DoxyPEP: Opportunities for Expansion.

Clinical trials show that doxycycline post-exposure prophylaxis (DoxyPEP) significantly reduces the risk of bacterial sexually transmitted infections (STIs), especially syphilis and chlamydia, in cisgender men who have sex with men and transgender women. Real-world data suggest DoxyPEP may be beneficial for other populations disproportionately affected by STIs. Given the ongoing STI epidemic we recommend discussing DoxyPEP with all eligible patients.

Establishing shared definitions of virological failure and discontinuation for long-acting injectable cabotegravir and rilpivirine therapy (the CONSENSUS-LAI Study): an international survey and Delphi process.

Background: Definitions of virological failure and treatment discontinuation for long-acting injectable (LAI) cabotegravir and rilpivirine antiretroviral therapy are inconsistent in clinical practice and observational studies, which complicates interpretation and implementation of findings. The CONSENSUS-LAI study aimed to establish consistent definitions of virological failure and treatment discontinuation to enhance evidence transferability and support optimal clinical outcomes.

Methods: The study had two phases.

Use of Doxycycline for STI Post-Exposure Prophylaxis in People Assigned Female at Birth in the United States.

This multi-center case series examines real-world use of doxycycline post-exposure prophylaxis (doxy-PEP) among persons assigned female at birth (AFAB) at four U.S. sexual health clinics.

Understanding Opportunities for Prescribing Pre-exposure Prophylaxis at Two Academic Medical Centers in a High Priority Jurisdiction for Ending the HIV Epidemic.

Pre-exposure prophylaxis (PrEP) is an effective yet underutilized tool for HIV prevention. We examined opportunities for prescribing PrEP at two large, urban, academic healthcare institutions. We analyzed electronic medical record data for 1/1/2015-12/31/2021 among patients ≥ 18 years of age, with ≥ 1 negative HIV test with indications for PrEP.

Early Virologic Success on Antiretroviral Therapy Among Individuals With Breakthrough HIV Acquisition on Long-Acting Cabotegravir Pre-exposure Prophylaxis.

HIV-1 breakthrough on long-acting cabotegravir (CAB-LA) for HIV prevention is rare but could impact viral suppression on integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART). We report the first study of ART outcomes following CAB-LA breakthrough during routine clinical care. Three individuals acquired HIV-1 on CAB-LA despite on-time injections; 2 had low-frequency major INSTI resistance mutations.

Perspectives of Doxycycline Postexposure Prophylaxis among Pediatric Providers.

Doxycycline postexposure prophylaxis (doxyPEP) is a chemoprophylaxis that may reduce certain sexually transmitted infections in high-priority groups 18 years and older. This study utilized a cross-sectional survey among 167 pediatric providers in the USA, with ~40% reporting lacking comfort and familiarity with doxyPEP, and various barriers to use.

Using SARS-CoV-2 red cell kodecytes to assess vaccine-induced immune response to the conserved 1147-58 region of the spike protein in Indian blood donors: exploring the potential role of blood transfusion services in population surveillance.

Background And Objectives: Blood transfusion services are uniquely poised to take part in the population surveillance study by providing snapshots of the SARS-CoV-2 immunity status among vaccinated blood donors. The immunogenic 1147-58 region of the intact SARS-CoV-2 spike protein is partly spatially hidden. These 1147-58-region-specific antibodies have previously been observed in COVID-19 infected patients but have not been documented in vaccinated individuals.

Preferences for PrEP Implementation and Engagement in the HIV Pre-Exposure Prophylaxis (PrEP) Care Continuum among Patients Receiving Psychiatric Care in an Ending the HIV Epidemic Priority County.

Introduction: People living with mental illness (PLWMI) experience disproportionate HIV incidence. Research suggests use of HIV pre-exposure prophylaxis (PrEP) is low among PLWMI. The present study was conducted to understand self-reported HIV vulnerability, previous experiences with PrEP, interest in using PrEP, and preferences for PrEP modality and prescribers among PLWMI.

HIV pre-exposure prophylaxis re-initiation among men who have sex with men: a multi-center cohort study in China.

Background Data on persistent use of HIV pre-exposure prophylaxis (PrEP) is limited among Chinese men who have sex with men (MSM). This study aimed to explore factors associated with the re-initiation of PrEP among Chinese MSM from a longitudinal PrEP demonstration trial. Methods A multi-center cohort study was conducted in Guangzhou and Wuhan, China (September 2021-2024), providing 1134 MSM participants with a 12-month dosage of tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) as oral PrEP.

Early Experience and Effectiveness of Long-Acting Injectable Cabotegravir and Rilpivirine in a South Side Chicago HIV Clinic.

We describe referrals and uptake of long-acting injectable cabotegravir/rilpivirine at an academic clinic in Chicago. In a pharmacy-led model, 118 (18%) people with HIV were referred and 78 (12%) initiated long-acting injectable cabotegravir/rilpivirine from 1 January 2021 to 31 May 2023. Implementation, especially for people with HIV who were not virally suppressed, requires further support for patients, providers, and clinic systems.

Promises, Pitfalls, and Progress: Doxycycline Prophylaxis for Bacterial Sexually Transmitted Infections.

Purpose Of Review: Doxycycline post-exposure prophylaxis (doxy PEP) has proven to be highly effective in reducing the incidence of sexually transmitted infections (STIs) among men who have sex with men (MSM) and transgender women. In response, the US Centers for Disease Control and Prevention (CDC) issued official clinical guidance on the use of doxy PEP as a preventive intervention in these populations. However, despite strong evidence supporting its use, the potential risks of antimicrobial resistance (AMR) along with its limited accessibility in other key populations, remain significant concerns with doxy PEP.

Impact of Peer Referral on Pre-Exposure Prophylaxis Adherence and Persistence Among Men Who Have Sex with Men: A Cohort Study in China.

Peer referral leverages social networks to connect individuals with health services, potentially enhancing pre-exposure prophylaxis (PrEP) use. This study aims to investigate the impact of peer referral on PrEP adherence and persistence among men who have sex with men (MSM) in China. This study is nested in a 12-month PrEP (FTC/TDF) demonstration trial in China from September 2021 to December 2023.

Sexual wellness clinic collaborative initiative with a large urban emergency department: sexual health outcomes and linkage to HIV pre-exposure prophylaxis.

Introduction: Despite escalating rates of sexually transmitted infections (STIs) in the United States (US), there has been progressive divestment of sexual health services leading to the reliance on emergency departments (EDs) for sexual healthcare, particularly among vulnerable populations. The Sexual Wellness Clinic (SWC), a novel care delivery model operating in collaboration with the ED, offers comprehensive sexual health services.

Objectives: This study aims to analyze the demographics, STI positivity, and HIV Pre-Exposure Prophylaxis (PrEP) uptake among patients accessing the SWC.

Psychiatrists' Experiences, Training Needs, and Preferences Regarding Prescription and Management of HIV Pre-exposure Prophylaxis (PrEP) Within Psychiatric Care.

Background: People living with mental illness (PLWMI) experience a disproportionate prevalence and incidence of HIV. Preventing HIV among PLWMI is a priority for multiple domestic public health agencies. As key clinicians for this group, psychiatrists may have an important role to play in increasing PrEP use among PLWMI.

An Opt-Out Emergency Department Screening Intervention Leads to Major Increases in Diagnosis of Syphilis.

Background: With rising rates of syphilis in the United States, novel strategies are needed to improve early diagnosis, particularly among priority populations such as pregnant people. As the primary source of healthcare for many communities with limited access to care, the emergency department (ED) visit represents a crucial opportunity for syphilis detection and congenital syphilis prevention.

Methods: This pre-post design study examined all ED encounters for 2-year periods before and after implementation of an opt-out ED syphilis screening intervention in May 2019 at a large, urban, academic ED.

Impact of COVID-19 and Mpox on Sexual Practices and Disease Mitigation Strategies Over Time Among Men Who Have Sex With Men Affiliated With Collective Sex Venues.

Background: The COVID-19 pandemic and subsequent multinational mpox outbreak significantly disrupted sexual health care delivery, particularly impacting men who have sex with men (MSM). This study investigated these public health emergencies in relation to perceptions, attitudes, and sexual practices among MSM affiliated with a collective sex venue (CSV).

Methods: Electronic surveys were sent to clientele of a high-volume CSV between June 2021 and November 2022 across 3 time periods defined as pre-Omicron, post-Omicron, and mpox.

Risk factors for treatment non-completion among patients with syphilis.

Background: With recent increases in syphilis, there is growing interest in expanding screening; however, treatment rates have historically been low.

Objectives: This study examines demographic and clinical factors that may contribute to non-completion of syphilis treatment.

Design: This is a retrospective comparative cohort study of all patients with syphilis from January through November 2018 at an urban, tertiary care hospital.

HIV and Syphilis Co-Screening Rates Among Patients Tested for Gonorrhea and Chlamydia at a Large, Urban Hospital.

Background: Current guidelines recommend concurrent screening for HIV and syphilis with gonorrhea and chlamydia testing. Despite this, many patients are still not screened. This study describes trends in demographics and encounter locations associated with missed opportunities for HIV and syphilis screening among patients tested for gonorrhea or chlamydia.

Preexposure Prophylaxis (PrEP) for HIV Prevention at Outpatient Substance Use Treatment Facilities, United States, 2021.

To determine the percentage of US outpatient substance use treatment facilities that offer HIV preexposure prophylaxis (PrEP). We used a retrospective cross-sectional design with data from the National Substance Use and Mental Health Services Survey, which was administered to directors of US outpatient substance use treatment facilities in 2021. We evaluated the percentage of outpatient substance use treatment facilities offering PrEP and factors associated with the likelihood of offering PrEP.

Sexual Health for Transgender and Gender Diverse Individuals: Routine Examination, Sexually-Transmitted Infection Screening, and Prevention.

Gynecologists play a critical role in the office evaluation of transgender and gender diverse individuals. This includes the provision of essential healthcare services including the treatment and prevention of human immunodeficiency virus and sexually-transmitted infections and screening for human papillomavirus infection-related diseases and cancers. Caring for patients who identify as transgender or gender diverse (TGD) and who have undergone gender-affirming surgical treatments is challenging due in part to clinical gaps in knowledge resulting from insufficient training and educational resources.