Factores de riesgo para la adquisición de Infecciones de Transmisión Sexual en trabajadores/as del sexo: revisión sistemática / Risk factors for the acquisition of Sexually Transmitted Infections in sex workers: a systematic review

Fundamentos: las infecciones de transmisión sexual (its) son infecciones causadas por más de treinta bacterias, virus y pa-rásitos diferentes, que se transmiten por contacto sexual, incluido el coito vaginal, anal o bucal, aunque algunas infecciones también pueden transmitirse de la madre al hijo durante el embarazo, el parto y la lactancia. Según la organización mundial de la salud, una de las principales poblaciones de riesgo para la adquisición de estas infecciones son los/las trabajadores/as del sexo y sus clientes. El objetivo de este trabajo fue analizar los factores de riesgo en la adquisición de infecciones de transmisión sexual en la población de trabajadores/as del sexo.métodos: se realizó una revisión sistemática mediante búsqueda en scopus, pubmed, cinahl, medline, lilacs e ibecs, de estudios observacionales, longitudinales y mixtos realizados en trabajadores/as del sexo que fueron publicados entre enero de 2011 y marzo de 2021, obteniendo una muestra final de cuarenta y tres artículos. La herramienta de evaluación de métodos mixtos (mixed methods assessment tool) fue utilizada para evaluar la calidad metodológica de los trabajos. Resultados: después de analizar la bibliografía se obtuvieron once grupos de factores de riesgo relacionados con la adquisición de its, siendo estos factores económicos, relacionados con las prácticas sexuales, consumo de drogas, trabajo sexual, educación, problemas de salud, país de origen y movilidad, pareja, edad, violencia y otros factores no pertenecientes a las anteriores categorías.conclusiones: las/os profesionales del sexo tienen numerosas características y comportamientos que les convierten en una población vulnerable a las its. Destacan los años ejerciendo la prostitución, el consumo de drogas, el número de parejas y el uso del preservativo, siendo estos factores clave para futuras estrategias de prevención e intervención, así como de investigación.(AU)

Background: sexually transmitted infections (sti), as their name suggests, are infections caused by more than thirty different bacteria, viruses, and parasites and are transmitted through sexual contact, including vaginal, anal, or oral intercourse, although some sexually transmitted infections can also transmitted from mother to child during pregnancy, childbirth and lactation. According to world health organization, one of the main populations at risk for acquiring these diseases are sex workers and their clients. Due to the high prevalence, the characteristics and behaviors that favor the development of these diseases are analyzed. The main objective of this paper was to analyze the risk factors in the acquisition of sexually transmitted diseases in the population of sex workers. Methods: a literature search was conducted in scopus, pubmed, cinahl, medline, lilacs and ibecs, of observational, longitudinal and mixed methods studies conducted in sex workers and published between january 2011 and march 2021, with a final sample of four-ty-three articles. The mixed methods assessment tool (mmat) was used to assess the methodological quality of the papers.results: after analyzing the literature, eleven groups of risk factors related to the acquisition of sexually transmitted diseases were obtained, these being economic factors, factors related to sexual practices, drug use, sex work, education, health problems, country of origin and mobility, partner, age, violence and other factors not belonging to the previous categories.conclusions: sex workers have numerous characteristics and behaviors that make them vulnerable to sexually transmitted in-fections. Of note are years of prostitution, drug use, number of partners and condom use, which are key factors for future prevention and intervention strategies, as well as research.(AU)

Deadliest mpox outbreak ever sparks a new worry.

Congo cases suggest viral strain there is spreading sexually, like less lethal one that triggered last year's global outbreak.

Importancia clínica del aislamiento de Haemophilus spp. (excluyendo H. ducreyi) en muestras genitales. Revisión sistemática / Clinical significance of isolation of Haemophilus no ducreyi in genital samples. Systematic review

Introducción y objetivos Actualmente el diagnóstico microbiológico de las infecciones genitales se realiza con métodos moleculares, los cuales permiten detectar agentes etiológicos menos frecuentes, pero con potencial importancia patogénica, como Haemophilus spp. El objetivo de esta revisión es analizar y resaltar la importancia clínica del aislamiento de Haemophilus spp. en infecciones genitales y rectales, excluyendo H. ducreyi. Material y métodos Se ha realizado una revisión sistemática en base a una búsqueda exhaustiva de las publicaciones incluidas en la base de datos MEDLINE hasta el 5 de agosto de 2021, sobre la presencia de Haemophilus spp. en infecciones genitales y rectales, excluyendo H. ducreyi. Resultados Tras revisar lo descrito en la literatura, las especies de Haemophilus (excluyendo H. ducreyi: HSNOD) se detectaron en 2397 episodios de infección genital, siendo las especies más frecuentemente aisladas H. influenzae y H. parainfluenzae. La mayoría de los episodios (87,6%) están constituidos por aislamiento único. Existe un ligero predominio en mujeres (48,3%) donde puede producir cuadros de vaginitis, salpingitis, endometritis o complicaciones durante el embarazo. En hombres, el cuadro clínico suele corresponder a una uretritis. La mayoría de las muestras corresponde a exudados vaginales y uretrales, con una representación minoritaria a nivel rectal (2,3%). Conclusión HSNOD desempeña un papel patogénico relevante en episodios de infección genital, por lo que los protocolos de diagnóstico microbiológico deben incluir métodos que permitan su detección, así como incluirlos en el espectro etiológico de este tipo de cuadros clínicos (AU)

Introduction and objectives Currently, the microbiological diagnosis of genital infections is carried out with molecular methods, which allow the detection of less frequent etiological agents but with potential pathogenic importance, such as Haemophilus spp. The objective of this review is to analyze and highlight the clinical importance of the isolation of Haemophilus spp. in genital and rectal infections, excluding H. ducreyi. Material and methods A systematic review was carried out based on an exhaustive search of the publications included in the MEDLINE database up to August 5, 2021, on the presence of Haemophilus spp. in genital and rectal infections, excluding H. ducreyi. Results After reviewing what was described in the literature, Haemophilus spp. (excluding H. ducreyi: HSNOD) was detected in 2397 episodes of genital infection, the most frequently isolated species being H. influenzae and H. parainfluenzae. Most of the episodes (87.6%) are constituted by single isolation. There is a slight predominance in women (48.3%) where it can cause vaginitis, salpingitis, endometritis or complications during pregnancy. In men, the clinical picture usually corresponds to urethritis. Most of the samples correspond to vaginal and urethral exudates, with a minority representation at the rectal level (2.3%). Conclusion HSNOD plays a relevant pathogenic role in episodes of genital infection, so microbiological diagnostic protocols must include methods that allow their detection, as well as include them in the etiological spectrum of this type of clinical picture (AU)

Las enfermedades de transmisión sexual en el siglo XXI / Sexually transmitted diseases in the 21st century

Se hace un recorrido por las causas, estimaciones, contagios y tendencias de las enfermedades de transmisión sexual en el siglo XXI. Se incide en que si se mantienen los estilos sociales, demográficas y migratorias, la población expuesta a infecciones de transmisión sexual seguirá aumentando espectacularmente. La carga de morbilidad es particularmente pesada en el mundo en desarrollo, pero también en los países industrializados cabe prever un aumento de la carga de enfermedad debido a la prevalencia de infecciones víricas incurables, a las tendencias en el comportamiento sexual y al incremento de los viajes. (AU)

A tour of the causes, estimates, infections and trends of sexually transmitted diseases in the 21st century is made.It is stressed that if social, demographic and migratory styles are maintained, the population exposed to sexually transmitted infections will continue to increase dramatically.The burden of disease is particularly heavy in the developing world, but also in industrialized countries the burden of disease can be expect-ed to increase due to the prevalence of incur-able viral infections, trends in sexual behavior and increased travel. (AU)

Optimal vaccine allocation for the control of sexually transmitted infections.

The burden of sexually transmitted infections (STIs) poses a challenge due to its large negative impact on sexual and reproductive health worldwide. Besides simple prevention measures and available treatment efforts, prophylactic vaccination is a powerful tool for controlling some viral STIs and their associated diseases. Here, we investigate how prophylactic vaccines are best distributed to prevent and control STIs. We consider sex-specific differences in susceptibility to infection, as well as disease severity outcomes. Different vaccination strategies are compared assuming distinct budget constraints that mimic a scarce vaccine stockpile. Vaccination strategies are obtained as solutions to an optimal control problem subject to a two-sex Kermack-McKendrick-type model, where the control variables are the daily vaccination rates for females and males. One important aspect of our approach relies on conceptualizing a limited but specific vaccine stockpile via an isoperimetric constraint. We solve the optimal control problem via Pontryagin's Maximum Principle and obtain a numerical approximation for the solution using a modified version of the forward-backward sweep method that handles the isoperimetric budget constraint in our formulation. The results suggest that for a limited vaccine supply ([Formula: see text]-[Formula: see text] vaccination coverage), one-sex vaccination, prioritizing females, appears to be more beneficial than the inclusion of both sexes into the vaccination program. Whereas, if the vaccine supply is relatively large (enough to reach at least [Formula: see text] coverage), vaccinating both sexes, with a slightly higher rate for females, is optimal and provides an effective and faster approach to reducing the prevalence of the infection.

Региональные планы действий по ликвидации СПИДа и эпидемий вирусных гепатитов и инфекций, передаваемых половым путем, на 2022–2030 гг.

ВИЧ-инфекция, вирусные гепатиты и инфекции, передаваемые половым путем, остаются тяжелым бременем для общественного здравоохранения в Европейском регионе ВОЗ, затрагивая миллионы людей и вляясь причиной преждевременной смертности. Несмотря на некоторый прогресс в достижении целей, изложенных в предыдущем Плане действий сектора здравоохранения по борьбе с ВИЧ-инфекцией в Европейском регионе ВОЗ и Плане действий сектора здравоохранения по борьбе с вирусными гепатитами в Европейском регионе ВОЗ, проблемы сохраняются, особенно в странах Восточной Европы и Центральной Азии. Региональные планы действий по ликвидации СПИДа и эпидемий вирусных гепатитов и инфекций, передаваемых половым путем, на 2022–2030 гг. включают видение, цели и действия, требуемые для принятия ответных мер в связи с этими эпидемиями. Основываясь на достигнутом прогрессе и уроках, полученных в ходе выполнения предыдущих планов, Региональные планы действий обеспечивают концептуальную основу стратегической комбинации подходов, ориентированных на борьбу с конкретными заболеваниями, с сосредоточением внимания на людях – центральном компоненте ответных мер. Региональные планы действий помогут внедрению Глобальных стратегий сектора здравоохранения по ВИЧ, вирусному гепатиту и инфекциям, передаваемым половым путем, на 2022–2030 гг. путем проведения мероприятий, специфичных для Региона, и приведения ответных мер в соответствие с Европейской программой работы на 2020–2025 гг. «Совместные действия для улучшения здоровья». Планы действий будут способствовать реализации потенциала первичной медико-санитарной помощи за счет содействия оказанию многоуровневой помощи и развитию сетей медицинского обслуживания и продвижения программы всеобщего охвата услугами здравоохранения посредством улучшения доступа к услугам здравоохранения без финансовых трудностей.Региональные планы действий были приняты на семьдесят второй сессии Европейского регионального комитета наряду с резолюцией Регионального комитета EUR/RC72/R4.

Atendimento psicossocial à mulher que comete ofensa sexual / Psychosocial attention for women that commit sexual offenses / Atención psicosocial para mujeres que cometen delitos sexuales

Objetivamos apresentar uma proposta de atendimento psicossocial grupal oferecida para mulheres adultas que cometeram ofensa sexual, cuidadoras e mães. A experiência está sendo desenvolvida no Distrito Federal, Brasil, com pessoas do gênero feminino provenientes de encaminhamento judicial. Carece que os profissionais das áreas da justiça, saúde, serviço social e psicologia avancem no estudo e na compreensão desta temática, de modo a pensarem a atuação e o apoio terapêutico a essas mulheres. O modo de atendimento é focal e breve, com ênfase na criação de um ambiente lúdico como facilitador das interações grupais e da discussão sobre os temas: identidade; confiança nas relações afetivas e sociais; vivência pessoal com violência física e sexual; configuração de gênero; e expressão da sexualidade e futuro. A abordagem individual também se baseia no enfoque dos temas mencionados. O oferecimento de ajuda à mulher cuidadora ou à mãe tem participação ativa na interrupção do circuito abusivo sexual, pois essa violência é extremamente ocultada, ocasionando uma prolongada vulnerabilidade para as vítimas. Ressalta-se o valor do texto indicando a descrição de ação voltada para uma população permanentemente não estudada e evitada em seu reconhecimento. Os limites desta proposta encontram-se na falta de outras iniciativas que possibilitem uma discussão sobre essa experiência.(AU)

We aim to present a proposal of a group psychosocial intervention offered for adult female sexual offenders, caregivers, and mothers. The intervention is being developed at Federal District, Brazil, with female people coming from judicial referrals. Professionals in the areas of justice, health, social work, and psychology need to advance in the study and understanding this theme to think about action and therapeutic support for these women. The intervention is a focal and brief approach, with emphasis on the creation of a ludic environment as a facilitator of group interactions and discussion about the themes: identity; trust in affective and social relationships; personal experience with physical and sexual violence; gender configuration; and sexuality expression and future. The individual approach is also based on focusing on these themes. The offering of help to the female caregiver or the mother has an active participation in the interruption of the sexual offense circuit, since this violence is extremely hidden, bringing a prolonged condition of vulnerability to the victims. The value of this text is highlighted indicating the description of an action directed to a population that is permanently not studied and whose recognition is avoided. The limits of this proposal are found in the absence of other initiatives that would allow a discussion about this experience.(AU)

Este texto presenta una propuesta de atención psicosocial grupal destinada a mujeres adultas que han cometido delito sexual, a cuidadoras y madres. La intervención se está desarrollando en el Distrito Federal (Brasil), con personas del género femenino provenientes de remisiones judiciales. Es necesario que los profesionales de las áreas de justicia, salud, trabajo social y psicología avancen en el estudio y comprensión de esta temática para pensar en el desempeño y apoyo terapéutico de estas mujeres. El servicio es enfocado y breve, con énfasis en la creación de un ambiente lúdico como facilitador de interacciones grupales y discusión sobre los temas: identidad; confianza en las relaciones afectivas y sociales; experiencia personal con violencia física y sexual; configuración de género; y expresión de la sexualidad y el futuro. El enfoque individual también se centra en estos temas. La oferta de ayuda a la mujer cuidadora o a la madre es importante para la interrupción del circuito de abuso sexual, ya que esta violencia es extremadamente oculta y provoca una vulnerabilidad prolongada a las víctimas. Se destaca el valor del texto con la descripción de la acción dirigida a una población que no es objeto de estudios ni reconocida. Los límites de esta propuesta se encuentran en la ausencia de otras iniciativas que permitan un debate sobre esta experiencia.(AU)

Neurodegenerative disease in association with sexual transmission of human T-cell lymphotropic virus type 2 subtype b in Argentina.

BACKGROUND: The aim of this study is to show that human T-cell lymphotropic virus type 2 (HTLV-2) infection produces symptoms resembling those described for HTLV-1-associated myeloneuropathy and to highlight the role of sexual transmission in the silent dissemination of HTLV-2. METHODS: Patient samples were tested by particle agglutination and indirect immunofluorescence assay. The HTLV type was defined by molecular techniques. Nucleotide sequence analysis of HTLV-2 long terminal repeat region, T cell CD3/CD4 and T cell CD3/CD8 counts and typing of human leucocyte antigen (HLA) alleles A, B, C and DRB1 were also performed. RESULTS: HTLV-2 subtype b infection was confirmed in two blood donors and their sexual partners. Two patients exhibited distinctive signs and symptoms of progressive neurological disease. Three infected patients carried HLA-C*04. Both patients with neurological disease also carried HLA-A*31 and HLA-DRB1*07 alleles. CONCLUSIONS: Herein we describe for the first time sexual transmission of HTLV-2 in a non-endemic region of Argentina, highlighting the relevance of this transmission route in HTLV-2 silent dissemination out of the clusters of endemicity. We also provide evidence that HTLV-2 infection causes symptoms resembling those described for HTLV-1-associated myeloneuropathy. The evidence presented herein points to the critical need for public health strategies to reduce the spread of this neglected infection.

Hide and Seek: The Interplay Between Zika Virus and the Host Immune Response.

Zika virus (ZIKV) received worldwide attention over the past decade when outbreaks of the disease were found to be associated with severe neurological syndromes and congenital abnormalities. Unlike most other flaviviruses, ZIKV can spread through sexual and transplacental transmission, adding to the complexity of Zika pathogenesis and clinical outcomes. In addition, the spread of ZIKV in flavivirus-endemic regions, and the high degree of structural and sequence homology between Zika and its close cousin Dengue have raised questions on the interplay between ZIKV and the pre-existing immunity to other flaviviruses and the potential immunopathogenesis. The Zika epidemic peaked in 2016 and has affected over 80 countries worldwide. The re-emergence of large-scale outbreaks in the future is certainly a possibility. To date, there has been no approved antiviral or vaccine against the ZIKV. Therefore, continuing Zika research and developing an effective antiviral and vaccine is essential to prepare the world for a future Zika epidemic. For this purpose, an in-depth understanding of ZIKV interaction with many different pathways in the human host and how it exploits the host immune response is required. For successful infection, the virus has developed elaborate mechanisms to escape the host response, including blocking host interferon response and shutdown of certain host cell translation. This review provides a summary on the key host factors that facilitate ZIKV entry and replication and the mechanisms by which ZIKV antagonizes antiviral innate immune response and involvement of adaptive immune response leading to immunopathology. We also discuss how ZIKV modulates the host immune response during sexual transmission and pregnancy to induce infection, how the cross-reactive immunity from other flaviviruses impacts ZIKV infection, and provide an update on the current status of ZIKV vaccine development.

From Mosquito Bites to Sexual Transmission: Evaluating Mouse Models of Zika Virus Infection.

Following the recent outbreak of Zika virus (ZIKV) infections in Latin America, ZIKV has emerged as a global health threat due to its ability to induce neurological disease in both adults and the developing fetus. ZIKV is largely mosquito-borne and is now endemic in many parts of Africa, Asia, and South America. However, several reports have demonstrated persistent ZIKV infection of the male reproductive tract and evidence of male-to-female sexual transmission of ZIKV. Sexual transmission may broaden the reach of ZIKV infections beyond its current geographical limits, presenting a significant threat worldwide. Several mouse models of ZIKV infection have been developed to investigate ZIKV pathogenesis and develop effective vaccines and therapeutics. However, the majority of these models focus on mosquito-borne infection, while few have considered the impact of sexual transmission on immunity and pathogenesis. This review will examine the advantages and disadvantages of current models of mosquito-borne and sexually transmitted ZIKV and provide recommendations for the effective use of ZIKV mouse models.

Determinación de la incidencia de infecciones de transmisión sexual en la Consulta Infanto-Juvenil / Determination of Incidence of sexually transmitted diseases in Child and Adolescent Consultation

Fundamento: las infecciones de transmisión sexual afectan en especial a la población adolescente dada su vulnerabilidad biológica y psicológica, tienen consecuencias severas en la salud sexual y reproductiva. Objetivo: determinar la incidencia de infecciones de transmisión sexual en la Consulta Infanto-Juvenil. Métodos: se realizó un estudio observacional, descriptivo y transversal, cuyo universo fueron las 50 pacientes con infecciones de transmisión sexual que asistieron a Consulta Infanto-Juvenil del Policlínico de Especialidades Pediátricas de la provincia Camagüey, durante el período de estudio. Las variables estudiadas fueron: edad, estado civil, tipo de infección de transmisión sexual, asociación con otras, orientación sexual y factores predisponentes, los que comprendían: conducta sexual de riesgo, cervicitis y antecedentes de otras infecciones de transmisión sexual. La información obtenida fue procesada mediante el programa estadístico SPSS para Microsoft Excel 2017. Los métodos empleados fueron estadística descriptiva de distribución de frecuencias absolutas y relativas. Los resultados se expusieron en tablas. Resultados: predominaron las pacientes de 13 a 15 años de edad, solteras y heterosexuales. La candidiasis vaginal fue la afección más diagnosticada. Casi la mitad no presentaban otras infecciones de transmisión sexual y el condiloma acuminado fue la más asociada. Los factores predisponentes que prevalecieron fueron: antecedentes de infección de transmisión sexual y conducta sexual de riesgo, en esta última predominaron las relaciones sexuales tempranas y cambio frecuente de pareja. Conclusiones: los resultados del estudio evidencian la necesidad de realizar acciones educativas para que los adolescentes puedan vivir una sexualidad sana (AU)

Objective: to determine the incidence of sexually transmitted infections in child and adolescent consultation. Methods: an observational, descriptive, transversal study was conducted whose universe were all patients with diagnosis of sexually transmitted infections who attended child and adolescent consultation of pediatric specialty clinic, Camagüey, from September 1st, 2017 to August 31st, 2018, they were 50. The variables studied were: age groups, marital status, type of sexually transmitted infection, association with other sexually transmitted infections, predisposed factors for acquisition (sexual risk behavior, cervicitis and antecedents of former sexually transmitted infections), and sexual preferences. The information obtained was processed using the statistical package SPSS for Microsoft Excel 2017. The methods used were descriptive statistics distribution of absolute and relative frequencies. The results were presented in tables. Results: the most affected age group was between 13 to 15 years, singles and heterosexual. Vaginal candidiasis was predominated, followed by genital warts. About half of the patients have not transmitted infections consociated. Genital warts were the most consociated. The risk factors that prevailed were antecedents of former sexually transmitted infections and sexually risky sexual behavior. In the last one predominated early sexual life and frequent change of partner. Conclusions: these results show the necessity of sexual education for the adolescents to have a healthy sexuality (AU)

Sexual Abuse and Sexually-Transmitted HIV/AIDS in Jamaican Children and Adolescents Aged 6-19 Years.

INTRODUCTION: Risk factors and outcomes of sexually-acquired human immunodeficiency virus infection were characterized in Jamaican children and adolescents. METHODOLOGY: Management was carried out by multidisciplinary teams in Infectious Diseases clinics during August 2003 through February 2019 using modified World Health Organization HIV criteria. RESULTS: There were 78 clients, aged 6 to 19 years, with females:males = 4:1 (p < 0.05). Sexual-initiation occurred in 60%, 47 before < 16 years (median 13 years, with four < 10 years; females:males = 7:1). Sexual-initiation preceded HIV diagnosis in all cases (median 2 years). Secondary education 93% (69/77) and living with non-parental relatives 17% (13/78) were associated with early sexual-initiation (p < 0.042); as was later imprisonment in 6% (3/52). Other sexually transmitted infections 36% (19/53) were associated with sexual-initiation ≥ 16 years (p < 0.01). Risks for ongoing HIV-transmission included infrequent condom use 74% (39/53), body-piercings 50% (24/48), illicit drug use 37% (28/76), tattoos 36% (19/52), transactional sex 14% (7/53) and pregnancy 56% of girls. 77% (59/77) had Centres for Diseases Control's Category A HIV infection; 82% (61/75) initiated anti-retroviral therapy; 75% (56/75) had first-line drugs, with helper T lymphocyte counts ≥ 500 cells/µL in 61% (48/78) and HIV viral load of < 1,000 copies/µL in 63% (40/64). Complications included dermatological 39% (20/52), respiratory 25% (13/52) and neurological 15% (8/52). Early sexual initiation was associated with depression 43% (33/76; p < 0.004) and suicidal attempt or ideation 23% (18/77; p < 0.096). Four (5%) died. CONCLUSIONS: Sexually transmitted HIV/AIDS in children and adolescents should preempt prompt medical, legal and psychosocial interventions.

Do Not Neglect the Covid-19 Transmission Through Sexual Intercourse.

INTRODUCTION: Given the important role of sexual activity in most people's lives, in response to the question of whether the coronavirus is transmitted through sexual contact, this study was conducted to investigate the association of coronavirus transition with sexual contact. METHODS: Based on the PRISMA checklist, we review published articles on sexual contact with the Corona virus until 15 February 2021. Electronic databases based on search strategy including PubMed, Scopus, Web of Science was searched to identify relevant papers in English language. RESULTS: Retrieved from 4671, 29 titles and abstracts articles screened, eight were excluded. There were 21 articles in the selection criteria. Of the 21 studies whose full text was read, only 5 studies stated that coronavirus was not transmitted through sexual contact, and 16 articles argued that sexual transmission of the virus could not be ignored. Most studies have confirmed the transmission of the virus through semen, but its transmission through vaginal secretions is unknown. CONCLUSION: Transmission of the virus through semen should be taken seriously in patients and the necessary education should be given to men and their sexual partners. Health care providers need to increase their knowledge and awareness to provide the best practices to reduction the risks related to Covid-19 sexual transmission through counseling and appropriate approaches.

HIV-1 molecular transmission network among sexually transmitted populations in Liaoning Province, China.

INTRODUCTION: In recent years, with the development of molecular epidemiology, molecular transmission networks based on evolutionary theory and sequence analysis have been widely used in research on human immunodeficiency virus (HIV)-1 transmission dynamics and precise intervention for high-risk populations. The HIV-1 molecular transmission network is a new method to study the population's access to the network, the characteristics of clustering, and the characteristics of interconnection in the network. Here, we analyzed the characteristics of the HIV-1 molecular transmission network of sexually transmitted people in Liaoning Province. METHODS: A study of HIV-infected persons who were sexually transmitted in Liaoning Province from 2003 to 2019. HIV-1 RNA was extracted, amplified and sequenced, and a phylogenetic tree was constructed to determine the subtype using the well matched pol gene region sequence. The gene distance between sequences was calculated, the threshold was determined, and the molecular transmission network was constructed. RESULTS: 109 samples of pol gene region were obtained. The main subtype of HIV-1 was CRF01_AE, followed by B, CRF07_BC, etc. 12.8% of them were resistant to HIV. At the threshold of 0.55 gene distance, 60.6% of them entered the HIV-1 molecular transmission network. Workers, sample source voluntary counseling and testing, other testing, subtype B and drug resistance are the factors influencing the access to HIV-1 molecular transmission network. The subtype of CRF01_AE formed 6 clusters in the molecular transmission network. In the network, the difference of connection degree between different subtypes was statistically significant. DISCUSSION: The three subtypes CRF01_AE, CRF07_BC and B that enter the molecular transmission network do not have interconnections, and they form clusters with each other. It shows that the risk of transmission among the three subtypes is less than the risk of transmission within each subtype. The factors affecting HIV-1 entry into the molecular transmission network were occupation, sample source, genotype and drug resistance. The L33F mutation at the HIV-1 resistance mutation site constitutes the interconnection in the largest transmission cluster in the network. The epidemiological characteristics of HIV-infected persons in each molecular transmission cluster show that 97% of the study subjects come from the same area and have a certain spatial aggregation. CONCLUSION: Constructing a molecular transmission network and conducting long-term monitoring, while taking targeted measures to block the spread of HIV can achieve precise prevention and control.

Viral Venereal Diseases of the Skin.

Viral venereal diseases remain difficult to treat. Human papilloma virus (HPV) and herpes simplex virus (HSV) are two common viral venereal diseases. HPV infections are characterized by anogenital warts and less commonly by premalignant or malignant lesions. HSV infections classically present as grouped vesicles on an erythematous base with associated burning or pain; however, immunosuppressed patients may have atypical presentations with nodular or ulcerative lesions. This review discusses the epidemiology, diagnosis, and management of anogenital HPV and HSV infections with an emphasis on treatment modalities for the practicing dermatologist. Diagnosis of these diseases typically relies on clinical assessment, although multiple diagnostic techniques can be utilized and are recommended when diagnosis is uncertain or evaluating an individual with increased risk of malignancy. Management of HPV and HSV infections involves appropriate counseling, screening, and multiple treatment techniques. Particularly for HPV infections, a practitioner may need to use a combination of techniques to achieve the desired outcome.

Persistence of Zika virus RNA in the epididymis of the murine male reproductive tract.

Zika virus (ZIKV) can infect developing fetuses in utero and cause severe congenital defects independent of route of maternal infection. Infected men can shed ZIKV RNA in semen for over six months. Whether prolonged viral RNA shedding in semen indicates a persistent infection in the male reproductive tract is unknown. We hypothesized that if ZIKV establishes a persistent infection in the male reproductive tract (MRT), then immunosuppressant treatment should stimulate ZIKV replication and seminal shedding. Male mice were infected with ZIKV and immunosuppressed when they shed viral RNA but not infectious virus in ejaculates. Following immunosuppression, we did not detect infectious virus in ejaculates. However, we did detect ZIKV positive and negative sense RNA in the epididymal lumens of mice treated with cyclophosphamide, suggesting that ZIKV persists in the epididymis. This study provides insight into the mechanisms behind ZIKV sexual transmission, which may inform public health decisions regarding ZIKV risks.

Strategies for the Elimination of Syphilis in Peru. Program Impact and Cost-Effectiveness Projections Using the Syphilis Interventions Towards Elimination (SITE) Model

Control of syphilis is a key component of Peru’s national strategy and activities to control human immunodeficiency virus (HIV) and sexually transmitted infections (STIs). Compared to other countries in the Region of the Americas, Peru has a relatively low prevalence of syphilis in pregnant women, and this fell from 2012 to 2016 – whereas the prevalence in the Region increased. Syphilis Interventions Towards Transmission (SITE) is a new tool developed by Avenir Health with support from the Pan American Health Organization. SITE simulates adult syphilis transmission in a country and can be used to look at the impact and cost-effectiveness of different STI control programs and interventions, guiding countries toward syphilis elimination targets. The model has been piloted in Peru to identify opportunities for optimizing the country’s STI and syphilis control strategy, plan, targets, and cost estimates. This report presents a compilation of syphilis epidemiological and programmatic data, the model calibration based on those, and projection results for several program scenarios suggested as relevant by the national HIV/STI program. It discusses results in terms of the health and transmission impact, service levels, and cost of alternative and combined packages of prevention, screening, and treatment interventions.

Epididymal epithelium propels early sexual transmission of Zika virus in the absence of interferon signaling.

Recognition of Zika virus (ZIKV) sexual transmission (ST) among humans challenges our understanding of the maintenance of mosquito-borne viruses in nature. Here we dissected the relative contributions of the components of male reproductive system (MRS) during early male-to-female ZIKV transmission by utilizing mice with altered antiviral responses, in which ZIKV is provided an equal opportunity to be seeded in the MRS tissues. Using microRNA-targeted ZIKV clones engineered to abolish viral infectivity to different parts of the MRS or a library of ZIKV genomes with unique molecular identifiers, we pinpoint epithelial cells of the epididymis (rather than cells of the testis, vas deferens, prostate, or seminal vesicles) as a most likely source of the sexually transmitted ZIKV genomes during the early (most productive) phase of ZIKV shedding into the semen. Incorporation of this mechanistic knowledge into the development of a live-attenuated ZIKV vaccine restricts its ST potential.