Antimicrobial Resistance in Curable Sexually Transmitted Infections.

Purpose Of Review: Antimicrobial resistance in sexually transmitted infections (STIs) has become an urgent global public health threat, raising the specter of untreatable infections. This review summarizes the determinants of resistance among the five most common curable STIs Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, Treponema pallidum, and Trichomonas vaginalis, as well as strategies to mitigate the spread of resistance.

Recent Findings: Genetic mutations are key drivers of resistance for N.

Health provider perspectives on establishing service linkages for treatment and follow-up from an Australian, web-based STI testing service: a qualitative study.

Background Web-based, testing for sexually transmitted infections (STI) is becoming increasingly available. However, treatment pathways from web-based services are often not well-coordinated, contributing to treatment delays and access gaps. This study investigated clinician perspectives on building service linkages with a new, web-based, STI testing service in Victoria, Australia.

A global review of national guidelines of post-exposure prophylaxis for the prevention of HIV.

Introduction: The World Health Organization (WHO) recommends the use of antiretroviral drugs as post-exposure prophylaxis (PEP) for preventing HIV acquisition for occupational and non-occupational exposures. To inform the development of global WHO recommendations on PEP, we reviewed national guidelines of PEP for their recommendations.

Methods: Policies addressing PEP from 38 WHO HIV priority countries were obtained by searching governmental and non-governmental websites and consulting country and regional experts; these countries were selected based on HIV burden, new HIV acquisitions and the number of HIV-associated deaths.

2024 British Association for Sexual Health and HIV (BASHH) UK national guideline on the management of vulval conditions.

Background: The management of vulval disorders in Genitourinary Medicine (GUM) clinics requires targeted approaches due to the wide range of conditions affecting the vulva. Vulval diseases encompass various aetiologies, including dermatoses, pain syndromes, and pre-malignant conditions, necessitating specialized care often involving multidisciplinary collaboration.

Purpose: This guideline aims to provide evidence-based recommendations for the diagnosis and management of specific vulval conditions that may present in GUM clinics.

Identifying High-Risk Populations for Sexually Transmitted Infections in Chinese Men Who Have Sex With Men: A Cluster Analysis.

Background: This study aimed to identify subpopulations of Chinese men who have sex with men (MSM) with distinct sexual behavioral patterns and explore their correlations with sexually transmitted infections (STIs).

Methods: We recruited 892 eligible MSM in Xi'an, China, collecting sociodemographic, sexual behavior, and STI data. Cluster analysis identified distinct sexual behavioral patterns, allowing us to examine STI differences across clusters.

Rationale and Ethical Assessment of an Oropharyngeal Gonorrhoea Controlled Human Infection Model.

Infection with Neisseria gonorrhoeae, the causative agent of gonorrhoea, causes significant morbidity worldwide and can have long-term impacts on reproductive health. The greatest global burden of gonorrhoea occurs in low- and middle-income settings. Global public health significance is increasing due to rising antimicrobial resistance (AMR), which threatens future gonorrhoea management.

Evaluation of preventive medicine amongst people living with human immunodeficiency virus attending a hospital-based care setting.

Background: With improved outcomes in human immunodeficiency virus (HIV) due to the use of anti-retroviral therapy, ensuring adequate preventative healthcare and management of HIV-related comorbidities is essential.

Aims: To evaluate adherence with recommended guidelines for comorbidity and immunisation status screening amongst people living with HIV within a hospital-based setting across two timepoints.

Methods: A single-centre retrospective case series was conducted at a hospital between 2011 and 2021.

Preference for HIV Pre-exposure Prophylaxis Access Among Men who Have Sex With Men in China: A Discrete Choice Experiment.

Background: HIV pre-exposure prophylaxis (PrEP) is highly effective but not widely used by men who have sex with men (MSM; 27%) in China.

Methods: In June 2023, an online cross-sectional survey with a discrete choice experiment (DCE) was distributed to PrEP-eligible MSM in China who were at least 18 years old. The DCE explored attributes of PrEP modality (daily pill, on-demand pill, injections, implants), clinical care model (same-day, 2-visit, telehealth prescription), medication pickup (clinic, community health center, pharmacy, MSM-focused community-based organization, home delivery), enhanced support (self-management, smartphone app, text reminder, anonymous peer support group), and cost.

Photoreceptor metabolic window unveils eye-body interactions.

Photoreceptors are specialized neurons at the core of the retina's functionality, with optical accessibility and exceptional sensitivity to systemic metabolic stresses. Here we show the ability of risk-free, in vivo photoreceptor assessment as a window into systemic health and identify shared metabolic underpinnings of photoreceptor degeneration and multisystem health outcomes. A thinner photoreceptor layer thickness is significantly associated with an increased risk of future mortality and 13 multisystem diseases, while systematic analyses of circulating metabolomics enable the identification of 109 photoreceptor-related metabolites, which in turn elevate or reduce the risk of these health outcomes.

Prediction accuracy of discrete choice experiments in health-related research: a systematic review and meta-analysis.

Background: Discrete choice experiments (DCEs) are increasingly used to inform the design of health products and services. It is essential to understand the extent to which DCEs provide reliable predictions outside of experimental settings in real-world decision-making situations. We aimed to compare the prediction accuracy of stated preferences with real-world choices, as modelled from DCE data.

Exploring artificial intelligence for differentiating early syphilis from other skin lesions: a pilot study.

Background: Early diagnosis of syphilis is vital for its effective control. This study aimed to develop an Artificial Intelligence (AI) diagnostic model based on radiomics technology to distinguish early syphilis from other clinical skin lesions.

Methods: The study collected 260 images of skin lesions caused by various skin infections, including 115 syphilis and 145 other infection types.

Impact of achieving WHO's 90-70-90 targets on cervical cancer elimination and potential benefits in preventing other HPV-related cancers in China: a modelling study.

Background: In the context of the World Health Organization's (WHO) 90-70-90 targets for accelerating cervical cancer elimination, we aimed to assess the impact of achieving these targets and altering intervention factors on cervical cancer elimination in China and their potential benefits from preventing other human papillomavirus (HPV)-related cancers.

Methods: We developed a sexual contact network-Markov model to simulate HPV transmission and the progression of HPV-related cancers (cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers). We projected the population impact of achieving 90-70-90 targets by 2030 on the overall HPV-related cancer burden in China during 2024-2100.

Mucosal vaccination against SARS-CoV-2 using recombinant influenza viruses delivering self-assembling nanoparticles.

Recombinant influenza viruses are promising vectors that can bolster antibody and resident lymphocyte responses within mucosal sites. This study evaluates recombinant influenza viruses with SARS-CoV-2 RBD genes in eliciting mucosal and systemic responses. Using reverse genetics, we generated replication-competent recombinant influenza viruses carrying heterologous RBD genes in monomeric, trimeric, or ferritin-based nanoparticle forms.

Health care professionals' views on a new postpartum contraception audiovisual animation: a survey.

Background: The postpartum period is a high-risk time for unintended pregnancy. We developed a 2-minute audiovisual animation on postpartum contraception (PPC) including the return of fertility after birth for patients. The aim of our study was to determine the views of healthcare professionals (HCPs) involved in pregnancy care on the animation and to identify facilitators and barriers to its implementation into routine pregnancy care pathways.

Accuracy of symptom checker for the diagnosis of sexually transmitted infections using machine learning and Bayesian network algorithms.

Background: A significant proportion of individuals with symptoms of sexually transmitted infection (STI) delay or avoid seeking healthcare, and digital diagnostic tools may prompt them to seek healthcare earlier. Unfortunately, none of the currently available tools fully mimic clinical assessment or cover a wide range of STIs.

Methods: We prospectively invited attendees presenting with STI-related symptoms at Melbourne Sexual Health Centre to answer gender-specific questionnaires covering the symptoms of 12 common STIs using a computer-assisted self-interviewing system between 2015 and 2018.

A web-based tool for cancer risk prediction for middle-aged and elderly adults using machine learning algorithms and self-reported questions.

Background: From a global perspective, China is one of the countries with higher incidence and mortality rates for cancer.

Objective: Our objective is to create an online cancer risk prediction tool for middle-aged and elderly Chinese adults by leveraging machine learning algorithms and self-reported data.

Method: Drawing from a cohort of 19,798 participants aged 45 and above from the China Health and Retirement Longitudinal Study (2011 - 2018), we employed nine machine learning algorithms (LR: Logistic Regression, Adaboost: Adaptive Boosting, SVM: Support Vector Machine, RF: Random Forest, GNB: Gaussian Naive Bayes, GBM: Gradient Boosting Machine, LGBM: Light Gradient Boosting Machine, XGBoost: eXtreme Gradient Boosting, KNN: K - Nearest Neighbors), which are mainly used for classification and regression tasks, to construct predictive models for various cancers.

Comparing the impact of sexualised drug use with and without chemsex on sexual behaviours among men who have sex with men in China: a national multi-site cross-sectional study.

Background Sexualised drug use (SDU) is common in men who have sex with men (MSM). Chemsex, a form of psychoactive SDU, is a strong risk factor for sexually transmitted infections (STIs). We investigated the associations of SDU and chemsex with the sexual behaviours in Chinese MSM.

Linkage to care and prevention after HIV self-testing: a systematic review and meta-analysis.

Introduction: Effective linkage to prevention and care is a crucial step following HIV testing services. This systematic review aimed to determine the proportion of individuals linked to prevention and care after HIV self-testing (HIVST) and describe factors associated with linkage.

Methods: Following PRISMA guidelines, a comprehensive search across eight databases (2010-October 2023) identified studies on linkage to care after HIVST, defined as receiving a confirmatory test or initiating antiretroviral therapy (ART) if the self-test was reactive, and/or pre-exposure prophylaxis (PrEP) if the self-test was non-reactive.

Polyfunctionality and breadth of HIV-1 antibodies are associated with delayed disease progression.

HIV-1 infection leads to chronic disease requiring life-long treatment and therefore alternative therapeutics, a cure and/or a protective vaccine are needed. Antibody-mediated effector functions could have a role in the fight against HIV-1. However, the properties underlying the potential beneficial effects of antibodies during HIV-1 infection are poorly understood.

Preferences for online or in-person STI testing vary by where a person lives and their cultural background: a survey of young Australians.

Objectives: The objectives are to explore the acceptability of online sexually transmitted infection (STI) testing services among young Australians (16-29 years) and how this may vary between sociodemographic populations.

Methods: A cross-sectional, online survey (using both closed and open-ended questions) of Australians aged 16-29 years. Of 905 participants, 781 (86%) responded to the question on preference for online versus in-person STI testing and are included in this analysis.

Exploring the diversity of sexual acts in Chinese men who have sex with men and its impacts on the risk of HIV and sexually transmitted infections.

Objectives: High-risk sexual behaviour contributes to sexually transmitted infections (STIs), but the diversity of sexual acts in men who have sex with men (MSM) was understudied. We aimed to identify the diversity of sexual acts in Chinese MSM and its impacts on HIV/STI risk.

Study Design: Cross-sectional study.

Real-world clinical data-driven modelling on the initiation time of antiviral prophylaxis among pregnant women with chronic hepatitis B infection.

Background & Aims: The risk of mother-to-child transmission (MTCT) for pregnant women with chronic hepatitis B (CHB) still exists, especially for those with high HBV DNA levels. The guidelines for initiating prophylaxis for pregnant women with CHB vary across countries. We aimed to explore the latest prophylaxis initiation time for these women.

Preferences for attributes of an artificial intelligence-based risk assessment tool for HIV and sexually transmitted infections: a discrete choice experiment.

Introduction: Early detection and treatment of HIV and sexually transmitted infections (STIs) are crucial for effective control. We previously developed MySTIRisk, an artificial intelligence-based risk tool that predicts the risk of HIV and STIs. We examined the attributes that encourage potential users to use it.

Community-engaged strategies to improve sexual health services for adults aged 45 and above in the United Kingdom: a qualitative data analysis.

Background Sexual health is an essential component of health and well-being across the life course. However, sexual health research often focuses on young adults and excludes those aged 45years and older. We organized a national crowdsourcing open call and co-creation events to identify recommendations to improve sexual health service provision for middle-aged and older adults in the United Kingdom (UK).