Current News about Sexually Transmitted Disease

No abstract available 04/17/2025 01:00 AM
 

Background Human papillomavirus (HPV)–related cancer is highly preventable through HPV vaccination and cancer screening, but people experiencing homelessness or housing instability (PEH) may not engage in these behaviors due to conflicting priorities. This systematic review synthesized and estimated HPV-related cancer prevention behaviors among PEH. Methods Using PRISMA guidelines, articles published before 2023 were located via PubMed, Ovid/Medline, CINAHL, and Embase. Full-text, peer-reviewed studies that measured HPV-related cancer prevention in any sample of people experiencing homelessness were included. Two researchers abstracted data independently, with high interrater reliability (>90%). Results were narratively summarized with consensus, and proportions were compared using preventive behavior. Results After reviewing 405 articles, we included 18 articles from the United States from 1998 to 2022. There were 6674 people (e.g., women, youth, men who have sex with men) experiencing homelessness assessed for HPV-related cancer prevention behaviors. Pooled prevalence was approximately 59.8% (±6%) for cervical cancer screening in the last 3 years and 42.9% (±4.7%) for HPV vaccination initiation. Other factors related to housing instability and HPV-related cancer prevention included gender, sexual trauma, and procedural pain, with mixed results for housing status and HPV knowledge. Conclusions Findings demonstrate the varied adherence to HPV-related cancer prevention, with rates consistently below recommended World Health Organization guidelines. Future studies should adjust for specific risk factors in modeling that may be associated with or modified by the effects of homelessness and evaluate upstream prevention (e.g., vaccination) and other types of HPV-related cancer (e.g., anal cancer). 03/14/2025 01:00 AM
 

We analyzed syphilis case notifications in reproductive-aged women during 2013–2022. Late/unknown duration syphilis grew faster after 2020 (45.8% vs. 17.9% annual growth pre-2020). Increased screening, inaccurate staging, delayed diagnosis, or increased incidence following clinical and partner services gaps during 2020 may contribute to rises in late/unknown duration cases. 12/24/2024 01:00 AM
 

Background Congenital syphilis (CS) in the United States increased 10-fold in the last decade. At a large public hospital in Los Angeles, the numbers of infants born to mothers with untreated syphilis during pregnancy have continued to rise. Methods We compiled a retrospective case series from all infant rapid plasma reagin test results from 2022 to 2023 summarizing CS diagnosis and relevant diagnostic criteria. χ2 and Fisher exact tests were used to examine associations between maternal risk factors and CS diagnosis. Results Maternal syphilis complicated 97 of 2367 live births (4.1%) at our institution. Approximately 36% (n = 35) of infants born to mothers with a history of syphilis (n = 94) were born to a mother with inadequately treated syphilis or concern for reinfection. Infants with exposure to maternal syphilis were mostly asymptomatic at birth but had a high frequency of abnormalities in laboratory and radiographic evaluation. Compared with infants with less likely or unlikely CS, mothers of infants with highly probable or possible CS were more likely to have methamphetamine use during pregnancy (41% vs. 69%, P = 0.02), cocaine use during pregnancy (2% vs. 14%, P = 0.03), opiate use during pregnancy (7% vs. 37%, P = <0.001), and no prenatal care (7% vs. 40%, P ≤ 0.001). Conclusions This case series identified maternal substance use and no prenatal care as risk factors for highly probable or possible CS, underscoring the vulnerability of this population and informing future work in prevention of this disease. 03/14/2025 01:00 AM
 

Background The incidence of syphilis has been rising globally, but effective screening strategies are lacking. Preoperative syphilis screening is commonly performed at Japanese hospitals for infection prevention purposes. However, its effectiveness in improving subsequent management is unclear. Methods A retrospective cohort study was conducted to assess the effectiveness of universal preoperative syphilis screening testing implemented at a Japanese tertiary care hospital from April 2017 to March 2023. The annual prevalence of positive preoperative treponemal tests was tracked, and subsequent clinical management for patients with a positive test result was investigated. Attributes of patients with a positive result who were more likely to receive further evaluation were also elucidated. Results In total, 82,439 patients underwent surgery during the study period. Preoperative treponemal testing was performed in 94.8% (78,170 of 82,439) of the patients. A positive test result was recorded in 544 (0.70%), with an annual positivity rate ranging from 0.61% to 0.83%, whereas the proportion of presumed active syphilis ranged from 0.02% to 0.08%. A total of 85 patients with a positive syphilis screening test result, a nontreponemal test with a positive titer, and without history of syphilis were identified. Of those, only 45 patients (52.9%) received further evaluation. Conclusions The positivity of preoperative treponemal testing was low despite the rising incidence of syphilis in Japan, and the prevalence of presumed active syphilis identified during the preoperative period was even smaller. Routine treponemal testing in the preoperative setting had limited utility in effectively identifying patients with active syphilis. 02/25/2025 01:00 AM
 

Background The Centers for Disease Control and Prevention recommends test of cure (TOC) for persons with pharyngeal gonorrhea (GC) 7 to 14 days after treatment. We investigated the yield and feasibility of routine pharyngeal GC TOC to detect treatment failures. Methods During May 2021–July 2022, 4 US sexually transmitted disease clinics implemented pharyngeal GC TOC. Sites collected demographic, clinical, and behavioral data on all treated pharyngeal GC and positive TOC cases. Cases were dispositioned with the suspected reason for positive TOC. To assess perceived feasibility, sites participated in qualitative interviews. Results During the study period, 1968 pharyngeal GC infections were diagnosed. Among 1829 treated cases, 97.3% (n = 1777) received ceftriaxone and 45.7% (n = 836) returned for TOC, varying by site (range, 35.5%–70.8%). Among those with TOC, 4.7% (n = 39) were positive by nucleic acid amplification test. Of these, 48.7% had culture attempted; 6 positive TOCs (15.4%) were also positive by culture. Most positive TOCs (66.7%) were attributed to reinfection (n = 13) or false-positive results (n = 13). Six (15.4%) were treatment failures. Four failed recommended treatment and had a positive culture: 2 were susceptible to ceftriaxone and 2 did not have antimicrobial susceptibility results. Seven positive TOC (17.9%) had insufficient data to disposition. Sites perceived TOC to be feasible, although substantial resources were required. Conclusion Routine pharyngeal GC TOC yielded 5% positivity, although treatment failure was rare (<1%), and no cases of cephalosporin-resistant GC were identified. Low TOC return rates, limited culture collection, and limited culture yield highlight challenges to determining the cause of a positive TOC and the limitations of TOC in identifying cephalosporin resistance. 03/14/2025 01:00 AM
 

Background Public health emergencies can lead to reduced or suspended services in sexual health clinics (SHCs), raising questions about optimal ways to maintain access to care. We examined changes in sexual behaviors, human immunodeficiency virus preexposure prophylaxis use, telehealth preference, and correlates of delayed sexual health care among patients attending New York City (NYC) publicly funded SHCs during the COVID-19 pandemic. Methods Four hundred seventy patients from four SHCs (July to September 2021) completed a self-administered survey that collected data on access to sexual health care, overall and over three distinct periods (spring 2020 (COVID-19 wave 1), summer 2020, fall 2020/winter 2021 [COVID-19 wave 2]). We used log-binomial models to examine factors associated with delayed sexual health care. Results Participants reporting multiple in-person sexual contacts increased from 28% to 57% (P < 0.0001) between the first and second wave. Almost half of participants (35/72) taking HIV PrEP cited decreased use. Over 90% (423/460) of participants preferred in-person clinic visits over telehealth. Overall, delays in routine and urgent sexual health care were reported by 34% (129/375) and 12% (46/373) of participants, respectively. More men who have sex with men and transgender/gender nonconforming/nonbinary individuals experienced delayed care compared with women (men who have sex with men: adjusted prevalence ratio [aPR], 1.43; 95% confidence interval [CI], 1.00–2.03; transgender/gender nonconforming/nonbinary: adjusted prevalence ratio [aPR], 1.67; 95% CI, 1.04–2.69). Compared with participants who primarily sought sexual health care from private providers, those who primarily used SHCs experienced significantly more delayed care (aPR, 1.72; 95% CI, 1.14–2.59). Conclusions Delays in sexual health care access can have serious implications for certain patient populations. Additional resources are needed to maintain access to sexual health clinic services. 04/19/2024 01:00 AM
 

Background Given the continued increases in rates of both Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection, additional diagnostic assays may be useful in increasing access to testing for these sexually transmitted infections. We evaluated the performance of the NeuMoDx CT/NG Assay 2.0 on the NeuMoDx-96 and NeuMoDx-288 Molecular Systems. Methods The clinical sensitivity and specificity of the assay were assessed when used with (1) endocervical swabs, (2) self- and clinician-collected vaginal swabs, and (3) first-catch urine specimens (female and male). Results were compared with a patient infection status based on US Food and Drug Administration–cleared assays. Results The NeuMoDx CT/NG Assay 2.0 demonstrated high sensitivity and specificity in both symptomatic and asymptomatic participants. All specimen types other than endocervical swabs had ≥95% sensitivity and >99% specificity for both pathogens. For endocervical samples, sensitivities were 93.2% and 93.3% for CT and NG, respectively. There was no difference in performance based on platform. The frequency of invalid results was low (<1%). Conclusions The NeuMoDx CT/NG Assay 2.0 demonstrated performance similar to currently US Food and Drug Administration–cleared assays, with the added choice of a moderate- (96-sample) or a high-throughput (288-sample) platform. The system therefore offers solutions to laboratories running lower volumes of testing that may obviate the need for outsourcing to larger reference laboratories. 12/04/2024 01:00 AM