STI Podcast – Details, episodes & analysis

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

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