Explorez tous les épisodes du podcast STI Podcast

The experience of treating and/or losing a patient to anal cancer is deeply upsetting. Therefore, the early detection and treatment of precursors are of utmost importance to patients and clinicians. People with HIV have a higher prevalence and incidence of Human Papilloma Virus infection, an oncogenic virus, which may cause intraepithelial neoplasia, the precursor of squamous cell carcinomas in the anal canal. Though encouraging progress has been made to support gay and bisexual men and transgender women with HIV from developing anal cancer, research and health policies do not offer specific prevention strategies against anal cancer in people assigned female at birth. In this podcast Dr Tamzin Cuming outlines progress made so far and areas of research and health care that need further attention.   Links: https://iansoc.org/Board-of-Directors   Host: Ass. Prof./Dr. Fabiola Martin, BMJ STI Podcast Editor, Sexual Health and HIV Specialist, Clinical Associate Professor, Australian National University, Canberra, Australia Guest: Dr Tamzin Cuming, Consultant Colorectal Surgeon, President of International Anal Neoplasia Society, Homerton Hospital, in London, UK  

Previously we reported on the Rise of Syphilis world wide. Today we focus on the devastating effects of syphilis on parents and their children. Hand in hand with an increase in syphilis incidence in adults the rates of congenital syphilis are rising and missed opportunities to test and treat birthing parents, their partners and babies are preventable contributing factors. Congenital syphilis is caused by Treponema pallidum transmission to the foetus during pregnancy and birth, resulting in diverse clinical presentations. Congenital syphilis in a foetus may be associated with a full-term, seemingly healthy infant, but it can also cause multi-organ dysfunction, prematurity, and/or stillbirth. Routine screening and early treatment of pregnant people affected by syphilis is the hallmark of effective intervention to decrease infant morbidity and mortality.

Host: Ass Prof/Dr Fabiola Martin, Canberra Sexual Health Centre and Australian National University, Canberra, Australia Guests:

- Professor Clare Nourse, Member of the Order of Australia, a paediatric infection specialist at the Queensland Children’s Hospital and clinical professor of paediatrics at the University of Queensland - Dr Justin Penner, Consultant in paediatric infectious diseases at Imperial College NHS Healthcare Trust, London, UK and Honorary Senior Lecturer, Imperial College London

Continuing on the search for innovative strategies to shape the future of HIV cure research in the second part of this series, Dr Jillian Lau discusses how anti–PD1 immunotherapies and carefully designed treatment interruption studies are helping clinicians and scientists to better understand pathways to durable HIV remission. Dr Ming Lee then breaks down the results of the RIO study, highlighting the promising potential of broadly neutralising antibodies (bNAbs) in sustaining viral control without ongoing therapy. Together, they offer a forward-looking perspective on the scientific breakthroughs moving us closer to an HIV cure. Listen to part 1 of this podcast:

• Apple: https://podcasts.apple.com/us/podcast/world-aids-day-pt-1-progress-towards-an-hiv-cure/id356342980?i=1000739054089&uo=4
• Spotify: https://open.spotify.com/episode/73LY8Eie8EQ7I5FKF6F0SM
• Web: https://stibmj.podbean.com/e/world-aids-day-pt-1-progress-towards-an-hiv-cure/ 

Links:

• Sustained HIV-1 remission after heterozygous CCR5Δ32 stem cell transplantation

Host: Dr Ming Lee, Sexual Health Specialist, Canberra Sexual Health Centre, ACT, Australia; Honorary Clinical Senior Lecturer, Imperial College London, London, UK   Guests:  - Professor Christian Gaebler, Professor, Charité Universitätsmedizin Berlin, Berlin, Germany - Professor Beatriz Mothe, Group Leader and Senior Research Scientist, IrsiCaixa, Barcelona, Spain - Dr Jillian Lau, Infectious Disease Physician and Post doctoral Research Fellow, Department of Infectious Diseases, University of Melbourne and the Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia

 

In the first of this two-part series, we explore the latest advances in the search for an HIV cure. Professor Christian Gaebler shares insights from the remarkable case of the second Berlin patient —an individual cured of HIV following a stem cell transplant—and reflects on what similar cases mean for the future of curative strategies. We’re also joined by Professor Beatriz Mothe, who discusses the promise of therapeutic vaccines and their role in long-term HIV remission, and the results of the AELIX003 study.  Links:

• Sustained HIV-1 remission after heterozygous CCR5Δ32 stem cell transplantation

Host: Dr Ming Lee, Sexual Health Specialist, Canberra Sexual Health Centre, ACT, Australia; Honorary Clinical Senior Lecturer, Imperial College London, London, UK   Guests:  - Professor Christian Gaebler, Professor, Charité Universitätsmedizin Berlin, Berlin, Germany - Professor Beatriz Mothe, Group Leader and Senior Research Scientist, IrsiCaixa, Barcelona, Spain - Dr Jillian Lau, Infectious Disease Physician and Post doctoral Research Fellow, Department of Infectious Diseases, University of Melbourne and the Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australia

Over the last decade we have seen an exponential surge in research and peer reviewed publications about the sexual health of trans and gender diverse people. We now know that sexually transmitted infections are highly prevalent in this key population and there is an urgent need for concentrated efforts made by patient advocates, health care providers, public health policy developers and governments to improve health and prevent harm in this underserved population. Today we discuss with Prof Jade Ghosn, his team's latest publication in STI BMJ titled: "Pre-exposure prophylaxis (PrEP) uptake and retention in care in a group of transgender women at high risk of HIV: a French cohort of follow-up" and with Alisha Goburdhun, her team's work in supporting and advocating for trans clients at Accpetess-T.

 

Host: Ass Prof/Dr Fabiola Martin, Sexual health Specialist, Canberra Sexual Health Centre, Australian National University ‌

Guests: Alisha Goburdhun, Heath Mediator at Acceptess-T, Paris, France

Prof Jade Ghosn, Infectious Diseases Specialist at the Sexual Health Clinic in Bichat University Hospital in Paris, France

Most people requiring HIV pre-exposure prophylaxis (PrEP) are offered a daily or event driven oral tablet which contains two HIV antiretroviral drugs combined. Oral medication, however, may not be a feasible and/or effective PrEP option for some. FDA has approved two long-acting injectable HIV anti-viral drugs: Cabotegravir, an HIV integrase inhibitor (2 monthly injections) and Lenacapavir an HIV capsid inhibitor (6 monthly injections) as safe and efficacious HIV PrEP. Today we will discuss the efficacy of and access to long-acting HIV PrEP with Prof Sinead Delany-Moretlwe and Dr Claire Dewsnap.

 

STI has published extensively on the topic, here are a few examples of recent articles:

• Pre-exposure prophylaxis (PrEP) uptake and retention in care in a group of transgender women at high risk of HIV: a French cohort of follow-up
• Association between HIV risk perception, knowledge of biomedical prevention and sexual behaviour among sub-Saharan African immigrants living in a precarious situation in France
• Preferences for pre-exposure prophylaxis service package among men who have sex with men in Australia: a discrete choice experiment
• Estimating the number of people who could benefit from HIV pre-exposure prophylaxis (PrEP) in England and the unmet need
• Regression-based risk scores using sociodemographic and sexual behaviour data do not predict asymptomatic sexually transmitted infections among HIV PrEP users

 

Host: Ass Prof/Dr Fabiola Martin, Sexual Health Specialist, Associate Professor at Australian National University

Guests: Prof Sinead Delany-Moretlwe, Professor of Global Health and Infectious Diseases at the University of the Witwatersrand, Johannesburg

Dr Claire Dewsnap, President of the British HIV Association for HIV & Sexual Health (BASHH) and Consultant in Genitourinary Medicine, Sheffield Teaching Hospital, Sheffield, UK

Worldwide the prevalence of sexually transmitted infections is increasing. Today we will discuss innovative ways of testing and treating large number of patients with STIs that are equitable, reliable and potentially cost-effective. We will discuss the eSexual Health Clinic (eSHC) research published in The Lancet Public Health in 2017 and NIHR funded  SEQUENCE Digital research program based in UK as well as the multi-site co-designed EmERGE research program based in UK, Croatia and Zambia.

Host: Ass Prof/Dr Fabiola Martin, Sexual Health Specialist, Associate Professor at Australian National University

Guests: Professor Claudia Estcourt, Professor of Sexual Health & HIV in Glasgow, Scotland and in London and a sexual health clinician

Dr Mary Darking, Principal Lecturer in Social Policy and Innovation at Brighton University

Lancet paper: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(17)30034-8/fulltext 

Today we will discuss the evolution and efficacy of antenatal testing for blood borne pathogens as a strategy to improve pregnancy outcomes and prevent parent to child transmission. Over the last 40 years the number of infections tested for in the antenatal setting has expanded which has been followed closely by treatment guidelines for each infection. However, there are stark regional differences in the infections routinely tested for. Brazil has recently added Human T Leukaemia Virus (HTLV) to its antenatal testing and is planning to test 2.5 million pregnancies yearly. Pregnant people who test positive for HTLV are advised to avoid breast feeding and are provided with formula milk free of charge. Health care providers are being offered upskilling in HTLV care provision. This way Brazil aims to "Take HTLV out of Invisibility" and ultimately eliminate HTLV in Brazil.

Host: Ass Prof/Dr Fabiola Martin, Sexual Health Specialist, Associate Professor at Australian National University

Guests: Professor Graham Taylor, Head of Section of Virology at Imperial College London and a founder of the National Centre for Human Retrovirology at St. Mary’s Hospital – the UK’s clinical service for people living with Human T Leukaemia Virus (HTLV) infection.

Dr Pâmela Cristina Gaspar, General Coordinator of Sexually Transmitted Infections Surveillance at Ministry of Health of Brazil, Brasilia, Brazil Host: Ass Prof/Dr Fabiola Martin, Sexual health, HIV and HTLV Specialist, Canberra, Australia and Australian National University

 

Brazil HTLV ANC testing: - National guide: https://www.gov.br/aids/pt-br/central-de-conteudo/publicacoes/2022/guia_htlv_internet_24-11-21-2_3.pdf/view   - Folder HTLV for general population: https://www.gov.br/aids/pt-br/assuntos/ist/materiais-informativos/folder-htlv-final-grafica.pdf  - Distance Learning Course for HTLV: https://campusvirtual.fiocruz.br/gestordecursos/hotsite/htlv  

 NACCHO-ASHM, Australia, HTLV testing guidelines: https://htlv1.guidelines.org.au/ 

Today we will discuss different types of HIV and Syphilis antibody testing performed at home by the patient or consumer. Home testing for HIV and Syphilis empower people, especially pregnant women who live in remote areas or are marginalised and hard to reach, to screen themselves for these two serious and communicable infections at home and seek additional confirmitory testing, treatment and support if their screening test is reactive. We will discuss what these tests are, how they can be used as well as review their merits and potential risks.

Host: Dr Fabiola Martin, Sexual Health Specialist, Associate Professor at Australian National University

Guest: Dr Bobbie Van Der Pol, Professor of Medicine and Public Health at the University of Alabama at Birmingham, the Director of the UAB STD Diagnostics Laboratory and President of the International Society for STD Research.

Today we will discuss if screening asymptomatic Men who have sex with Men, also referred to as MSM, who are receiving HIV pre-exposure anti-retroviral medication, called HIV PrEP, routinely for bacterial STIs, gonorrhoea and chlamydia through pharyngeal, urine and rectal PCR testing every three months- also referred to as 3x3 testing is indeed of benefit or may cause harm. This year, in Lancet HIV, the Gonoscreen trial, a randomised controlled trial, of 500 MSM on PrEP in each arm followed up for 12 months reported that 3x 3 testing does not reduce the incidence of gonorrhoea and chlamydia infections in this specific cohort. In Belgium, this trial has led to a change in clinic practice through the Belgium HIV PrEP guidelines where patients will be screened less frequently and intensely. Lancet ID on the other hand published an opinion piece by Raccagni et al where concerns about transmission and morbidity risk of untreated infection and implications of using poor quality screening tools are voiced. We will discuss today the merit of the Gonoscreen trial and other studies that support a decrease in screening & treating asymptomatic bacterial STIs and exercising stricter antimicrobial stewardship versus the risks associated with leaving asymptomatic infections untreated and risking morbidity and transmission.

Relevant links:

Effect of screening for Neisseria gonorrhoeae and Chlamydia trachomatis on incidence of these infections in men who have sex with men and transgender women taking HIV pre-exposure prophylaxis (the Gonoscreen study): results from a randomised, multicentre, controlled trial

Primum non-nocere: Is it time to stop screening for Neisseria gonorrhoeae and Chlamydia trachomatis in men who have sex with men taking HIV pre-exposure prophylaxis?

The arrested immunity hypothesis in an immunoepidemiological model of Chlamydia transmission

Gonorrhoea and chlamydia screening for asymptomatic people with HIV and HIV PrEP users: open issues

Host: Dr Fabiola Martin, Sexual Health Specialist and Associate Professor, Australian National University, Canberra, Australia

Dr Thibaut Vanbaelen, physician and post-doctoral researcher at The Institute of Tropical Medicine in Antwerp, Belgium

Dr Angelo Roberto Raccagni, physician at Vita-Salute San Raffaele University in Milan, Italy

Today we provide you with an update on the sexually transmitted infection: Trichomonas vaginalis, a protozoan which infects the vagina, urethra and paraurethral glands. It is an uncommon cause of vaginal discharge and penile urethritis and can persist for a long time if left untreated. Up to 50% of people with vaginal infections and especially people with urethral infections remain asymptomatic. Persistent trichomonas infection has been associated with facilitating the transmission of human immunodeficiency virus (HIV) and adverse poor reproductive health outcomes. Dr Christina Muzny, Professor in Infectious Diseases at University of Alabama, Birmingham, USA, will present on published clinical trial data on novel treatment against trichomoniasis.

Relevant publications:

Van Gerwen OT, Aaron KJ, Schroeder J, et al. Spontaneous resolution of Trichomonas vaginalis infection in men. Sexually Transmitted Infections. Published Online First: 27 June 2024. doi: 10.1136/sextrans-2024-056160.

Muzny CA, Van Gerwen OT, Kaufman G, Chavoustie S. Efficacy of single-dose oral secnidazole for the treatment of trichomoniasis in women co-infected with trichomoniasis and bacterial vaginosis: a post hoc subgroup analysis of phase 3 clinical trial data. BMJ Open. 2023;13:e072071

Kissinger PJ, Gaydos CA, Seña AC, McClelland RS, Soper, Secor WE, Legendre D, Workowski KA, Muzny CA, Diagnosis and Management of Trichomonas vaginalis: Summary of Evidence Reviewed for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines, Clinical Infectious Diseases, Clinical Infectious Diseases, Volume 74, Issue Supplement_2, 15 April 2022

Howe K and Kissinger PJ. Single-dose compared with multidose metronidazole for the treatment of trichomoniasis in women: a meta-analysis. Sex Transm Dis 2017; 44: 29–34.

Kissinger P, Muzny CA, Mena LA, et al. Single-dose versus 7- day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial. Lancet Infect Dis 2018; 18: 1251–1259.

Sherrard J, Pitt R, Hobbs KR, Maynard M, Cochrane E, Wilson J, Tipple C. British Association for Sexual Health and HIV (BASHH) United Kingdom national guideline on the management of Trichomonas vaginalis 2021. Int J STD AIDS. 2022 Jul;33(8):740-750.

STI Guidelines Australia - Trichomoniasis

Host: Dr Fabiola Martin, STI BMJ Podcast editor, a Sexual Health, HIV and HTLV Specialist, Canberra & University of Queensland, Brisbane, Australia

Guest: Dr Christina Muzny, Professor in Infectious Diseases at University of Alabama, Birmingham, USA

You will recall a previous podcast about preventing Neisseria gonorrhoea through an effective vaccine. Neisseria gonorrhoeae is a ubiquitous sexually transmitted bacteria that can cause both localised and systemic disease if left untreated. It may be transmitted to neonates. We also reported on a rise of the gonorrhoea incidence, as well as increasing rates of antibiotic resistance.

Today we will revisit the implementation of vaccinations against gonorrhoea in the UK. Here is an exciting up-date on the advice provided by UK's Joint Committee on Vaccination and Immunisation, JCVI, on using the vaccine 4CMebB OMV against Meningococcus used off-label for the prevention of gonorrhoea infection

• in patients at significant risk of infection with bacterial STIs who

• attend specialist sexual health services. Host:

Dr. Fabiola Martin, Sexual Health HIV, HTLV Specialist, Canberra Sexual Health Services & University of Queensland, Australia

Participants: Dr. Suneeta Soni, Consultant in Sexual Health and HIV, University Hospitals Sussex and Chair of the Bacterial special interest group for BASHH *British Association for Sexual health and HIV)

Dr. Yen Bui, Consultant in Vaccination and Travel Health, Institut national de santé publique du Québec, Canada

A/P. Dr. Kate Seib, NHMRC Leadership Fellow and Associate Director for Research, Institute for Glycomics, Griffith University, Australia

Today we will focus on the alternative treatments of early Syphilis. Worldwide many of us have experienced a shortage of gold standard treatment benzathine benzylpenicillin injections for syphilis. It is time we look for alternative antibiotic treatments and prevention strategies for syphilis. In conversation with Prof Jeffery Klausner, Professor of Medicine, Infectious Diseases and Public Health at the Keck School of Medicine of the University of Southern California, we will discuss a new study published in the Lancet in 2024. Mitja O. et al compared oral linezolid with benzathine penicillin G for treatment of early syphilis in adults (Trep-AB Study) in Spain, which is a prospective, open-label, non-inferiority, randomised controlled trial.

Acknowledgement for his valuable contributions to the content of the podcast: Dr Oriol Mitjà, Skin Neglected Tropical Diseases and Sexually Transmitted Infections Section, Fundació Lluita Contra les Infeccions, Barcelona, Spain.

Related link:

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00683-7/fulltext 

In our final episode in honour of the World AIDS Day we have a conversation with Assistant Prof. Rajasuriar, who coordinates the translational research program in HIV immunology and Ageing at the Centre of Excellence for Research in AIDS (CERiA) in Kuala Lumpur, Malaysia. Today, thanks to effective HIV antiretroviral therapy, people living with HIV can live long and healthy lives. According to the latest data from the Centers for Disease Control and Prevention (CDC), in 2021, of the nearly 1.1 million people living with diagnosed HIV in the United States and dependent areas, over 53% were aged 50 or older. Hosted by: Dr Fabiola Martin, the BMJ STI Podcast editor and Sexual Health Specialist based in Australia and Senior Clinical Lecturer at School of Public Health at University of Queensland.

Growing older with HIV in the Treat-All Era Reena Rajasuriar 1 , Heidi M Crane 2 , Aggrey S Semeere 3 PMID: 36176021 PMCID: PMC9522984 DOI: 10.1002/jia2.25997 https://onlinelibrary.wiley.com/doi/10.1002/jia2.25997 

Integrated care for older people (‎ICOPE)‎: guidance for person-centred assessment and pathways in primary care https://www.who.int/publications-detail-redirect/WHO-FWC-ALC-19.1 

Today we are honouring the World AIDS Day on 1st December in 2023, by focusing on young people who live with HIV. Adolescents and young people represent a significant share of people living with HIV worldwide. In 2022 alone, 255,000-760,000 young people between the ages of 10 to 24 were newly infected with HIV, of whom 35,000-250,000 were adolescents between the ages of 10 and 19. In conversation with Prof Natella Rakhmanina, who is a Professor of Paediatrics at the George Washington University and the Director of the HIV Program at Children's National Hospital, we will discover the pro & cons of long-acting antiretrovirals to mange HIV infection in young people. Hosted by: Dr Fabiola Martin, the BMJ STI Podcast editor and Sexual Health Specialist based in Australia and lecturer at School of Public Health at University of Queensland.

Welcome to the 4th episode of the 2023 BMJ Sexually Transmitted Infections Podcast Series. This year the International AIDS Society Conference was held for the first time in Brisbane Australia in July 2023. It was wonderful to learn about many new research findings, community perspectives and to connect with old friends and make new ones. Today we will provide you with some of the many clinical, vaccine and policy research highlights of this conference and share our subjective perspectives. We were joined by: Dr Ming Lee, a sexual health & HIV physician and UK MRC Clinical Research Training Fellow at Imperial College London, London, UK, Prof Damian Purcell, Head of the Molecular Virology Laboratory in the Department of Microbiology and Immunology at the Peter Doherty Institute, University of Melbourne, Melbourne, Australia, Dr Meg Doherty, Director of Global HIV, Hepatitis and Sexually Transmitted Infection Programmes at World Health Organization, Heath Quarter. Hosted by: Dr Fabiola Martin, the BMJ STI Podcast editor and Sexual Health Specialist based in Australia and lecturer at School of Public Health at University of Queensland.

In honour of World Hepatitis Day, today we focus on the Hepatitis B virus (HBV), a virus that can be transmitted through contact with infected blood and from mother to child during labour. HBV can also be transmitted sexually. It infects liver cells and causes both acute and chronic infections, which can be severe. Since HBV was discovered in 1965, we have made great progress in reducing the burden of infections and disease through prevention and antiviral treatment, but much is left to do. The World Health Organization has called for enhanced efforts along four main pathways: i) increasing awareness of HBV infection, ii) promoting prevention strategies, iii) expanding access to testing and treatment; and iv) improving surveillance, data collection and research. Today we will discuss these topics with a focus on the European Region with our three guests:

- Dr. Erika Duffell, Public Health Physician, the European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

- Prof. Anna Maria Geretti, Editor in Chief, STI journal; Professor & Consultant in Infectious Diseases & Virology, Fondazione PTV, University of Rome Tor Vergata, Rome, Italy; North Middlesex University Hospital and King’s College London, London, United Kingdom

- Prof.  Simon de Lusignan, Senior Academic General Practitioner (GP) and Director of the Royal College of GPs Research & Surveillance Centre, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom

Hosted by: Dr. Fabiola Martin, Sexual Health, HIV, HTLV specialist, BMJ STI Podcast Editor, Brisbane, Australia 

 

Relevant papers:

Hepatitis B virus infection in general practice across England: An analysis of the Royal College of General Practitioners Research and Surveillance Centre real-world database

https://www.journalofinfection.com/article/S0163-4453(23)00130-5/

Impact of maternal HIV–HBV coinfection on pregnancy outcomes in an underdeveloped rural area of southwest China

https://sti.bmj.com/content/96/7/509

Prevalence of hepatitis B immunity and infection in home self-sampling HIV service users

https://sti.bmj.com/content/98/4/286

Hepatitis A and B vaccination in gbMSM in Ireland: findings from the European MSM Internet Survey 2017 (EMIS-2017)

https://sti.bmj.com/content/99/5/337

Hepatitis A and B vaccine uptake and immunisation among men who have sex with men seeking PrEP: a substudy of the ANRS IPERGAY trial

https://sti.bmj.com/content/99/2/140

Hepatitis A, hepatitis B and HPV vaccine needs and coverage in MSM initiating HIV PrEP in a sexual health clinic in Paris

https://sti.bmj.com/content/99/5/361

 

 

Neisseria gonorrhoeae, in short NG, is a ubiquitous sexually transmitted bacteria that can cause both localised and systemic disease if left untreated. NG may also be transmitted vertically from mother to baby. Over the last years, we have seen a rise in the number of people diagnosed with gonorrhoea, alongside growing rates of antibiotic resistance. New research makes us hopeful that a vaccine may soon become available to provide global, large scale benefits. In this podcast, we explore this possibility with three experts in the field: Prof Kate Seib (1), Dr Claire Dewsnap (2) and Dr Silvia Nozza (3).   Would you like to know more about the topic? Please read the paper we recently published in STI: "Prior Neisseria meningitidis (Nm) proctitis does not prevent Neisseria gonorrhoeae (Ng) proctitis among men who have sex with men (MSM)": https://sti.bmj.com/content/99/3/215   (1) NHMRC Leadership Fellow and Associate Director for Research, Institute for Glycomics, Griffith University, Gold Coast, Australia    (2) President of the British HIV Association for HIV & Sexual Health (BASHH) and Consultant in Genitourinary Medicine, Sheffield Teaching Hospital, Sheffield, UK   (3) Consultant in Infectious Diseases, Head of Prevention Unit, San Raffaele Hospital (IRCCS), Milan, Italy

Welcome back to the 2023 BMJ STI Podcasts. Today we will focus on the worsening Syphilis epidemic worldwide. Syphilis is a bacteria that infects humans, and is transmitted horizontally through close sexual contact and vertically to unborn babies and neonates. It can cause acute and severe illness in those affected, such as neurosyphilis, and have tragic consequences for mother and baby. With the discovery of penicillin, access to testing, and especially public health interventions such as regular testing of asymptomatic, sexually active people and routine antenatal testing, we thought we could start focusing on eradicating Syphilis one day. Alas, over the last decade we have seen what seems an unstoppable rise of syphilis incidence world-wide. In conversation with Prof Clare Nourse, Prof. James Ward and Dr Angelica Espinosa Miranda we explore the issue at hand focusing on Australia and South America.

Today we talk about transmission, diagnosis and management of MPox. We will also review the UK community and the World Health’s Organization's perspective on this virus. Please note that after the recording of this podcast the WHO implemented a change of the name of the virus to MPox. Dr Fabiola Martin, STI's Podcast editor, interviews Dr Liesbeth Van Gestel, ID physician and clinical researcher at the Tropical Institute of Antwerp, Belgium; Mr Simon Collins, director and co-founder of HIV iBase London, UK; as well as Dr Meg Doherty, the World Health Organisation’s Director of Global HIV, Hepatitis and STIs Programmes.

For more information, please read the STI recently published articles: one from Vanhamel and co-authors tracking the transmission of the virus in the early phases of the outbreak in Belgium (https://sti.bmj.com/content/early/2022/11/17/sextrans-2022-055601), and a second from Heskin and colleagues reporting on the rapid response of sexual health services to the outbreak in the UK (https://sti.bmj.com/content/early/2022/12/14/sextrans-2022-055558?rss=1).

In this double-interview podcast, the Editor-in-Chief of the STI journal, Professor Anna Maria Geretti, brings you some of the highlights from the HIV Glasgow 2022 conference. In the first interview (starting at 1:00), Professor Geretti interviews Jean-Michel Molina*, who discusses HIV and STI prevention. The second interview (starting at 12:30) is with Professor Miłosz Parczewski**. They discuss the effects of the war in Ukraine on the country’s healthcare system, in particular on the prevalence of STIs. *Professor of Infectious Diseases University of Paris, France and Head of the Infectious Diseases Department, Saint-Louis Hospital and Lariboisière Hospital Paris, France. **Clinical specialist and Professor of Infectious Diseases Pomeranian Medical University, Szczecin, Poland. Associate Editor on STI and newly elected Vice President of the European AIDS Clinical Society. To hear more episodes of the STI Podcast, please subscribe:

https://podcasts.apple.com/gb/podcast/sti-podcast/id356342980

Today we talk with the principal investigators of the DoxyPEP trial which was prematurely terminated due to its amazing success: participants receiving a stat dose of Doxycycline 200mg in less than 72 hours after condom-less sex were 63% less likely to develop a bacterial STI compared to participants in the control arm. Prof Annie Leutkemeyer based in San Francisco (UCSF) and Prof Connie Celum, based in Seattle (WA)join Dr Fabiola Martin, STI's Podcast editor, in this short interview. Please listen to a recent podcast on the wider subject of Bacterial STIs: https://soundcloud.com/bmjpodcasts/management-of-bacterial-stis?in=bmjpodcasts/sets/sti Related links: https://www.aidsmap.com/news/jul-2022/taking-antibiotic-after-sex-cuts-stis-two-thirds-doxypep-study-finds academic.oup.com/cid/article/70/6/1247/5557867 www.ncbi.nlm.nih.gov/pmc/articles/PMC8360665/

To hear more episodes of the STI Podcast, please subscribe: https://podcasts.apple.com/gb/podcast/sti-podcast/id356342980

Today we focus on presumptive and prophylactic management of bacterial STIs, talking with Dr Manoji Gunathilake, Head of sexual health services in Darwin, Australia, and Assistant Prof Will Nutland, the director of the NGO, the Love Tank, in London, UK. Related links: STI Guidelines Australia: https://sti.guidelines.org.au/ The Love Tank: http://thelovetank.info/ GRASP report: data to June 2021 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1033882/GRASP_2020_Report.pdf Taking antibiotic after sex cuts STIs by two-thirds, ‘DoxyPEP’ study finds - www.aidsmap.com/news/jul-2022/tak…xypep-study-finds

Doxycycline PEP significantly reduces STIs in people at high risk of infections - i-base.info/htb/43528

In this podcast, we interview Professor Joel Palefsky about the ANCHOR study. Sexually Transmitted Infections' Editorial Fellow, Dr Ming Lee, speaks to the journal Editor in Chief, Professor Anna Maria Geretti, and Professor Palefsky, chief investigator of the randomised controlled trial, about the study which investigated treatment of anal high-grade squamous intraepithelial lesions (HSIL) to prevent progression to anal cancer. The study was stopped early following an interim analysis showing a clear benefit in reducing the risk of progression to anal cancer by 57 %, and the findings were recently published in the New England Journal of Medicine. Professor Palefsky also discusses how screening for anal cancer could be improved.

Related link about the ANCHOR study: https://www.nejm.org/doi/10.1056/NEJMoa2201048?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

Thank you for joining us for the HTLV2022 Conference review. Dr Fabiola Martin speaks to Joanna Curteis, the Australian patient representative, Dr Carolina Rosadas, researcher associate at National Centre for Human Retrovirology, Imperial College London, who specialises in HTLV-1 vertical transmission and Prof Damian Purcell. Damian's research group investigates the HIV-1 and HTLV-1 human retroviruses that cause AIDS and leukaemia/inflammatory pathogenesis respectively at Doherty Institute, Melbourne. We also discuss the Global Call to Action towards the elimination of HTLV-1 and an important message from the World Health Organisation delivered by Dr Meg Doherty. Related blog post: https://blogs.bmj.com/sti/2022/07/06/ichr-2022/ Related links: https://www.htlvnet.com https://www.htlvaware.com HTLV Channel https://www.youtube.com/channel/UCI6aLSTtk7chXMeybJ92Fhw Follow @HTLVChannel National Centre for Human Retrovirology http://www.htlv.eu/

WHO HTLV technical report https://apps.who.int/iris/handle/10665/339773

In this podcast, we focus on the bacterial genitourinary pathogen Mycoplasma genitalium (MGEN). We have known this pathogen for a long-time but only in recent years we have been testing and treating more frequently for this bacteria. In this conversation with Dr Fabiola Martin, STI's Podcast editor, Dr Emma Sweeney, Prof Catriona Bradshaw and Prof Nicola Low provide a clinical and research update on MGEN. Dr Emma Sweeney is a Postdoctoral researcher, The University of Queensland Centre for Clinical Research, Brisbane, Australia. Prof Catriona Bradshaw is a Clinician researcher based at Melbourne Sexual Health Centre, Melbourne, Australia. Prof Nicola Low is an Infectious disease epidemiologist, leading the Sexual and Reproductive Health Research Group at the Institute of Social and Preventive Medicine, University of Bern, Switzerland. Read the blog post: https://blogs.bmj.com/sti/2022/04/06/mgen/ Some relevant papers published by STI: Adverse pregnancy and perinatal outcomes, 2022, Frenzer C, Egli-Gany D, Vallely L, et al. https://sti.bmj.com/content/early/2022/03/28/sextrans-2021-055352 Prevalence in different populations, 2018, Baumann L, Cina M, Egli-Gany D, et al. https://sti.bmj.com/content/94/4/255

Persistence, concordance, complications in non-pregnant people, 2019, Cina M, Baumann L, Egli-Gany D, et al. https://sti.bmj.com/content/95/5/328

Today we focus on NATSAL and NATSAL COVID. These are Britain’s National Surveys of Sexual Attitudes and Lifestyles. NATSAL has been undertaken every 10 years since 1990 and is a key data source for sexual and reproductive health policy development. However, the COVID-19 pandemic disrupted many aspects of sexual lifestyles, prompting the initiation of the NATSAL-COVID study with the aim of understanding the impact of COVID-19 on sexual behaviour and service use. Professor Cath Mercer and Professor Nigel Field join us to discuss the results of this study. All the findings relate to the first four months of lockdown in Britain, which started in March 2020. Related blog: https://blogs.bmj.com/sti/2022/02/23/natsal-covid-sex-love-and-lockdown/ Relevant Natsal-COVID papers: - STI paper on sexual behaviour during the pandemic: https://sti.bmj.com/content/early/2021/12/14/sextrans-2021-055210 - Paper in Lancet PH on sexual health services: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00253-X - Paper in BMJ Open on sex outside of the household: https://bmjopen.bmj.com/content/12/2/e055284

- Natsal-COVID wave 1 method paper: https://wellcomeopenresearch.org/articles/6-209

On the World HTLV Day (10th November), we focus on how the Human T leukaemia virus affects people, and review new developments in HTLV treatment and vaccination medicine. HTLV is a retrovirus similar to HIV which incorporates its DNA indefinitely into the human CD4 T lymphocytes. It is predominantly transmitted through condomless sex, but also from mother-to-child and through contact with HTLV positive blood. Unlike HIV, HTLV causes severe disease only in about 5% of PLHTLV, so it is easy for HTLV transmission to go unnoticed. The two dominant HTLV associated diseases are Adult T cell leukaemia (ATL) and HTLV-1 associated myelopathy (HAM/TSP). Participants: STI's Podcast Editor, Dr Fabiola Martin, interview Ms Kristy Blakeborough, Lived experience and UK patient rep; Prof Yoshihisa Yamano, Neurologist St Marianna University Japan; A/P Keith Chappell, University of Queensland. Read the blog post: https://blogs.bmj.com/sti/2021/11/10/world_htlv_day/ Other relevant links: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2818%2930974-7/fulltext https://gvn.org/who/ https://pubmed.ncbi.nlm.nih.gov/27965813/ https://pubmed.ncbi.nlm.nih.gov/33250897/

https://www.htlvaware.com

In this podcast we discuss the reported impact of HIV infection on people who are hospitalised with COVID-19, by reviewing three publications: 1. Outcomes of COVID-19 Related Hospitalization Among People With HIV in the ISARIC WHO Clinical Characterization Protocol: A Prospective Observational Study. Clinical Infectious Diseases, 23 October 2020 (https://www.who.int/publications/i/item/WHO-2019-nCoV-Clinical-HIV-2021). 2.Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis.Nature, Scientific Reports, 18 March 2021 (https://www.nature.com/articles/s41598-021-85359-3). 3. Clinical features and prognostic factors of COVID-19 in people living with HIV hospitalized with suspected or confirmed SARS has just been released. WHO Global Clinical Platform, 15 July 2021 (https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1605/5937133). STI's Podcast Editor, Dr Fabiola Martin, interviews Prof Anna Maria Garretti, Diseases at the Policlinico Tor Vergata, University of Rome Tor Vergata, Chair of the British HIV Association Vaccination Guidelines Panel, and Editor in Chief of the STI Journal; and Associated Research Professor Dr Paddy Ssentongo, from the Penn State University, Pennsylvania, USA.

Read the blog post: https://blogs.bmj.com/sti/2021/09/16/c19-plwh-revisited/

On World Hepatitis Day 2021, we discover how Australian patients, patient advocates and health care providers are working together to reach the WHO elimination targets for chronic Hepatitis C virus infection. Professor Gail Matthews, Infectious Diseases Physician and Program Head of Therapeutic Research and Vaccine Program at The Kirby Institute, Ms Carrie Fowlie, CEO of Hepatitis Australia, and Ms Lisa Carter, Patient advocate and peer educator at Hepatitis SA, join Dr Fabiola Martin to discuss the many different approaches needed to eliminate hepatitis C.

Related blog post: https://blogs.bmj.com/sti/2021/07/27/world-hepatitis-day-2021/

July 2021 marks 40 years from the first reports of a 'strange disease' soon to be known as HIV/Aids. In this "very special edition" themed Sexual Diversity and the City, the STI & HIV 2021 World Congress is inviting people from all walks of life, with some being able to participate for free. Listen to all the details in this conversation of STI's Social Media Editor Harrison Austin with Henry de Vries, Professor of skin infections at the University of Amsterdam and President of the Congress, and Mark Vermeulen, Executive Director of Aidsfonds – Soa Aids Nederland. Sexually Transmitted Infections (https://sti.bmj.com/) is the official journal of the STI & HIV 2021 World Congress, held as a virtual event on 14-17 July. The mission is to address diversity, health, and sexuality in the urban context. This bi-annual meeting is organised by the International Society for STD Research (ISSTDR) in collaboration with the International Union against STI World (IUSTI World) and is dedicated to STI in its broadest sense.

https://www.stihiv2021.org/

Today we focus on the challenges and success stories of HPV vaccine uptake, specifically in Italy and Australia. The HPV vaccine rollout has translated into a significant reduction in the prevalence of cervical and anal cancers. Since its discovery, many different strategies have been used to increase and maintain its uptake in school children, both girls and boys. STI's Podcast Editor, Dr Fabiola Martin, interviews Prof Anna Maria Garretti, Diseases at the Policlinico Tor Vergata, University of Rome Tor Vergata, Chair of the British HIV Association Vaccination Guidelines Panel, and Editor in Chief of the STI Journal; Prof Carlo Giaquinto, Director of the Paediatric Infectious Diseases Unit at the Department of Woman's and Child's Health of the University of Padova Prof; and Ian Frazer, Clinical immunologist and scientist, The University of Queensland Diamantina Institute, Brisbane, Australia. Read the related blog post: https://blogs.bmj.com/sti/2021/06/04/hpv-vaccine-uptake-achievements-and-challenges/ Related content from STI: https://sti.bmj.com/content/early/2020/09/02/sextrans-2020-054428 https://sti.bmj.com/content/95/5/386 https://sti.bmj.com/content/95/8/608

https://sti.bmj.com/content/early/2020/12/23/sextrans-2020-054726

Thousands of people are currently being vaccinated against COVID-19 worldwide. In this podcast, we discuss if the authorised vaccines are useful to people who live with HIV. STI's Podcast Editor, Dr Fabiola Martin, interviews Prof Anna Maria Garretti, Diseases at the Policlinico Tor Vergata, University of Rome Tor Vergata, Chair of the British HIV Association Vaccination Guidelines Panel, and Editor in Chief of the STI Journal; Dr Laura Waters, Sexual Health and HIV specialist at The Mortimer Market Centre, London, and chair of BHIVA; and Mr Simon Collins, HIV patient advocate and editor of the HIV Treatment Bulletin at the i-Base. Read the related blog post: https://blogs.bmj.com/sti/2021/04/23/2021episode3/

Related article: https://www.bhiva.org/SARS-CoV-2-vaccine-advice-for-adults-living-with-HIV-plain-english-version-update

In this podcast, we explore how the HIV endemic has evolved over time in Indonesia and is tracking against UNAIDS 90:90:90 treatment for all goals. We discuss the impact the COVID-19 pandemic has had on the already stressed health care system in Indonesia. Dr Fabiola Martin interviews Dr Keerti Gedela, Consultant physician and researcher in HIV and sexual health medicine, Chelsea & Westminster NHS Trust, London, and Dr Hendry Luis, general physician with an interest in HIV and Sexual Health Medicine, working at the Bali Peduli Foundation, Indonesia. Read the related blog post: https://blogs.bmj.com/sti/?p=1476&preview=true

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In this podcast, we focus on why health care services need to adapt and provide inclusive and non-discriminating services for people independent of their gender or sexual preferences.

Dr Fabiola Martin interviews Dr Jae Sevelius, Associate Professor at the University of California San Francisco, USA, and Dr Graham Neilsen, Sexual Health Specialist at Royal Brisbane Women's Hospital and Stonewall Medical Centre, Brisbane, Australia. They also discuss gender affirmation and healthcare empowerment research and actions taken to improve provide inclusive health care provision.

In the third episode to honor World AIDS Day, on the 1st December, we are discussing the U=U message with Professor Paul Volberding, University of California San Francisco. We touch on the recently published multicentre study: Undetectable equals untransmittable (U = U): awareness and associations with health outcomes among people living with HIV in 25 countries discuss by Okoli et al. Read the open-access paper on the Sexually Transmitted Infections website: http://dx.doi.org/10.1136/sextrans-2020-054551 .

Please subscribe to the STI podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify to get the latest episode onto your device.

In the second episode to honor World AIDS Day, on the 1st December, we are discussing the U=U message with Brent Allen, HIV patient representative. He explains why U=U means so much to people who live with HIV and those who are HIV negative. Read the related paper: Undetectable equals untransmittable (U = U): Awareness and associations with health outcomes among people living with HIV in 25 countries. Read the open-access paper on the Sexually Transmitted Infections website: http://dx.doi.org/10.1136/sextrans-2020-054551 .

Please subscribe to the STI podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify to get the latest episode onto your device.

To honor World AIDS Day, on the 1st December, we are bringing you three special interviews over the next few days. In this first episode, we are discussing the U=U message with Chinyere Okoli, clinical pharmacist at ViiV Health care and principle investigator of the study: Undetectable equals untransmittable (U = U): Awareness and associations with health outcomes among people living with HIV in 25 countries. Read the open-access paper on the Sexually Transmitted Infections website: http://dx.doi.org/10.1136/sextrans-2020-054551 .

Please subscribe to the STI podcast via all podcast platforms, including Apple Podcasts, Google Podcasts, Stitcher and Spotify to get the latest episode onto your device.

Dr Fabiola Martin talks to Dr John McSorely about the rapid adjustments applied to UK's sexual health care services as a response to COVID-19 pandemic lockdown and deployment of sexual health care providers to support other health care services. They discuss implemented service innovations such as 'Digital First' and 'Telehealth'. Dr John McSorley is a Consultant Physician in Sexual Health and HIV Medicine and President of BASHH (https://www.bashh.org/bashh-groups/board-and-trustees/elected-officers-and-representatives/dr-john-mcsorley/).

To read more about this subject, please visit the STI section about COVID-19: https://sti.bmj.com/pages/collections/covid19/ and read the related blog post: https://blogs.bmj.com/sti/2020/10/12/sexual-health-and-covid-19/

The original content of this podcast was removed in September 2022 after a participant withdrew their consent. This was the first in a series of podcasts on HIV and COVID-19 co-infection, and was recorded at a time when vaccines and treatments were not yet available. You can find later episodes on HIV and COVID-19 co-infection on the Sexually Transmitted Infections channel: - https://soundcloud.com/bmjpodcasts/covid-19-vaccine-and-people-who-live-with-hiv?in=bmjpodcasts/sets/sti - https://soundcloud.com/bmjpodcasts/impact-of-hiv-infection-on-covid-19-clinical-outcome?in=bmjpodcasts/sets/sti There's also a blog post with further information and resources:

- https://blogs.bmj.com/sti/2020/06/04/hiv-covid-19-podcast/

Two women die a week in consequence of domestic violence and abuse in the UK. It is increasingly recognised that enquiry by healthcare practitioners can enable pathways to earlier intervention and support. Editor-in-Chief of Sexually Transmitted Infections, Jackie Cassell, is joined by two specialists in the field to discuss the special issue of the journal on domestic and intimate partner violence, published in March 2018: http://sti.bmj.com/content/94/2. Neha Pathak (Wellcome Trust Clinical PhD Fellow, Institute for Epidemiology & Healthcare, University College London) and Gene Feder (University of Bristol, Centre for Academic Primary Care) discuss the various forms of the abuse and how healthcare practitioners can intervene. Related papers discussed in this podcast: - Highlights from this issue - http://sti.bmj.com/content/94/2/79 - Editorial: Routine enquiry for domestic violence and abuse in sexual health settings - http://sti.bmj.com/content/94/2/81 - Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention - http://sti.bmj.com/content/94/2/83 - Assessing for domestic violence in sexual health environments: a qualitative study - http://sti.bmj.com/content/94/2/88 - Sexual relationships, intimate partner violence and STI partner notification in Cape Town, South Africa: an observational study -

http://sti.bmj.com/content/94/2/144

Dr James Bingham, regarded by many as a father figure of the modern speciality, tells Lt Col Ngozi Dufty about the beginning of the field of venereal disease in the UK and how the origins of the sexual health service developed in consequence of the need to protect the health of the military troops first, and then the general population as a result. This interview is one of two podcasts published by the Sexually Transmitted Infections journal to signal the Centenary of the Venereal Disease Act 1917. Read all the articles here:

http://sti.bmj.com/pages/bashh-centenary-of-the-venereal-disease-act-1917.

Dr. George Kinghorn, genitourinary medicine physician with 35 years' experience, talks to Dr. Maryam Shahmanesh (Consultant and Senior Lecturer at the University College London and Mortimer Market Centre) about the “dramatic changes” introduced in the treatment of STIs with the Venereal Disease Act 1917. Professor George Kinghorn also analyses how the effects of the easier access to travel, the introduction of the contraceptive pill and the decriminalisation of homosexuality lead to a “rapid increase in the number of sexually transmitted infections” in the last 40 years and which translated into an increasing need for specialists. Commenting on the particular case of the UK, Dr Kinghorn advocates the need for specialised services in the NHS, saying that an “urgent access to [STI clinics] services is essential to preserve low-cost control of STIs”. He also looks to the main future challenges in this medical field. The interview is one of two podcasts published by the Sexually Transmitted Infections journal to signal the Centenary of the Venereal Disease Act 1917. Read all the articles here:

http://sti.bmj.com/pages/bashh-centenary-of-the-venereal-disease-act-1917.

How can burdens and trends of gonorrhoea and syphilis be estimated using surveillance data routinely collected in low- and middle-income countries? Eline Korenromp, epidemiologist from the Avenir Health, Geneva, Switzerland, tells STI Editor Jackie Cassell how the Spectrum-STI tool, developed at request of the World Health Organization, facilitates standardised, country-level estimation of trends in adult prevalence of sexually transmitted infections. The Spectrum-STI is an epidemiological framework which facilitates data review, validation and strategic analysis, prioritisation of data collection needs and surveillance strengthening by national experts. It has so far been applied in Zimbabwe, Morocco and Mongolia.

Read the full details of the study, “Estimating prevalence trends in adult gonorrhoea and syphilis in low- and middle-income countries with the Spectrum-STI model: results for Zimbabwe and Morocco from 1995 to 2016”, on the STI website (http://dx.doi.org/10.1136/sextrans-2016-052953).

Audit vs. Quality Improvement Methodology. How to undertake quality improvement and integrate it into GUM and HIV services? Hanna Bos, from the Municipal Health Service of Deventer, The Netherlands, discusses with Anna Hartley, one of the authors of a article, which explores the premise that true quality improvement methodology is poorly understood and poorly used in the NHS. Dr. Hartley, from the Ambrose King Centre, Barts Health NHS Trust, London, UK, brings some examples to the discussion to illustrate why audits alone cannot bring about continual improvement.

"How to integrate quality improvement into GUM and HIV services" is the title of the study that can be found here: http://sti.bmj.com/content/early/2016/08/22/sextrans-2016-052732.

In this podcast, Jackie Cassell, the Editor in Chief of STI, talks to Anatole Menon-Johansson, from the Department of Sexual Health, Guy's & St Thomas’ NHS Foundation Trust, London, UK, about partner notification technologies. The STI blog post "Improving Partner Notification with a new online tool from SXT Health CIC [Community Interest Company]" is the starting point for a broad conversation about why is partner notification on STIs so important, what's the tool about and what the future holds in the digital era. Read the blog post here: http://blogs.bmj.com/sti/2016/05/05/improving-partner-notification-with-a-new-online-tool-from-sxt-health-cic-from-anatole-menon-johansson/. On the STI website: - Claudia Estcourt study on Accelerated Partner Treatment for primary care: http://sti.bmj.com/content/91/8/548.full.pdf+html?sid=17d93526-4a85-4ae6-a34b-7a603dd67873.

- Hannelore Götz study of an online partner notification tool: "Initial evaluation of use of an online partner notification tool for STI, called ‘suggest a test’: a cross sectional pilot study", http://sti.bmj.com/content/90/3/195.abstract.

In this podcast we explore the management of STI outbreaks. Ian Simms, of the HIV & STI Department, Public Health England, interviews two authors who have managed STI outbreaks. Kirsty Foster, of the Public Health England North East, investigated an outbreak of gonorrhoea in young heterosexual adults in that area of the UK. Read the full letter here: http://sti.bmj.com/content/92/5/364.full. Giri Shankar, of the Health Protection Team, Public Health England, talks about hepatitis B in the East of the country. He studied and managed an outbreak of the infection in men who have sex with men but identify as heterosexual. Read the full text here: http://sti.bmj.com/content/early/2016/01/04/sextrans-2015-052490.full. The STI Outbreaks issue, which was published in August 2016, was guest edited by Gwenda Hughes and Ian Simms. It includes articles that explore epidemics, clusters, changes in antibiotic resistance, changes in behaviours that increase the chance of outbreaks, as well as considering how we respond to and describe outbreaks.

Here is the Outbreak special issue, with editorial material and field reports on the control of STI outbreaks: http://sti.bmj.com/content/92/5.toc.

What do we know about sexual behaviour when travelling? Are backpackers and gap year travellers a special group? These are some of the questions Christopher Lewis, from the University of Birmingham, and Dr Clare Tanton, from the UCL's Centre for Sexual Health and HIV research, answer in this podcast. They are the authors of two recent studies published at sti.bmj.com. Read the full studies: 'Sexual behaviour of backpackers who visit Koh Tao and Koh Phangan, Thailand: a cross-sectional study', by Dr Christopher Lewis, is accessible here: http://sti.bmj.com/content/early/2016/04/19/sextrans-2015-052301.full. 'Forming new sex partnerships while overseas: findings from the third British National Survey of Sexual Attitudes & Lifestyles (Natsal-3)', by Dr Clare Tanton is available here: http://sti.bmj.com/content/early/2016/04/19/sextrans-2015-052459.full. Read the related STI Editorial: 'The Holy Grail of prevention of sexually transmitted infections in travelers' by Dr. Alberto Matteelli (http://sti.bmj.com/content/early/2016/04/19/sextrans-2016-052573.full). For more information on these issues, please visit the NHS page about sex on holiday: http://www.nhs.uk/livewell/sexualhealth/pages/sexonholiday.aspx.

Find your nearest 'Sexual health information and support services': http://www.nhs.uk/service-search/sexual-health-information-and-support/locationsearch/734.

In this podcast, Dr Khalil Ghanem discusses ocular syphilis with the authors of two studies. Dr Susan Tuddenham, from the Johns Hopkins University in Baltimore, Maryland, USA, is the author of 'Increasing Case Reports of Ocular Syphilis in the United States: An Opportunity to Address Important Unanswered Questions', accessible here: http://goo.gl/cPcbLM and Dr Motoyuki Tsuboi, from the AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan, is the author of 'Prognosis of ocular syphilis in HIV-infected patients in the antiretroviral therapy era': http://goo.gl/giAx9s .

A lot has changed since the last study among shipboard populations has been conducted, about 20 years ago. What is the health of shipboard military personnel and why is it important to study their sexual health? How is life in a deployment? How can the findings of this study apply to civilian populations? In this podcast, Judith Harbertson of San Diego State University and US Military HIV Research Program talks to Tom Nadarzynski, Brighton and Sussex Medical School, about these questions and the main conclusions of the study. Read the related article: Sexually transmitted infections and sexual behaviour of deploying shipboard US military personnel: a cross-sectional analysis

goo.gl/5GPm2D