Sexually Transmitted Infections

BackgroundBetween May and December 2022, the UK Health Security Agency reported 3,585 cases of mpox. The 2022 global outbreak was characterised by transmission predominantly within sexual networks of gay and bisexual men (GBMSM). UK public health responses included information and vaccination campaigns, supported by behaviour change among GBMSM. We describe community reflections on the UK mpox outbreak and the responses to it. MethodsBetween August 2023 and April 2024, we conducted five focus g...

BackgroundAustralia is experiencing its worst syphilis epidemic in decades, driven by two distinct outbreaks -- a heterosexual epidemic disproportionately affecting Aboriginal and Torres Strait Islander communities in northern Australia, and a predominantly MSM-associated epidemic in urban centres. We examined the spatial dynamics of this dual epidemic, including geographic clustering, service accessibility associations, and COVID-19 impacts. MethodsWe analysed publicly available aggregate surv...

BackgroundInfertility affects approximately one in six people globally and is associated with diminished quality of life (QoL). In Uganda, an estimated 6.4% of women experience infertility, yet evidence on fertility-specific QoL and its determinants remains limited. We assessed fertility-related QoL and associated factors among individuals seeking fertility care in public and private hospital settings in Kampala to inform patient-centred services. MethodologyWe conducted a hospital-based cross-...

BackgroundThe COVID-19 pandemic disrupted access to sexual and reproductive health (SRH) services, including contraception. Understanding contraceptive use during this period is critical for strengthening health system resilience in small developing states. ObjectiveTo identify factors associated with contraceptive use among reproductive-age women during the COVID-19 pandemic in Barbados. MethodsA cross-sectional online survey was conducted in Barbados between April 28 and May 3, 2020 among ad...

ObjectivesThis study aimed to estimate the prevalence of antibiotic post-exposure prophylaxis (STI PEP) use among gay, bisexual and other men who have sex with men (GBMSM) in England, and to identify demographic and behavioural factors associated with STI PEP use among early adopters. MethodsWe synthesised individual-level data from nine surveys conducted between 2019 and 2024. To harmonise variables that differed subtly across surveys, we generated composite indicators for STI diagnosis, chems...

High-risk sexual behaviour has been shown to be influenced by interpersonal, social, and economic factors in different situations and been linked to food insecurity. This study therefore investigated the individual, household and community factors associated with high-risk sexual behaviour among women age 18-49 in Zambia, paying particular attention to food insecurity status. It was anchored on the Socio-Ecological Model and used a cross-sectional non-intervention study design. We fitted survey ...

BackgroundWomen with limited or no English proficiency experience persistent barriers to accessing maternity care in the UK, contributing to well-documented inequalities in maternal and perinatal outcomes. NHS parent education classes are predominantly delivered in English, and provision of multilingual classes within individual maternity units is often limited and duplicative. Evidence to inform collaborative, cross-trust service models remains scarce. ObjectiveTo assess womens access to, pref...

Despite the existence of strong global and national human rights frameworks that support disability inclusion, women with disabilities in Kenya are still heavily discriminated against and stigmatised due to the negative perceptions of the community. This study examined community attitudes toward the sexuality of women with disabilities in Kibra Sub-County, Nairobi, and investigated demographic factors influencing these views. Using a quantitative cross-sectional design, a stratified multistage r...

STUDY QUESTIONAre pathogenic variants in Homeodomain-interacting protein kinase (HIPK4) associated with sperm head abnormalities causing male infertility? SUMMARY ANSWERHIPK4 is a novel candidate gene associated with sperm head defects and human male infertility. WHAT IS KNOWN ALREADYNumerous genes causing male infertility due to Multiple Morphological Abnormalities of the sperm flagella (MMAF) have been described but the genetic basis of sperm head defects is less well understood. STUDY DESI...

BackgroundPerformance-based financing (PBF) aims to improve healthcare quality by offering financial incentives to service providers. This study evaluated PBFs impact on obstetric care quality in Nkambe Health District, Cameroon. MethodsWe employed a cross-sectional mixed-methods study from December 2016-July 2017 in PBF-implementing facilities. We surveyed 315 women attending prenatal and postnatal visits and 23 service providers using structured questionnaires. Quantitative data were analyzed...

Study question: How is glycodelin, a glycoprotein secreted by reproductive tissues, causally related to reproductive diseases and traits? Summary answer: We present evidence for a causal role of sex hormones in determining glycodelin levels, but limited evidence that glycodelin subsequently causally impacts reproductive traits. What is known already: Glycodelin is expressed in female and male reproductive tissues and has four glycoforms (-A, -C, -F and -S), with the glycosylation pattern determi...

IntroductionThe long-standing disconnection of abortion legislation in Nigeria with the estimated incidence of 1.8 million terminations a year has contributed to systematic gaps in reliable abortion data for health policy. Any subnational monitoring under conditions of legal restraint tends to remain hidden beneath under-reporting and spatial instability such that policy makers are not left with a clear picture of where and why these decisions are being made. Methods and AnalysisTo address this...

BackgroundTalaromycosis, caused by the fungus Talaromyces marneffei, is a leading cause of HIV-associated death in Southeast Asia. Current culture-based diagnosis only identifies late-stage infection, limiting understanding of disease burden and disease spectrum. We evaluated the clinical performance of anti-Mp1p IgM and IgG enzyme immunoassays (EIA) for talaromycosis diagnosis. MethodsThis diagnostic study included 423 adults with advanced HIV disease and culture-confirmed talaromycosis as cas...

IntroductionRecreational and medical cannabis use (CU) information is often available within the electronic health record (EHR) in a format that is impractical for health care provider use. Transformation of free-text EHR documentation in notes to discrete elements is possible using natural language processing (NLP) and has the potential to characterize CU efficiently. The objective of this study was to develop an NLP algorithm to identify documentation of CU within EHR unstructured clinical not...

The host response to Neisseria gonorrhoeae is variable, and understanding its systemic and local components is critical to understanding anti-gonococcal immunity for vaccine development. We used a controlled human infection model of male gonococcal urethritis in naive volunteers in combination with multiplex cytokine analyte analysis of blood and urine specimens taken before infection, at the time of acute symptoms, and after curative treatment of N. gonorrhoeae to study responses to early infec...

ObjectiveCongenital syphilis remains a preventable cause of fetal and neonatal morbidity and mortality, despite the availability of inexpensive diagnostics and effective treatment. We aimed to evaluate the maternal and congenital syphilis burden at the Instituto Nacional Materno Perinatal, Perus national referral center for maternal and perinatal care. MethodsWe conducted a retrospective analysis of aggregated, de-identified surveillance data from January 2023 to December 2025. Maternal prevale...

BackgroundAfrica continues to have a significant public health problem with mpox, where endemic transmission persists and overlaps with a high burden of other infectious diseases. Although their epidemiology and clinical impact are still poorly understood throughout the continent, coinfections with human immunodeficiency virus (HIV) and varicella-zoster virus (VZV) can affect the clinical picture, severity of the disease, and accuracy of the diagnosis. MethodsFollowing PRISMA criteria, we regis...

BackgroundLoss to follow-up (LTFU) undermines the success of antiretroviral therapy (ART) programs, especially in high HIV prevalence regions like Njombe, Tanzania. Understanding factors influencing LTFU is critical to enhance patient retention. AimTo assess the prevalence and predictors of LTFU among people living with HIV (PLHIV) receiving ART in Njombe, Tanzania, from 2017 to 2021 MethodsWe conducted a retrospective cohort study using the National Care and Treatment Clinic (CTC2) database, ...

BackgroundAchieving optimal adherence and retention in HIV care is essential for sustaining viral suppression. Pharmacy refill records offer an objective approach to assessing adherence in settings where routine viral load testing is limited. This study evaluated pharmacy refill adherence, loss to follow-up (LTFU), and their predictors among people living with HIV (PLHIV) in the Manyara region of Tanzania. MethodsWe conducted a retrospective cohort analysis of 22,650 PLHIV across five districts...

BackgroundAdolescent girls and young women (AGYW) are disproportionately vulnerable to HIV. Despite expanded HIV testing services (HTS), the majority of AGYW remain unaware of their HIV status. This study aimed to assess determinants of HIV testing uptake among AGYW in mainland Tanzania before and after stratifying by age group (15-19 and 20-24 years) using data from three national surveys conducted over time. MethodologyA cross-sectional secondary data analysis was conducted using data from th...