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.

Among 133 women attending an STI referral service in the Brazilian Amazon, multiplex real-time PCR identified a heterogeneous microbiological profile, including STI pathogens, bacterial vaginosis-associated microorganisms, Candida species, and frequent codetection. Clinical and epidemiological characteristics showed variable associations, while self-reported vaginal discharge had limited ability to distinguish specific molecular findings.

Bacterial vaginosis (BV) is the commonest vaginal infection globally, resulting from a shift from Lactobacillus-dominant microbiota to an overgrowth of anaerobes. Although standard antibiotic therapy achieves short-term cure, recurrence remains high. Recent evidence suggests that male genital microbiota is a potential reservoir for BV-associated bacteria (BVAB), prompting investigation into the role of concurrent male partner treatment (MPT). We conducted a systematic review and meta-analysis of randomized controlled trials to assess the effect of MPT on BV recurrence and cure. The study followed Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and was registered in PROSPERO (CRD420251132582). Embase, Scopus, Google Scholar, and PubMed databases were searched independently, from 1980 to September 2025. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using random-effects models. Risk of bias and certainty of evidence were assessed using RoB 2 and GRADE. Eight randomized controlled trials were included. MPT showed no significant effect on BV recurrence (RR 0.92; 95% CI 0.69-1.23; I2 = 64%) or cure rate (RR 1.01; 95% CI 0.94-1.07; I2 = 46%). Adverse events were mild and similar across groups (RD 0.04; 95% CI 0.02-0.11). However, lower recurrence was observed among fully adherent couples, particularly in a recent trial using combined oral and topical therapy. While the overall pooled effect of routine partner treatment is neutral, a benefit may exist among fully adherent couples receiving intensive regimens. Targeted approaches that optimize regimen intensity and adherence warrant further investigation.

Many men with HIV (MWH) want children. MWH with unmet reproductive goals may prioritize conception over preventing HIV/STI transmission. Therefore, we evaluated whether MWH with unmet versus met reproductive goals were more likely to have detectable HIV-RNA or STIs, and explored socio-structural factors (e.g., HIV/infertility stigma, gender dynamics) conceptualized to influence this association. We recruited 100 MWH in Uganda who reported condomless sex with intent to conceive, half had/had not fathered a child in the last year, defined as "met"/"unmet" reproductive goals. A questionnaire assessed demographics, sexual and health behaviors, infertility and childbearing stigmas, and socio-structural factors hypothesized to associate with the outcomes of prevalent detectable HIV-RNA or syphilis, gonorrhea, or chlamydia infection. We conducted logistic regression to assess whether unmet reproductive goals were associated with detectable HIV-RNA or STI. We enrolled 100 MWH: 50 had met, 50 had unmet reproductive goals. Median age was 41 (range 24-68). Most (89%) knew their pregnancy partner's HIV serostatus, and 65% reported an HIV-negative partner. 10% had HIV-RNA >200 copies/mL ("detectable") and 30% had >1 curable STI. Men reported stigma related to childbearing (4 (1.8-5.0), max 12) and infertility (63.5 (46.0-86.0), max 100). Unmet reproductive goals were not associated with detected HIV-RNA (aOR 0.79, 95%CI 0.14-4.57) or curable STI (aOR 1.02, 95%CI 0.39-2.65). Among MWH, unmet reproductive goals were not associated with HIV viremia or STIs. However, nearly one-third of MWH had curable STIs highlighting opportunities to improve STI screening and care for MWH to optimize the health of MWH, their partners and offspring.

Point-of-care testing (POCT) for sexually transmitted infections (STIs) holds promise to improve care across clinical settings in the United States (US). However, multiple barriers to widespread adoption remain, and universal use will not be appropriate. At a minimum, decision-makers require robust, real-world evidence that STI POCTs improve patient outcomes within specific clinical contexts for these tests to be reimbursed and adopted, and data among priority patient groups may help guide targeted utilization. To inform decisions in the US and identify gaps in the evidence base, we reviewed literature on impact of STI POCTs for gonorrhea (NG), chlamydia (CT), trichomoniasis and syphilis on clinical outcomes across emergency departments (EDs), STI/sexual health clinics, primary care and gynecology clinics, and urgent care centers. Because US outcome data are sparse in several settings, we included studies from other high-income regions (Europe, Australia and Canada) noting where findings may not generalize to US practice. Evidence was summarized for priority patient groups (including symptomatic individuals and STI contacts), stratified by sex. We found some evidence for improved outcomes, particularly for symptomatic women in the ED. However, most studies did not stratify results by priority population, and the majority examined ≥90-minute CT/NG tests which, especially outside the ED, returned results only after the visit. Additional research is needed on the impact of STI POCTs on clinical outcomes in priority populations (including ≤30-minute tests), on workflow strategies enabling actionable results before the end of the encounter, and to provide updated cost or cost-effectiveness analyses across US clinical settings.