International Journal of STD & AIDS

We assessed the feasibility of point-of-care testing (POC) for Chlamydia trachomatis (CT) among Men who have Sex with Men (MSM) and Transgender Women (TGW) attending community-based clinics (CBOs) in Thailand.

A secondary analysis using data from a study that enrolled participants aged ≥18 years who were at risk of HIV. They were tested for CT and Neisseria gonorrhoeae (NG) using Cepheid Xpert® POC tests. Behaviors were assessed using a questionnaire. Logistic regression was used to evaluate factors associated with CT infections.

A total of 1885 participants were enrolled between 2019 and 2021, with 89.7% identifying as MSM. Of all participants, 15.9% were living with HIV (PLHIV), 20.6% initiated PrEP, 31.7% were already using it, and 31.8% had never used PrEP.

Of all participants, 13.4% and 18.8% tested positive for NG and CT, respectively. CT prevalence was associated with age groups: 34.6% in 18–19 years (AOR 3.2), 24.1% in 20–24 years (AOR 1.7), compared to 14.5% in those ≥25 years. CT prevalence was higher in PLHIV (28.3%) compared to those who were HIV-negative and had never used PrEP (17.0%).

Almost one-fifth of Thai MSM and TGW had CT infection. POC testing is feasible and should be integrated into STI screening.

Human Immunodeficiency Virus (HIV) infection remains a global public health concern due to its high morbidity and mortality rates, as well as the significant costs associated with treatment and healthcare services.

To determine the incidence of HIV and its associated factors among blood donors in the city of Medellín, Colombia.

A longitudinal study was conducted using secondary data from 23,122 repeat blood donors at a blood bank in Medellín. The cumulative incidence was estimated along with its 95% confidence interval. Pearson’s chi-square test, Fisher’s exact test, and relative risk calculations were used to identify associated factors.

The HIV incidence was 9.1 per 10,000 donors (95% CI: 5.0–13.2). Subgroups with the highest incidence per 10,000 donors included those recruited through mobile blood drives (12.3), individuals under 40 years of age (12.0), men (11.3), and altruistic donors (10.6).

A relatively low number of new HIV cases was found among repeat donors. However, the identification of subgroups with higher incidence is critical for developing targeted strategies to ensure the safety of these priority populations and to enhance active epidemiological surveillance systems for HIV in the general population.

Several antiretroviral regimens have been used for prevention of mother to child transmission (MTCT) of HIV, with maternal dolutegravir-based regimens (e.g. tenofovir/lamivudine/dolutegravir - TLD) being the latest, initiated in last 3–4 years. There is a need for assessment of effectiveness of this new regimen as compared to earlier efavirenz-based (tenofovir/lamivudine/efavirenz - TLE) and other regimens in program settings.

We conducted this retrospective cohort study to determine effectiveness of the TLD regimen in preventing antenatal, intranatal and postnatal MTCT compared to earlier regimens. 1905 HIV-exposed infants in West Bengal, India from April 2017 to March 2023 with available polymerase chain reaction for HIV at 314 Integrated Counselling and Testing Centres were considered. Duration of antenatal antiretroviral treatment and infant feeding practices types were also analyzed.

Among all mothers, 666 (35%) received TLD and 1194 (63%) TLE. With TLD, MTCT rate was significantly lower (2% vs 6.5%) [Adjusted Odds Ratio (AOR) = 0.28; 0.15–0.52] than all other regimens. Duration of maternal antiretroviral therapy (weeks) (AOR = 0.96; 0.95–0.98) and infant feeding practices (AOR = 0.09; 0.03–0.25) showed significant association with reduced MTCT rate.

Dolutegravir-based ART is more effective than earlier regimens and promises to achieve the elimination of pediatric HIV.

Filipino adolescents and young adults are at higher risk for acquiring human immunodeficiency virus (HIV) than any other age groups; 46% of new HIV infections in 2022 were in people aged 15 – 24 years. However, little is known about the prevalence and associated factors of HIV sexual risk behavior (SRB) among this vulnerable population in the Philippines.

This is a secondary analysis of a cross-sectional study from the 2021 Young Adult Fertility and Sexuality Study (YAFS5). 3120 sexually experienced Filipinos aged 15 – 24 were included in the analysis. Binary logistic regression and Poisson regression were used to test the relationship between the proposed independent variables and HIV SRB.

Approximately two-thirds (n = 2101, 65.5%) of Filipino youth engage in HIV SRB, and this is significantly higher among males (n = 1212, 74.9%, p < .001). Factors associated with HIV SRB include ever married/cohabited (AOR: 0.25, 95% CI: 0.20 – 0.32), have had sex with a virtual partner (AOR: 2.44, 95% CI: 1.25 – 4.78), currently smoking (AOR: 1.35, 95% CI: 1.04 – 1.76), lifetime drug use (AOR: 4.30, 95% CI: 2.15, 8.59), and suicidal ideation (AOR: 1.51, 95% CI: 1.17, 1.96). Differences between males and females were also noted.

This study highlights the vulnerabilities and co-occurring health risk behaviors among young Filipinos that may increase their risk of HIV transmission. Findings underscore the need for integrated, youth-focused programs—such as comprehensive sexual and reproductive education and improved service access—while acknowledging sociocultural challenges in a deeply religious context.

HIV self-testing (HIVST) was endorsed by WHO in 2016 to expand access to HIV diagnosis, especially for young people. Kenyan youths, including university students, remain vulnerable to HIV, yet uptake of free HIVST kits is inconsistent. This study assessed determinants of HIVST utilization among health sciences undergraduates at the University of Nairobi.

We conducted a cross-sectional analytical study at the Chiromo and Faculty of Health Sciences campuses. Multi-stage cluster sampling yielded 412 students from Medicine, Pharmacy, Nursing, Dentistry and Medical Laboratory Science. Data on socio-demographics, sexual behaviour, stigma, and institutional access were collected via self-administered questionnaires and analysed in R. Associations were examined using χ²/Fisher’s exact tests and Wilcoxon tests; variables with p < .05 entered a multivariable mixed-effects logistic regression model to account for clustering by course and year of study.

Overall, 30.5% reported prior HIVST use. Uptake was higher among older students and those in advanced years. Being in a relationship and consistently using condoms were associated with lower HIVST uptake. Recency of the last HIV test strongly predicted use, with students tested within the preceding 3–6 months more likely to self-test. Residence and gender were not independent predictors after adjustment.

HIVST uptake among Kenyan health sciences undergraduates is moderate but uneven. Age, academic seniority and recent HIV testing history increase uptake, whereas perceived low risk (e.g. condom use) reduces it. Universities and the Ministry of Health should pair easy kit access with messaging that encourages routine testing regardless of perceived risk to accelerate progress toward UNAIDS 95-95-95 targets.

Cervical cancer (CC) is highly prevalent in Nigeria, with over 12,000 cases and 8000 deaths annually. Differences in diagnostic methods for human papillomavirus (HPV) genotypes have generated varied prevalence rates across populations.

We analyzed the prevalence and distribution of high-risk HPV (HR-HPV) genotypes among women with CC, comparing HIV-negative women and women living with HIV (WLWH), using data from a prospective Nigerian cohort study (2018–2022). High-throughput next-generation sequencing (NGS) of the HPV L-1 gene identified and classified genotypes.

Among 189 women tested for HR-HPV, 74.1% (140/189) were HIV-negative, and 25.9% (49/189) were WLWH. The median age was lower for WLWH at 48 years [IQR: 41–54] compared to HIV-negative women at 60 years [IQR: 49–69] (p < .001). The overall prevalence of HR-HPV was 64.6% (122/189; 95% CI: 57.4–71.1), with higher rates in WLWH (77.6%, 38/49) than HIV-negative women (60.0%, 84/140) (p < .001). Among HR-HPV-positive cases, HPV16 or HPV18 accounted for the highest proportion, representing 67.2% (95% CI: 58.3–75.0). The most prevalent HR-HPV types detected were HPV16 (46.7%), HPV18 (20.5%), HPV45 (9.8%), HPV35 (6.6%), and HPV52 (5.7%). Quadrivalent and nonavalent HPV vaccines would cover 67.2% (95% CI: 58.3–75.0) and 86.1% of HR-HPV infections, respectively.

Our NGS approach findings among women with CC identified HPV types not covered by the Gardasil-4 vaccine used in Nigeria. This highlights the need for broader vaccine coverage against most HR-HPV types, regardless of HIV status, in Nigeria.

Transgender women in Mexico face a high HIV prevalence, yet they remain insufficiently engaged in pre-exposure prophylaxis (PrEP). This study aimed to evaluate willingness to use HIV pre-exposure prophylaxis (PrEP) and its connection to risk behaviors among transgender women in Mexico.

In 2021, a cross-sectional study was conducted among Mexican transgender women to assess HIV risk factors and willingness to use PrEP. We used Latent Class Analysis to cluster participants with similar HIV risk behaviors, and multivariable logistic regression to identify covariates of willingness to use PrEP.

Among 266 transgender women, 40% were aware of PrEP, yet 78% reported willingness to use it after a brief introduction. Only 25% of the participants perceived themselves at high HIV risk. Through Latent Class Analysis, three classes were identified: 1) transactional sex with lower risk (10%); 2) no transactional sex with higher risk (25%); and 3) transactional sex with higher risk (65%), with reported willingness to use PrEP at 61%, 66% and 85%, respectively. In the multivariable model, belonging to class 3 (vs class 1) was associated with higher willingness to use PrEP (aOR:3.3; CI:1.2–9.5).

Willingness to use PrEP aligned with HIV risk in those with a higher risk (class 3) and lower risk (class 1), but not in those at higher risk despite not reporting transactional sex (class 2). Therefore, not all who could benefit from PrEP may want it. Strategies are needed to promote PrEP’s awareness and willingness to use considering the needs of transgender women subgroups.

New guidelines recommend anal cancer screening for priority populations with increased likelihoods of anal cancer including people with a history of HIV, gynecologic cancers, condyloma acuminata, and solid organ transplantation. However, little is known about U.S.-based screening practices prior to these guidelines.

We examined outpatient clinical encounters between 01/01/2015 and 08/01/2022 and analyzed provider characteristics and screening behaviors in an urban medical system in Boston, U.S. We used chi-squared tests and logistic regression to identify provider factors associated with anal cancer screening.

Of 1098 providers, 48.5% completed at least one screening, including 93.8% (n = 75/80) of infectious disease (ID) providers, 54.6% (n = 372/681) of primary care providers (PCPs), and 28.3% (n = 41/145) of obstetrician/gynecologists (OBGYNs) (p < 0.001). Annual screening of priority populations was most common among providers trained in high-resolution anoscopy (19.8%–27.9% screened), and less common among ID providers (4.4%–8.7%), PCPs (0.4%–1.4%), and OBGYNs (0.1%–0.8%). In multivariate analysis, providers treating proportionately more cisgender women (adjusted odds ratio [aOR] = 0.988; 95% confidence interval [CI] 0.982–0.995), more non-white patients (aOR = 0.984; 95% CI 0.976–0.992), or fewer people with HIV were less likely to be screeners.

Most providers caring for priority populations did not complete anal cancer screenings, and annual screening levels were low across disciplines. Strategies are needed to optimize anal cancer screening practices, particularly for patients who are HIV-negative, non-white, and cisgender women.

This narrative review examines the impact of the United States on the war against HIV/AIDS and thus the impact of political ideologies on the financing of the medical sector.

Initially marked by stigma, particularly in the early years of the epidemic, the US response was transformed with the launch of the Presidential Emergency Plan for AIDS Relief (PEPFAR) in 2003. PEPFAR has partnered with entities such as the Global Fund and the Joint United Nations Programme on HIV/AIDS (UNAIDS), retranslating global health governance. Despite this success, the global response remains dependent on the support of the United States. Political changes under the leadership of the conservatives have limited funding. Therefore, political polarization in the US is undermining long-term progress on HIV/AIDS prevention and treatment, particularly in low- and middle-income countries.

By tracing historical developments and analysing current funding trends, the article highlights the urgent need for sustainable and depoliticized investments in global health systems. Without renewed bipartisan commitment and greater local ownership, the vision of eliminating AIDS as a public health threat by 2030 is seriously threatened.