UNASSIGNED: Drug users are a high-risk group for HIV infection and are prominent HIV carriers. Given the emergence of new drugs, we explored current drug-using behaviors, HIV infections, and the correlation between drug-using behaviors and HIV infection risk among drug users from 2014 to 2021.
UNASSIGNED: We aimed to identify the prevalence of HIV infection risk among drug users and explore drug use behaviors based on the updated data, which could provide evidence for the precision of HIV prevention strategies among drug users.
UNASSIGNED: Data were collected from sentinel surveillance of drug users in rehabilitation centers and communities in Hangzhou (2014-2021), including sociodemographic characteristics, HIV awareness, drug use, risky sexual behaviors, and HIV infection status. Multivariate logistic regression was used to identify the factors influencing HIV infection and risky sexual behaviors among drug users.
UNASSIGNED: In total, 5623 drug users (male: n=4734, 84.19%; age: mean 38.38, SD 9.94 years) were included. New drugs dominated among the participants (n=3674, 65.34%). The main mode of drug use was noninjection (n=4756, 84.58%). Overall, for 27.45% (n=1544) of injected drugs in the last month before the investigation, the average daily injection frequency was 3.10 (SD 8.24). Meanwhile, 3.43% of participants shared needles. The incidence of sexual behaviors after drug use was 33.13% (n=1863), with 35.75% (n=666) of them using a condom in the last time. Overall, 116 participants tested positive for HIV antibodies (infection rate=2.06%). New drug users exhibited more postuse sexual behaviors than traditional drug users (odds ratio [OR] 7.771, 95% CI 6.126-9.856; P<.001). HIV-aware drug users were more likely to engage in risky sexual behaviors (OR 1.624, 95% CI 1.152-2.291; P=.006). New-type drug users were more likely to engage in unprotected sexual behavior (OR 1.457, 95% CI 1.055-2.011; P=.02). Paradoxically, drug users with greater HIV awareness were more prone to engaging in unprotected sexual behavior (OR 5.820, 95% CI 4.650-7.284; P<.001). Women engaged less in unprotected sex than men (OR 0.356, 95% CI 0.190-0.665; P=.001). HIV rates were higher among injecting drug users (OR 2.692, 95% CI 0.995-7.287; P=.04) and lower among drug users who used condoms during recent sex than those who did not (OR 0.202, 95% CI 0.076-0.537; P=.001). Higher education levels were associated with higher HIV infection rates. However, there was no significant correlation between HIV cognition level and HIV infection.
UNASSIGNED: New drug types and noninjection were the main patterns in last 7 years. Using new types of drugs, rather than traditional drugs, was associated with an increased risk of HIV infection. Injection drug use was a risk factor for HIV infection. HIV awareness among drug users was high, but the incidence of risky sexual behaviors remained high. Therefore, it is important to promote the behavioral transformation of high-risk populations from cognition to attitude, and then to taking protective measures.

To investigate epidemiology of and risk factors for laboratory-confirmed mpox during the 2022 outbreak in Nigeria, we enrolled 265 persons with suspected mpox. A total of 163 (61.5%) were confirmed to have mpox; 137 (84.0%) were adults, 112 (68.7%) male, 143 (87.7%) urban/semi-urban dwellers, 12 (7.4%) self-reported gay men, and 3 (1.8%) female sex workers. Significant risk factors for adults were sexual and nonsexual contact with persons who had mpox, as well as risky sexual behavior. For children, risk factors were close contact with an mpox-positive person and prior animal exposure. Odds of being mpox positive were higher for adults with HIV and lower for those co-infected with varicella zoster virus (VZV). No children were HIV-seropositive; odds of being mpox positive were higher for children with VZV infection. Our findings indicate mpox affects primarily adults in Nigeria, partially driven by sexual activity; childhood cases were driven by close contact, animal exposure, and VZV co-infection.

A global outbreak of monkeypox (mpox) caused by the mpox virus (MPXV) has posed a serious threat to public health worldwide, thus calling for the urgent development of antivirals and vaccines to curb its further spread. In this study, we screened 41 anhydride-modified proteins and found that 3-hydroxyphthalic anhydride-modified β-lactoglobulin (3HP-β-LG), a clinically used anti-HPV agent, was highly effective in inhibiting infection of vaccinia virus Tiantan strain (VACV-VTT) and MPXV. Mechanistic studies demonstrated that 3HP-β-LG bound to the virus, not the host cell, by targeting the early stage of virus entry, possibly through the interaction between the amino acids with negatively charges in 3HP-β-LG and the key amino acids with positive charges in the target region of A29L, a key surface protein of MPXV. A synergistic effect was observed when 3HP-β-LG was combined with tecovirimat, a small-molecule antiviral drug approved by the United States Food and Drug Administration and the European Medicine Agency for the treatment of smallpox and mpox. Because of its clinically proven safety and stability, 3HP-β-LG shows promise for further development as a prophylactic agent to prevent the sexual transmission of MPXV.

UNASSIGNED: Marburg virus (MARV) is a highly virulent virus of animal origin and the cause of a lethal infection (known as Marburg virus disease [MVD]) with a case-fatality ratio ranging from 24% to 90%. While the potential nonzoonotic routes of virus spread are plausible, the risk is not yet fully determined. Here, we described the ways by which MARV spreads within the human population focusing mainly on the potential of sexual transmission. In addition, we addressed some measures that should be taken to minimize the risk of sexual spread of the virus and proposed a future research agenda on the risk of sexual transmission.
UNASSIGNED: For this perspective, we searched four electronic databases (i.e., PubMed, Scopus, Web of Science, and Google Scholar) and included the most relevant studies published since the first identification of the virus in 1967. We used \"Marburg virus,\" \"Marburg virus disease,\" \"Seminal fluid,\" \"Sexually-transmitted virus,\" \"Sexual transmission,\" and \"Emerging infectious disease\" as keywords.
UNASSIGNED: MARV is transmitted to humans via both direct and indirect contact with infected animals (most importantly bats) and individuals who have recently been diagnosed with or died of the disease. The virus transmission through sexual contact has been previously suspected (exclusively from men to their sexual partners). Studies suggest that this virus persists predominantly in testicular Sertoli cells within seminiferous tubules over a relatively long period and is released through seminal fluid (in some reports >200 days post onset of infection) both could potentially threaten sexual health. In addition to men, women could theoretically, although less probably contribute to the sexual transmission of the disease.
UNASSIGNED: MVD, however, rarely, could be passed through sex, and men appear to be the main carriers in this regard. Taking preventive countermeasures and practicing safe sex are recommended to reduce the risk of interhuman transmission.

Zika virus infection, most oft n responsible for a benign arboviral disease or an asymptomatic infection, rarely Guillain-Barré syndrome, can become problematic in pregnant women, due to a risk of fetal malformations, in particular microcephaly linked to its neurotropism. The most recent large-scale epidemic was observed throughout Latin America between 2015 and 2017, causing several hundred thousand cases. Transmission is predominantly vector-borne, but sexual transmission has been described, mainly among travelers, although it undoubtedly accounts for a significant proportion of transmission in epidemic areas. The aim of this review is to describe this sexual transmission, mainly through examples linked to this large-scale epidemic in Latin America, to describe the link with prolonged excretion of infectious viral particles in genital secretions, especially semen but also vaginal secretions, and to highlight possible preventive measures apart from vector transmission, in particular the need for pregnant women or women wishing to become pregnant to avoid visiting countries where circulation of Zika virus is described.

Infertility affects approximately one-sixth of couples globally, with the incidence of male infertility steadily increasing. However, our understanding of the impact of viral infections on fertility remains limited. This review consolidates findings from previous studies, outlining 40 viruses identified in human semen and summarizing their key characteristics, modes of transmission, and their effects on both the reproductive and endocrine systems. Furthermore, it elucidates potential pathogenic mechanisms and treatment prospects of viruses strongly associated with male infertility. This synthesis will enhance our comprehension of how viral infections influence male reproductive health, offering valuable insights for future research as well as the diagnosis and treatment of infectious infertility.

UNASSIGNED: The ongoing multi-country mpox outbreak in previously unaffected countries is primarily affecting sexual networks of men who have sex with men. Evidence is needed on the effectiveness of recommended preventive interventions. To inform WHO guidelines, a systematic review and qualitative evidence synthesis were conducted on mpox preventive behavioural interventions to reduce: (i) sexual acquisition; (ii) onward sexual transmission from confirmed/probable cases; and (iii) utility of asymptomatic testing.
UNASSIGNED: Medline, EMBASE, PubMed, Cochrane and WHO trial databases, grey literature and conferences were searched for English-language primary research published since 1 January 2022. A reviewer team performed screening, data extraction and bias assessment. A qualitative thematic synthesis explored views and experiences of engagement in prevention in individuals at increased risk.
UNASSIGNED: There were 16 studies: 1 on contact-tracing, 2 on sexual behaviour, and 13 on asymptomatic testing. Although MPXV was detected in varying proportions of samples (0.17%-6.5%), the testing studies provide insufficient evidence to fully evaluate this strategy. For the qualitative evidence synthesis, four studies evaluated the experiences of most affected communities. Preferences about preventive interventions were shaped by: mpox information; the diversity of sexual practices; accessibility and quality of mpox testing and care; and perceived cost to wellbeing.
UNASSIGNED: Evidence on the effectiveness of interventions to prevent the sexual transmission of mpox remains scarce. Limited qualitative evidence on values and preferences provides insight into factors influencing intervention acceptability. Given global and local inequities in access to vaccines and treatment, further research is needed to establish the effectiveness of additional interventions.

Men who have sex with men (MSM) are at high risk of acquiring hepatitis A virus (HAV) and in recent years several HAV outbreaks mostly affecting MSM have been described. These outbreaks were caused by subtype IA strains circulating in this high-risk population. After years of low incidence, an outbreak among MSM in Hungary caused a significant increase in reported HAV infections in 2022. Samples from 224 HAV IgM-positive patients diagnosed in 2022 were tested for HAV RNA and positive samples were genotyped by sequencing. In 171 patients a unique subtype IB virus was detected with 99.8-100% sequence identity in the VP1/P2A junction. It was distinct from previously published strains, but most closely related to an Egyptian isolate. Sequence analysis revealed one dominant and three minor variants based on VP1/P2A. Whole genome sequencing revealed limited variation among these variants, suggesting a recent common origin. Epidemiological data indicated that sexual transmission was driving the outbreak for most of the year, suggested by the high male to female ratio and the large number of coinfections with HIV and other sexually transmitted infections among the patients. The outbreak was also associated with a restaurant cluster, in which one of the variants was detected and frozen berries were implicated as the source of infections. The outbreak strain was also detected in other countries around Europe and remained frequently detectable in Hungary in 2023. This study provides insights into the molecular and epidemiological characteristics of the described HAV outbreak. The results show that sequencing is not only useful in connecting cases to an outbreak, but also helps to clarify the relatedness of detected variants. Prevention strategies focusing on vulnerable communities may reduce the burden of HAV infections in the future.

OBJECTIVE: HIV-2 infection is a neglected disease caused by a human retrovirus that causes AIDS more slowly than HIV-1. Infection with HIV-2 is endemic in West Africa. Given its differential features, guidelines recommend ruling out HIV-2 infection in all newly diagnosed HIV-seropositive individuals.
METHODS: A national registry of HIV-2 cases was created in Spain in 1989, following the first report of three HIV-2+ individuals in Barcelona. The main demographics, clinical, and virological data are reported up to December 2023.
RESULTS: A total of 424 individuals with HIV-2 infection were recorded in the Spanish registry. After a peak in 2009 when 31 cases were reported, new HIV-2 diagnoses steadily decreased. Less than 10 cases/year have been notified since the COVID-19 pandemic. In 2023, only eight cases were reported. Mean age at HIV-2 diagnosis was 44 years old, ranging from birth to 83 years. A total of 265 (62.5%) were male. Migrants predominated, being 322 (76%) Sub-Saharan Africans; however, 60 (14.2%) were native Spaniards. Heterosexual exposure was the most likely route of infection in at least 287 (67.7%) cases. A few cases could be traced to transfusions (n = 4), vertical infection (n = 2), or injection drug use (n = 7). In addition, 15 individuals (3.5%) were men who had sex with men. Coinfection with HIV-1 was recognized in 39 (9.2%) individuals. Molecular characterization of HIV-2 subtypes was performed in 139 individuals, 121 being infected with subtype A and 18 with subtype B.
CONCLUSIONS: The annual incidence of HIV-2 infection in Spain has decreased after peaking 15 years ago, being the current number of cases below 10 per year. Three-quarters are African migrants, and two-thirds are male. Circulation of HIV-2 in Spain is limited and steadily decreasing.

An outbreak of hepatitis A is ongoing in Portugal, with 71 confirmed cases from 7 October 2023 to 24 April 2024. Most cases are male, aged 18-44 years, with many identifying as men who have sex with men (MSM) and reported as suspected sexual transmission. Phylogenetic analysis identified the subgenotype IA, VRD 521-2016 strain, last observed in an MSM-associated multi-country outbreak in 2016 to 2018. We wish to alert colleagues in other countries to investigate potential similar spread.