In this edition of Microbiology Time, we focused on three studies covering diverse aspects of STIs and HPV screening and diagnosis.

• Self-collection-based screening can improve the detection and outcome of asymptomatic STIs in high-risk populations (such as men who have sex with men, MSM), but its reliability needs to be consolidated. In this first article, German researchers included asymptomatic MSM with a sexual risk profile for STIs in a multicenter cohort study diagnosing Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) with molecular techniques and comparing self- versus HCP-performed sampling. The results showed that almost 20% of the tested individuals were positive for CT and/or NG through self- or HCP-performed sampling, demonstrating comparable diagnostic outcomes between the two methods, with high acceptance in high-risk MSM.
• The second study aims to describe age-specific and type-specific carcinogenic HPV prevalence prior to the large-scale effect of HPV vaccines in Estonia, assessing the risk factors associated with this infection. The researchers relied on a self-administered questionnaire and self-collected vaginal swabs for detection of HPV infection in more than 3000 women aged 30–33, 57–60, and 67–70 years. Results HPV prevalence was highest among women aged 30–33 years followed by those aged 67–70 years and 57–60 years. Vaccination with nonavalent vaccine would have halved the carcinogenic HPV prevalence among women aged 30–33 years. The odds of infection with carcinogenic HPV were higher among women with six or more sexual partners and lower among younger married women. This study indicates that public health providers should focus on developing an extension of HPV testing in Estonia beyond the current screening age of 65 years.
• To demonstrate the acceptability and feasibility of introducing HPV testing as a principal cervical cancer screening method in public health programs in sub-Saharan Africa, the researchers followed 45 health clinics in Malawi, Nigeria, Senegal, Uganda and Zimbabwe. The study enrolled more than 15 thousand women between 25 and 54 years old, offering HPV testing to eligible women as a primary screening for cervical cancer. HPV-positive women were referred for visual inspection with acetic acid (VIA), and if lesions identified, received treatment or referral. One third of the women tested were HPV positive of which circa 5% were VIA-positive. Of these VIA-positive women, 87% received treatment. The researchers conclude that HPV testing is feasible across the five study countries in a public health setting, and that with sufficient resources and supportive infrastructure to ensure linkage to treatment, use of HPV testing for cervical cancer screening as recommended by WHO is a promising model in low-income and middle-income countries.

Read the full studies below:Age-specific and genotype-specific carcinogenic human