STI Podcast

Rise of Syphilis

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.

MPox 101, Community and Global response

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).

HIV and STI prevention, plus HIV in Ukraine

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

Bacterial STIs: The DoxyPEP Trial

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

Presumptive and Prophylactic management of Bacterial STIs

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

Preventing anal cancer in people with HIV: learnings from the ANCHOR study

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

HTLV2022: 20th International Conference on Human Retrovirology

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

Mycoplasma Genitalium: Easy to detect, hard to treat

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

NATSAL-COVID: Britain’s National Surveys of Sexual Attitudes and Lifestyles

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

World Human T Leukaemia Virus Day: patient, clinician and scientist’s perspectives

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