The association between Jewish ritual circumcision and genital herpes simplex virus type 1 infection has been well described. We report a case of genital herpes that first presented at the age of 2½ years. We believe that the infection was acquired asymptomatically through direct orogenital suction performed during circumcision in the newborn period.

BACKGROUND:

Studies in women indicate that some sexually transmitted infections promote human papillomavirus (HPV) persistence and carcinogenesis. Little is known about this association in men; therefore, we assessed whether Chlamydia trachomatis (CT) infection and herpes simplex virus type 2 (HSV-2) serostatus are associated with genital HPV prevalence, an early event in HPV-related pathogenesis.

METHODS:

Genital exfoliated cells, first-void urine, and blood from 3971 men recruited in the United States, Mexico, and Brazil were tested for HPV, CT, and HSV-2 antibodies, respectively. Multivariable logistic regression was used to assess the association of CT infection and HSV-2 serostatus with 4 HPV outcomes (any, oncogenic, nononcogenic only, and multiple infections).

RESULTS:

A total of 64 (1.6%) men were CT positive, and 811 (20.4%) men were HSV-2 seropositive. After adjustment for potential confounders, CT was associated with any HPV (adjusted odds ratio [aOR], 2.19; 95% confidence interval [CI], 1.13-4.24), oncogenic HPV (aOR, 3.10; 95% CI, 1.53-6.28), and multiple HPV (aOR, 3.43; 95% CI, 1.69-6.95) prevalence. Herpes simplex virus type 2 serostatus was associated with any HPV (aOR, 1.25; 95% CI, 1.02-1.52), nononcogenic HPV only (aOR, 1.38; 95% CI, 1.08-1.75), and multiple HPV (aOR, 1.33; 95% CI, 1.06-1.68) prevalence. In analyses stratified by sexual behavior, CT infection was significantly associated with HPV detection among men reporting 2 or more recent sexual partners, whereas HSV-2 serostatus was significantly associated with HPV detection in men reporting 0 to 5 lifetime sexual partners.

CONCLUSION:

In this population, CT infection and HSV-2 serostatus were associated with prevalent genital HPV infection. Future prospective studies should investigate whether these infections influence HPV acquisition and/or persistence.

National survey data designed to delineate clinician perspectives on the indications to hospitalize adolescents for pelvic inflammatory disease indicate that clinicians endorse care consistent with the Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines but that there is less agreement on the social factors that may impair an adolescent's ability to self-care in the outpatient setting.

A cross-sectional study that investigated the association between cervical infection of Chlamydia trachomatis, Neisseria gonorrhoeae, or Mycoplasma genitalium and infection with high-risk types of human papillomavirus among female sex workers in China found that the presence of cervical C. trachomatis or M. genitalium infection was independently associated with infection with certain high-risk types of specific high-risk human papillomavirus among this population.

The diagnosis of syphilis remains challenging. The absence of classical features of the disease, such as the rash of secondary syphilis or genital lesion, may pose diagnostic difficulties. In this article, we report a case of secondary syphilis in which the clinical syndrome and pattern of fluorodeoxyglucose uptake mimicked malignant lymphoma. This case highlights the importance of thorough history taking including sexual contact. Clinicians should be alert for syphilis-underlying unexplained lymphadenopathy, even in the absence of typical rash or genital lesion.

A sample of 327 men (age, 16-36 years) responded to self-completed questionnaires, which included questions regarding their most recent female sexual partner and specific behaviors pertaining to that partner. Analyses showed significant differences in several variables including condom use and sexually transmitted infection history, among the different relationship types.

We report new sequence types of 14 penicillinase-producing Neisseria gonorrhoeae, isolated from sexually transmitted disease clinic attendees in Manaus, Brazil. They were characterized by WI/WII/WIII groups, susceptibility testing and Multi-Antigen Sequencing Typing/Mutilocus Sequence Typing protocols. Twelve were classified as WII/III and 2 as WI and were presented resistance to penicillin and tetracycline. New alleles for por and AroE genes and novel sequence types were identified, revealing molecular characteristics not described previously. ST1590 is the common ancestor after eBURST analysis, and these findings represent an important contribution of molecular epidemiology approach in gonococci's research in Amazonas.

Accurate measurement of unprotected sex is essential in HIV prevention research. Since 2001, the 100% Condom Use Program targeting female sex workers (FSWs) has been a central element of the Cambodian National HIV/AIDS Strategy. We sought to assess the validity of self-reported condom use using the rapid prostate-specific antigen (PSA) test among Cambodian FSWs.From 2009 to 2010, we enrolled 183 FSWs in Phnom Penh in a prospective study of HIV risk behavior. Prostate-specific antigen test results from the OneStep ABAcard were compared with self-reported condom use in the past 48 hours at quarterly follow-up visits.Among women positive for seminal fluid at the first follow-up visit, 42% reported only protected sex or no sex in the detection period. Discordant results were more likely among brothel and street-based FSW versus entertainment (56% vs. 17%), recent (last 3 months) amphetamine-type stimulant (ATS) users (53% vs. 20%), and those with 5 or more partners in the past month (58% vs. 13%). In multivariable regression models, positive PSA results were associated with recent ATS use (adjusted risk ratio [ARR], 1.5; 95% confidence interval [CI], 1.1-2.2), having a nonpaying last sex partner (ARR, 1.7; CI, 1.2-2.5), and sex work venue (ARR, 3.0; CI, 1.4-6.5). Correspondingly, women with a nonpaying last sex partner were more likely to report unprotected sex (ARR, 1.5; CI, 1.1-2.2), but no associations were found with sex work venue or ATS use.Results confirm the questionable validity of self-reported condom use among FSW. The PSA biomarker assay is an important monitoring tool in HIV/sexually transmitted infection research including prevention trials.