Treatment failure is greater at the rectal site compared with the genital site. The pH of the tissue may be a reason. This paper reports changes in rectal pH among men who have sex with men.

People at-risk of HIV infection in Malaysia are testing and seeking treatment late in the course of their infection, despite the availability of current and heavily subsidised therapies. The delay is due to belief of low risk of infection, perceptions of stigma and discrimination, limited health literacy, and minimal knowledge about HIV antiretroviral therapy. These jeopardise efforts to improve treatment uptake and engagement with biomedical prevention and care technologies.

This study found that the serum SHBG level was the strongest predictor of health-related symptoms for men with hypogonadism in comparison with other sex hormones and serum lipid levels. These results suggest that lower waist circumference will have a greater clinical effect on and can better identify the risk of developing symptoms of hypogonadism than BMI. SHBG should be used to predict the symptoms of hypogonadism.

Communication between sexual partners about sex is critical for preventing sexually transmissible infections and pregnancy among adolescents. This study found that adolescent girls who have greater social self-efficacy (or confidence in their ability to successfully manage social relationships) are more likely to be assertive and have greater self-efficacy to communicate with their partners about sex. Including a social self-efficacy-strengthening component within sexual health programs for adolescents may be warranted.

Pelvic inflammatory disease (PID) remains an important reproductive health issue for women, and timely diagnosis and management is imperative to reduce the risk of complications. We explored the diagnostic practices of Australian general practitioners (GPs), finding that many GPs do not routinely perform pelvic examinations for patients with symptoms suggestive of PID due to multiple barriers. Pelvic examinations are an important diagnostic tool for PID; finding the best way to incorporate them into a consultation when needed will be beneficial.

Health inequity has seriously impacted the health of gender minority groups, and Chinese transgender individuals encounter significant barriers to accessing health care. Strategies, such as improving access to HIV prevention services, improving mental health services, and improving access to gender reassignment surgery and gender-affirming hormone health services, are needed.

In Japan, the increase in congenital syphilis has become a public health concern. Of the 13 mothers who participated in this case series, seven had regular prenatal care visits, including four who had tested negative at their first trimester syphilis screening. Raising awareness for syphilis prevention during pregnancy, partner testing, and considering additional syphilis testing at the third trimester of pregnancy during times of increased syphilis prevalence is imperative.

Pharyngeal chlamydia is poorly understood in men who have sex with men (MSM). We reviewed cases of pharyngeal chlamydia in MSM during 2019. The prevalence of pharyngeal chlamydia was 75/6613 (1.13%; 95% confidence interval (CI) = 0.9–1.14). Four (5%) reported sore throat and 20 (26%) were HIV+. MSM also had concomitant infection: rectal chlamydia [39 (52%)], urethral chlamydia [12 (16%)], early syphilis [2 (3%)] and gonorrhoea [14 (19%)]. HIV-positive MSM with pharyngeal chlamydia were older (P = 0.02) and more likely to have had previous syphilis (odds ratio = 4.9; 95% CI = 1.6–14.7; P = 0.005). Further research is needed to explore the characteristics of pharyngeal chlamydia.