Category: sexual behaviour

Book: The Moral Lessons of Chemsex, by Maurice Nagington and

Dear STIRF

I wanted to write to let you know that I have been successful in getting a book published from a grant you awarded me several years ago*. It is with a major academic publisher and has also been awarded open access funding from the University of Manchester. The “in person” book launch was held in Manchester on the 24th June 2025 and the online event will be on July 2, 2025.
The book is called: “The Moral Lessons of Chemsex” published by Routledge. It is a major review of chemsex from the 1960s through to current day, the core of the book is built around the interview portion of the research that STIRF funded.
Both the book and the article (below) that rose out of this study are open access:
I just wanted to write a personal thank you for the support that the research grant gave in producing this book (along with the other publication I wrote to you about a couple of years ago). It has been an absolute pleasure to work on this topic and it would not have been possible without the funding which STIRF provided. It has provided an invaluable way for me to develop knowledge in this area and to build future research collaborations on the topic of chemsex, and sexual health more broadly.
Dr Maurice Nagington

 

Funding applications invited for research projects or PhD Studentship: 2025 Round

We invite researchers in various fields related to sexual health, HIV and other sexually transmitted infections to apply for funds to undertake:

  1. Original research
  2. Topic-based commissions
  3. Part funding of PhD Studentship

Sexually Transmitted Infections Research Foundation (STIRF) was set up to pump prime research projects relating to the epidemiology, pathophysiology, management, and health care delivery of sexually transmitted infections and HIV in the

East Midlands – East Midlands Deanery
North east and north Cumbria –  HEE North East
North west – North West Postgraduate Medicine and Dentistry
West Midlands – West Midlands Deanery
Yorkshire and Humber – Yorkshire and Humber Deanery

The primary aim is to provide initial funding to allow promising projects from researchers early in their career to obtain preliminary results as a prelude to acquire further funds from larger funding bodies.

We invite applications from researchers in the above regions on projects or part funding of PhD Studentships relating to sexual health, sexually transmitted diseases and HIV. All projects will be initially screened by the Scientific Committee of STIRF and those considered suitable will be sent for peer review by experts in the field.

The following fields of research will be considered in relation to sexual health, STIs and HIV:

  • Epidemiology of HIV and other sexually transmitted diseases
  • Research on HPV and other sexually transmissible malignancies
  • Health care delivery including views of clients
  • Issues relating to deprived or marginalised communities.
  • Pathophysiology of diseases and syndromes
  • Inter-relationship between diseases
  • Treatment modalities
  • Complications of treatment and co-morbidities

STIRF is also interested in commissioning work based on specific priority topics for research. Applicants should supply a brief (no more than one A4 size) preliminary application, outlining the following:

  • title
  • the proposed research question
  • justification for why this should be a research priority
  • a brief outline of the research methodology proposed to answer the research question
  • existing resources which are available to the researchers
  • a provisional estimate of the total grant requested

A more detailed application will be requested if appropriate following review of the preliminary application.

Applications for research grants should not exceed £60,000 in the first year. Depending on satisfactory reports a further £30,000 may be available for the second year. Joint funding with other grant giving bodies will be considered. Applications for part funding of PhD Studentship should not exceed a maximum of £70,000 over 3-4 years

For further information and guidance on how to apply for a research grant visit:

https://stirf.org/application-for-research-funds-from-stirf/

And for details of how to apply for part funding of a PhD Studentship visit:

https://stirf.org/research/applications-for-part-funding-of-phd-in-sexual-health-and-related-topics/

Deadline for applications (both for research projects and PhD Studentship) for 2025 is April 30, 2025

COVID-19 restrictions and changing sexual behaviours in MSM in London, UK

A recent article in the journal Sexually Transmitted Infections has looked at changes in behaviour in MSM in London during the Covid 19 pandemic. The study was web-based and only among HIV-negative MSM in a large urban setting.

Objectives: The COVID-19 pandemic and its related restrictions have affected attendance to and delivery of UK sexual healthcare services.

Methods: This was a cross-sectional, anonymous, web-based survey among HIV-negative MSM at high risk of HIV infection who attended  a sexual health and HIV clinic in London in August 2020. They collected data on sociodemographic characteristics, sexual behaviour and related mental well-being experienced during lockdown.

Results: 814 MSM completed the questionnaire: 75% were PrEP users; three quarters reported they have been sexually active, about half  had sex outside their household. The majority reported fewer partners than prior to lockdown. Interestingly 73% had discussed COVID-19 transmission risks with their sexual partners.

One out of five reported guilt for breaching COVID-19 restrictions and three out of four implemented one or more changes to their sexual behaviour. PrEP users reported higher partner number, engagement in ‘chemsex’ and use of sexual health services than non-PrEP users.

Conclusions: COVID-19 restrictions had a considerable impact on sexual behaviour and mental well-being in respondents. High rates of sexual activity and STI diagnoses were reported during lockdown. Changes to sexual health services provision for MSM must respond to high rates of psychological and STI-related morbidity and the challenges faced by this population in accessing services.

Is antiretroviral treatment for HIV increasing the susceptibility to syphilis

Recently, the world has experienced a rapidly escalating outbreak of infectious syphilis primarily affecting men who have sex with men (MSM); many are taking highly active antiretroviral therapy (ARV) for HIV-1 infection.

Treatment with ARV reduces risk of infection (because of greatly reduced viral load) and near-normal life expectancy for those on treatment. The currently accepted hypothesis is that these factors result in increased sexual risk-taking, especially unprotected anal intercourse, leading to more non-HIV-1 sexually transmitted infections, including gonorrhoea, chlamydia and syphilis.

However, syphilis incidence has increased more rapidly than other STDs. In a recent open access article in the journal Sexually Transmitted Infections, Reckart and colleagues hypothesise that ART itself  may alter the innate and acquired immune responses to Treponema pallidum, the bacterium causing infectious syphilis, and that this biological explanation plays an important role in the current syphilis epidemic.

In a leading article in the same journal, Susan Tuddenham and colleagues (only available to subscribers), find the hypothesis intriguing despite some flaws. They go on to suggest that further work is necessary to look at the mechanisms underlying the current syphilis epidemic.

In the same issue David Glidden et al point out that in the early double blind trials with pre-exposure prophylaxis (PrEP) no increase in syphilis was found between those taking PrEP and those taking placebo. These findings would suggest that short term exposure to ART has no effect on the acquired immune responses to Treponema pallidum.

Sexually transmitted infections: challenges ahead

A commissioned article in Lancet Infectious Diseases on July 9, 2017 highlights some of the major issues and challenges facing us in the growing global epidemic of sexually transmitted infections (STI). Authors Prof Mabhus Unemo et al summarise the key issues as follows:

WHO estimated that nearly 1 million people become infected every day with any of four curable sexually transmitted infections (STIs): chlamydia, gonorrhoea, syphilis, and trichomoniasis. Despite their high global incidence, STIs remain a neglected area of research.

In this Commission, we have prioritised five areas that represent particular challenges in STI treatment and control.

Chlamydia remains the most commonly diagnosed bacterial STI in high-income countries despite widespread testing recommendations, sensitive and specific non-invasive testing techniques, and cheap effective therapy. We discuss the challenges for chlamydia control and evidence to support a shift from the current focus on infection-based screening to improved management of diagnosed cases and of chlamydial morbidity, such as pelvic inflammatory disease.

The emergence and spread of antimicrobial resistance in Neisseria gonorrhoeae is globally recognised. We review current and potential future control and treatment strategies, with a focus on novel antimicrobials.

Bacterial vaginosis is the most common vaginal disorder in women, but current treatments are associated with frequent recurrence. Recurrence after treatment might relate to evidence that suggests sexual transmission is integral to the pathogenesis of bacterial vaginosis, which has substantial implications for the development of effective management approaches.

STIs disproportionately affect low-income and middle-income countries. We review strategies for case management, focusing on point-of-care tests that hold considerable potential for improving STI control.

Lastly, STIs in men who have sex with men have increased since the late 1990s. We discuss the contribution of new biomedical HIV prevention strategies and risk compensation.

Overall, this Commission aims to enhance the understanding of some of the key challenges facing the field of STIs, and outlines new approaches to improve the clinical management of STIs and public health.

Read full article on Lancet Infectious Diseases

Measuring patient experience and outcome in health care settings on receiving care after sexual violence

We are delighted to receive support from STIRF and the Queen Elizabeth Hospital Birmingham Charity (QEHBC) to fund research in the area of sexual violence.

The project aims to increase our understanding of what matters to patients when they attend health care settings after experiencing sexual violence. This is on the background of the reporting of sexual offences in the UK being at the highest level since introduction of the National Crime Recording Standard in 2002, and also an awareness that it can be extremely difficult for patients to present to health care services, disclose what has happened and seek support.

This systematic review will collect data from a wide range of sources and will be reviewed in a robust and thorough manner, to look at patient experience and outcome after attending a range of health care settings. Identifying key themes and practice that are of greatest importance to patients will then be disseminated to a wide and relevant audience so that this can be put into practice.

Rachel Caswell

Risks for pelvic inflammatory disease in students

In the latest issue of the Sexually Transmitted Infections, Phillip Hay and colleagues in the UK report on a prospective study of female students attending 11 universities and 9 further education colleges in London.

At the start, the students were asked to fill a questionnaire and provide a self taken vaginal sample for infection screening. After 12 months, they were assessed for pelvic inflammatory disease (PID), a condition that can lead to infertility and other complications.

PID was found in 1.6% of the particpants. Unsurprisingly the strongest predictor of PID was the presence of Chlamydia trachomatis at the first visit (relative risk (RR) 5.7).

However, adjusting for this, the authors reported that significant predictors of PID were ≥2 sexual partners (RR 4.0) or a new sexual partner during follow-up (RR 2.8), and age <20 years (RR 3.3). Somewhat surprisingly recruitment from a further education college rather than a university also increased the relative risk of PID 2.6 fold, perhaps reflecting different health protection behaviors (eg condom use) between the two groups.

The study concluded that in addition to known risk factors such as multiple or new partners in the last 12 months and younger age, attending a further education college rather than a university were risk factors for PID.

They recommended that sexual health education and screening programs could be targeted at these high-risk groups.

Sexually abused children should be offered HPV vaccination

Should children exposed to sexual abuse be offered human papillomavirus (HPV) vaccination alongside screening for sexually transmitted infections? A recent article in the Lancet argues for a yes answer.

The WHO defines childhood sexual abuse  as the involvement in sexual activity of a child under the age of 18 years who did not give informed consent or is not developmentally prepared.

The global prevalence of childhood sexual abuse is estimated to be 8–31% for girls and 3–17% for boys. The true figures are probably nearer the upper figure.

According to a review, parents were the perpetrators of about 45% of cases of childhood sexual abuse in the USA, and other relatives were responsible for a further 19%.  Others included figures of authority such as priests and teachers. Survivors of such abuse are often hesitant to report such incidents because of shame and fear of retribution. Thus, the incidence and prevalence of childhood sexual abuse is almost certainly underestimated. Read more

Daily pri-exposure prophylaxis (PrEP) prevents HIV infection in high risk gay men

Daily HIV medicine taken by men who have sex with men (MSM) reduces risk of HIV infection by 86% as was reported by Molina J-M, and colleagues in the ANRS Ipergay trial  at the Conference on Retroviruses and Opportunistic Infections held in Seattle, USA in 2015 (23LB.).

Molina et al reported the final results of a three year study which randomised MSM who were negative for HIV to either take daily HIV prophylaxis with two anti-retroviral drugs in a single tablet immediately or deferred for 1 year.

The study showed that those taking the drugs on a daily basis have a 86% reduction in the risk of being infected by HIV than MSM not taking the drug (p=0.0001). The trial was stopped in October of 2014 and all participants in the  deferred group were offered pre-exposure prophylaxis (PrEP)

As a Lancet editorial commented:

The science is now clear: oral pre-exposure prophylaxis (PrEP) with a coformulation of tenofovir disoproxil fumarate and emtricitabine (Truvada) significantly reduces the risk of HIV infection among individuals at high risk of HIV infection.

The news that PrEP has shown consistent efficacy among those who take it as prescribed should be a cause for celebration, and galvanise action to ensure access to PrEP for those who could benefit the most. But almost 3 years since the US Food and Drug Administration approved tenofovir–emtricitabine for PrEP little is being done on implementation.

With more than 2 million new HIV infections every year worldwide, it is time for that to change.