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Background In light of the potential for non-sexual transmission of human papillomavirus (HPV), this study aims to investigate the presence of α-HPV in public sanitary environments to explore the possibility of environmental transmission. Methods Over a 30-day period, environmental samples were collected from three distinct areas across four locations, chosen based on their potential infection risk. The samples were analyzed for 23 HPV genotypes using real-time PCR. Results A total of 360 environmental samples were collected during 30 days, with 87 samples testing positive for HPV (24.17%, 87/360). The positivity rates at the four locations—public restrooms, community health centers, obstetrics and gynecology hospitals, and general hospitals—were 13.33%, 14.44%, 30.00%, and 38.89%, respectively. Among the different sampling areas, door handles, washbasins, and squat toilets showed positive rates of 5.00%, 14.17%, and 53.33%, respectively. Of the HPV-positive samples, 53.8% exhibited moderate to high viral concentrations as defined by this study. A total of 19 HPV genotypes were detected, with high-risk types accounting for 88.46% and low-risk types for 11.54%. The five most frequently detected genotypes were 51, 16, 52, 58, and 56. Conclusion HPV was detected in all four locations, with a more pronounced positivity rate found in general hospitals and obstetrics and gynecology hospitals. Squat toilets exhibited the highest positivity rate among sampling areas. High-risk HPV types were significantly more prevalent than low-risk types, and positive rates were higher in the high and medium concentration groups compared to the low concentration group. Notably, high-concentration HPV residues can persist for up to 7 h. These findings suggest that public restroom may serve as potential sources of HPV transmission, with shared public areas such as door handles, washbasins, and squat toilets representing possible routes for non-sexual transmission of the virus.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) receptor, angiotensin-converting enzyme 2 (ACE2), has been identified in the human testis, but the risk of transmission of SARS-CoV-2 through sexual intercourse still needs to be defined. The goal of our study was to determine if SARS-CoV-2 is detectable in the semen of patients suffering or recovering from coronavirus disease-19 (COVID-19), still testing positive at nasopharyngeal swabs but showing mild or no symptoms at the time of sampling. Detection of SARS-CoV-2 RNA in semen was performed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and nested PCR targeting open reading frame (ORF) 1ab. Medical history of the enrolled patients was taken, including COVID-19-correlated symptoms, both at the time of diagnosis and at the time of interview. Results of real-time RT-PCR and nested PCR in semen showed no evidence of SARS-CoV-2 RNA in the 36 patients suffering or recovering from COVID-19 but still positive in a nasopharyngeal swab, from over 116 patients enrolled in the study. SARS-CoV-2 detection and persistence in semen would have an impact on both clinical practice and public health strategies, but our results would suggest that SARS-CoV-2 is not present in the semen of men recovering from COVID-19.

The recent Zika virus outbreak has been spreading rapidly all over the world, expanding its traditionally geographical affected regions, making it a global public health hazard and endangering millions of people. One unique property of the Zika virus compared to most vector-borne diseases is the fact that the virus is transmitted both by mosquitoes and by direct sexual contact. In the present manuscript, we formulate and analyze five mathematical compartmental models of Zika transmission. We model both transmission routes (i.e., vector-borne and sexual transmission). In order to make the model more realistic, heterogeneity in the sexual transmission is modeled in several ways. We fitted the five different models to data, inferred the parameters and selected the most appropriated model, which describes the Zika outbreak in Columbia. For all the models, we estimate the reproduction numbers, namely direct (sexual) transmission, vector transmission and the basic reproduction number \\[(R_0)\\]. The analysis revealed that the sexual transmission contribution to \\[R_0\\] is highest [15.36% (95% CI 12.83–17.4)] for the model which stratifies each gender to high-risk and low-risk individuals in their sexual behavior. For this model, the estimated \\[R_0\\] is 1.89 (95% CI 1.21–2.13), the direct transmission reproduction number is 0.42 (95% CI 0.29–0.64), and the vector transmission reproduction number is 1.51 (95% CI 1.23–1.87). The sensitivity analysis demonstrated that the value of \\[R_0\\] depends on three controllable parameters: the biting rate, the sexual transmission rate and the average ratio of mosquito to human.

Objectives Levels of knowledge about the sexual transmission of Zika virus are consistently low in populations at risk of a mosquito-borne outbreak, including among women of childbearing age and women who are pregnant or intend to become pregnant. We investigated the effectiveness of sources of public health messaging about sexual transmission to women who are pregnant or intend to become pregnant in Arizona. Methods In 2017, we conducted an Arizona-statewide survey 15 months after the initial release of US guidelines on sexual transmission of Zika virus. We used Poisson regression, adjusting for demographic factors, to estimate the likelihood among women who were pregnant or intended to become pregnant of knowing that Zika virus is sexually transmitted relative to other women of childbearing age. We used multinomial logistic regression models to explore associations with most used health information sources, either in person (eg, medical providers) or online (eg, Facebook), categorized by extent of dependability. Results Women who were pregnant or intended to become pregnant had similarly poor knowledge of the sexual transmission of Zika virus as compared with other women of childbearing age (adjusted prevalence ratio = 1.14 [95% CI, 0.83-1.55]). Only about one-third of all respondents reported knowledge of sexual transmission. Reliance on high- vs low-dependability information sources, whether in person or online, did not predict the extent of Zika virus knowledge among women who were pregnant or intended to become pregnant. Conclusion As late as the second year of local Zika virus transmission in the United States, in 2017, women in Arizona were not receiving sufficient information about sexual transmission, even though it was available. To prepare for possible future outbreaks, research should explore which aspects of Zika information campaigns were ineffective or inefficient.

Outbreaks of monkeypox (mpox) have historically resulted from zoonotic spillover of clade I monkeypox virus (MPXV) in Central Africa and clade II MPXV in West Africa. In 2022, subclade IIb caused a global epidemic linked to transmission through sexual contact. Here we describe the epidemiological and genomic features of an mpox outbreak in a mining region in eastern Democratic Republic of the Congo, caused by clade I MPXV. Surveillance data collected between September 2023 and January 2024 identified 241 suspected cases. Genomic analysis demonstrates a distinct clade I lineage divergent from previously circulating strains in the Democratic Republic of the Congo. Of the 108 polymerase chain reaction-confirmed mpox cases, the median age of individuals was 22 years, 51.9% were female and 29% were sex workers, suggesting a potential role for sexual transmission. The predominance of APOBEC3-type mutations and the estimated emergence time around mid-September 2023 imply recent sustained human-to-human transmission. Genomic and epidemiologic analyses of monkeypox cases stemming from a recent outbreak in the Democratic Republic of the Congo suggest that a new clade I lineage is circulating and that its spread may be linked to sexual transmission.

This case report presents evidence of sexual transmission of Ebola virus from a man to a woman, nearly 200 days after the initial illness in the man. In December 2013, EBOV emerged in Guinea and quickly spread to several neighboring countries, resulting in the largest recorded outbreak of EVD in history. 1 On September 3, 2015, Liberia was declared to be free from EVD for the second time, and although new cases were still being reported in Guinea and Sierra Leone as of September 9, 2015, weekly numbers were just a fraction of those reported during the peak of the outbreak. 1 As the EVD outbreak in western Africa wanes, the affected countries must transition from controlling an EVD epidemic to addressing the needs of an unprecedented number of . . .

The risk of sexual transmission of HIV from individuals with low-level HIV viraemia receiving antiretroviral therapy (ART) has important public health implications, especially in resource-limited settings that use alternatives to plasma-based viral load testing. This Article summarises the evidence related to sexual transmission of HIV at varying HIV viral load levels to inform messaging for people living with HIV, their partners, their health-care providers, and the wider public. We conducted a systematic review and searched PubMed, MEDLINE, Cochrane Central Register of Controlled Trials, Embase, Conference Proceedings Citation Index-Science, and WHO Global Index Medicus, for work published from Jan 1, 2010 to Nov 17, 2022. Studies were included if they pertained to sexual transmission between serodiscordant couples at various levels of viraemia, the science behind undetectable=untransmittable, or the public health impact of low-level viraemia. Studies were excluded if they did not specify viral load thresholds or a definition for low-level viraemia or did not provide quantitative viral load information for transmission outcomes. Reviews, non-research letters, commentaries, and editorials were excluded. Risk of bias was evaluated using the ROBINS-I framework. Data were extracted and summarised with a focus on HIV sexual transmission at varying HIV viral loads. 244 studies were identified and eight were included in the analysis, comprising 7762 serodiscordant couples across 25 countries. The certainty of evidence was moderate; the risk of bias was low. Three studies showed no HIV transmission when the partner living with HIV had a viral load less than 200 copies per mL. Across the remaining four prospective studies, there were 323 transmission events; none were in patients considered stably suppressed on ART. Among all studies there were two cases of transmission when the index patient's (ie, patient with previously diagnosed HIV infection) most recent viral load was less than 1000 copies per mL. However, interpretation of both cases was complicated by long intervals (ie, 50 days and 53 days) between the transmission date and the most recent index viral load result. There is almost zero risk of sexual transmission of HIV with viral loads of less than 1000 copies per mL. These data provide a powerful opportunity to destigmatise HIV and promote adherence to ART through dissemination of this positive public health message. These findings can also promote access to viral load testing in resource-limited settings for all people living with HIV by facilitating uptake of alternative sample types and technologies. Bill & Melinda Gates Foundation.

PurposeThere have been significant biomedical improvements in the treatment and prevention of HIV over the past few decades. However, new transmissions continue to occur. Alcohol use is a known barrier to medication adherence and consistent condom use and therefore may affect treatment as prevention (TasP) efforts. The purpose of this study was to further explore how alcohol is associated with condom use and sexual transmission behavior in three international cities.MethodHIV Prevention Trials Network 063 was an observational mixed-methods study of HIV-infected patients currently in care in Rio de Janeiro, Brazil; Chiang Mai, Thailand; and Lusaka, Zambia. Across these three global cities, 80 qualitative interviews were conducted from 2010 to 2012. From these interviews, quotes related to substance use, almost all of which were alcohol, were analyzed using thematic analysis to identify how the use was related to sexual transmission behaviors.ResultsOverall, the theme that alcohol impairs cognitive abilities emerged from the data and included the following subthemes: expectancies, impaired decision-making, loss of control, and less concern for others. Themes specific to international settings and risk subgroups were also identified.ConclusionOur analysis identified how alcohol influences sexual transmission behavior in HIV patients in three international settings. These findings may provide direction for content development for future secondary prevention interventions to effectively implement TasP internationally.

In this large, international study of HIV-1–serodiscordant couples, the receipt of antiretroviral therapy by the infected partner decreased transmission to the uninfected partner as well as rates of clinical events in the HIV-1–infected partner. Combination antiretroviral therapy decreases the replication of human immunodeficiency virus type 1 (HIV-1) and improves the survival of infected persons. 1 , 2 Such therapy has been shown to reduce the amount of HIV-1 in genital secretions. 3 – 5 Because the sexual transmission of HIV-1 from infected persons to their partners is strongly correlated with concentrations of HIV-1 in blood 6 and in the genital tract, 7 it has been hypothesized that antiretroviral therapy could reduce sexual transmission of the virus. Several observational studies have reported decreased acquisition of HIV-1 by sexual partners of patients receiving antiretroviral therapy. 8 – 11 These results have been extrapolated to . . .

WHO estimated that nearly 1 million people become infected every day with any of four curable sexually transmitted infections (STIs): chlamydia, gonorrhoea, syphilis, and trichomoniasis. Despite their high global incidence, STIs remain a neglected area of research. In this Commission, we have prioritised five areas that represent particular challenges in STI treatment and control. Chlamydia remains the most commonly diagnosed bacterial STI in high-income countries despite widespread testing recommendations, sensitive and specific non-invasive testing techniques, and cheap effective therapy. We discuss the challenges for chlamydia control and evidence to support a shift from the current focus on infection-based screening to improved management of diagnosed cases and of chlamydial morbidity, such as pelvic inflammatory disease. The emergence and spread of antimicrobial resistance in Neisseria gonorrhoeae is globally recognised. We review current and potential future control and treatment strategies, with a focus on novel antimicrobials. Bacterial vaginosis is the most common vaginal disorder in women, but current treatments are associated with frequent recurrence. Recurrence after treatment might relate to evidence that suggests sexual transmission is integral to the pathogenesis of bacterial vaginosis, which has substantial implications for the development of effective management approaches. STIs disproportionately affect low-income and middle-income countries. We review strategies for case management, focusing on point-of-care tests that hold considerable potential for improving STI control. Lastly, STIs in men who have sex with men have increased since the late 1990s. We discuss the contribution of new biomedical HIV prevention strategies and risk compensation. Overall, this Commission aims to enhance the understanding of some of the key challenges facing the field of STIs, and outlines new approaches to improve the clinical management of STIs and public health.