The worldwide outbreak of mpox (formerly monkeypox) in 2022 emerged as a public health emergency posing greater threat to persons with sexually transmitted infections (STIs). This outbreak featured an increase in overlap between mpox and STIs reflecting evolving transmission dynamics in sexual networks. Epidemiological data reveal that STIs such as human immunodeficiency virus (HIV), Chlamydia trachomatis, herpes simplex virus, syphilis have been frequently associated with mpox infection highlighting the role of sexual contact in its transmission. A narrative review was conducted using PubMed and Google Scholar to identify relevant literature published between 2008 and 2026, focusing on mpox, STIs, co-infections, and pregnancy outcomes. Evidence suggests that biological, behavioural and structural factors may interact to influence mpox transmission and clinical outcomes. STI co-infection may be associated with mucosal invasion and immune modulation plausibly affecting disease progression, however direct mechanistic evidence remains limited. Although mpox infection has majorly affected gay, bisexual and other men who have sex with men (GBMSM), its severity in women particularly during pregnancy raises concerns regarding vertical transmission and maternal and neonatal complications. This review highlights current evidence on mpox-STI co-infections, and applies a syndemic framework to interpret their co-occurrence within biological, behavioural and structural contexts. While this perspective provides understanding regarding transmission patterns, further research is needed to establish the extent of these interactions. Recognizing these factors is important for screening, early diagnosis and management strategies to mitigate future outbreaks and impact of mpox. Summary: This narrative review on mpox and STI co-infections explores syndemic interactions, transmission dynamics and implications for disease outcomes and public health management.

Despite the current recommendations of the CDC and IUSTI, controversy persists regarding the adequate dose and duration of benzathine penicillin G (BPG) for early syphilis in people living with HIV (PLWH). PubMed, Embase, and Cochrane were searched from inception to October 2025 for studies comparing a single-dose versus a 3-dose BPG regimen in PLWH with early syphilis. A random-effects meta-analysis was performed using risk ratios (RRs) with 95% confidence intervals (CIs). The primary outcome included serologic cure, defined as a ≥4-fold (2-dilution) decline from baseline in antibody titers measured by nontreponemal (lipoidal antigen) tests, including rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) tests, at 6 and 12 months. A total of 8 studies, including 2randomized controlled trials (RCTs) and 6observational studies, were included. Pooled analysis showed no significant difference in serologic cure between a single-dose versus 3-dose BPG at 6months (RR 1.00; 95% CI 0.93 to 1.07; P = 0.95) or 12 months (RR 0.98; 95% CI 0.92 to 1.04; P = 0.46). Overall, our pooled results did not show a significant difference between single-dose and 3-dose BPG. However, our study did not evaluate selected high-risk subgroups, particularly individuals with advanced immunosuppression or untreated HIV infection. Thus, a potential benefit of enhanced therapy in these specific populations cannot be entirely ruled out, underscoring the need for future RCTs focused on these subgroups and designed to stratify or adjust for key disease-modifying factors.

In the United States, 1% of mothers with pregnancies affected by congenital syphilis had HIV and 16% of these mothers had unknown HIV status. Those affected by HIV were more likely to be Black and reside in the South; they also had larger proportions of pre-term birth and low birthweight.

Among 117 men with symptomatic urethritis in the Brazilian Amazon, Neisseria gonorrhoeae was most frequent (53.0 to 56.4%, across the two molecular workflows), followed by Chlamydia trachomatis (14.5 to 15.4%), Mycoplasma genitalium (6.8%), and Trichomonas vaginalis (1.7%). Overall molecular workflow agreement was 92.3% for CT and 82.9% for NG.

Oral syphilis may present as a non-scrapable white lesion that clinically mimics oral leukoplakia. This combined case report and systematic review aimed to characterize syphilis-associated oral lesions with a white component and to evaluate separately cases classified as syphilitic leukoplakia. PubMed, Scopus, Web of Science, and Embase were searched through December 2025. Eligible English-language reports described a confirmed diagnosis of syphilis and an oral lesion with a white component. Two reviewers independently screened records, data were synthesized descriptively, and the included publications were appraised using the corresponding JBI tools. Sixteen publications met the inclusion criteria; together with the present case, they yielded 28 patients. Most patients were male (85.7%), and the tongue was the most frequently involved site (57.1%). Extraoral or systemic findings were documented in 39.3%, explicitly absent in 25.0%, and unreported in 35.7%. Five cases, including the present case, were classified as syphilitic leukoplakia. All five underwent biopsy, and epithelial dysplasia was identified in three. Among the 18 patients with reported outcomes, complete or near-complete resolution occurred in 17 and partial remission in one after antimicrobial therapy. Syphilis should be considered in the differential diagnosis of unexplained oral white lesions, particularly those resembling leukoplakia, to ensure appropriate serologic testing, histopathological assessment, and treatment.

Sexually transmitted infections are endemic in South Africa, partly because of the limitations of syndromic management as the standard approach. In recruitment initiative for a novel gonorrhea antibiotic trial, 8189 adults aged ≥18 years were reached and 3381 tested for Chlamydia and Gonorrhea, revealing high prevalence, especially among young people.