Sexually Transmitted Infections

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...

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 ...

Background/ObjectivesIn England, gay, bisexual and other men-who-have-sex-with-men (GBMSM) are eligible for vaccinations at NHS sexual health services, including human papillomavirus (HPV), hepatitis A virus (HAV), and hepatitis B virus (HBV). However, current research shows limited understanding of the factors influencing vaccination uptake among GBMSM. This study aimed to examine the barriers and facilitators affecting the offer and uptake of these vaccination programmes. MethodsA qualitative...

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...

Remote consultations, including telephone, video, text or web-based consultations, are now common in sexual and reproductive health services (SRHS) in England and Wales, offering convenience and efficiency but raising concerns about safeguarding service users compared to in-person care. Ensuring protection and support for individuals remain central to SRHS. While guidance exists, evidence on how safeguarding is enacted remotely is limited. This study explores how safeguarding is managed in remot...

PurposeTo explore mens assisted reproductive technology (ART) experiences, awareness and concerns about fertility-associated health outcomes, and perceptions of using administrative health records in the United Kingdom (UK) without consent to investigate these outcomes. MethodsOver a two-year period, all adult men were eligible to complete an anonymous online survey distributed via a UK-based fertility charitys social media. Free-text responses underwent thematic analysis, and categorical respo...

Erectile dysfunction is commonly perceived as a condition of older men, yet increasing evidence suggests that it also affects younger populations. Data on erectile dysfunction among young men in sub-Saharan Africa remain limited, particularly at the community level. This study assessed the prevalence of erectile dysfunction among young men in Nairobi County and examined associated sociodemographic, lifestyle, and health-related factors. A community-based cross-sectional survey was conducted amon...

IntroductionRates of sexually transmitted infections are on the rise globally, including those caused by Neisseria gonorrhoeae. Retrospective analyses across clinical settings around the world have indicated that rates of gonorrhea declined following mass vaccination campaigns vaccines made with outer membrane vesicles (OMV) from Neisseria meningitidis serogroup B, a pathogen closely related to N. gonorrhoeae. The US FDA-approved N. meningitidis serogroup B vaccine (4CMenB) contains N. meningiti...

Women with HIV(WLHIV) have diverse and complex reproductive health needs that require patient-centered, informed decision making. Digital tools to support reproductive life planning may improve reproductive health counseling and outcomes for these women. We evaluated user-experiences with a self-administered, tablet-based family planning(FP) counseling tool as part of a packaged digital health intervention evaluated in a cluster randomized trial in Kenya. We conducted focus group discussions wi...

Adolescents and young people living with HIV (AYPLHIV) face persistent challenges related to stigma, autonomy, and sustained engagement in care. Self-care services including tools and practices that enable individuals to manage their health play a critical role in HIV prevention and treatment by promoting adherence, empowerment, quality of life, and improved health outcomes. Despite their importance, evidence on the uptake and determinants of self-care services among AYPLHIV in Zambia remains li...

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-...

ObjectivesUnderstanding fertility desires is one of the key components for understanding total fertility rates. The study aims to explore how attitudes towards fertility and childbearing are associated with fertility desires. MethodsA cross-sectional online survey was conducted among 822 childfree, heterosexual women aged between 18 and 35 who were involved in a romantic relationship and were not diagnosed with infertility. The relationship between attitudes to fertility and childbearing and bo...

IntroductionPersistent infection with high-risk Human Papillomavirus (hr-HPV) in women is a leading cause of cervical cancer, and its co-infection among people living with HIV (PLHIV) increases the risk of HPV-associated cancer, including oropharyngeal and anogenital cancers. In sub-Saharan Africa, awareness of HPV is limited, screening and vaccine adoption are critically low, undermining efforts toward sexually transmitted infection (STI) elimination. MethodsFrom Awareness to ACTion (FACT) stu...

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...

Commercially available disposable products such as cell culture utensils and catheters do not necessarily possess sufficient quality for in vitro fertilization (IVF), from the perspective of pyrogen contamination. We aimed to comprehensively analyze the pyrogen contamination status, including bacterial endotoxins, of the products used for IVF in assisted reproductive technology (ART) and improve their cleanliness using a new sterilization technology. Pyrogen contamination levels were evaluated u...

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 ...

BackgroundHigh-risk fertility behaviors (HRFB) remain a public health concern in Zambia due to their association with maternal and newborn complications. Despite improvements in reproductive health services, updated national evidence on the magnitude and determinants of HRFB is limited. This study used data from the 2024 Zambia Demographic and Health Survey (ZDHS) to estimate the prevalence of HRFB and identify associated factors among women of reproductive age. MethodsA cross-sectional analysi...

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...