Sexually Transmitted Infections

In the UK, gay, bisexual, and other men who have sex with men (GBMSM) at risk of sexually transmitted infections (STIs) are recommended quarterly testing, but it is not known how many are following this recommendation. We described the prevalence and correlates of frequent STI testing amongst GBMSM. We analysed data on participants of the community-based Reducing Inequalities in Sexual Health (RiiSH) online survey of GBMSM, recruited in November-December 2024 via social media and dating apps. Pa...

ObjectivesTo develop a classification of sexual partner types for use in partner notification (PN) and other interventions to prevent sexually transmitted infections (STI). MethodsA four-step process: 1) an iterative synthesis of five sources of evidence: scoping review of social and health sciences literature on partner types; analysis of relationship types in dating apps; systematic review of PN intervention content; review of PN guidelines; qualitative interviews with public, patients and he...

ObjectivesMany countries recommend 3-monthly chlamydia/gonorrhoea screening for men-who-have-sex-with-men (MSM). New evidence about the limited impact of frequent, asymptomatic gonorrhoea/chlamydia screening on population prevalence, coupled with concerns about overburdened health services and antimicrobial resistance (from over-treatment), calls into question current approaches to asymptomatic screening. We explored sexual health professionals/experts arguments in favour/against reducing asympt...

BackgroundThere has been an increasing trend in bacterial sexually transmitted infections (STIs) in England since the early 2000s. Since 2008, surveillance of STIs in England has been conducted using the Genitourinary Medicine Clinic Activity Dataset (hereafter referred to as GUMCAD), a depersonalised dataset of all attendances at all publicly-commissioned sexual health services (SHS). The aim is this article is to describe and evaluate the impact of the piloting and rollout of an enhanced spec...

BackgroundHigh rates of repeat infections post-treatment are reported in women infected with Trichomonas vaginalis (TV). Determining the origin of repeat infections is generally limited to clinical queries of adherence to treatment and sexual exposure. The purpose of this study was to add micro-satellite (MS) genotype data to classification criteria for origin of repeat TV infection, and examine if the addition of TV genotype changes classification as treatment failure, re-infection, or new infe...

OBJECTIVEClinical trials have shown that doxycycline as post-exposure prophylaxis after sexual contact (doxy-PEP) prevents sexually transmitted bacterial infections (STI). We investigated current awareness about informal use of antibiotics as pre- and post-exposure prophylaxis to prevent STI (STI-PrEP/PEP) among men who have sex with men (MSM). In addition, we investigated psychosocial determinants of its use. METHODSData were collected in the Amsterdam Cohort Study among MSM, the Netherlands, ...

Evidence from real-world studies suggests that 3-monthly screening for asymptomatic chlamydia/gonorrhoea is not reducing incidence and is driving increased antibiotic use and antimicrobial resistance (AMR). While some countries are recommending less screening, changes to guidelines require clinician buy-in. This study explored the views of Australian sexual health clinicians to changing practices around asymptomatic screening for chlamydia/gonorrhoea in gay, bisexual and other men-who-have-sex-w...

IntroductionAustralia recorded its first case of COVID-19 in late January 2020. On 22nd March 2020, amid increasing daily case numbers, the Australian Government implemented lockdown restrictions to help flatten the curve. Our study aimed to understand the impact of lockdown restrictions on sexual and reproductive health. Here we focus on sexual practices. MethodsAn online survey was open from the 23rd April 2020 to the 11th May 2020. Participants were recruited online via social media and oth...

BackgroundSexual health service (SHS) delivery in England has shifted substantially following a rapid expansion of online services during the COVID-19 pandemic. While digital provision may improve reach, there are limited data on the extent of unmet need for in-person SHS in England. We sought to address this among men and gender-diverse individuals who have sex with men in England, a group disproportionately affected by sexual health inequalities. MethodsWe analysed data from "Reducing inequal...

RationaleThe first key step in contact tracing for sexually transmitted infections (STIs) is to notify recent exposed sex partners. Gay and bisexual men and other men who have sex with men (GBMSM) bear a high burden of STIs and one-off partners contribute disproportionately to community transmission, posing a particular challenge to contact tracing. Here we explore and theorise the barriers and facilitators of GBMSM telling their one-off sexual partners about their exposure to STIs. DesignUsin...

IntroductionPeople from underserved groups experience disproportionately poor sexual health and challenges accessing care. Asynchronous online consultations (a user completes a health questionnaire online, which is reviewed by a clinician) are being used within sexual healthcare to prescribe chlamydia treatment. Users require sufficient health and digital literacy to access online services and use them safely. MethodsWe used the PROGRESS-Plus framework to guide purposive recruitment of 35 parti...

Sexually transmitted infections (STIs) are increasing globally. To improve understanding of the epidemiology of STIs in key populations, we analysed sentinel surveillance data on STI test positivity among individuals tested using subsidised tests at anonymous walk-in clinics in North Rhine-Westphalia (NRW), Germany. This was a cross-sectional analysis of sentinel surveillance data from all 53 local health authority anonymous walk-in clinics in NRW during 2021. Test positivity for HIV, syphilis,...

IntroductionThe number of bacterial sexually transmitted infections diagnosed among men who have sex with men (MSM) continues to rise annually. Innovative public health interventions are needed to address this. Partner notification (PN), is important in reducing STI transmission by identifying, testing and treating the sex partners of people with STIs. Outcomes of PN in MSM are sub-optimal; some MSM with STIs report high numbers of "one-off" sex partners (where sex occurs on one occasion only) w...

ObjectivesThough highly vulnerable to HIV and STIs, transgender female sex workers (TFSW) are understudied in the U.S. HIV and STI response. This study examined the correlates of laboratory-confirmed STIs among a cohort of 62 TFSW followed over the course of one year and explored associations between specimen site and self-reported engagement in insertive and receptive anal intercourse. MethodsParticipants completed an interviewer-administered computer assisted personal interview at baseline, 3...

BackgroundUsing programme theory we report a process evaluation of Accelerated Partner Therapy (APT) - a novel contact tracing (partner notification) intervention for people with chlamydia as part of the LUSTRUM trial. MethodsFollowing the specification and visualisation of initial programme theory, questions of context dependency, fidelity, and functioning of putative intervention mechanisms were addressed using deductive thematic analysis of qualitative data collected through focus groups and...

IntroductionYoung people have a disproportionate burden of sexually transmitted infections. Despite strengthening HIV prevention with the introduction of PrEP, STI services have remained relatively unchanged, and the standard of care remains syndromic management. We used a discrete choice experiment to investigate young peoples preferences for the diagnosis and treatment of STIs in South Africa. Methods and FindingsBetween 1 March 2021 and 20 April 2021, a cross-sectional online questionnaire h...

BackgroundRemote consultations (via telephone or video) were critical during COVID-19 restrictions for Sexual and Reproductive Health Services (SRHS) in England and Wales and continue to be implemented widely. However, there remains limited evidence on their impact on outcomes and health inequalities. This study, guided by the Framework for Digital Health Equity, explores the equity implications of remote sexual health consultations in England and Wales, examining their acceptability and appropr...

BackgroundSexually transmitted infections (STIs) and bacterial vaginosis (BV) are frequently asymptomatic in women. They cause genital inflammation and can increase transmission and acquisition of HIV. GIFT (Genital InFlammation Test) is a novel, point-of-care (POC) device under development for detecting genital inflammation in women. We aimed to obtain consensus to inform the development of GIFT and its integration into management guidelines. MethodsWe employed a Delphi technique through two r...

ObjectivesChemsex is the use of select psychoactive drugs to enhance sexual experiences and has been described among gay, bisexual, and other men who have sex with men (GBMSM). We aimed to characterise sexual risk, wellbeing and health-seeking behaviours among GBMSM and gender-diverse people reporting chemsex-associated drug use. MethodsWe analysed data from Reducing inequalities in Sexual Health (RiiSH), an online community survey of 2,758 UK-resident men and gender-diverse people having sex ...

BackgroundResearch demonstrates that pandemics adversely impact sexual and reproductive health (SRH), but few have examined their impact on peoples participation in sex. We examined self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the public health response to COVID-19. MethodsWe conducted an online, nationally representative, cross-sectional survey of U.S. adults (N=1010; aged 18-94 years; 62% response rate) from April 10-20, 2020. We used weighted multi...