas vaginalis culture in research studies in low-resource settings
Trichomonas vaginalis is the most common non-viral sexually transmitted infection (STI) worldwide, with an estimated 156 million new cases per year globally.1 Incidence and prevalence are highest in low-income settings, especially the African region.2 If symptomatic, T. vaginalis causes vaginal discharge and dysuria. Untreated T. vaginalis has been associated with adverse birth outcomes and an increased risk of HIV acquisition and transmission.3 Antimicrobial resistance to 5-nitroimidazole agents such as metronidazole is reported to occur in about 5%–10% of isolates in the USA.4 T. vaginalis can be diagnosed by wet m...
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Peters, R. P. H., Mdingi, M. M., Gigi, R. M. S., Lim, L., Medina-Marino, A., Klausner, J. D., Muzny, C. A. Tags: PostScript Source Type: research
HIV testing at visits to US emergency departments: 2021 update
In this updated cross-sectional analysis of the National Hospital Ambulatory Medical Care Survey, we found that among the 2.5 million more weighted emergency department (ED) visits in 2021 compared with 2020, there was an insignificant increase in HIV testing per ED visit in 2021 compared with 2020 (0.81% to 0.86%). This suggests HIV testing during ED visits did not increase in line with rebounding visit volumes after the pandemic nadir. (Source: Sexually Transmitted Infections)
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Clay, C., Kuglen, B. C., Bennett, C. L. Tags: PostScript Source Type: research
Unusual presentation of disseminated gonococcal infection
A 30-year-old homosexual man living with HIV and receiving virologically suppressive antiretroviral treatment presented to the emergency department with a 3-day history of pain in his left wrist accompanied by fever and chills. On examination, the left wrist showed redness, swelling, tenderness and decreased range of movement. The patient had no history of trauma, insect bites or scratches. Four weeks earlier, he had engaged in unprotected oral sex with a casual partner. Nucleic acid amplification tests (NAATs) for Chlamydia trachomatis and Neisseria gonorrhoea (Ng) were performed from oropharyngeal, anal and urine samples...
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: AlHammadi, M., Schembri, A., Calleja, L., Padovese, V. Tags: PostScript Source Type: research
STI self-testing: ensuring representation and outreach to teens and adolescents in expanded approaches
In our correspondence, we describe the results from a quality improvement survey in a sexual health clinic in North Carolina regarding attitudes and perceptions among adolescents and providers regarding specimen self-collection. We find that adolescents have high levels of acceptability for self-collection and confidence in their ability to self-collection; however, providers expressed hesitation regarding the ability of adolescents to self-collection. Our study shows that while self-collection may provide a way to expand testing access to difficult-to-reach populations, we must ensure that providers are confident in the c...
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: DeWitt, M. E., Pabon, V., Vasquez, A., Wenner, J. J., McNeil, C. J. Tags: COVID-19 PostScript Source Type: research
Case of Haemophilus influenzae urethritis in a male patient
We report a case of H. influenzae urethritis and describe a relatively novel treatment approach. A man presented to Melbourne Sexual Health Centre with a 3-day history of penile discharge and dysuria. He engaged in condomless oral and anal sex with casual male partners in preceding months. On examination, purulent urethral discharge was noted. Urethral microscopy showed Gram-positive bacilli and epithelial cells. Screening for chlamydia, gonorrhoea, Mycoplasma genitalium, Trichomonas vaginalis, HIV and syphilis was performed. He was treated for NGU with a 1-week course of doxycycline. Initial investigations were all negati...
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Samra, R. S., Plummer, E. L., Vodstrcil, L., Bradshaw, C. S. Tags: PostScript Source Type: research
Childhood sexual abuse, risk behaviours and chemsex engagement among men who have sex with men in Paris, France
Drückler et al suggest that chemsex engagement among men who have sex with men (MSM) is significantly associated with reporting non-consensual sex.1 Inspired by clinical stories gathered in a sexual healthcare service, we investigated a possible relationship between childhood sexual abuse (CSA), that is, having been a victim of forced genital contact by an adult before age 13, and current chemsex engagement. To our knowledge, only one recent study reports a ‘higher frequency’ of early sexual abuse—but without specification of type and age of sexual abuse—among adult chemsex-users MSM.2 These...
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Shelly, M., Bost, S., Moreau, D. Tags: Open access PostScript Source Type: research
Can laboratory HIV and infectious syphilis data inform future pre-exposure prophylaxis use in women in Ontario, Canada?
Conclusion
Although it is clinically appropriate to recommend HIV PrEP to women with syphilis, Ontario surveillance data suggest that the population-level impact of this strategy on the HIV epidemic in Ontario would have been modest during this 11-year period. Future studies should explore additional ways of prioritising women for PrEP. (Source: Sexually Transmitted Infections)
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Sadeghi, Y., Nelson, P., Sullivan, A., Allen, V., Hasso, M., Liu, J., Tran, V., Tan, D. H. S. Tags: Open access Short reports Source Type: research
Chemsex and risk of sexually transmitted infections: a perspective from India
Introduction Chemsex, also called as party and play or intensive sex partying, is the intentional use of psychoactive drugs before or during sex, mostly by gay and bisexual men having sex with men (GBMSM) to enable, enhance and prolong sexual interaction.1 The practice is now becoming increasingly common among heterosexual individuals too.1 Various chemsex drugs have been described (table 1), the principal three that are commonly used include mephedrone, gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL) and crystallised methamphetamine.1 The injectable use of these substances for similar purpose is called as slamming or ...
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Juyal, D., Pal, S., Joshi, C., Dhawan, N., Rawre, J., Dhawan, B. Tags: Education Source Type: research
Minimum inhibitory concentrations of Neisseria gonorrhoeae strains in clients of the Amsterdam sexual health clinic with a Dutch versus an international sexual network
Conclusions
For three cephalosporin antibiotics, we found Ng strains with slightly higher MICs in clients with partner(s) from Europe or Latin America and the Caribbean. International travel might contribute to the spread of Ng with lower susceptibility. More understanding of the emergence of AMR Ng is needed. (Source: Sexually Transmitted Infections)
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Teker, B., Schim van der Loeff, M., Hoornenborg, E., Boyd, A., Reedijk, S., van Dam, A., Jongen, V. W., de Vries, H. Tags: Original research Source Type: research
Impact of national commissioning of pre-exposure prophylaxis (PrEP) on equity of access in England: a PrEP-to-need ratio investigation
Conclusions
Despite the overall increase in PrEP use, substantial PrEP Impact trial inequities widened postcommissioning in England, particularly across gender, ethnicity and region of residence. This study emphasises the need to guide HIV combination prevention based on equity metrics relative to the HIV epidemic. The PnR could support the optimisation of combination prevention to achieve zero new HIV infections in England by 2030. (Source: Sexually Transmitted Infections)
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Coukan, F., Sullivan, A., Mitchell, H., Jaffer, S., Williams, A., Saunders, J., Atchison, C., Ward, H. Tags: Open access, Editor's choice, COVID-19 Original research Source Type: research
Assessing the effectiveness of HIV/STI risk communication displays among Melbourne Sexual Health Centre attendees: a cross-sectional, observational and vignette-based study
Conclusions
Displaying risk differently affects an individual’s perceived risk of an HIV/STI and influences their intention to test. (Source: Sexually Transmitted Infections)
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Latt, P. M., Soe, N. N., Fairley, C., Xu, X., King, A., Rahman, R., Ong, J. J., Phillips, T. R., Zhang, L. Tags: Open access Original research Source Type: research
Association of same-sex criminalisation laws and national HIV policies with HIV testing in African MSM: an ecological single-level and multilevel cross-sectional study of sub-Saharan African countries
Conclusions
This study suggests elimination of discriminatory laws and policies might be important for increasing HIV status awareness of MSM, an important first step in epidemic control. Additionally, we highlight heterogeneity between South Africa and other SSA countries, which has implications for studying SSA countries as a homogeneous group. (Source: Sexually Transmitted Infections)
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Kalu, N., Ross, M. W., Taegtmeyer, M., Lamontagne, E., Howell, S., Neuman, M. Tags: Open access Original research Source Type: research
Understanding the association between intimate partner violence and sexually transmitted infections among women in India: a propensity score matching approach
Conclusion
This study provides evidence of a significant association between IPV and STIs among women in India and underscores the urgent need for intensified efforts and interventions to address both IPV and STIs, to improve the overall health and well-being of women in India. (Source: Sexually Transmitted Infections)
Source: Sexually Transmitted Infections - April 18, 2024 Category: Sexual Medicine Authors: Chakrabarty, M., Singh, A., Mohan, D., Singh, S. Tags: Original research Source Type: research
