Venereology, Volume 3, Issue 1 (March 2024) – 5 articles

Background: This study seeks to understand the empirical nature of macro-financial factors associated with the worsening of HIV infections and the risks that need to be carefully monitored for a sustainable improvement in HIV outcomes as developing countries seek to achieve the United Nations 95-95-95 targets. Methods: The author used a panel VAR model to study the long-term endogenous relationships between percentage changes in the annual spot price of the most traded commodities, GDP per capita, health spending, and the HIV infection rate of developing countries. Results: The author discovered that shocks of global commodity prices negatively impact GDP per capita, real government health spending, and real private health spending. These shocks have adverse spillover effects characterized by worsening HIV infections. The reactions from price shocks suggest that GDP per capita contract immediately when a commodity price shock hits developing economies. Real government health spending and real private health spending also contract instantly. HIV infections begin worsening three years after the shock in the energy and precious metal blocks of countries. HIV infections also begin to worsen two years after shocks in the agricultural block of counties. These impacts are statistically significant and can potentially reverse the positive HIV infection gains achieved in the previous years. Emergency funds, insurance schemes, and international aid for HIV need to discharge more funds to counter these shocks. Conclusions: There is a significant risk of reversing HIV infection outcomes arising from commodity price shocks. Funding agencies must protect HIV prevention services from global macro-economic shocks as countries move closer to the United Nations 95-95-95 targets. Full article

Trichomoniasis is the most common non-viral sexually transmitted infection (STI) in the world. The estimated global prevalence in 2016 was 156 million adults aged 15–49. However, these data are underestimated, since the most used diagnostic method is the wet mount, which has low sensitivity, the information regarding the estimated duration of infection is limited and there is evidence of undiagnosed asymptomatic cases in both sexes. Currently 80% of cases—including both sexes—are asymptomatic, which makes the disease silent and chronic in course, leading to complications. The aim of this review was to discuss the diagnostic methods for T. vaginalis detection that are currently available and applicable in the clinical laboratory routine. Overall, nucleic acid amplification techniques are the best option for T. vaginalis detection, with higher sensitivity and specificity than other tests. Although these techniques present higher cost, their implementation should be supported to ensure correct trichomoniasis diagnosis and treatment beyond contributing to questions on epidemiology and control. Full article

The Arg753Gln polymorphism in Toll-like receptor 2 has been associated with an increased risk of bacterial infections as well as with protection from the late stages of Lyme disease and the acquisition of syphilis. In this study, we determined the presence of this polymorphism in samples collected from men having sex with men/men with women in the Amsterdam Cohort Studies. The presence of the polymorphism was determined by nested PCR, followed by Sanger sequencing. A set of 90 syphilis-seronegative individuals was compared to 95 syphilis-diagnosed participants. A polymorphism allele frequency of 3.9% was found in the control group and 2.63% in the syphilis case group, respectively. None of the individuals showed a homozygous Arg753Gln polymorphism. The number of self-reported sexual contacts was higher in the group of syphilis patients compared to the control group (p = 0.0063). Moreover, in the syphilis case group (n = 49), participants heterozygous for the TLR2-Arg753Gln reported higher numbers of sexual contacts (p = 0.037) compared to wild-type homozygotes. Our findings suggest a possible protective effect of TLR2-Arg753Gln in the acquisition of syphilis. In addition, the determination of the number of self-reported sexual contacts can be used in an evaluation of the protective effect of polymorphism in a population with a low prevalence of it. Full article

Women living in the semi-arid region of Caatinga in the northeast of Brazil report the use of plant mixtures to treat diseases in the genitourinary tract. Plant extracts were obtained from barks to simulate traditional use. The anti-trichomonads activity as well as the cytotoxic effect of plant extracts were tested. Herein, we confirmed this traditional knowledge by testing plants aqueous extracts against Trichomonas vaginalis and Tritrichomonas foetus, the etiologic agents of human and bovine trichomoniasis. All plant extracts were active individually against at least one trichomonads species except for Prosopis juliflora and Amburana cearensis. Cedrela sp. was the most active against both trichomonads species. Finally, a mixture of plants used in traditional medicine was evaluated for activity. A mixture containing extracts of the plants Ximenia americana, Anadenanthera colubrina var. cebil, Myracrodruon urundeuva, Sideroxylon obtusifolium, and Amburana cearensis was active against the two trichomonads. This finding confirms the traditional practice by women living in the Caatinga region of using a mixture of plants during sitz baths to treat vaginal infections. Altogether, these results highlight the ethnopharmacological use of Cedrela sp. and of the plant mixture for the treatment of venereal diseases by Caatinga residents. Full article

Background: Since the implementation of pre-exposure prophylaxis (PrEP) in HIV prevention, a significant increase in the prevalence of other sexually transmitted infections (STIs) has been reported, especially among men who have sex with men (MSM). Doxycycline is being examined as a potential pharmacological agent in preventing these infections. This review aims to summarize available data on the effectiveness and potential side effects of doxycycline for the prevention of bacterial STIs. Methods: We reviewed the National Library of Medicine and the National Center of Biotechnology Information in order to find clinical trials and relevant observational studies regarding doxycycline usage in STI prophylaxis. Results: Doxycycline prophylaxis reduced the risk of acquiring chlamydia, syphilis, and, in a majority of the trials, the risk of gonorrhea. The clinical trials on doxycycline STI prophylaxis were underpowered to determine if doxycycline promotes the selection of resistance in Neisseria gonorrhoeae and Chlamydia trachomatis. Additionally, no serious side effects of this preventive measure have been reported. None of the studies aimed to compare the efficacy of post- and pre-exposure prophylaxis of STDs with doxycycline. Conclusions: The preliminary results regarding STI prophylaxis with doxycycline seem to be promising. Further research is needed to determine the potential risk of doxycycline prophylactic prescription. Full article